Tracy Kempton

Co-occurence of substance abuse with conduct, anxiety, and depression disorders in juvenile delinquents☆

The purpose of the current study was to examine the co-occurrence of substance abuse and three other psychiatric disorders (conduct disorder, depression, anxiety) in an incarcerated juvenile delinquent sample. Diagnostic interviews were utilized to place participants in one of three groups: No substance abuse, alcohol/marijuana abuse, or polysubstance abuse. Frequency of diagnosis and number of symptoms of three psychiatric disorders were then examined. The results indicated that the diagnosis of conduct disorder increased significantly with the occurrence of substance abuse. Also, the number of symptoms for conduct disorder, anxiety, and depression increased with substance abuse. With polysubstance abuse the probability of having more than one of the other psychiatric diagnoses was above 50%. Potential explanations for the findings, focusing on the developmental trajectory for conduct problems and self-medication for internalizing disorders, are discussed.

The role of family stressors and parent relationships on adolescent functioning.

This study examined the association between cumulative family stressors (divorce, interparental conflict, maternal depression) and adolescent functioning as well as the protective role of the parent-adolescent relationship as perceived by the adolescent when family stressors are present. Two hundred and thirty-one adolescents, their mothers, and their social studies teachers served as the subjects. Results indicated that, as family stressors increased, adolescent functioning deteriorated. Furthermore, a positive parent-adolescent relationship as perceived by the adolescent was associated with less deterioration in all areas of functioning. The role of the relationship in protecting the adolescent supported both a stress buffering model and a main effect model.

Adolescent depressed mood and young adult functioning: a longitudinal study.

The present study examined two aspects of depressed mood in adolescence: (1) stability across the adolescent years and (2) ability to predict functioning in young adulthood. Participants included 82 Caucasian individuals (46 females and 36 males) who were assessed one time per year for 4 consecutive years during adolescence (mean age at initial assessment = 13.5 years) and again during young adulthood (mean age = 19). The results indicated that depressed mood, as measured by the Childrens Depression Inventory (CDI), remained relatively stable across at least 3 consecutive years of data collection during adolescence. In addition, adolescent CDI scores predicted young adult functioning in each of four areas: prosocial competence, self-esteem, externalizing problems, and internalizing problems.

Suicide attempts among juvenile delinquents; the contribution of mental health factors

This study examined which, if any, of four variables (depression, hopelessness, conduct problems, substance abuse) differentiated suicide attemptors from nonattemptors among incarcerated juvenile delinquents. Fifty-one male youth served as subjects. The predictor variables were collected by either a standardized interview or an orally administered questionnaire. Youth self-report data regarding suicide attempts were collected. The results indicated that depression served as a predictor of suicide attempts but only in white, not black, youth. Suicide attempts also were reported three times more often in white than black participants. Implication, as well as limitations, of the findings are discussed.

Dimensions of interparental conflict and adolescent functioning

While research has repeatedly demonstrated that interparental conflict is related to poorer child/adolescent functioning in the areas of internalizing and externalizing problems, as well as prosocial and cognitive competence, the particular relevant dimensions of the conflict have yet to be studied. The present study examined the contributions of three different dimensions of conflict to these difficulties in adolescent functioning. Forty-eight mother-father-adolescent triads participated by completing questionnaires regarding the following dimensions of their interparental conflict: frequency, method of handling, and outcome. Assessment of adolescent functioning was obtained independently through teacher-completed measures of internalizing and externalizing problems and prosocial and cognitive functioning. The results of correlational analyses indicated that father-completed measures, particularly the use of verbal and physical aggression to handle conflict, were related to all four measures of adolescent functioning. In contrast, mother-completed measures were not related. Multiple regression analyses were also conducted. For all four measures, either father physical or father verbal aggression entered first and accounted for 17 to 48% of the variance across the four dependent measures. No other indices of conflict individually accounted for a significant portion of the variance beyond that accounted for by fathers verbal or physical aggression. Possible explanations for the relationship between fathers method of handling of conflict and adolescent functioning are discussed.

Social Skills and Depression in Adolescent Substance Abusers

The present study provided an assessment of social skills and depression in adolescent substance abusers hospitalized in an inpatient psychiatric setting. Level of social skill was evaluated using the Adolescent Assertion Expression Scale and the Loneliness Scale. Depression and related problems were examined through administration of the Beck Depression Inventory. Beck Hopelessness Scale, and the Rosenberg Self-Esteem Scale. Comparisons with normative values and clinical cut-offs (by gender) indicated that female adolescent substance abusers were less submissive and more aggressive than normative counterparts; male substance abusers exhibited less assertiveness. In addition, mild to moderate levels of depression were evident in both female and male substance abusers. Further, results of correlational analyses revealed several significant relationships between measures of social skills and depression. Results are discussed in terms of: (a) the need for finer grained analyses of social functioning in adolescent substance abusers, (b) the potential value of skills intervention for a subgroup of these individuals, and (c) the need for longitudinal data to more clearly explicate patterns and sequencing of social (mal)adjustment, affective disorder, and onset of substance abuse in this population.

Juvenile sex offenders: Similar to, or different from, other incarcerated delinquent offenders?

The purpose of the present study was to compare incarcerated juvenile sex offenders to incarcerated youth who committed confrontational but nonsex offenses, and to those youth who committed only nonconfrontational, nonsex offenses. Furthermore, comparisons were made between two subtypes of sex offenders: those youth convicted for rape or sodomy vs those convicted for child molestation. Eighty-three male juvenile delinquents served as participants. Teachers within the correctional facility completed an instrument which allowed the examination of the two areas of interest: externalizing problems and internalizing problems. The results indicated that sex offenders generally, and particularly those who had committed only sex offenses, were perceived as having fewer externalizing and internalizing problems. No differences emerged between the two subtypes of sex offenders. Implications, as well as limitations, of the findings are discussed.

Juvenile delinquency entry and persistence: Do attention problems contribute to conduct problems?

We examined the role of attention deficit hyperactivity disorder (ADHD) in juvenile delinquency. Forty-two incarcerated male delinquents participated. Thirty of these youths met the criterion for conduct disorder (CD), only while 12 met the criterion for CD and ADHD. The results indicated that the latter group were arrested at an earlier age and had more total arrests than those in the former group; however, they did not have more criminal charges against them. The role of intellectual and academic skills in these findings was considered. It appears that ADHD has an important additive influence on the development and persistence of juvenile delinquency. Implications for the behavior therapist are discussed.

Cognitive Distortions and Psychiatric Diagnosis in Dually Diagnosed Adolescents

OBJECTIVE The purpose of this study was to examine the characteristics and patterns of cognitive distortions among psychiatrically hospitalized adolescents. METHOD Measures of cognitive distortions, depression, and hopelessness were administered to 135 adolescents on two psychiatric inpatient units. Subjects were grouped according to their Axis I diagnoses: depression only, conduct disorder only, depression and substance abuse, conduct disorder and substance abuse, all three diagnoses, and none of the three diagnoses. RESULTS Multivariate analyses of covariance indicated that differently diagnosed adolescents exhibited varying levels of cognitive distorting as measured by the Childrens Negative Cognitive Errors Questionnaire (CNCEQ). In particular, adolescents with multiple Axis I diagnoses tended to score highest. On all but one of four CNCEQ subscales, the depression only group evidenced as much cognitive distortion as did the group with multiple diagnoses. However, each diagnostic grouping demonstrated its own somewhat distinct distortions based on CNCEQ subscales. CONCLUSIONS Findings are discussed in terms of the utility of differentiating cognitive styles for subsequent treatment. It is suggested that disparate cognitive interventions could be matched with adolescents displaying particular problems.

Early retention: Are there long-term beneficial effects?

The purpose of this study was to examine whether retention of kindergarten and first-grade children is associated with long-term beneficial effects. Thirty-one children who had been retained were compared to 31 children who had similar grades but had never been retained. The dependent measures were grade point average in the second through fifth grades and four teacher-assessed areas of functioning in the fourth and fifth grade: social competence, cognitive competence, externalizing problems, and internalizing problems. The results indicated that retention was not associated with long-term beneficial effects but rather, especially for White children, appeared to be associated with poorer academic and social functioning. Implications and limitations of the study are discussed.