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JURIDOGENIC HARM AND ADVERSE CHILDHOOD EXPERIENCES.

I. INTRODUCTION

The consequences of trauma can be devastating and long-term. Children, trauma, victimization, and the legal system are complex topics and can become overwhelming when combined. Yet, due to the immense risk, juridogenic harm must be recognized and addressed. Juridogenic harm is "harm that law may generate as a consequence of its operations." (1) Without a clear understanding of developmental psychology and its intersection with the law, there is potential for the legal system to cause significant adverse childhood experiences above and beyond victimization events.

II. TRAUMA

A. WHAT IS TRAUMA?

At its core, trauma is an event that causes physical, emotional, and psychological harm that is associated with a "constellation of negative outcomes in adulthood" and needs to be appropriately classified to allow for evidenced-based treatment. (2) There is a great deal of research on the psychological distress that results from trauma, including effects due to directly experienced trauma, re-traumatization, and re-victimization. When addressing trauma, most first think of post-traumatic stress disorder ("PTSD"), but reactions to trauma are highly individualized. People can experience the same type of traumatic event; however, some will develop PTSD and others will not. Despite this, there are still lasting negative outcomes with trauma experience even if it does not lead to PTSD. (3)

PTSD as a diagnosis captures trauma, but not complex trauma. (4) Complex trauma (i.e. chronic maltreatment or repeated trauma exposures) has "pervasive effects on the development of mind and brain [neurobiological development]." (5) Other trauma-related difficulties include substance abuse, anxiety, shame, and impairment of daily functioning. (6) It can be difficult treating children as they are often treated for anxiety disorders, rather than the underlying trauma, even if they are victims with a clear history of confirmed adverse childhood experience. (7) If the underlying distress is not treated symptoms such as anxiety may continue to manifest. (8)

B. CONSEQUENCES OF TRAUMA

Trauma during childhood leads to a significant increase in the need for correctional and mental health services. Indeed, many individuals in the juvenile criminal justice population have a history of childhood trauma, abuse, and neglect. (9) The Centers for Disease Control and Kaiser Permanente conducted the Adverse Childhood Experiences study with 17,337 participants. (10) In 63.9% of participants, a minimum of one type of adverse childhood experience was reported; however, four or more adverse childhood experiences were reported in 12.5% of participants. (11) Adverse childhood experiences included emotional abuse, physical abuse, sexual abuse, witnessing parental alcohol abuse, mothers being battered, family drug abuse, and exposure to family mental illness that impacted them negatively. (12)

The consequences of childhood trauma can be devastating and long-term. In children, brain development is altered after experiencing trauma resulting in neurocognitive delays. (13) Trauma "interrupts and strains children's cognitive abilities and development," and puts them a significant risk for the development of severe psychiatric problems. (14) The higher the number of adverse childhood experiences, the higher the risk of depression, suicide attempts, alcoholism, domestic violence, and physical illnesses related to stress including cancer, heart disease, diabetes, and stroke. (15) Attempted suicide risk increases two to five times if there is adverse childhood experience in any category. (16) If a mental disorder appears in childhood, it will often persist into adulthood. (17) Given the long lasting impact of trauma in early child development, it is no surprise that this has become a pressing public health issue. According to some research, the effects of childhood trauma may even be one of the key factors associated with early death. (18)

III. JURIDOGENIC HARM

Society operates under the assumption that medicine cures and promotes health without consideration for the harm that can occur as a result of medical error. (19) Yet, medical error accounts for nearly a quarter of patient deaths. (20) Similarly, society also operates under the premise that law is about "extending rights rather than creating wrongs," but it is clear that the system is fallible and does cause harm. (21) Litigation itself can contribute to and maintain psychological trauma. (22)

Harm is a broad, multidimensional term that encompasses trauma. (23) In medicine and psychology, there is an emerging concept called "iatrogenic harm" that specifically addresses harm caused to the client by professionals. For example, the goal of therapy is to increase freedom, (24) but if therapy induces shame and guilt, then harm occurs. (25) At the present time, however, there is limited research on the concept of iatrogenic harm as it applies to the legal system and child trauma victims.

Juridogenic harm is the "legal equivalent of iatrogenic harm." (26) Juridogenic harm is "harm that law may generate as a consequence of its operations." (27) At its core, juridogenic harm results when "legalistic approaches to decision-making" violate what is in the best interest of the patient. (28) There are competing interests, such as the immediate preservation of evidence (i.e., social services photographing marks on a child victim without parental consent or court order in a nonmedical location) and avoiding the creation of an adverse childhood experience. Which should take precedence?

At a minimum, consideration of this issue should take place, rather than marching onwards with the faulty assumption that the resilience of children can get them through another traumatic experience. Resilience is not found in an unlimited amount, particularly when an increase of psychosocial stress factors is present (e.g., emotional stress or abuse within the family, inconsistency in caregivers, or a peer group with negative influence). (29) Without appropriate support and a facilitative environment, vulnerability will overtake resilience. (30) There is a correlation between child-reported traumatic experiences and child-reported onset of psychiatric symptoms. (31)

A. STRIP SEARCHING VICTIMS

Juridogenic harm can occur in various forms. One example is that of strip searching children who are allegedly victims of abuse and neglect in a nonmedical setting. Strip searches are "a serious intrusion upon personal rights" and are "demeaning, dehumanizing, undignified, humiliating, terrifying, unpleasant, embarrassing, [and] repulsive...." (32) "Children are especially susceptible to possible traumas from strip searches," even more so when they are already victims of sexual abuse. (33)

For example, while investigating allegations of abuse and neglect, Colorado currently allows Colorado Department of Human Services (CDHS) employees to photograph the presence of marks or no marks on any private area of a child's body. This is permitted without much limitation, not even requiring parental notification. (34) There was a recent attempt in Colorado to change this. House Bill 16-1389 was introduced to clarify which parts of the child's body may be photographed and by whom. (35) Specific language allowed for photographs of areas "visible in plain sight," but for photographs of "a private area of a child," clothing was to be removed only if there was consent, if a court order was issued for the child to be examined by a medical professional, or where a photograph was necessary in a medical emergency for treatment or to prevent serious bodily injury to the child. (36)

This bill failed to pass. Testimony against this bill included an attorney from the Colorado Office of the Child's Representative stating that, while photographing private areas can be traumatic to a child, a reasoned approach is "balancing parent's rights, balancing children's rights but also balancing the community's rights in... preventing child abuse." (37) Additional testimony against House Bill 16-1389 included a representative from the Colorado Association of Chiefs of Police, who stated that "[t]he necessity for a court order would add time and... unnecessary delay in the assessment of... the injuries...." (38) In response to the question of whether "photographs taken of [children's] most intimate parts... without consent or without a court order is a violation of the 4th Amendment," the representative responded "no." (39) Nudity in a context unfamiliar to a child may be perceived by a child as a sexual boundary intrusion (e.g., insisting that a teenager who is an alleged victim of child abuse expose her bare buttocks for a photograph in the garage versus exposure during a medical exam). (40) Such actions constitute adverse childhood experiences that are "harmful behaviors directed toward the child, such as emotional, physical, and sexual abuse." (41)

Strip searches are traumatic and result in a loss of autonomy, (42) or the ability to act independently and demonstrate control over one's environment. (43) The development of autonomy is a crucial stage in early adolescence (44) that is positively correlated with psychological maturity. (45) Part of developing autonomy is the ability to resist peer pressure and pressure from adults, (46) an increased subjective feeling of self-reliance, (47) and ability to have increased independence in decision making/self-governance. (48) The ability to resist or say no during a strip search protects autonomy for adults, but children are not given this option. Yet, depending on their age, children are able to consent or refuse certain medical procedures, as well as having control over parental access to some medical records (e.g., drug and alcohol treatment records). (49)

B. INTERVIEWS AND TESTIMONY

The creation of false memories in psychological treatment is harmful. In psychology, causing harm includes worsening symptoms and the appearance of new symptoms. (50) To combat harm added by the profession, psychologists are charged with the ethical mandate to "take reasonable steps to avoid harming their clients/patients... and to minimize harm where it is foreseeable and unavoidable." (51) There are specific protocols in place to minimize trauma that occurs during a child's interview and to maximize the quality of information obtained while minimizing contamination, which has the potential to lead to false memories. (52) Most memory errors are source monitoring failures (53) or source confusion. (54) Regretfully, false memories are more persistent than true memories in both adults and children. (55) If children are forced to answer a question that they do not have the answer to or do not understand regarding a witnessed event, then there is a risk for confabulation. (56) That confabulation carries over into later recall of the witnessed event because the child believes the false information is now true. (57) The more often a child is asked the same or similar questions, the greater the likelihood that there is an increase reliance on gist memory, which is connecting meaning across multiple events. (58) The creation of false memories can be an adverse childhood experience since false memories in this context are likely negative, such as false memory of victimization. (59)

Additionally, the retelling of a traumatic incident multiple times is harmful. (60) It is harmful because there is a heightened risk for posttraumatic stress disorder symptoms. (61) If there is pressure, for instance, to tell your story or else the person that did it to you will get away, then conduct problems are exacerbated. (62) When action by a professional results in a significant increased risk of symptoms, there is iatrogenic or juridogenic harm. (63)

IV. TRAUMA INFORMED JUSTICE

The above sections addressing the harm caused by strip searches and the creation of false memories serve to highlight the necessity for a system that takes developmental psychology and the impact of added trauma into consideration before acting so that additional harm to children is avoided if at all possible. Can justice really be served when a child victim is further victimized by the system that is assumed to provide protection and justice? Awareness of immediate goals, such as evidence preservation, must be balanced by the knowledge of consequences to minimize juridogenic harm. For example, the emotional resiliency and cognitive maturity of child victims should be considered before requiring testimony in a criminal law matter to accurately assess the ability of the child to testify without causing additional harm (64) and before ordering any contact with family in matters where there has been abuse and neglect since trauma reminders may trigger psychological distress. (65)

Regarding juvenile offenders, if there is placement in a high stress or high risk environment, like juvenile detention centers where there is exposure to other peers with histories of aggression and violence, there is aggravation of trauma symptoms, behavioral impulsivity, and cognitive impulsivity, all of which increase the risk of re-offense. (66) These are just a few examples of where juridogenic harm can be minimized or entirely avoided. There is a need for change to avoid committing further harm to an already vulnerable child.

V. CONCLUSION

Let us be aware of the consequences that our actions have upon children who are in contact with the legal system. With broader awareness, we can decrease the occurrences of juridogenic harm (an adverse childhood experience) and lessen the chances of the long-term consequences of added trauma and reduce the chance that a child victim will later enter the system as an offender.

AUTUMN R. ASCANO ([dagger]) & JOSEPH A. MEADER ([double dagger])

([dagger]) J.D., University of South Dakota School of Law, 2007. M.S. Clinical Psychology, Capella University, 2017. B.A. Psychology, Minnesota State University Moorhead, 2004. Thank you to Theresa Sidebotham of Telios Law for providing access to the Hearing on HB16-1389 transcripts. See Safety Procedures Photos as Evidence of Child Abuse, Hearing on HB16-1389 Before the H. Comm. on State, Veterans, & Military Affairs, 70th Gen. Assemb., 2d Reg. Sess. 33:24 (Colo. 2016). She also generously provided access to court filings from John Doe v Joanna McAfee. See Brief in Support of County Defendant's Motion to Dismiss Third Amended Complaint Pursuant to Fed. R. Civ. P. 12(b)(1) and 12(b)(6), John Doe v. Joanna McAfee, (D. Colo 2013) (Civil Action No. 13-cv-01287). Thank you to Joseph Meader for his assistance with this article.

([double dagger]) J.D., University of South Dakota School of Law, 2017; B.A., Government & International Affairs, Communication Studies, Augustana College, 2013. Thank you to Autumn Ascano for letting me join on this article to shed light on such a necessary topic.

(1.) CAROL SMART, SOCIOLOGY OF LAW AND CRIME: FEMINISM AND THE POWER OF LAW 12 (2d ed. 2002).

(2.) Masuma Rahim, Developmental trauma disorder: An attachment-based perspective, 19 CLINICAL CHILD PSYCHOL. & PSYCHIATRY 548, 550 (2014) (citations omitted).

(3.) See generally Vincent J. Felitti et al., Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study, 14 AM. J. PREVENTIVE MED. 245 (1998) (concluding that childhood exposures to trauma strongly and cumulatively impair adult social, emotional, and cognitive health, increase the likelihood of adopting health-risk behaviors, and lead to early death).

(4.) See generally BESSEL A. VAN DER KOLK, ALEXANDER C. MCFARLANE & LARS WEISAETH, TRAUMATIC STRESS: THE EFFECTS OF OVERWHELMING EXPERIENCE ON MIND, BODY, AND SOCIETY (2006). There are a psychological problems that trauma survivors experience that are not included in the DSM diagnosis of PTSD (e.g., self-destructive behavior). Id.

(5.) Alessandra Simonelli, Posttraumatic Stress Disorder in Early Childhood: Classification and Diagnostic Issues, 4 EUR. J. OF PSYCHOTRAUMATOLOGY 1, 7 (2013).

(6.) NAT'L COLLABORATING CTR. FOR MENTAL HEALTH, POST-TRAUMATIC STRESS DISORDER: THE MANAGEMENT OF PTSD IN ADULTS AND CHILDREN IN PRIMARY AND SECONDARY CARE 6-7 (2005), https://www.nice.org.uk/guidance/cg26/evidence/full-guideline-including-appendices-113-pdf-193442221.

(7.) Rahim, supra note 2, at 550.

(8.) James C. Ballenger et al., Consensus Statement on Generalized Anxiety Disorder From the International Consensus Group on Depression and Anxiety, 62 J. CLINICAL PSYCHIATRY 53, 54 (2001). Spontaneous remission rate for generalized anxiety disorder is approximately 20% to 25%. Id. The spontaneous remission rate for major depressive disorder is 32%. Michael Posternak & Mark Zimmerman, Short-Term Spontaneous Improvement Rates in Depressed Outpatients, 188 J. OF NERVOUS MENTAL DISEASE 799, 803 (2000).

(9.) Linda A. Teplin et al., Psychiatric Disorders in Youth in Juvenile Detention, 59 ARCHIVES GEN. PSYCHIATRY 1133, 1136 (2002) (citations omitted).

(10.) Maxia Dong et al., Insights Into Causal Pathways for Ischemic Heart Disease: Adverse Childhood Experiences Study, 110 CIRCULATION 1761, 1761 (2004).

(11.) Id. at 1763.

(12.) Id.

(13.) Katie A. McLaughlin, Margaret A. Sheridan & Hilary K. Lambert, Childhood Adversity and Neural Development: Deprivation and Threat as Distinct Dimensions of Early Experience, Al NEUROSCIENCE & BIOBEHAVIORAL REV. 578, 583 (2014).

(14.) Karen Zilberstein et al., Neurocognitive Considerations in the Treatment of Attachment and Complex Trauma in Children, 19 CLINICAL CHILD PSYCHOL. & PSYCHIATRY 336, 337 (2014); Arthur Becker-Weidman, Treatment for Children with Trauma-Attachment Disorders: Dyadic Developmental Psychotherapy, 23 CHILD & ADOLESCENT SOC. WORK J. 147, 148 (2006) (citations omitted).

(15.) Felitti et al., supra note 3, at 249-50; Dong et al., supra note 10, at 1761.

(16.) Shanta R. Dube et al., Childhood Abuse, Household Dysfunction, and the Risk of Attempted Suicide Throughout the Life Span: Findings From the Adverse Childhood Experiences Study, 286 J. AM. MED. ASS'N 3089, 3093 tbl.2 (2001). Adverse childhood experience categories include "emotional abuse," "physical abuse," "sexual abuse," "battered mother," "substance abuse in the home," "mentally ill household member," "parental separation/divorce," and "incarcerated family member." Id.

(17.) M. Lambert et al., Mental Health of Children, Adolescents and Young Adults--Part 1: Prevalence, Illness Persistence, Adversities, Service Use, Treatment Delay and Consequences, 81 FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 614, 615 (2013).

(18.) See William H. Foege, Commentary, Adverse Childhood Experiences: A Public Health Perspective, 14 AM. J. PREVENTIVE MED. 354, 354-355 (1998) (pointing to the Adverse Childhood Experiences Study as research indicating that early death and "prolonged, even lifelong health problems associated with... early trauma").

(19.) See SMART, supra note 1, at 12 ("Just as medicine is seen as curative rather than iatrogenic, so law is seen as extending rights rather than creating wrongs.").

(20.) Rodney A. Hayward & Timothy P. Hofer, Estimating Hospital Deaths Due to Medical Error: Preventability Is in the Eye of the Reviewer, 286 J. AM. MED. ASS'N 415, 417 (2001). Similar to previous studies, the 383 reviews of 111 patient deaths indicated that 22.7% of the deaths "were rated as having at least uncertain or possible preventability...." Id.

(21.) SMART, supra note 1, at 12; see also D. Michael Risinger, Innocents Convicted: An Empirically Justified Factual Wrongful Conviction Rate, 97 J. CRIM. L. & CRIMINOLOGY 761, 762 (2007) (disagreeing with United States Supreme Court Justice Antonin Scalia and Joshua Marquis' determination that only twenty-seven of every 100,000 criminal felony convictions are factually erroneous). Risinger, Professor of Law at Seton Hall University School of Law, determined that the more accurate rate of wrongful convictions for capital rape-murders in the 1980s was 3.3-5%, showing that there was harm caused and that harm was irreversible. Id. at 761, 780.

(22.) See generally J.A. Call, Liability for Psychological Injury: History of the Concept, in PSYCHOLOGICAL INJURIES AT TRIAL 40-64 (I.Z. Schultz & D.O. Brady eds., 2003).

(23.) See generally Scott O. Lilienfeld, Psychological Treatments That Cause Harm, 2 PERSP. ON PSYCHOL. SCI. 53 (2007) (discussing potential harmful treatments ("PHTs") in psychotherapy).

(24.) Richard M. Ryan et al., Motivation and Autonomy in Counseling, Psychotherapy, and Behavior Change: A Look at Theory and Practice, 39 THE COUNSELING PSYCHOLOGIST 193, 225 (2011).

(25.) See generally Joseph S. Weiner & Jesse Roth, Avoiding Iatrogenic Harm to Patient and Family while Discussing Goals of Care Near the End of Life, 9 J. PALLIATIVE MED. 451 (2006) (purporting that, in psychology and medicine, clients experience iatrogenic harm through ineffective or wrong interventions due to poor communication).

(26.) William Obomanu & Harry G. Kennedy, Opinion & Debate, 'Juridogenic' Harm: Statutory Principles for the New Mental Health Tribunals, 25 PSYCHIATRIC BULL. 331, 333 (2001).

(27.) SMART, supra note 1, at 12.

(28.) Obomanu & Kennedy, supra note 26, at 331.

(29.) Norman Garmezy, Special Report, STRESS, COMPETENCE, AND DEVELOPMENT: Continuities in the Study of Schizophrenic Adults, Children Vulnerable to Psychopathology, and the Search for Stress-Resistant Children, 57 AM. J. ORTHOPSYCHIATRY 159, 165-66, 169-70 (1987); Seija Sandberg et al., Do High-threat Life Events Really Provoke the Onset of Psychiatric Disorder in Children?, 42 J. OF CHILD PSYCHOL. & PSYCHIATRY 523, 524 (2001).

(30.) Robert B. Brooks, CHILDREN AT RISK: Fostering Resilience and Hope, 64 AM. J. ORTHOPSYCHIATRY 545, 547 (1994).

(31.) See Sandberg et al., supra note 29, at 527 tbl.3 (comparing "weekly rates of severe events" to child-reported onset of psychiatric symptoms and impairment).

(32.) Justice v. City of Peachtree City, 961 F.2d 188, 192 (11th Cir. 1992); Mary Beth G. v. City of Chicago, 723 F.2d 1263, 1272 (7th Cir. 1983) (quoting Tinetti v. Wittke, 479 F. Supp. 486, 491 (E.D. Wis. 1979)).

(33.) N.G. ex rel. S.C. v. Connecticut, 382 F.3d 225, 239 (2d Cir. 2004) (Sotomayor, J., dissenting) (quoting Eddings v. Oklahoma, 455 U.S. 104, 115 (1982)).

(34.) Safety Procedures Photos as Evidence of Child Abuse, Hearing on HB16-1389 Before the H. Comm. on State, Veterans, & Military Affairs, 70th Gen. Assemb., 2d Reg. Sess. 33:24 (Colo. 2016) (statement of Theresa Sidebotham, Attorney, Telios Law), http://www.leg.state.co.us/clics/csLFrontPages.nsf/Audio?OpenPage.

(35.) H.B. 16-1389, 70th Gen. Assemb., 2d Reg. Sess. (Colo. 2016).

(36.) Id.

(37.) Safety Procedures Photos as Evidence of Child Abuse, Hearing on HB16-1389 Before the H.Comm. on State, Veterans, & Military Affairs, 70th Gen. Assemb., 2d Reg. Sess. 58:08 (statement of Dorothy Macais, Legislative Liason and Staff Attorney, Colorado Office of the Child's Representative), http://www.leg.state.co.us/clics/cslFrontPages.nsf/Audio?OpenPage.

(38.) Safety Procedures Photos as Evidence of Child Abuse, Hearing on HB16-1389 Before the H.Comm. on State, Veterans, & Military Affairs, 70th Gen. Assemb., 2d Reg. Sess. 1:13:25 (statement of Ron Sloane, Colorado Association of Chiefs of Police), http://www.leg.state.co.us/clics/cslFrontPages.nsf/Audio?OpenPage.

(39.) Id. at 1:18:09.

(40.) Jesse A. Raley, Etiology of Exhibitionism in Adolescence: A Case Example of Countershame Theory, 1 ADOLESCENT PSYCHIATRY 179, 181 (2011). Forced exhibitionism may include nude photography, particularly if there is no consent. Id.

(41.) Derek C. Ford et al., Examination of the Factorial Structure of Adverse Childhood Experiences and Recommendations for Three Subscale Scores, 4 PSYCHOL. OF VIOLENCE 432, 433 (2014).

(42.) Mary Beth G. v. City of Chicago, 723 F.2d 1263, 1275 (7th Cir. 1983).

(43.) Bonnie Benard, Fostering Resilience in Children, ERIC DIGEST, 1-2 (1995), http://files.eric.ed.gov/fulltext/ED386327.pdf.

(44.) See Laurence Steinberg & Susan B. Silverberg, The Vicissitudes of Autonomy in Early Adolescence, 57 CHILD DEV. 841, 841 (1986) (discussing the findings of a study concerning three aspects of adolescent autonomy).

(45.) Marc J. Noom et al., Autonomy, Attachment and Psychosocial Adjustment During Adolescence: A Double-Edged Sword?, 22 J. ADOLESCENCE 771, 772 (1999).

(46.) Thomas J. Berndt, Developmental Changes in Conformity to Peers and Parents, 15 DEVELOPMENTAL PSYCHOL., 608, 614 (1979).

(47.) ELIZABETH DOUVAN & JOSEPH ADELSON, THE ADOLESCENT EXPERIENCE 169 (1966).

(48.) Ellen Greenburger, Defining Psychosocial Maturity in Adolescence, in 3 ADOLESCENT BEHAVIOR DISORDERS: FOUNDATIONS AND CONTEMPORARY CONCERNS 6-7 (Paul Karoly & John J. Steffen eds., 1984).

(49.) See generally Carol Sanger, Decisional Dignity: Teenage Abortion, Bypass Hearings, and the Misuse of Law, 18 COLUM. J. GENDER & L. 409 (2009) (noting judicial refusal to release medical records in relation to minors who request a judicial bypass).

(50.) See generally Charles Boisvert, Negative Effects in Psychotherapy: Research Findings and Clinical Implications, 15 DIRECTIONS CLINICAL COUNSELING PSYCHOL. 37 (2003).

(51.) AM. PSYCHOL. ASS'N, ETHICAL PRINCIPLES OF PSYCHOLOGISTS AND CODE OF CONDUCT 6 (2010), http://www.apa.org/ethics/code/principles.pdf.

(52.) JOHN YUILLE, THE STEPWISE INTERVIEW: A PROTOCOL FOR INTERVIEWING CHILDREN 1 (2002), http://redengine.lawsociety.sk.ca/inmagicgenie/documentfolder/ac2062.pdf.

(53.) Marcia K. Johnson, Source Monitoring and Memory Distortion, 352 PHIL. TRANSACTIONS ROYAL Soc'Y LAND B. 1733, 1734(1997).

(54.) Robert F. Belli & Elizabeth F. Loftus, Recovered Memories of Childhood Abuse: A Source Monitoring Perspective, in DISSOCIATION: CLINICAL AND THEORETICAL PERSPECTIVES 415, 433 (Steven Jay Lynn & Judith W. Rhue, eds., 1994).

(55.) C.J. Brainerd & V.F. Reyna, Fuzzy-Trace Theory and False Memory, 11 CURRENT DIRECTIONS PSYCHOL. SCI. 164, 167 (2002).

(56.) Jennifer K. Ackil & Maria S. Zaragoza, Memorial Consequences of Forced Confabulation: Age Differences in Susceptibility to False Memories, 34 DEVELOPMENTAL PSYCHOL. 1358, 1358 (1998).

(57.) Id. at 1367-68.

(58.) Brainerd, supra note 55, at 167.

(59.) Michael D. Kopelman, Varieties of False Memory, 16 COGNITIVE NEUROPSYCHOLOGY 197, 199-200 (1999).

(60.) Lilienfeld, supra note 23, at 59-60.

(61.) Id.

(62.) See id. (discussing various psychotherapy techniques that can have harmful effects on patients).

(63.) Id.; see generally Obomanu & Kennedy, supra note 26 (advocating that the legal community respect therapeutic relationships between clients and their physicians, not exacerbating iatrogenic harm in conducting legal duties).

(64.) Stressful events are an additional burden on the limited resources of resiliency and without resiliency the chances of harm occurring increase. See generally Brooks, supra note 30 at 549 (discussing methods of building emotional resiliency in children).

(65.) See Judith A. Cohen & Anthony P. Mannarino, Trauma-Focused Cognitive Behavioral Therapy for Children and Parents, 13 CHILD & ADOLESCENT MENTAL HEALTH 158, 159 (2008) (showing exposure to trauma reminders (e.g., traumatic person, event, location) increases psychological distress and the possibility for cognitive flashbacks). Psychological distress is caused by traumatic events. See generally Rahim, supra note 2 (explaining the role of traumatic events developing into a unique, long-term psychological distress).

(66.) Robert Prentky et al., An Actuarial Procedure for Assessing Risk with Juvenile Sex Offenders, 12 SEXUAL ABUSE: J. RES. & TREATMENT 71-93 (2000); Michael J. Miner et al., Factors Associated with Recidivism in Juveniles: An Analysis of Serious Juvenile Sex Offenders, 38 J. RES. IN CRIME AND DELINQ., 421-36 (2002); Cindy C. Cottle et al., The Prediction of Criminal Recidivism in Juveniles: A Meta-Analysis, 28 CRIM. JUST. & BEHAV. 367, 386-90 (2001); Gail A. Wasserman & Larkin S. McReynolds, Contributions to Traumatic Exposure and Posttraumatic Stress Disorder in Juvenile Justice Youths, 24 J. TRAUMATIC STRESS 422, 422 (2011); Linda L. Dahlberg, Youth Violence in the United States: Major Trends, Risk Factors, and Prevention Approaches, 14 AM. J. PREVENTATIVE MED. 259, 261 (May 1998); Carly B. Dierkhising et al., Trauma Histories Among Justice-Involved Youth: Findings from the National Child Traumatic Stress Network, 4 EUR. J. PSYCHOTRAUMATOLOGY 20, 274 (2013).
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