Date of Award


Document Type


Degree Name

Doctor of Psychology (PsyD)


Graduate Department of Clinical Psychology

First Advisor

Dr. Rodger K. Bufford, PhD

Second Advisor

Dr. Kathleen A. Gathercoal, PhD

Third Advisor

Dr. Glena L. Andrews, PhD., MSCP, ABPP


Adverse Childhood Experiences or ACEs are traumatic experiences that occur for children including abuse, neglect, and household dysfunction (Centers for Disease Control and Prevention, 2021). The pattern of ACEs grouping together, or what will be known as ACEs Clusters, has impact on outcomes for specific populations (Lacey et al., 2020). Individuals convicted of a sexual offense (ICSO) have often experienced childhood physical and verbal abuse (Levenson et al., 2014). It was hypothesized that ACEs clusters for the ICSO population will be: low ACEs, household dysfunction, and household violence. To evaluate whether an ICSO is at risk for engaging in violent behavior, general reoffending, or sexual offending, the Inventory of Offender Risk, Needs, and Strengths (IORNS) is often used (Miller, 2018). Both ACEs and IORNS scores can be used with ICSO populations; however, research is lacking in the influence of ACEs and IORNS scores on the ICSO length of incarceration or treatment outcomes. It was also hypothesized that ACEs Cluster scores would predict the IORNS Overall Risk Index and treatment success. The participants for this study included 133 adult, male, court-ordered individuals convicted of a sexual offense in an outpatient treatment setting. Their data on ACEs, IORNS, and treatment outcomes were analyzed through stepwise regression for treatment outcomes and linear regression for the length of incarceration. Results indicate that for the outpatient ICSO sample, the three clusters found were: the parents divorced/separated ACE (Cluster 1), low number of ACEs (Cluster 2), and high number of ACEs (Cluster 3). These clusters were found to be predictive of the IORNS Overall Risk Index and treatment success. For specific ACEs, ACE 3 (specific to sexual abuse) was predictive of length of incarceration, but not treatment completion. It was found that ICSO who were in the higher number of ACES cluster (cluster 3) were less likely to complete treatment. Generality of results has not been established; however, results for these participants suggest a trauma-informed approach may be important when working with ICSO.

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