Protective Factors for Antisocial Behavior in Youth: What is the Meta-Analytic Evidence?

Although both risk and protective factors are important components of etiological theories for antisocial behavior, far less is known about protective factors and their impact. This review summarized primary studies on the impact of different protective factors for antisocial behavior in youth. In total, 305 studies reporting on 1850 potentially protective factors were included. Each extracted factor was first classified into one of 77 mutually exclusive groups of similar factors (referred to as domains), after which a three-level meta-analysis was conducted to determine the protective effect of each domain. A significant and negative effect was found for 50 domains, which were therefore designated as being truly protective. The largest impact (r < -0.20) was found for higher levels of conservativeness, self-transcendence, life satisfaction, involvement in romantic relationships, the capacity to reflect or mentalize, peer relationships quality, prosocial peers, prosocial values, agreeableness, school self-esteem, parental control, general resilience, and social skills. Analyses revealed that the impact of some of the 77 domains was moderated by the youth's age (five domains) and gender (four domains) as well as the severity of antisocial behavior they exhibit (two domains), indicating that the impact of these domains differs across subgroups of antisocial youth. Given the substantial number of factors that were identified as being protective for antisocial behavior in youth, this study discusses implications for future directions, assessment strategies, and (preventive) interventions.

Identifying effective moderators of cognitive behavioural trauma treatment with caregiver involvement for youth with PTSD: a meta-analysis.

Children can develop post-traumatic stress disorder (PTSD) and mental health symptoms after traumatic events. This meta-analysis evaluated the influence of moderators of cognitive behavioural trauma treatment (CBTT) with caregiver involvement in traumatized children. A total of 28 studies were included, with 23 independent samples and 332 effect sizes, representing the data of 1931 children (M age = 11.10 years, SD = 2.36). Results showed a significant medium overall effect (d = 0.55, t = 2.478, p = 0.014), indicating CBTT with caregiver involvement was effective in treating PTSD (d = 0.70), with somewhat smaller effect sizes for internalizing, externalizing, social, cognitive and total problems (0.35 < d > 0.48). The positive treatment effect was robust; we found somewhat smaller effect sizes at follow-up (d = 0.49) compared to post-test (d = 0.57) assessments. Furthermore, several sample (i.e. child's age, gender, and trauma event), programme (i.e. the duration of treatment, number of sessions), study (i.e. control condition, type of instrument, informant, type of sample), and publication (i.e. publication year and impact factor) characteristics moderated the treatment outcomes of the child. In sum, the results of our meta-analysis might help to improve the effectiveness of cognitive behavioural trauma treatment for youth with PTSD, and guide the development of innovative trauma interventions that involve caregivers. Implications for theory and practice are discussed.

What makes Dutch youth comply with preventive COVID-19 measures? An explorative study.

The measures to contain the spread of COVID-19 are challenging for youth, especially the social isolation measures. These measures are antagonistic to healthy youth development, which requires sufficient social contact with peers and adults. This explorative study examined what factors are associated with adherence to COVID-19 measures in a sample of Dutch youth (N = 263; 79.8% female) with ages ranging between 16 and 24 years (M = 21.1 years; SD = 2.44 years), who completed an online questionnaire about their compliance to measures, resilience, coping strategies, mental health, and availability of a natural mentor. Results showed that youth with fewer depressive symptoms adhered better to measures of social distance. Youth who were less suspicious, more resilient, and those with an active coping strategy or a natural mentor more often complied with COVID-19 measures. These results can be used to help youth comply with the COVID-19 measures.

Youth Initiated Mentoring: A Meta-analytic Study of a Hybrid Approach to Youth Mentoring.

Youth initiated mentoring is a hybrid approach that empowers youth to identify and recruit natural mentors, potentially combining the strengths of informal mentoring relationships with the infrastructure and support provided by formal mentoring programs. This meta-analytic review examined the association between youth-initiated programs and youth outcomes across four domains: academic and vocational functioning, social-emotional development, physical health, and psychosocial problems. Results indicated that youth-initiated programs are significantly associated with positive youth outcomes. There was a small-to-medium effect size of g = 0.30 for youth-initiated programs overall, which was based on 14 studies with 11 independent samples (3594 youth and 169 effect sizes) from 2006 to 2019. The effect size was somewhat larger (g = 0.40) when controlling for possible selection bias, and was moderated by participant gender and year of publication. Implications for theory and practice regarding this relatively new approach to mentoring are discussed.

Risk Factors for School Absenteeism and Dropout: A Meta-Analytic Review.

School absenteeism and dropout are associated with many different life-course problems. To reduce the risk for these problems it is important to gain insight into risk factors for both school absenteeism and permanent school dropout. Until now, no quantitative overview of these risk factors and their effects was available. Therefore, this study was aimed at synthesizing the available evidence on risk factors for school absenteeism and dropout. In total, 75 studies were included that reported on 781 potential risk factors for school absenteeism and 635 potential risk factors for dropout. The risk factors were classified into 44 risk domains for school absenteeism and 42 risk domains for dropout. The results of a series of three-level meta-analyses yielded a significant mean effect for 28 school absenteeism risk domains and 23 dropout risk domains. For school absenteeism, 12 risk domains were found with large effects, including having a negative attitude towards school, substance abuse, externalizing and internalizing problems of the juvenile, and a low parent-school involvement. For dropout, the risk domains having a history of grade retention, having a low IQ or experiencing learning difficulties, and a low academic achievement showed large effects. The findings of the current study contribute to the fundamental knowledge of the etiology of school absenteeism and dropout which in turn contributes to a better understanding of the problematic development of adolescents. Further, more insight into the strength of effects of risk factors on school absenteeism and dropout is important for the development and improvement of both assessment, prevention and intervention strategies.

Participatory Peer Research in the Treatment of Young Adults With Mild Intellectual Disabilities and Severe Behavioral Problems.

This study provides an illustration of a research design complementary to randomized controlled trial to evaluate program effects, namely, participatory peer research (PPR). The PPR described in current study was carried out in a small sample (N = 10) of young adults with mild intellectual disabilities (MID) and severe behavioral problems. During the PPR intervention, control and feedback to individuals is restored by training them to become participant-researchers, who collaborate in a small group of people with MID. Their research is aimed at the problems the young adults perceive and/or specific subjects of their interest. The study was designed as a multiple case study with an experimental and comparison group. Questionnaires and a semistructured interview were administered before and after the PPR project. Results of Reliable Change Index (RCI) analyses showed a decrease in self-serving cognitive distortions in the PPR group, but not in the comparison group. These results indicate that PPR helps to compensate for a lack of adequate feedback and control, and in turn may decrease distorted thinking and thereby possibly later challenging behavior.

Practitioner review: Effective ingredients of prevention programs for youth at risk of persistent juvenile delinquency--recommendations for clinical practice.

BACKGROUND: There is a lack of knowledge about specific effective ingredients of prevention programs for youth at risk for persistent delinquent behavior. The present study combines findings of previous studies by examining the effectiveness of programs in preventing persistent juvenile delinquency and by studying which particular program, sample, and study characteristics contribute to the effects. Information on effective ingredients offers specific indications of how programs may be improved in clinical practice. METHOD: A literature search in PsychINFO, ERIC, PubMed, Sociological Abstracts, Criminal Justice Abstracts, and Google Scholar was performed. Only (quasi)experimental studies and studies that focused on adolescents at risk for (persistent) delinquent behavior were included. Multilevel meta-analysis was conducted on 39 studies (N = 9,084). Participants' ages ranged from 6 to 20 years (M = 14 years, SD = 2.45). RESULTS: The overall effect size was significant and small in magnitude (d = 0.24, p < .001). Behavioral-oriented programs, focusing on parenting skills training, behavioral modeling, or behavioral contracting yielded the largest effects. Multimodal programs and programs carried out in the family context proved to be more beneficial than individual and group-based programs. Less intensive programs yielded larger effects. CONCLUSIONS: Prevention programs have positive effects on preventing persistent juvenile delinquency. In order to improve program effectiveness, interventions should be behavioral-oriented, delivered in a family or multimodal format, and the intensity of the program should be matched to the level of risk of the juvenile.

The development and validation of the Youth Actuarial Care Needs Assessment Tool for Non-Offenders (Y-ACNAT-NO).

BACKGROUND: In The Netherlands, police officers not only come into contact with juvenile offenders, but also with a large number of juveniles who were involved in a criminal offense, but not in the role of a suspect (i.e., juvenile non-offenders). Until now, no valid and reliable instrument was available that can be used by Dutch police officers for estimating the risk for future care needs of juvenile non-offenders. In the present study, the Youth Actuarial Care Needs Assessment Tool for Non-Offenders (Y-ACNAT-NO) was developed for predicting the risk for future care needs that consisted of (1) a future supervision order as imposed by a juvenile court judge and (2) future worrisome incidents involving child abuse, domestic violence/strife, and/or sexual offensive behavior at the juvenile's living address (i.e., problems in the child-rearing environment). METHODS: Police records of 3,200 juveniles were retrieved from the Dutch police registration system after which the sample was randomly split in a construction (n = 1,549) and validation sample (n = 1,651). The Y-ACNAT-NO was developed by performing an Exhaustive CHAID analysis using the construction sample. The predictive validity of the instrument was examined in the validation sample by calculating several performance indicators that assess discrimination and calibration. RESULTS: The CHAID output yielded an instrument that consisted of six variables and eleven different risk groups. The risk for future care needs ranged from 0.06 in the lowest risk group to 0.83 in the highest risk group. The AUC value in the validation sample was .764 (95% CI [.743, .784]) and Sander's calibration score indicated an average assessment error of 3.74% in risk estimates per risk category. CONCLUSIONS: The Y-ACNAT-NO is the first instrument that can be used by Dutch police officers for estimating the risk for future care needs of juvenile non-offenders. The predictive validity of the Y-ACNAT-NO in terms of discrimination and calibration was sufficient to justify its use as an initial screening instrument when a decision is needed about referring a juvenile for further assessment of care needs.

Child Maltreatment as a Risk Factor for Rejection Sensitivity: A Three-Level Meta-Analytic Review.

Theoretical and empirical evidence has suggested that child maltreatment victimization is associated with rejection sensitivity. However, empirical evidence on this association is inconsistent. Therefore, this meta-analysis aimed to examine the overall association between child maltreatment and rejection sensitivity, and to investigate variables that may affect the strength of this association. Studies eligible for inclusion were searched in the databases: Web of Science, Science Direct, PubMed, MEDLINE, and China National Knowledge Infrastructure after which relevant studies were coded. Studies were synthesized in advanced three-level meta-analytic models in R. A total of 16 studies (N = 5,335 participants) yielding 41 effect sizes were included. Results showed that child maltreatment is significantly and positively related to rejection sensitivity (mean r = 0.230; p < .001), and to a small extent. Furthermore, this association is stronger for emotional abuse (r = 0.275) than for physical abuse (r = 0.157). It is not affected by the mean age and gender distribution of primary study samples nor by sample type (community sample versus clinical sample). It is concluded that child maltreatment is a risk factor for developing rejection sensitivity later in life. Therefore, interventions for rejection sensitivity should consider potential trauma resulting from prior child maltreatment experiences.

Interrelatedness of Family and Parenting Risk Factors for Juvenile Delinquency: A Network Study in U.S. and Dutch Juveniles.

Family interventions that address a diversity of family and parenting factors are often used to prevent juvenile delinquency, but are effective to only a limited extent. This study applied a network approach to risk factors for juvenile delinquency and examined the interrelatedness of specifically family and parenting risk factors in a U.S. and separate Dutch sample of juveniles and their family members. Differences in interrelatedness between these samples were examined as well. Secondary analyses were conducted on data collected in the United States with the Washington State Juvenile Court Assessment (WSJCA) and on data collected in the Netherlands with a Dutch-adapted translation of the WSJCA. Network analyses were performed, separately for the U.S. (N = 13,613) and Dutch (N = 3,630) sample, on seven risk factors that were assessed with a three-point Likert scale ranging from each factor's protective side to a corresponding risk side. In the U.S. sample network, "inadequate parental punishment" and "lack of parental supervision" that both refer to an authoritarian parenting style were the most "central" factors and had the strongest associations with the other risk factors. In the Dutch sample network, "the family not providing opportunities" and "inadequate parental reward" were the most "central" factors, which refer to an authoritative parenting style. The family and parenting factors identified as most central in the networks may be promising to address in family interventions, as it can be expected that both the directly addressed problems and their correlated problems will improve. The current results may inform attempts to strengthen family interventions for juvenile delinquency in the United States and the Netherlands.

The Association Between Child Maltreatment and Pathological Narcissism: A Three-Level Meta-Analytic Review.

Emerging evidence has documented the positive association between child maltreatment and both phenotypes of pathological narcissism (i.e., vulnerable and grandiose narcissism). However, results across these studies are inconsistent. Therefore, the present meta-analysis aimed to examine the extent to which child maltreatment is associated with vulnerable and grandiose narcissism, and whether these associations differed by study or sample characteristics. A systematic literature review was conducted in Web of Science, ScienceDirect, PubMed, Google Scholar, and China National Knowledge Infrastructure. Three-level meta-analyses were performed in R to synthesize the effect sizes. A total of 15 studies (N = 9,141 participants) producing 129 effect sizes were included. Results showed that child maltreatment was positively related to both vulnerable narcissism (mean r = .198; p < .001) and grandiose narcissism (mean r = .087; p < .001), but only to a small extent. Further, the association between child maltreatment and vulnerable narcissism was stronger for neglect (r = .278) than for physical abuse (r = .130). The strength of the association between child maltreatment and grandiose narcissism was larger for samples that were on average younger than 18 years (r = .187) than for samples that were on average older than 18 years (r = .068). Also, the strength of the association was stronger for females than for males. Child maltreatment is a risk factor for developing both vulnerable and grandiose narcissism. Interventions targeting pathological narcissism should be aware of potential trauma resulting from victimization of child maltreatment.

Gay Community Stress in Sexual Minority Men and Women: A Validation Study in the Netherlands.

Intraminority gay community stress theory posits that social stressors within sexual minority communities of men may be risk factors for mental health problems in gay and bisexual men. The recently developed 20-item Gay Community Stress Scale (GCSS) is a valid and reliable measure of gay community stress, but was not yet validated in the Netherlands. This study developed a Dutch-translated version of the GCSS and validated this scale in sexual minority men and sexual minority women, as it was hypothesized that sexual minority women may also experience intraminority stress. Exploratory and confirmatory factor analyses were subsequently performed in independent samples of men and women, and produced a 16-item GCSS for men and a 12-item GCSS for women. The four-factor structure of the original GCSS was replicated in men and women, and encouraging support for discriminant and concurrent validity of the GCSS was found in both men and women. The total scale and subscales were internally consistent in men (α and ω ≥ .87) and in women (α and ω ≥ .78). The Dutch-translated GCSS seems to offer a valid and reliable way to assess intraminority stress in Dutch-speaking sexual minority men and sexual minority women, although further validation is warranted.

Ramping Up Detention of Young Serious Offenders: A Safer Future?

When youth commit serious violent or sexual offenses, this often generates a call for more severe punishments and longer detention sentences. An important question is whether (long) detention sentences are effective in decreasing recidivism among serious young offenders. To estimate recidivism rates in serious young offenders and elucidate the link between sentencing (in terms of custodial vs. non-custodial and length of imprisonment) and recidivism, three multilevel meta-analyses were conducted. With a systematic literature search, 27 studies and four datasets were traced, involving N = 2,308 participants, yielding 90 effect sizes for overall recidivism, 24 for specifically violent recidivism, and 23 for the association between length of imprisonment and recidivism. The average weighted overall recidivism rate was 44.47% (95% confidence interval [CI]: 37.59-51.46%) over an average period of 8.68 years. The rate of violent recidivism was estimated at 30.49% (95% CI: 20.92-40.52%), over an average period of 11.45 years. Recidivism rates were higher when recidivism was defined as an arrest for any new offense rather than for a specific offense and in studies conducted in the United States versus European studies. Violent recidivism rates were higher in studies with longer follow-up periods. Based on the limited available studies, no difference in recidivism rates following custodial and non-custodial sentences were found, nor an association between length of imprisonment and recidivism. To increase rehabilitation chances for youth offenders, further research is warranted to better understand the impact of sentencing and to ascertain what is needed to make custodial and non-custodial sentences more effective.

Associations between psychological inflexibility and mental health problems during the COVID-19 pandemic: A three-level meta-analytic review.

BACKGROUND: An increasing number of research has documented the positive associations between psychological inflexibility (PI) and mental health problems (i.e., depressive, anxiety, and stress symptoms) during the COVID-19 pandemic. However, the documented associations have been inconsistent. This review thus aimed to quantitatively summarize primary research to gain better estimates of these associations. METHODS: A systematic literature review was conducted in six databases and three-level meta-analytic models were used to statistically synthesize effect sizes and to examine moderators of the associations between PI and depressive, anxiety, and stress symptoms. RESULTS: A total of 22 studies yielded 63 effect sizes on associations between PI and depressive, anxiety, or stress symptoms. The results of three separate meta-analyses revealed a large and significant association between PI and depressive (r = 0.580, 95 % CI [0.549; 0.775]), anxiety (r = 0.548, 95 % CI [0.468; 0.761]), and stress symptoms (r = 0.548, 95 % CI [0.506; 0.725]). The association between PI and depressive symptoms is stronger for males than for females, and the association between PI and stress symptoms varies by type of measure that primary studies use to assess PI and stress symptoms. LIMITATIONS: Temporal or causal conclusions are not allowed due to cross-sectional nature of the associations included in meta-analyses. Clinical samples with high levels of stress were underrepresented. CONCLUSIONS: PI seems an important risk factor for symptoms of depression, anxiety, and stress, and should therefore be targeted in interventions addressing mental health problems during the COVID-19 pandemic and beyond.

Effectiveness of Moral Developmental Interventions for Youth Engaged in Delinquent Behavior: A Meta-Analysis.

There is vast empirical evidence showing that juvenile delinquency is associated with delays in moral development, including moral judgment, empathy, and self-conscious emotions (guilt and shame). Consequently, interventions have been developed that target moral development of juvenile delinquents to reduce criminal offense recidivism. However, a comprehensive synthesis of studies examining the effectiveness of these interventions was not yet available. The present meta-analysis of (quasi-)experimental research therefore examined the effects of interventions that target moral development of youth engaged in delinquent behavior. Interventions that targeted moral judgment (11 studies and 17 effect sizes) showed a significant and small-to-medium effect on moral judgment (d = 0.39), with intervention type as a significant moderator, but no significant effect on recidivism (d = 0.03; 11 studies and 40 effect sizes). No (quasi-)experimental studies were found that targeted guilt and shame in juvenile offenders, and an insufficient number of studies (i.e., only two) were found to conduct a meta-analysis of interventions that target empathy. The discussion focuses on potential ways to improve moral development interventions for youth engaged in delinquent behavior, and provides suggestions for future research.

Differences in developmental problems between victims of different types of child maltreatment.

This study examined differences in developmental problems between children who were victims of two child maltreatment dimensions: abuse versus neglect, and physical versus emotional maltreatment. Family demographics and developmental problems were examined in a clinical sample of 146 Dutch children from families involved in a Multisystemic Therapy - Child Abuse and Neglect treatment trajectory. No differences were found in child behavior problems within the dimension abuse versus neglect. However, more externalizing behavior problems (e.g., aggressive problems) were found in children who experienced physical maltreatment compared to children who experienced emotional maltreatment. Further, more behavior problems (e.g., social problems, attention problems, and trauma symptoms) were found in victims of multitype maltreatment compared to victims of any single-type maltreatment. The results of this study increase the understanding of the impact of child maltreatment poly-victimization, and highlight the value of classifying child maltreatment into physical and emotional maltreatment.

Victims of Child Abuse Dropping Out of Trauma-Focused Treatment: A Meta-Analysis of Risk Factors.

A substantial number of children who experienced child maltreatment drop out of evidence-based trauma-focused treatments (TF-CBT). Identifying child, family, and treatment-related factors associated with treatment dropout is important to be able to prevent this from happening and to effectively treat children's trauma-related symptoms. Methods: A quantitative review was performed based on a systematic synthesis of the literature on potential risk factors for dropout of trauma-focused treatment in maltreated children. Results: Eight studies were included, that examined TF-CBT, reporting on 139 effects of potential risk factors for dropout. Each factor was classified into one of ten domains. Small but significant effects were found for the "Demographic and Family" risk domain (r = .121), with factors including being male, child protective services involvement or placement, and minority status, and for the "Youth Alliance" risk domain (r = .207), with factors including low therapist-child support and low youth perception of parental approval. Moderator analyses suggested that family income and parental education may better predict the risk for TF-CBT dropout than other variables in the "Demographic and Family" domain. Conclusions: Our results provide a first overview of risk factors for dropout of trauma-focused treatments (TF-CBT) after child maltreatment, and highlight the role of the therapeutic relationship in this. Supplementary Information: The online version contains supplementary material available at 10.1007/s40653-022-00500-2.

The Association between School Corporal Punishment and Child Developmental Outcomes: A Meta-Analytic Review.

School corporal punishment (SCP) is still widely used in many countries. Although primary studies have pointed toward detrimental effects of SCP, a quantitative review of these studies was not yet available. To gain better insight into effects of SCP, three meta-analyses were conducted on the association between SCP and children's (1) externalizing behavior, (2) internalizing behavior, and (3) school performance. These meta-analyses synthesized 21 studies (120 effect sizes; N = 67,400), 14 studies (18 effect sizes; N = 39,917), and 20 studies (47 effect sizes; N = 977,367), respectively. Studies were synthesized using a three-level approach to meta-analysis. The results revealed that SCP is positively associated with externalizing behavior (r = 0.27, p < 0.001) and internalizing behavior of children (r = 0.16, p < 0.001), and negatively with children's school performance (r = −0.11, p < 0.001). This review concludes that SCP is a risk factor for externalizing behavior, internalizing behavior, and reduced school performance of children. Other techniques than SCP should be used for class management, and we recommend psychoeducational programs for schools and the wider community in which corporal punishment is still used. These programs should convey the detrimental effects of SCP and alternative discipline techniques. More awareness of the detrimental effects of SCP is needed to make the school environment a safe place for all children across the world.

Personalizing Child Protection: The Clinical Value and Usability of a Needs Assessment Instrument in The Netherlands.

Studies on child maltreatment prevention programs show that the effects of these programs are rather small. Drawing on the need principle of the Risk-Need-Responsivity model, program effects may be enhanced by properly assessing all the needs of individual families involved in child protection so that programs can be adapted to those needs. Recently, a needs assessment tool (ARIJ-Needs) has been developed in the Netherlands to support child protection practitioners in not only the assessment of treatment needs in individual families, but also in selecting the program(s) and/or intervention(s) that best target those needs. This study assessed the clinical value and usability of ARIJ-Needs by interviewing Dutch child protection practitioners (N = 15). A vignette describing a child protection case was used to examine differences between needs assessments based on unstructured clinical judgment (i.e., without using the assessment tool), and structured clinical judgment in which the assessment tool was used. The results showed that significantly more treatment needs were identified when ARIJ-Needs was used relative to clinical judgment in which ARIJ-Needs was not used. Specifically, needs related to parenting, the parent(s), and the family were identified more often when the assessment tool was used. This is an important finding, as these needs comprise the (changeable) risk factors that are most predictive of child maltreatment and should be addressed with priority to prevent child maltreatment. This study shows that ARIJ-Needs supports practitioners in assessing relevant needs in families at risk for child maltreatment. Study implications and recommendations for improvement of the ARIJ-Needs are discussed.

Mental Health of Lesbian, Bisexual, and Other-Identified Parents and Non-Parents from a Population-Based Study.

Studies have compared sexual minority mothers (mostly lesbian) to heterosexual mothers on mental health, but little research has compared sexual minority women with and without children. This was the first study to compare sexual minority women who did or did not have children, using a population-based sample with three age cohorts. Unlike prior convenience studies, this study finds parents more likely to be bisexual, in a relationship with a man, and non-urban. Bisexual parents scored higher than lesbian parents on psychological distress and lower on life satisfaction and happiness; they also reported less connection to the lesbian, gay, bisexual, and transgender (LGBT) community. Among lesbians, the oldest non-parents reported more happiness and less psychological distress than the youngest non-parents. Parents with other identities perceived more social support from friends and reported lower levels of internalized homophobia than bisexual parents. The results will help professionals and policymakers understand how parenthood status affects women across sexual identities.