Monday, May 14, 2012

Introduction to the Special Issue: Treatment Considerations for Aggressive Adolescents in Secure Settings | Complex Trauma and Aggression in Secure Juvenile Justice Settings - Behavioral Forensics

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via Criminal Justice and Behavior recent issues by Langton, C. M. on 5/10/12

via Criminal Justice and Behavior recent issues by Ford, J. D., Chapman, J., Connor, D. F., Cruise, K. R. on 5/10/12
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.

via Criminal Justice and Behavior recent issues by Connor, D. F., Ford, J. D., Chapman, J. F., Banga, A. on 5/10/12
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.

via Criminal Justice and Behavior recent issues by Doran, N., Luczak, S. E., Bekman, N., Koutsenok, I., Brown, S. A. on 5/10/12
Substance use disorders (SUDs) in youth are strongly associated with aggression, delinquency, and involvement with the juvenile justice and mental health systems. This article reviews the relationship between aggression and SUDs and discusses evidence-based approaches to assessment and intervention, with a focus on youth in secure settings. While evidence indicates etiological overlap, SUDs also confer risk for aggression and delinquent behavior. SUDs and aggression are each influenced by executive functions that develop as youth transition toward adult roles. Additionally, the effects of substance use on the adolescent brain impair neurocognitive function and increase the risk for aggression and further substance use. In terms of assessment, it is important to identify function and form of aggression in order to understand motives and associations with substance use and to select appropriate interventions. Evidence-based screening and assessment of aggression, substance involvement, and related domains is also critical. In terms of treatment, youth with SUDs tend to be underserved, particularly when they are also involved with the juvenile justice system. Multiple modes of evidence-based treatment for substance use are available. Approaches that address risk factors common to SUDs and aggression across multiple domains (e.g., family therapies) have been found to be most effective but may be difficult to adapt for use in secure settings. Individual therapy approaches also have empirical support and may generally be more practical in secure settings.

via Criminal Justice and Behavior recent issues by Novick Brown, N., Connor, P. D., Adler, R. S. on 5/10/12
Youth with fetal alcohol spectrum disorders (FASDs) are in a perilous circumstance. FASD is associated with a high rate of self-regulation problems and trouble with the law and is underdiagnosed. Standard juvenile corrections-based interventions often do not meet the needs of these vulnerable youth. This article describes what is known about conduct-disordered adolescents with FASD and the neurocognitive deficits that directly affect emotional and behavioral self-control. The authors propose guidelines for the assessment of FASD within residential treatment settings and analyze interventions that show promise for inpatient treatment of youth with FASD.

via Criminal Justice and Behavior recent issues by Munoz, L. C., Frick, P. J. on 5/10/12
This article reviews the current research literature on the development of aggression and callous-unemotional traits. Research suggests there are two functions to aggression, reactive and instrumental, and each has concomitant cognitive and emotional factors associated. Furthermore, callous-unemotional (CU) traits (i.e., an absence of empathy and guilt) have been shown to be associated with the instrumental type of aggression. Research on CU traits suggests that there are distinct developmental mechanisms operating in the development of aggressive and violent behavior for youths with and without these traits. These distinct developmental mechanisms have important implications for the assessment and treatment of aggressive and violent youths.

via Criminal Justice and Behavior recent issues by Worling, J. R., Langton, C. M. on 5/10/12
Some adolescents who have committed a sexual crime are placed by the courts in secure residential settings. Given the heterogeneity of this client group, it is important for clinicians in these settings to complete comprehensive assessments to determine the course and content of specialized treatment, if necessary. With a focus on residential care, suggestions are provided for the assessment of strengths, risks, and needs. Particular attention is paid to issues related to informed consent, interviewing, and risk assessment. Also reviewed are various treatment issues with implications in secure settings, including the delivery of therapeutic services, use of manuals, therapeutic relationships and context, and self-care for providers. The growing evidence base for cognitive-behavioral treatment for adolescents who have sexually offended is outlined, and common treatment goals for youth who have offended sexually are critically examined. With an emphasis on treatment tailored to the unique needs of each adolescent, suggestions are offered regarding goals such as increasing accountability, recovery from posttraumatic distress, developing offense-prevention strategies, and enhancing awareness of victim impact, prosocial sexual attitudes, and healthy sexual interests. Additional issues that are considered with implications for clinicians working in secure settings include sibling sexual abuse and offenses involving child abuse imagery.

via Criminal Justice and Behavior recent issues by MacKay, S., Feldberg, A., Ward, A. K., Marton, P. on 5/10/12
Firesetting by juveniles results in billions of dollars of property loss, thousands of burn injuries, and hundreds of deaths each year. A review that specifically focuses on adolescents’ role in this devastating and costly behavior is not available. To address this gap, the current article reviews the past 30+ years of literature on adolescent firesetters, examining topics such as models of firesetting behavior, risk factors and correlates of adolescent firesetting, diagnostic issues, assessment tools and approaches, and current interventions. The article concludes with a discussion of goals for the field, including the development of relevant criteria for pathological firesetting.

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