Kids With Criminal Minds: Psychiatric Disorders or Criminal Intentions?

By Claude R.Shema

Early research that generated risk based assessment lead us to appreciate what the conditions were regarding why certain youth committed crime, and once being able to determine the nature and level of risk, how to allocate resources in their intensity and nature in order effectively target interventions that addressed the cause of crime.

The science of youth criminal conduct has now matured to the point where we can build on this early work and address additional areas that have heretofore not been the subject of rigorous research. This is where Dr. Shema's contribution is so welcomed.

Arguably, what the early research on criminogenic risk overlooked was the relevance of mental health status with certain youth.  Over the past decade, our own work focused on mental health indicators in youth justice that were relevant targets of service (Leschied, 2008; Leschied, 2011).

• Language: English
• Publisher: Shema Discovery Institute
• Release date: Jan 5, 2019
• ISBN: 9781386405948

Claude R.Shema

Claude R.Shema, MD.Msc.graduated in psychiatry field from Cardiff University ( Wales-UK), a family and community mental health clinician focusing on children and adolescents mental health, with more than a decade working in communities with high crime rates and high prevalence of mental health issues. Beside working in the aftermathc of civil wars, he has extensive experience in working with young offenders, mainly Indigenous juvenile offenders in psychiatry and forensic psychiatric field. He is also a speaker, supervisor, consultant and author. Founder and CEO of Shema Discovery Institute.

Book preview

KIDS WITH CRIMINAL MINDS

Psychiatric Disorders or Criminal Intentions?

Psychophysiological and Forensic Analysis of Young Offenders Behavior.

Canadian Case study

Claude R.Shema,MD.Msc.

TABLE OF CONTENTS

Foreword.................................................6

Book structure...........................................9

Dedication..............................................10

Preface...................................................11

Acknowledgment.........................................12

Chapter: I

JUVENILE DELINQUENTS

Mental health and polarized perceptions..............14

Diversity and juvenile delinquency behavior

Risks and protective factors...........................36

Chapter: II

Prevalence of psychiatric disorders

among juvenile delinquents in Canada 

A literature systematic review-based study...........49

-  ABSTRACT.....................................51

-  Mental disorders among young offenders...56

-  Mental Disorders in Juvenile Offenders

and Criminal Justice System.............................70

-  RESULTS.........................................82

-  Associations between Mental Disorders

and Juvenile Offenders in Canada......................91

-  Treatment of young offenders with mental health disorders.........................................100

Chapter: III

CONDUCT DISORDER AND CRIMINAL BEHAVIOR

Developmental Psychopathological Analysis........129

Forensic analysis perspectives..........................133

Medical conditions and conduct disorder.............139

Conduct Disorder and criminogenic correlation.....143

Parenting and development of conduct disorder......157

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Chapter: IV

ABORIGINAL YOUNG OFFENDERS AND CONDUCT DISORDER

Forensic hypothetical psychopathology pathways.........159

Aboriginal young offenders and Conduct disorder.........160

THE MISSING PIECE

Culturally uprooted childhood.................................176     

Chapter: V

ASSESSMENTS

Tools and protocols..............................................180

Chapter: VI

TREATMENT OPTIONS

Treatment options and prognostic outcomes.................185

Treatment, challenges and management.......................187

Chapter: VII

WHAT IS KNOWN NOW AND WHAT’S NEXT?

Summary, conclusion and recommendations.................198

Future research....................................................201

Future direction for CD treatment and management........202

Neuroscientific assessment approach..........................203

Callous unemotional traits focus...............................203

Final notes.........................................................205

REFERENCES...................................................206

FOREWORD

By Dr.Alan W. Leschied (PhD., C. Psych.)

The University of Western Ontario

London, Ontario, CANADA

Declaration of the Juvenile Delinquents Act in1908 was the first piece of legislation in Canada that reflected the tension between the desire for the public to hold young people accountable for their actions juxtaposed to the belief that there was something unique about youths who commit crime and become involved in the criminal justice system due to their state of dependency, relative immaturity and the broad context surrounding the causes that are underpinning their criminal involvement.

In Canada we have attempted to balance the accountability frameworks of justice processing while still advancing our understanding on the need to address the causes of youth crime. The Young Offenders Act [YOA] of 1984 tipped the balance too far in the direction of justice processing and accountability and we witnessed dramatic increases in the use of secure custody while largely diminishing the role of rehabilitation.

Extremes within the YOA were largely tempered with revisions to the law in the proclamation of The Youth Criminal Justice Act of 2003 that, once again, situated rehabilitation and addressing the causes of youth crime as fundamental to our effective prevention and intervention approaches in the lives of certain at risk youth.

While we cannot avoid the fact that much of the debate on legal frameworks surrounding youth crime has been driven by competing ideologies, what the evolution of youth justice frameworks, not only in Canada but in many western industrialized nations reflects, is the tenacity of research evidence that helps us, whether we are researchers, policy framers or practitioners, in appreciating that in addressing the issues related to youth crime, it is first necessary to understand what places certain youth at risk of coming into conflict within their communities.

It has not been that long that expressions such as ‘evidence based frameworks for intervention’; evidence informed practice’; and ‘research based service planning’ have been part of our lexicon in youth justice.  It is largely thanks to the leadership of scholars dating back to the 1980s and 1990s such as Don Andrews of Carleton University and Paul Gendreau of the University of New Brunswick, that our understanding in the youth justice / forensic area has embraced research as the basis of justice processing.

Early research that generated risk based assessment lead us to appreciate what the conditions were regarding why certain youth committed crime, and once being able to determine the nature and level of risk, how to allocate resources in their intensity and nature in order effectively target interventions that addressed the cause of crime.

The science of youth criminal conduct has now matured to the point where we can build on this early work and address additional areas that have heretofore not been the subject of rigorous research. This is where Dr. Shema’s contribution is so welcomed.

Arguably, what the early research on criminogenic risk overlooked was the relevance of mental health status with certain youth.  Over the past decade, our own work focused on mental health indicators in youth justice that were relevant targets of service (Leschied, 2008; Leschied, 2011).

This along with coincidental literature that was emerging at the time reflected that the rates of youth in the justice system who were experiencing diagnosable levels of a mental health disorder could no longer be ignored. Studies out of the National Center for Mental Health and Juvenile Justice (Shufelt & Cocozza, 2006) reported that youth in the justice system experienced a diagnosable mental health disorder at a rate that hovered around 70 per cent, with the majority of youth presenting with co morbid and co-occurring disorders.

And the literature relating mental disorder and crime is now sufficient, that leading researchers are addressing the causality issue in the following, "Do mental health problems cause crime? Does crime cause mental health problems? Or are both crime and mental health problems symptoms of a more fundamental issue, without one causing the other?" (Ttofi, Piquero, Farrington & McGee, 2018).

An additional area that demands our attention is the number of youth who enter our child protection system and subsequently become involved in the justice system. These cross over youth enter one of our systems of care, child welfare, due to their experience with victimization and / or neglect.

These prior traumatic experiences, if not met effectively, place these traumatized youths at a greater risk for later justice involvement. Ray Corrado and his colleagues out of British Columbia have reported the (Corrado, Freedman & Blatier, C. 2011) vast over representation of youth in child welfare care who subsequently appear in the youth justice system.

Our own research at an Ontario court clinic facility has indicated that over three quarters of youth referred for an assessment under the YCJA had a trauma history reflected some form of physical, emotional/psychological, sexual, and/or witnessing domestic violence, with many of these youth having a formal PTSD diagnosis (Kolpin, 2018).

Dr. Shema’s volume reminds us that these are the very clinical issues that we need to address if our system of justice for youth indeed lives up to its promise.

References

Corrado, R., Freedman, L. F., & Blatier, C. (2011). The over-representation of children in care in    the youth criminal justice system in British Columbia: Theory and police issues.   International Journal of Child, Youth, and Family Studies, 1 & 2, 99-118

Kolpin, H. (2018). Post-Traumatic Stress Disorder in Crossover Youth: The Pathway to   Development and the Relationship with Life-Time Offending. The University of Western   Ontario.

Leschied, A.W. (2008). The roots of violence: Evidence from the literature with emphasis on   child and youth mental health disorder. The Provincial Centre of Excellence for Child   and Youth Mental Health at CHEO. Ottawa ON.

Leschied, A.W. (2011). Youth justice and mental health in perspective. Healthcare Quarterly,   14, 58-63.

Shufelt, J.L. & Cocozza, J.J. (2006). Youth with mental health disorders in the juvenile justice   system: Results from a multi-state prevalence study. National Center for Mental Health   and Juvenile Justice Delmar NY.

Ttofi, M.M., Piquero, A.R., Farrington, D. P. & McGee, E.R. (2018). Editorial—mental health   and crime: Scientific advances and emerging issues from prospective longitudinal   studies. Journal of Criminal Justice, (https://doi.org/10.1016/j.jcrimjus.2018.10.004).

-Dr. Alan W. Leschied, PhD., C. Psych.

(University of Western Ontario-Canada).

BOOK STRUCTURE

Juvenile delinquency in biopsychosocial model lenses

DEDICATION 

To all parents with children in youth detention centers, and young offenders who are struggling to find their way out of endless juvenile legal system, and to the community terrorised by juvenile delinquents’ criminal or other anti-social behavior.  On a deeper and personal note, my heart goes out to those who lost their lives due to young offenders’ criminal behaviors, such as premeditated homicide and gang related violence, accidental substance abuse and drug overdose related deaths, or those who ended their own lives due to unbearable psychological wounds, when the world becomes inhabitable and incompatible place to be.

But for all of you my bros, roaming streets with gangs, bandanas, weapons, and criminal mind over your shoulders, thinking that no hope is in sight for the future. I know your struggle, I can feel your battles, in and out of jail on weekly or monthly basis, but you gotta keep your head up. Keep trying to change and transform yourself.  I believe you, I know you have been crying out for help for so deep and so long.  I have faith in you, the brain you use for bad behavior, can be surprisingly be used for the best you can be: A BETTER YOU! Although you don’t ever think about it, all the windows of opportunities are still widely open for YOU.

Take a deep breath, make change for yourself, and you can be everything good you always dreamed to be. I believe you, time to believe in yourself, time to heal your invisible wounds has come, now it’s time to rise above and reach your potential. We got your back!

-Claude R.Shema, MD.Msc.

ACKNOWLEDGEMENTS

I owe deepest gratitude to my instructors, mainly my tutor in psychiatry Dr. Dean Burnett, and the study program director Dr.Paul Buckland, both from Cardiff University, UK.  My deepest gratitude to Ms. J.Chatting (administrative officer), for compassion and highest level of support and professionalism. I thank you all for patience, encouragement, immense knowledge, and constructive criticism, without which, I would never have been able to complete this dissertation.

Furthermore, I thank the administration of University of Saskatchewan (Canada), for accommodating my academic and scientific needs during my term in Canada. I am profoundly grateful to researchers/scientists who shared their original papers and wisdom pertaining to this literature:

-  Dr. Ulzen T.

-  Dr. Thapar A.,

-  Dr. Max J.E.,

-  Dr. Decety J.,

-  Dr. Lacourse E.,

-  Dr. Popova S.,

-  Dr. Leschied A.,

-  Dr. Fontaine N.M.G.,

-  Dr. Waddell C.,

-  Dr. Rawana .S.J.

Chapter: I

JUVENILE DELINQUENTS

Mental health and polarized perceptions

Introduction

In the first chapter of this book, the aim is to explore juvenile delinquents as a specific group with criminal behavior, and characteristics and descriptive terms pertaining to this category of people in Canada. More over, this part also explores types of crimes committed by young offenders, their demographics vis a vis to adults population and adult offenders as well.

Last, this part also illustrates some difference in terms of perceptions, and clinical case studies from experience. These examples are actual narrative story and professional work records in the field of forensic psychiatry, involving some relevant experiences or clinical anecdotal examples of young offenders own statements and behavior.

OVERVIEW

Juvenile delinquency phenomenon is a significant challenge that requires appropriate and effective interventions in different ways. Often, parents and communities are left with many questions to what may be the causes of juvenile criminal behavior factors, and what would be the magic wand or silver bullet for immediate transformation these youths. Main factors in some instances have been blamed to be the negative peer pressure, maladaptive behaviors and imitation from some families, but there is also tendency in society or community of labelling the juvenile delinquency as young sociopaths since juvenile delinquents exhibit anti-social behavior as cardinal feature among others.  Moreover, many studies in many developed countries have shown time and time again a strong relationship between juvenile delinquency or antisocial behavior in youth and psychiatric disorders, mainly conduct disorder and other comorbid psychiatric disorders. Despite the paucity, and often completely absence of studies  related to juvenile delinquency and psychiatric disorders in developing countries, there is evidence of  a significant prevalence of mental disorders among juvenile delinquents in developing countries as well ( Choi et al.,2017).

However, there is no evidence thus far to suggesting that juvenile delinquency behaviors are solely caused by psychiatric disorders, but combination of three components rather, such as:

›  Biological/medical conditions as pre-disposing factor

›  Psychological factors, and of course

›  Social (environmental) factors such as high rate of violence associated with low income neighbourhood.

In psychological perspective, the early learning, or early childhood trauma (adverse events) and inconsistent/harsh or poor parenting approaches have been suggested to be the most appealing factor associated with criminal behavior in youths. 

Therefore, juvenile delinquency phenomenon can not be fully and better understood without putting it into biopsychosocial model, as all of the above contributing factors can individually and parallelly lead to the same outcomes of juvenile criminal offence behaviour.

––––––––

General overview of juvenile delinquency

The broader definition of juvenile delinquency is based on a youth or juvenile individual under age of eighteen involved in crimes and subsequently with justice system (World Youth Report,2003 ), or young persons in conflict with the law, or simply the juvenile law-breakers (Leon,1977). The evidence suggests serious concerns related to juvenile delinquency and violent crimes worldwide, on both individual and group related offences level (World Youth Report,2003).

Since early 80s, several studies in juvenile delinquency behavior have merged, trying to understand this phenomenon, which sometimes can be exacerbated or confound  with normal developmental stage of youth, especially pruning period in which  changes in behavior and mood occur, such as anti-social behavior, aggression, disobedience, violence hence  a great number of them become involved with law enforcement and justice system, at a rate of  about 120,000 any given day  in North America for instance ( Odgers et al,2005).

Furthermore, studies in juvenile delinquency behavior also suggest that the severe delinquency behavior usually occur in the same period of developmental age, adolescence, marked by rebellion behavior against rules or authorities ( Frick, 2012). Moreover, in quest to find the causal factors associated with juvenile delinquency, it has been suggested that some mental health issues might be the key in juvenile delinquency and antisocial related behavior (Kendall et al.,1992; Glenn et al.,1994), whilst social and environment factors are believed also to be risk and key factors beside medical, biological or organic factors (Murray et al.,2010).

Thus, there is no a standalone factor associated with juvenile delinquency, but multitude of factors embodied in entire functioning systems of youth delinquents, such as biological predisposing factors, psychological and social-environment respectively, including but not limited to socioeconomic status (SES) associated with high violence rated neighbourhood ( Hurley et al.,2006; Lacourse et al.,2006). International study in comparison of young offending behavior in different select countries in the world ( Egli et al.,2010), has found mental disorders to be the most predominant risk factors, but  some other relevant factors, such as  SES, psychological factors, history of steady violence in neighbourhood associated with deviant peers, to be consistently associated with development of juvenile delinquency and various related criminal behavior.

Juvenile delinquency in Canadian

Juvenile delinquency behavior and criminal involvement commonly known as young offenders in Canada, not only has caught attention of some clinicians and researchers, but it causes enormous anxiety among communities, due to the juvenile delinquency behavior and criminal behavior outcomes associated with it, whilst families are often left with burden to deal with the outcomes, not to mention the financial cost associated with each young offender in and out young offenders residence, and negative outcomes to the sufferers as well.

However, the common question about young offenders in Canada, possibly elsewhere in dealing with young offenders, is based on what are the underlying factors associated with juvenile delinquency behaviors? Are there any biological, organic factors (mainly genetic