Anger Mediates the Relation Between Violence Exposure and Violence Perpetration in Incarcerated Boys

Adolescent Contact, Lasting Impact? Lessons Learned From Two Longitudinal Studies Spanning 20 Years of Developmental Science Research With Justice-System-Involved Youths

In this article, we summarize key findings from 20 years of research conducted at the intersection of developmental psychology and juvenile justice in the United States. We predominantly examine data from two large-scale, multisite longitudinal studies involving justice-system-involved adolescents-the Pathways to Desistance study and the Crossroads study. Topics of discussion include predictors of offending and desistance from crime; youth outcomes and psychosocial needs; and emerging research, programs, and policy initiatives. First, individual-level (e.g., age, psychosocial maturity) and contextual-level (e.g., antisocial peers, exposure to violence) risk factors associated with offending are explored. Second, we discuss short-term and long-term outcomes of justice-system contact for youths engaging in moderate offenses. We highlight main findings from the Crossroads study indicating that youths who are sanctioned by the justice system at their first arrest have worse outcomes than youths who are diverted from formal processing. Additionally, we discuss the high prevalence of youths' exposure to violence and mental health disorders as well as the differential treatment of youths of color in the justice system. Third, we extend the conversation to justice-system-involved young adults and discuss emerging, innovative legal solutions, including young adult courts. Last, we discuss real-world implications of these findings.

Trauma, post-traumatic stress disorder and violence in the prison population: prospective cohort study of sentenced male prisoners in the UK

BACKGROUND

Violence is a common problem in prisons. Post-traumatic stress disorder (PTSD), a prevalent disorder in prison populations, has been identified as a risk factor for violent behaviour in community and military populations. Although cross-sectional associations between PTSD and prison violence have been documented, prospective cohort studies are required.

AIMS

To investigate whether PTSD is an independent risk factor for prison violence, and examine the potential role of PTSD symptoms and other trauma sequelae on the pathway from trauma exposure to violent behaviour in prison.

METHOD

A prospective cohort study was conducted in a large, medium security prison in London, UK. A random sample of sentenced prisoners arriving into custody (N = 223) took part in a clinical research interview, which assessed trauma histories, mental disorders including PTSD, and other potential sequelae of trauma (anger, emotion dysregulation). Incidents of violent behaviour were measured with prison records covering the 3 months after reception into custody. Stepped binary logistic regression and a series of binary mediation models were performed.

RESULTS

Prisoners who met current (past month) criteria for PTSD were more likely to engage in violent behaviour during the first 3 months of imprisonment, after adjusting for other independent risk factors. The relationship between lifetime exposure to interpersonal trauma and violent behaviour in custody was mediated by total PTSD symptom severity. Hyperarousal and negatively valenced cognitive and emotional appraisal symptoms were particularly implicated in this pathway.

CONCLUSIONS

The identification and treatment of PTSD has the potential to reduce violence in prison populations.

Examining the Relationships Between Childhood Exposure to Intimate Partner Violence, the Dark Tetrad of Personality, and Violence Perpetration in Adulthood

Intimate partner violence (IPV) is a major international public health concern that poses significant mental and physical health risks for affected individuals. To improve prevention efforts, it is imperative that researchers and government bodies understand risk factors for IPV. One such risk factor concerns the extent to which violence is intergenerational, such that exposure to violence predisposes individuals to engage in violence toward intimate partners. The purpose of this research is to assess childhood exposure to violence as a risk factor for perpetration of IPV in adulthood, and to evaluate the Dark Tetrad personality traits as mediators in this relationship. We recruited 153 men and 246 women (age range = 18-73, M_age = 33.50, SD_age = 10.26) through Amazon's Mechanical Turk to complete a series of questionnaires and an open-ended IPV perpetration assessment. Results showed no relationship between IPV perpetration and childhood IPV exposure, indicating that mediation analyses were not possible. Possible explanations are discussed. Follow-up exploratory analyses demonstrated that gender moderated the relationships between childhood IPV exposure and levels of Factor 1 psychopathy and Machiavellianism. Specifically, men who were exposed to IPV in childhood were more likely to develop higher levels of Factor 1 psychopathy and Machiavellianism, whereas women were not. Overall, our findings highlight the importance of providing researchers and clinicians with a greater understanding of environmental events preceding maladaptive trait development. It is also important for researchers and clinicians to consider gender differences in pathways between exposure to IPV and subsequent development of dark personality traits. Theoretical and practical implications are discussed.

Patterns of Community Violence Exposure among African American Adolescents Living in Low-Resourced Urban Neighborhoods

African American adolescents living in neighborhoods with concentrated economic disadvantage are disproportionately exposed to community violence. This study builds upon previous research and examines patterns, severity, and chronicity of violence exposure, within a sample of African American adolescents living in low-resourced, urban neighborhoods (n = 327). The influence of both individual- and contextual-level factors on community violence exposure (CVE) is examined. Data were collected across four time points at 6-month intervals. Latent transition analysis identified three patterns of CVE at each time point: low witnessing and low victimization (LW-LV), high witnessing and low victimization (HW-LV), and high witnessing and high victimization (HW-HV), as well as transitions between each class. Although a stable LW-LV class membership over time was the most prevalent pattern, most adolescents experienced some change in exposure. Nearly one-third of the participants were classified in the HW-HV group at some point in time. Analyses on individual- and contextual-level factors revealed that more depressive symptoms, community problems (e.g., drugs, graffiti, noise), or community resources (e.g., schools, parks, recreational facilities) were associated with an increased likelihood of experiencing high levels of violent victimization. Implications for intervention and prevention of CVE are discussed.

Hopelessness and Delinquent Behavior as Predictors of Community Violence Exposure in Ethnic Minority Male Adolescent Offenders

Justice-involved boys from urban communities are disproportionately impacted by community violence exposure (ECV) and despite decades of research, rates of ECV in youth continue to increase particularly for youth involved in the juvenile justice system. Despite the increased risk of exposure, the majority of research focuses on what may protect youth from the deleterious outcomes associated with violence exposure, rather than strategies that may prevent the violence exposure from occurring. The current study seeks to shift the focus of research in this area to examining factors that may predict future violence exposure. Specifically, the purpose of the current study is to examine the role of hopelessness as a predictor of the risk for violence exposure in a sample of 831 justice-involved, urban boys ages 14-18 (52.2% African American, 42.1% Hispanic, 5.7% other). Results revealed that baseline levels of low aspirations and hopelessness towards the future indirectly predicted violence exposure 1 year later through engagement in delinquent behavior. Clinical implications for targeting youth with elevated risk and preventing future violence exposure are discussed.

PTSD in prison settings: A systematic review and meta-analysis of comorbid mental disorders and problematic behaviours

Purpose

Prevalence rates of PTSD are higher in the prison population than in the community. We sought to systematically review the extent to which this disorder is associated with other mental health disorders and problematic suicidal or aggressive behaviours in the prison population.

Methods

Studies reporting a relationship between PTSD and comorbid mental disorders and/or problematic behaviours in imprisoned adolescent and adult populations were identified from four bibliographic indexes. Primary studies involving clinical interviews, validated instruments leading to DSM or ICD diagnoses, or validated self-report questionnaires such as the PTSD checklist were included. Random-effects meta-analysis was conducted where possible. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed.

Results

This review identified 36 studies, with a combined sample of 9594 participants, (6478 male and 2847 female prisoners) from 11 countries. Thirty-four of the identified studies employed a cross-sectional design. We identified significant associations between PTSD and comorbid mental disorders including depression (OR = 3.4, 95% confidence interval (CI): 2.3–4.9), anxiety (OR = 2.9, 95% confidence interval (CI): 1.8–4.7) and substance use (OR = 1.9, 95% confidence interval (CI): 1.5–2.4). We also identified significant associations between PTSD and suicidality (OR = 3, 95% confidence interval (CI): 2.4–3.8) and aggressive behaviours (this latter finding was not subject to meta-analysis). Significant methodological heterogeneity was identified between studies.

Conclusions

High rates of psychiatric comorbidity among prisoners with PTSD, and links to suicidal behaviour, self-harm and aggressive behaviour, provide further support for the need for trauma-informed treatment approaches in prisons. However, significant gaps in the current evidence were apparent. In particular, a lack of large, longitudinal studies meant that the temporal relationships between PTSD and relevant outcomes cannot currently be determined.

Exposure to Community Violence, Affiliations With Risk-Taking Peer Groups, and Internet Gaming Disorder Among Chinese Adolescents: The Moderating Role of Parental Monitoring

Among adolescents, exposure to community violence (ECV) has been consistently linked to problem behaviors such as Internet gaming disorder (IGD). However, the associated risk and protective factors have not been adequately explored in past studies. Therefore, in accordance with the risk-buffering model and social development model, this study aimed to test whether parental monitoring moderated the relationship between ECV and IGD among adolescents, and whether this moderating effect was mediated by affiliations with risk-taking peer groups. A sample of 2,423 Chinese middle-school students anonymously responded to questionnaires that assessed ECV, IGD, affiliations with risk-taking peer groups, and parental monitoring. The results of structural equation modeling revealed that the interaction between ECV and parental monitoring negatively related to IGD among adolescents. Specifically, the positive relationship between ECV and IGD was stronger for adolescents, who reported low levels of parental monitoring than for those who reported high levels of parental monitoring. Moreover, this moderating effect was mediated by affiliations with risk-taking peer groups. These results suggest that parental monitoring is an important protective factor that can mitigate the risk of IGD among adolescents who have been exposed to community violence. Accordingly, these findings serve as an empirical base upon which prevention and intervention strategies that are aimed at mitigating the risk of IGD among adolescents can be developed.

Reactive Protection? Fear, Victimization, and Fighting Among U.S. High School Students

Youth violence in high schools is a pervasive and persistent problem in the United States. Students engage in physical fights, experience bullying and teen dating violence (TDV), are threatened with weapons, and miss school due to safety concerns. However, despite theoretical support, research has not sufficiently addressed the relationship between students' fear and fighting at school. This secondary analysis used data from the 2013 Youth Risk Behavior Survey (n = 13,583) to examine the relationship between fear at school, victimization, and engagement in fighting at school among high school students. We created a 3-item composite fear variable, conducted logistic regression to examine likelihood of fighting, and multinomial regression to examine risk for multiple fights, and stratified all models by gender. Findings indicate that both male and female students who experienced fear were more likely to engage in fights at school than peers who did not experience fear, even when controlling for other factors. Likewise, the more fear incidents a student experienced, the more at risk they were for engaging in multiple fights. Findings on victimization indicate that the relationship with fighting is more straightforward for male students than for female students. For males, being bullied and experiencing multiple incidents of physical and sexual TDV were all associated with fighting at school. For females, however, only one type of victimization was associated with fighting at school: experiencing multiple incidents of physical TDV. Overall, findings suggest that fear may be more than merely a by-product of fighting, but rather-as the extant research supports-fear also can be generalized across situations and displayed through patterns of aggression. Findings support the need for interventions aimed at skill-building in areas of communication, emotion regulation, conflict resolution, and healthy relationships to help youth-particularly those in younger grades-negotiate interpersonal relationships without the use of violence.

Understanding the link between exposure to violence and aggression in justice-involved adolescents

The current study advanced research on the link between community violence exposure and aggression by comparing the effects of violence exposure on different functions of aggression and by testing four potential (i.e., callous-unemotional traits, consideration of others, impulse control, and anxiety) mediators of this relationship. Analyses were conducted in an ethnically/racially diverse sample of 1,216 male first-time juvenile offenders (M = 15.30 years, SD = 1.29). Our results indicated that violence exposure had direct effects on both proactive and reactive aggression 18 months later. The predictive link of violence exposure to proactive aggression was no longer significant after controlling for proactive aggression at baseline and the overlap with reactive aggression. In contrast, violence exposure predicted later reactive aggression even after controlling for baseline reactive aggression and the overlap with proactive aggression. Mediation analyses of the association between violence exposure and reactive aggression indicated indirect effects through all potential mediators, but the strongest indirect effect was through impulse control. The findings help to advance knowledge on the consequences of community violence exposure on justice-involved youth.

Mindfulness-based interventions for youth in the criminal justice system: a review of the research-based literature

Mindfulness is a technique and sense of being present in the moment that incorporates aspects of acceptance, openness and meditation with the ultimate intention of improving well-being. Research indicates that mindfulness can significantly improve negative personality traits, reduce stress, increase attention, alleviate chronic pain and enhance mental health. Mindfulness-based interventions in correctional facilities have resulted in reduced hostility and improved self-esteem for adults, but less is known about its applicability amongst youth. This article reviews the research-based literature on the use of mindfulness-based interventions for youths (aged 13 to 24 years) involved in the justice system. A total of ten studies were located and synthesised into four themes of stress reduction, self-regulation, anger management and acceptance. The article concludes by considering the methodological rigour of the reviewed studies, providing recommendations for future research and contemplating the positive impact that mindfulness interventions might have on youth in the criminal justice system.

Emotion regulation difficulties in traumatized youth: a meta-analysis and conceptual review

This article provides a quantitative and conceptual review of emotion regulation difficulties in trauma-exposed young people, and informs future directions in the field. Despite long-standing interest in the influence of emotion regulation difficulties on different internalizing and externalizing psychiatric disorders in childhood, several questions remain unresolved with respect to children and adolescents with PTSD (post-traumatic stress disorder). Meta-analytic data from adult victims suggest that emotion regulation problems are associated with PTSD, but this has never been studied in children and young people. We therefore provide a conceptual review of features related to the phenomenology, assessment, severity and treatment of emotion regulation difficulties in trauma-exposed children and young people. We combine this with a meta-analysis of published literature. We searched studies in Medline, PsychINFO, and Embase databases based on pre-selected criteria. Eight hundred and eighty-six papers were identified and 41 were included. We found that children and adolescents with a diagnosis of PTSD reported more emotion regulation difficulties than those who did not develop PTSD, and that the overall association between the two symptom dimensions was moderately strong. We identify a number of research priorities: the development of instruments to assess emotion regulation difficulties in children, the design of studies that describe its prevalence in young epidemiological traumatized samples, its predictive role in the onset, severity and persistence of post-traumatic symptoms, and its relevance as a moderator, outcome or treatment target for young survivors.

Posttraumatic Stress and Youth Violence Perpetration: a Population-Based Cross-Sectional Study

Background

Exposure to trauma was found to increase later violent behaviours in youth but the underlying psychopathological mechanisms are unclear. This study aimed to test whether posttraumatic stress disorder (PTSD) is related to violent behaviours and whether PTSD symptoms mediate the relationship between the number of trauma experiences and violent behaviours in adolescents.

Method

The present study is based on a nationally representative sample of 9th grade students with 3434 boys (mean age = 15.5 years) and 3194 girls (mean age = 15.5 years) in Switzerland. Lifetime exposure to traumatic events and current PTSD were assessed by the use of the University of California at Los Angeles Posttraumatic Stress Disorder Reaction Index (UCLA-RI). Logistic regression was used to assess associations between PTSD and violent behaviours, and structural equation modelling (SEM) was used to examine the meditation effects of PTSD.

Results

PTSD (boys: OR = 7.9; girls: OR = 5.5) was strongly related to violent behaviours. PTSD symptoms partially mediated the association between trauma exposure and violent behaviours in boys but not in girls. PTSD symptoms of dysphoric arousal were positively related to violent behaviours in both genders. Anxious arousal symptoms were negatively related to violent behaviours in boys but not in girls.

Conclusions

In addition to trauma, posttraumatic stress is related to violent outcomes. However, specific symptom clusters of PTSD seem differently related to violent behaviours and they do not fully explain a trauma-violence link. Specific interventions to improve emotion regulation skills may be useful particularly in boys with elevated PTSD dysphoric arousal in order to break up the cycle of violence.

Community Violence Exposure and Callous-Unemotional Traits in Adolescents: Testing Parental Support as a Promotive Versus Protective Factor

Although callous-unemotional (CU) traits are associated with maladjustment in youth, literature predicting CU using prospective designs is rare. In the present study we examine associations between exposure to community violence, supportive relationships with caregivers, and CU in a sample of 236 low-income youth (M age = 13.00 yrs, SD = 1.56 yrs; 43% male; 92% African American) participating in a 3-wave longitudinal study of violence exposure and adjustment. Both promotive and protective models of linkages between exposure to community violence, support, and CU were investigated. Given known sex differences in CU, sex was explored as a moderator. Regression analysis revealed that witnessing and hearing about community violence, aggregated over 2 waves, were positively associated with CU at the final study wave. Supportive relationships with caregivers, aggregated over 2 waves, were negatively associated with CU but did not interact with violence exposure, suggesting that supportive relationships with caregivers has a promotive but not a protective association with CU in the context of exposure to violence. The pattern of associations did not vary by sex. This study informs our understanding of factors that contribute to the development of CU.

Trauma History and PTSD Symptoms in Juvenile Offenders on Probation

Detained and incarcerated juveniles are found to have heightened rates of trauma and posttraumatic stress disorder (PTSD). Less is known about probation youth, who represent the majority of juveniles in the criminal justice system. This study examined trauma history and PTSD and associations with behavioral health problems among 13-17 year-old juveniles on probation (N=61). Most (93%) reported at least one traumatic event, and 12% met diagnostic criteria for PTSD. Trauma exposure and PTSD symptoms were associated with mental health problems but not substance use or risky sexual behavior. Findings underscore the importance of addressing trauma history in probation youth.

Severity of Victimization and Co-Occurring Mental Health Disorders Among Substance Using Adolescents

BACKGROUND: Co-occurring mental health disorders are widespread among substance using adolescents. Severity of victimization may be an important factor in explaining co-occurrence of mental health problems among adolescents with substance misuse problems. PURPOSE: The purpose of this study was to evaluate whether severe victimization experiences were shared risk factors for internalizing only, externalizing only, and co-occurring internalizing and externalizing disorders among victimized substance-using adolescents. METHOD: Data for this cross-sectional study were obtained from a multisite research project. Adolescents, ages 11-18, participated in a comprehensive screening program for substance abuse at 106 Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Substance Abuse Treatment (CSAT)-funded grantee sites throughout the United States. RESULTS: Longer duration/frequent victimization, more than one type of victimization, and recent victimization were related to co-occurring internalizing and externalizing disorders. Victimization by a trusted person, however, was only related to internalizing disorders. CONCLUSION: The findings show that some indicators of severe victimization experiences are shared risk factors for internalizing, for externalizing, and for co-occurring internalizing and externalizing problems, thus providing support for the common factors model of co-morbidity. These findings suggest that practitioners in substance abuse treatment must thoroughly assess for severe victimization experiences among adolescents presenting with co-occurring mental health issues. Treatment planning and interventions may focus on helping adolescents cope effectively with their victimization experiences and addressing their MH needs.