Kempker Samantha M, Schmidt Adam T, Espinosa Erin M
Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Bellefield Towers, Room 325, Pittsburgh, PA, 15213, USA.
Department of Psychological Sciences, Texas Tech University, Campus Box 42051, Lubbock, TX, 79409, USA.
J Youth Adolesc. 2017 Jul;46(7):1562-1581. doi: 10.1007/s10964-016-0572-5. Epub 2016 Sep 26.
Justice-involved youth have high rates of psychiatric diagnoses, and these youth are often placed out-of-home, although evidence identifies several negative implications of juvenile confinement, especially for youth with psychopathology. Furthermore, youth in the justice system may be processed differently based on gender. As males and females tend to manifest symptoms differently, the psychopathology of youth may act to moderate the relationship between gender and placement in the juvenile justice system. The present study used a large, diverse sample (n = 9 851, 19.8 % female) to examine whether youth placed in various types of out-of-home facilities differed in terms of externalizing, internalizing, substance use, or comorbid disorders, and to determine the predictive value of mental health diagnoses in placement decisions. The moderation effect of psychopathology and substance use on the relationship between gender and placement also was explored. The results indicated that each type of disorder differed across placements, with internalizing being most prevalent in non-secure, and externalizing, comorbid, and substance use being most prevalent in secure settings. Mental health diagnoses improved the prediction of placement in each out-of-home placement beyond legal and demographic factors such that externalizing and substance use disorders decreased the likelihood of placement in non-secure settings, and internalizing, externalizing, and substance use disorders increased the likelihood of placement in secure and state-secure facilities. The relationship between internalizing pathology and placement in more secure facilities was moderated by externalizing pathology. The relationship between gender and placement was significantly moderated by mental health such that females with mental health diagnoses receive less secure placements. Implications for policymakers and practitioners are discussed, as well as implications for reforming juvenile justice within a developmental approach.
涉及司法的青少年有很高的精神疾病诊断率，这些青少年通常被安置在家庭之外，尽管有证据表明青少年监禁有若干负面影响，尤其是对有精神病理学问题的青少年。此外，司法系统中的青少年可能会因性别而受到不同对待。由于男性和女性表现出症状的方式不同，青少年的精神病理学可能会调节性别与被安置在少年司法系统之间的关系。本研究使用了一个规模大且多样化的样本（n = 9851，19.8%为女性），以检验被安置在各种类型家庭外设施中的青少年在外化、内化、物质使用或共病障碍方面是否存在差异，并确定心理健康诊断在安置决策中的预测价值。还探讨了精神病理学和物质使用对性别与安置之间关系的调节作用。结果表明，每种类型的障碍在不同安置环境中存在差异，内化障碍在非安全环境中最为普遍，外化、共病和物质使用障碍在安全环境中最为普遍。心理健康诊断在法律和人口统计学因素之外，改善了对每种家庭外安置的预测，使得外化和物质使用障碍降低了被安置在非安全环境中的可能性，而内化、外化和物质使用障碍增加了被安置在安全和州立安全设施中的可能性。外化病理学调节了内化病理学与被安置在更安全设施之间的关系。心理健康显著调节了性别与安置之间的关系，以至于有心理健康诊断的女性获得的安置安全性较低。文中讨论了对政策制定者和从业者的启示，以及在发展方法框架内改革少年司法的启示。
