Accuracy of sexually violent person assessments of juveniles adjudicated for sexual offenses.

This study reviewed the records of 198 juveniles who were committed to secured custody after being adjudicated delinquent for a sexually violent offense that qualified them for possible commitment under a Sexually Violent Person's (SVP) civil commitment law. For an individual to be committed, the statute requires that the individual have a qualifying mental disorder and is "likely," to commit a future act of sexual violence. Each youth was screened by at least two expert examiners in a two-step process. Fifty-four of the youth were found to meet the commitment criteria in an initial examination and were subject to an SVP petition. The remaining 144 were screened out. Subsequent criminal charges were collected over a 4.97-year mean follow-up. The results showed that the prevalence rates for general sexual offending and felony sexual offending did not differ between youth who were screened out and those who were subject to a petition. Among petitioned youth, 11.76% were charged with a new sexual offense including 9.80% who were charged with a felony sexual assault. By comparison, 17.36% of the youth that were screened out were charged with a sexual offense including 13.19% who were charged with a felony sexual assault, a nonsignificant difference.

Treatment-related changes in behavioral outcomes of psychopathy facets in adolescent offenders.

This study examines the association between the facets of psychopathy embedded in the Psychopathy Checklist: Youth Version (PCL:YV; Forth et al., Psychopathy Checklist: Youth Version, 2003), and changes in institutional behavior and post-treatment violent and general offending in a sample of juvenile delinquent males treated in the Mendota Juvenile Treatment Center (MJTC), an intensive treatment program. Affective, Interpersonal, Behavioral and Antisocial facet scale scores were calculated from items of the Psychopathy Checklist: Youth Version (PCL:YV; Forth et al., 2003). Data on daily institutional behavior were collected from treatment records. In order to analyze re-offense patterns, the number and type of new criminal charges were collected over a mean follow-up of 54 months (range = 24-79 months), after the youth was released from custody. The Interpersonal facet of the PCL:YV was significantly related to admission behavior problems, while other facet scores were not. Youth with elevated Interpersonal facet scores showed the greatest improvement in institutional behavior during treatment. Treatment was also associated with a significant decrease in general and violent offending for each facet. The Interpersonal facet of the PCL:YV was found to play a key role in institutional and community violence in this study. Treatment appeared to disrupt the link between institutional and community violence and psychopathy features in this population.

Dimensions of impulsivity related to psychopathic traits and homicidal behavior among incarcerated male youth offenders.

Despite impulsivity being included as scoring criteria within several measures of youth psychopathic traits, the relationship between psychopathic traits and dimensions of impulsivity among high-risk youth is not well-understood. Here we assessed psychopathic traits via total, factor, and facet scores from the Psychopathy Checklist: Youth Version (PCL:YV) and impulsivity through total, three-factor, and six-factor model scores from the Barratt Impulsiveness Scale (BIS-11) in incarcerated male youth offenders. Correlational analyses indicated PCL:YV total, Factor 2, Facet 3, and Facet 4 scores were significantly positively correlated with BIS-11 total scores. Additionally, psychopathy scores were significantly positively correlated with specific scores from the three-factor model of the BIS-11 (e.g. Motor and Non-Planning Impulsivity scores) and the six-factor model of the BIS-11 (e.g., Attention, Self-Control, and Cognitive Complexity Impulsivity scores). Secondary analyses suggest that participants who had previously committed homicide scored higher on lifestyle/antisocial psychopathic traits and specific dimensions of impulsivity (e.g., BIS-11 Non-Planning and Self-Control Impulsivity factor scores) compared to youth who had not previously committed homicide. Our results improve our understanding of the specific forms of impulsivity significantly correlated with youth psychopathic traits and how specific factors underlying both constructs potentially characterize youth associated with severe forms of antisocial behavior.

Sex offender registration and recidivism risk in juvenile sexual offenders.

Juvenile sex offenders are increasingly included in sex offender registration laws, based, in part, on the assumption that they pose a distinctively high risk for future sexual violence and registration may help to mitigate this risk. To test this assumption, the current study compares risk scores on the static scales of the Juvenile Sex Offender Assessment Protocol-II (JSOAP-II; Prentky & Righthand, 2003) and the Youth Level of Service/Case Management Inventory (YLS/CMI; Hoge, Andrews, & Leschied, 2002), between samples of 106 registered and 66 unregistered juvenile sex offenders. New criminal charges, including sexually based crimes, were examined over a mean follow-up of 49.2 months (SD = 29.6 months). Results indicated that registered youth had lower risk scores on scales that most accurately predicted recidivism and registered youth were charged with new crimes at rates similar to those of unregistered youth. Reoffense risk, as measured by the risk scales, was not moderated by registration. The findings did not support the assumption that registration can effectively lower the risk for reoffense in juvenile offenders.

The structural brain correlates of callous-unemotional traits in incarcerated male adolescents.

Youth with severe conduct problems impose a significant cost on society by engaging in high levels of antisocial and aggressive behavior. Within this group, adolescents with high levels of callous- unemotional traits have been found to exhibit more severe and persistent patterns of antisocial behavior than youth with severe conduct problems but normative levels of callous-unemotional traits. Existing neuroimaging studies, along with theoretical accounts of psychopathology, suggest that dysfunction within the paralimbic cortex and limbic system may underlie elevated levels of callous-unemotional traits. The present study examines this hypothesis by investigating gray matter correlates associated with callous-unemotional traits. A sample of incarcerated male adolescents (N = 269), were assessed using voxel-based morphometry. Callous-unemotional traits were assessed using the Inventory of Callous-Unemotional traits (Frick 2004). Total callous-unemotional traits were negatively correlated with anterior temporal lobe gray matter volume (GMV). Callous traits in particular exhibited a reliable negative correlation with gray matter volume in nearly every paralimbic brain region examined. Uncaring traits were positively correlated with GMV in the orbitofrontal and anterior cingulate cortices. These findings demonstrate specific neural features within the paralimbic cortex and limbic system that accompany elevated callous-unemotional traits and serves to expand our understanding of pathophysiological mechanisms that may give rise to severe conduct problems in youth.

A retrospective evaluation of adjunctive risperidone treatment in severely behaviorally disordered boys receiving psychosocial treatment.

OBJECTIVE: The aim of this study was to investigate the effectiveness of risperidone and psychosocial treatment as compared to psychosocial treatment alone in reducing disruptive behavior in adolescents with persistent conduct disorder (CD). METHOD: This was a retrospective study of the treatment records of 129 delinquent males diagnosed with childhood onset and persistent CD. Sixty youths were prescribed risperidone in addition to psychosocial treatment. These youths were compared to a similar group of 69 youths who received treatment that did not include risperidone. The outcome measure was daily behavioral scores measured by continuous observation over the course of the day. Scores for the 21 days before administration of the medication were compared to those of the 21 days following the initial administration of risperidone. RESULTS: The risperidone group showed significant improvement on a composite measure of interpersonal behavior and rule compliance compared to the baseline period (effect size = 0.44). A repeated measures analysis of variance (ANOVA) found a significant treatment group x behavioral scores effect. The risperidone group's behavioral scores improved an average of 9.1%. The most common adverse events were somnolence (26%), weight gain (18%), increased appetite (17%), and constipation (14%). CONCLUSIONS: Risperidone appeared to be safe and effective over the short term in reducing disruptive behavior in this group of severely conduct-disordered adolescent boys.

Functional connectivity during affective mentalizing in criminal offenders with psychotic disorders: Associations with clinical symptoms.

Psychotic disorders are associated with neurobehavioral impairments in mental state attribution (mentalizing). These impairments are most severe in psychotic patients with elevated symptom levels, particularly negative and cognitive symptoms. There have been few studies of functional connectivity related to mentalizing in psychotic disorders and associations with symptoms. We conducted a functional MRI study of affective mentalizing in individuals with psychotic disorders and varying symptom levels (positive, negative, cognitive). Participants were drawn from an adjudicated inpatient forensic psychiatric population (criminal offenders). Functional MRI scans were acquired using a 32-channel ultra-fast multiband imaging sequence. Mentalizing task performance and functional connectivity were assessed in psychotic criminal offenders (n = 46) and nonpsychotic offenders (n = 41). Temporal coherent brain networks were estimated with group independent component analysis (ICA). Relative to nonpsychotic offenders, psychotic offenders showed impaired task performance and reduced activation in a component comprising the dorsomedial prefrontal cortex, superior temporal gyrus, and ventrolateral prefrontal cortex. Positive and cognitive symptoms were inversely correlated with component activity and task performance. The results are discussed with reference to potential mechanisms underlying impaired social cognition in psychotic disorders and across symptom types.

Psychopathy and behavioral correlates of victim injury in serious juvenile offenders.

The study examines delinquent behavior and psychopathy and assesses their relationship to victim injury in a population of 168 incarcerated juvenile delinquent males with lengthy histories of criminal and violent behavior. A series of multiple regressions found that 17% of the variance associated with level of victim injury was accounted for by a model that included the three-factor model of the Psychopathy Checklist: Youth Version [Forth, Kosson, and Hare, 2003], criminal versatility, and age of onset of criminal offending. Notably, anger and DSM-IV symptoms of conduct disorder were not related to level of victim injury. The results of this study support an escalation hypothesis where individuals with earlier onset to criminal behavior and greater criminal versatility escalate to more severe violence. The current results demonstrate the importance of integrating established theories of juvenile delinquency when explaining severe violence in youth.

Socio-neuro risk factors for suicidal behavior in criminal offenders with psychotic disorders.

Relative to the general population, individuals with psychotic disorders have a higher risk of suicide. Suicide risk is also elevated in criminal offenders. Thus, psychotic-disordered individuals with antisocial tendencies may form an especially high-risk group. We built upon prior risk analyses by examining whether neurobehavioral correlates of social cognition were associated with suicidal behavior in criminal offenders with psychotic disorders. We assessed empathic accuracy and brain structure in four groups: (i) incarcerated offenders with psychotic disorders and past suicide attempts, (ii) incarcerated offenders with psychotic disorders and no suicide attempts, (iii) incarcerated offenders without psychotic disorders and (iv) community non-offenders without psychotic disorders. Established suicide risk variables were examined along with empathic accuracy and gray matter in brain regions implicated in social cognition. Relative to the other groups, offenders with psychotic disorders and suicide attempts had lower empathic accuracy and smaller temporal pole volumes. Empathic accuracy and temporal pole volumes were significantly associated with suicide attempts independent of other risk variables. The results indicate that brain and behavioral correlates of social cognition may add incremental value to models of suicide risk.

Reducing violence in serious juvenile offenders using intensive treatment.

This study reports on the reduction in violent offending in a population of serious and violent juvenile offenders following an intensive institutional treatment program. The treatment group (N=101) is compared to a similar group that was assessed but not treated (N=147). All youth were sent to the program from a juvenile corrections institution where they had received the customary rehabilitation services. The results show a significant reduction in the prevalence of recidivism in the treated group after controlling for time at risk in the community and other covariates. The effects of non-random group assignment were reduced by including a propensity score analysis procedure in the outcome analysis. Untreated comparison youth appeared to be about twice as likely to commit violent offenses as were treated youth (44% vs. 23%). Similarly, treated youth had significantly lower hazard ratios for recidivism in the in the community than the comparison youth, even after accounting for the effects of non-random group assignment.

What we do not know about juvenile sexual reoffense risk.

States have increasingly subject juvenile sexual offenders to sex offender registration and commitment under sexual predator laws in recent years. These statutes assume that sexual offenders present a sustained risk to recommit sexually violent crimes over an extended time period. Implicit in this assumption is that criminal sexual behavior is a product of some form of stable trait or condition that continues to push the juvenile toward sexually violent behaviors as they get older. This article examines these assumptions in light of the available research on the stability of sexually offending behavior in juveniles. The difficulties attendant to applying adult offender risk assessment models to juvenile sexual offenders are addressed. The available evidence indicates that the development and persistence of sexually criminal behavior is poorly understood, making the prediction of sustained sexual offending in juveniles that is required by some sexual predator statutes a particularly difficult task.

Study characteristics and recidivism base rates in juvenile sex offender recidivism.

This study reports on the results of a review and meta-analysis of 63 data sets that examine sexual recidivism among juvenile sex offenders. The studies include a total of 11,219 juvenile sex offenders, followed for a weighted mean of 59.4 months (SD = 36.1 months). Recidivism is identified through official records of arrest or conviction. The weighted mean sexual recidivism rate is 7.08% ( SD = 3.9%). The weighted mean rate of general recidivism is 43.4% ( SD = 18.9%). Studies that examine sexual recidivism during adolescence find monthly sexual recidivism rates that are more than 4 times higher than those found in studies that rely only on adult recidivism records. Neither the level of secured placement (community, residential, or secured custody) nor the use of arrest versus conviction as an outcome significantly influences sexual recidivism rates.

Sexual offense adjudication and sexual recidivism among juvenile offenders.

This study compares the recidivism patterns of a cohort of 249 juvenile sexual offenders and 1,780 non-sexual offending delinquents who were released from secured custody over a two and one half year period. The prevalence of sex offenders with new sexual offense charges during the 5 year follow-up period was 6.8%, compared to 5.7% for the non-sexual offenders, a non-significant difference. Juvenile sex offenders were nearly ten times more likely to have been charged with a nonsexual offense than a sexual offense. Eighty-five percent of the new sexual offenses in the follow-up period were accounted for by the non-sex offending delinquents. None of the 54 homicides (including three sexual homicides) was committed by a juvenile sex offender. The implications of the results for recent public policy trends that impose restrictions that are triggered by a sexual offense adjudication are discussed.

Testing factor models of the Psychopathy Checklist: Youth Version and their association with instrumental aggression.

Although there is a documented link between psychopathy and instrumental violence in adult offenders, the association between these constructs has not garnered significant attention in adolescent offenders. In this study, we evaluated the relationship between psychopathy and instrumental aggression in a sample of 122 male adolescents incarcerated in a state facility for serious and chronic offenders. We evaluated the primary (2-, 3-, and 4-factor) models of the Psychopathy Checklist: Youth Version (PCL:YV; Forth, Kosson, & Hare, 2003) and assessed their relationship to a separate 5-item measure of instrumental violence. CFA revealed good model fit for the 3- and 4-factor latent variable models of adolescent psychopathy and a single-factor model reflecting a 5-item measure of instrumental violence. Structural equation modeling results indicate that the 4-factor model accounted for 20% of the variance for instrumental violence. In contrast, the 3-factor model of the PCL:YV accounted for 8%, and the 2-factor model accounted for 5% of the variance associated with instrumental violence.