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Psychological and social characteristics of juvenile offenders with serious mental and behavioral disorders.

Children's behavior is impacted by genetic, social and environmental factors. In 2002, more than 110,000 youths dwelled daily in juvenile detention and correctional facilities across the U.S. and, among them, more than two-thirds had a diagnosable mental disorder and approximately 20 percent had a serious mental health disorder (NCMHJJ, 2005). Research shows that many of these offenders experience psychosocial and educational problems (Brown, Borduin and Henggeler, 2001), psychological trauma including depression, post-traumatic stress disorder, anxiety, anger, dissociation, severe personality disorders emerging in childhood and sexual problems (Avinger and Jones, 2007; Spilsbury et al., 2007; Vizard et al., 2004). Other research findings demonstrate that nearly two-thirds of boys and three-fourths of girls in juvenile detention have at least one psychiatric disorder, illustrating how common these problems are among detained youths (Ankarsater et al., 2007; Teplin et al., 2002). More studies analyzing youths' offending behavior and describing their unmet needs for mental health services would contribute to a better understanding of their conditions and temper the increasing public support for more stringent laws regarding indictment, conviction and incarceration of juveniles (Deitch et al., 2009; Ghetti and Redlich, 2001). Additionally, in-depth studies using psychological reports focusing specifically on this particular population are needed. The gap in the literature can be attributed to difficulties related to sampling, data collection and access to the incarcerated offenders. It may also be due to researchers' inclination to study other phenomena such as gang membership and substance, physical or sexual abuse experienced by offenders diagnosed with mental health and behavior disorders. The current study contributes in-depth information on the personal, social, psychological and psychiatric characteristics as well as the family structure and functioning of this particular subset of juvenile offenders.

Researchers agree that no single risk factor leads children to delinquency. It is reported that being a witness to or victim of community violence is associated with criminal behavior as well as a variety of behavioral, emotional and cognitive-functioning problems (Eitle and Turner, 2002; Scarpa, 2001; Spilsbury et al., 2007). Also, disruptions to parenting and family processes might contribute to juvenile delinquency (Gainer et al., 2007; Radosh, 2002; Smith and Farrington, 2004; Stewart et al., 2002). Other findings suggest that the concentration of offenders in families and family criminality could be used to predict boys' delinquency (Farrington et al., 2001). The incarceration of both parents, particularly that of the mother, leads to parenting disruption. Radosh (2002) reported that in 1999, there were about 87,000 women incarcerated in the U.S. and estimates indicated that 80 percent of them had dependent children at the time of incarceration. In 1999, there were at least 126,100 children with jailed mothers and many more had fathers in prison (Radosh, 2002). Parents' incarceration affects children as it deprives them of the emotional attachment and supervision they need. Children subjected to inadequate supervision and discipline are likely to manifest anti-social behavior and affiliate with deviant peers (Nesbitt, Lombe and Linsey, 2007; Stewart et al., 2002).

Farrington et al. (2001) and Smith and Farrington (2004) studied continuities in anti-social behavior and parenting across family generations: concentration of offenders in families; family criminality in the prediction of boys' delinquency; and the extent to which criminal relatives predict a boy's delinquency. Their findings suggest that the number of arrested individuals in a family is a predictor of a boy's delinquency; there are intergenerational continuities in anti-social behavior (Smith and Farrington, 2004); and that both a father's and mother's convictions were significantly related to having a child with a high level of disruptive behaviors.

A linkage between the effects of child abuse and violence among adolescents has been established as well (Benda and Corwyn 2002; Farmer and Pollock, 2003; Moses, 1999). In a sample of sexually abused and sexually abusing children, Farmer and Pollock (2003) found that half of the sexually abused youths had sexually abused another child at some stage. The consequential damages of the abuse may be so pervasive that adult sexual abuse survivors report that recovery is possible but healing is not (Anderson and Hiersteiner, 2008). Other research findings link alcohol or illicit drug use with juvenile offending behaviors (Bergen et al., 2004); Brecklin and Ullman, 2001; Kingree and Phan, 2002). Welte, Zhang and Wieczorek (2001) found that there is a causal relationship between substance use and criminal offending behavior.

Studies suggest that violent adolescent offenders' problems should be viewed in holistic terms (Dembo and Schmeidler, 2003) because youths are on one hand influenced by distal contextual risk factors such as community, school violence, family disruptions, physical abuse, sexual abuse, neglect and substance abuse; and on the other hand by proximal risk factors such as lack of supervision, the multiple consequences of abuse and the youths' levels of emotional disturbance and intellectual and functioning abilities. These distal and proximal risk factors are cumulative and interactive as they operate in several areas (Wasserman et al., 2002). Determining which yield the most consequential damage to children would contribute to a more effective early identification of children at risk for delinquency and prompt early and efficient professional intervention (Farrington, 2005; Lay et al., 2005).

Recognizing the dearth of in-depth information on adolescent offenders exhibiting mental health symptoms and violent behaviors, this study examines detailed psychological and social information on a sample of juvenile offenders being considered for a diversion program.


Procedures, program and participants. This research is a secondary analysis using data collected from full psychological evaluation reports of 88 juvenile offenders who were being considered for entrance into a Northeast Ohio diversion/treatment program for violent offenders with mental health problems. This pilot treatment program was part of a statewide grant to provide treatment-based diversion services to youths with histories of violent offenses who were thought to have had mental health problems underlying these offenses. The program was jointly sponsored by the Ohio Department of Youth Services, the Ohio Department of Job and Family Services, the Ohio Department of Mental Health and the Office of Criminal Justice Services.

Juvenile offenders in this study were referred for evaluation by juvenile courts in Lorain County, Ohio. The Bellefaire Jewish Children's Bureau, a social agency located in the Cleveland area, completed a written psychological evaluation of each juvenile based on a series of interviews and assessments. Licensed psychologists tested each youth and presented results of their assessments in individual reports. These written reports included standardized test scores, diagnoses from the Diagnostic and Statistical Manual of Mental Disorders, historical information, and narrative and clinical conclusions. Also included in these reports was information generated from interviews with biological parents, adoptive parents or step-parents, other relatives, school officials, and social service and mental health professionals. The assessments served as a basis to determine possible referral to appropriate evidence-based treatment services outside the juvenile justice system. Juveniles referred for evaluation met the following criteria:

* Between the ages of 11 and 17 years;

* Committed a violent offense;

* Identified as having a diagnosable mental disorder resulting in a significant mental impairment; and

* Viewed as progressing toward a commitment to the Ohio Department of Youth Services "due to failure in less restrictive programs."

This study was approved by the Case Western Reserve University Institutional Review Board.

Measures. The evaluators used a number of sources and measures to collect data on each participant. These sources and measures included the juvenile record review, the family's clinical records, a clinical interview with client, the Wechsler Intelligence Scale for Children, Third Edition-Short Form (WISC-III), the Wechsler Adult Intelligence Scale-III (WAIS-III), the Wechsler Individual Achievement Test-Screener (WIAT-Screener; Groth-Marnat, 2003), the Youth Level of Service/Case Management Inventory (YLS/CMI; Hoge and Andrews, 2002), the Ohio Scales (youth, parent and worker versions) and the Disposition Investigation Report (DIR).

The WISC (Groth-Marnat, 2003) is a test designed to identify cognitive functioning in children. A WISC score represents a combination of two scores made by a child on the verbal and performance subtests. Verbal and performance scores are based on scores on 13 subscales (6 for verbal IQ and 7 for performance IQ). There may be a discrepancy between the two scores; for example, a child might achieve a verbal IQ of 87 and a performance IQ of 86. The full IQ score of 85 reflects both scores. Revisions of the WISC have led to the revised version (WISC-R) and to the WISC, Third Edition (WISC-III). This test, also used to detect gifted children, includes six verbal and seven performance subtests (Groth-Marnat, 2003). In order to evaluate the IQ of younger subjects in this sample, the psychologists administered the WISC-III and the WIAT-Screener; with older subjects, they used the WAIS-III.

Designed in 1992, the WIAT-Screener is used for more in-depth assessment of achievement and for the diagnosis and assessment of mental retardation. High to moderate correlations (r=0.9 to r=0.4) were found between the WAIS-III and the WIAT-Screener (Groth-Marnat, 2003).

The DIR is an instrument used in the assessment process by the Ohio Department of Youth Services to collect information on juvenile offenders. The DIR provides the following information:

* Demographics;

* Committing offense information;

* Victim information;

* Court history;

* Family members and family information;

* Youth information;

* Religion;

* School and employment history;

* Mental retardation/developmental delay issues;

* Mental health issues;

* Medical information;

* Alcohol and drug history;

* Personal/social information;

* Post-disposition information;

* Prior court referrals; and

* Victim impact information.

This instrument is administered to the children in a semi-structured interview format because of the specific meaning of some constructs that interviewees may not understand, but also because of the inclusion of open-ended questions that may require more details from the participants. No reliability or validity data are provided.

The YLS/CMI is an instrument developed by Hoge and Andrews (2002). It is used for an initial assessment of risk of failure, needs for services, and responsibility factors in young offenders. The YLS/CMI involves a lace-to-face interview and a review of case records. The inter-rater reliability estimates of all its subscales range from 0.65 to 0.85, making it widely recognized as valid in predicting recidivism (Juvenile Justice Authority of Kansas, 2009).

The short form of the Ohio Youth Problem, Functioning and Satisfaction Scales (Ogles et al., 2001) were used in the data collection process. This instrument has three versions; the youth form, the parent form and the agency worker form. While the youth and parent forms are identical in content, they differ in perspective since the youths and their parents address two sets of 20 items assessing, respectively, the youths' problem severity and functioning. In their form, agency workers address the 40 items assessing the youths' problem severity and functioning, and provide information on school placement and suspensions, psychoactive medications, arrests and self-harm attempts. Regarding the reliability of this instrument, Ogles et al. (2001) report that internal consistency estimates (Cronbach's alpha) for each scale on the short form for community and clinical samples vary between 0.86 and 0.93.


Using the Statistical Package for Social Science, operations such as descriptive, and frequency test, cross-tabulation, chi-square and t-tests were performed. The sample of 88 subjects included primarily males (n = 71); the majority of the sample was white (60 percent), with black and Hispanic youths comprising the remainder of the subjects (27 percent and 13 percent, respectively). Ages ranged from 12 to 17 years (mean age = 14.95; SD = 1.41).

Of the 88 children, 31 (35 percent) had parents who had been divorced, 27 (31 percent) had parents who had never been married, 19 (22 percent) had their biological parents still married at the time of the assessment and no information was provided on the marital status of 11 youths' parents (13 percent). By 5 years of age. 30 percent of youths had started exhibiting behavior problems, and by the age of 10, an additional 39 percent had displayed such behavior. All but three subjects had been incarcerated between one and 12 times (mean = 3.5; SD = 2.72; median = 3; mode = 2). The other three subjects had never been arrested and only served on probation. At the time of the assessment, 18 participants (21 percent) were released from detention, 21 youths (24 percent) were on probation, and 49 (56 percent) were in a detention facility. Of the 88 youths, three had only one legal charge (mean 7.6; SD = 5.20; median = 6; mode = 4) and one outlier had 35 charges.

The assessments indicate that 21 youths (23 percent) had been placed in foster care. Age of placement for foster care youths ranged from birth to 9 years. The number of foster care placements for these 21 subjects ranged from one to 11. An additional 19 youths had been removed from the home, but were not in foster care. Among these 19 youths, five had been placed for adoption and the other 14 were either living with a relative or placed in a child-care institution. Assessment information also indicates that of the 21 youths placed in foster care six had been adopted. The additional youth adopted was not removed from home until age 15.

Based on the YLS/CMI assessment of future risk of committing criminal acts, youths in this sample were categorized at the following levels: low, 6 (7 percent); moderate, 33 (38 percent); high, 47 (53 percent); very high, 2 (2 percent). Thus, more than half the subjects in this sample (55 percent) were assessed as being at high or very high risk of committing future criminal acts.

The youths in this sample were very impulsive and prone to injuring themselves and others. Approximately 88 percent of the youths were noted as having impulsive behavior. Almost 3 in 4 juveniles (74 percent) had made a suicidal threat or gesture/act. Slightly more than 1 in 3 (39 percent) were documented as having attempted suicide, including eight of the 17 girls in the sample. A high percentage of juveniles (71 percent) were assessed as severely and extremely violent offenders, which means they were both verbally and physically aggressive and/or had committed crimes against people during which they used a weapon (as specified in the DIR). One-quarter (22) of the youths had perpetrated violent acts on animals/pets such as dogs and cats by killing, mutilating or burning them. Slightly more than 11 (12 percent) had committed at least one sexual offense and were adjudicated sexual predators. Thirty-seven youths (42 percent) had been noted as fire-setters. Almost three of four juveniles (72 percent) had perpetrated family violence. Finally, almost one-third of the subjects (32 percent) were victims of sexual abuse, with all females in the sample being victims of sexual and/or physical abuse. It was noted that 28 children (32 percent) were victims of sexual abuse perpetrated by siblings, cousins, stepfathers, boyfriends or acquaintances. Eleven youths (13 percent) had committed at least one sexual offense and were adjudicated sexual predators (10 males, one female), six of whom committed their sexual offense at 12 years of age or younger. Among the 28 sexually abused victims comprising 18 boys and 10 girls, there were five sexual predators (four males, one female). A cross-tabulation of gender, sexual abuse victim and physical abuse victim disclosed that all females in this sample were victims of either sexual, physical or both sexual and physical abuse, while 49 of the 71 males were reported as having been sexually (n = 4), physically (n = 31) or both sexually and physically abused (n = 14). Twenty-one youths (23.9 percent) were recorded as being sexually active; and 23 committed indecent sexual gestures such as inappropriate touching (n = 9), exhibitionism (n = 7) and other objectionable sexual acts (n = 7).

Compromised intellectual functioning was indicated in almost half the sample (see Table 1). Nearly half (48 percent) of the youths in this sample had full scale IQ scores at or below the range of borderline intellectual functioning. Further, more than 1 in 5 youths (19) had a provisional diagnosis related to a learning problem (i.e., reading disorder, mathematic disorder, learning disorder or written expression disorder).
Table 1. IQ Scores of Youth Sample, N = 88

                IQ full score

Scores             n    %

Moderate MRDD      3   3.4

Mild MRDD         14   16

Borderline        25  28.4

Low normal        29   33

High normal       15   17

No information    2    2.2

* MRDD stands for mental retardation and developmental disabilities

As can be seen in Table 2, most of the youths in this study were diagnosed with some type of mental disorder related to aggressive /violent behavior. Seventy-one (81 percent) of the subjects were diagnosed by licensed professional psychologists who tested each youth with some type of disruptive behavior or adjustment disorder. Mood disorders were diagnosed in 34 adolescents (39 percent). One or more substance use disorders were diagnosed in 26 adolescents (30 percent; total number of diagnoses is 42 due to some youths having more than one substance use disorder). Finally, attention-deficit disorders were diagnosed in almost 1 in 3 youths.
Table 2. Diagnoses on DSM-IV Axis I

Diagnostic Disorder                                         n    %

Mood Disorders

  Depressive disorder                                       18  20.5
  Major depression                                           2   1.1
  Major depressive episode                                   1   1.1
  Mood disorder, NOS *                                       1   1
  Bipolar I disorder                                         2   2.3
  Dysthymia                                                 10  11.4

Behavioral Disorders

  Conduct disorder                                          38  43.2
  Oppositional defiant disorder                             24  27.3
  Disruptive behavioral disorder, NOS *                      6   6.8

Substance Use Disorders

  Substance abuse, cannabis                                 21  23.9
  Alcohol abuse                                             15  17.1
  Polysubstance abuse                                        3   3.4
  Cannabis dependence                                        3   3.4


  Adjustment disorder with disturbance of conduct, chronic   3   3.4
  Attention deficit hyperactivity disorder                  28  31.8

* NOS stands for not otherwise specified.

Parental abuse of alcohol/drugs was noted in many records. More than half the fathers (55 percent) were cited as abusing alcohol and/or drugs. Approximately 43 percent of mothers were noted as alcohol/drug abusers. Parental histories of involvement in the legal system were also noted in the reports. About one-third of the fathers and about 1 in 5 mothers had been incarcerated or on probation.


Although the mean age of this sample was approximately 15 years, the findings demonstrate that this group is characterized by an early onset of behavior problems and instability in living environment. Findings show that the exhibition of behavior problems early in life is among the characteristics of these youths, almost one-third of whom by the age of 5 had demonstrated acting out behaviors that raised parents' and professionals' concerns. Findings also illustrate a significant instability of home environment evidenced by numerous subjects having histories of being removed from their biological parents' homes to be sent to foster homes; by age 5, this had happened to 17 percent of youths. By age 10, 2 in 3 youths had exhibited acting out problems, and almost one in four had been removed from home.

All youths placed in foster care were younger than 10 at the time of placement, and represented 22.7 percent of the sample. Knowing that, in 2002, among the general population of children entering foster care, 60 percent were younger than 10 years old, (Snyder and Sickmund, 2006), it appears that youths in the general population are more likely to enter foster care by this age than those in this sample (60 percent compared with 22.7 percent). Further, the rate of adopted youths (6.8 percent) in this sample of 88 young offenders is very low when compared with the 18 percent of the general population of exiting foster care youths who were adopted in 2002. Consequently, both observations lead to the conclusion that these research participants are less likely to be accepted in foster homes or to be adopted, probably due to their mental health statuses and to the nature of their personal, psychosocial, psychiatric and familial problems.

In this study, the number of subjects who attempted suicide is 34 (38.6 percent). The rate of suicide attempts among females in this sample (47 percent) is higher than that of males (37 percent). These findings support statistics provided in the Oregon Vital Statistics (Oregon Department of Human Services, 2003) that report that in 2003 78 percent of all reported suicide attempts were committed by girls; this result eon-firms a trend showing that girls have consistently been more likely to attempt suicide than boys. Comparing this study's findings of 39 percent suicide attempts and 57 percent of youths who exhibited suicidal ideations to the 17.6 percent and 16.9 percent of a previous study of 271 male delinquents diagnosed with conduct disorder (Ruchkin et al., 2003), the prevalence of the two phenomena is higher among youths in the current sample. This variation might stem from the composition of this sample, which includes males and females 12 to 17 years old, when the previous includes male participants only ages 14 to 19 years old. Further, all the youths in this sample have mental and behavioral disorders while in the Ruchkin et al. [2003] study, a diagnosis of mental or behavioral disorder was not a criterion for selection. These two studies' findings reveal that the variables "gender" and "mental health diagnosis" should be taken into account when analyzing suicide attempts and suicide ideations among delinquent youths.

Other results of this study show that many of these subjects (42 percent) were inclined to hurt themselves. In general, self-mutilation is viewed as a means to get attention, manipulate others or to request help. Given the multiple diagnoses of both mental and drug use disorders, this high level of self-inflicted harm is not surprising.

Results from this study demonstrate a range of aggressive behaviors, including verbal threats, physical aggression (especially domestic violence), animal cruelty and self-harm. Such aggressiveness places these youths at high risk for future delinquency.

This study's findings also contribute to the understanding of this population's educational/learning deficits. More than 1 in 5 had a provisional diagnosis related to a learning disorder. In the present study, despite the fact that many subjects were provisionally diagnosed with reading, mathematics and disorder of written expression, none of them was given a formal evaluation for dyslexia due to the additional time/expense. Further assessment and evaluation of learning difficulties is warranted for youths involved with the juvenile justice system.

Previous research has documented the overrepresentation of offenders diagnosed with learning disability and mental retardation in juvenile corrections. For example, a national survey of 51 heads of state departments of juvenile and adult correctional systems revealed that the average prevalence rate of youths with disabling conditions was 33.4 percent (Quinn et al., 2005). These findings are supported by the current study's results, which found that 48 percent of youths had low IQ varying from borderline to mild and moderate mental retardation, and that 23 percent of subjects were diagnosed with provisional learning disabilities.

While the depth of information on individual subjects was a major strength of this study and distinguishes it from many previous studies of this population of juvenile offenders with mental and behavioral disorders, several limitations are present. This study was exploratory and thus no causal inferences can be drawn. Further, the small sample size and nonrandom selection of subjects suggests caution in applying the findings to the larger population of violent delinquents with mental/behavioral disorders. Also, secondary data analysis posed limitations because of the ways in which some variables were defined and measured due to the pre-existence of the categories/scores. Nevertheless, the current data contributes to further identification and understanding of this particular population of youths with mental and behavioral disorders whose special needs should to be taken into account during the process of indictment, conviction, incarceration and treatment.

Conclusions and Recommendations

The high degree of pathology found in this sample of delinquents is noteworthy and includes serious acts of violence, sexual offenses, fire-setting, animal cruelty, mental and substance disorders, suicide threats/attempts and extensive histories of legal problems. The contextual background of these youths includes high rates of parental incarceration, parental substance abuse, family instability, compromised intellectual functioning, learning problems, early documentation of behavioral problems (i.e., by age 5) and sexual/physical abuse. Clearly, this population of youths requires an array of interventions to address these pathologies and backgrounds.

Early identification of the above problems is key. The earlier identification and treatment occur, the more likely the treatment will be successful. In this study, one in three youths was identified as having a behavior problem by the age of 5. Research has demonstrated that when such children and their families are given appropriate clinical interventions at this early age, treatment is often successful (Hill, 2003).

While such early identification and intervention are preferable, identification during later stages of development, is also important. When children first encounter the juvenile justice system, attention should be given to their psychosocial needs and statuses. Screening and assessment for mental health should be a required step in the admission process of young offenders on probation and in juvenile court and institutional settings. The outcome of this mental health assessment along with other factors, such as the type and violence level of the offense committed and the cognitive and intellectual potentials of the youths, would provide valuable information toward managing these offenders and making appropriate decisions for possible diversion options.

Caseloads for professionals should reflect the degree of their clients' illnesses; for example, the high degree of disturbance found in the current study's population should be reflected by a lower caseload. Lower caseload adjustments should also be made for this population of violent juvenile offenders with mental and behavioral problems in nonresidential juvenile justice settings such as probation and parole; in residential settings, they should not be assigned to crowded units.

In conclusion, the data in this study suggest high levels of proximal as well as distal risk factors across a number of domains in youths being considered for a juvenile justice diversion program. The scope and intensity of these problems warrant substantial assessment and treatment services to address and treat the dysfunctional behaviors of these youths. Without such services, many of these youths are likely to become adults with severe educational, occupational, emotional and behavioral impairments--making them prime candidates for future and recurrent incarceration.


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Mamadou M. Seck, Ph.D., is an assistant professor in the School of Social Work at Cleveland State University. Mark I. Singer, Ph.D., is the Leonard W. Mayo Professor of Family and Child Welfare at the Mandel School of Applied Social Sciences at Case Western Reserve University. Daniel Flannery, Ph.D., is professor of justice studies and director of the Institute for the Study and Prevention of Violence at Kent State University.
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Author:Seck, Mamadou M.; Singer, Mark I.; Flannery, Daniel
Publication:Corrections Compendium
Date:Mar 22, 2010
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