John F. Chapman

COMPLEX TRAUMA AND AGGRESSION IN SECURE JUVENILE JUSTICE SETTINGS

Youth in secure juvenile justice settings (e.g., detention, incarceration) often have histories of complex trauma: exposure to traumatic stressors including polyvictimization, life-threatening accidents or disasters, and interpersonal losses. Complex trauma adversely affects early childhood biopsychosocial development and attachment bonding, placing the youth at risk for a range of serious problems (e.g., depression, anxiety, oppositional defiance, risk taking, substance abuse) that may lead to reactive aggression. Complex trauma is associated with an extremely problematic combination of persistently diminished adaptive arousal reactions, episodic maladaptive hyperarousal, impaired information processing and impulse control, self-critical and aggression-endorsing cognitive schemas, and peer relationships that model and reinforce disinhibited reactions, maladaptive ways of thinking, and aggressive, antisocial, and delinquent behaviors. This constellation of problems poses significant challenges for management, rehabilitation, and treatment of youth in secure justice settings. Epidemiological and clinical evidence of the prevalence, impact on development and functioning, comorbidity, and adverse outcomes in adolescence of exposure to complex trauma are reviewed. Implications for milieu management, screening, assessment, and treatment of youth who have complex trauma histories and problems with aggression in secure juvenile justice settings are discussed, with directions for future research and program development.

Traumatic Victimization, Posttraumatic Stress Disorder, Suicidal Ideation, and Substance Abuse Risk Among Juvenile Justice-Involved Youth

Psychological trauma and post-traumatic stress disorder (PTSD) are prevalent among youth involved in the juvenile justice system. However, the impact on functioning and risky behavior of different forms of psychological trauma in this population is not known. In a sample of 264 youth (73% boys) ages 10–17 years old admitted within the prior 24–72 hours to pretrial juvenile detention centers, 61% reported a history of psychological trauma. Physical abuse, domestic violence, and traumatic neglect were independently associated with suicide ideation and drug and alcohol abuse risk. Findings suggest that education and treatment models are needed to address the impact of victimization, neglect, loss, and accidental trauma on health risks such as suicidality and substance abuse among juvenile justice-involved youth.

Poly-victimization among juvenile justice-involved youths

OBJECTIVES This study replicates and extends the research literature on poly-victimization with a vulnerable and under-served population, juvenile justice-involved youths. METHODS N=1959, 10-16 year old youths (76% male; 74% youth of color) consecutively newly admitted to juvenile detention facilities completed psychometric measures of trauma history, posttraumatic stress, affect regulation, alcohol/drug use, suicide risk, and somatic complaints. RESULTS Using latent class analysis derived from 19 types of adversity, three unique classes best fit the data. A poly-victim class (49% female, 51% youth of color) accounted for 5% of the sample and reported a mean of 11.4 (SD=1.1) types. A relatively moderate adversity class (31% female, 70% youth of color) accounted for 36% of the sample and reported a mean of 8.9 (SD=0.3) types of adversity and 2.65 (SD=1.1) types of traumatic adversity. A low adversity class (59% of the sample; 17% female, 78% youth of color) reported a mean of 7.4 (SD=0.4) adversity types but only 0.3 (SD=0.45) types of traumatic adversity. The relatively moderate adversity class was comparable to poly-victims in endorsing extensive non-victimization traumatic adversity (e.g., accidental and loss trauma), but poly-victims were distinct from both moderate and low adversity class members in the likelihood of reporting all but one type of traumatic victimization, multiple types of traumatic victimization, and severe emotional and behavioral problems. Girls were at particularly high risk of poly-victimization, and African American and White youths also were at risk for poly-victimization. CONCLUSIONS Although youth involved in the juvenile justice system typically have experienced substantial victimization, a poly-victimized sub-group, especially (but not exclusively) girls, warrants particular scientific, clinical, and rehabilitative attention in order to address the most severe behavioral and mental health problems and risks faced by this vulnerable population.

Risk-needs assessment in juvenile justice: Predictive validity of the SAVRY, racial differences, and the contribution of needs factors.

The authors conducted a prospective study of the predictive validity of the Structured Assessment of Violence Risk in Youth (SAVRY) using a 5-year follow-up period and a sample of 480 male adolescents assessed by juvenile detention personnel. Analyses were conducted to examine differential validity by race-ethnicity, the relative contribution of structured professional judgments of risk level, and the incremental validity of dynamic to static risk factors. Overall, the SAVRY total scores were significantly predictive of any type of reoffending with some variability across racial-ethnic groups. Youths rated as moderate to high risk by evaluators using structured professional judgment had greater odds of rearrest, but these risk ratings did not have incremental validity over numeric scores. Static factors were most strongly predictive of nonviolent rearrest, but dynamic factors (social-contextual) were the most predictive of violent rearrest. Implications for use of risk-needs assessment tools in juvenile justice programs and areas in need of further investigation are discussed.

Violence Risk and Race in a Sample of Youth in Juvenile Detention The Potential to Reduce Disproportionate Minority Confinement

Overrepresentation of minorities and their disproportionate confinement in the U.S. justice system are pernicious, unyielding problems. The authors used the Structured Assessment of Violence Risk in Youth to examine risk and protective factors of 757 juveniles admitted to detention centers. A chi-square analysis revealed that significantly more African American youth were rated low risk for violence compared to White counterparts. African American and Hispanic youth initiated violent behavior earlier and frequently lived in violent, disorganized neighborhoods. However, they had more prosocial involvement, stronger attachments and bonds, and more resilient personality traits. Ideas for targeted release and intervention with minority youth are described.

Relationships Between Suicide Risk, Traumatic Experiences, and Substance Use Among Juvenile Detainees

Youth suicide ideation in juvenile justice settings is a phenomenon with multiple determinants. This article examines relationships among determinants of suicidal ideation utilizing various screening instruments. Consecutive youth admitted to detention in Connecticut (N = 757) completed the Massachusetts Youth Screening Instrument 2 (MAYSI-2), the Suicidal Ideation Questionnaire (SIQ), measures of substance use, and risk and protective factors for violence during intake screening. In bivariate and multivariate analyses (controlling for demographic and MAYSI-2 sub-scale scores), relationships were found between the Traumatic Experiences and Alcohol and Drug Use subscales of the MAYSI-2 and the SIQ. The potential impact of traumatic stress and substance use symptoms in understanding and detecting youths who are at risk for suicide is discussed.

Mental Illness, Violence Risk, and Race in Juvenile Detention: Implications for Disproportionate Minority Contact

Disproportionate minority contact (DMC) is a pervasive problem throughout the juvenile justice system. This article explored whether mental illness may be an explanatory factor in DMC. Data such as measures of violence risk and symptoms of mental illness were taken from intake interviews with 482 detained youth in Connecticut. Results indicated that racial minorities in detention have significantly lower violence risk than Caucasians but are disproportionately represented among detention populations relative to their proportions in the general population. In addition, DMC in these data was not explained by mental illness, seriousness of charges, violence risk, age, or gender. We suggest that mandated efforts to reduce DMC will need to address more than improving behavior or reducing symptoms of mental illness among detained minority youth. Instead, efforts should be focused on reducing the racial disparity evident in decisions made within the juvenile justice system.

Adolescent Attention Deficit Hyperactivity Disorder in the Secure Treatment Setting

This article examines issues related to adolescent and young adult attention deficit hyperactivity disorder (ADHD) in juvenile justice treatment settings. Characteristics of ADHD are first discussed including diagnostic criteria, gender, and prevalence in both community and secure settings. Next, the importance of adolescent ADHD to the juvenile justice system is examined, including risk for psychosocial impairments, antisocial problems, and aggressive behavior while in secure treatment settings and the issue of psychiatric comorbidity in ADHD youths. Recommendations for assessment of the ADHD adolescent are discussed. Evidence-based treatments are next reviewed and suggestions for modifying extant ADHD evaluation and treatment criteria for use with juvenile detainees are presented. Finally, we discuss issues pertaining to ethnicity in adolescent ADHD and how these issues are of importance to the evaluation and treatment of adolescent and young adult ADHD in the secure treatment setting.