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Cavelti M, Thompson K, Betts J, Fowler C, Luebbers S, Cotton SM, Chanen AM. Borderline Personality Disorder Diagnosis and Symptoms in Outpatient Youth as Risk Factors for Criminal Offenses and Interpersonal Violence. J Pers Disord 2021; 35:23-37. [PMID: 33779276 DOI: 10.1521/pedi_2021_35_503] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The aim of the current study was to examine the risk for offending among outpatient youth with borderline pathology. Demographic and diagnostic data from 492 outpatients who attended a public mental health service for 15-to 25-year-olds between January 1998 and March 2008 were linked with information regarding criminal offenses and intervention orders collected from a statewide police database between March 1993 and June 2017. BPD diagnosis and number of BPD criteria were both associated with an elevated risk for violent and nonviolent offenses and family violence intervention orders. Moderation analyses revealed that the number of BPD criteria might affect males and females differently in terms of offending. Both impulsivity and anger independently predicted the risk for violent and nonviolent offenses and family violence intervention orders. Early detection of increased risk of offending among youth with BPD features is essential to develop targeted treatments for criminal or violent behavior.
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Affiliation(s)
- Marialuisa Cavelti
- Orygen, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia.,University Hospital for Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Katherine Thompson
- Orygen, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Jennifer Betts
- Orygen, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | | | - Stefan Luebbers
- Centre for Forensic Behavioural Science, Swinburne University of Technology, Melbourne, Australia
| | - Sue M Cotton
- Orygen, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Andrew M Chanen
- Orygen, Melbourne, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
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Piehler TF, Distefano R, Ausherbauer K, Bloomquist ML, Almy B, August GJ. Self-Regulatory Profiles and Conduct Problems in Youth Referred to Juvenile Diversion. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2020; 30:372-388. [PMID: 31539179 PMCID: PMC7082186 DOI: 10.1111/jora.12530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The current study utilized a person-centered approach to explore how self-regulatory profiles relate to conduct problems in an ethnically diverse sample of 197 adolescents referred to juvenile diversion programming. Utilizing a multidomain, multimethod battery of self-regulation indicators, three common profiles emerged in a latent profile analysis. The profiles represented an Adaptive group, a Cognitively Inflexible group, and an Emotionally Dysregulated group. Group membership was associated with severity and type of conduct problems as well as callous and unemotional traits. The Adaptive group demonstrated lower severity conduct problems when compared to the other groups. The Emotionally Dysregulated group was more likely to commit violent offenses and demonstrated higher levels of some callous and unemotional traits than youth characterized by cognitive inflexibility.
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Affiliation(s)
- Timothy F. Piehler
- Corresponding Author Contact Information: 290 McNeal Hall, 1985 Buford Avenue, Saint Paul, MN, 55108, Phone: 612-301-1484, Fax: 612-625-4227,
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The validity of conduct disorder symptom profiles in high-risk male youth. Eur Child Adolesc Psychiatry 2019; 28:1537-1546. [PMID: 31004293 DOI: 10.1007/s00787-019-01339-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 04/15/2019] [Indexed: 01/03/2023]
Abstract
Conduct disorder (CD) is a heterogeneous pattern of rule-breaking and aggressive symptoms. Until now it has been unclear whether valid, clinically useful symptom profiles can be defined for populations in youth at high-risk of CD. Interview-based psychiatric disorders, CD symptoms and officially recorded offences were assessed in boys from a detention facility and a forensic psychiatric hospital (N = 281; age 11.2-21.3 years). We used latent class analyses (LCA) to examine CD subtypes and their relationships with comorbid psychiatric disorders, suicidality, and criminal recidivism. LCA revealed five CD subtypes: no CD, mild aggressive CD, mild covert CD, moderate CD, and severe CD. The severe and, to a lesser degree, the moderate CD subtype were related to comorbid attention deficit hyperactivity disorder, substance use disorder, affective disorder, and suicidality. Time to violent criminal re-offending was predicted by severe CD (OR 5.98, CI 2.5-13.80) and moderate CD (OR 4.18, CI 1.89-9.21), but not by any other CD subtype in multivariate Cox regressions (controlling for age, low socioeconomic status and foreign nationality). These results confirm the existence of different CD symptom profiles in a high-risk group. Additional variable-oriented analyses with CD symptom count and aggressive/rule-breaking CD-dimensions further supported a dimensional view and a dose-response relationship of CD and criminal recidivism. Classifying high-risk young people according to the number of aggressive and rule-breaking CD symptoms is of major clinical importance and may provide information about risk of violent recidivism.
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Rinnewitz L, Parzer P, Koenig J, Bertsch K, Brunner R, Resch F, Kaess M. A Biobehavioral Validation of the Taylor Aggression Paradigm in Female Adolescents. Sci Rep 2019; 9:7036. [PMID: 31065043 PMCID: PMC6504877 DOI: 10.1038/s41598-019-43456-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 04/18/2019] [Indexed: 01/12/2023] Open
Abstract
This research assessed the behavioral, emotional, endocrinological and autonomic reactivity to the laboratory Taylor Aggression Paradigm (TAP) in a sample of healthy female adolescents. Twenty participants were induced with the TAP to behave aggressively (aggression group) and 20 age-matched participants were not induced to behave aggressively (control group). Regression analysis revealed that the aggression group displayed significant higher levels of aggressive behavior compared to the control group (χ2 (2) = 255.50, p < 0.0001). Aggressive behavior was not related to self-reported measures of trait aggression, impulsiveness or psychopathy features. Regarding the biological responses, regression analysis on cortisol, missed the set level of significance (χ2 (1) = 3.73, p = 0.054), but showed significant effects on heart rate as a function of aggression induction (χ2 (1) = 5.81, p = 0.016). While aggression induction was associated with increased autonomic arousal (heart rate), the interpretation of the effects on cortisol warrant caution, given existing differences between groups at baseline and overly elevated cortisol attributable to the general experimental procedures and not the TAP per se. No differences were found with respect to testosterone. In summary, the present study lends preliminary support for the validity of the TAP and its use in female adolescents on a behavioral and autonomic level.
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Affiliation(s)
- Lena Rinnewitz
- Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Blumenstrasse 8, 69115, Heidelberg, Germany.,Clinic of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Blumenstrasse 8, 69115, Heidelberg, Germany
| | - Peter Parzer
- Clinic of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Blumenstrasse 8, 69115, Heidelberg, Germany
| | - Julian Koenig
- Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Blumenstrasse 8, 69115, Heidelberg, Germany
| | - Katja Bertsch
- Clinic of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Vossstrasse 2, 69115, Heidelberg, Germany
| | - Romuald Brunner
- Clinic of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Blumenstrasse 8, 69115, Heidelberg, Germany.,Department of Child and Adolescent Psychiatry, University of Regensburg, Universitätsstraße 84, 93053, Regensburg, Germany
| | - Franz Resch
- Clinic of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Blumenstrasse 8, 69115, Heidelberg, Germany
| | - Michael Kaess
- Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Blumenstrasse 8, 69115, Heidelberg, Germany. .,Clinic of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Blumenstrasse 8, 69115, Heidelberg, Germany. .,University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland.
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Whipp AM, Korhonen T, Raevuori A, Heikkilä K, Pulkkinen L, Rose RJ, Kaprio J, Vuoksimaa E. Early adolescent aggression predicts antisocial personality disorder in young adults: a population-based study. Eur Child Adolesc Psychiatry 2019; 28:341-350. [PMID: 30019148 PMCID: PMC6407741 DOI: 10.1007/s00787-018-1198-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 07/07/2018] [Indexed: 11/04/2022]
Abstract
Modestly prevalent in the general population (~ 4%), but highly prevalent in prison populations (> 40%), the diagnosis of antisocial personality disorder (ASPD) involves aggression as one of several possible criteria. Using multiple informants, we aimed to determine if general aggression, as well as direct and indirect subtypes, assessed in early adolescence (ages 12, 14) predict young adulthood ASPD in a population-based sample. Using data from a Finnish population-based longitudinal twin cohort study with psychiatric interviews available at age 22 (N = 1347), we obtained DSM-IV-based ASPD diagnoses. Aggression measures from ages 12 (parental and teacher ratings) and 14 (teacher, self, and co-twin ratings) were used to calculate odds ratios (OR) of ASPD from logistic regression models and the area under the curve (AUC) from receiver operating characteristic curve analysis. Analyses were adjusted for sex, age, and family structure. All informants' aggression ratings were significant (p < 0.05) predictors of ASPD (OR range 1.3-1.8; AUC range 0.65-0.72). Correlations between informants ranged from 0.13 to 0.33. Models including two or more aggression ratings, particularly age 14 teacher and self ratings, more accurately predicted ASPD (AUC: 0.80; 95% confidence interval 0.73-0.87). Direct aggression rated by all informants significantly predicted ASPD (OR range 1.4-1.9), whereas only self-rated indirect aggression was significantly associated with ASPD (OR = 1.4). Across different informants, general and direct aggression at ages 12 and 14 predicted ASPD in a population-based sample. Psychiatric, social, and parenting interventions for ASPD prevention should focus on children and adolescents with high aggression levels, with an aim to gather information from multiple informants.
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Affiliation(s)
- Alyce M. Whipp
- 0000 0004 0410 2071grid.7737.4Institute for Molecular Medicine Finland, University of Helsinki, PL 20 (Tukholmankatu 8 B), 00014 Helsinki, Finland
| | - Tellervo Korhonen
- 0000 0004 0410 2071grid.7737.4Institute for Molecular Medicine Finland, University of Helsinki, PL 20 (Tukholmankatu 8 B), 00014 Helsinki, Finland ,0000 0004 0410 2071grid.7737.4Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Anu Raevuori
- 0000 0004 0410 2071grid.7737.4Department of Public Health, University of Helsinki, Helsinki, Finland ,0000 0000 9950 5666grid.15485.3dDepartment of Adolescent Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
| | - Kauko Heikkilä
- 0000 0004 0410 2071grid.7737.4Institute for Molecular Medicine Finland, University of Helsinki, PL 20 (Tukholmankatu 8 B), 00014 Helsinki, Finland
| | - Lea Pulkkinen
- 0000 0001 1013 7965grid.9681.6Department of Psychology, University of Jyvaskyla, Jyvaskyla, Finland
| | - Richard J. Rose
- 0000 0001 0790 959Xgrid.411377.7Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN USA
| | - Jaakko Kaprio
- 0000 0004 0410 2071grid.7737.4Institute for Molecular Medicine Finland, University of Helsinki, PL 20 (Tukholmankatu 8 B), 00014 Helsinki, Finland ,0000 0004 0410 2071grid.7737.4Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Eero Vuoksimaa
- 0000 0004 0410 2071grid.7737.4Institute for Molecular Medicine Finland, University of Helsinki, PL 20 (Tukholmankatu 8 B), 00014 Helsinki, Finland
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