Mental Health Assessments in Juvenile Justice: Report on the Consensus Conference

Wasserman, Gail A.; Jensen, Peter S.; Ko, Susan J.; Cocozza, Joseph J.; Trupin, Eric W.; Angold, Adrian; Cauffman, Elizabeth; Grisso, Thomas

doi:10.1097/01.chi.0000046873.56865.4b

Cited by 116 publications

(91 citation statements)

References 20 publications

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“…The L scale first correctly classified most of the non-substance abusers under the SI condition as well as the substance abusers faking good. Of the few substance abusers' faked profiles that escaped detection as invalid, only 17.5% were not subsequently classified as substance abusive by ACK for the sample of N = 87 (this number is 19.4% for N = 126 (Wasserman et al, 2003). In these cases, when testing and interview data conflict, clinicians may consider placing more emphasis on testing results because adolescents may be more honest during computer-driven and paper-pencil testing than in face-to-face interviews (Turner, Lessler, & Devore, 1992;Waterton & Duffy, 1984).…”

Section: Discussionmentioning

confidence: 99%

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Ability of Substance Abusers to Escape Detection on the Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A) in a Juvenile Correctional Facility

Stein

Graham

2005

Assessment

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The ability of respondents to underreport successfully on substance abuse and validity scales of the Minnesota Multiphasic Personality Inventory-Adolescent was evaluated. Incarcerated teens (67 substance abusing, 59 non-substance abusing) completed the MMPI-A twice: once under standard instructions (SI) and once under instructions to fake good (FG). Under SI, substance scales correctly classified about 60% to 85% of adolescents. Under FG, substance-and nonsubstance-abusing juveniles produced lower scores on substance scales. However, the Lie Scale (L) was able to detect more than 75% of deceptive profiles and about 77% of honest profiles. When scale L and the best substance scale were used in combination, only about 18% of faking substance abusers were not identified as either substance abusers or as underreporting. For feigning substance abusers, only about 10% of substance abusers were detected, with about 72% being categorized as faking and needing further assessment. Keywords incarcerated; faking; MMPI-A; substance useGiven the social and economic costs of adolescent substance abuse, professionals have attempted to develop valid and efficient screening and assessment instruments to identify adolescents with such problems (Personal Experiences Inventory [PEI], Winters, 1999; Substance Abuse Subtle Screening Inventory for Adolescents [SASSI-A], Miller, 1990). It is especially important to screen and assess for such disorders in juvenile correctional settings, where often this is the adolescent's first opportunity for intervention. There is a high rate of substance use and abuse in justice-involved teens (Teplin, Abram, McClelland, Dulcan, & Mericle, 2002), and it is important to be able to identify those adolescents who need more services and those who may not require as many services from a system with few resources.There has been increasing interest in the application of the MMPI-A (Butcher et al., 1992) to juvenile offender populations (e.g., see Cashel, Rogers, Sewell, & Holliman, 1998;Pena, Megargee, & Brody, 1996;, 2001). Screening and assessing for substance problems can be important for understanding factors that may have been involved in misconduct as well as treatment placement. However, screening and assessment can be impeded by motivation to misreport symptoms of substance use. It is important that NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript screening and assessment measures be able to effectively detect substance use difficulties and misreporting. Fortunately, the MMPI-A has scales to detect substance use problems as well as misreported symptoms and behavior. Detecting Substance Abuse Using the MMPI-AThe MMPI-A has three scales to detect substance use problems: the MacAndrew Alcoholism Scale-Revised (MAC-R; Butcher et al., 1992), the Alcohol/Drug Problem Acknowledgment (ACK) scale, and the Alcohol/Drug Problem Proneness (PRO) scale (Weed, Butcher, & Williams, 1994). The MAC-R was originally devised by MacAndrew in 1965 and was called the MAC. Effectiveness o...

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Section: Discussionmentioning

confidence: 99%

“…Assessment typically should consist of direct observation, face-to-face interview, mental status exam, chart review, interview with collaterals (parents), and family history (Wasserman et al, 2003). Clinicians must look for converging information for final determination regarding substance abuse status.…”

Section: Discussionmentioning

confidence: 99%

Ability of Substance Abusers to Escape Detection on the Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A) in a Juvenile Correctional Facility

Stein

Graham

2005

Assessment

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“…The high prevalence rates of psychiatric disorders underscore the need of standardized mental health screening at start of placement. 71,72 Importantly, mental health problems should not be considered a temporary phenomenon, as detained male adolescents who were reassessed 3 months after detention admission and 2 years after discharge continue to have a high rate of mental health problems. 51,73 Therefore, mental health assessment should be continued during detention and after discharge, and be followed by adequate and targeted intervention.…”

Section: Implications For Clinical Practicementioning

confidence: 99%

Psychiatric Disorders in Detained Male Adolescents: A Systematic Literature Review

Colins

Vermeiren

Vreugdenhil³

et al. 2010

Can J Psychiatry

183

125

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Objective: To provide a best estimate of the prevalence of psychiatric disorders among detained male adolescents, with particular emphasis on impairment, multi-informant assessment, and race or ethnicity. Method:Computer-assisted searches were executed to identify relevant studies.Results: Fifteen studies using adolescents as informants met inclusion criteria (n = 3401), of which only 2 reported within a subsample on parent-derived diagnoses. The mean prevalence of any disorder was 69.9% (95% CI 69.5% to 70.3%); with conduct disorder occurring most frequently (46.4%, 95% CI 45.6% to 47.3%), followed by substance use disorder (45.1%, 95% CI 44.6% to 45.5%), oppositional defiant disorder (19.8%, 95% CI 19.2% to 20.3%), and attention-deficit hyperactivity disorder (13.5%, 95% CI 13.2% to 13.9%). Although lower, rates for internalizing disorders were still substantial, with any anxiety disorder found in 15.9% (95% CI 15.6% to 16.1%), major depression in 12.0% (95% CI 11.7% to 12.2%), and posttraumatic stress disorder in 9.6% (95% CI 9.2% to 10.0%). Three studies reported on psychotic disorders, finding low rates (1.35%, 95% CI 1.32% to 1.39%). Estimates of prevalence were only marginally different when impairment was not required, while consistency between adolescents and parents was poor. Findings on the relations between race or ethnicity were too scarce and inconsistent to interpret. Conclusion:Detained male adolescents bear substantial mental health needs, emphasizing the need to organize effective mental health services for this troubled group. However, our knowledge on mental disorders in detained youth should be enhanced, in particular regarding the reliability of adolescents, compared with parent report, and whether clinically relevant differences exist by race or ethnicity.Can J Psychiatry. 2010;55(4):255-263. Clinical Implications· Across countries, detained and incarcerated adolescents have substantial mental health needs. · Standardized mental health screening at detention intakes is warranted. · Effective mental health services should be developed. Limitations· The systematic search of the literature was restricted to detained and incarcerated male adolescents only. · The number of studies on psychiatric disorders in detained male adolescents using a standardized psychiatric interview is still small. · Methodological differences hamper comparison and interpretation of the 15 index study results.

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“…Juvenile detention centers often provide the first opportunity to systematically screen youth for risk for suicide and to provide interventions, yet the majority of facilities do not perform sound screening for "emergent risk." 66 A recent study found that facilities that screen all juveniles within 24 hours of arrival had lower prevalence rates of serious suicide attempts than those that screen only juveniles considered at risk for suicide. 67 Fewer than half of the detainees with recent suicidal thoughts had shared this with someone else.…”

mentioning

confidence: 99%

Suicidal Ideation and Behaviors Among Youths in Juvenile Detention

Abram¹,

Choe²,

Washburn³

et al. 2008

Journal of the American Academy of Child & Adolescent Psych

123

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Objective-To examine suicidal ideation, suicide attempts, lethality of suicide attempts, and the relationship between psychiatric disorder and recent attempts in newly detained juveniles.Methods-The sample included 1829 juveniles, aged 10 to 18 years, sampled after intake to a detention center in Chicago, IL. Interviewers administered the Diagnostic Interview Schedule for Children (DISC) to assess for thoughts of death, suicidal ideation, suicide plans, lifetime suicide attempts, number of attempts, age at first attempt, attempts within the last 6 months, method of suicide attempts, and psychiatric disorder.Results-More than one-third of juvenile detainees and nearly half of females had felt hopeless or thought about death in the 6 months prior to detention. Approximately 1 of 10 (10.3%, CI: 7.7% -12.8%) juvenile detainees had thought about committing suicide in the past 6 months, and 1 of 10 (11.0%, CI: 8.3% -13.7%) had ever attempted suicide. Recent suicide attempts were most prevalent in females and youth with major depression and generalized anxiety disorder.Conclusions-Fewer than half of detainees with recent thoughts of suicide had told anyone about their ideation. Identifying youth at risk for suicide --especially those suffering from depressive and anxiety disorders --is a crucial step to preventing suicide.

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Mental Health Assessments in Juvenile Justice: Report on the Consensus Conference

Cited by 116 publications

References 20 publications

Ability of Substance Abusers to Escape Detection on the Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A) in a Juvenile Correctional Facility

Ability of Substance Abusers to Escape Detection on the Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A) in a Juvenile Correctional Facility

Psychiatric Disorders in Detained Male Adolescents: A Systematic Literature Review

Suicidal Ideation and Behaviors Among Youths in Juvenile Detention

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