Evidencing the Need to Screen for Social Determinants of Health Among Boys Entering a Juvenile Prison: A Latent Profile Analysis.

Social determinants of health influence who ends up in the juvenile legal system and how individuals fare when entering and leaving the system. The present study utilized latent profile analysis to determine the extent to which social determinants of health were present in a sample of incarcerated youth and the patterns in which they appear. The authors then examined their relationships to racial groups, depression, substance misuse, and recidivism risk. Data were from 1288 adolescent boys sentenced to a juvenile prison in one Southeastern state for serious offending (i.e., repeat offenses, offenses involving physical or sexual violence). We ran a latent class analysis to test for patterns with which youth present with various social determinants of health. Profiles with more violence exposure and higher social support were comprised of more Black boys than the referent profile. Property and sexual offenses also differed significantly from the referent profile. Altogether, results from our examination of selected social determinants of health indicated such factors meaningfully contribute to our understanding of experiences of young people in the juvenile legal system and may be targets for mental health and substance use intervention as they may contribute to problem behaviors or negative outcomes.

Behavioral Skills Training to Increase Appropriate Reactions of Adolescent Males in Residential Treatment.

Adolescents in secured residential facilities may engage in excess behavior immediately following verbal directives or corrective statements from staff. Excess behavior may include verbal aggression, indices of disrespect (e.g., eye rolling, grunting, and obscene gestures), or even physical aggression. These excess behaviors may evoke further directives or corrective statements from staff that, in turn, escalate the adolescent's excess behavior and can produce undesirable effects for both the adolescent (e.g., loss of privileges) and staff members (e.g., increased burn out). Teaching detained adolescents to respond appropriately to staff directives and corrective statements may produce large collateral changes in the way staff interact with adolescents in detention facilities. These changes could be conceptualized as a behavioral cusp. We used behavioral skills training to teach 11 adolescent males to respond appropriately to staff directives. All 11 students showed low percentages of trials with appropriate reactions in baseline and high percentages of trials with appropriate reactions during treatment and generalization sessions. Further, two students showed maintenance of the skill 1 month and 5 months following treatment.

Using Arousal Suppression Exercises to Decrease Inappropriate Sexual Arousal in Detained Adolescent Males: Three Clinical Demonstrations.

Reyes, Vollmer, and Hall (2011) found that 2 arousal suppression strategies, 1 of which involved counting backward from 100 to 0, decreased sexual arousal for 2 male sex offenders with intellectual disabilities. In the current clinical study, we taught 3 adolescent males who had been adjudicated for illegal sexual behavior to self-report arousal when they were presented with sexually arousing visual stimuli. Based on the procedures in the Reyes et al. (2011) study, we taught participants to count backward from 100 to 0 when they verbally reported a criterion level of sexual arousal in the presence of visual media. Subsequently, we gradually faded therapists' instructions for 2 participants until they independently used the arousal suppression exercise. Results showed that each participant's self-reported sexual arousal decreased upon implementation of treatment relative to baseline. Decreased sexual arousal continued even under conditions of faded therapist instructions for 2 participants. The relative merits of using self-report measures are discussed.

Group Procedures for Decreasing Problem Behavior Displayed by Detained Adolescents.

As one component of providing treatment in a residential facility, Brogan, Falligant, and Rapp decreased problem behavior by two groups of detained adolescents using group contingency procedures. The current series of studies evaluated the extent to which group procedures could be extended to other contexts within a residential facility. In Study 1, fixed-time delivery of attention by dormitory staff decreased problem behavior displayed by a group of five to 11 detained adolescents during free periods. In Study 2, rules from a therapist plus contingencies for following those rules increased appropriate line walking during specific transition periods. Subsequently, rules alone maintained appropriate line walking, however, direct training was required to produce appropriate line walking during other transitions. Measures of social validity indicated the procedures and outcomes in both studies were acceptable to facility personnel.