پرخاشگری و آسیب شناسی روانی در دختران نوجوان بازداشت شده

The aim of the study was to investigate a group of detained females with regard to aggression and psychopathology and to examine the relationship between the two conditions. For this purpose, a representative sample of 216 detained adolescent females aged 12–18 (mean 15.5) was studied with a standard set of self-report instruments, while a subgroup of 73 parents was interviewed by telephone on the participants' externalizing psychopathology. Based on aggression items derived from the Conduct Disorder section of the Kiddie-SADS, the following three aggression subgroups were identified: (1) non-aggressive (NA; 41%), (2) mildly aggressive (MA; 39%), and (3) severely aggressive (SA; 20%). In addition to high levels of psychopathology for the group as a whole, differences were found between aggression groups, with the NA group demonstrating the lowest levels, the MA group intermediate levels, and the SA group the highest levels. These differences were most pronounced for externalizing psychopathology, and were also found for post-traumatic stress symptomatology (PTSS) and suicidality. The clinical implications of these findings should be investigated in the future, but may well relate to issues of diagnostic identification and administration of adequate and targeted treatment, especially with regard to PTSS and suicidality. Since the current study was cross-sectional, the predictive effect of the investigated relationships should be the focus of further study.

Although adolescent delinquency is still a predominantly male phenomenon, the steady increase of offending rates by girls cannot be overlooked (National Research Council, 2001). In the USA, between 1980 and 2003, the juvenile arrest rate for simple assault increased 269% for females, while this was 102% for males (OJJDP, 2003). And although the 1994–2003 US arrest rate declined sharply for most types of crime in males, this was not so for females. A similar alarming increase in female offending and detention has been noticed in other Western countries, such as the Netherlands. In spite of the severity of this problem, little is known about the specific characteristics of female delinquents. Pajer (1998) has observed that the problem of female delinquency has not received the attention it requires, because female problem behavior is all too often considered a benign and temporary phenomenon. Recent sparse reports have, however, shown the fallacy of this assumption, since detained adolescent females do demonstrate substantial rates of psychopathology (Dixon et al., 2004, Lederman et al., 2004 and Teplin et al., 2002); see review by Vermeiren et al. (2006). Not surprisingly, the long-term prognosis of this population is not favorable, and is characterized by a multitude of problems such as continued (mental) health problems, dependence on social welfare, professional dysfunctioning and severe relational problems. Therefore, further study of the correlates of delinquency in this troubled population is needed. Findings from the few existing studies on the mental health characteristics of detained girls show that, as in detained boys, a vast majority of incarcerated females can be diagnosed with a disruptive behavior disorder (DBD) or a substance-use disorder (SUD). In addition, distressingly high levels of depression, anxiety and post-traumatic stress disorder (PTSD) have been found. The presence of PTSD and other internalizing disorders is not surprising, since an absolute majority of detained females report sexual and/or physical abuse in their past. Also, the mental health consequences of trauma may appear more frequently in detained girls than in similar male samples (Steiner et al., 1997 and Ruchkin et al., 2002). In incarcerated boys, relationships have been suggested between the aggressive tendencies of detained youth and trauma-related mental health problems. Therefore, apart from investigating prevalence rates of mental health problems in detained girls, an assessment of the relationship with aggression also appears relevant. Although samples of detained females have not yet been studied with regard to the overlap between aggression and mental health problems, support for such a relationship can be derived from investigations in other populations. Apart from the obvious relationship with disruptive behavior disorders, aggression and violence have been demonstrated to be associated with sexual/physical trauma, depression, post-traumatic stress disorder, dissociation, substance abuse, and suicidal behavior in a diversity of clinical and general population samples (Garnefski and Diekstra, 1997, Kaplan et al., 1998, Silva et al., 2001, Connor et al., 2003, Hoaken and Stewart, 2003, Lillehoj et al., 2005, Mann et al., 2005 and Oquendo et al., 2005). Also, a population-based self-report study in three different countries (Vermeiren et al., 2002) has shown positive relationships between severity of antisocial behavior and both internalizing and externalizing problems. Research is not consistent, however, since some studies in detained boys did not support a relationship between aggressive behavior and psychopathology. In a study by Haapasalo and Hamalainen (1996), violent offenders were found to be similar to property offenders in negative childhood experiences, family problems and psychiatric diagnoses, while Vreugdenhil et al. (2003) described a negative association between substance abuse and violent offending. Several methodological problems may explain these findings, such as the reliance on official delinquency reports, the low prevalence of internalizing problems in these studies or the fact that PTSD was not included as a diagnosis. Also, since the mental health characteristics of female detainees differ substantially from those of boys, further gender-specific research is warranted. Because an increasing number of females are being arrested and detained, and only a limited number of studies have investigated the mental health characteristics of detained females, we set up a study aimed at investigating a representative group of detained females from the Netherlands. The specific aims of the study were (1) to assess the prevalence of aggression and psychopathology in detained adolescent females, and (2) to clarify possible relationships between aggression and psychopathology. We expected to find high rates of psychopathology and aggression in this sample. Also we expected to find a relationship between aggression severity and levels of psychopathology, both externalizing and internalizing.