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Ressler et al. “ MURDERERS WHO RAPE AND MUTILATE 1984), and prevention efforts (Conte, 1984; Swift, 1977). Yet our understanding of undisclosed childhood sexual abuse and its long- term effects is limited in regard to gender differences and behavioral outcomes. It becomes even more imperative, given our findings on behavioral differences, that we not only learn how to detect cases of child sexual abuse early but also delve further into behavioral out- comes particularly in noncriminal abused adults. For the men who repeat sexual murder, their internal processing and cognitive operations appear to sustain and perpetuate fantasies of sexually violent actions. As a result, clinicians are urged to take careful note of patients reporting sadistic as well as criminal fantasies and record a systematic history on the content, duration, progression, and affect triggered by the fantasy. For law enforcement, murder that appears to be motiveless—that is, the victim is a stranger and there is no profit to be gained from the death of the victim—suggests that the victim and offense must be seen as having symbolic meaning to the offender reflecting violent sadistic fantasies. REFERENCES Beck, A. T. (1976). Cognitive therapy and the emotional disorders. New York: Inter- national University Press. Brittain, R. P. (1970). The sadistic murderer. Medical Science and the Law, 10, 198-207. Browne, A., & Finkelhor, D. (1984). The impact of child sexual abuse: A review of the research. (Unpublished manuscript) Buckley, J. (1981). Child sexual abuse and the law. Washington, DC: National Legal Resource Center for Child Advocacy and Protection, American Bar Association. Burgess, A. W., Hartman, C. R., McCausland, M. P., & Powers, P. (1984). Response patterns in children and adolescents exploited through sex rings and pornography. American Journal of Psychiatry, 141 (5), 656-662. Burgess, A. W., Hartman, C. R., Ressler, R. K., Douglas, J. E., & McCormack, A. (1986). Sexual homicide: A motivational model. Journal of Interpersonal Violence, I (3). Carmen, E. H., Rieker, P. P., & Mills, T. (1984). Victims of violence and psychiatric illness. American Journal of Psychiatry, 141 (3), 378-383. Conte, J. R. (1984). Progress in treaiing the sexual abuse in children. Social Work, 258-263. Densen-Gerber, J., & Benward, J. (1976). Incest as a causative factor in antisocial behavior. New York: Odyssey Institute. Eysenck, H. J. (1968). A theory of the incubation of anxiety/fear response. Behaviour Research and Therapy, 6, 309-321. Freud, S. (1895). Totem and taboo. New York: New Republic Edition. Garbarino, J., & Plantz, M. C. (1984). Child maltreatment and juvenile delinquency: What are the links? Pennsylvania State University, unpublished manuscript.