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BackgroundAdverse childhood experiences (ACEs) and psychiatric disorders are common in juvenile detainees. Emotional dysregulation resulting from cumulated ACEs may be characterized by symptoms of irritability. The present study examined whether the accumulation of ACEs, irritability, or both predicted mental disorders in incarcerated adolescents with and without controlling for one another and for socio-demographic factors.MethodsOne hundred thirty male detained juvenile offenders (aged 13.8–19.5 years) were assessed by structured clinical interviews and a self-reporting scale for irritability. Univariate and multivariate regression models were used to examine the shared and distinct associations of ACEs and irritability with psychiatric diagnoses.ResultsA total of 75 % of the participants reported more than one ACE. The ACE total score was positively related to self-reported irritability. The ACE total score predicted depressive disorders, suicidality, post-traumatic stress disorder (PTSD), and anxiety disorders. Irritability was positively related to depressive disorders, suicidality, disruptive behavior disorder (DBD), substance use disorder (SUD), and attention deficit hyperactivity disorder (ADHD). These associations remained significant in multivariate models.ConclusionsThis study provides evidence for the predictive impact of self-reported ACEs and irritability with regard to adolescent psychiatric disorders in young male inmates. Both variables differed in their predictive power for PTSD, internalizing, and externalizing disorders indicating the need for specific therapeutic interventions. Taking a close look at their trauma history seems to be of special importance for juveniles suffering from PTSD and anxiety disorders. For delinquent adolescents with DBD, ADHD and SUD, the training of emotion regulation techniques appears most promising. Approaches focusing on both, ACEs and emotion-focused contents may be implemented in the treatment of depressive disorders and suicidality.

Juveniles who sexually offended (JSOs) are differentially burdened with adverse childhood experiences (ACEs). The present study used Latent Class Analysis (LCA) to derive subtypes of JSOs according to their patterns of 10 different ACEs. An extensive file analysis of 322 male JSOs (M = 14.14, SD = 1.94) revealed five subtypes with (a) multiple (9.0%), (b) mainly family related (17.1%), (c) mainly peer related (21.7%), (d) mainly neglectful (18.6%), and (e) little/no (33.5%) ACEs. Differences among ACE subtypes with regard to several offense and victim characteristics (e.g., the use of penetration or violence, the choice of a child, a male, a stranger, or multiple victims) were examined. Whereas no differences were found for the use of physical violence or the choice of male, stranger, or multiple victims, binary logistic regressions revealed associations of the multiple-ACE subtype with the choice of a child victim, the family-ACE subtype with the use of penetration as well as further nonsexual delinquency, the peer-ACE subtype with the use of penetration and the choice of a child victim, and the neglect-subtype with the choice of a child victim. Additional analyses including single ACE categories instead of LCAderived subtypes supported these results. Findings highlight the need for a comprehensive consideration of ACEs in research and clinical work to understand developmental pathways to juvenile sexual offending.

The present findings confirm the presence of ODD dimensions/subtypes in a highly disturbed adolescent offender sample. Irritable youths were at risk of suicide and persistent criminal behaviours. Due to the severe consequences of irritability, a standardized assessment approach and a specific treatment is needed in prison to prevent suicide among the detainees and further harm to the society. As defined in the DSM-5, the present findings confirm the validity of ODD and ODD dimensions/subtypes as a diagnostic category among older youths.

Although accurate risk appraisals are mandatory to provide effective treatment to juveniles who have sexually offended (JSOs), the current knowledge on the validity of risk assessment instruments for JSOs is inconclusive. We compared the predictive validities of the Juvenile Sex Offender Assessment Protocol II (J-SOAP II), the Estimate of Risk of Adolescent Sexual Offense Recidivism (ERASOR), and the Violence Risk Appraisal Guide-Revised (VRAG-R) scores concerning sexual, nonsexual-violent, and general criminal recidivism (based on both official and nonregistered reoffenses) in a consecutive sample of 597 male JSOs (Mage = 14.47 years, SDage = 1.57 years) while accounting for different recidivism periods, offense severities, and cumulative burden of adverse childhood experiences (ACEs). Receiver Operator Characteristic (ROC) curves and Cox regression analyses indicated that the tools allowed valid predictions of recidivism according to their intended purposes: The ERASOR was best suited to predict sexual recidivism within 0.5 and 3 years, the J-SOAP II was valid for predictions of sexual and nonsexual-violent recidivism within these recidivism periods, and the VRAG-R showed potential strengths in predicting nonsexual-violent recidivism, especially when committed above age 18. Elevated offense severity and burden of ACEs impeded predictive accuracies of the J-SOAP II and the VRAG-R, particularly in case of sexual recidivism. Our findings emphasize that risk assessment for JSOs must not rely solely on scores derived from risk assessment instruments, but a comprehensive consideration of a JSOs offense severity and psychosocial adversities is additionally necessary to approach accurate risk appraisals. (PsycINFO Database Record (c) 2018 APA, all rights reserved).