Psychopathology among substance abusing juvenile offenders

The prevalence of substance abuse and coexisting DSM-III psychiatric disorders was evaluated in 111 juvenile offenders. As expected, a high rate of conduct disorder (91%) was present in both substance abusing and nonsubstance abusing juvenile offenders. However, significantly higher rates of attention deficit disorder and aggressive subtype of conduct disorder were present in those offenders who abused drugs and alcohol (54%). Excluding all conduct and oppositional disorder diagnoses, 39% of substance abusers versus 14% of the nonsubstance abusers demonstrated comorbid psychiatric diagnoses. These findings suggest that careful psychiatric evaluation of juvenile substance abusers may be necessary to optimize treatment planning.     

Learning disabilities in juvenile offenders

The article briefly reviews the literature on the association between learning disabilities and conduct problems across correctional communities and clinical settings. It first reviews the literature on the prevalence of learning deficiencies among criminal offenders. It then discusses a number of relevant points from studies of the association between low academic achievement and conduct problems in nonincarcerated population samples. Third, it discusses studies of postrelease academic profiles of juvenile offenders. The article closes with a comment on possible future directions of the research linking reduced levels of academic achievement and delinquency.     

Mental health problems and service use among female juvenile offenders: their relationship to criminal history

OBJECTIVE: To describe (1) the level of mental health problems and lifetime use of specialty mental health services and special education programs among incarcerated female juvenile offenders and (2) how these indices relate to their criminal history. METHOD: Between 1997 and 1998, fifty-four female youths incarcerated in California were interviewed on-site using standardized self-report measures of depression and anxiety symptoms and substance use problems. RESULTS: Eighty percent of the youths had symptoms of an emotional disorder or substance use problem, and almost two thirds (63%) had a history of recidivism. Of those with emotional symptoms or a substance use problem, 51% had used specialty mental health services and 58% had been in a special education program during their lifetime. In addition, among recidivistic youths, 82% had a history of a substance use problem and 47% had used specialty mental health services during their lifetime. CONCLUSIONS: A substantial proportion of female juvenile offenders merit a mental health evaluation. Interventions for these high-risk youths should include an assessment for substance use disorders because of the association of recidivism and substance use problems in this population.     

Offence and clinical characteristics of Australian juvenile sex offenders

This study evaluated a series of pre‐sentence reports of a sample of juvenile sex offenders with the aim of providing information on the offence characteristics, developmental history and clinical profile of Australian juvenile sex offenders. The contents of 70 reports representing all juvenile sex offenders in contact with the New South Wales Juvenile Justice Department for the period 1996 to 1998 were analysed according to a structured protocol developed by the authors. The protocol assessed offence characteristics, developmental, cognitive, educational, psychosexual, and psychosocial factors. The profile findings indicated that juvenile sex offenders in New South Wales have problems across multiple domains of functioning, including the intra‐personal, social, educational, and sexual. The profile was similar to studies of juvenile sex offenders in the USA and Britain. The findings provide important information to those who adjudicate and care for this group of young people.     

Affective startle potentiation in juvenile offenders: The role of conduct problems and psychopathic traits

Emotion processing difficulties are observed in antisocial individuals exhibiting serious antisocial behavior. This study examined emotion processing in 40 male juvenile offenders (JOs) and 52 male controls by measuring startle reflex responses to aversive sounds during the passive viewing of affective and neutral images. JOs as a group exhibited reduced startle-elicited blinks across all slide categories compared to normal controls. Moreover, within the offender group those with more conduct disorder symptoms and higher levels of psychopathic traits displayed reduced startle amplitudes compared to lower-scoring offenders. The finding that startle magnitudes were inversely related to severity of conduct problems supports a dimensional or continuous approach to understanding externalizing disorders. Reductions in amygdala activity could lead to blunted startle magnitudes. The current findings not only provide further evidence that antisocial children have a general defensive motivational system dysfunction and present with impairments in neural systems that subserve emotion processing, but also show for the first time that those with more severe conduct problems have reduced startle responses compared to those who are less severely affected. The implications of these findings for interventions with JOs are discussed.     

Trauma exposure, posttraumatic stress, and psychiatric comorbidity in female juvenile offenders

OBJECTIVE: To document the rate of posttraumatic stress disorder (PTSD) in female juvenile offenders and its relationship to trauma history, comorbid diagnoses, attributional style, and family functioning. METHOD: The psychological profiles and trauma histories of 100 incarcerated female juvenile offenders (ages 13.5-19 years) were assessed using a semistructured interview. Two self-report measures were used to assess family functioning and attributional style. RESULTS: High rates of PTSD were reported by offenders (37%), with sexual abuse the precipitant in 70% of cases. Offenders with PTSD had significantly more comorbid diagnoses than those without (PTSD = 5.4, no PTSD = 3.1, p < .001). The majority (73%) of comorbid diagnoses appeared concurrently with or after PTSD onset. The presence of four or more psychiatric diagnoses (OR = 14.48, p < .001) and a history of sexual abuse (OR = 7.91, p < .001) were independently associated with a diagnosis of PTSD among female juvenile offenders. CONCLUSIONS: These results suggest a link among trauma, PTSD, and the development of further psychopathology in female juvenile offenders. This link highlights the importance of comprehensive diagnosis and treatment of this and other comorbid disorders to ensure the effectiveness of interventions designed to treat antisocial behavior.     

男性青少年罪犯的人格特征比较研究

目的了解男性青少年罪犯的人格基本特征。方法采用自编青少年犯罪行为一般情况调查表和艾森克人格问卷（EPQ）对某未成年犯管教所300名男性青少年犯进行集体测评。结果青少年犯具有典型精神质（P）人格特征的占40.3%,典型神经质（N）的占25.3%,高于一般人群的12.5%;典型外向（E）的占12.0%,掩饰性（L）高分（〉61.5）占8.0%,低于一般人群的12.5%。与全国同龄人群平均水平相比,男性青少年犯的精神质（P）、神经质（N）得分较高,而外向性（E）、掩饰性（L）得分较低,有显著性差异;不同犯罪类型青少年人格特征无显著性差异;青少年罪犯的人格特征城乡无显著性差异。外向性（E）不同的青少年犯,P分、N分有显著性差异。结论男性青少年罪犯的人格多偏离正常;不同犯罪类型、不同地域来源的犯罪青少年人格特征无明显差异;青少年犯群体中人格类型有一定的差异。     

Legal probation of juvenile offenders after release from penal reformative training

Over recent years, there has been an increase in adolescent delinquency in Germany and Switzerland. In this context, the episodic character of the majority of adolescent delinquency is usually pointed out; however, numerous studies show high re-offending rates for released adolescents. The goal of this study is to examine the legal probation of juvenile delinquents after release from penal reformative training. In this study, the legal probation of adolescents committed to the AEA Uitikon, in the Canton of Zurich, between 1974 and 1986 was scrutinized by examining extracts from their criminal record as of 2003. The period of catamnesis was thus between 17 and 29 years. Overall, 71% of offenders reoffended, 29% with a violent or sexual offence. Bivariate logistic regression showed that the kind of offence committed had no influence on the probability of recidivism. If commitment to the AEA was due to a single offence (as opposed to serial offences), the risk of recidivism was reduced by 71% (OR=0.29). The results of the study show that young delinquents sentenced and committed to penal reformative training have a high recidivism risk. Furthermore, the results point out the importance of the evaluation of the offense-preventive efficacy of penal measures.     

A review of mood disorders among juvenile offenders

OBJECTIVES: This article provides an overview of what is known about the prevalence, diagnosis, and effective treatment of mood disorders among youths, particularly among juvenile offenders, and discusses the unique problems that arise for the delivery of treatment services. The relationship between mood disorders and disruptive or delinquent behaviors as well as the particular importance of proper diagnosis and treatment of mood disorders in this population are discussed. METHODS: A search was conducted of the MEDLINE and PsycINFO databases for articles that had been published since 1980 on mood disorders in the juvenile offender population as well as articles on adolescent mood disorders. RESULTS: The studies on the prevalence of mood disorders among juvenile offenders varied significantly in the methodology used and in the rates of prevalence found, although all studies showed that this population had high rates of mood disorders. The identification and effective treatment of mood disorders is critical because these disorders are a leading cause of suicide among adolescents and because mood disorders may contribute to or exacerbate delinquent and disruptive behaviors. CONCLUSIONS: Juvenile detainees have a constitutional right to needed mental health treatment. More comprehensive mental health services are required to ensure that juvenile offenders with mental illness are identified and cared for appropriately. Doing so not only will alleviate painful symptoms but may also contribute significantly to improvements in psychosocial functioning, interpersonal relations, and school performance and to decreases in delinquent, disruptive, and suicidal behaviors.     

Evaluation of typical psychopathic traits with juvenile offenders

The concept of psychopathy has received many definitions for the first days of psychiatry. Recently, the Hare's Psychopathy Check List Revised has been created. This scale has the advantage to investigate the classically characteristic traits of the syndrome (need of stimulation, lack of culpability, superficial activity, lack of empathy, impassivity) and to point out the early development of behavior disturbances. In the American classification (DSM IV), oppositional and aggressive behavior in child and adolescent is grouped under the Conduct Disorder diagnostic criteria. This trouble appears to be a strong predictive factor of psychopathy in adult. Identifying the high risk factors of evolution to psychopathic personality would allow an earlier intervention and prevention by multisystemic interventions for example. The present study aims to evaluate in what measure characteristic traits of psychopathy in adults are present in severe juvenile offenders and to point out, in a second time, the differences between adolescents meeting the DSM IV criteria for Conduct Disorder and a control population by a dimensional personality inventory. METHOD: The sample consists in 47 severe juvenile offenders referred for at least 3 months by a Youth Court to a Public Institution for Youth Protection (Belgium, Wauthier-Braine, 1999-2001), who have given an oral contentment and completely fulfilled the Temperament and Character Inventory-TCI. We have collected data about: schooling year by year, number of fails, changes of school; antecedents of oppositional defiant disorder with provocation (ODD, DSM IV criteria); antecedent of Conduct Disorder (CD, DSM IV criteria); penal antecedents (Youth Judge, works of general interest, placements); medico-psychological antecedents (consultation to a psychologist or a psychiatrist, hospitalization, illness, surgical intervention); psychoactive drug use or abuse. We used the TCI--Temperament and Character Inventory. This is a dimensional personality inventory. Based on biological, genetic and clinical hypothesis, it describes 2 types of variables defining personality: Variables of temperament (genetically transmitted and biologically controlled), and Variables of character (learned part of the personality reflecting the degree of adaptation and maturity, varying with environment through development). We have chosen this tool because of its dimensional aspect. Adolescence being a time of psychological and personality changes, such a tool is more useful than a categorical one. We also used this tool to verify the existence of the specific triad described by Cloninger and Svrakic. According to these authors, psychopathic personality in adult is characterized by a specific triad in which novelty seeking is high while harm avoidance and reward dependence are low. These observations are highly correlated to Hare's definition of psychopathy. We give the principal scores for the 7 personality dimensions expressed in global scores (total of the items for each dimension) and pondered ones (global scores divided by the number of items of the dimension x 100). RESULTS: Statistical analysis was performed with the Stateview 5.0 t-test program for data analysis. Statistical results show the absence of a statistically significant difference between the 2 groups for TCI 1, 4.5 and 7 but a statistically significant difference for TCI 2, 3 and 6 (p <.0001). DISCUSSION: The first limitation of our study is linked to the sample composed of young adolescents placed in an Institution for Youth Protection who doesn't reflect the whole population of offenders. A second limitation is correlated to the randomization system: randomization for age but not for sex, ethnical and cultural origin and socioeconomic status. Our results with adolescent offenders don't completely meet the Cloninger's psychopathy triad in adults. Moreover, in literature data, aggressive behavior is correlated to high novelty seeking and associated with low harm avoidance, reward dependence and persistence in children, these items are predictive of antisocial behavior in teenage and young adulthood. In our sample where antisocial behaviors are severe, we should be expecting a high novelty seeking but that is not the case. Our results should be explained by the fact that adolescence in itself is a more powerful factor of high novelty seeking than psychopathic trait. Harm avoidance and reward dependence seem to be a real problem in offending population and reflect aggressive behaviors in adolescents (lack of harm perception, sensitivity and empathy). Another interesting element is the cooperation factor that is significantly lower in the study group. This seems to comfort the hypothesis of a lower social maturity in institutionalized adolescents. CONCLUSION: Regarding to a control group subjects from 15 to 25 years old, adolescent offenders observed in an Institution for Youth Protection show a significantly different profile in the TCI for Harm Avoidance, Reward Dependence and Cooperation. Regarding to adult psychopaths, adolescent offenders partially meet the classical diagnostic triad of psychopathy, what should be indicating that such adolescents already show emotional perturbations: lower harm avoidance, reward dependence and cooperation than control population. This third factor is not characteristic of psychopathy but reflects relational difficulties, which are important in adolescent offenders. So, our study point out the complex psychopathology of adolescent offenders and the coexistence in such adolescents of attachment disorder and the difficulty to treat them because of their multiple lacks (cognitive, psychopathological, familial and scholar). We think important to discuss the necessity of approaches based on the development of personal creative abilities and involving all the professionals concerned in the young's universe. Future researches should compare adolescent offenders and controls randomized for age, sex, socioeconomic, ethnical and cultural status. They also should test specifically the diagnostic triad of psychopathology developed by Cloninger, especially the novelty seeking dimension. Moreover, it would be interesting to integrate these results in a wider protocol and to compare them with clinical, forensic and neurocognitive data, individually and within the familial context.     

Serious juvenile offenders: classification into subgroups based on static and dynamic charateristics

Background

The population in juvenile justice institutions is heterogeneous, as juveniles display a large variety of individual, psychological and social problems. This variety of risk factors and personal characteristics complicates treatment planning. Insight into subgroups and specific profiles of problems in serious juvenile offenders is helpful in identifying important treatment indicators for each subgroup of serious juvenile offenders.

Methods

To identify subgroups with combined offender characteristics, cluster-analyses were performed on data of 2010 adolescents from all juvenile justice institutions in the Netherlands. The study included a wide spectrum of static and dynamic offender characteristics and was a replication of a previous study, in order to replicate and validate the identified subgroups. To identify the subgroups that are most useful in clinical practice, different numbers of subgroup-solutions were presented to clinicians.

Results

Combining both good statistical fit and clinical relevance resulted in seven subgroups. Most subgroups resemble the subgroups found in the previous study and one extra subgroups was identified. Subgroups were named after their own identifying characteristics: (1) sexual problems, (2) antisocial identity and mental health problems, (3) lack of empathy and conscience, (4) flat profile, (5) family problems, (6) substance use problems, and (7) sexual, cognitive and social problems.

Conclusions

Subgroups of offenders as identified seem rather stable. Therefore risk factor scores can help to identify characteristics of serious juvenile offenders, which can be used in clinical practice to adjust treatment to the specific risk and needs of each subgroup.

     

Clinical utility and policy implications of a statewide mental health screening process for juvenile offenders

OBJECTIVES: This study examined the utility of screening adjudicated juvenile offenders for mental health symptoms at intake to the State of Washington Juvenile Rehabilitation Administration. The authors assessed the ability of a screening measure, the Massachusetts Youth Screening Inventory, second edition (MAYSI-2), to identify youths with mental health problems and co-occurring substance use problems. This study also examined the relationship of these symptoms to treatment utilization both before and after intake to the juvenile justice system. Ethnic and gender differences in the screening results were studied. METHODS: The MAYSI-2 was administered to 1,840 youths consecutively admitted to state custody. Cluster analysis was used to group the youths by mental health symptom status, and the relationship between symptoms and treatment utilization was tested in the groups identified in the cluster analysis. RESULTS: Youths who reported a high level of mental health symptoms, with or without co-occurring substance use problems, were more likely to have received previous mental health treatment than youths with a low level of mental health symptoms. Youths with a high level of mental health symptoms were more likely to receive extraordinary sentences and were thus less likely to be eligible for community transition programs than youths with a low level of mental health symptoms. Significant gender and ethnic differences in mental health symptom reporting on the screening inventory were found. Female offenders were significantly more likely than male offenders to report a high level of symptoms, and Hispanic youths were significantly less likely than youths in other ethnic groups to report a high level of symptoms. CONCLUSIONS: The MAYSI-2 has utility in identifying youths in the juvenile justice system who have mental health problems, and MAYSI-2 results are related to use of treatment services both before and after intake to the juvenile justice system. Ethnic and gender differences in MAYSI-2 reporting must be considered in interpreting mental health screening data.     

男性青少年犯的人格特征差异研究

目的：了解男性青少年犯及其个体间的人格特征。方法：按照青少年男犯（n=126)和对照组（n=72)在MMPI上T分数和聚类分析结果。比较两组的人格特征以及青少年犯群体间的人格差异。结果：青少年男犯在效度量表F，临床量表Hs,D,Hy,Pd,Pa,Pt和Sc的T分明显升高，与对照组差异明显（P＜0．001），三组青少年男犯分别为神经症型（n=48,38．1%)，正常型或中间型（n=38,30.16%)和精神病质型或类精神病型（n=40,31.75%)，结论：青少年犯群体的人格特征有明显异常。     

Affective disorder in juvenile offenders: A preliminary study

OBJECTIVE: The authors' goal was to determine the prevalence of major mental disorders and substance abuse in adolescents admitted to a juvenile detention center. METHOD: As part of a routine mental health screening, modules from the Diagnostic Interview Schedule for Children were administered to 50 youths (11-17 years old) at an urban juvenile detention center. RESULTS: A high rate of affective disorder (42%) was found among these adolescents: 10 (20%) met criteria for mania, another 10 met criteria for major depressive disorder, and one met criteria for bipolar disorder, mixed type. Thirty (60%) met criteria for conduct disorder, and very high rates of alcohol, marijuana, and other substance dependence were found. There was a strong association between affective disorder and conduct disorder; adolescents with mania had much higher rates of reported abuse of substances other than alcohol or marijuana. CONCLUSIONS: Juvenile offenders have high rates of affective disorder. Further studies are needed to examine the relationship of affective disorder to substance abuse as well as to antisocial behavior.     

Psychopharmacologic treatment in juvenile offenders

This article first reviews ways to assess children in the justice system who may benefit from psychopharmacologic treatments. Second, it summarizes the emerging understanding of the nature of aggression and violence and the utility of using the schema of reactive ("hot") and proactive ("cold") aggression as a way to consider pharmacologic options. Third, it summarizes the current published studies on the treatment of conduct disorder, which roughly corresponds to the population of children in the juvenile justice system. Finally, it examines the ways that different classes of medications might be considered when approaching juvenile delinquents and the ways that psychopharmacology could be used as part of an overall treatment plan.     

The relationship between intellectual disability, Indigenous status and risk of reoffending in juvenile offenders on community orders

Background   Intellectual disability (ID), age and aboriginal status have been independently implicated as risk factors for offending to varying degrees. This study examined the relationship between age, ID and the Indigenous status of juvenile offenders. It also examined the outcomes of the sample's offending in terms of court appearances and sentencing, criminogenic needs and risk of reoffending.
Method   The sample comprised 800 juvenile offenders on community orders of whom 19% were Indigenous, who completed the New South Wales Young People on Community Order Health Survey between 2003 and 2005. Risk and criminogenic needs were evaluated using the Youth Level of Service/Case Management Inventory (Australian Adaptation) (YLS/CMI: AA).
Results   Those with an ID were found to have a higher risk of reoffending than those without an ID. Those with an ID were also more likely to be younger and Indigenous. For Indigenous young offenders, there was no difference between those with and without an ID in risk category allocation or number of court dates. For non-Indigenous young offender, those with an ID had higher risk scores and more court dates.
Conclusions   This study provided evidence that Indigenous status may play a significant role in the relationship between ID and offending in juvenile offenders on community orders. These findings have clear implications for the 'risk', 'needs' and 'responsivity' principles of offender classification for treatment. Emphasis is placed on the requirement for addressing the needs of Indigenous juvenile offenders with an ID.     

Four-year follow-up of multisystemic therapy with substance-abusing and substance-dependent juvenile offenders

OBJECTIVE: Although several treatments for adolescent substance abuse have been identified as promising by reviewers and federal agencies, treatment effects extending beyond 12 months have not been demonstrated in randomized clinical trials. The primary purpose of this report was to examine the 4-year outcomes of an evidence-based treatment of substance-abusing juvenile offenders. METHOD: Eighty of 118 substance-abusing juvenile offenders participated in a follow-up 4 years after taking part in a randomized clinical trial comparing multisystemic therapy (MST) with usual community services. A multimethod (self-report, biological, and archival measures) assessment battery was used to measure the criminal behavior, illicit drug use, and psychiatric symptoms of the participating young adults. RESULTS: Analyses demonstrated significant long-term treatment effects for aggressive criminal activity (0.15 versus 0.57 convictions per year) but not for property crimes. Findings for illicit drug use were mixed, with biological measures indicating significantly higher rates of marijuana abstinence for MST participants (55% versus 28% of young adults). Long-term treatment effects were not observed for psychiatric symptoms. CONCLUSIONS: Findings provide some support for the long-term effectiveness of an evidenced-based family-oriented treatment of substance-abusing juvenile offenders. The clinical, research, and policy implications of these findings are noted.     

Differences between juvenile offenders with and without intellectual disability in offense type and risk factors

The present study aimed to examine differences between American juvenile offenders with and without intellectual disability (ID) in offense type and risk factors. The sample consisted of adolescents with ID (n=102) and without ID (n=526) who appeared before the courts for a criminal act and for whom the Washington State Juvenile Court Assessment (WSJCA) was completed. Results showed that adolescents with ID had committed more offenses against persons compared to adolescents without ID. Few differences in risk factors were found between juvenile offenders with and without ID in the domains of school, family and use of free time. Juvenile offenders without ID more often had problems in the relationship and alcohol/drugs domain, whereas juveniles with ID more often experienced problems in the domains of attitude, aggression and skills.     

Suicide among personality-disordered offenders: a follow-up study of 1943 male criminal offenders

Suicide mortality among all male criminal offenders in Sweden who had been subjected to a major forensic psychiatric examination 1988–1991 (n=1943) was studied, with special reference to offenders with personality disorders. The cohort was followed until the end of 1995. Altogether 135 individuals (6.9%) died during the follow-up period; the mode of death was suicide in 50 individuals (2.6%). The unadjusted suicide mortality ranged from 2.8% among those with personality disorders to 6.1% among those with drug-related psychosis. The standardised mortality ratio (SMR) among personality-disordered offenders was 1212, i.e. around 12 times that of the general population. Survival analyses by means of Cox regression models were performed to identify background factors associated with completed suicide. No specific principal diagnosis showed significantly increased risk for completed suicide. However, concomitant depression and drug abuse were significantly linked to suicide. Violent crime showed no association. Among personality-disordered offenders suicide methods did not differ from those of suicide victims in the general population. There was no association between violent index criminality or between life-time violent criminality and choice of a violent suicide method.