Psychiatric morbidity among convicted male sex offenders at Kamiti maximum security prison
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Date
2006-06Author
Kanyanya, Ian M
Type
ThesisLanguage
enMetadata
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BACKGROUND: Sexual offending is associated with enormous emotional pain and
suffering to the victims and their families, as well as huge economic loses to the victims,
their families and the state. Prevalence of, and factors associated with, sexual offending
in Kenya should be determined with the view to reducing incidence to the minimum
level possible. OBJECTIVE: (a).To determine the prevalence and distribution of
psychiatric morbidity among convicted male sex offenders (MSOs) aged 18years and
above, and (b). Establish factors associated with male sexual offending in Kenya.
DESIGN: Cross-sectional descriptive survey. METHOD: Those who voluntarily came
forward and gave written informed consent were individually interviewed using a
socio-demographic and sexual questionnaire designed by the researcher, International
Personality Disorder Examination (IPDE) and Structured Clinical Interview for the
Diagnosis and Statistical Manual IV (SCID) instruments. SETTING: Seventy-six (76)
convicted MSOs at Kamiti M.5.P. were interviewed. Data collected was analyzed using
SPSSversion 11.5 computer software. RESULTS: Of the 76 subjects, 47 (61.8%) were
convicted of defilement and attempted defilement, 23 (30.3%) were convicted of rape
and attempted rape, while 6 (7.9%) were convicted of various other sex offences.
Twenty-seven (27) out of 76 (35.5%) had a DSM-IV Axis I disorder while 26 (34.2%) had
a DSM-IV Axis II disorder. A further breakdown of this distribution showed that 12
(15.8%)and 11 (14.?%) had Axis I and II diagnoses, respectively while 15 (19.7%) had
both Axis I and II diagnoses i.e. co-morbidity. Majority of those subjects who met the
criteria for DSM-IV Axis I were dependent on or abused substances (71.1% of Axis I
diagnoses).The substances most commonly misused were alcohol. cannabis and khat.
Noneof the subjects had psychiatric morbidity of psychotic proportions.
Ofthosewho met criteria for Axis II diagnosis, Antisocial and Impulsive Personality
Disorderswere the most commonly occurring disorders (twelve out of twenty-six
(46.2%)).Personality disorder unspecified also accounted for a significant number (six or
23.1%)of the twenty-six. The others (30.7%) had Histrionic, Schizoid, Paranoid and
BorderlinePersonality Disorders.
Exposureto erotica (see Abbreviations, Acronyms and Definitions) was significantly
associated with both Axes I and II (p = 0.02 and p= 0.0003 respectively) and
preoccupation with thoughts about sex was associated with Axis II disorders (p= 0.01).
CONCLUSIONS: The following conclusions were drawn from this study:
1. More than a third (34.2%) of the subjects had personality and/or other psychiatric
disorders (DSM-IV Axis II and/or I), while about a fifth (19.7%) had both (DSMIV)
Axis I and II diagnoses, 15.8% had an Axis I diagnosis alone and another
14.5% had an Axis II diagnosis alone.
2. Substance use disorders were the most commonly occurring DSM-IV Axis I
disorders (71.1%).
3. Among those with Axis II disorders, those with antisocial and impulsive
personality disorders accounted for nearly half of the subjects. The other half had
histrionic, schizoid, obsessive-compulsive, borderline, paranoid and personality
disorder unspecified.
4. There was a significant statistical association between Axes I and II disorders and
exposure to sexually explicit materials but there was no such an association with
other socio-demographic factors. Further Axis II disorders were significantly
associated with preoccupation with thoughts about sex too.
5. Majority ~61.8%)of the offenders (defilers and potential defilers) targeted
children aged less than 14 years.
Most of those with psychiatric morbidity targeted children and had antisocial or
impulsive personality disorder. Awareness campaigns to enlighten the public of the fact
that children are the commonest victims and research to determine the most effective
ways of treating and rehabilitating sexual offenders could reduce the sexual offending inthis country.