A 3-year follow-up study of Swedish youths committed to juvenile institutions: Frequent occurrence of criminality and health care use regardless of drug abuse.
This 3-year follow-up study compares background variables, extent of criminality and criminal recidivism in the form of all court convictions, the use of inpatient care, and number of early deaths in Swedish institutionalized adolescents (N=100) with comorbid substance use disorders (SUD) and Attention-Deficit/Hyperactivity Disorder (ADHD) (n=25) versus those with SUD but no ADHD (n=30), and those without SUD (n=45). In addition it aims to identify whether potential risk factors related to these groups are associated with persistence in violent criminality. Results showed almost no significant differences between the three diagnostic groups, but the SUD plus ADHD group displayed a somewhat more negative outcome with regard to criminality, and the non-SUD group stood out with very few drug related treatment episodes. However, the rate of criminal recidivism was strikingly high in all three groups, and the use of inpatient care as well as the number of untimely deaths recorded in the study population was dramatically increased compared to a age matched general population group. Finally, age at first conviction emerged as the only significant predictor of persistence in violent criminality with an AUC of .69 (CI (95%) .54-.84, p=.02). Regardless of whether SUD, with or without ADHD, is at hand or not, institutionalized adolescents describe a negative course with extensive criminality and frequent episodes of inpatient treatment, and thus requires a more effective treatment than present youth institutions seem to offer today. However, the few differences found between the three groups, do give some support that those with comorbid SUD and ADHD have the worst prognosis with regard to criminality, health, and untimely death, and as such are in need of even more extensive treatment interventions.
This study explores the feasibility of adapting Kleinman's concept of explanatory models of illness to the study of youth violence and is conducted within the hermeneutic tradition. Data were collected by interviewing 11 violent adolescents, their parents, and their caregivers. Four types of explanatory models representing the adolescent girls', the adolescent boys', the caregivers', and the parents' understanding of youth violence are found; they correspond sufficiently to Kleinman's concept and establish the feasibility of adapting it to the study of youth violence. The developmental nature of the parents' and adolescents' models makes it feasible to study them by means of hermeneutic methodology. There are some clinically significant discrepancies between the caregivers' and the clients' explanatory models; identifying such discrepancies is an essential step in the process of breaking down barriers to therapeutic communications. Violent adolescents should be encouraged to define their own explanatory models of violence through dialogue with their caregivers.
A nation-wide sample of 1072 Norwegian adolescent psychiatric inpatients were followed up 15-33 (mean 23.8) years after hospitalisation, by record linkage to the National Register of Criminality. Defining criminal behaviour as entry into the criminal registry, 481 patients (45%) had an adolescent criminal debut, entering the registry before the age of 21. Of these, 130 (27%) had no criminal record after the age of 21 and were consequently considered as adolescence-limited criminal offenders, as opposed to the remaining 351 (73%) individuals who continued their criminal behaviour beyond the age of 21 and were considered as life-course-persistent criminal offenders. On the basis of hospital records, all patients were rediagnosed according to DSM-IV and scored on factors hypothesised to have predictive power as to persistence of criminal behaviour. We found that 79.6% of the male, and 58.8% of the female adolescent delinquents went on to life-course-persistent criminality. In females, intravenous use of illegal drugs, and being discharged from the hospital elsewhere than to the family home, were strong and independent predictors of life-course-persistent criminal behaviour. In males, the following were significant and independent predictors of life-course-persistent criminality: a high number of conduct disorder criteria fulfilled, comorbidity of psychoactive substance use disorder, and having attended correctional school.
To investigate the impact of adolescent violent and non-violent criminality and subsequent risk of morbidity and mortality in adulthood in a large Swedish cohort of young men conscripted for military service in 1969/70.
The cohort consisted of 49,398 18-year-old Swedish conscripts followed up for morbidity and mortality up to the age of 55?years in Swedish national registers. Information about convictions for crime before conscription was obtained from national crime registers. Data from a survey at conscription were scrutinized to get information on potential confounders.
Hospitalization due to alcohol and drug related diagnoses and attempted suicide were significantly more evident in the violent group compared to non-violent criminals and non-criminals. More than one fifth (21.13%) of the young violent offenders, 12.90% of the non-violent offenders and 4.96% of the non-criminals had died during the follow-up period. In Cox proportional multivariate analyses, young violent offenders had twice the hazard (HR?=?4.29) of all-cause mortality than the non-violent offenders (HR?=?2.16) during the follow-up period. Alcohol and drug related mortality, suicide and fatal accidents were most evident in both violent and non-violent offenders.
Men with adolescent criminality received more inpatient care due to alcohol and drug related diagnoses and attempted suicide as adults. Mortality due to unnatural causes, alcohol, and drug related diagnoses, suicide and accidents was most evident in violent offenders, while these causes of death were much lower in non-criminals. Men with adolescent criminality are a high-risk group for multiple adverse health outcomes and for early death. Efforts for detection of substance use and psychiatric disorders in this group is important for the prevention work in both local- and community levels as well as national prevention programs.
This study examines drug selling among representative samples of high school students in Ontario. It involves three approaches, (i) examining the trend in drug selling between 1983 and 1989, (ii) assessing differences between sellers and non-sellers on demographic characteristics, levels of alcohol and drug use, and problems, and (iii) drawing detailed profiles of drug seller types. Drug selling declined considerably between 1983 and 1989. Sellers were more likely to be males and to use alcohol and drugs more often than non-sellers. Sellers also had more alcohol and drug problems and engaged in more delinquent acts. Drug sellers who sold cannabis only were less frequent users of drugs, less likely to have drug problems, and were also delinquent.
This descriptive study of 120 girls removed temporarily from parental care during early adolescence raises questions regarding the efficiency and effectiveness of current intervention strategies. The findings suggest that clinical and legal efforts on behalf of girls such as these, who have been victims of neglect, deprivation, and abuse, are likely to remain unsatisfactory in the absence of a broad societal commitment to the needs and rights of children.
To examine disparities in hazardous and harmful drinking, illicit drug use, delinquency, and psychological distress among three immigrant generations of youth.
Data on 4,069 students were derived from the 2005 cycle of the Ontario Student Drug Use Survey, a province-wide school-based survey of 7th to 12th graders. The survey employed a two-stage cluster design (school, class). Analyses include adjustments for the complex survey design, specifically stratification, clusters, and weights.
Both drug use and hazardous and harmful drinking increase across immigrant generations. First-generation youth report significantly less use than second-generation youth, who in turn report less use than third and later generations. Generational differences in the levels of hazardous and harmful drinking increase with age. Delinquency is significantly less among first-generation youth relative to youth of other immigrant generations. Symptoms of psychological distress are highest among first-generation youth compared to youth of other immigrant generations.
The nature of differences between foreign- and native-born adolescents varies across behaviours. As such, it is important to gain knowledge about the adjustment levels of these two groups with regard to specific components of well-being. Such knowledge is necessary for developing policies and programs to promote emotional and behavioural health.
We examined mid-adolescent psychosocial problems as risk factors for subsequent depression up to adulthood proper, and differences in these for episodic and persistent depression.
In a 16-year follow-up of an urban Finnish community cohort (547 males and 714 females) from age 16 years risk factors for subsequent depression (S-BDI) were studied. Data were collected with a classroom questionnaire at 16 years and a postal questionnaire at 22 and 32 years. Differences in predictors for episodic depression (only at age of 22 or 32 y) and persistent depression (both at 22 and 32 y) were studied using logistic and multinomial regression analyses.
Mid-adolescent depressive symptoms predicted persistent and female sex episodic depression. Low self-esteem, dissatisfaction with academic achievement, problems with the law, having no dating experiences, and parental divorce all predicted both episodic and persistent depression.
We had two assessment points in adulthood, but no information about depression between these.
The associations between mid-adolescent psychosocial problems and subsequent depression extended up to adulthood proper, somewhat differently for episodic and persistent depression. Preventive efforts should be focused towards young people at risk.
