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Abstract
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An 18-year follow-up of 66 aggressive and disturbed adolescents admitted to the children's unit of a large mental hospital in 1960 reveals a high degree of antisocial and criminal behavior persisting into adulthood, with lessening psychiatric involvement as the subjects matured. Factors contributing to this pattern of continuing antisocial behavior are identified, and implications for treatment programs are considered.
VioLit summary:
OBJECTIVE:
The objective of this research by Faretra was to trace patterns of aggressive behavior exhibited in a group of aggressive and disturbed adolescents through the adolescent period and into adulthood.
METHODOLOGY:
The researcher employed a quasi-experimental longitudinal projected design for her study. The sample was drawn from the 438 admissions to the children's unit of a state hospital in 1960, providing a final sample of 66 patients of at least 12 years of age who had a history of seriously aggressive behavior as well as their psychiatric disturbance. Aggressive behavior was defined as serious assault including homicide, sexual attacks, attacks or threats with a weapon, fire-setting or suicide attempts or threats. Each act led to serious injury requiring medical attention, or at least to a great risk for serious injury. Information about the subjects was obtained via utilization of the hospital's medical records, state-wide data information systems and public arrest records.
FINDINGS/DISCUSSION:
Of the 53 boys and 15 girls, 13% of the boys but none of the girls were readmissions. 67% of the subjects were black or Hispanic, with two-thirds being diagnosed in 1960 as suffering from schizophrenia and most of the remaining third having a primary behavior disorder. Most of the subjects had low-average to average intelligence quotients, and also exhibited reading disabilities. 29% of the boys and 50% of the girls had attempted suicide, with more than half of the subjects displaying other behavioral problems such as vandalism, truancy and stealing. All of the subjects displayed thought disturbances and other psychiatric symptoms, with suicide ideation and depression being the most common. 24 of the children's families exhibited both mental and antisocial problems, with 19 reporting only mental problems and 15 only antisocial difficulties. For 61% of the subjects, one of the parents was absent from the family unit. Half of the subjects were in hospital for under six months, 18% were released before one year had passed, and the remaining 32% were hospitalized up to 55 months. Follow-up data was gathered for three five-year periods, from 1961 to 1965, from 1966 to 1970 and from 1971 to 1975. During the first follow-up period, the majority of the subjects had come into contact with the courts, with 24 subjects having spent time in a correctional facility. This pattern of continuing antisocial behavior was also evident in the next two study periods. For each of the three phases, assault and theft were the primary types of antisocial behavior exhibited by the subjects, with weapon possession and substance abuse increasing after 1965. No relationship was found between antisocial activity in previous years and subsequent acts - rather, a seemingly random and unpredictable sequence was evident. Over 75% of the younger admissions (12 and 13 years old) followed a course of contact with agencies for psychiatric and antisocial behavior, whilst only 50% of the 14 and 15 year olds followed this pattern. The author concluded from this finding that the earlier the subject initiated antisocial behavior, the more likely for such behavior to form an enduring pattern. A preponderance of lower class and minority subjects were found to have come into contact with correctional agencies rather than being directed to mental health services, which would have been an appropriate alternative. Of the 42 individuals who had been diagnosed as schizophrenics in 1960, 8 had consistently been under the care of mental health professionals, more than a third had fallen into the correctional course and 13 showed a pattern of both mental health and correctional contacts. Levels of intelligence and reading ability did not differentiate between life course patterns. Children with the longest duration of problems prior to admission followed a life course pattern of contact with both correctional and mental health services, with children in the correctional only and mixed groups exhibiting higher levels of antisocial, abusing parents and single-family homes than those who had predominantly been in contact with mental health services alone. Whilst antisocial and criminal behavior continued in the subjects over the years, the incidence of psychiatric involvement decreased. The author concluded that the children with the most extensive history of continuing antisocial behavior were mostly males, with long histories of problems before admission, exhibiting unstable and aggressive behavior at the hospital and presenting for admission with antisocial and behavioral problems rather than with psychiatric symptoms. Most came from disrupted homes with a history of parental antisocial behavior, and many were of minority or disadvantaged status. It must be noted, however, that in the later years of the study, 48 of the original 66 subjects were no longer known to the researcher or to the various correctional, social or mental health agencies.
AUTHOR'S RECOMMENDATIONS:
The author stressed the need for early childhood treatment programs that focus not only upon psychiatric problems, but also upon family and social environments of the individual. Treatment should include social and vocational guidance within the community, with an emphasis on managing problem behaviors before they become disruptive. Families must be wiling to continue contacts with the treatment agencies in order to insure successful recovery of the patient, and short-term and long-term follow-up studies must be conducted to evaluate the effectiveness of various programs.
EVALUATION:
This study provides a vital insight into the continuation of antisocial and psychiatric problems from adolescence into adulthood. Its primary contribution is its use of longitudinal data to ascertain temporal sequencing of events. However, its small sample size and the clinical nature of the sample, together with the attrition of the majority of the sample by the end of the study, precludes any widespread generalization of results. Also, the use of official medical and arrest records might have limited the nature and amount of information available to the researcher about each subject. Despite these limitations, the study provides an excellent base for future policy and treatment planning. (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 - Long-Term
KW - Longitudinal Studies
KW - Follow-Up Studies
KW - Child Antisocial Behavior
KW - Child Behavior
KW - Child Offender
KW - Child Violence
KW - Child Aggression
KW - Child Development
KW - Late Childhood
KW - Late Adolescence
KW - Early Adolescence
KW - Juvenile Behavior
KW - Juvenile Antisocial Behavior
KW - Juvenile Aggression
KW - Juvenile Development
KW - Juvenile Offender
KW - Juvenile Violence
KW - Adult Antisocial Behavior
KW - Adult Behavior
KW - Adult Aggression
KW - Adult Offender
KW - Adult Violence
KW - Mental Illness
KW - Mentally Ill Child
KW - Mentally Ill Juvenile
KW - Mentally Ill Offender
KW - Mentally Ill Adult
KW - Developmental Pathway
KW - Behavior Causes
KW - Violence Causes
KW - Aggression Causes
KW - Violence Treatment
KW - Aggression Treatment
KW - Behavior Treatment
KW - Treatment Recommendations
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