The New Zealand drug harms ranking study: A multi-criteria decision analysis.

AIMS: The harms arising from psychoactive drug use are complex, and harm reduction strategies should be informed by a detailed understanding of the extent and nature of that harm. Drug harm is also context specific, and so any comprehensive assessment of drug harm should be relevant to the characteristics of the population in question. This study aimed to evaluate and rank drug harms within Aotearoa New Zealand using a multi-criteria decision analysis (MCDA) framework, and to separately consider harm within the total population, and among youth. METHODS: Two facilitated workshops involved the separate ranking of harm for the total population, and then for youth aged 12-17, by two expert panels. In the total population workshop, 23 drugs were scored against 17 harm criteria, and those criteria were then evaluated using a swing weighting process. Scoring and weighting were subsequently updated during the youth-specific workshop. All results were recorded and analysed using specialised MCDA software. RESULTS: When considering overall harm, the MCDA modelling results indicated that alcohol, methamphetamine and synthetic cannabinoids were the most harmful to both the overall population and the youth, followed by tobacco in the total population. Alcohol remained the most harmful drug for the total population when separately considering harm to those who use it, and harm to others. CONCLUSIONS: The results provide detailed and context-specific insight into the harm associated with psychoactive drugs use within Aotearoa New Zealand. The findings also demonstrate the value of separately considering harm for different countries, and for different population subgroups.

All-of-community by all-of-government: reaching Pacific people in Aotearoa New Zealand during the COVID-19 pandemic.

A large portion of Pacific communities throughout Aotearoa New Zealand continue to face socioeconomic hardship and have ongoing health needs that are affected by social and economic influences. The impact of COVID-19 has only exacerbated these needs and will continue to have an adverse effect on the current wellbeing, future health and sustainable development of these communities-if targeted efforts are not undertaken to meet their unique needs. The collective worldview of Pacific communities is fundamental to their existence; therefore, a response needs to be within a collective community. This viewpoint looks at the worldview of Pacific communities and the impact of COVID-19 and then discusses six key priorities for working with these diverse communities. The successful management and elimination of a pandemic should be assessed by how well Pacific and other vulnerable communities survive such a crisis.

Young female offenders and the New Zealand Youth Justice System: the need for a gender-specific response.

Young female offenders comprise approximately one fifth of the New Zealand youth offender population; however, they remain an understudied population of offenders. This paper aims to provide a current overview of the key characteristics of this population and recommendations for how the youth justice system could better cater to this population. These recommendations include more training of professionals (specifically judges, youth advocates and justice coordinators) and practitioners (specifically social workers, psychologists and youth workers) in the youth-justice system in matters specific to young female offenders. A gender-responsive and trauma-informed approach to addressing offending behaviour is also necessary. There is a need for new empirical research in the New Zealand context on young female offenders and the best way to address offending by this group. Finally, a focus on the diversity of young female offenders is a priority, given the over-representation of indigenous and ethnic-minority communities in justice jurisdictions worldwide.

Characteristics of Female Youth Offenders in New Zealand.

Female youth offending is poorly understood, despite increased rates of such offending. Research indicates there are a range of factors that have a causal impact on the development of offending in young people. This study investigated risk factors using a retrospective file audit of 184 female youth offenders in New Zealand. The findings were classified using Bronfenbrenner's ecological model, which highlights the different contextual levels that influence behavior, including individual, family, peer, school, community, and cultural factors. The results indicate that there are significant risk factors for female youth offenders. There were high rates of mental health difficulties, drug use, histories of maltreatment, family stressors, peer issues, and school behavior problems in the cohort. There was very little difference between violent and nonviolent offenders. All the young women had risk factors affecting them at many levels. Targeted, multisystemic intervention and prevention programs are therefore needed to address female youth offending.

Indigenous Adolescents' Perception of an eMental Health Program (SPARX): Exploratory Qualitative Assessment.

BACKGROUND: Depression is a major health issue for indigenous adolescents, yet there is little research conducted about the efficacy and development of psychological interventions for these populations. In New Zealand there is little known about taitamariki (Maori adolescent) opinions regarding the development and effectiveness of psychological interventions, let alone computerized cognitive behavioral therapy. SPARX (Smart, Positive, Active, Realistic, X-factor thoughts) is a computerized intervention developed in New Zealand to treat mild-to-moderate depression in young people. Users are engaged in a virtual 3D environment where they must complete missions to progress to the next level. In each level there are challenges and puzzles to completeIt was designed to appeal to all young people in New Zealand and incorporates several images and concepts that are specifically Maori. OBJECTIVE: The aim was to conduct an exploratory qualitative study of Maori adolescents' opinions about the SPARX program. This is a follow-up to an earlier study where taitamariki opinions were gathered to inform the design of a computerized cognitive behavior therapy program. METHODS: Taitamariki were interviewed using a semistructured interview once they had completed work with the SPARX resource. Six participants agreed to complete the interview; the interviews ranged from 10 to 30 minutes. RESULTS: Taitamariki participating in the interviews found SPARX to be helpful. The Maori designs from the SPARX game were appropriate and useful, and the ability to customize the SPARX characters with Maori designs was beneficial and appeared to enhance cultural identity. These helped young people to feel engaged with SPARX which, in turn, assisted with the acquisition of relaxation and cognitive restructuring skills. Overall, using SPARX led to improved mood and increased levels of hope for the participants. In some instances, SPARX was used by wider whanau (Maori word for family) members with reported beneficial effect. CONCLUSIONS: Overall, this small group of Maori adolescents reported that cultural designs made it easier for them to engage with SPARX, which, in turn, led to an improvement in their mood and gave them hope. Further research is needed about how SPARX could be best used to support the families of these young people.

Does childhood neglect contribute to violent behavior in adulthood? A review of possible links.

Child neglect, whether intentional or unintentional on the part of caregivers, has serious and far-reaching negative consequences for children. Neglect is the most prevalent form of child maltreatment and has been associated with impaired cognitive development, changes in brain structure and nervous systems, behavioral and personality disorders and poor academic performance. However, the role of child neglect, and subtypes of neglect, in the development of adult violent behavior is not well understood. The "cycle of violence" hypothesis, which predicts that individuals exposed to child physical abuse are more likely to be physically violent in adulthood, is well supported by the literature. However, a growing number of studies suggests that child neglect may be equally predictive, or more predictive, of adult violent behavior than child physical abuse. The present review considers a range of studies that investigate aspects of this relationship, and identifies key patterns and trends that have emerged from these investigations. Methodological issues and limitations of the existing literature are also identified and new research directions suggested. This review also considers studies that support the possibility of protective factors against the development of adult violent behavior in victims of child neglect.

Screening for mental health needs of New Zealand youth in secure care facilities using the MAYSI-2.

BACKGROUND: Young people admitted to secure facilities generally have particularly high rates of mental, emotional and behavioural problems, but little is known about the mental health needs of this group in New Zealand. AIMS: To describe prevalence of probable mental health disorder and related needs among young people in secure facilities in New Zealand. METHODS: Massachusetts youth screening instrument - second version (MAYSI-2) data were obtained from the records of young people admitted to one secure care facility (n = 204) within a 12 month period. We used descriptive statistics to determine prevalence of problems overall and multivariate analysis of variance to compare MAYSI-2 scores between gender and ethnic groups. RESULTS: Nearly 80% of these young people scored above the 'caution' or 'warning' cut-off on the MAYSI-2, a substantially higher proportion than reported in studies in other countries. There was a tendency for girls and for Maori and Pacific Islander subgroups to have a higher rate of probable psychopathology. CONCLUSIONS: Young people in secure facilities in New Zealand have substantial service needs. Early intervention that engages them in services upon first contact with the youth justice system might help reduce this burden. Further validation of the MAYSI-2 in New Zealand may be warranted because of the unique ethnic make-up of these young offenders. Copyright © 2017 John Wiley & Sons, Ltd.

The Views of the Public on Youth Offenders and the New Zealand Criminal Justice System.

Public perceptions of crime and punishment have taken on increasing importance as countries grapple with how to address youth violence. The current study aimed to compare the views of those who have had personal experience of victimisation from youth offenders and those who have not, on what could be improved in managing youth offending in New Zealand. A qualitative methodology was used with data from open-ended survey responses from a nationally representative sample. Public sentiments favoured addressing systemic issues and providing rehabilitation as main emphases followed by more punitive measures, prevention, and restorative justice. Victims were over-represented on sentiments of prevention whereas non-victims were over-represented in support for more punitive measures and restorative justice. There was also considerable support for a multi-facetted approach that utilised a number of the approaches above, suggesting that the solution is as complex as the offender's circumstances. These findings are very much in line with the current goals of the youth justice system with its emphasis on diversion and rehabilitation.

Betaine in the Brain: Characterization of Betaine Uptake, its Influence on Other Osmolytes and its Potential Role in Neuroprotection from Osmotic Stress.

Betaine (N-trimethylglycine), a common osmolyte, has received attention because of the number of clinical reports associating betaine supplementation with improved cognition, neuroprotection and exercise physiology. However, tissue analyses report little accumulation of betaine in brain tissue despite the presence of betaine/GABA transporters (BGT1) at the blood brain barrier and in nervous tissue, calling into question whether betaine influences neuronal function directly or indirectly. Therefore, the focus of this study was to determine what capacity nervous tissue has to accumulate betaine, specifically in the hippocampus, a region of the brain associated with learning and memory and one that is particularly susceptible to damage (e.g., seizure activity). Here we report that hippocampal slices actively accumulate betaine in a time, dose and osmolality dependent manner, resulting in peak intracellular concentrations four times extracellular concentrations within 8 h. Our data also indicate that betaine uptake differentially influences the accumulation of other osmolytes. Under isosmotic conditions, betaine uptake minimally impacted some osmolytes (e.g., glycerylphosphorylcholine and glutamate) while significantly reducing others (taurine, creatine, and myo-inositol). Under osmotic stress (hyperosmotic) conditions, we observed dramatic changes in osmolytes like glycine and glutamine-key players in inhibitory neurotransmission-and little change in osmolytes such as taurine, creatine and myo-inositol when betaine was available. These data suggest that betaine may influence pathways of inhibitory neurotransmitter production/recycling in addition to serving as an osmolyte and metabolic intermediate. In sum, our data provide detailed characterization of betaine uptake in the hippocampus that implicates betaine in the modulation of hippocampal neurophysiology and neuroprotection.

A Comparison of Pacific, Maori, and European Violent Youth Offenders in New Zealand.

Pacific Island and Maori youth are disproportionately overrepresented in Aotearoa/New Zealand in violent offending. To date, research has not examined Pacific Island violent youth offenders in comparison with other ethnic populations. This study compared Pacific Island violent youth offenders with Maori and European violent youth offenders to determine whether similarities or differences existed in their offending, social, and demographic characteristics. Findings showed that Pacific Island violent youth offenders, in comparison with Maori and European violent youth offenders, were more likely to have grown up in the lowest socioeconomic deprivation areas in New Zealand, were more likely to be older when they first started offending, and their first offence was more likely to be of a serious, violent nature. Family violence was present among all three ethnic groups highlighting the ongoing importance of intervention in this area. The findings of the current study are likely to have implications for government department policy makers, along with program providers and practitioners. Recommendations are made regarding clinical implications and future research on this population.

"I Couldn't Do It to a Kid Knowing What It Did to Me": The Narratives of Male Sexual Abuse Victims' Resiliency to Sexually Offending.

Research has shown that child sexual abuse victims are overrepresented among sexual abuse offenders, leading to the sexually abused-sexual abuser hypothesis. However, a large proportion of child sexual abuse victims do not go on to sexually offend, and such individuals are labeled as resilient victims. Surprisingly few studies have looked at why some male victims of sexual abuse do not go on to offend. In-depth qualitative interviews were conducted with 47 resilient men focusing on their beliefs as to why they had not gone on to sexually abuse others. Results revealed four themes for why the victims did not offend: empathy, morals, lack of sexual desire, or a combination of the previous three. In regard to the process of developing their resiliency, some participants claimed they made a conscious decision, whereas others reported the decision was an unconscious one. The various factors that were reported as contributing to the conscious or unconscious decision (becoming aware of sexual abuse, admitting the experience had happened to them, empathy, social support, and lack of sexual desire to abuse) are discussed, along with the four themes, and the implication of these results for prevention. Finally, conclusions are drawn that the victim-offender pathway is far from inevitable as most participants stated their reason for not offending was directly related to their own experience of sexual abuse victimisation.

The design and relevance of a computerized gamified depression therapy program for indigenous maori adolescents.

BACKGROUND: Depression is a major health issue among Maori indigenous adolescents, yet there has been little investigation into the relevance or effectiveness of psychological treatments for them. Further, consumer views are critical for engagement and adherence to therapy. However, there is little research regarding indigenous communities' opinions about psychological interventions for depression. OBJECTIVE: The objective of this study was to conduct semistructured interviews with Maori (indigenous New Zealand) young people (taitamariki) and their families to find out their opinions of a prototype computerized cognitive behavioral therapy (cCBT) program called Smart, Positive, Active, Realistic, X-factor thoughts (SPARX), a free online computer game intended to help young persons with mild to moderate depression, feeling down, stress or anxiety. The program will teach them how to resolve their issues on their own using Cognitive Behavioural Therapy as psychotherapeutic approach. METHODS: There were seven focus groups on the subject of the design and cultural relevance of SPARX that were held, with a total of 26 participants (19 taitamarki, 7 parents/caregivers, all Maori). There were five of the groups that were with whanau (family groups) (n=14), one group was with Maori teenage mothers (n=4), and one group was with taitamariki (n=8). The general inductive approach was used to analyze focus group data. RESULTS: SPARX computerized therapy has good face validity and is seen as potentially effective and appealing for Maori people. Cultural relevance was viewed as being important for the engagement of Maori young people with SPARX. Whanau are important for young peoples' well-being. Participants generated ideas for improving SPARX for Maori and for the inclusion of whanau in its delivery. CONCLUSIONS: SPARX computerized therapy had good face validity for indigenous young people and families. In general, Maori participants were positive about the SPARX prototype and considered it both appealing and applicable to them. The results of this study were used to refine SPARX prior to it being delivered to taitamariki and non-Maori young people. TRIAL REGISTRATION: The New Zealand Northern Y Regional Ethics Committee; http://ethics.health.govt.nz/home; NTY/09/003; (Archived by WebCite at http://www.webcitation/6VYgHXKaR).

"Inflaming your neighbors": copycat firesetting in adolescents.

The objective of this article is to consider and discuss existing research and theory concerning copycat problem behaviors and copycat offending and how this may be applicable to populations of firesetting children and adolescents. The primary databases used to search for literature were PsychInfo, Medline, and Eric. Google Scholar was used as an additional Internet search engine. While the primary focus was on literature published since 1990, earlier literature considered to be important was also included. Qualitative and quantitative studies suggest that consumption of violent media affects aggressive behaviors and supports the existence of a copycat effect within some offending populations. Existing literature suggests that processes such as desensitization, observational learning, priming, and alteration of scripts are involved in copycat behaviors and are mediated by individual, environmental, and media factors. While literature concerning firesetters has largely overlooked the possibility of a copycat effect, given their young age, and the often antisocial nature and individual and environmental problems associated with firesetters, they may be a population particularly vulnerable to such an effect. There is a need for consideration of the potential role of the media in copycat behaviors and for care to be taken in the way that the media reports events.

Offending behaviours of child and adolescent firesetters over a 10-year follow-up.

BACKGROUND: To assess the postintervention arson recidivism and other offending rates of a group of 182 firesetting children and adolescents referred to the New Zealand Fire Awareness and Intervention Program (FAIP) over a follow-up period of 10 years. To investigate predictors of offending behaviour as well as variables associated with previous involvement in firesetting behaviour and offending severity. METHOD: Data collected at the time of the FAIP intervention was provided by the New Zealand Fire Service and the offence histories of the sample were accessed from the New Zealand Police database (NIA). Data were analyzed using both descriptive and inferential statistics. RESULTS: Although the arson recidivism rate was low (2%), rates of general offending were high, with 59% of the sample having committed an offence during the follow-up period. Fifteen percent of the sample was classified as severe offenders, 40% as moderate and 4% as minor. Of offenders, 12.6% had been imprisoned during the follow-up period. Offending was predicted by experience of abuse and a previous firesetting behaviour at the time of the FAIP intervention. Living with both parents at the time of intervention decreased the probability of an individual engaging in future offending behaviour. The presence of family stress and a diagnosis of Attention Deficit Disorder or Attention Deficit Hyperactivity Disorder (ADD/ADHD) were associated with previous firesetting behaviour. In addition, involvement with family violence (as a perpetrator, complainant or victim) was associated with more severe offending behaviour. CONCLUSIONS: In light of existing research, the findings of this study indicate that many firesetters are at risk for future offending and that identification of high-risk individuals is therefore an important consideration for any organization involved with firesetters. To minimize this risk, there is a need for a collaborative, multiagency approach to firesetting behaviour involving comprehensive risk assessment and appropriate referral for at-risk individuals.

The impact of incarceration on juvenile offenders.

Increasingly, research points to the negative effects of incarcerating youth offenders, particularly in adult facilities. Literature published since 2000 suggests that incarceration fails to meet the developmental and criminogenic needs of youth offenders and is limited in its ability to provide appropriate rehabilitation. Incarceration often results in negative behavioral and mental health consequences, including ongoing engagement in offending behaviors and contact with the justice system. Although incarceration of youth offenders is often viewed as a necessary means of public protection, research indicates that it is not an effective option in terms of either cost or outcome. The severe behavioral problems of juvenile offenders are a result of complex and interactive individual and environmental factors, which elicit and maintain offending behavior. Therefore, the focus of effective treatment must be on addressing such criminogenic needs and the multiple "systems" in which the young person comes from. Recent research demonstrates that in order to achieve the best outcomes for youth offenders and the general public, community-based, empirically supported intervention practices must be adopted as an alternative to incarceration wherever possible.

Community reintegration of sex offenders of children in new zealand.

Reintegration of offenders following incarceration is most successful if matched to the needs of offenders, victims, and the community. This study explored child sex offenders' expectations for and experiences of reintegration into the community. A longitudinal design was used in which semistructured interviews covered issues identified in the literature as being related to reintegration. Nine offenders were interviewed within 1 week prior to release, 3 months post release, and 6 months post release. Interviews were analysed using thematic analyses producing six key themes. The interviews revealed that most of the participants feared their release from prison into the community and once released struggled to live in society. Overall, reintegration planning was simplistic and aimed primarily to manage risk factors rather than promote reintegration. Those participants who reported most satisfaction with their adjustment following release had more comprehensive reintegration plans, which enabled them to visualise what life would be like after release.

Measuring outcome in child and adolescent mental health services: consumers' views of measures.

BACKGROUND: Outcome measurement in child and adolescent mental health services in New Zealand became mandatory in 2005 and little is known about how this is perceived by service users. AIMS: This study aimed to ascertain what service users think about routine outcome measurement in child and adolescent mental health services. METHOD: Nine semi-structured focus groups of child and adolescent service users (n=34) and family members (n=21) were held in different sites in New Zealand to determine their views on outcome measures. RESULTS: Consumers supported outcome assessment with some provisos that have important implications for clinical services: the method of collecting information is critical to acceptance; assessment should be done in the context of an established relationship with the clinician; care is needed over the timing and context of assessment, access to information and feedback of results; and measures should be brief and holistic and their limitations recognised. CONCLUSION: Service users support outcome measures but their implementation requires care and consultation.

"If he had 40 cents he'd buy matches instead of lollies": motivational factors in a sample of New Zealand adolescent firesetters.

Motivation has been proposed as an important factor in both the causality and subsequent treatment of juveniles who deliberately light fires. Thus, a wide range of research has previously been completed, investigating such motives. This research has resulted in the creation of classifications of firesetting motives and behaviours, all of which fit upon a continuum of motivational categories-ranging from curiosity or match play, through to deliberate delinquent acts. This current study aimed to gain insight into how both firesetters and their caregivers perceived firesetting motivation. A total of 18 male youths, who had engaged in deliberate firesetting, and 13 parents were interviewed. Qualitative analysis gathered from interviews with adolescent participants reported personality and individual characteristic themes, the most frequent of these being anger, experimenting, peer pressure, and boredom. Parents on the other hand initially cited family historical factors as being a cause for their son's firesetting. This study showed the difficulties in attempting to classify firesetters. It became clear that there were often multiple motivations involved in adolescent firesetting, meanwhile a variation of motivations were reported by parents and firesetters. The differences between and ambiguities inherent in existing motivational typologies also became evident. The study produced strong evidence for the effectiveness of utilising multiple sources to gain a comprehensive understanding as to why children deliberately light fires.

New Zealand youth that sexually offend: improving outcomes for Maori rangatahi and their whanau.

Maori youth are overrepresented in criminal justice statistics and youth forensic services. Maori youth that engage in sexual offending behaviors have a higher risk of dropping out of treatment than Pakeha(1) youth. Research into Maori mental health is important to inform ongoing service development and is essential to strive for equity in mental health outcomes and offending rates among Maori. In this study, the researchers investigated the coexisting emotional and behavioral problems and victimization histories of an age-matched sample of Maori (n = 75) and Pakeha (n = 75) youth who were referred to a community treatment program for sexual offending in Auckland between 1996 and 2008. The Child Behavior Checklist was used to investigate ethnic differences. After controlling for socioeconomic deprivation, Maori youth scored significantly higher than Pakeha youth on the Delinquent Behaviors syndrome scale. Maori youth were also more likely than Pakeha youth to have a background of physical abuse. Implications of these findings are discussed, with regard to the unique needs of Maori youth and appropriate interventions.

Young people and caregivers' perceptions of an intervention program for children who deliberately light fires.

A significant number of children and adolescents engage in deliberate fire setting, beyond the scope of curiosity and experimentation. Interventions developed to respond to the needs of such fire setters generally involve educational and/or psychosocial approaches. Research evaluating the effectiveness of these interventions is dominated by outcome studies which rely on recidivism rates determined by either official records or parent reports. There has however, been no process evaluation studies published. This study presents a process analysis which aimed to identify the strengths and weaknesses of a Fire Awareness and Intervention Program in New Zealand, from the perspectives of program consumers. Qualitative research methods were employed, with data being derived from in-depth interviews with young people and their parents/caregivers. The analysis indicated that (a) the FAIP was generally regarded as a positive experience, (b) practitioners' qualities of empathy and understanding are important for developing rapport with the young people and their parents, (c) education-based intervention tailored to the young person's age and developmental level is important, (d) educational resources need to be updated and used flexibly to respond appropriately to the age and developmental level of the young person, and (e) inter-agency and intra-agency relationships need to be developed and maintained, with formal arrangements for reciprocal referral systems developed in order to respond to the needs of the clients. The resulting implications for service providers, along with future research are discussed.