Early development of local data dashboards to depict the substance use care cascade for youth involved in the legal system: qualitative findings from end users.

INTRODUCTION: Rates of substance use are high among youth involved in the legal system (YILS); however, YILS are less likely to initiate and complete substance use treatment compared to their non legally-involved peers. There are multiple steps involved in connecting youth to needed services, from screening and referral within the juvenile legal system to treatment initiation and completion within the behavioral health system. Understanding potential gaps in the care continuum requires data and decision-making from these two systems. The current study reports on the development of data dashboards that integrate these systems' data to help guide decisions to improve substance use screening and treatment for YILS, focusing on end-user feedback regarding dashboard utility. METHODS: Three focus groups were conducted with n = 21 end-users from juvenile legal systems and community mental health centers in front-line positions and in decision-making roles across 8 counties to gather feedback on an early version of the data dashboards; dashboards were then modified based on feedback. RESULTS: Qualitative analysis revealed topics related to (1) important aesthetic features of the dashboard, (2) user features such as filtering options and benchmarking to compare local data with other counties, and (3) the centrality of consistent terminology for data dashboard elements. Results also revealed the use of dashboards to facilitate collaboration between legal and behavioral health systems. CONCLUSIONS: Feedback from end-users highlight important design elements and dashboard utility as well as the challenges of working with cross-system and cross-jurisdiction data.

Childhood maltreatment, shame, and self-esteem: an exploratory analysis of influencing factors on criminal behavior in juvenile female offenders.

OBJECTIVE: This study aimed to investigate the relationships between childhood maltreatment, shame, and self-esteem among juvenile female offenders and to explore the potential influencing factors on their criminal behavior. METHODS: Using a stratified cluster sampling method, 1,227 juvenile female offenders from 11 provinces in China were surveyed using the Childhood Trauma Questionnaire (CTQ), Self-Esteem Scale (SES), and a self-developed Shame Questionnaire for Juvenile Offenders. Data were analyzed using descriptive statistics, correlation analysis, chi-square tests, t-tests, and structural equation modeling with mediation analysis. RESULTS: (1) Childhood maltreatment have a significant potential influencing factors on criminal behavior; (2) Childhood maltreatment was positively correlated with self-esteem(ß = 0.351, p < 0.001); (3) shame (ß = 0.042, p < 0.001) mediate the relationship between Childhood maltreatment and self-esteem (childhood maltreatment → shame → self-esteem (95% Cl: 0.033, 0.052)). CONCLUSION: This study demonstrates that childhood maltreatment is a significant predictor of criminal behavior among juvenile female offenders. childhood maltreatment can directly influence of self-esteem, which can also affect juvenile female offenders'self-esteem indirectly through shame. The findings suggest that shame are important variables that mediate the effect of the juvenile female offenders'childhood maltreatment on their self-esteem.

Alcohol Use and Moffitt's Maturity Gap Thesis for Adolescent Offending: An Evolutionary Perspective and Analysis.

While a wealth of research has focused on testing several arguments from Moffitt's developmental taxonomy of antisocial behavior-mainly the presence of life-course-persistent vs. adolescence-limited offending and predictors of each trajectory-much less attention has been devoted to examining how evolutionarily adaptive lifestyle factors common during adolescence may condition the relationship between the maturity gap and delinquent offending. One factor that may play a role during this period of development is alcohol use, as many adolescents begin to experiment with consuming alcohol in varying degrees in social settings to model adult-like behaviors. Yet presently much is unknown about the role of alcohol use on the association between the maturity gap and delinquency. The current study aims to address this void in the literature by analyzing data from a U.S. sample of adolescent males (N = 1,276) to assess whether alcohol use moderates the relationship between the maturity gap and delinquent behavior. Findings suggest that the maturity gap is associated with delinquent behavior and that the association becomes weaker at higher levels of alcohol use. The implications of these findings for Moffitt's maturity gap thesis and male offending from an evolutionary perspective are discussed.

Health Service Utilization in Adolescents Following a First Arrest: The Role of Antisocial Behavior, Callous-Unemotional Traits, and Juvenile Justice System Processing.

Previous research indicates that youth exhibiting antisocial behavior are at risk for utilizing a disproportionate amount of health services compared to youth without these problems. The present study investigates whether being processed by the juvenile justice system and showing callous-unemotional (CU) traits independently predict health service utilization (medical and mental health service use and out-of-home placement) over and above the severity of antisocial behavior across adolescence. A total of 766 participants who had been arrested for the first time in adolescence provided data at ten appointments over a period of seven years. Results showed that self-reported antisocial behavior at the time of arrest predicted increased use of most health service use types over the next seven years (i.e. medicine prescriptions, tests for sexually transmitted infections, mental health service appointments, and out-of-home placements). All except prescription medication use remained significant when controlling for justice system processing and CU traits. Further, justice system processing added significantly to the prediction of medical service appointments. Whereas CU traits were associated with mental health service appointments and out-of-home placements, these did not remain significant when controlling for severity of antisocial behavior. These findings are consistent with prior research documenting the health care costs of antisocial behavior.

Social Bonding, Risky Lifestyle, and Polyvictimization Among a Sample of Chinese Adolescents.

Polyvictimization has received substantial scholarly attention globally since it has been put forward two decades ago. However, the current lack of understanding of the causes of polyvictimization hinders the design of intervention programs. This study aims to integrate social bonding theory and lifestyle-routine activity theory to understand the etiology of polyvictimization in the Chinese context. Our results suggest that social bonding exerted not only a direct effect on polyvictimization (ß = -.030, p < .001) but also an indirect effect through delinquency and association with delinquent peers. Surprisingly, we found that the pathways linking social bonding and polyvictimization do not differ across genders. Implications for practice and theories are discussed.

Childhood maltreatment and psychopathy in Chinese juvenile offenders: person-centered perspective.

BACKGROUND: Childhood maltreatment stands as a salient risk factor in the etiology of juvenile delinquency, with a profound impact on the behavioral trajectories of young offenders. However, there is limited research on latent profile analysis to explore distinctive patterns of childhood maltreatment in Chinese juvenile offenders. Consequently, there is a lack of understanding regarding the associations between maltreatment profiles and relevant variables in this context. The present study aimed to explore meaningful subgroups of childhood maltreatment in juvenile offenders, and we further examined the associations between subgroups and multiple outcomes especially psychopathy. METHODS: The data was obtained from a sample of Chinese juvenile offenders (N = 625, M age = 17.22, SD = 1.23). This study employed a latent profile analysis (LPA) based on factor scores of the Childhood Trauma Questionnaire-Short Form to identify the subgroups and examined the differences across subgroups using outcomes variables including psychopathy, callous-unemotional traits, aggression and anxiety. This study includes three self-report measures to evaluate psychopathy, with due regard for the nuanced considerations on the factor structure inherent in the conceptualization of psychopathy. RESULTS: Two subgroups were identified, including the non-maltreatment subgroup (80.2%) and the maltreatment subgroup (19.8%). Maltreatment subgroup was characterized by a greater level of all types of maltreatment with particularly higher of emotion neglect. Besides, we found that maltreatment subgroup showed a significantly higher level of psychopathy across multiple self-report measures, and greater callous-unemotional traits, lack of empathy, aggression and anxiety. We found two subgroups of child maltreatment in Chinese juvenile offenders. CONCLUSIONS: These findings may provide a further understanding of childhood maltreatment and the clinical intervention on psychopathy in the early period.

A Systematic Review of Multisystemic Therapy in Adolescent Sex Offenders.

Multisystemic therapy (MST) is an intense, family-focused, community-based treatment designed for youth with criminal behaviors. Literature on its usefulness among juvenile sexual offenders (JSOs) remains limited. We conducted a systematic review of published studies assessing effectiveness of MST among JSOs. A comprehensive search of published studies, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, was undertaken using multiple databases. Search terms included "multisystemic therapy" or "multisystemic family therapy." A total of 542 articles were obtained on initial search. After excluding duplicates, 297 articles were included in further analysis that yielded 48 articles for full-text analysis. Six randomized controlled trials of MST, comprising 231 juvenile sex-offenders, were assessed for final review. MST performed favorably relative to alternative treatments among juvenile sex offenders while also demonstrating lasting treatment effect on sustained follow-up.

Interpersonal Violence, Racial Discrimination, and Mental Health Symptoms Among Adolescents of Color in the Juvenile-Justice System.

The current study examined how interpersonal racial discrimination experiences operate together with other forms of interpersonal violence to contribute to mental health symptoms among justice-involved adolescents of color. Participants were 118 justice-involved adolescents of color aged 14 to 17 (M = 15.77, SD = 1.08; 52.5% male; 77.1% Black/African American) and their mothers. At baseline, adolescents reported on experiences of interpersonal racial discrimination, harsh parenting, teen dating violence, and exposure to interparental physical intimate partner violence. At baseline and the 3-month follow-up assessment, adolescents reported on trauma symptoms, and adolescents and their mothers reported on the adolescents' externalizing and internalizing symptoms. Multivariate multilevel modeling results indicated that interpersonal racial discrimination experiences contributed additively to adolescent mental health symptoms at both the baseline and 3-month follow-up assessments, after accounting for exposure to other forms of interpersonal violence. The current findings highlight the importance of considering adolescents' experiences of interpersonal racial discrimination, together with other forms of interpersonal violence, in work focused on understanding the mental health symptoms of justice-involved adolescents of color.

Randomized controlled internal pilot trial of a diversion programme for adolescents in police custody who possess illicit substances.

BACKGROUND: Adolescents involved in criminal proceedings are significantly more likely to re-offend than a similar population diverted away from criminal justice. Adolescents who use substances and offend are at higher risk of experiencing negative social, psychological and physical problems that often persist into adulthood. There is some evidence that brief interventions combined with appropriate psychoeducation may be effective in reducing adolescent substance use. METHODS: Prospective two-armed, individually randomized internal pilot randomized controlled trial (RCT) with follow-up at 6 months. Young people across three police forces-Kent, Cornwall and Sefton-arrested in possession of class B or C illicit substances were randomly allocated to receive the ReFrame intervention or business as usual. In total, 102 participants were eligible of whom 76 consented and 73 were followed up at 6 months. Outcomes addressed offending behaviour, frequency of substance use, wellbeing and mental health. The study was conducted between February and December 2022. RESULTS: All progression criteria were met, 80% of those eligible consented, 96% adhered to their allocated treatment and 88% were followed up at the primary endpoint. CONCLUSIONS: The feasibility of conducting the pilot trial was a success and it will now proceed to a definitive RCT.

Neuropsychological profiles of adolescents sentenced to detention in Western Australia with and without prenatal alcohol exposure.

BACKGROUND/AIMS: Youth with prenatal alcohol exposure (PAE) are under-recognised in the justice system, warranting improved identification. This study aimed to compare neuropsychological profiles of adolescents, with and without PAE and identify neuropsychological tasks predictive of PAE-group membership. It was hypothesised that participants with PAE would score significantly lower on neuropsychological tests. METHODS: Participants included 85 young people sentenced to detention (mean 15.7 years, 78 males), 46 with PAE. A one-way-multivariate analysis of variance tested differences in neuropsychological functioning between PAE/No-PAE groups, while logistic regression determined tests predictive of PAE. RESULTS: No statistically significant difference in test scores emerged between groups, and regression was not indicative of any models predictive of PAE-group membership. Neuropsychological profiles were characterised by both strengths and weaknesses, with lower verbal and mathematical skills. CONCLUSION(S): While no statistically significant differences were found between the groups, the results provided a unique insight into the neurocognitive profile of Australian youth in detention. Routine screening assessments were recommended for young people sentenced to detention.

Co-Occurring Alcohol Misuse and Criminal Offending in Adolescence: Is It a Matter of Similarity, Severity, or Accumulation of Risk Factors?

OBJECTIVE: Alcohol misuse and criminal offending often co-occur, and although previous studies indicate an overlap in risk factors, this evidence originates from studies focusing on either alcohol misuse or criminal offending. Co-occurrence might also stem from the severity or accumulation of risk factors. The aim of the following study was to examine whether risk factors for developing co-occurring alcohol misuse and criminal offending in adolescence are similar or unique, and to examine whether risk factors are more severe or accumulative compared with alcohol misuse only and criminal offending only. METHOD: Data were used from the prospective longitudinal project Futura01, consisting of 4,013 randomly selected adolescents in Sweden (males: n = 1,798). Outcomes and a wide variety of risk factors were measured by self-report at two time points. Logistic regression analysis was carried out on groups of (a) no behavior (reference), (b) alcohol misuse only, (c) criminal offending only, and (d) co-occurring behaviors. RESULTS: The findings indicated that similar factors predicted co-occurring behaviors for alcohol misuse only and criminal offending only. Regarding severity, only more severe sensation seeking was associated with co-occurring behaviors compared with alcohol misuse and criminal offending only. Instead, an accumulation of risks (i.e., more risk factors present) increased the probability of co-occurring behaviors compared with alcohol misuse only and criminal offending only. CONCLUSIONS: The results indicated that the risk factors for developing co-occurring alcohol misuse and criminal offending in adolescence are similar rather than unique and that it is the accumulation of the risk factors, as opposed to their severity, that is associated with co-occurring behaviors when comparing with alcohol misuse and criminal offending only.

Narrative Discourse in Youth Offenders: Examining Individual Differences.

PURPOSE: This study examined narrative discourse in youth offenders, focusing on quality of story retelling, story comprehension, critical thinking, and the use of complex syntax. METHOD: The participants were 15 incarcerated adolescents, ages 13-18 years (Mage = 16 years). Each was evaluated at their detention center via Zoom, using a standardized language test and language samples that elicited narrative speaking with fables. After retelling a fable, the participant answered questions that examined story comprehension and critical thinking. RESULTS: Most participants performed below average on the standardized language test and had difficulty on one or more of the language sampling measures. Areas of concern included quality of story retelling, story comprehension, critical thinking, and the use of complex syntax. Had language sampling not been employed, those weaknesses might have been overlooked. CONCLUSIONS: When evaluating youth offenders, it is important to elicit language samples that can provide detailed information about an adolescent's ability to communicate for genuine purposes. In this regard, the tasks employed in the current study could be helpful to speech-language pathologists in working with youth offenders, enabling them to pinpoint deficits and offer targeted intervention.

Evolution, the Cognitive Sciences, and the Science of Victimization.

Despite clear aversion to such labels, one of the most impactful criminological theories is rooted in cognitive science. Gottfredson and Hirschi's general theory has been repeatedly tested, replicated relatively well, and has since reached beyond its original scope to explain other important outcomes like victimization. However, the work never viewed itself as part of a larger scientific landscape and resisted the incursion of neuroscience, cognitive science, and evolutionary theory from the start. This missed opportunity contributes to some of the theory's shortcomings. We begin by considering relevant literatures that were originally excluded and then conduct a new analysis examining the cognitive underpinnings of victimization in a high-risk sample of adolescents. We used the Future of Families and Child Wellbeing Study (n = 3,444; 48% female; 49% Black, 25% Hispanic) which contained sound measures of self-control and intelligence, as well as four types of adolescent victimization. Self-control was robustly associated with all forms of victimization, whereas intelligence had generally no detectable effect. We discuss how these findings fit into a broader understanding about self-control and victimization.

Investigating Trauma Symptomology as a Mediator of the Relationships Between Childhood Maltreatment and Sexual and Non-Sexual Delinquency.

Maltreatment is a risk factor for both sexual and non-sexual delinquency. Little is known about how specific forms of maltreatment relate to the distinct offending outcomes. Though trauma symptoms have been associated with maltreatment and delinquency, the intervening role of trauma symptoms in pathways from maltreatment to offending is not well understood. The goal of the current study was to test social learning and general strain theory explanations for sexual and non-sexual delinquency in adolescence, exploring trauma symptoms as a mediator between the four major types of maltreatment and offending outcomes. Data were collected via surveys of 136 incarcerated youth at seven residential treatment and community corrections facilities in a Midwestern state. Confirmatory factor analysis (CFA) was used to establish a measurement model, and structural equation modeling was employed to test direct and indirect pathways from maltreatment to offending. Individual forms of maltreatment had differential relationships with offending outcomes, with neglect having a significant association with non-sexual delinquency, and sexual abuse having a significant direct relationship with sexual delinquency. Trauma symptomology did not mediate these relationships. Future research should explore developmentally appropriate proxies for measuring childhood trauma. Practice and policy should consider the role of maltreatment victimization history in the inception of delinquency behaviors, prioritizing therapeutic alternatives to detention and incarceration.

Promotive, Mixed, and Risk Effects of Individual Items Comprising the SAPROF Assessment Tool With Justice-Involved Youth.

The Structured Assessment of PROtective Factors for violence risk (SAPROF) is a widely used structured professional judgment (SPJ) tool. Its indices have predictive validity regarding desistance from future violence in adult correctional/forensic psychiatric populations. Although not intended for applied use with youth, SAPROF items lend themselves to an investigation of whether their operationalizations capture only strengths or also risks. With 229 justice-involved male adolescents followed for a fixed 3-year period, promotive, risk, and mixed effects were found. Most SAPROF items exerted a mixed effect, being associated with higher and lower likelihoods of violent and any reoffending at opposite ends of their trichotomous ratings. Summing items weighted using their promotive and risk odds ratios produced statistically significant improvements in predictive accuracy, improvements found also with a cross-validation sample of 171 justice-involved youth. The nature of strengths and implications for the development of SPJ tools and training in their use were discussed.

Differential Item Functioning in Reports of Delinquent Behavior Between Black and White Youth: Evidence of Measurement Bias in Self-Reports of Arrest in the Adolescent Brain Cognitive Development Study.

Youth self-reports are a mainstay of delinquency assessment; however, making valid inferences about delinquency using these assessments requires equivalent measurement across groups of theoretical interest. We examined whether a brief 10-item delinquency measure exhibited measurement invariance across non-Hispanic White (n = 6,064) and Black (n = 1,666) youth (ages 10-11 years old) in the Adolescent Brain Cognitive Developmentsm Study (ABCD Study®). We detected differential item functioning (DIF) in two items. Black youth were more likely to report being arrested or picked up by police than White youth with the same score on the latent delinquency trait. Although multiple covariates (income, urgency, and callous-unemotional traits) reduced mean-level difference in overall delinquency, they were generally unrelated to the DIF in the Arrest item. However, the DIF in the Arrest item was reduced in size and no longer significant after adjusting for neighborhood safety. Results illustrate the importance of considering measurement invariance when using self-reported delinquency scores to draw inferences about group differences, and the utility of measurement invariance analyses for helping to identify mechanisms that contribute to group differences generally.

Editorial: Justice-Involved Youth: A National State of Emergency in Children's Mental Health.

In 2020, an estimated 424,300 youth were arrested and nearly 128,000 youth were detained in the United States, with disproportionately higher rates for minoritized youth when compared to White youth.1 Although the number of youth in detention facilities has decreased since the late 1990s, a staggering number of children and adolescents enter the justice system each year. This remains a critical issue for child and adolescent psychiatrists. By the time youth enter juvenile detention, individual mental health needs are already exceptionally high.

Inequities in Mental Health Services: A 16-Year Longitudinal Study of Youth in the Justice System.

OBJECTIVE: To examine: (1) if youth who have mental health disorders receive needed services after they leave detention-and as they age; and (2) inequities in service use, focusing on demographic characteristics and type of disorder. METHOD: We used data from the Northwestern Juvenile Project, a longitudinal study of 1,829 youth randomly sampled from detention in Chicago, Illinois in 1995. Participants were re-interviewed up to 13 times through 2015. Interviewers assessed disorders using structured diagnostic interviews and assessed service use using the Child and Adolescent Service Assessment and the Services Assessment for Children and Adolescents. RESULTS: Less than 20% of youth who needed services received them, up to median age 32 years. Female participants with any disorder had nearly twice the odds of receiving services compared with male participants (OR: 1.82; 95% CI: 1.41, 2.35). Compared with Black participants with any disorder, non-Hispanic White and Hispanic participants had 2.14 (95% CI: 1.57, 2.90) and 1.50 (95% CI: 1.04, 2.15) times the odds of receiving services. People with a disorder were more likely to receive services during childhood (< age 18) than during adulthood (OR: 2.29; 95% CI: 1.32, 3.95). Disorder mattered: participants with an internalizing disorder had 2.26 times and 2.43 times the odds of receiving services compared with those with a substance use disorder (respectively, 95% CI: 1.26, 4.04; 95% CI: 1.49, 3.97). CONCLUSION: Few youth who need services receive them as they age; inequities persist over time. We must implement evidence-based strategies to reduce barriers to services.

Religiosity and Associations with Substance Use and Delinquency Among Urban African American Adolescents.

Adolescent delinquency and substance use are global problems. African American adolescents are especially susceptible to the life-changing consequences of these problem behaviors. Religiosity is a notable protective factor that has been shown to mitigate these behaviors. This study uses a person-centered approach to examine the extent to which religiosity is associated with lower rates of delinquency and substance use among urban African American adolescents in the United States. Latent Class Analysis was used to examine the heterogeneity in five religiosity items among a sample of adolescents ages 13-18. After identifying religiosity classes through a class enumeration process, we examined predictors of the classes using multinomial logistic regression. The classes were then used to predict several substance use and delinquency outcomes. Three religiosity classes were identified; "low religious beliefs and engagement," (15.19%, n = 94), "religious with low active engagement," (56.70%, n = 351), and "religious with high active engagement," (28.11%, n = 174). Protective effects of religiosity on substance use (e.g., alcohol) and delinquency were found (e.g., assault). Implications for research and practice are discussed.