Detained adolescent females' multiple mental health and adjustment problem outcomes in young adulthood

Juvenile Justice-Based Interdisciplinary Collective Care: An Innovative Approach

Mental health concerns among juvenile-justice-involved youth (JJIY) continue to be a major health crisis in the United States (US). While scholarship has explored mental health concerns among JJIY, and the link to negative life outcomes, there are gaps in the existing research, particularly in effective interventions and models aimed at addressing both the mental health concerns and criminogenic risk contributing to recidivism and other negative life outcomes of this population. In this paper, we present Justice-Based Interdisciplinary Collective Care (JBICC), an innovative framework to address both the mental health needs and delinquent behavior of youth offenders. The model bridges community partners, with the purpose of informing future interventions, implementations, and research in this area. Increased justice-based interdisciplinary collective collaboration between the juvenile justice system and community programs/organizations would be a major benefit to youth offenders and their families. We also focus on the need for cultural responsiveness to be interwoven throughout all aspects of treatment. JBICC offers an opportunity to expanded services outside traditional settings and methods to ensure that youth offenders and their families receive validating and culturally responsive access to services.

Women sleeping rough: The health, social and economic costs of homelessness

This study seeks to assess the health, social and economic outcomes associated with rough sleeping among women and compare those outcomes with those of (1) men sleeping rough, and (2) women experiencing other forms of homelessness (such as being housed in temporary supported accommodation due to family and domestic violence). The paper analyses survey data using the Vulnerability Index-Service Prioritization Decision Analysis Tool (VI-SPDAT) collected from 2735 women experiencing homelessness and 3124 men sleeping rough in Australian cities from 2010 to 2017. We find that women sleeping rough report poorer physical and mental health outcomes and greater problematic drug and or alcohol use relative to both men sleeping rough and women experiencing other types of homelessness (all p < 0.5). Women sleeping rough report significantly higher levels of crisis service utilisation (Β = 17.9, SE = 3.9, p < 0.001) and interactions with police in the previous 6 months (Β = 1.9, SE = 0.3, p < 0.001) than women experiencing homelessness not sleeping rough. Women sleeping rough also report greater healthcare utilisation, and, therefore, healthcare costs, than women experiencing homelessness not sleeping rough and men sleeping rough (all p < 0.05). From a policy perspective, the evidence presented in this paper supports a social determinants approach that moves from addressing symptoms of poor health outcomes associated with homelessness to preventing and ending homelessness with a particular focus on the life trajectories of women. Integrated services and homelessness strategies need to be developed through a gender lens, providing women sleeping rough with tailored permanent housing with wrap-around supportive housing to address poor health outcomes.

Mental Disorders Into Adulthood Among Adolescents Placed in Residential Care: A Prospective 10-Year Follow-up Study

Background

Child welfare and juvenile justice placed youths show high levels of psychosocial burden and high rates of mental disorders. It remains unclear how mental disorders develop into adulthood in these populations. The aim was to present the rates of mental disorders in adolescence and adulthood in child welfare and juvenile justice samples and to examine their mental health trajectories from adolescence into adulthood.

Methods

Seventy adolescents in shared residential care, placed by child welfare (n = 52, mean age = 15 years) or juvenile justice (n = 18, mean age = 17 years) authorities, were followed up into adulthood (child welfare: mean age = 25 years; juvenile justice: mean age = 27 years). Mental disorders were assessed based on the International Classification of Diseases 10th Revision diagnoses at baseline and at follow-up. Epidemiological information on mental disorders was presented for each group. Bivariate correlations and structural equation modeling for the relationship of mental disorders were performed.

Results

In the total sample, prevalence rates of 73% and 86% for any mental disorder were found in adolescence (child welfare: 70%; juvenile justice: 83%) and adulthood (child welfare: 83%; juvenile justice: 94%) respectively. General psychopathology was found to be stable from adolescence into adulthood in both samples.

Conclusions

Our findings showed high prevalence rates and a high stability of general psychopathology into adulthood among child welfare and juvenile justice adolescents in Swiss residential care. Therefore, continuity of mental health care and well-prepared transitions into adulthood for such individuals is highly warranted.

Prevalence and 10-Year Stability of Personality Disorders From Adolescence to Young Adulthood in a High-Risk Sample

Background

With the implementation of the 11th edition of the International Classification of Diseases (ICD-11) in early 2022, there will be a radical change in the framework and process for diagnosing personality disorders (PDs), indicating a transition from the categorical to the dimensional model. Despite increasing evidence that PDs are not as stable as previously assumed, the long-term stability of PDs remains under major debate. The aim of the current paper was to investigate the categorical and dimensional mean-level and rank-order stability of PDs from adolescence into young adulthood in a high-risk sample.

Methods

In total, 115 young adults with a history of residential child welfare and juvenile-justice placements in Switzerland were included in the current study. PDs were assessed at baseline and at a 10-year follow-up. On a categorical level, mean-level stability was assessed through the proportion of enduring cases from baseline to follow-up. Rank-order stability was assessed through Cohen's κ and tetrachoric correlation coefficients. On a dimensional level, the magnitude of change between the PD trait scores at baseline and at follow-up was measured by Cohen's d. Rank-order stability was assessed through Spearman's ρ.

Results

The prevalence rate for any PD was 20.0% at baseline and 30.4% at follow-up. The most frequently diagnosed disorders were antisocial, borderline, and obsessive-compulsive PDs, both at baseline and at follow-up. On a categorical level, the mean-level stability of any PD was only moderate, and the mean-level stability of specific PDs was low, except of schizoid PD. Likewise, the rank-order stability of any PD category was moderate, while ranging from low to high for individual PD diagnoses. On a dimensional level, scores increased significantly for most PDs, except for histrionic traits, which decreased significantly from baseline to follow-up. Effect sizes were generally low. The rank-order stability for dimensional scores ranged from low to moderate.

Conclusion

The findings indicate low to moderate stability of Pds and Pd traits from adolescence to adulthood, which supports the growing evidence that categorical diagnoses of Pds are quite unstable. This in turn, emphasizes the use of the upcoming ICD-11 that Acknowledgments Pds to be only "relatively" stable.

Mental disorders among adults formerly in out-of-home care: a systematic review and meta-analysis of longitudinal studies

While children and adolescents placed in child welfare or juvenile justice out-of-home care show higher prevalence rates of mental disorders compared to the general population, it remains unclear whether this pattern persists into adulthood. A quantitative synthesis of existing studies is lacking. The aim of this meta-analysis was to estimate the prevalence rates for mental disorders among adults with a foster or residential child welfare or juvenile justice care history, comparing them where possible to rates among the general population. PubMed, PsycInfo, EMBASE, and Web of Science were systematically searched for epidemiological studies published up to 28 October 2020. Nineteen studies, totaling 604,257 participants, met our inclusion criteria. Random-effects models were used for prevalence rates and odds ratios (OR) of mental disorders, and study quality was rated. A prevalence rate of 30% [95% CI (23.36, 37.36)] for any mental disorder in adults with a child welfare care history was found (3-17% for specific disorders). A prevalence rate of 45% [95% CI (42.38, 47.38)] for any mental disorder was found in adults with a juvenile justice care history (6-66% for specific disorders). For out-of-home placement history, adult mental disorders were significantly higher than in the general population (OR = 1.33-2.76). Studies differed in terms of methodology and the disorder groups considered, so heterogeneity between effect sizes ranged from low to high. Our findings suggest that the high risk that mental health issues will persist in adults with an out-of-home placement history needs to be taken seriously in the transition from adolescence to adulthood. The care systems involved need to collaborate and to be aware of these risks.

Risikofaktoren für und Stabilität einer Persönlichkeitsstörung vom Jugendalter bis ins junge Erwachsenenalter in einer Hochrisikopopulation

Zusammenfassung. Theoretischer Hintergrund: Studien zeigen, dass Persönlichkeitsstörungen (PS) weniger stabil und bei einer frühzeitigen Erkennung gut behandelbar sind. Fragestellung: Ziel dieser Studie ist, 1) die Prävalenz von PS bei ehemalig fremdplatzierten jungen Erwachsenen zu beschreiben, 2) die kategoriale Stabilität von PS vom Jugendalter bis ins junge Erwachsenenalter zu bestimmen und 3) prospektive Risikofaktoren für eine PS im Erwachsenenalter zu identifizieren. Methoden: 180 ehemalig fremdplatzierte junge Erwachsene ( M = 26.3 Jahre) aus einer schweizweiten Längsschnittstudie wurden untersucht. Ergebnisse: 35 % der Teilnehmenden wiesen eine PS auf. Die kategoriale Stabilität belief sich auf 47 %. Folgende Risikofaktoren für eine PS im Erwachsenenalter wurden identifiziert: vorangehende PS, psychopathische Persönlichkeitszüge, Substanzmissbrauch, emotionale Vernachlässigung, kumulierte Misshandlungserfahrungen und Deliktschwere. Diskussion und Schlussfolgerung: Die kategoriale Stabilität irgendeiner PS in dieser Stichprobe gilt als mittelgradig. Dies unterstreicht die Notwendigkeit, PS nicht mehr mit einem lebenslangen, unveränderbaren Schicksal gleichzusetzen. Das Erkennen möglicher Risikofaktoren ist eine wichtige Voraussetzung, um individuelle Behandlungsmöglichkeiten zu gewährleisten und einer Chronifizierung entgegenzuwirken.

The Role of Personal Resilience and Interpersonal Support in Building Fulfilling and Prosocial Lives: Examining the Good Lives Model among Young Women Four Years after Youth Detention

Despite growing interest in strength-based rehabilitation frameworks, relevant internal/external resources that are likely to facilitate the rehabilitation of detained female adolescents (DFA) have been understudied. This study aims to fill this gap by studying the role of young women's personal resilience and interpersonal support in building fulfilling and prosocial lives 4 years after youth detention, thereby examining the strength-based good lives model (GLM). Forty-nine former DFA (M_age = 20.75) completed questionnaires about resilience, support, Quality of Life (QoL), and offending. Hierarchical multiple regression analyses showed that young women with more resilience displayed higher QoL and less offending, while more support was associated with higher QoL only. The relationship between resilience and QoL/offending did not depend upon the level of support. Overall, our results support the applicability of the GLM to former DFA, showing evidence for the importance of both internal and external resources in building fulfilling and prosocial lives.

A Qualitative Study on Young Women's Lives Prior to and Four Years after Youth Detention: Examining the Good Lives Model's Aetiological Assumptions

Detained female adolescents constitute a vulnerable, challenging, and understudied minority. Interventions for DFA are still dominated by risk management approaches with less focus on strength-based approaches such as the Good Lives Model (GLM). This study explored the functionality of DFA’s behaviour prior to and four years after release from detention, using the GLM as the guiding theoretical framework. A theory-driven thematic analysis was conducted of 30 in-depth interviews with former DFA (M_age = 20.80), exploring the fulfilment of their basic human needs (e.g., relatedness, independence) before and after detention. Before detention, the young women experienced multiple problems trying to fulfil multiple human needs, often contributing to poor balance in their lives and their antisocial behaviour. Although external and internal obstacles to fulfilling human needs were still present at follow-up, important improvements were noted, e.g., in the scope of their human needs and the resources available to fulfil their needs. The findings provide additional insights into the issues experienced by young women in detention and indicate there are opportunities to assist these young women, through the development of appropriate resources and capacities which provide them with appropriate means for fulfilling their needs and moving towards a personally meaningful and prosocial life.

Psychiatric morbidity amongst adolescents in a Nigerian juvenile correctional facility

Background

The high occurrence of psychiatric disorders amongst adolescents within the Juvenile Justice System (JJS) has been confirmed. Most of the available data are from developed countries and some of them focus on just a single psychiatric disorder which may not be representative of the situation in low-income countries, hence the need for more studies in developing countries, including Nigeria.

Aim

The study aimed to determine the prevalence of psychiatric disorders amongst adolescent residents of a correctional facility.

Setting

The study was carried out at a Borstal Institution in North-Central Nigeria.

Methods

A descriptive cross-sectional study design was used. One hundred and twenty adolescents were assessed using the socio-demographic pro forma questionnaire designed by the researcher and the Kiddies Schedule for Affective Disorders and Schizophrenia (KSADS-PL). Data were analysed using EPI-INFO 4.06 d version 6.04 software.

Results

A total of 62.5% of the male respondents were older than 15 years. The percentage of respondents with a psychiatric disorder was 82.5%. The rate of psychiatric disorders was high with disruptive behaviour disorders being the most common at 40.8%, others were substance use disorders (15.8%), anxiety disorders (14.2%), psychosis (6.7%) and mood disorders (5%).

Conclusion

This study has established a high prevalence rate of psychiatric disorders amongst incarcerated adolescents. This is in line with the findings of numerous studies worldwide. This study has identified the need to increase awareness and knowledge about the high morbidity of mental disorders in growing juvenile detainee populations. This will allow early identification of adolescents at risk of psychiatric disorders and ensure efficient resource distribution of both JJS service and mental healthcare. Effective and appropriate interventions have shown to improve overall health, quality of life and reduce the rate of recidivism amongst incarcerated juveniles.

An Updated Systematic Review and Meta-regression Analysis: Mental Disorders Among Adolescents in Juvenile Detention and Correctional Facilities

OBJECTIVE

To synthesize evidence on the prevalence of mental disorders in adolescents in juvenile detention and correctional facilities and examine sources of heterogeneity between studies.

METHOD

Electronic databases and relevant reference lists were searched to identify surveys published from January 1966 to October 2019 that reported on the prevalence of mental disorders in unselected populations of detained adolescents. Data on the prevalence of a range of mental disorders (psychotic illnesses, major depression, attention-deficit/hyperactivity disorder [ADHD], conduct disorder, and posttraumatic stress disorder [PTSD]) along with predetermined study characteristics were extracted from the eligible studies. Analyses were reported separately for male and female adolescents, and findings were synthesized using random-effects models. Potential sources of heterogeneity were examined by meta-regression and subgroup analyses.

RESULTS

Forty-seven studies from 19 countries comprising 28,033 male and 4,754 female adolescents were identified. The mean age of adolescents assessed was 16 years (range, 10-19 years). In male adolescents, 2.7% (95% CI 2.0%-3.4%) had a diagnosis of psychotic illness; 10.1% (95% CI 8.1%-12.2%) major depression; 17.3% (95% CI 13.9%-20.7%) ADHD; 61.7% (95% CI 55.4%-67.9%) conduct disorder; and 8.6% (95% CI 6.4%-10.7%) PTSD. In female adolescents, 2.9% (95% CI 2.4%-3.5%) had a psychotic illness; 25.8% (95% CI 20.3%-31.3%) major depression; 17.5% (95% CI 12.1%-22.9%) ADHD; 59.0% (95% CI 44.9%-73.1%) conduct disorder; and 18.2% (95% CI 13.1%-23.2%) PTSD. Meta-regression found higher prevalences of ADHD and conduct disorder in investigations published after 2006. Female adolescents had higher prevalences of major depression and PTSD than male adolescents.

CONCLUSION

Consideration should be given to reviewing whether health care services in juvenile detention can address these levels of psychiatric morbidity.

Experiences of (young) women after out of home placement: An examination of personality disorder symptoms through the lens of child maltreatment

BACKGROUND

Child maltreatment has been associated with the development of various mental health problems, including the development of personality disorders.

OBJECTIVE

This study investigated the association between child maltreatment and personality disorder symptoms in 125 women who transitioned out of residential care.

METHOD

The Child Trauma Questionnaire was used for the measurement of child maltreatment, and Personality disorder symptoms were measured using the Personality Diagnostic Questionnaire 4 + . The Psychological Distress Index was used to control for symptoms of distress.

RESULTS

A Stepwise regression analysis showed that the majority of the associations were found between self-reported emotional abuse, neglect and personality disorder symptoms. Emotional abuse was significantly related to the Paranoid (β = .42, p<0.001), Schizoid (β = .18, p <0.05), Schizotypal (β = .18, p<0.05), Histrionic (β = .22, p<0.05), Avoidant (β = .31, p <  .001), Dependent (β = 0.31, p <  .001), Obsessive Compulsive (β = 0.29, p = .001), Passive Aggressive (β = 0.23, p<0.01) and the Depressive personality disorder (β = .38, p <  .001). Emotional neglect was significantly associated to the Borderline Personality Disorder (β = .32, p<0.001) and the Paranoid Personality Disorder (β =-0.22, p<0.05).

CONCLUSIONS

The current study underlines the detrimental effects of childhood maltreatment, and in particular the effects of emotional abuse and neglect.

Predicting quality of life during and post detention in incarcerated juveniles

Purpose

Besides reducing recidivism, juvenile justice institutions aim to rehabilitate juvenile delinquents, in order for them to reintegrate in society. As such, improving quality of life (QoL), especially post detention, is an important treatment goal. However, research is primarily focused on recidivism as an outcome measure for juvenile detention. The aim of the current study is therefore to describe and predict QoL of detained young offenders up to 1 year after an initial assessment, and to examine whether QoL differs between youth who are still detained versus released.

Methods

A sample of 186 juveniles admitted to juvenile justice institutions in the Netherlands was assessed within the institution (initial assessment/T0), using psychosocial and neurobiological factors as predictors (self-control, treatment motivation, trauma, mental health problems, respiratory sinus arrhythmia). QoL (MANSA), as well as substance use (alcohol, cannabis) and daily activities (education, work) were assessed at first, second, and third follow-up (respectively 2.5 months, 4.5 months, and 12 months after T0).

Results

QoL increased from first to third follow-up, and was higher for individuals who were no longer detained. The model that best predicted higher QoL upon follow-up consisted of lower trauma and stronger parasympathetic nervous system reactivity. The effects of the predictors did not differ between the various follow-ups, nor between individuals who were or were not detained.

Conclusion

Methods incorporating trauma-sensitive focus and relaxation techniques in treatment protocols in juvenile justice institutions may be of added value in improving the general functioning of these individuals.

The prospective usefulness of callous-unemotional traits and conduct disorder in predicting treatment engagement among detained girls

Although treatment engagement (TE) is crucial for treatment success it is not well known how likely detained girls are to engage in treatment and what features may impede them from doing so. This study is the first to examine the prognostic usefulness of two features of potential interest, being callous-unemotional (CU) traits and conduct disorder (CD), in relation to TE. Detained girls and their parents (n = 75) were interviewed with the Diagnostic Interview Schedule for Children to assess CD, and completed the Antisocial Process Screening Device to assess CU traits dimensionally and categorically as in the new diagnostic and statistical manual of mental disorders, fifth edition (DSM-5) CU-based specifier. One to two months later, the girls reported how much they engaged in treatment. At the zero-order level, self-, but not parent-reported CU traits and CD were predictive of lower levels of TE. The incorporation of CU traits into a diagnosis of CD identified girls with lower levels of future TE, a finding that held across different informants. Of note, the aforementioned findings only became apparent when using a dimensional measure of CU traits, and not when using the categorical measure of CU traits currently included in DSM-5. This study showed that CU traits can help developing an understanding of what factors hinder TE among detained girls. Our findings also support recommendations to incorporate CU traits into the CD diagnosis, and suggest that dimensional approaches to do so may yield relevant information about future levels of TE.

Do post-trauma symptoms mediate the relation between neurobiological stress parameters and conduct problems in girls?

OBJECTIVE

Attenuated activity of stress-regulating systems has consistently been reported in boys with conduct problems. Results in studies of girls are inconsistent, which may result from the high prevalence of comorbid post-trauma symptoms. Therefore, the aim of the present study is to investigate post-trauma symptoms as a potential mediator in the relation between stress-regulation systems functioning and conduct problems in female adolescents.

METHODS

The sample consisted of 78 female adolescents (mean age 15.4; SD 1.1) admitted to a closed treatment institution. The diagnosis of disruptive behaviour disorder (DBD) was assessed by a structured interview-the diagnostic interview schedule for children version IV (DISC-IV). To assess post-trauma symptoms and externalizing behaviour problems, self-report questionnaires, youth self report (YSR) and the trauma symptom checklist for Children (TSCC) were used. The cortisol awakenings response (CAR) measured hypothalamic-pituitary-adrenal (HPA) axis activity, whereas autonomous nervous system (ANS) activity was assessed by heart rate (HR), pre-ejection period (PEP) and respiratory sinus arrhythmia (RSA). Independent t-tests were used to compare girls with and without DBD, while path analyses tested for the mediating role of post- trauma symptoms in the relation between stress regulating systems and externalizing behaviour.

RESULTS

Females with DBD (n = 37) reported significantly higher rates of post-trauma symptoms and externalizing behaviour problems than girls without DBD (n = 39). Path analysis found no relation between CAR and externalizing behaviour problems. With regard to ANS activity, positive direct effects on externalizing behaviour problems were present for HR (standardized β = 0.306, p = 0.020) and PEP (standardized β = -0.323, p = 0.031), though not for RSA. Furthermore, no relation-whether direct or indirect-could be determined from post-trauma symptoms.

CONCLUSIONS

Present findings demonstrate that the neurobiological characteristics of female externalizing behaviour differ from males, since girls showed heightened instead of attenuated ANS activity. While the prevalence of post-trauma symptoms was high in girls with DBD, it did not mediate the relation between stress parameters and externalizing behaviour. Clinical implications and future directions are discussed.

Child Maltreatment and Social Connectedness Among Formerly Institutionalized Females: Links With Depression

This study aimed to examine the effects of child maltreatment subtypes (physical abuse, sexual abuse, neglect, and exposure to domestic violence) and cumulative child maltreatment on depressive symptoms in adulthood, and examine the protective effects of social connectedness in a sample of formerly institutionalized females. The sample consisted of 124 females who were institutionalized in a Dutch juvenile justice institution during adolescence and were followed-up when they were on average 32 years old. Information about child maltreatment was extracted from treatment files. Retrospective data on social connectedness in young adulthood were established during interviews using a Life History Calendar. Relationship quality at follow-up was assessed with items derived from the Rochester Youth Development Study. The Center for Epidemiological Studies Scale for Depression (CES-D) was used to measure depressive symptoms in adulthood. Results showed that 85.5% of the females experienced child maltreatment, and co-occurrence of subtypes was high. Cumulative child maltreatment increased the risk of depression in adulthood. Furthermore, social connectedness, that is, more employment over time and the quality of the romantic relationship at follow-up, protected against the development of depression. However, social connectedness did not buffer the effect of maltreatment on depression. Our findings indicate that treatment of these girls should focus on improving the social-emotional development to promote positive interpersonal relationships and include educational and vocational components to guide these girls toward increased opportunities on the labor market.

Gender differences in psychiatric disorders and clusters of self-esteem among detained adolescents

Detained minors display substantial mental health needs. This study focused on two features (psychopathology and self-esteem) that have received considerable attention in the literature and clinical work, but have rarely been studied simultaneously in detained youths. The aims of this study were to examine gender differences in psychiatric disorders and clusters of self-esteem, and to test the hypothesis that the cluster of adolescents with lower (versus higher) levels of self-esteem have higher rates of psychiatric disorders. The prevalence of psychiatric disorders was assessed in 440 Belgian, detained adolescents using the Diagnostic Interview Schedule for Children-IV. Self-esteem was assessed using the Self-perception Profile for Adolescents. Model-based cluster analyses were performed to identify youths with lower and/or higher levels of self-esteem across several domains. Girls have higher rates for most psychiatric disorders and lower levels of self-esteem than boys. A higher number of clusters was identified in boys (four) than girls (three). Generally, the cluster of adolescents with lower (versus higher) levels of self-esteem had a higher prevalence of psychiatric disorders. These results suggest that the detection of low levels of self-esteem in adolescents, especially girls, might help clinicians to identify a subgroup of detained adolescents with the highest prevalence of psychopathology.

Girls' quality of life prior to detention in relation to psychiatric disorders, trauma exposure and socioeconomic status

PURPOSE

Practice and research on detained girls has mainly been problem oriented, overlooking these minors' own perspective on and satisfaction with life. The aim of this study was to examine how girls evaluate multiple domains of quality of life (QoL) and how each domain is affected by psychiatric (co)morbidity, trauma, and socioeconomic status (SES).

METHODS

An abbreviated version of the World Health Organization (WHO) QoL Instrument was used to assess the girls' (N = 121; M(age) = 16.28) QoL prior to detention. This self-report questionnaire consists of two benchmark items referring to their overall QoL and health, and 24 remaining items measuring their QoL regarding four domains (physical health, psychological health, social relationships, and environment). The Diagnostic Interview Schedule for Children-IV was used to assess the past-year prevalence of psychiatric disorders and life-time trauma exposure.

RESULTS

Detained girls perceived their QoL almost as good as the 12- to 20-year-olds from the WHO's international field trial on all but one domain (i.e., psychological health). They were most satisfied with their social relationships and least satisfied with their psychological health. Psychiatric disorders, trauma, and low SES were distinctively and negatively related to various domains of QoL. The girls' psychological health was most adversely affected by psychosocial and socioeconomic problems, while these variables had an almost negligible impact on their satisfaction with their social relationships.

CONCLUSIONS

The particularity of each domain of QoL supports a multidimensional conceptualization of QoL. Regarding treatment, psychological health appears as a domain of major concern, while social relationships might serve as a source of resilience.

Persistence of aggression into adulthood in detained adolescent females

OBJECTIVE

Although detained adolescent females show high rates of severe aggression, we know little about the long-term impact of this risk-behavior. Furthermore, qualitative differences in aggression between males and females argue for gender specific research. In contrast to males, females display aggressive acts more often towards themselves (inward aggression; self harm behavior) than towards others (outward aggression). Therefore, this prospective study investigated the prevalence and predictive validity of different types of aggression in detained adolescent females.

METHOD

Participants were 139 adolescent females (mean age 20.1) assessed at start of detention and 5 years later. Both inward and outward aggression subtypes were assessed twice using standardized instruments. Mutual relations over time were analyzed by means of structural equation modeling.

RESULTS

High levels of all types of aggression were found repeatedly, suggesting substantial persistence over time. While inward aggression predicted both inward and outward aggression at follow-up, outward aggression was related to outward aggression only. Furthermore, the covert form of outward aggression only, and not the overt subtype, predicted outward aggression 5 years later.

CONCLUSIONS

This study suggests that aggression in detained adolescent females does not fade away, and should thus be given substantial clinical attention. In assessment, focus should also be on inward and covert subtypes. Further research should explore the necessity of developing gender-specific diagnostic instruments, treatment modules and risk assessment tools. When replicated, our findings may also bear implications for the classification of behavior disorders in adolescent females.

Girls in residential care: from child maltreatment to trauma-related symptoms in emerging adulthood

The current study examined the association between child maltreatment and trauma-related symptoms in emerging adulthood--over and above the incidence of such symptoms and conduct problems during adolescence--among a sample of female adolescents in residential care. This study used data from a longitudinal study. The sample was composed of 89 adolescent females who were first interviewed at time of admission in a residential center (M(age)=15.33 years, SD=1.31) and later in young adulthood (M(age)=19.27, SD=1.55). At time 1, trauma-related symptoms were assessed with the Trauma Symptom Checklist for Children and conduct problems with a composite measure. At time 2, child maltreatment was assessed retrospectively with the Childhood Trauma Questionnaire, and trauma-related symptoms were reassessed with the Trauma Symptom Inventory-2. Results indicated that child maltreatment, especially emotional abuse and neglect, was related to anxious arousal, depression, and anger in emerging adulthood. This study showed that females from our sample often reported different types of maltreatment during childhood and that these traumatic experiences were significantly associated with poor adult psychological functioning.