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The role of the facial images in arousal and attraction has been examined before but never via penile plethysmography (PPG). This retrospective chart review aimed to determine the significance and magnitude of differences in arousal measured by PPG in 1,000 men exposed to slide stimuli with or without facial blurring in subjects of various ages. Arousal in response to blurred stimuli was significantly higher than nonanonymized stimuli with modest effect sizes for slides across age and gender categories. Facial blurring increased differences in arousal between adults and adolescents with a modest effect size. Our findings support the use of facial blurring to further protect the anonymity of models and limit the ethical and legal challenges of using slide stimuli with child models.

The authors examined differences between students with and without written parental consent to take part in a sensitive health survey. The data were collected using a consent procedure combining "active" and "passive" response options. Two thousand seven hundred five 9th and 12th graders whose parents provided written consent completed a full survey. An identical survey, without sex-related questions, was completed by 3,533 students whose parents gave "passive" consent to this less sensitive version. Students with written consent were more likely to be White, to live in two-parent households, to have a grade point average of B or above, and to be involved in extracurricular activities. They were also more likely to have been exposed to health promotion interventions. Irregular seat belt use was lower in the written-consent group at both grade levels. Among 9th graders, cigarette smoking was less prevalent in the written-consent group. There were no significant differences in alcohol or illicit drug use.

Objectives. Physicians acknowledge the need to advise their patients about dietary habits, but they may not have the training or tools to do this efficiently. In the context of a randomized trial, we investigated the feasibility of enlisting physicians to implement a dietary intervention in the primary care setting. Methods. Physicians from 14 primary care practices were assigned via randomization to introduce a self-help booklet to promote dietary change at routine appointments. Delivery of the booklet was recorded by these intervention physicians at the clinic appointment; intervention participants were asked 3 months later in a telephone interview about whether they received and used the booklet. Results. According to physician documentation, 95 % of intervention participants who kept an appointment (n = 935) received the booklet; among participants completing a 3-month interview (n = 890), 96% reported the same. However, only about 50% of participants reported receiving the booklet from their physician; the remainder received the booklet from other clinic staff. Overall, 93 % reported reading at least part of the booklet. Use of the booklet varied little whether it was delivered by a physician or staff person, but it was more likely to be read as time spent discussing the booklet increased. Conclusions. Physician cooperation and evidence of intervention effectiveness support the use of primary care for the delivery of interventions to change diet; training the entire health team and repeating dietary advice at subsequent visits may improve the success of such interventions.

Seventeen extrafamilial homicidal child molesters (HCM) were compared to 35 convicted extrafamilial child molesters (CM) who had not murdered, or attempted to murder, their victims. The two groups did not differ on age, IQ, education, history of marriage, or family history, although marriage rates of both groups were well below the national average. Similarly, both groups had high rates of features representing family instability. HCM more frequently victimized strangers. The results on the self-report psychological inventories, the Derogatis Sexual Functioning Inventory (DSFI) and the Buss-Durkee Hostility Inventory (BDHI), did not distinguish between the groups, although the DSFI revealed sexual inadequacy in both groups. The BDHI did not describe the groups as pathological. The Psychopathy Checklist—Revised Total Score, Factor 1, and Factor 2 described both groups as demonstrating high levels of psychopathy, with the HCM scoring significantly higher. Factor 1 and Factor 2 scores placed the HCM group in the 93rd and 82nd percentiles, respectively, compared to published norms for forensic patients. A greater proportion of HCM suffered from antisocial personality disorders and paraphilias, especially sexual sadism. Over 53% of the HCM, and none of the CM, were comorbid for pedophilia and sexual sadism. Significantly more HCM received three or more DSM III-R diagnoses. The phallometric assessments generally supported DSM diagnoses. The HCM demonstrated significantly higher levels of deviant arousal to pedophilic and adult assault stimuli. Police files revealed that, prior to the index offense, a significantly greater proportion of HCM had been charged with, or convicted of, violent nonsexual, and sexual offenses. The HCM had been charged with, or convicted of, more than 2.5 times as many criminal charges than the CM. A discriminant function analysis revealed that two variables, Factor 1 of the PCL-R and the number of violent entries in the police records, correctly predicted 78.6% of the HCM and 97.1% of the CM. Implications for understanding homicidal child molesters and for future research are discussed.

One hundred ninety-two convicted extrafamilial child molesters were followed for an average of 7.8 years after their conviction. The percentage of men who had committed a sexual, a violent, or any criminal offense by the 12th year was 15.1, 20.3, and 41.6, respectively. The sexual recidivists, compared with the nonrecidivists, demonstrated more problems with alcohol and showed greater sexual arousal to assaultive stimuli involving children than to mutually consenting stimuli with children. The violent recidivists, compared with the nonrecidivists, were more likely to have a history of violence in the families in which they were raised and were rated significantly more psychopathic on the Psychopathy Checklist—Revised (PCL-R). They also showed more sexual arousal to stimuli depicting mutually consenting sexual interactions with children than to adult stimuli. In terms of any criminal recidivism, recidivists were younger, had completed fewer years of school, and were raised in psychologically more harmful family environments compared with nonrecidivists. They also reported that, before 16 years of age, they were more likely to have been physically abused and were more likely to have been removed from their homes compared to those that did not recidivate. In addition, recidivists demonstrated more general hostility on the Buss-Durkee Hostility Inventory and were rated significantly more psychopathic on the PCL-R. The phallometric assessments revealed, that the criminal recidivists, compared to the nonrecidivists, showed more sexual arousal to stimuli depicting coercive sexual activity with children than consenting sexual activities with children. In addition, they showed more sexual arousal to scenes depicting adult rape then adult mutually consenting sex. Finally, the rcidivists also had more charges or convictions for violence and any criminal acts. The small number of significant differences between recidivists and nonrecidivists in the sexual and violent categories precluded an attempt to determine which combination of factors meaningfully predicted reoffending. However, for criminal recidivism, a stepwise discriminant function analysis to assess the combination of factors that most successfully distinguished between groups in terms of criminal recidivism was significant, with subjects' age, total number of criminal convictions, and pedophile assault index being retained for optimal prediction. The procedure correctly classified 70.6% of the original group, 82.8% of the nonrecidivists, and 52.6% of the recidivists. PCL-R Total Score alone was equally successful in a similar discriminant function.

Researchers doing school surveys of adolescent health behavior frequently provide feedback reports to the schools summarizing the survey results, but it is not generally known how useful this information is for the recipients. The authors conducted a survey of 43 high school principals in 11 communities about the usefulness of feedback reports generated from data collected as part of the evaluation of the Henry J. Kaiser Family Foundation's Community Health Promotion Grants Program. The results of the survey suggest that principals found the reports to be extremely valuable: The reports were distributed widely among staff, parents, and school boards, and were put to use in a variety of ways, including planning, needs assessment, and evaluation. Furthermore, many principals said that without the promise of feedback they would not have participated in the survey. These results suggest that this information, if properly presented, can be very useful to schools as they design and implement adolescent health programs.

Purpose.To describe youth smoking-related attitudes and evaluate the effects of parental factors on child adoption of positive attitudes about smoking.Design.This study used baseline and 20-month data from a family-based smoking-prevention study (82.9% completed both surveys).Setting.Telephone recruitment from two health maintenance organizations.Subjects.Children aged 10 to 12 years and one parent of each child (n = 418 families) were randomly assigned to a frequent assessment cohort (12.5% of participants).Intervention.Families received a mailed smoking-prevention packet (parent handbook, videotape about youth smoking, comic book, pen, and stickers), outreach telephone counselor calls to the parent, a newsletter, and medical record prompts for providers to deliver smoking-prevention messages to parents and children.Measures.Demographics, tobacco status, attitudes about smoking (Teenage Attitudes and Practices Survey), family discussions about tobacco, family cohesiveness (family support and togetherness), parent involvement, parent monitoring, and parenting confidence.Results.One-third of the children endorsed beliefs that they could smoke without becoming addicted, and 8% to 10% endorsed beliefs on the benefits of smoking. Children's positive attitudes about smoking were associated with lower family cohesiveness (p = .01). Parental use of tobacco was the only significant predictor of children's positive attitudes about tobacco at 20 months (p = .03).Conclusions.Children as young as 10 years underestimate addictive properties of smoking, which may place them at risk for future smoking. Parental use of tobacco and family cohesiveness are important factors in the formulation of preteen attitudes about smoking.