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1.
J Clin Child Adolesc Psychol ; 50(3): 326-336, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-31393169

RESUMEN

We examined whether childhood socioeconomic disadvantage was associated with adolescent gun violence and whether early symptoms of conduct disorder and/or exposure to delinquent peers accounted for the linkage. Participants were 503 predominately Black and White boys who were recruited in 1st grade from Pittsburgh public schools. Multi-informant assessments were conducted regularly from approximately ages 7 to 20. A latent socioeconomic disadvantage factor was estimated with census-tract and parent-reported data when boys were about age 7½. Latent growth curve models assessed parent/teacher-reported conduct problems and youth-reported peer delinquency from about ages 7½ to 10. The outcome was youth-reported engagement in gun violence by about age 20. We also controlled for race. Analyses examined whether the association between childhood socioeconomic disadvantage and adolescent gun violence was mediated through early conduct problems and/or increased exposure to delinquent peers. Childhood socioeconomic disadvantage was associated with adolescent gun violence, and some of this effect was mediated through peer delinquency and conduct problems. Specifically, childhood socioeconomic disadvantage was associated with greater affiliation with delinquent peers in early childhood, and early peer delinquency promoted a greater increase in conduct problems across childhood, and these conduct problems, in turn, led to an increased risk for adolescent gun violence. In summary, this study found that early socioeconomic disadvantage was directly and indirectly related to adolescent gun violence. Results suggest that interventions that aim to reduce conduct problems and deviant peer group affiliation in childhood might be important windows of opportunity for reducing gun violence in impoverished neighborhoods.


Asunto(s)
Trastorno de la Conducta/epidemiología , Violencia con Armas/economía , Violencia con Armas/estadística & datos numéricos , Delincuencia Juvenil , Grupo Paritario , Factores Socioeconómicos , Adolescente , Niño , Humanos , Delincuencia Juvenil/economía , Delincuencia Juvenil/estadística & datos numéricos , Masculino , Adulto Joven
2.
Psychol Trauma ; 12(7): 730-738, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32212775

RESUMEN

OBJECTIVE: Dissociative disorders (DDs) are associated with intensive, long-term treatment, suicidality, recurrent hospitalizations, and high rates of disability. However, little is known about the specifics of the economic burden associated with DDs. This worldwide, systematic review examines the results of studies in adults on direct and indirect costs associated with DDs. METHOD: We searched 6 databases and the reference lists of articles. We also approached researchers to identify unpublished studies. No language restrictions were imposed. RESULTS: A total of 1,002 records met the search criteria, of which 29 papers were selected for full-text inspection. Ultimately, of these, we reviewed four empirical studies. We provide a narrative discussion of study findings. Our findings suggest that DDs are costly to society, and that there is a reduction in service utilization and associated costs over time with diagnosing of and specialized treatment for DDs. However, the overall quality of the economic evaluations was low; several types of DDs, comorbid conditions, and costs were not included; and men were underrepresented. Due to the heterogeneity among studies, we could not perform a meta-analysis. CONCLUSIONS: Due to the heterogeneity and low quality of the identified economic evaluations, no firm conclusions about the economic burden of DDs alone can be drawn. Higher quality research, including a detailed description of the study design, population, and primary outcome measures used, utilizing appropriate clinical alternatives and including major comorbidities, is urgently needed to more rigorously assess the economic impact of DDs. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Asunto(s)
Trastornos Disociativos/economía , Costos de la Atención en Salud , Servicios de Salud/economía , Seguridad Social/economía , Crimen/economía , Derecho Penal/economía , Eficiencia , Cuidados en el Hogar de Adopción/economía , Servicios de Salud/estadística & datos numéricos , Hospitalización/economía , Hospitalización/estadística & datos numéricos , Humanos , Delincuencia Juvenil/economía , Servicios de Salud Mental/economía , Servicios de Salud Mental/estadística & datos numéricos
3.
J Ment Health Policy Econ ; 22(2): 71-79, 2019 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-31319377

RESUMEN

BACKGROUND: Youth mental health interventions aimed at reducing substance use and delinquency in adolescents compete with other types of interventions for reimbursement from public funding. Within the youth mental health domain, delinquent acts impose high costs on society. These costs should be included in economic evaluations conducted from a societal perspective. Although the relevance of these costs is recognized, they are often left out because the unit costs of delinquent acts are unknown. AIMS OF THE STUDY: This study aims to provide a method for estimating the unit costs per perpetrator of 14 delinquent acts common in the Netherlands and included in self reported delinquency questionnaires: robbery/theft with violence, simple theft/pickpocketing, receiving stolen goods, destruction/vandalism of private or public property, disorderly conduct/discrimination, arson, cybercrime, simple and aggravated assault, threat, forced sexual contact, unauthorised driving, driving under the influence, dealing in soft drugs, and dealing in hard drugs. METHODS: Information on government expenditures and the incidence of crimes, number of perpetrators, and the percentage of solved and reported crimes was obtained from the national database on crime and justice of the Research and Documentation Centre of the Ministry of Justice and Security, Statistics Netherlands, and the Council for the Judiciary in the Netherlands. We applied a top-down micro costing approach to calculate the point estimate of the unit costs for each of the delinquent acts and, subsequently, estimated the mean (SD) unit costs for each of the delinquent acts by taking random draws from a triangular distribution while taking into account a 10% uncertainty associated with the associated point estimate. RESULTS: The mean (SD) unit costs per delinquent act per perpetrator ranged between EUR495 (EUR1.30) for "Driving under the influence" and EUR33,813 (EUR78.30) for a "Cybercrime". These unit costs may be considered as outliers as most unit costs ranged between EUR 2,600 and EUR 13,500 per delinquent act per perpetrator. DISCUSSION: This study is the first to estimate the unit costs per delinquent act per perpetrator in the Netherlands. The results of this study enable the inclusion of government expenditures associated with crime and justice in economic evaluations conducted from a societal perspective. IMPLICATIONS FOR HEALTH CARE PROVISION AND USE: Youth mental health interventions aimed at reducing substance use and delinquency in adolescents are increasingly subjected to economic evaluations. These evaluations are used to inform decisions concerning the allocation of scarce healthcare resources and should cover all the costs and benefits for society, including those associated with delinquent acts. IMPLICATIONS FOR HEALTH POLICIES: The results of this study facilitate economic evaluations of youth mental health interventions aimed at reducing substance use and delinquency in adolescents, conducted from a societal perspective. IMPLICATIONS FOR FURTHER RESEARCH: Based on health-economic evaluations conducted in the field of youth mental health and the results of the current study, we recommend including the estimated unit costs in guidelines for health-economic evaluations conducted from a societal perspective. Future research could aim at examining whether these unit costs require regular updating. The methodology applied in this study allows for this.


Asunto(s)
Servicios de Salud del Adolescente/economía , Delincuencia Juvenil/economía , Trastornos Relacionados con Sustancias/economía , Adolescente , Análisis Costo-Beneficio , Servicios de Salud/economía , Humanos , Delincuencia Juvenil/rehabilitación , Salud Mental , Países Bajos , Trastornos Relacionados con Sustancias/terapia , Encuestas y Cuestionarios
4.
BMC Health Serv Res ; 18(1): 660, 2018 Aug 23.
Artículo en Inglés | MEDLINE | ID: mdl-30139384

RESUMEN

BACKGROUND: The aim of this systematic literature review is to identify and critique full economic evaluations of interventions for high risk young people with the purpose of informing the design of future rigorous economic evaluations of such intervention programs. METHODS: A PRISMA compliant search of the literature between 2000 and April 2018 was conducted to identify full economic evaluations of youth focussed interventions for at risk young people. Duplicates were removed and two researchers independently screened the article titles and abstracts according to PICOS criteria for exclusion and inclusion. The remaining full text articles were assessed for eligibility and a quality assessment of the included articles was conducted using the Drummond checklist. RESULTS: The database, grey literature and hand searches located 488 studies of interventions for at risk young people. After preliminary screening of titles and abstracts, 104 studies remained for full text examination and 29 empirical studies containing 32 separate economic evaluations were judged eligible for inclusion in the review. These comprised 13 cost-benefit analyses (41%), 17 cost-effectiveness analyses (53%), one cost-utility analysis (3%) and a social return on investment (3%). Three main methodological challenges were identified: 1. attribution of effects; 2. measuring and valuing outcomes; and 3. identifying relevant costs and consequences. CONCLUSIONS: A cost-benefit analysis would best capture the dynamic nature of a multi-component intervention for high risk young people, incorporating broader intersectoral outcomes and enabling measurement of more domains of risk. Prospective long-term data collection and a strong study design that incorporates a control group contribute to the quality of economic evaluation. Extrapolation of impact into the future is important for this population, in order to account for the time lag in effect of many impacts and benefits arising from youth interventions.


Asunto(s)
Análisis Costo-Beneficio , Delincuencia Juvenil/economía , Psicoterapia/economía , Adolescente , Maltrato a los Niños , Humanos , Delincuencia Juvenil/prevención & control , Factores de Riesgo , Asunción de Riesgos
5.
Behav Ther ; 49(4): 551-566, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-29937257

RESUMEN

Several states have made considerable investments into large-scale implementation of evidence-based treatments (EBTs), yet little is known about key success indicators for these implementation efforts such as cost and sustainability. To that end, the present study examined the economic impact of statewide implementation of multisystemic therapy (MST; Henggeler, Schoenwald, Borduin, Rowland, & Cuningham, 2009), a family- and community-based behavioral EBT for serious juvenile offenders in New Mexico. Participants were 1,869 youth who received MST across 23 teams during the study period. We conducted a cost-benefit analysis using metrics from state data sources that compared the cost of MST to its benefits (i.e., avoided expenses from pre- to posttreatment) in two domains: (a) behavioral health services (i.e., Medicaid claims) and (b) juvenile crime (i.e., taxpayer expenses, tangible and intangible expenses to crime victims). MST costs were based on Medicaid claims, which were reimbursed at an enhanced billing rate that was intended to cover expenses for both clinical and implementation (e.g., training, quality assurance) activities. Results suggest that implementation of MST in New Mexico over the 7-year study period may have produced net benefits, through 2 years posttreatment, of more than $4,643 per youth in avoided behavioral health claims and $15,019 per youth through reductions in juvenile crime. Stated differently, every dollar that New Mexico spent on MST appeared to have returned $3.34 for a total benefit of $64.2 million over the course of the study. We discuss implications of these findings for policymakers, administrators, and researchers who are interested in increasing the sustainability of complex EBTs in community settings.


Asunto(s)
Análisis Costo-Beneficio/métodos , Medicina Basada en la Evidencia/economía , Medicina Basada en la Evidencia/métodos , Delincuencia Juvenil/economía , Psicoterapia/economía , Psicoterapia/métodos , Adolescente , Terapia Combinada/economía , Terapia Combinada/métodos , Crimen/economía , Crimen/psicología , Víctimas de Crimen/economía , Víctimas de Crimen/psicología , Femenino , Humanos , Masculino , New Mexico/epidemiología
6.
J Behav Health Serv Res ; 45(3): 321-339, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-29582233

RESUMEN

Juvenile drug court (JDC) programs are an increasingly popular option for rehabilitating juvenile offenders with substance problems, but research has found inconsistent evidence regarding their effectiveness and economic impact. While assessing client outcomes such as reduced substance use and delinquency is necessary to gauge program effectiveness, a more comprehensive understanding of program success and sustainability can be attained by examining program costs and economic benefits. As part of the National Cross-Site Evaluation of JDC and Reclaiming Futures (RF), an economic analysis of five JDC/RF programs was conducted from a multisystem and multiagency perspective. The study highlights the direct and indirect costs of JDC/RF and the savings generated from reduced health problems, illegal activity, and missed school days. Results include the average (per participant) cost of JDC/RF, the total economic benefits per JDC/RF participant, and the net savings of JDC/RF relative to standard JDC.


Asunto(s)
Derecho Penal/economía , Delincuencia Juvenil/economía , Servicios Legales/economía , Trastornos Relacionados con Sustancias/economía , Adolescente , Servicios Comunitarios de Salud Mental/economía , Análisis Costo-Beneficio , Costos de la Atención en Salud , Humanos , Evaluación de Programas y Proyectos de Salud , Trastornos Relacionados con Sustancias/terapia , Estados Unidos , Voluntarios
7.
Trials ; 18(1): 225, 2017 05 19.
Artículo en Inglés | MEDLINE | ID: mdl-28526087

RESUMEN

BACKGROUND: Effective interventions for young adults with severe, multiple problems - such as psychosocial and psychiatric problems, delinquency, unemployment and substance use - are scarce but urgently needed in order to support an adequate transition to adulthood. A multimodal day treatment program called "New Opportunities" (in Dutch: "De Nieuwe Kans"; DNK) was specifically developed to target multi-problem young adults in The Netherlands. The aim of this study protocol is to describe the design of a randomized controlled trial (RCT) in clinical practice to examine the effectiveness of DNK in comparison with care as usual (CAU). METHODS/DESIGN: Multi-problem young adults in Rotterdam, The Netherlands, will be assigned randomly to DNK (expected N = 150) and CAU (expected N = 150). Primary outcome measures are recidivism and self-sufficiency. Secondary outcome measures include quality of life, attending school/work, psychological functioning, cognitive distortions and substance use. Participant and program characteristics will be examined as potential moderators of effectiveness. Additionally, cost-effectiveness will be measured. During 14 months, data from multiple resources will be collected at four time points. DISCUSSION: This study is one of the first RCTs on the effectiveness of interventions developed for multi-problem young adults. The results will contribute to the currently scant knowledge about what works for various multi-problem young adults in their transition to adulthood. In addition, the study protocol will provide insight into implementing an RCT in a dynamic setting of clinical practice. TRIAL REGISTRATION: Dutch Trial Register, identifier: NTR5163 . Registered on 17 April 2015; retrospectively registered during the recruitment phase.


Asunto(s)
Terapia Cognitivo-Conductual/métodos , Delincuencia Juvenil/rehabilitación , Trastornos Mentales/rehabilitación , Trastornos Relacionados con Sustancias/rehabilitación , Desempleo/psicología , Adolescente , Adulto , Factores de Edad , Cognición , Terapia Cognitivo-Conductual/economía , Terapia Combinada , Análisis Costo-Beneficio , Educación/métodos , Femenino , Costos de la Atención en Salud , Humanos , Delincuencia Juvenil/economía , Delincuencia Juvenil/psicología , Masculino , Trastornos Mentales/diagnóstico , Trastornos Mentales/economía , Trastornos Mentales/psicología , Motivación , Países Bajos , Grupo de Atención al Paciente , Reincidencia , Proyectos de Investigación , Factores de Riesgo , Automanejo , Trabajadores Sociales , Trastornos Relacionados con Sustancias/diagnóstico , Trastornos Relacionados con Sustancias/economía , Trastornos Relacionados con Sustancias/psicología , Factores de Tiempo , Resultado del Tratamiento , Adulto Joven
8.
BMC Psychiatry ; 16: 237, 2016 07 13.
Artículo en Inglés | MEDLINE | ID: mdl-27412612

RESUMEN

BACKGROUND: Family therapy and family-based treatment has been commonly applied in children and adolescents in mental health care and has been proven to be effective. There is an increased interest in economic evaluations of these, often expensive, interventions. The aim of this systematic review is to summarize and evaluate the evidence on cost-effectiveness of family/family-based therapy for externalizing disorders, substance use disorders and delinquency. METHODS: A systematic literature search was performed in PubMed, Education Resource information Centre (ERIC), Psycinfo and Cochrane reviews including studies conducted after 1990 and before the first of August of 2013. Full economic evaluations investigating family/family-based interventions for adolescents between 10 and 20 years treated for substance use disorders, delinquency or externalizing disorders were included. RESULTS: Seven hundred thirty-one articles met the search criteria and 51 studies were initially selected. The final selection resulted in the inclusion of 11 studies. The quality of these studies was assessed. Within the identified studies, there was great variation in the specific type of family/family-based interventions and disorders. According to the outcomes of the checklists, the overall quality of the economic evaluations was low. Results varied by study. Due to the variations in setting, design and outcome it was not feasible to pool results using a meta-analysis. CONCLUSIONS: The quality of the identified economic evaluations of family/family-based therapy for treatment of externalizing disorders, adolescent substance use disorders and delinquency was insufficient to determine the cost-effectiveness. Although commonly applied, family/family-based therapy is costly and more research of higher quality is needed.


Asunto(s)
Conducta del Adolescente/psicología , Déficit de la Atención y Trastornos de Conducta Disruptiva/economía , Terapia Familiar/economía , Delincuencia Juvenil/psicología , Trastornos Relacionados con Sustancias/economía , Adolescente , Déficit de la Atención y Trastornos de Conducta Disruptiva/terapia , Análisis Costo-Beneficio , Humanos , Delincuencia Juvenil/economía , Trastornos Relacionados con Sustancias/terapia
9.
Eval Program Plann ; 56: 43-9, 2016 06.
Artículo en Inglés | MEDLINE | ID: mdl-27031834

RESUMEN

Family-centered program research has demonstrated its effectiveness in improving adolescent outcomes. However, given current fiscal constraints faced by governmental agencies, a recent report from the Institute of Medicine and National Research Council highlighted the need for cost-benefit analyses to inform decision making by policymakers. Furthermore, performance management tools such as balanced scorecards and dashboards do not generally include cost-benefit analyses. In this paper, we describe the development of an Excel-based decision support tool that can be used to evaluate a selected family-based program for at-risk children and adolescents relative to a comparison program or the status quo. This tool incorporates the use of an efficient, user-friendly interface with results provided in concise tabular and graphical formats that may be interpreted without need for substantial training in economic evaluation. To illustrate, we present an application of this tool to evaluate use of Boys Town's In-Home Family Services (IHFS) relative to detention and out-of-home placement in New York City. Use of the decision support tool can help mitigate the need for programs to contract experts in economic evaluation, especially when there are financial or time constraints.


Asunto(s)
Análisis Costo-Beneficio/métodos , Técnicas de Apoyo para la Decisión , Terapia Familiar/métodos , Delincuencia Juvenil/prevención & control , Adolescente , Terapia Familiar/economía , Humanos , Delincuencia Juvenil/economía , Masculino , Evaluación de Programas y Proyectos de Salud/métodos
10.
Drug Alcohol Depend ; 162: 154-61, 2016 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-27006273

RESUMEN

OBJECTIVE: To evaluate the cost-effectiveness of Multidimensional Family Therapy (MDFT) for adolescents with a cannabis use disorder, compared to Cognitive Behavioural Therapy (CBT). METHODS: A parallel-group randomized controlled trial was performed. 109 adolescents with a DSM-IV cannabis use disorder (CBT n=54; MDFT n=55) were included. Assessments were conducted at baseline, and 3, 6, 9 and 12 months post-baseline, and included measures on cannabis and other substance use, delinquency, health care utilization, and general health related quality of life. RESULTS: Excluding those with missing cost-data, 96 participants (MDFT n=49; CBT n=47) were included. From a health care perspective, the average annual direct medical costs in the CBT group were €2015 (95%C.I. 1397-2714), compared to €5446 (95%C.I. 4159-7092) in the MDFT group. The average quality-adjusted life years (QALY's) gained were 0.06 QALY higher for the MDFT group, which led to an incremental cost-effectiveness ratio (ICER) of 54,308 Euro/QALY or €43,405 per recovered patient. Taking the costs of delinquency into account, the costs increased to €21,330 (95%C.I. 12,389-32,894) for the CBT group and to €21,915 (95%C.I. 16,273-28,181) for the MDFT group, which lead to an ICER of 9266 Euro/QALY or a cost per recovered patient of €7491. CONCLUSIONS: This is the first comprehensive CEA of MDFT compared to CBT and it demonstrated that when costs of delinquency were included, the ICERS were modest. The results underline the importance of adopting a broader perspective regarding cost effectiveness analyses in mental health care.


Asunto(s)
Terapia Cognitivo-Conductual/economía , Análisis Costo-Beneficio , Terapia Familiar/economía , Costos de la Atención en Salud/estadística & datos numéricos , Abuso de Marihuana/terapia , Adolescente , Femenino , Humanos , Delincuencia Juvenil/economía , Masculino , Abuso de Marihuana/psicología , Calidad de Vida , Años de Vida Ajustados por Calidad de Vida
11.
PLoS One ; 10(7): e0131255, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26146831

RESUMEN

OBJECTIVES: To investigate whether a value of information analysis, commonly applied in health care evaluations, is feasible and meaningful in the field of crime prevention. METHODS: Interventions aimed at reducing juvenile delinquency are increasingly being evaluated according to their cost-effectiveness. Results of cost-effectiveness models are subject to uncertainty in their cost and effect estimates. Further research can reduce that parameter uncertainty. The value of such further research can be estimated using a value of information analysis, as illustrated in the current study. We built upon an earlier published cost-effectiveness model that demonstrated the comparison of two interventions aimed at reducing juvenile delinquency. Outcomes were presented as costs per criminal activity free year. RESULTS: At a societal willingness-to-pay of €71,700 per criminal activity free year, further research to eliminate parameter uncertainty was valued at €176 million. Therefore, in this illustrative analysis, the value of information analysis determined that society should be willing to spend a maximum of €176 million in reducing decision uncertainty in the cost-effectiveness of the two interventions. Moreover, the results suggest that reducing uncertainty in some specific model parameters might be more valuable than in others. CONCLUSIONS: Using a value of information framework to assess the value of conducting further research in the field of crime prevention proved to be feasible. The results were meaningful and can be interpreted according to health care evaluation studies. This analysis can be helpful in justifying additional research funds to further inform the reimbursement decision in regard to interventions for juvenile delinquents.


Asunto(s)
Crimen/prevención & control , Teoría de las Decisiones , Delincuencia Juvenil/prevención & control , Modelos Económicos , Evaluación de Programas y Proyectos de Salud/economía , Adolescente , Niño , Comportamiento del Consumidor , Análisis Costo-Beneficio , Costos y Análisis de Costo , Crimen/economía , Terapia Familiar/economía , Terapia Familiar/organización & administración , Estudios de Factibilidad , Hogares para Grupos/economía , Hogares para Grupos/organización & administración , Humanos , Delincuencia Juvenil/economía , Cadenas de Markov , Países Bajos , Política Pública , Valores Sociales , Procesos Estocásticos , Incertidumbre
12.
J Fam Psychol ; 29(5): 687-96, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-26075740

RESUMEN

This study investigated the economics of multisystemic therapy for problem sexual behaviors (MST-PSB), a family-based treatment that has shown promise with juvenile sexual offenders. We evaluated the cost and benefits of MST-PSB versus usual community services using arrest data obtained in an 8.9-year follow-up from a randomized clinical trial with 48 juvenile sexual offenders, who averaged 22.9 years of age at follow-up (Borduin, Schaeffer, & Heiblum, 2009). The net benefit of MST-PSB over usual community services was calculated in terms of (a) the value to taxpayers, which was based on measures of criminal justice system expenses (e.g., police and sheriff's offices, court processing, community supervision); and (b) the value to crime victims, which was based on measures of both tangible (e.g., property damage and loss, health care, lost productivity) and intangible (e.g., pain, suffering, reduced quality of life) losses. Lower rates of posttreatment arrests in the MST-PSB versus usual community services conditions were associated with lasting reductions in expenses for both taxpayers and crime victims, with an estimated total benefit of $343,455 per MST-PSB participant. Stated differently, every dollar spent on MST-PSB recovered $48.81 in savings to taxpayers and crime victims over the 8.9-year follow-up. These findings demonstrate that a family-based treatment such as MST-PSB can produce lasting economic benefits with juvenile sexual offenders. Policymakers and public service agencies should consider these findings when making decisions about interventions for this challenging clinical population.


Asunto(s)
Criminales , Comunicación Interdisciplinaria , Delincuencia Juvenil/economía , Delincuencia Juvenil/prevención & control , Delitos Sexuales/economía , Delitos Sexuales/prevención & control , Adolescente , Adulto , Análisis Costo-Beneficio , Víctimas de Crimen , Femenino , Estudios de Seguimiento , Humanos , Delincuencia Juvenil/legislación & jurisprudencia , Delincuencia Juvenil/psicología , Masculino , Problema de Conducta , Delitos Sexuales/legislación & jurisprudencia , Delitos Sexuales/psicología , Estados Unidos , Adulto Joven
13.
J Youth Adolesc ; 43(10): 1781-99, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25146466

RESUMEN

Serious youthful offenders are presented with a number of significant challenges when trying to make a successful transition from adolescence to adulthood. One of the biggest obstacles for these youth to overcome concerns their ability to desist from further antisocial behavior, and although an emerging body of research has documented important risk and protective factors associated with desistance, the importance of the neighborhoods within which these youth reside has been understudied. Guided by the larger neighborhood effects on crime literature, the current study examines the direct and indirect effects of concentrated disadvantage on youth reoffending among a sample of highly mobile, serious youthful offenders. We use data from Pathways to Desistance, a longitudinal study of serious youthful offenders (N = 1,354; 13.6% female; 41.4% African American, 33.5% Hispanic, 20.2% White), matched up with 2000 Census data on neighborhood conditions for youth's main residence location during waves 7 and 8 of the study. These waves represent the time period in which youth are navigating the transition to adulthood (aged 18-22; average age = 20). We estimate structural equation models to determine direct effects of concentrated disadvantage on youth reoffending and also to examine the possible indirect effects working through individual-level mechanisms as specified by theoretical perspectives including social control (e.g., unsupervised peer activities), strain (e.g., exposure to violence), and learning (e.g., exposure to antisocial peers). Additionally, we estimate models that take into account the impact that a change in neighborhood conditions may have on the behavior of youth who move to new residences during the study period. Our results show that concentrated disadvantage is indirectly associated with youth reoffending primarily through its association with exposure to deviant peers. Taking into account youth mobility during the study period produced an additional indirect pathway by which concentrated disadvantage is associated with goal blockage (i.e., the gap between belief in conventional goals and perceived potential to reach those goals), which was then associated with exposure to deviant peers and indirectly, reoffending behavior. We conclude that the neighborhood effects literature offers a promising framework for continued research on understanding the successful transition to adulthood by serious youthful offenders.


Asunto(s)
Crimen/psicología , Delincuencia Juvenil/psicología , Áreas de Pobreza , Características de la Residencia , Medio Social , Adolescente , Arizona , Crimen/economía , Femenino , Humanos , Entrevistas como Asunto , Delincuencia Juvenil/economía , Estudios Longitudinales , Masculino , Modelos Psicológicos , Modelos Estadísticos , Grupo Paritario , Philadelphia , Dinámica Poblacional , Adulto Joven
14.
J Consult Clin Psychol ; 82(4): 694-705, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-24684692

RESUMEN

OBJECTIVE: This study investigated the economic benefits of multisystemic therapy (MST) versus individual therapy (IT) using arrest data from 176 serious juvenile offenders and 129 of their closest-in-age siblings who participated, on average, 25 years earlier in a randomized clinical trial (Borduin et al., 1995). METHOD: Two types of benefits of MST were evaluated: (a) The value to taxpayers was derived from measures of criminal justice system expenses (e.g., police and sheriffs' offices, court processing, community supervision), and (b) the value to crime victims was derived from measures of both tangible (e.g., property damage and loss, health care, lost productivity) and intangible (e.g., pain, suffering, reduced quality of life) losses. RESULTS: Reductions in criminality in the MST versus IT conditions were associated with lasting benefits to both taxpayers and crime victims, with cumulative benefits of MST estimated at $35,582 per juvenile offender and $7,798 per sibling. Overall, every dollar spent on MST recovered $5.04 in savings to taxpayers and crime victims in the 25 years following treatment. CONCLUSIONS: This study represents the most comprehensive cost-benefit analysis of an MST clinical trial to date and demonstrates that an evidence-based treatment such as MST can produce modest economic benefits well into adulthood. Implications of the authors' findings for policymakers and public service agencies are discussed.


Asunto(s)
Víctimas de Crimen , Criminales , Delincuencia Juvenil , Hermanos , Adolescente , Adulto , Análisis Costo-Beneficio , Femenino , Humanos , Delincuencia Juvenil/economía , Masculino , Missouri , Psicoterapia , Calidad de Vida , Características de la Residencia , Estados Unidos , Adulto Joven
15.
Behav Sci Law ; 31(3): 381-96, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23733324

RESUMEN

Youth development and violence prevention are two sides of the same public policy. The focus of much theoretical and empirical effort is identifying delinquency risks and intervening. Given the great costs of homicide and the historically high nationwide prison population, new policies must address increasing violence and rising expenses. Treatments of prenatal care, home visitation, bullying prevention, alcohol-substance abuse education, alternative thinking promotion, mentoring, life skills training, rewards for graduation and employment, functional family and multi-systemic therapy, and multi-dimensional foster care are effective, because they ameliorate age-specific risks for delinquency. At present, these interventions only yield a 10-40% diversion from crime however. Returns on investment (ROIs) vary from $1 to $98. Targeting empirical treatments to those determined to be most at risk, based on statistical models or actuarial testing, and using electronic surveillance for non-violent prisoners significantly diverted youth from violence, improving ROI, while simultaneously saving costs.


Asunto(s)
Crimen/prevención & control , Delincuencia Juvenil/rehabilitación , Violencia/prevención & control , Adolescente , Crimen/economía , Humanos , Delincuencia Juvenil/economía , Delincuencia Juvenil/prevención & control , Violencia/economía
17.
Can J Psychiatry ; 58(3): 169-76, 2013 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-23461888

RESUMEN

OBJECTIVE: Adolescent depressive symptoms are associated with difficult family relationships. Family systems and interpersonal theories of depression suggest that this association could reflect a circular process in which symptoms and family functioning affect each other over time. Few longitudinal studies have tested this hypothesis, and the results of these studies have been equivocal. In this study, we examine reciprocal prospective associations in early adolescence between depressive symptoms and 2 important aspects of parent-child relationships: communication and conflict. METHODS: Participants were 3862 students who annually filled out self-reports. Path analysis was used to examine prospective associations between depressive symptoms and perceived communication and conflict with parents from the age of 12 to 13 and 14 to 15 years. Independence of these associations was assessed by controlling for family context (parental separation and family socioeconomic status) and adolescent behaviour problems (delinquent behaviours and substance use). Sex differences were evaluated with multiple group analysis. RESULTS: Reciprocal prospective associations were found between depressive symptoms and perceived conflict with parents, but not between depressive symptoms and communication with parents. Depressive symptoms were found to predict poorer communication with parents over time, but communication was not predictive of lower depressive symptoms in subsequent years. All paths were sex-invariant and independent from family context and behaviour problems. CONCLUSION: This study highlights the importance of considering the potential impact of adolescent symptomatology on parent-child relationships and suggests that reciprocity may characterize the association between depressive symptoms and negative aspects of parent-child relationships. The role of adolescent perceptions in the interplay between depressive symptoms and family relationships remains to be clarified.


Asunto(s)
Conducta del Adolescente/psicología , Comunicación , Depresión/psicología , Conflicto Familiar/psicología , Modelos Psicológicos , Relaciones Padres-Hijo , Adolescente , Niño , Depresión/economía , Composición Familiar , Conflicto Familiar/economía , Femenino , Humanos , Delincuencia Juvenil/economía , Delincuencia Juvenil/psicología , Masculino , Estudios Prospectivos , Factores Sexuales , Percepción Social , Trastornos Relacionados con Sustancias/economía , Trastornos Relacionados con Sustancias/psicología
18.
Health Soc Work ; 38(3): 147-57, 2013 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-24437020

RESUMEN

Rapid urbanization globally threatens to increase the risk to mental health and requires a rethinking of the relationship between urban poverty and mental health. The aim of this article is to reveal the cyclic nature of this relationship: Concentrated urban poverty cultivates mental illness, while the resulting mental illness reinforces poverty. The authors used theories about social disorganization and crime to explore the mechanisms through which the urban environment can contribute to mental health problems. They present some data on crime, substance abuse, and social control to support their claim that mental illness reinforces poverty. The authors argue that, to interrupt this cycle and improve outcomes, social workers and policymakers must work together to implement a comprehensive mental health care system that emphasizes prevention, reaches young people, crosses traditional health care provision boundaries, and involves the entire community to break this cycle and improve the outcomes of those living in urban poverty.


Asunto(s)
Protección a la Infancia/economía , Servicios Comunitarios de Salud Mental/provisión & distribución , Política de Salud , Trastornos Mentales/economía , Pobreza/psicología , Salud Urbana/economía , Adolescente , Niño , Servicios Comunitarios de Salud Mental/economía , Víctimas de Crimen/economía , Víctimas de Crimen/psicología , Accesibilidad a los Servicios de Salud/economía , Accesibilidad a los Servicios de Salud/normas , Personas con Mala Vivienda/psicología , Humanos , Delincuencia Juvenil/economía , Delincuencia Juvenil/psicología , Trastornos Mentales/etiología , Delitos Sexuales/economía , Delitos Sexuales/psicología , Trastornos por Estrés Postraumático/economía , Trastornos por Estrés Postraumático/etiología , Trastornos por Estrés Postraumático/psicología , Trastornos Relacionados con Sustancias/economía , Trastornos Relacionados con Sustancias/psicología , Violencia/economía , Violencia/psicología
19.
J Fam Psychol ; 26(4): 576-84, 2012 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-22709262

RESUMEN

The current study examines the role of economic strain as a moderator of the microsocial processes influencing younger siblings' delinquency (externalizing behavior and substance use) in a longitudinal design. The younger siblings (122 younger brothers and 122 younger sisters) were from 244 families with same-sex biological siblings. Structural equation modeling was utilized to examine a process model whereby mothers' harsh/inconsistent parenting and older sibling delinquency influence younger siblings' delinquent behavior via sibling aggression and delinquent peer affiliation. Findings suggest that indirect mechanisms vary as a function of economic strain, with sibling aggression having a stronger, more detrimental effect on adolescent delinquency in economically strained families. Data suggest that familial economic conditions contextualize the relative roles of parenting, sibling, and peer processes in the transmission of risk to adolescent delinquency.


Asunto(s)
Delincuencia Juvenil/economía , Adolescente , Agresión/psicología , Niño , Conflicto Familiar/psicología , Femenino , Humanos , Delincuencia Juvenil/psicología , Estudios Longitudinales , Masculino , Modelos Teóricos , Responsabilidad Parental/psicología , Grupo Paritario , Factores de Riesgo , Hermanos/psicología , Factores Socioeconómicos
20.
Sociol Inq ; 81(2): 195-222, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21858930

RESUMEN

Using a national probability sample of adolescents (12­17), this study applies general strain theory to how violent victimization, vicarious violent victimization, and dual violent victimization affect juvenile violent/property crime and drug use. In addition, the mediating effect and moderating effect of depression, low social control, and delinquent peer association on the victimization­delinquency relationship is also examined. Based on SEM analyses and contingency tables, the results indicate that all three types of violent victimization have significant and positive direct effects on violent/property crime and drug use. In addition, the expected mediating effects and moderating effects are also found. Limitations and future directions are discussed.


Asunto(s)
Víctimas de Crimen , Criminales , Delincuencia Juvenil , Proyectos de Investigación , Violencia , Adolescente , Conducta del Adolescente/etnología , Conducta del Adolescente/historia , Conducta del Adolescente/fisiología , Conducta del Adolescente/psicología , Víctimas de Crimen/economía , Víctimas de Crimen/educación , Víctimas de Crimen/historia , Víctimas de Crimen/legislación & jurisprudencia , Víctimas de Crimen/psicología , Criminales/educación , Criminales/historia , Criminales/legislación & jurisprudencia , Criminales/psicología , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Delincuencia Juvenil/economía , Delincuencia Juvenil/etnología , Delincuencia Juvenil/historia , Delincuencia Juvenil/legislación & jurisprudencia , Delincuencia Juvenil/psicología , Conducta Social/historia , Condiciones Sociales/economía , Condiciones Sociales/historia , Condiciones Sociales/legislación & jurisprudencia , Políticas de Control Social/historia , Responsabilidad Social , Violencia/economía , Violencia/etnología , Violencia/historia , Violencia/legislación & jurisprudencia , Violencia/psicología
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