December 30, 2008

Will “revolutionary” Diana Screen end pedophile menace?

Vatican enlisting psychologists to perform miracles

The new movie Doubt paints the issue of pedophilic priests in shades of gray. Is the priest (played by Philip Seymour Hoffman) really a pedophile? Or is the head nun (Meryl Streep) just after him because, with his friendly manner and long fingernails, he fits her stereotype? Most provocative of all is the ostracized boy's mother (Viola Davis), who cares more about the priest's kindness to her son than about whether the relationship is sexual.

The movie is set in the 1960s, two decades before the pedophilia scandals sprang into the limelight to tarnish the reputation of the Catholic Church. Revelations of sexual misconduct by priests resulted in staggering financial losses - an estimated $2 billion in civil damages paid by the U.S. Catholic Church alone.

Anxious to mend its reputation and plug the money drain, the Vatican just announced a new fix: Candidates for the priesthood will undergo psychological screening to determine their suitability for the job.

What makes a candidate unsuitable, according to the Vatican? "Uncertain sexual identity," "deep-seated homosexual tendencies," and "grave immaturity" are among the factors. Painting a pseudoscientific veneer on the campaign, the Vatican said "expert" psychologists will screen select candidates on a case-by-case basis.

Mental health professionals, already flush with domain expansion into the emergent sex offender industry, are rushing into this new and potentially lucrative niche.

Leading the charge is Gene Abel, the psychiatrist who invented the controversial Abel Screen, which measures sexual proclivities based on how long men look at visual images of different types of models. Abel is promoting a new "pass/fail" test called the Diana Screen as a "breakthrough in technology" that can accurately identify men who have molested children.

"Who should use it?" asks the tool's website. "Any organization where there are professionals or volunteers who work with children," including churches, youth groups, schools, hospitals, foster care homes, and amusement parks.

In an appeal that combines sex panic emotionalism with a promise of revenue, Abel asks professionals to step forward and "make a difference" by becoming Diana Screen administrators: "You don't just add to your business opportunity, you take a stand against molestation and you help others to also take a stand."

Who can resist an appeal like that?

A quick web search found several psychologists already offering to do Diana Screens for employers. One bragged of having a "Certificate of Achievement" from Abel "in recognition of [his] knowledge about this important technology."

Child molesters are a heterogeneous bunch, with no unitary psychological "profile." So, before rushing to sign on, I decided to read the published literature on the Diana Screen to find out how it works, and whether it is reliable and valid.

Searching "Diana Screen" in an academic database, I did not get any hits. An Internet search was slightly more productive. I found several presentations by Abel. He presented the Diana Screen to the Society for Sex Therapy and Research; the Assessment, Treatment and Safe Management of Sexually Abusing Children, Adolescents, and Adults conference, and the California Coalition on Sexual Offending (CCOSO).

At these conferences, Abel reported on research he conducted with 100-plus applicants for priesthood training jobs. Unfortunately, the research does not appear to have been peer-reviewed or published, as required for admissibility in court under the Daubert standard.

Searching further, I found some strategically placed advertising; searches with the keywords "child molestation" cause Diana Screen ads to pop up on some news sites. The Screen was also a featured exhibitor at this year's conference of the Chartered Property Casualty Underwriters Society, which offers "cutting-edge tools" for "risk management professionals."

More humorously, in the blogosphere I bumped into a group of sex offenders discussing how easy it is to beat the test (and its precursor, the Abel). All you have to do, wrote one man, is ignore the instructions to rate your sexual arousal level to each slide, and instead respond at "a regular timing interval," which is what is really being measured.

"You'll laugh when you find out just how easily the test can be beaten! The entire thing rides on the theory that no one will know what it's really testing."

Another agreed: "It's so seriously EASY to play the test like a harp."

These sex offenders would likely quarrel with the Screen developers' claim that it can identify "over 50 percent of actual child sexual abusers."

But my own question about the 50 percent success rate was, How can they know they are identifying half of all pedophiles? And, perhaps more importantly from an ethical point of view, what is the rate of false positives, or people whom the test wrongly identify as child molesters?

Hoping to learn more, I contact the company directly and asked for any published research. In due time, I received a packet of materials - glossy brochures and fliers, a sample report, graphs, and more promises that the Screen will help "bring an end to child molestation." No references to published research, though.

The materials did include a handout on the aforementioned (unpublished?) study of candidates for religious ordination. Of the 135 applicants screened, 18 (or about 13 percent) failed the test. Of those, 7 "were found to be true sexual risks to children" (based on followup inquiry and polygraph testing), while 2 "were found to have mental health problems" and 9 "required a closer look, but were found to have little or no risk."

Stated another way, that's a false positive rate of at least 50 percent. Even if it is just a screening test, psychologists should be cautious in administering a test with such a high false-positive rate and no published, peer-reviewed data on its reliability or validity.

More fundamentally, this type of testing raises philosophical issues about how far society should go in the name of protecting children, especially when most victimization is done not by teachers or amusement park workers but by family members. Who, for example, should be screened? As a colleague commented, it is one thing to screen airline pilots for alcohol abuse, but if priests, teachers, hospital employees, and even carnival workers will be screened, where will we draw the line? How much personal information are employers entitled to know? And what recourse will there be for those who are denied employment or lose their jobs based on their innermost thoughts, their sexual identity, an incident in their distant pasts, or - worst of all - erroneous test results?

The most pernicious problem with false positives is, how can one really know? As the movie Doubt suggests, proving innocence is difficult, and those who claim to be protecting children may have more complicated motives.

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JULY 2015 POSTSCRIPT: The Atlantic has just published an interesting article on the controversies swirling around Abel Assessment by Maurice Chammah, a staff writer at The Marshall Project.