Proefschrift

6 130 CHAPTER 6 perspective, Major Depressive Disorder (American Psychiatric Association, 2013) can be considered a system of causally interacting symptoms such as sadness, anhedonia, fatigue, insomnia, concentration problems, and suicidal ideation, instead of as involving some single underlying factor causing these symptoms (e.g., Fried et al., 2017; Wichers et al., 2021). Each individual may experience some of these (interacting) psychological and behavioral features occasionally; for instance, insomnia causing fatigue resulting in concentration problems (Fried et al., 2017). However, when they become strongly enough connected, symptoms may keep each other activated, through feedback processes (e.g., insomnia causing fatigue resulting in concentration problems and sadness leading to insomnia), which may result in and constitute clinical depression. Within the network approach to psychopathology, this stable state of continuous, mutually activating symptoms is referred to as a self-sustaining network or equilibrium (Borsboom, 2017). Ideally, treatment for depression leads to a healthier self-sustaining network characterized by fewer or less strongly connected symptoms resulting in the dissolution of the clinical depression. The shift to a new, in this case healthier, state or equilibrium of the self-sustaining network is referred to as a critical transition (Kossakowski, 2020). Before outlining our NBM-RSR, we will first address and discuss the Propensities Model’s approach to understand psychological and behavioral variables associated with sexual reoffending. 6.1.1 THE PROPENSITIES MODEL Central to the Propensities Model are latent constructs, called propensities, which refer to relatively stable intra-individual features that influence an individual’s probability of sexual reoffending (Lussier et al., 2020; Prentky et al., 2015; Thornton, 2016). Despite their relative stability, propensities are considered to be amendable to change by treatment or risk management strategies (Mann et al., 2010). Typically, such propensities are referred to as dynamic risk factors (Douglas & Skeem, 2005), criminogenic needs (Andrews et al., 1990), dynamic predictors (Bonta & Andrews, 2017), or psychologically meaningful factors (Mann et al., 2010). Although specific definitions of these constructs vary, they all refer to amendable psychological and behavioral factors, which, when changed, will affect the probability of perpetrating a new sexual offense (Hanson et al., 2020; Prentky et al., 2015; Thornton, 2016). For consistency reasons, we will use the term dynamic risk factor throughout this manuscript. Although latent constructs cannot be observed directly, depending on their strength and their interaction with the environment, dynamic risk factors may manifest themselves and can be measured through their cognitive, affective, or behavioral expressions, according to the Propensities Model (Mann et al., 2010). These risk-relevant cognitions, emotions and behaviors are not related in a direct way but connected to each other by way of an underlying latent variable (see Figure 6.1). In the Propensities Model, the short-term probability of sexual reoffending depends on the balance between the

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