Jack van Honk, Dennis J. Schuttera, Peter A. Bosa, Anne-Wil Kruijt, Eef G. Lentjes, and Simon Baron-Cohen (2010). Testosterone administration impairs cognitive empathy in women depending on second-to-fourth digit ratio. (link to abstract)
Let me say first that this is a really cool paper. Let me say second that I will not do it full justice, simply because it includes reference to a lot of stuff that is out of my professional realm, as it were. Nonetheless, I think there are some really interesting bits in here that persons who work with sexual offenders might need to consider, at least in extrapolating aspects of the findings to our client population.
I've been thinking a lot recently about denial, minimization, and empathy; mostly, because of Ruth Mann et al.'s talk at the ATSA conference in Phoenix. Specifically, I'm interested in the role of emotions management (or, perhaps, emotions dysregulation) in sexual offense risk.
Principally, it has always fascinated me that many of my sexual offending clients seem so darned normal when they are not offending--an observation made by most who work with this population.
When we, the nonoffending world, engage in behavior that elicits a negative response from the people around us, we typically stop and check in with those folks to see what's the matter. At least, that's what happens most of the time.
Presumably, victims of sexual abuse give off clear signals (overt or otherwise) that the experience of being abused is aversive, painful, horrifying, etc. How is it that offenders are somehow able to "turn off" whatever cognitive mechanism it is that should cause them to "stop and check in to see what's the matter"?
After the fact, many offenders can demonstrate some degree of empathy with the role of sexual offense victims, although some research suggests that they have difficulty empathisizing with their own specific victim(s). I think the research on this topic still has lots to answer.
So, what do van Honk et al. have to add to this?
Well, you may need to take a conceptual or logical leap with me, but I think what they've found is helpful in maybe better understanding what might be happening for some of our offending clients.
The role of testosterone in sexual offending is pretty clear in some senses, but not so clear in others. In that the vast majority of sexual offenders are male, the link is pretty clear. But how some men become involved in this behavior while others do not is what makes it less so.
The literature on the use of therapeutic sex drive reduction as a treatment option for some sexual offenders is varied in its conclusions. There appears to be at least a subgroup of sexually offending males who may benefit from lowered serum testosterone, either by physical or chemical castration. In North America, the latter is the most typical approach--with several medications having been suggested as possible avenues for "turning down the volume," as it were, regarding intrusive sexual thoughts and fantasies, potentially leading to offending.
However, what is apparently unclear is whether those who benefit from pharmacological interventions have too much testosterone to begin with (which does not always seem to be the case) or that their bodies seem to make much better use of the testosterone available (which also does not always seem to be the case). I don't know the answer, and would love to hear from any endocrinologically minded readers out there who might clarify in a comment to this post.
Van Honk and colleagues conducted a very interesting study in which they administered sublingual testosterone or placebo to a group of 16 young women and then measured any possible effects on social intelligence, specifically cognitive empathy. In a crossover, double-blind, placebo-controlled, within-subjects design (what a mouthful, eh?), these folks then used Baron-Cohen's Reading the Mind in the Eyes Task (RMET) as the behavioral measure of social intelligence. They also measured right-hand second-to-fourth (2D:4D) digit ratio because, as they explain, this is a proxy of fetal testosterone. If you, like me, had no previous idea what this was, it is the length ratio of the right hand’s second (i.e., index) to fourth (i.e., ring) finger. This is how they explain measuring this ratio in the paper:
Digit Ratio Measurement. Digit ratio was measured from a scan of the right hand of the subjects. The use of scanned images is a valid method to measure finger lengths. When conducting this scan, we ensured that details of major creases could be seen. Lengths of the second and fourth digits were measured from the ventral proximal crease of the digit to the fingertip by using Adobe Photoshop. When there was a band of creases at the base of the digit, measurement was taken from the most proximal crease.
Generally, women demonstrate greater cognitive empathy than men, which I doubt many readers will find terribly surprising. However, van Honk and crew found that those women administered the testosterone had significantly lower performance in regard to cognitive empathy and that this was found even with only one administration of the hormone! Further, this was "powerfully predicted" by the participant's 2D:4D ratio. To quote:
Our data thus not only demonstrate down-regulatory effects of current testosterone on cognitive empathy, but also suggest these are preprogrammed by the very same hormone prenatally.
Further, in using the RMET procedure, the authors were able to show that testosterone administration to the female subjects in this study led to significant impairment in the cognitive empathic ability to infer emotions, intentions, feelings, and other mental states from the eye region of the face.
So, I'm thinking...Men have more testosterone and men are more inclined to commit acts of sexual violence, which they ought to know--in the moment--will cause significant pain and suffering in the victim during the assault. Further, it is to be expected that the emotions experienced by the victims would be easily ascertained from facial expressions. Is it possible that the lessened cognitive empathy / social intelligence that seems implicit in sexual assault is related in some way to the presence of testosterone? Is it possible that some of our clients may have a marker in the way of the 2D:4D ratio?
I'd be very interested to hear what others think.
RJW
PS For those who are interested in such things, reknowned "theory of mind" scientist and autism specialist extraordinaire Simon Baron-Cohen is cousin to Sacha Baron-Cohen of Borat fame.
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