Centre Jeunesse de Montréal –
Institut Universitaire
THE USE OF THE MULTIDIMENSIONAL INVENTORY OF
DEVELOPMENT, SEX AND AGGRESSION WITH JUVENILES
Augur Enterprises, Inc.
Phone: 877-373-2844
Website: http:www.midsa.us
Email: midsa@midsa.us
© 2014 by Augur Enterprises, Inc.
Raymond Knight, Ph.D.
Brandeis University
knight2@brandeis.edu
Overview of the Talk
1.
2.
3.
Importance of assessmentbased treatment;
Introducing the MIDSA, an
aid to treatment planning:
Coverage, reliability, &
validity;
Overview of the MIDSA
Report
a)
b)
Developmental History
Utility of the MIDSA scales:
i.
Sexual Preference;
Part 1: Assessment-Based Treatment
a) Role for correctional
samples;
b) Comparable role for
juveniles and adults
who have offended
sexually;
c) Identifying treatment
targets.
PART 1a
Putting Assessment
in Context
Critical Role of
Assessment in
Correctional Samples
Principles of Effective Correctional Treatment
Andrews and Bonta (2006) have articulated
three primary principles for effective
correctional treatment and have provided
substantial data supporting the efficacy of
these principles-The risk principle
treatment services should be directed
at higher risk offenders
The need principle
target factors that are closely related
to recidivism
The responsivity principle
use of treatment methods that are
appropriate to the abilities, learning
style, and personality characteristics
of the clients treated
Principles of Effective Correctional Treatment
Andrews, Bonta, and Wormith (2011)
have stressed that essential to the
RNR program are:
1. reliable and valid assessment of offender risk
traits;
2. description of the individual’s standing
relative to
a) normative samples and
b) the performance of others in comparative risk
groups (i.e., sex offenders)
3. feedback to the client on the results of
structured assessments.
PART 1b
Putting Assessment
in Context
Role of Assessment for
Sex Offenders
Yes, it does --

Hanson, Bourgon, Helmas,
and Hodgson (2009) examined
whether the Andrews and
Bonta’s principles apply to
sex offenders.
Hanson et al., (2009) concluded:
“Programs that adhered to the RNR
principles showed the largest reductions
in sexual and general recidivism.”
“RNR principles should be a major
consideration in the design and
implementation of treatment programs for
sexual offenders.”
PART 1c
Putting Assessment
in Context
Identifying Treatment
Targets
Fixed or
historical
factors
Kinds
of Risk
Factors
that cannot be changed
(such as age at first offense)
Potentially changeable factors, both
Whereas static determinants
may be
stable, but potentially
changeable
risk traits, and
helpful to determining
risk,
acute, rapidlyfactors
changing factors.
assessment of dynamic
is
essential for the needs and
responsivity principles of
intervention.
Identifying Domains of Critical Dynamic Factors
What are the dynamic criminogenic
need domains that must be
addressed in sexually aggressive
individuals?
These are the core factors that
increase the risk of recidivism and
must be targeted in an individualized
way in treatment.
Identifying Domains of Critical Dynamic Factors
What domains need to be
assessed
for those who sexually offend?
Identifying Domains of Critical Dynamic Factors
Sexual Preferences
Sexual fixation on children
Emotional congruence with children
Sexualization
Hypersexuality
Sexual compulsivity
Sexual preoccupation
Sexual deviance
Paraphilias
Sadism and sexual violence
Pornography use
Sexual Offense Planning and Investment
Identifying Domains of Critical Dynamic Factors
Self-Management
Delinquency
Adult criminal history
Impulsivity
Substance Abuse
Anger and emotional dysregulation
Intimacy Deficits
Friendships
Romantic relationships
Marriage and cohabitation
Relational Styles
Callousness
Grievance thinking
PART 2
A Solution to the Assessment Problem
Multidimensional Inventory of
Development, Sex, and Aggression
MIDSA -- What is it?
Computerized self-report
inventory
Respondents answer questions
about their history, behaviors,
attitudes, and thoughts
History of the MIDSA
Formerly the MASA, its research
predecessor.
Now only exists in computerized
version.
Has been administered to > 4500
males and females.
There are 25 publications
supporting itsMASA
reliability and
validity.
Coverage
Essential Assessment Domains for Sexual Aggression:
ATSA Practice Standards and Guidelines
ATSA -- Practice Standards and Guidelines
Availability of appropriate community supports,
Detailed coverage
Access to potential victims,
Criminal and other antisocial behavior and values,
Developmental history and family background,
Deviant sexual interests and arousal,
Education and employment histories,
History of aggression or violence,
History of sexually abusive behavior, including details about victims, tactics used in the
commission of the offense, and the circumstances in which the sexual abuse
occurred,
Insight into offense precursors and risk,
Level of cognitive functioning and other responsivity factors,
Level of self-disclosure and accountability,
Medical and mental health history,
Official and unreported history of sexual and nonsexual crimes,
Peer and romantic relationship history,
Relevant personality traits such as, but not limited to suspiciousness, hostility, risktaking, impulsivity, and psychopathy,
Sexual history, including sexual fantasies, urges, and behavior, early sexual
experiences; number and duration of sexual relationships; gender identity and sexual
orientation; masturbation and intercourse frequency; sexual functioning; and
unusual sexual interests or behavior that are not sexually deviant (as defined in this
document) or illegal, such as cross-gender dressing,
Substance use,
Use of sexually arousing materials (e.g., magazines, computer pornography, books,
videos, Internet sites, telephone sex services).
ATSA -- Practice Standards and Guidelines
Availability of appropriate community supports,
Detailed coverage
Access to potential victims,
Criminal and other antisocial behavior and values,
Moderate coverage
Developmental history and family background,
Deviant sexual interests and arousal,
Education and employment histories,
History of aggression or violence,
History of sexually abusive behavior, including details about victims, tactics used in the
commission of the offense, and the circumstances in which the sexual abuse
occurred,
Insight into offense precursors and risk,
Level of cognitive functioning and other responsivity factors,
Level of self-disclosure and accountability,
Medical and mental health history,
Official and unreported history of sexual and nonsexual crimes,
Peer and romantic relationship history,
Relevant personality traits such as, but not limited to suspiciousness, hostility, risktaking, impulsivity, and psychopathy,
Sexual history, including sexual fantasies, urges, and behavior, early sexual
experiences; number and duration of sexual relationships; gender identity and sexual
orientation; masturbation and intercourse frequency; sexual functioning; and
unusual sexual interests or behavior that are not sexually deviant (as defined in this
document) or illegal, such as cross-gender dressing,
Substance use,
Use of sexually arousing materials (e.g., magazines, computer pornography, books,
videos, Internet sites, telephone sex services).
ATSA -- Practice Standards and Guidelines
Availability of appropriate community supports,
Detailed coverage
Access to potential victims,
Criminal and other antisocial behavior and values,
Moderate coverage
Developmental history and family background,
Touches on
Deviant sexual interests and arousal,
Education and employment histories,
History of aggression or violence,
History of sexually abusive behavior, including details about victims, tactics used in the
commission of the offense, and the circumstances in which the sexual abuse
occurred,
Insight into offense precursors and risk,
Level of cognitive functioning and other responsivity factors,
Level of self-disclosure and accountability,
Medical and mental health history,
Official and unreported history of sexual and nonsexual crimes,
Peer and romantic relationship history,
Relevant personality traits such as, but not limited to suspiciousness, hostility, risktaking, impulsivity, and psychopathy,
Sexual history, including sexual fantasies, urges, and behavior, early sexual
experiences; number and duration of sexual relationships; gender identity and sexual
orientation; masturbation and intercourse frequency; sexual functioning; and
unusual sexual interests or behavior that are not sexually deviant (as defined in this
document) or illegal, such as cross-gender dressing,
Substance use,
Use of sexually arousing materials (e.g., magazines, computer pornography, books,
videos, Internet sites, telephone sex services).
ATSA -- Practice Standards and Guidelines
Availability
Availability of
of appropriate community
community supports,
Detailed coverage
Access
Access to
to potential
potential victims,
victims,
Criminal and other antisocial behavior and values,
Moderate coverage
Developmental history and family background,
Touched on
Deviant sexual interests and arousal,
Education and employment histories,
History of aggression or violence,
History of sexually abusive behavior, including details about victims, tactics used in the
commission of the offense, and the circumstances in which the sexual abuse
occurred,
Insight into offense precursors and risk,
Level of cognitive functioning and other responsivity factors,
Level of self-disclosure and accountability,
Medical and mental health history,
Official and unreported history of sexual and nonsexual crimes,
Peer and romantic relationship history,
Relevant personality traits such as, but not limited to suspiciousness, hostility, risktaking, impulsivity, and psychopathy,
Sexual history, including sexual fantasies, urges, and behavior, early sexual
experiences; number and duration of sexual relationships; gender identity and sexual
orientation; masturbation and intercourse frequency; sexual functioning; and
unusual sexual interests or behavior that are not sexually deviant (as defined in this
document) or illegal, such as cross-gender dressing,
Substance use,
Use of sexually arousing materials (e.g., magazines, computer pornography, books,
videos, Internet sites, telephone sex services).
ATSA -- Practice Standards and Guidelines
Availability of appropriate community supports
Access to potential victims
Only items the MIDSA does not assess at all.
Reliability
Reliability of the MIDSA
Good to excellent test-retest
reliability and internal
consistency (Knight, Prentky, & Cerce, 1994; Knight &
Cerce, 1999).
Test-Retest Reliability
Adults Juveniles
(n = 50) (n = 71)
1
Social Competence
.97
.71
2
Juvenile Antisocial
.83
.82
3
Adult Antisocial
.89
4
Pervasive Anger
.75
.72
5
Expressive Agg.
.90
.75
6
Sadism
.81
.83
7
Paraphilias
.91
.82
8
Sexual Drive
.84
.83
9
Offense Planning
.85
.72
10
Pornography Use
.86
.77
For Juveniles
90% > .70
For Adults
92% > .70
Internal Consistencies
ASO
JSO
Controls
>.70
95%
87%
84%
>.80
79%
63%
45%
Level
Validity
Concurrent Validity
Scales
1.
2.
3.
4.
5.
________
________
________
________
....
Archival Files
(Knight et al., 1994; Knight & Cerce, 1999)
Construct Validity
Multiple contributions to -Theoretically consistent differentiations
of sexual offenders from community
and criminal controls;
The generation and corroboration of
structural equation models of the
etiology of sexual aggression;
The revision of typological models for
child molesters and rapists and the
integration of the revised typologies
with etiology.
Replication of important findings on
core traits.
Construct Validity
Multiple contributions to -Theoretically consistent differentiations
of sexual offenders from community
and criminal controls;
The generation and corroboration of
structural equation models of the
etiology of sexual aggression;
Construct Validity: Group Differentiations
Generic
Criminals
Multiple scales assessingSexual Behavior
and
Sexual Fantasy
Adult Sex Offenders
Community
Controls
Multiple scales assessingSexual Behavior and
Sexual fantasy
Psychopathy
Emotional
Dysregulation
(Knight et al., 1994; Knight & Cerce, 1999)
Construct Validity: Group Differentiations
Residential JSOs
Incarcerated ASOs
Outpatient
JSOs
Community
Controls
Construct Validity: Group Differentiations
Impulsivity
Emotional Dysregulation
Callousness
Residential JSOs
Non-sexual
Delinquents
Residential JSOs
Non-sexual
Delinquents
Sexualization
Sexual Abuse
Construct Validity: Etiological Models
Generating Etiological
Models for Rape and
Child Molestation
SEM Etiological Models for Rape & CM
Rape SEM Etiology Model
(Knight
(Knight& &Sims-Knight,
Sims-Knight,2003)
2014)
CM SEM Etiology Model
(Daversa & Knight, 2007)
PART 3
The MIDSA Report
Part 3: Overview of the MIDSA Report
Kinds of information
Kinds of Information in Report
Descriptive
Timeline
Text
Tables
Lists
Scales
Illustrated in
the
Developmental
subpart
Kinds of Information in Report
Descriptive
Timeline
Text
Tables
Lists
Scales
Case Summary -- Matt
14-year old Black male
10 counts of unlawful sexual
contact at 12 years
3rd of 6 children
Father absent from birth until
recently
Sexually abused by stepfather
Timeline
Kinds of Information in Report
Descriptive
Timeline
Text
Tables
Lists
Scales
Kinds of Information in Report
Descriptive
Timeline
Text
Tables
Lists
Scales
Adding Frequency to
Historical Information
Physical Abuse History: Matt
Narrative Report: Matt, Physical Abuse
Physical Punishment And Abuse
This part of the report tells the respondents' experiences with physical abuse.
The respondent was punished by his birth mother from the time he was 9 until he was 12. She punished him
a few times a year, but less than once a month.
The respondent reported the following kinds of punishment or abuse received from his birth mother:
Type of
Punishment/Abuse
Never
Once or
a few
times
A few
times a
year
Being hit or spanked
√
Being hit with
something other than
a hand
√√
Being punched or
kicked
√√
Being burned
√√
Broken bones
√√
Injuries requiring
medical attention
√
Other
√√
√
Once or
twice a
month
Once or
twice a
week
Almost
every day
Kinds of Information in Report
Descriptive
Timeline
Text
Tables
Lists
Scales
Sexual Abuse History: Sean
Case Summary -- Sean
15 year old Caucasian male
Child molesting behavior in
prior home
3rd of 3 children
Father absent since year old
Sexually abused by older
sister
Sexual acting out supposedly
began in residential placement
for delinquents at age 12
Narrative Report: Sean, Sexual Abuse
Sexual Contact with Respondent’s Sister Jessica
The respondent reported that he was 4 years old the first time he had sexual contact with his Sister Jessica and
9 years old the last time they had sexual contact. His Sister Jessica had sex with him once or twice a month.
The respondent described how often he was the victim, consenting partner, or perpetrator in sexual encounters
with his Sister Jessica:
The respondent:
Never
Once or
a few
times
A few
times a
year
Once or
twice a
week
Almost
every day
√
was manipulated or tricked
was bribed to have sex
Once or
twice a
month
√
√
was forced by verbal threats
was physically forced
√
was willing to have sex
√
manipulated, tricked or bribed
his sister
√
Verbally or physically forced his
sister
√
For those incidents in which the respondent was forced or manipulated, the sex involved the following
Touching, fondling, or sexual kissing
Oral sex
Attempted intercourse
Section 2b
Scales
MIDSA Scales: Three Components
Community Controls:
Array of T-Scores
(M=50, SD = 10)
25
Residential JSO Group: 10%
Whisker Plot Percentiles
30
35
25%
Individual Juvenile: Mean T-Score
40
45
50
50%
55
60
65
75%
70
75
90%
MIDSA Scales: Format
Community Controls Mean T-Score = 50
Juveniles who Sexually Offend Median = 50
Individual Juvenile Mean T-Score = 50
Stand
Score
Scale X
%ile25
30
35
40
45
50
55
60
65
50
50 50
50
10%
25%
50%
75%
90%
70
75
Sexual Preoccupation: Sean
Community Controls Mean T-Score = 50
Juveniles Who Sexually Offend Median = 57.5
Individual Mean T-Score: Ronald = 75.3
Stand
Stand
Score
Score
Sexual
Sexual
Preoccupation
C ompulsivity
75.3
%ile
%ile
25
25
3030
3535 40 40 45 45 50 50 55 5560
60
65
65
70
70
75
75
89
10%
10% 25%
25%
50%
50%
75
%
75%
90%
90%
Sexual Preference II
Child Molester/Rapist Differentiation
Child Molestation Scales
Child Sexual Arousal
Child Sexual Sadism
Child Molester Cognitive
Distortions
Child Sexual Arousal

jv = .87
ad = .88
This scale consists of 5 items that assess being sexually
aroused by children and fantasizing sexual activity with
them. Respondents who score high on this scale report
high sexual arousal to children.
Example-I get sexually turned on by little girls.
Child Sexual Sadism

jv = .86
ad = .85
This scale consists of 7 items that assess fantasies and
behaviors involving hurting or frightening a child
during sex. Respondents who score high on this scale
report inclinations to high sexual sadism with
children.
Example-I have really hurt a child during sex.
Child Molester Cognitive Distortions

jv = .80
ad = .91
This scale consists of 6 items that endorse attitudes
conducive to or supporting sexual behavior with
children. Respondents who score high on this scale
evidence high endorsement of such cognitive
distortions.
Example-Sex with children can help the child learn about
sex.
Child Molestation Scales
Matt
Child Molestation Scales
Sean
Masculine Adequacy and Sexual Inadequacy Scales
Masculine Adequacy
Anxiety with Women
Sexual Performance Anxiety
Erectile Dysfunction
Masculine Adequacy

jv = .73
ad = .75
This scale consists of 5 items. Respondents who
scored high on this scale report that they are manly,
good in fights and in sex.
Example-I think I am really manly.

jv = .74
ad = .80
Anxiety with Women
This scale consists of 5 items. Respondents who score
high on this scale report feeling anxious, nervous,
inadequate, and guilty around women and sex.
Example-I feel nervous around females
.
Sexual Performance Anxiety

jv = .70
ad = .86
This scale consists of 3 items that measure anxiety
about their penis and their sexual performance.
Example--
I am so afraid I might fail sexually with a
female, that it hurts my sex life.
Erectile Dysfunction

jv = .62
ad = .80
This scale consists of 3 items. Respondents who score
high on this scale report difficulties with erection and
ejaculation.
Example--
I have had problems getting a hard-on during
sex.
Sexual Anxiety Scales
Matt
Anxiety
with
Women
Sexual Anxiety Scales
Sean
Anxiety
with
Women
Conclusions
The MIDSA provides information that
is important for making treatment
and dispositional decisions about
juveniles who sexually offend.
It captures information that is often
not available in clinical records.
It allows comparison of the an
offender’s attitudes and behaviors
to comparative samples of both
other sex offenders and community
controls.
Student Collaborators
Collaborators
Ariel Berman
Adam Grabell
Franklyn Graham
Grant Johnson
Nayla Hamdi
Sonja Krstic
Carrie Robertson
Maria Daversa
Jean-Pierre Guay
Danielle Harris
Genevieve Martin
Scott Ronis
Judith Sims-Knight
Barry Zakireh
Detecting Hidden Treatment Targets
Pervasive Anger Scales
Constantly Angry
Physical Fighting
Cruelty to Animals
Fantasies of Hurting
People
Constantly Angry

jv = .86
ad = .89
This scale consists of 8 items that assess instances of
anger and failure to control one’s temper. Respondents
who score high on this scale report grouchiness, frequent
anger, and temper tantrums.
Example-I get grouchy about little things.
Physical Fighting

jv = .75
ad = .82
This scale consists of 4 items that assess instances of
assaultive behavior (getting into physical fights)
against both males and females as an adult.
Example-I enjoy getting into physical fights.
Cruelty to Animals

jv = .77
ad = .76
This scale consists of 4 items that assess the frequency
that the respondent has been cruel to animals, other
than in sport (hunting).
Example-I enjoy seeing animals in pain or hurt.
Fantasies of Hurting People

jv = .74
ad = .81
This scale consists of 4 items that assess the frequency of
having fantasies of hurting other people or seeing them
hurt.
Example-I enjoy seeing other people getting hurt.
Pervasive Anger Scales
Matt
Constant
Anger
Fighting
Cruelty to
Animals
Aggressive
Fantasies
Stand
Score
%ile
57.8
38
Stand
Score
%ile
56.2
38
Stand
Score
%ile
44.2
25
Stand
Score
%ile
50.7
38
25
30
35
40
45
50
55
60
65
70
75
79.3
25
30
35
40
45
50
55
60
65
70
75
25
30
35
40
45
50
55
60
65
70
75
45
50
55
60
65
70
75
44.2 is the lowest
possible T Score
25
30
35
40
44.1 is the lowest
possible T Score
Pervasive Anger Scales
Sean
Constant
Anger
Fighting
Cruelty to
Animals
Aggressive
Fantasies
Stand
Score
%ile
74.3
84
Stand
Score
%ile
60.7
52
Stand
Score
%ile
51.2
55
Stand
Score
%ile
60.6
66
25
30
35
40
45
50
55
60
65
70
75
25
30
35
40
45
50
55
60
65
70
75
25
30
35
40
45
50
55
60
65
70
75
45
50
55
60
65
70
75
44.2 is the lowest
possible T Score
25
30
35
40
44.1 is the lowest
possible T Score