[¶ 1] Maurice Robert Thill appeals from a district court order denying his petition for discharge from civil commitment as a sexually dangerous individual. We affirm, concluding the district court did not err in finding Thill remains a sexually dangerous individual.
I
[¶ 2] In August 2012, the district court found Thill was a sexually dangerous individual and committed him to the custody of the director of the Department of Human Services. In April 2018, Thill filed a petition for discharge with the district court and requested a hearing. Dr. Robert Li-sota, a licensed psychologist at the North Dakota State Hospital, completed an annual re-evaluation of Thill. Dr. Lisota recommended Thill’s continued commitment because he remains a sexually dangerous individual who has serious difficulty controlling his behavior and is likely to engage in future sexually predatory conduct. The court also appointed Dr. Stacey Benson, a licensed clinical psychologist, to complete an independent evaluation of Thill. Dr. Benson, who had also completed an evaluation of Thill at the time of his initial commitment, again evaluated Thill and opined that he no longer remains a sexually dangerous individual.
[¶ 8] In August 2013, the district court held a discharge hearing on Thill’s petition and heard testimony from both Dr. Lisota and Dr. Benson. Both experts’ reports were made part of the record. Thill also testified on his own behalf. After the hearing, the court denied his petition for discharge. The court found Thill continues to be a sexually dangerous individual and ordered his continued commitment.
II
[¶ 4] This Court reviews the civil commitment of a sexually dangerous individual under a modified clearly erroneous standard of review.
In re Hehn,
(1) the individual has engaged in sexually predatory conduct; (2) the individual has a congenital or acquired condition that is manifested by a sexual disorder, a personality disorder, or other mental disorder or dysfunction; and (3) the disorder makes the individual likely to engage in further acts of sexually predatory conduct.
See
N.D.C.C. § 25-03.3-01(8);
Hehn,
at ¶ 8. The phrase “likely to engage in further acts of sexually predatory conduct” means the individual’s propensity to pose a threat to others.
In re E.W.F.,
[¶ 6] In addition to the three statutory elements,-the State must also prove a constitutionally required element that the individual has “serious difficulty controlling his behavior.”
E.W.F.,
“construe[s] the definition of a sexually dangerous individual to mean that proof of a nexus between the requisite disorder and dangerousness encompasses proof that the disorder involves serious difficulty in controlling behavior and suffices to distinguish a dangerous sexual offender whose disorder subjects him to civil commitment from the dangerous but typical recidivist in the ordinary criminal case.”
Matter of G.R.H.,
Ill
[¶ 7] Thill does not contend that the State failed to meet its burden on the first two prongs of N.D.C.C. § 25-03.3-01(8). Under the first prong of N.D.C.C. § 25-03.3-01(8), the district court found, and both experts agree, that Thill has engaged in sexually predatory conduct. Thill’s criminal history includes four prior convictions for gross sexual imposition in the early 1990s, and a gross sexual imposition conviction in about 2004, stemming from conduct in 1999.
See State v. Thill,
[¶ 8] The district court also found clear and convincing evidence Thill has a sexual disorder, and both Dr. Lisota and Dr. Benson diagnosed Thill with “pedophelia, sexually attracted to both, non-exclusive type.” As the district court also noted in its order, in the original commitment proceeding, Dr. Jennifer Krance had additionally diagnosed Thill with the sexual disorder of sexual sadism. In this proceeding, Dr. Lisota concurred with Thill’s additional diagnoses of sexual sadism and personality disorder, not otherwise specified with antisocial and narcissistic features.
A
[¶ 10] Thill argues the district court’s finding that he is likely to engage in further acts of sexually predatory conduct, is not supported by clear and convincing evidence. Specifically, he contends Dr. Lisota’s opinion, that Thill’s pedophelia diagnosis in part established this nexus, and Dr. Lisota’s attempt to buttress his conclusion through use of the Stable 2007 test to suggest “dynamic risk factors” support the conclusion of a likelihood to reoffend is not supported by sufficient evidence. Thill argues that, when “professional research by the experts in the field” cannot conclude to a reasonable degree of certainty that successful completion of treatment has the necessary protective value to reduce an offender’s risk of reoffending, Dr. Liso-ta’s opinion that Thill is likely to reof-fend is not supported by clear and convincing evidence.
[¶ 11] Here, the district court found clear and convincing evidence that Thill is likely to reoffend. The court initially noted its previous finding on this prong in the original commitment order was based on the sum of the risk assessment tests, Thill’s history of behavior, and the compelling nature of the factors in Thill’s diagnosis, all of which the court found were still valid. The court found Thill had not sufficiently progressed in treatment since his commitment and no facts indicated Thill was less likely to reoffend than when the original finding was made. The court also found two therapists that had collateral contact with Thill at the State Hospital were highly corroborative, in that one therapist said Thill was doing well but it would take at least three years before he would be ready for a transition center and another therapist expressed concerns regarding Thill’s participation in group therapy. The district court also found Thill’s deviant sexual preferences carried “great weight” and found Thill had a high level of psychopathy still present. The court found Thill’s score on risk assessment instruments, in light of all the other facts, sufficient to support the finding he was likely to reoffend.
[¶ 12] Clear and convincing evidence in the record supports the district court’s findings. Dr. Lisota testified regarding his annual review and report regarding Thill and his conclusions regarding the three statutory prongs and the “serious difficulty” requirement. Dr. Lisota testified that Thill received a score of six on the Static-99R risk assessment test, which places Thill in the high-risk range for re-offence. Dr. Lisota testified the “average sex offender” in the Static-99R sample has a score of two, and Thill’s score places him in a group of individuals who are approximately 3.7 times more likely than the average sex offender to reoffend. Dr. Lisota also testified that Thill’s diagnosis of pe-dophelia provides part of the nexus in the likelihood to reoffend, because that condition is very difficult to treat and is also a condition that is never cured. Dr. Lisota testified at best an individual learns to manage those thoughts, urges and feelings, and hopefully is able to do so successfully across time as a result of treatment.
[¶ 18] Further, Dr. Lisota testified that he reviewed Dr. Krance’s earlier scoring of the Psychopathy Checklist Revised and that Thill’s score of 34.4 is accurate, which indicates a high existence of psychopathy
B
[¶ 14] Thill argues Dr. Lisota’s opinion that he has serious difficulty controlling his behavior is not supported by clear and convincing evidence. According to Thill, he has demonstrated he had no serious difficulty in a structured environment, as indicated in Dr. Lisota’s report, and Dr. Lisota’s conclusion did not consider that Thill successfully completed treatment at the state penitentiary. However, Dr. Lisota testified that it is community behavior, rather than institutional behavior, that is the concern for “serious difficulty,” and the treatment afforded at the penitentiary would be insufficient to meet Thill’s particular needs. Dr. Lisota opined that, while Thill has made some progress in treatment in the last year since his commitment, he is not safe to return to the community.
[¶ 15] Thill nonetheless contends Dr. Benson’s testimony demonstrates he is only a “moderate risk” to reoffend under the diagnostic tests. Thill relies on Dr. Benson’s conclusion that Thill would not have serious difficulty in controlling his behavior in the community. In essence, Thill invites this Court to reweigh Dr. Benson’s testimony and report over that of Dr. Lisota’s testimony and report.
[¶ 16] Here, the district court again found by clear and convincing evidence Thill has serious difficulty controlling his behavior and that applies to his serious inability to control his urges to commit further sexually predatory conduct. In so finding, the court looked to Thill’s criminal history, his prior flight to avoid prosecution, his pedophelia diagnosis and inherent difficulty the condition causes, and his anti-social and narcissistic behavior. Significantly, the court found none of these considerations had abated and are still concerns. Clear and convincing evidence supports the court’s findings. As Dr. Li-sota opined Thill has a long and extensive history of sexually offending and problematic behaviors. Given the diagnoses, Dr. Lisota opined the treatment and treatment participation Thill has received to date has not been adequate to negate the overwhelming amount of historical evidence, as well as the diagnostic and actuarial indicators.
[¶ 17] This Court gives great deference to the district court’s credibility determinations of expert witnesses and the weight given to their testimony.
Matter of Mangelsen,
IV
[¶ 19] We affirm the district court’s order finding Thill continues to be a sexually dangerous individual and continuing his treatment at the State Hospital.