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ORIGINAL RESEARCH article

Front. Psychiatry

Sec. Forensic Psychiatry

This article is part of the Research TopicInterdisciplinary Approaches to Interpersonal Violence: Psychopathology, Treatment, and PreventionView all articles

Analysis of Factors Influencing the Assessment of Sexual Self-Defense Capacity in Individuals with Mental Disorders

Provisionally accepted
zhong zuozhong zuo1,2Qiang WangQiang Wang3Jie XuJie Xu4Li YuanLi Yuan5Zitong ShenZitong Shen6Xuedong WangXuedong Wang7Yunge ZhangYunge Zhang8Jie XuJie Xu2Guangjian LiGuangjian Li2,8Xianhu YaoXianhu Yao9Yajun XuYajun Xu2*
  • 1Wannan Medical College, Wuhu, China
  • 2Department of Psychology, Wannan Medical College, Wuhu, China, Wuhu, China
  • 3School of Law, Nanjing University, Nanjing, Nanjing, China
  • 4Judicial Authentication Center of Beijing Borui Testing Co., Ltd., Beijing China, Beijing, China
  • 5Guangyuan Mental Health Center, Guangyuan China, Guangyuan, China
  • 6Suzhou Second People's Hospital, Suzhou, China, Suzhou, China
  • 7Anqing Sixth People's Hospital, Anqing, China, Anqing, China
  • 8Psychology Department,Changzhou De'an Hospital, Changzhou, China, Changzhou, China
  • 9Ma'anshan Fourth People's Hospital, Ma'anshan City, China, Mananshan, China

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Background:China's Sexual Self-Defense Capacity (SSDC) assessment evaluates mentally disordered females' ability to protect sexual rights, critically impacting rape adjudication. Despite 3-5× higher sexual assault risk in this population, key SSDC impairment predictors — Intellectual Level (FSIQ/VIQ/PIQ) and Activities of Daily Living (ADL) — face standardization challenges due to regional variations in assessment tools/thresholds. Methods: Retrospective analysis of 398 forensic SSDC cases (2020-2024) from five Chinese institutions, following national guidelines. Univariate, correlation, regression, ROC, and combined modeling analyses identified predictors. Results:(1) ADL score exerted the strongest effect on CSSAS, followed by FSIQ. (2)Critical thresholds established: Retained SSDC (CSSAS score≥21): ADL score≤22.5 or FSIQ≥66.5;Diminished SSDC score(7≤CSSAS<21): 22.531.5 or FSIQ<53.5(3) Combined model (ADL score+FSIQ) achieved higher AUC than single factors. Conclusion:(1) Both ADL and FSIQ are significant factors influencing SSDC.(2) ADL demonstrates superior predictive efficacy compared to FSIQ.(3) The combined predictive model (ADL + FSIQ) outperforms the use of FSIQ alone.(4)The predictive efficacy of the combined ADL-FSIQ model failed to exceed that of the ADL-only model.(5) The comprehensive use of ADL and FSIQ assessments can effectively improve the accuracy of SSDC evaluation in forensic psychiatric expertise, facilitating rape identification and sentencing. It also helps law enforcement preliminarily judge the SSDC of involved individuals, guide targeted criminal investigations, and initiate forensic procedures promptly.

Keywords: Forensic Psychiatry, Sexual self-defense capacity, Mental Disorders, Intellectual level, Activities of Daily Living, individuals with mental disorders

Received: 27 Sep 2025; Accepted: 31 Oct 2025.

Copyright: © 2025 zuo, Wang, Xu, Yuan, Shen, Wang, Zhang, Xu, Li, Yao and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Yajun Xu, xuyajun@wnmc.edu.cn

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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