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Abstract
The 2018/2019 Child and Adolescent Psychiatry and Mental Health (CAPMH) thematic series
on forensic child and adolescent psychiatry and mental health is focused on longitudinal
research. Although the importance of such studies is widely recognised, they are still
rare in adolescent forensic psychiatry and psychology.
Longitudinal studies like Emmy Werner’s Kauai Study [1], Michael Rutter’s Isle-of-White-Study
[2], David Farrington’s Cambridge Study [3], the Great Smoky Mountains Study [4] or,
above all, the Dunedin Study [5], have had and still have a substantial influence
on our understanding of child psychiatric disorders and their development over time.
Though mental disorders and psychopathology in general are the core of these studies,
all of them have also yielded significant contributions to the understanding of the
aetiology and course of delinquent behaviour. One prominent example is the distinction
between life-course persistent versus adolescence-limited antisocial behaviour, a
developmental taxonomy that Moffitt has proposed on the basis of findings from the
Dunedin Study [6]. This important distinction has been confirmed in many studies [7],
and has stimulated further research on antisocial trajectories [8].
When forensic experts write reports for the court, they try to disentangle the complex
context that may have led to a person’s crime. This search for an understanding of
the individual causes of a criminal act is done retrospectively, which might inform
us about potential causes of the offending behaviour. However, what seems plausible
in a retrospective view is often not sufficient to predict future behaviour. We, therefore,
need prospective, longitudinally designed studies that broaden our knowledge about
the causes of criminal behaviour, its course and its prognosis. Thus, preventing the
onset of delinquency, or, if criminal behaviour already occurred, to prevent recidivism,
should be in the focus of our scientific work in adolescent forensic psychiatry.
The 2018 thematic series comprises four papers:
In the first paper, Souverein et al. [9] report the results of a panel discussion
at the 2018 European Association for Forensic Child and Adolescent Psychiatry, Psychology
and other involved Professions (EFCAP) congress in Venice, regarding the current situation
of services for delinquent youths in various European countries as well as future
directions for the improvement of these services. The panel integrated the view from
five European countries (Finland, Great-Britain, Italy, Netherlands and Switzerland)
and formulated cross-national mission statements for adolescent forensic health care.
In the second paper Ed Hilterman et al. [10] present a longitudinal study on 5205
male juvenile offenders from the Catalan juvenile justice system. These youths received
multiple SAVRY risk/need assessments over time. With the use of growth mixture modeling
and multinomial logistic regression analyses four heterogeneous trajectories of offending
were identified.
The next paper of Van der Pol et al. [11] describes the long-term outcome of a randomised
controlled trial. In total, 109 adolescents with cannabis use disorder and comorbid
problem behavior were treated with Multidimensional Family Therapy (MDFT) or Cognitive
Behavior Therapy (CBT). Both treatments were found to be effective in reducing delinquent
behavior. No differences were found between MDFT and CBT in the efficacy to reduce
the frequency or severity of offending over a 6 years’ time period.
Finally, Collins and Grisso [12] describe the use of two short screening instruments
(Massachusetts Youth Screening Instrument—Second Version [MAYSI-2] and Strengths and
Difficulties Questionnaires [SDQ]) in a sample of 1259 detained boys and its ability
to predict violent offending. Their results showed that the relation between MAYSI-2
and SDQ scale scores and future violent offending varied between different ethnic
groups. They even found opposite relations for boys from different ethnic backgrounds.
The disillusioned conclusion of the authors is that screening for psychiatric problems
in boys cannot be recommended to identify those adolescents who are at risk for committing
future violent crimes and that ethnic differences in the relation between psychiatric
problems and future criminality have to be taken into account.
Again, like last year, the majority of authors of the 2018 thematic series is from
the Netherlands. While we warmly welcome the engagement of our young Dutch colleagues
we would like to stimulate researchers from other European and non-European countries
to engage in research on adolescent forensic issues and to submit papers for the next
edition of this thematic series.
The Dunedin Multidisciplinary Health and Development Study began more than four decades ago. Unusual at the time, it was founded as a multidisciplinary research enterprise, and was strongly supported by the Dunedin community, both professional and lay, in its early years. Seven research themes have evolved over the past 40 years focusing on mental health and neuro-cognition, cardiovascular risk, respiratory health, oral health, sexual and reproductive health, and psychosocial functioning. A seventh, more applied theme, seeks to maximise the value of the Study findings for New Zealand’s indigenous people—Māori (or tangata whenua transl people of the land). The study has published over 1200 papers and reports to date, with almost 2/3 of these being in peer-reviewed journals. Here we provide an overview of the study, its history, leadership structure, scientific approach, operational foci, and some recent examples of work that illustrate the following: (a) the value of multidisciplinary data; (b) how the study is well positioned to address contemporary issues; and (c) how research can simultaneously address multiple audiences—from researchers and theoreticians to policy makers and practitioners. Near-future research plans are described, and we end by reflecting upon the core aspects of the study that portend future useful contributions.
This article reports a comparison on outcomes of 26-year-old males who were defined several years ago in the Dunedin longitudinal study as exhibiting childhood-onset versus adolescent-onset antisocial behavior and who were indistinguishable on delinquent offending in adolescence. Previous studies of these groups in childhood and adolescence showed that childhood-onset delinquents had inadequate parenting, neurocognitive problems, undercontrolled temperament, severe hyperactivity, psychopathic personality traits, and violent behavior. Adolescent-onset delinquents were not distinguished by these features. Here followed to age 26 years, the childhood-onset delinquents were the most elevated on psychopathic personality traits, mental-health problems, substance dependence, numbers of children, financial problems, work problems, and drug-related and violent crime, including violence against women and children. The adolescent-onset delinquents at 26 years were less extreme but elevated on impulsive personality traits, mental-health problems, substance dependence, financial problems, and property offenses. A third group of men who had been aggressive as children but not very delinquent as adolescents emerged as low-level chronic offenders who were anxious, depressed, socially isolated, and had financial and work problems. These findings support the theory of life-course-persistent and adolescence-limited antisocial behavior but also extend it. Findings recommend intervention with all aggressive children and with all delinquent adolescents, to prevent a variety of maladjustments in adult life.
All over Europe youth delinquency is decreasing; our understanding of the factors related to juvenile delinquency and the characteristics of effective forensic youth care has increased substantially. However, effective prevention and intervention strategies are not always employed due to financial, demographical and socio-political challenges countries face, while the burden of mental health in juvenile justice populations is high. With this commentary, we highlight the importance of international collaboration to set out a direction to improve forensic youth care, to bundle our strengths and overcome our challenges. It is a continuation of the course that was set out by Doreleijers and Fegert (Child Adolesc Psychiatry Ment Health 5:20, 2011), in their editorial they highlighted the importance of collaboration and presented an overview of the state of the art on forensic youth care in eight European countries (and Russia). With this manuscript, we present an overview of statistics in juvenile justice of all European countries and present an integrated mission statement for forensic youth care, which was formulated in a keynote debate at the 6th biennial congress of the European Association for Forensic Child and Adolescent Psychiatry, Psychology and other involved professions (EFCAP).
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