The Structured Trauma-Related Experiences and Symptoms Screener (STRESS): Assessing factor structure and clinical utility in a juvenile justice sample.

OBJECTIVE: High prevalence of traumatic event exposure and posttraumatic stress disorder (PTSD) among justice-involved adolescents has necessitated the use of trauma screening in juvenile justice settings. The present study explored the psychometric properties, factor structure, and construct validity of a trauma screen, the Structured Trauma-Related Experiences and Symptoms Screener (STRESS), in a detained adolescent sample. Prior to the current study, psychometric characteristics of the STRESS were evaluated only in a child welfare sample (Grasso et al., 2015). METHOD: The sample consisted of 132 adolescents in secure detention facilities in a southeastern state. Participants were included in the study if they engaged in the mental health screening process at intake and a follow-up assessment process with facility staff psychologists. Data consisted of de-identified, archival records. RESULTS: The STRESS total symptom and 4 criterion symptom count scores demonstrated high internal consistency. Confirmatory factor analysis revealed that the STRESS had excellent fit with the DSM-5 four-factor PTSD model. Equally strong evidence was found for a higher order PTSD model, thus reinforcing the use of both STRESS PTSD total and criterion symptom count scores with justice-involved adolescents. Additionally, preliminary evidence of convergent and discriminant validity was supported. CONCLUSIONS: Findings support the STRESS as a reliable and valid trauma screen for use with detained adolescents. Results suggest that both STRESS total symptom and criterion symptom count scores have clinical utility for intake-level mental health decisions in juvenile detention settings. Implications for expanding use of the STRESS to inform appropriate interventions for justice-involved adolescents are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Effects of Microaggressions on Depression in Young Adults of Color: Investigating the Impact of Traumatic Event Exposures and Trauma Reactions.

Microaggressions are a common way that individuals experience racism in the United States. The current study examined the extent to which microaggressions contribute to mental health difficulties, namely trauma reactions and depression, after controlling for other traumatic event exposures. We sought to address gaps in the literature by quantitatively assessing the associations among microaggressions, posttraumatic stress symptoms, and depression symptoms. Participants were 140 young adults of color (68.8% female) who were recruited online. Linear regression analyses evidenced that microaggressions were uniquely associated with depression symptoms, B = 0.27, after controlling for lifetime traumatic event exposures, with this association partially mediated by trauma reactions, B = 0.49. These results suggest that microaggressions are a clinically relevant factor in understanding mental health problems reported by Black, Indigenous, and People of Color in the United States and warrant analysis, assessment, and intervention through a trauma lens.

Assessing Risk for Victimization in a Forensic Psychiatric Setting Using the Short-Term Assessment of Risk and Treatability.

Although a growing literature on community-based victimization of people with mental illness exists, victimization within institutional settings is comparatively understudied. The current study seeks to fill this gap by exploring factors related to risk of victimization in a male forensic psychiatric sample using a relatively new risk assessment measure. The Short-Term Assessment of Risk and Treatability (START) is a short-term risk assessment measure that compiles information about several clinically relevant risk factors to evaluate risk of victimization, among other adverse outcomes. Nearly one-third (31.3%) of the sample experienced some type of victimization during their hospitalization. The summary risk judgment and subsets of select START items effectively predicted risk of victimization in this sample with a fair degree of accuracy over a 2-month period.

Juvenile probation officers' evaluation of traumatic event exposures and traumatic stress symptoms as responsivity factors in risk assessment and case planning.

Juvenile probation officers (JPOs) are increasingly using risk/needs assessments to evaluate delinquency risk, identify criminogenic needs and specific responsivity factors, and use this information in case planning. Justice-involved youth are exposed to traumatic events and experience traumatic stress symptoms at a high rate; such information warrants attention during the case planning process. The extent to which JPOs identify specific responsivity factors, in general, and trauma history, specifically, when scoring risk/need assessments is understudied. In the current study, 147 JPOs reviewed case vignettes that varied by the adolescents' gender (male vs. female), traumatic event exposure (present vs. absent), and traumatic stress symptoms (present vs. absent), and then scored the YLS/CMI and developed case plans based on that information. JPOs who received a vignette that included trauma information identified a higher number of trauma-specific responsivity factors on the YLS/CMI. Despite an overall high needs match ratio (57.2%), few JPOs prioritized trauma as a target on case plans. The findings underscore the importance of incorporating trauma screening into risk/needs assessment and case planning. (PsycINFO Database Record

A Study of the Impact of Screening for Poly-Victimization in Juvenile Justice: The Rocky Road to a Successful Investigation in the Real World.

Poly-victimization during formative developmental periods represents an important focus for screening and assessment in settings and populations in which interpersonal violence is pervasive. This article describes the multistage evolution of a research project designed to empirically test a poly-victimization enhancement of a widely used and validated behavioral health screening tool for youth using retrospective and prospective archival juvenile justice system outcome data. Several operational and methodological revisions to the project's design and procedures were necessitated by barriers that arose as a result of unforeseen shifts in the host juvenile justice system's policies and personnel. The present report describes real-world challenges that face investigators working in public sector systems, and highlights the key role of establishing long-term collaborative professional relationships with personnel at all levels in those systems based on providing services and evaluation data that meet the system's core goals, responsibilities, and mission. Also highlighted are the methodological and logistical adaptations needed to successfully accomplish a project's internal objectives while striking a balance between flexibility in operational and methodological tactics on one hand, and adherence to ethical, conceptual/clinical, and methodological principles on the other hand.

The Influence of Age and Sexual Drive on the Predictive Validity of the Juvenile Sex Offender Assessment Protocol-Revised.

The Juvenile Sex Offender Assessment Protocol-Revised (J-SOAP-II) is the most commonly used measure in the assessment of recidivism risk among juveniles who have committed sexual offenses (JSOs), but mixed support exists for its predictive validity. This study compared the predictive validity of the J-SOAP-II across two offender characteristics, age and sexual drive, in a sample of 156 JSOs who had been discharged from a correctional facility or a residential treatment program. The J-SOAP-II appeared to be a better predictor of sexual recidivism for younger JSOs (14-16 years old) than for older ones (17-19 years old), with significant differences found for the Dynamic Summary Scale and Scale III (Intervention). In addition, several of the measure's scales significantly predicted sexual recidivism for JSOs with a clear pattern of sexualized behavior but not for those without such a pattern, indicating that the J-SOAP-II may have greater clinical utility for JSOs with heightened sexual drive. The implications of these findings are discussed.

Juvenile Probation Officer Self-Assessed Mental Health Competency as a Predictor of Case Management Practices.

Justice-involved youth endorse high rates of mental health problems. Juvenile probation is the most common disposition in the justice system and juvenile probation officers (JPOs) are crucial for connecting justice-involved youth with appropriate care. We examined the role of mental health competency on the use of self-report case management strategy types (deterrence, restorative justice, and treatment) by JPOs and whether jurisdiction-level differences were relevant. Results suggest that mental health competency predicted use of restorative justice and treatment strategies and all three strategy types varied at the county level. The role of mental health competency in use of treatment strategies is relevant to connecting justice-involved youth to mental health care. Furthermore, a substantial amount of the variance predicting the use of all three strategies was accounted for at the county level.

Obstacles to research in residential juvenile justice facilities: recommendations for researchers.

Federal, state, and local initiatives to improve the treatment and outcomes for young people in the juvenile justice system prompt the need for additional research. Despite the call for empirical data, researchers encounter numerous obstacles when initiating and conducting studies in detention and post-adjudication facilities. These obstacles are often only briefly mentioned in publications, but they can interfere with researchers' desires and abilities to conduct studies in these settings. This paper reviews legal, ethical, and methodological challenges to successfully conducting research in detention and residential post-adjudication placements, including selecting and accessing appropriate facilities, obtaining institutional review board approval, seeking parental permission and youth assent, reporting child abuse and neglect, responding to participants' threats to harm self or others, working effectively with facilities, juvenile justice system-related attrition, and the dissemination of research findings. Recommendations are presented to help investigators anticipate obstacles when designing and executing research protocols to prevent interference and to encourage ethical responses and successful study completion.

Pilot Implementation and Preliminary Evaluation of START:AV Assessments in Secure Juvenile Correctional Facilities.

The Short-Term Assessment of Risk and Treatability: Adolescent Version (START:AV) is a new structured professional judgment guide for assessing short-term risks in adolescents. The scheme may be distinguished from other youth risk assessment and treatment planning instruments by its inclusion of 23 dynamic factors that are each rated for both vulnerability and strength. In addition, START:AV is also unique in that it focuses on multiple adverse outcomes-namely, violence, self-harm, suicide, unauthorized leave, substance abuse, self-neglect, victimization, and general offending-over the short-term (i.e., weeks to months) rather than long-term (i.e., years). This paper describes a pilot implementation and preliminary evaluation of START:AV in three secure juvenile correctional facilities in the southern United States. Specifically, we examined the descriptive characteristics and psychometric properties of START:AV assessments completed by 21 case managers on 291 adolescent offenders (250 boys and 41 girls) at the time of admission. Results provide preliminary support for the feasibility of completing START:AV assessments as part of routine practice. Findings also highlight differences in the characteristics of START:AV assessments for boys and girls and differential associations between the eight START:AV risk domains. Though results are promising, further research is needed to establish the reliability and validity of START:AV assessments completed in the field.

Taking Stock and Taking Steps: The Case for an Adolescent Version of the Short-Assessment of Risk and Treatability.

The field of violence risk assessment has matured considerably, possibly advancing beyond its own adolescence. At this point in the field's evolution, it is more important than ever for the development of any new device to be accompanied by a strong rationale and the capacity to provide a unique contribution. With this issue in mind, we first take stock of the field of adolescent risk assessment in order to describe the rapid progress that this field has made, as well as the gaps that led us to adapt the Short-Term Assessment of Risk and Treatability (START; Webster, Martin, Brink, Nicholls, & Desmarais, 2009) for use with adolescents. We view the Short-Term Assessment of Risk and Treatability: Adolescent Version (START:AV; Nicholls, Viljoen, Cruise, Desmarais, & Webster, 2010; Viljoen, Cruise, Nicholls, Desmarais, & Webster, in progress) as complementing other risk measures in four primary ways: 1) rather than focusing solely on violence risk, it examines broader adverse outcomes to which some adolescents are vulnerable (including self-harm, suicide, victimization, substance abuse, unauthorized leave, self-neglect, general offending); 2) it places a balanced emphasis on adolescents' strengths; 3) it focuses on dynamic factors that are relevant to short-term assessment, risk management, and treatment planning; and 4) it is designed for both mental health and justice populations. We describe the developmentally-informed approach we took in the adaptation of the START for adolescents, and outline future steps for the continuing validation and refinement of the START:AV.

Assessment of Multiple Risk Outcomes, Strengths, and Change with the START:AV: A Short-Term Prospective Study with Adolescent Offenders.

The Short-Term Assessment of Risk and Treatability: Adolescent Version (START:AV; Nicholls, Viljoen, Cruise, Desmarais, & Webster, 2010; Viljoen, Cruise, Nicholls, Desmarais, & Webster, in preparation) is a clinical guide designed to assist in the assessment and management of adolescents' risk for adverse events (e.g., violence, general offending, suicide, victimization). In this initial validation study, START:AV assessments were conducted on 90 adolescent offenders (62 male, 28 female), who were prospectively followed for a 3-month period. START:AV assessments had good to excellent inter-rater reliability and strong concurrent validity with Structured Assessment of Violence Risk in Youth assessments (SAVRY; Borum, Bartel, & Forth, 2006). START:AV risk estimates and Vulnerability total scores predicted multiple adverse outcomes, including violence towards others, offending, victimization, suicidal ideation, and substance abuse. In addition, Strength total scores inversely predicted violence, offending, and street drug use. During the 3-month follow-up, risk estimates changed in at least one domain for 92% of youth, and 27% of youth showed reliable changes in Strength and/or Vulnerability total scores (reliable change index, 90% confidence interval; Jacobsen & Truax, 1991). While these findings are promising, a strong need exists for further research on the START:AV, the measurement of change, and on the role of strengths in risk assessment and treatment-planning.

Violence risk assessment and women: predictive accuracy of the HCR-20 in a civil psychiatric sample.

Research to date has not adequately demonstrated whether the HCR-20 Violence Risk Assessment Scheme (HCR-20; Webster, Douglas, Eaves, & Hart, 1997), a structured violence risk assessment measure with a robust literature supporting its validity in male samples, is a valid indicator of violence risk in women. This study utilized data from the MacArthur Study of Mental Disorder and Violence to retrospectively score an abbreviated version of HCR-20 in 827 civil psychiatric patients. HCR-20 scores and predictive accuracy of community violence were compared for men and women. Results suggested that the HCR-20 is slightly, but not significantly, better for evaluating future risk for violence in men than in women, although the magnitude of the gender differences was small and was largely limited to historical factors. The results do not indicate that the HCR-20 needs to be tailored for use in women or that it should not be used in women, but they do highlight that the HCR-20 should be used cautiously and with full awareness of its potential limitations in women.

Differences in offending patterns between adolescent sex offenders high or low in callous-unemotional traits.

In the present study, the authors investigated whether callous and unemotional (CU) traits designated a distinct and important group of adolescent sex offender. A sample of 150 detained adolescents (mean age = 15.89, SD = 1.53) with a current sexual offense disposition was assessed with a self-report measure of CU traits and through extensive assessments of the characteristics of their sexual offending behaviors using self-report interviews and file review. Results indicated that after controlling for the severity of their history of impulsive/antisocial behaviors, offenders high on CU traits had a greater number of sexual offense victims, used more violence with their victims, and engaged in more sexual offense planning than those low on these traits. The 2 groups did not differ greatly on the age of, gender of, or relationship with their victims.

Differential correlates to self-report and parent-report of callous-unemotional traits in a sample of juvenile sexual offenders.

The association of callous-unemotional (CU) traits with violence and severe antisocial behavior has led to a recent focus on the association between CU traits and sexual offending behavior. When assessing juveniles with sexual offenses, practice standards recommend that multiple sources of data are considered. However, the differential correlates of parent-report versus self-report of CU traits in juvenile sex offenders have not been investigated. A sample of 94 detained male youth (mean age = 15.22, SD = 1.48) was administered both youth and parent versions of the Inventory of Callous-Unemotional Traits (ICU), a general delinquency risk assessment tool (YLS), and a sexual offending risk assessment tool (J-SOAP-II) to investigate concordance between self-report and parent-report of CU traits as well as association with general and sex-specific risk factors. Both parent-report and self-report of CU traits were significantly related to higher general delinquency risk scores, with parent-report showing stronger correlations than self-report. Both parent-report and self-report were related to sex-specific risk factors. However, only parent-report significantly predicted static sexual risk, while self-report significantly predicted dynamic sexual risk scores. Evidence supports the importance of including both parent- and self-report of CU traits in the comprehensive assessment of sexually offending youth.

Assessing callous-unemotional traits in adolescent offenders: validation of the Inventory of Callous-Unemotional Traits.

The presence of callous-unemotional (CU) traits designates an important subgroup of antisocial youth. To improve upon existing measures, the Inventory of Callous-Unemotional Traits (ICU) was developed to provide an efficient, reliable, and valid assessment of CU traits in samples of youth. The current study tests the factor structure and correlates of the ICU scale in a sample (n=248) of juvenile offenders (188 boys, 60 girls) between the ages of 12 and 20 (M=15.47, SD=1.37). Confirmatory factor analyses are consistent with the presence of three independent factors (i.e., Uncaring, Callousness, and Unemotional) that relate to a higher-order callous-unemotional dimension. Also, CU traits overall showed associations with aggression, delinquency, and both psychophysiological and self-report indices of emotional reactivity. There were some important differences across the three facets of the ICU in their associations with these key external criteria.

Internal consistency reliability of the self-report antisocial process screening device.

The self-report version of the Antisocial Process Screening Device (APSD) has become a popular measure for assessing psychopathic features in justice-involved adolescents. However, the internal consistency reliability of its component scales (Narcissism, Callous-Unemotional, and Impulsivity) has been questioned in several studies. This study evaluates the internal consistency reliability of the self-report APSD by examining various indices (e.g., Cronbach's alpha, mean interitem correlation) across 11 studies. Whereas the Narcissism and Impulsivity scales display moderate to good reliability, internal consistency indices for the Callous-Unemotional scale are consistently poor across studies. Suggestions are made for revisions to this scale that would substantially improve its internal consistency reliability.

The influence of psychosocial maturity on male juvenile offenders' comprehension and understanding of the Miranda warning.

Self-report measures of psychosocial maturity and screening measures of achievement and intelligence (Wechsler Abbreviated Scale of Intelligence; WASI) were used to investigate the influence of psychosocial maturity on male juvenile offenders' comprehension and appreciation of the Miranda warning (Grisso's Instruments for Assessing Understanding and Appreciation of Miranda Rights; GUAM). A sample of 67 male juvenile offenders, placed in a short-term detention facility or juvenile boot camp facility, participated in the study. Demographic differences revealed that youths in short-term detention were approximately one year older than boot camp youths. The two groups did not differ in IQ or measures of psychosocial maturity. Detention youths had GUAM subtest scores that were slightly higher than, but comparable to, those of boot camp youths. Consistent with previous research, verbal IQ correlated positively with GUAM subtest scores and was a significant predictor of all four scores after controlling for setting and age in a series of hierarchical regressions. In addition, the psychosocial maturity factor of Responsibility was a significant predictor of two GUAM subtests (CMR and FRI), while the Temperance and Perspective factors were not.

Prototypical analysis of adolescent psychopathy: investigating the juvenile justice perspective.

The past ten years have seen a dramatic increase in the empirical investigation of psychopathic characteristics in children and adolescents. In general, the focus of this research has been on the validation of assessment instruments to evaluate psychopathy as well as concurrent and predictive validity. Little attention has been directed toward elucidating the core characteristics of this construct. The current study expands on previous research by asking juvenile justice personnel (424 juvenile detention and probation officers) to identify the core characteristics of the construct via prototypical analysis for both male and female adolescents. Results of separate factor analyses by gender revealed five identifiable dimensions: juvenile delinquency, serious/violent conduct problems, narcissistic/manipulation of others, impulsivity/acting out, and family problems. The results suggest that juvenile justice personnel focus on a wide range of behavioral indicators as indicative of adolescent psychopathy in addition to affective and interpersonal characteristics typically viewed as crucial to the construct by clinicians.

Screening for adolescent psychopathy among at-risk youth: initial validation of the Survey of Attitudes and Life Experiences.

Psychopathic youth pose special challenges to clinicians in providing effective treatment and safe management. Because comprehensive assessments of psychopathy are time intensive and require specialized training, programmatic research is needed to develop time-efficient and useful screens that eliminate from further consideration acting-out adolescents who are unlikely to be psychopathic. The clinical utility of the Survey of Attitudes and Life Erperiences as a psychopathy screen was investigated by combining three samples of adolescent offenders (total N = 223). Its primary purpose was the identification of nonpsychopaths who were distinguished from adolescents in either the mixed or psychopathic ranges. A Psychopathy Screen (PS) Scale was developed with 24-item (PS-24) and 11-item (PS-11) versions. Both appeared moderately effective in excluding nonpsychopaths from further evaluation. Preliminary data on response styles suggest that these scales are not susceptible to social desirability.