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Considerable theoretical and research efforts have gone into formulations which suggest that sex offenders differ from nonoffenders in their processing of sexual material. This article reviews the literature concerning patterns of empathy, social skills, and other cognitive processes (i.e., theories, attitudes, and distorted cognitions) of incarcerated sex offenders or those who have identified themselves as sex offenders. We choose these three general topic areas because many see these phenomena as central to the understanding of sex offending. First, we present general empirical findings relevant to the phenomena of empathy, social skills, and distorted cognitions. We then move to a discussion of specific cognitive models that have been offered to account for the data. We briefly discuss the available data relevant to these cognitive models. The next section of the article reviews the treatments that have been applied to sex offenders with the stated goal of modifying the processes we are examining. Our final section attempts to summarize and highlight some of the identified problems and weaknesses in the study of the aforementioned processes in sex offending. We argue that too little attention has been paid to basic cognitive psychology and the role that cognitions or conceptualizations can play in promoting our understanding of the sex offender. We suggest that following the information processing approach as a generalized model will help integrate and direct research efforts.