VioLit summary: OBJECTIVE: The goal of this article by Myers and Kemph was to report on the characteristics and treatment of four male homicidal adolescents during their placement in a juvenile detention center. METHODOLOGY: A non-experimental review of clinical cases was employed for this study. The four cases were collected from a detention center over 12 months and were referred for dangerous behavior either to themselves or to others in the facility. The sample included all inmates who had completed or attempted homicide for the first time. However, these youths did have previous delinquent histories. Additionally, all came from chaotic, disturbed environments characterized by neglect, physical abuse, and/or abandonment. FINDINGS/DISCUSSION: Each youth met DSM III-R criteria for conduct disorder. There were two different kinds of offenders among the four. The first type was shown by the two boys who had had emotional relationships with their victims. These boys were judged to have undifferentiated type conduct disorder. These boys were suicidal, and psychotherapy was the clinicians' method of choice. The two boys who shot strangers were judged as solitary, aggressive types with self initiated, physically aggressive behavior towards others. They were outwardly aggressive and required behavioral therapy. The authors said that some of the predisposing factors in the literature came into focus in this study. All of the youths had been violent in the past; 3/4 came from a history of physical abuse or neglect. All had experienced school difficulties caused by poor impulse control, learning disabilities, or truancy. Intelligence was tested to be average to low average, and none were psychotic. All had clear cut perceptions of why they did what they did. Treatment was determined by ego strengths and ability to form relationships at the initial time of therapy. The youth who murdered someone close to them were found to be in emotional pain which motivated them to seek help and expressed anger internalized through suicidal ideation. Brief focused psychotherapy was used to assess and manage suicidality, help strengthen impaired ego functioning, promote identification with a stable, nonviolent adult figure, and to provide a nonjudgmental empathetic setting. The youths who murdered strangers continued to act aggressively, externalizing their anger, and did not allow for a working relationship to be established. They experienced violent behavior as ego syntonic and showed no remorse. Contingency management was used in the structured environment. Desired nonviolent behavior was reinforced through such activities as sports and recreation; undesired behaviors were negatively reinforced through such punishments as isolation. Concerns of counter-transference issues were brought up as potential pitfalls for the therapist. It was argued that the therapist may want to do something within the treatment situation that will make it better. The lessening of guilt through therapy could potentially interfere with society's duty to provide punishment. Also, there was the possibility of conflict between the therapist, who is supposed to be helping the client, and the practical role of the detention center as punitive. AUTHORS' RECOMMENDATIONS: The authors said that more studies were needed to confirm whether treatment strategies for homicidal adolescents could be based on such variables as conduct disorder subtype, the presence of an emotional relationship with the victim, and the channelling of aggression toward the self or others. Larger sample sizes were needed. Also, the authors maintained that early assessment and initiation of treatment, if indicated, is of utmost importance to help decrease aggression to self and others. Brief focused psychotherapy and behavior therapy were seen as potentially helpful. EVALUATION: This study offers support for the heterogeneity of juvenile homicide offenders. The findings should be taken with caution given the small sample size, descriptive nature of the study, and lack of information on the long term effectiveness of the treatments. (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) Offender Characteristics Case Studies Juvenile Male Juvenile Offender Juvenile Violence Juvenile Homicide Homicide Offender Early Adolescence Late Adolescence Juvenile Treatment Offender Treatment Psychotherapy Male Offender Male Violence
Language: en
LA - en SN - 0890-8567 UR - http://dx.doi.org/ ID - ref1 ER -