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Abstract
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VioLit summary:
OBJECTIVE:
The objective of this paper by Mezzich was to establish a multiaxial system of diagnosis that would be specifically applied for the purpose of providing a comprehensive description of the violent adolescent delinquent.
METHODOLOGY:
Using a non-experimental exploratory design, the author conducted a review of the literature in order to extract the variables that might display either descriptive or predictive value in the study of this complex condition.
FINDINGS/DISCUSSION:
The author identified a number of different variables that might play a significant role in the development of the violent adolescent.
Axis I: Psychiatric Syndromes. Psychiatric symptomatology was considered a crucial element in the characterization of this condition, with measurement being conducted from the Diagnostic and Statistical Manual-III (DSM) Axis I.
Axis II: Personality and Specific Developmental Disorders. These disorders were included in the multiaxial model, with measurement again coming from the DSM, AXIS II.
Axis III: Physical Disorders. This axis included nonpsychiatric problems that might be relevant to the onset of the condition or that should be taken into consideration when planning for treatment. Measurement would be formulated from the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM).
Axis IV: Severity of Psychosocial Stressors. Environmental and psychosocial factors would be measured via identification of any specific stressors in the subject's past year and subsequent rating of these stressors according to the DSM scale of no stress severity (1) to catastrophic stress severity (7).
Axis V: Adaptive Functioning. Social functioning and performance of expected roles would take into account school or work performance as well as functioning within the family, within peer networks and within the legal system. Measurement would examine both highest level of functioning in the past year, as well as current function levels, using a scale from superior (1) to grossly impaired (7).
Axis VI: Intelligence Level. The individual's current level of intellectual functioning and ability would be measured via use of either the WISC-R or the WAIS-R, depending on the age of the individual.
Axis VII: Social Class. Class would be measured with the Hollingshead scale, based upon measures of both education and occupation of the individual at the head of the household.
Axis VIII: Index of Mental Illness and Criminality in the Family. This measure would examine psychopathology and criminality within the individual's immediate family by examining the proportion of family members with a history of either of these conditions.
Axis IX: Chronicity of Legal History. This axis would provide a measure of the age of the individual at the time of the firs offense, as ell as measures of recidivism or number of delinquent adjudications.
Axis X: Magnitude of Offenses. As well as the chronicity of offense, the number and severity of such behavior would be measured in terms of actual number of offenses committed over the individual's lifetime, and the severity of the most serious offense as measured by Coombs' scale.
The author concluded that this multiaxial model for diagnosis of violent delinquent adolescents would provide a comprehensive description that included not only psychiatric conditions, but also the individual's intelligence, social functioning, legal status and family history. By considering each aspect separately, the author claimed that the various aspects could be studied and rated individually, and that an interdisciplinary and holistic approach could be implemented.
AUTHOR'S RECOMMENDATIONS:
The author recommended that the multiaxial model be used to aid in the establishment of a more complete solution to the problem of violent delinquent adolescents, by providing a conceptual basis for the planning of treatment and rehabilitation programs. The model was also seen as a basis for improved formulation of the individual's prognosis in terms of clinical, functional and legal outcomes. Future research could also be aided by the model, by facilitating the study of specific factors underlying each of the various components of the condition. Finally, the model might also be used to facilitate the development and evaluation of more specialized treatment, placement and training programs for the violent delinquent adolescent.
EVALUATION:
This paper provides an interesting insight into future possibilities in the realm of diagnostic psychiatry. However, more discussion of each of the various components, as well as a more thorough examination of the implications of this model, would have been useful. (CSPV Abstract - Copyright © 1992-2007 by the Center for the Study and Prevention of Violence, Institute of Behavioral Science, Regents of the University of Colorado)
KW - Offender Assessment
KW - Offender Classification
KW - Offender Typology
KW - Offender Characteristics
KW - Juvenile Delinquency
KW - Juvenile Offender
KW - Juvenile Violence
KW - Offender Personality
KW - Psychosocial Factors
KW - Social Class
KW - Class Factors
KW - Socioeconomic Factors
KW - Sociocultural Factors
KW - Offender Intelligence
KW - Juvenile Functioning
KW - Offender Functioning
KW - Family Criminality
Language: en |