Girls in Juvenile Justice Institutions. Psychopathology and Sexual Risk Behavior
11 / 2003 - 09 / 2008
Psychiater in opleiding Sannie Hamerlynck pleit in haar proefschrift voor een zorgvuldige screening en diagnostisering van tienermeisjes in justitiële jeugdinrichtingen. Ook geeft zij het belang aan van voorlichting, behandeling en nazorg. Tienermeisjes in justitiële jeugdinrichtingen hebben veel psychiatrische problemen en één op de vijf meisjes is al zwanger geweest. ADHD, posttraumatische stress, depressie, gedrags- en verslavingsproblemen komen heel veel voor. De meeste meisjes hebben één of meer trauma s meegemaakt. Deze factoren verdienen meer aandacht, want ze hebben niet alleen negatieve gevolgen voor de meisjes zelf en voor hun omgeving, ze hangen ook vaak nauw samen met agressief gedrag van de meisjes in de inrichting.
OBJECTIVES: To investigate the determinants of aggression in Dutch detained adolescent females and to examine the relationship between psychopathology and aggression. Secondly, to investigate which characteristics contribute to further deviant development and recidivism after release from detention. METHODS: A representative sample of 218 detained adolescent females aged 12-18 (mean 15.5) was studied to examine aggression, externalising (disruptive behavioural disorders, substance abuse disorders) and internalising (depression, post-traumatic stress symptoms, and suicidal behaviour) psychopathology, by means of a semi-structured psychiatric interview (K-SADS) and self-report questionnaires (the Beck Depression Inventory and the Child Post-traumatic Stress Disorder-Reaction Index ). Traumatic events were investigated using the Traumatic Events Questionnaire. Overt and covert aggression were assessed using the Buss-Durkee Hostility Inventory (BDHI). Based on K-SADS aggression items, three aggression subgroups were identified: non-aggressive, moderately aggressive, and severely aggressive. All girls will be followed up after their release from detention to investigate recidivism rates and their further psychosocial development. RESULTS: The first part of this study was recently finished. Overall, high levels of aggression and psychopathology were found. On the basis of the total aggression score on the K-SADS, 20.2% of the girls were severely aggressive, 38.5% moderately aggressive, and 41.3% non-aggressive. As for externalising psychopathology, 56.0% of the girls fulfilled criteria for CD, 38.9% for ODD, and 56.0% for ADHD. Alcohol and drug problems were also frequent: 51.9% of the girls fulfilled criteria for drug abuse, while 29.8% were drug dependent, and 18.6% fulfilled criteria for alcohol abuse, while 6.0% were alcohol dependent. As for the internalising disorders, 33.3% of the girls scored above the cut-off for depression, and 21.0% scored above the cut-off for serious post-traumatic stress disorder, while 46.8% of girls showed symptoms of being suicidal. Most variables of interest gradually increased with increasing aggression. This increase was most pronounced for externalising psychopathology, symptoms of being suicidal, and post-traumatic stress symptomatology. While the relation between aggression and externalising psychopathology is well known, the relation between aggression and post-traumatic stress disorder has received much less attention until now. With regard to the history of trauma, 85.3% of the participants reported at least one trauma, which is an alarmingly high number. Moreover, the total number of traumas was related to levels of covert aggression, but not to levels of overt aggression. The second part of this study, the follow-up of these girls after their release from detention, is now being planned.