Community Violence Exposure and Conduct Problems in Children and Adolescents with Conduct Disorder and Healthy Controls

Exposure to community violence as a mechanism linking neighborhood socioeconomic disadvantage and neural responses to reward

A growing literature links socioeconomic disadvantage and adversity to brain function, including disruptions in reward processing. Less research has examined exposure to community violence (ECV) as a specific adversity related to differences in reward-related brain activation, despite the prevalence of community violence exposure for those living in disadvantaged contexts. The current study tested whether ECV was associated with reward-related ventral striatum (VS) activation after accounting for familial factors associated with differences in reward-related activation (e.g. parenting and family income). Moreover, we tested whether ECV is a mechanism linking socioeconomic disadvantage to reward-related activation in the VS. We utilized data from 444 adolescent twins sampled from birth records and residing in neighborhoods with above-average levels of poverty. ECV was associated with greater reward-related VS activation, and the association remained after accounting for family-level markers of disadvantage. We identified an indirect pathway in which socioeconomic disadvantage predicted greater reward-related activation via greater ECV, over and above family-level adversity. These findings highlight the unique impact of community violence exposure on reward processing and provide a mechanism through which socioeconomic disadvantage may shape brain function.

Effectiveness of Community-Based Programs on Aggressive Behavior Among Children and Adolescents: A Systematic Review and Meta-Analysis

Adolescent aggressive behavior has increasingly become a central issue affecting the safety of both school campuses and the broader society. Despite the existence of numerous community interventions targeting this issue, there has been a paucity of efforts to consolidate the findings on the effectiveness of community-based programs in preventing aggressive behavior. This meta-analysis sought to address this gap by reviewing and assessing the impact of community-based initiatives on reducing adolescent aggression. A thorough search was carried out on 12 electronic databases: EBSCO, ERIC, PubMed, PsycINFO, MEDLINE, EMBASE, Scopus, Web of Science, ProQuest Dissertations and Theses, the China National Knowledge, Wanfang Databases, and China Science and Technology Journal Database. Sixteen studies were finalized, and meta-analyses were performed using a random effect model on RevMan v5.4 software developed by Cochrane. The analysis encompassed 16 published studies, involving a total of 2,585 participants. The key components of existing programs for aggression reduction included providing behavioral skills and training for adolescents, employing a problem-solving approach to address behavioral issues, offering psychological treatment, and emphasizing community supervision. The results indicate a significant positive effect of community-based interventions on aggression reduction (standardized mean difference = -0.26, 95% confidence intervals [-0.39, -0.13], Z = 3.84, p < .001). The subgroup analyses revealed that the intervention's effectiveness was moderated by the duration of the intervention, its theoretical foundation, and the sample size. This study furnishes empirical evidence supporting the enhancement of policies and practices to foster community engagement in mitigating aggressive behavior.

Neighborhood Crime and Externalizing Behavior in Toddlers: A Longitudinal Study With Neonatal fMRI and Parenting

OBJECTIVE

Prenatal exposure to neighborhood crime has been associated with weaker neonatal frontolimbic connectivity; however, associations with early childhood behavior remain unclear. We hypothesized that living in a high-crime neighborhood would be related to higher externalizing symptoms at age 1 and 2 years, over and above other adversities, and that neonatal frontolimbic connectivity and observed parenting behaviors at 1 year would mediate this relationship.

METHOD

Participants included 399 pregnant women, recruited as part of the Early Life Adversity, Biological Embedding, and Risk for Developmental Precursors of Mental Disorders (eLABE) study. Geocoded neighborhood crime data was obtained from Applied Geographic Solution. A total of 319 healthy, non-sedated neonates underwent scanning using resting-state functional magnetic resonance imaging (fMRI) on a Prisma 3T scanner and had ≥10 minutes of high-quality data. Infant-Toddler Socioemotional Assessment Externalizing T scores were available for 274 mothers of 1-year-olds and 257 mothers of 2-year-olds. Observed parenting behaviors were available for 202 parent-infant dyads at 1 year. Multilevel and mediation models tested longitudinal associations.

RESULTS

Living in a neighborhood with high violent (β = 0.15, CI = 0.05-0.27, p = .004) and property (β = 0.10, CI = 0.01-0.20, p = .039) crime was related to more externalizing symptoms at 1 and 2 years, controlling for other adversities. Weaker frontolimbic connectivity was also associated with higher externalizing symptoms at 1 and 2 years. After controlling for other adversities, parenting behaviors mediated the specific association between crime and externalizing symptoms, but frontolimbic connectivity did not.

CONCLUSION

These findings provide evidence that early exposure to neighborhood crime and weaker neonatal frontolimbic connectivity may influence later externalizing symptoms, and suggest that parenting may be an early intervention target for families in high-crime areas.

DIVERSITY & INCLUSION STATEMENT

We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.

Action initiation and punishment learning differ from childhood to adolescence while reward learning remains stable

Theoretical and empirical accounts suggest that adolescence is associated with heightened reward learning and impulsivity. Experimental tasks and computational models that can dissociate reward learning from the tendency to initiate actions impulsively (action initiation bias) are thus critical to characterise the mechanisms that drive developmental differences. However, existing work has rarely quantified both learning ability and action initiation, or it has relied on small samples. Here, using computational modelling of a learning task collected from a large sample (N = 742, 9-18 years, 11 countries), we test differences in reward and punishment learning and action initiation from childhood to adolescence. Computational modelling reveals that whilst punishment learning rates increase with age, reward learning remains stable. In parallel, action initiation biases decrease with age. Results are similar when considering pubertal stage instead of chronological age. We conclude that heightened reward responsivity in adolescence can reflect differences in action initiation rather than enhanced reward learning.

Conduct problems among middle adolescents in the community settings: A concept analysis

Background

Adolescent problem behavior in research and practice has been traditionally categorized as Oppositional Deviant Disorder and Conduct Disorder. However, a significant number of adolescents remain underdiagnosed. To address this issue, the term "Conduct Problem" has emerged as a commonly used descriptor for those who have not yet received a formal diagnosis, particularly within the community. It is crucial for nurses to comprehend the characteristics of these conduct problems to address them effectively.

Objective

This concept analysis aimed to clarify the concept of conduct problems among adolescents aged 14 to 16, specifically within community settings.

Methods

The concept analysis followed Walker and Avant's approach. The usage of the concept was examined in five databases (PsyINFO, ProQuest, PubMed, ScienceDirect, Scopus), which yielded 41 relevant studies for comprehensive analysis.

Results

The identified attributes of conduct problems in adolescents included oppositional problems, antisocial problems, and criminal-related problems. These conduct problems were found to have antecedents stemming from personal, parental, and environmental factors. Furthermore, the consequences of conduct problems significantly impacted both middle adolescents and their parents.

Conclusion

The findings of this concept analysis contribute to a better comprehension of the concept of conduct problems among middle adolescents in community settings. The insights gained from this analysis will assist in using this term more effectively in research and nursing practice, ultimately leading to improved care and support for affected adolescents and their families.

Timing of Violence Exposure and Girls' Temperament Stability From Childhood to Adolescence

Individual differences in temperament (e.g., negative emotionality) are robust early predictors of emotional and behavioral health. Although temperament is often conceptualized as relatively stable across the lifespan, evidence suggests that it may change over time as a function of social context. Extant studies have been limited by cross-sectional or short-term longitudinal designs that have precluded tests of stability as well as factors that may influence stability across developmental periods. In addition, few studies have tested the impact of social contexts that are common for children living in urban and under-resourced environments, such as exposure to community violence. In the present study we hypothesized that levels of negative emotionality, activity, and shyness would decrease across development from childhood to mid-adolescence as a function of early exposure to violence in the Pittsburgh Girls Study, a community study of girls enriched for families living in low-resourced neighborhoods. Temperament was assessed by parent- and teacher-report on the Emotionality Activity Sociability Shyness Temperament Survey in childhood (5-8-years-old), early-adolescence (11-years-old), and mid-adolescence (15-years-old). Violence exposure (e.g., victim of or witness to violent crime, exposure to domestic violence) was assessed annually via child and parent report. Results showed that on average, combined caregiver and teacher reports of negative emotionality and activity level exhibited small but significant reductions from childhood to adolescence, whereas shyness remained stable. Violence exposure in early adolescence predicted increases in negative emotionality and shyness by mid-adolescence. Violence exposure was not associated with stability of activity level. Our findings suggest that exposure to violence, particularly in early adolescence, amplifies individual differences in shyness and negative emotionality, underlying an important pathway of risk for developmental psychopathology.

A multinational case-control study comparing forensic and non-forensic patients with schizophrenia spectrum disorders: the EU-VIORMED project

BACKGROUND

The relationship between schizophrenia and violence is complex. The aim of this multicentre case-control study was to examine and compare the characteristics of a group of forensic psychiatric patients with a schizophrenia spectrum disorders and a history of significant interpersonal violence to a group of patients with the same diagnosis but no lifetime history of interpersonal violence.

METHOD

Overall, 398 patients (221 forensic and 177 non-forensic patients) were recruited across five European Countries (Italy, Germany, Poland, Austria and the United Kingdom) and assessed using a multidimensional standardised process.

RESULTS

The most common primary diagnosis in both groups was schizophrenia (76.4%), but forensic patients more often met criteria for a comorbid personality disorder, almost always antisocial personality disorder (49.1 v. 0%). The forensic patients reported lower levels of disability and better social functioning. Forensic patients were more likely to have been exposed to severe violence in childhood. Education was a protective factor against future violence as well as higher levels of disability, lower social functioning and poorer performances in cognitive processing speed tasks, perhaps as proxy markers of the negative syndrome of schizophrenia. Forensic patients were typically already known to services and in treatment at the time of their index offence, but often poorly compliant.

CONCLUSIONS

This study highlights the need for general services to stratify patients under their care for established violence risk factors, to monitor patients for poor compliance and to intervene promptly in order to prevent severe violent incidents in the most clinically vulnerable.

Impaired sustained attention in groups at high risk for antisocial personality disorder: A contingent negative variation and standardized low-resolution tomographic analysis study

Objective

This study aimed to explore the characteristics of contingent negative variation (CNV) in groups at high risk for antisocial personality disorder.

Materials and methods

A classic CNV paradigm was used to compare the characteristics of attention maintenance among a group of individuals with conduct disorder (CD group; n = 27), a group of individuals with antisocial personality traits (AP; n = 29), a group of individuals with conduct disorder and antisocial personality traits (CD + AP group; n = 25), and a group of healthy controls (CG group; n = 30), to examine the characteristics of the amplitude and latency of CNV in different processing stages.

Results

Results of the event-related potential analysis were as follows: The mean amplitude analysis between 500 and 1,000 ms revealed that the mean CNV amplitudes in the CD + AP group (-1.388 ± 0.449 μV, P < 0.001) were significantly lower than that in the CG group (-4.937 ± 0.409 μV). The mean amplitude analysis between 1,000 and 1,500 ms revealed that the mean CNV amplitude in the CD + AP group (-0.931 ± 0.646 μV) was significantly lower than that in the CG group (4.809 ± 0.589 μV, P < 0.001). The mean amplitude analysis between 1,500 and 2,000 ms revealed that the mean CNV amplitude in the CG group (3.121 ± 0.725 μV) was significantly higher than that in the CD + AP group (-0.277 ± 0.795 μV, P = 0.012), whereas the mean CNV amplitude in the CD + AP group was not significantly different in the AP group (P = 0.168) and CD group (P > 0.05). Source localization results indicated altered activity in frontal-temporal regions.

Conclusion

The CNV amplitude characteristics in the CD + AP group and AP group were more consistent and fluctuated around the baseline, indicating the absence of attention maintenance resulted in impairments in attention allocation and motor preparation in the CD + AP group and AP group.

Evidencing the Need to Screen for Social Determinants of Health Among Boys Entering a Juvenile Prison: A Latent Profile Analysis

Social determinants of health influence who ends up in the juvenile legal system and how individuals fare when entering and leaving the system. The present study utilized latent profile analysis to determine the extent to which social determinants of health were present in a sample of incarcerated youth and the patterns in which they appear. The authors then examined their relationships to racial groups, depression, substance misuse, and recidivism risk. Data were from 1288 adolescent boys sentenced to a juvenile prison in one Southeastern state for serious offending (i.e., repeat offenses, offenses involving physical or sexual violence). We ran a latent class analysis to test for patterns with which youth present with various social determinants of health. Profiles with more violence exposure and higher social support were comprised of more Black boys than the referent profile. Property and sexual offenses also differed significantly from the referent profile. Altogether, results from our examination of selected social determinants of health indicated such factors meaningfully contribute to our understanding of experiences of young people in the juvenile legal system and may be targets for mental health and substance use intervention as they may contribute to problem behaviors or negative outcomes.

Home, school, and community violence exposure and emotional and conduct problems among low-income adolescents: the moderating role of age and sex

PURPOSE

The purpose of this study is to assess whether violence exposure is associated with emotional/conduct problems, when adjusting for confounders/covariates and controlling for comorbidity, and to investigate interactions between violence exposure and sex and/or age.

METHODS

This cross-sectional study evaluated a community-based sample of 669 in-school 11-15-year-olds. A three-stage probabilistic sampling plan included a random selection of census units, eligible households, and target child. Multivariable logistic regression investigated the effect of severe physical punishment by parents, peer victimization at school, and community violence on the study outcomes (adolescent-reported emotional/conduct problems identified by the Strengths and Difficulties Questionnaire/SDQ) when controlling for confounders (resilience, parental emotional warmth, maternal education/unemployment/anxiety/depression) and covariates (age, sex, stressful life events, parental rejection).

RESULTS

Considering interactions, emotional problems were associated with community violence victimization among girls, while conduct problems were associated with severe physical punishment among the younger, suffering peer aggression among the oldest, bullying victimization among girls, and witnessing community violence among boys. Desensitization (less emotional problems with greater violence exposure) was noted among the youngest exposed to severe physical punishment and the oldest who witnessed community violence.

CONCLUSION

Age and sex are moderators of the association between violence exposure and emotional/conduct problems. Interventions at local health units, schools, and communities could reduce the use of harsh physical punishment as a parental educational method, help adolescents deal with peer aggression at school and keep them out of the streets by increasing the usual five hours in school per day and making free sports and cultural/leisure activities available near their homes.

Community Violence Exposure and Youth Aggression: The Moderating Role of Working Memory

Community violence exposure (CVE) is associated with aggression among youth, particularly those who reside in low-income, urban neighborhoods. However, not all youth who experience CVE exhibit aggression. Working memory (WM) difficulties may interfere with attributions or retrieval of nonaggressive responses, suggesting that individual differences in WM may contribute to proactive and/or reactive aggression among youth who experience CVE. Participants were 104 low-income, urban youth (M = 9.92 ± 1.22 years old; 50.5% male; 95% African American). Youth reported on frequency of direct victimization and witnessing of violence in the community and completed two WM tasks. Teachers reported on youth proactive and reactive aggression. WM moderated the relation between direct victimization and proactive and reactive aggression, and between witnessing violence and reactive aggression. Among youth reporting less frequent victimization and witnessing, lower WM was associated with higher levels of proactive and reactive aggression. Among youth reporting more frequent direct victimization, lower WM was associated with higher levels of proactive aggression. Proactive and reactive aggression levels were similar among youth reporting more frequent witnessing regardless of WM levels. WM represents a potential target for early identification and intervention efforts to reduce reactive and proactive aggression among low-income, urban youth who are at elevated risk for CVE.

Positive and negative parenting in conduct disorder with high versus low levels of callous-unemotional traits

Less is known about the relationship between conduct disorder (CD), callous-unemotional (CU) traits, and positive and negative parenting in youth compared to early childhood. We combined traditional univariate analyses with a novel machine learning classifier (Angle-based Generalized Matrix Learning Vector Quantization) to classify youth (N = 756; 9-18 years) into typically developing (TD) or CD groups with or without elevated CU traits (CD/HCU, CD/LCU, respectively) using youth- and parent-reports of parenting behavior. At the group level, both CD/HCU and CD/LCU were associated with high negative and low positive parenting relative to TD. However, only positive parenting differed between the CD/HCU and CD/LCU groups. In classification analyses, performance was best when distinguishing CD/HCU from TD groups and poorest when distinguishing CD/HCU from CD/LCU groups. Positive and negative parenting were both relevant when distinguishing CD/HCU from TD, negative parenting was most relevant when distinguishing between CD/LCU and TD, and positive parenting was most relevant when distinguishing CD/HCU from CD/LCU groups. These findings suggest that while positive parenting distinguishes between CD/HCU and CD/LCU, negative parenting is associated with both CD subtypes. These results highlight the importance of considering multiple parenting behaviors in CD with varying levels of CU traits in late childhood/adolescence.

Community Violence Exposure and School Functioning in Youth: Cross-Country and Gender Perspectives

Background: Many children and adolescents experience violent events which can be associated with negative consequences for their development, mental health, school, and social functioning. However, findings between settings and on the role of gender have been inconsistent. This study aimed to investigate cross-country and gender differences in the relationship between community violence exposure (CVE) and school functioning in a sample of youths from three countries. Methods: A self-report survey was conducted among school students (12-17 years old) in Belgium (Antwerp, N = 4,743), Russia (Arkhangelsk, N = 2,823), and the US (New Haven, N = 4,101). Students were recruited from within classes that were randomly selected from within schools that had themselves been randomly selected (excepting New Haven, where all students were included). CVE was assessed with the Screening Survey of Exposure to Community Violence. School functioning was assessed with four measures: the Perceived Teacher Support scale, Negative Classroom Environment scale, and Academic Motivation and Perception of Safety at School scales. Multivariate Analyses of Covariance were performed to assess differences in the levels of school-related problem behaviors in boys and girls, who reported different degrees of CVE. Results: Participants in all three countries reported a relatively high prevalence of violence exposure (36.2% in Belgium, 39.3% in Russia and 45.2% in the US who witnessed violence), with a higher proportion of girls than boys witnessing violent events (varied from 37.4 to 51.6% between the countries), whereas boys reported more episodes of victimization by violence than girls (varied from 32.3 to 49.9% between the countries). Youths who experienced increased CVE (from no exposure to witnessing to victimization) reported an increase in all school functioning problems in all of the countries and this association was not gender-specific. Conclusions: Our findings suggest that regardless of differences in the level of CVE by country and gender, violence exposure is negatively associated with school functioning across countries. Nonetheless, even though reactions to community violence among adolescents may be expressed in a similar fashion, cross-country differences in social support systems should also be taken into account in order to provide culturally sensitive treatment modalities.

Differences and similarities in lying frequency, moral evaluations, and beliefs about lying among children with and without conduct problems

The current study examined whether children (6-12 years old) with varying levels of conduct problems differ from those without conduct problems in three key areas: their perceptions of how often other people tell lies, their moral evaluations of truth- and lie-telling in different social contexts, and how often they tell antisocial and prosocial (i.e., "white") lies. Using a continuous measurement of conduct problems, we found that children with greater conduct problems believed that other people tell lies more often compared with children with fewer conduct problems. However, unexpectedly, children's moral evaluations of truth- and lie-telling in antisocial and prosocial contexts did not significantly differ based on conduct problems. Using parent-report methods, we found that children tell more antisocial lies with increasing severity of conduct problems, but they tell prosocial lies at a similar rate regardless of conduct problems. Finally, after grouping children based on level of conduct problems (none, low, or high), we found that children in the group with no conduct problems told more prosocial lies than antisocial lies, but the reverse was found for children in the group with high conduct problems. These findings highlight the importance of considering social context when examining the development of lying in children experiencing conduct problems.

Modeling the Comorbidity of Cannabis Abuse and Conduct Disorder/Conduct Problems from a Cognitive Neuroscience Perspective

Objective: A cognitive neuroscience perspective seeks to understand behavior, in this case the comorbidity of cannabis abuse and conduct disorder/conduct problems, in terms of dysfunction in cognitive processes underpinned by neural processes. The goal of this review is to articulate a cognitive neuroscience account of this comorbidity. Methods: Literature on the following issues will be reviewed: (i) the longitudinal relationship between cannabis abuse and conduct disorder/conduct problems (CD/CP); (ii) the extent to which there are genetic and environmental (specifically maltreatment) factors that underpin this relationship; (iii) forms of neurocognitive function that are reported dysfunctional in CD/CP and also, when dysfunctional, appear to be risk factors for future cannabis abuse; and (iv) the extent to which cannabis abuse may further compromise these systems leading to increased future abuse and greater conduct problems. Results: CD/CP typically predate cannabis abuse. There appear to be shared genetic factors that contribute to the relationship between CD/CP and cannabis abuse. Moreover, trauma exposure increases risk for both cannabis abuse and CP/CD. One form of neurocognitive dysfunction, response disinhibition, that likely exacerbates the symptomatology of many individuals with CD also appears to increase the risk for cannabis abuse. The literature with respect to other forms of neurocognitive dysfunction remains inconclusive. Conclusions: Based on the literature, a causal model of the comorbidity of cannabis abuse and CD/CP is developed.

Cognitive-Emotional and Inhibitory Deficits as a Window to Moral Decision-Making Difficulties Related to Exposure to Violence

In the present review, we illustrate how exposure to violence results in an increased probability of developing functional impairments of decision mechanisms necessary for moral behavior. We focus in particular on the detrimental effects of exposure to violence on emotional (e.g., Empathy), cognitive (e.g., Theory of Mind), and inhibitory control abilities. Relying on studies that document impaired moral behavior in individuals with deficits in these abilities, we propose a "model" of how exposure to violence can affect moral behavior. We then discuss how impaired moral decision making can also be a factor increasing the likelihood of reiterating violence: agents who lack abilities such as understanding and resonating with others' emotions or inhibitory control, can lead to an increase of violent displays. Thus, if not properly addressed, the noxious effects of exposure to violence on morality can lead to a violence generating cycle. We conclude proposing that interventions targeted at improving moral behavior can maximize their efficacy focusing on mitigating the impact of violence on the basic cognitive, emotional, and inhibitory abilities discussed.

Conduct disorder

Conduct disorder (CD) is a common and highly impairing psychiatric disorder that usually emerges in childhood or adolescence and is characterized by severe antisocial and aggressive behaviour. It frequently co-occurs with attention-deficit/hyperactivity disorder (ADHD) and often leads to antisocial personality disorder in adulthood. CD affects ~3% of school-aged children and is twice as prevalent in males than in females. This disorder can be subtyped according to age at onset (childhood-onset versus adolescent-onset) and the presence or absence of callous-unemotional traits (deficits in empathy and guilt). The aetiology of CD is complex, with contributions of both genetic and environmental risk factors and different forms of interplay among the two (gene-environment interaction and correlation). In addition, CD is associated with neurocognitive impairments; smaller grey matter volume in limbic regions such as the amygdala, insula and orbitofrontal cortex, and functional abnormalities in overlapping brain circuits responsible for emotion processing, emotion regulation and reinforcement-based decision-making have been reported. Lower hypothalamic-pituitary-adrenal axis and autonomic reactivity to stress has also been reported. Management of CD primarily involves parent-based or family-based psychosocial interventions, although stimulants and atypical antipsychotics are sometimes used, especially in individuals with comorbid ADHD.

Violence exposure in an urban city: A GxE interaction with aggressive and impulsive behaviors

BACKGROUND

Previous research has demonstrated a reciprocal relationship between community violence exposure and disruptive behavior problems among youth. No study to date, however, has explored the potential interaction between violence exposure in early adolescence and genetics.

METHODS

We explore the gene x environment interaction's impact on teacher-rated aggressive and impulsive behaviors. Violence exposure during the middle school years was assessed using self-report. Genetic data collection occurred in emerging adulthood. A polygenic score was created using findings from a conduct disorder symptomatology genome-wide association study.

RESULTS

Three longitudinal classes of teacher reported aggressive and impulsive behavior were identified. We found a significant relationship between violence exposure and class membership. There was a significant GxE interaction, such that those with below average levels of the polygenic score and who were exposed to violence were more likely to be in the moderately high aggressive and impulsive class as compared to the no to low class.

CONCLUSIONS

These findings highlight the influence of genetic risk together with violence exposure on adolescent problem behavior. Although youth may have little control over the environments in which they live, interventions can and should focus on helping all youth.