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Antisocial behaviour and conduct disorders are the most common reason for referral to child and adolescent mental health services and have a significant impact on the quality of life of children and young people and their parents and carers. Rates of other mental health problems (including antisocial personality disorder) are considerably increased for adults who had a conduct disorder in childhood. This new NICE guideline seeks to address these problems by offering advice on prevention strategies and a range of psychosocial interventions.It reviews the evidence across the care pathway, encompassing access to and delivery of services, experience of care, selective prevention interventions, case identification and assessment, psychological and psychosocial indicated prevention and treatment interventions, and pharmacological and physical interventions.Readership: Intended for healthcare professionals in CAMHS, but this will also be useful to professionals in primary care (as there is much emphasis on recognition).
Edited by four leading violence researchers, this book takes a systemic view, offering a critical appraisal of research and theory that focuses on violence in youth, families, and communities.
African American youth are disproportionately located in neighborhoods characterized by crime and are at an increased risk for exposure to community violence and perceiving their neighborhoods to be violent. Each of these three experiences with violence has been linked with conduct problems. However, methodological problems in the existing literature limit our ability to understand whether these three types of violence differentially affect the development of adolescent conduct problems and if so, what the relative effects of these experiences with violence are. In addition, research has not examined whether the more proximal experiences with violence (i.e., community violence exposure and perceived neighborhood violence) are more useful for explaining the development of conduct problems that more distal experiences such as neighborhood crime. To address these issues, the present study examined whether neighborhood crime, community violence exposure, and perceived neighborhood violence differentially predicted youth conduct problems. Participants were an epidemiologically-defined community sample of 585 African American adolescents (53.2% male) assessed at regular intervals from elementary school through adolescence. Results revealed that each experience with violence was differentially associated with youth conduct problems, with varied effects for males and females. Understanding the effects of neighborhood crime, community violence exposure, and perceived neighborhood violence on the development of conduct problems is an initial step in the development of contextually-relevant interventions to promote healthy developmental outcomes in urban adolescents.
Intro: The transition from childhood to adolescence is a period of increased risk for psychological problems (e.g. Keiley, & Martin, 2002). Exposure to community violence, may impact the degree to which psychological problems emerge during adolescence (Grant et al., 2004). Previous research also indicates that low-income urban youth are disproportionately exposed to severe community violence, leaving them at higher risk to experience psychopathology (Grant et al., 2004). However, recent longitudinal research suggests that this elevated risk may decline throughout the adolescent years (Murphy et al., 2000) especially for internalizing problems (J. Twenge & S. Nolen-Hoeksema, 2002). The current research hypothesizes that youth that are exposed to high rates of severe community violence that increase with age, may view internalizing behaviors leaving them vulnerable to further victimization (Guerra et al., 2003, Ng-Mak et al., 2002). To protect themselves, youth most exposed may avoid expressing internalizing distress, instead becoming more likely to externalize. Methods: The current study used multi-group growth curve models to examine the trajectories of internalizing problems and externalizing problems, respectively, comparing low-income urban youth in high and low exposure to violence groups. Symptoms were measured using broadband scales of psychopathology from Achenbach's Youth Self-Report and Child Behavioral Checklist (2001). Exposure to Community Violence was measured using Exposure to Violence Survey--Screening Version (Martinez & Richters, 1993). Results & Discussion: Results support the extant literature that indicates that low-income urban youth are at heightened risk for psychological problems. At wave 1, youth in our sample were more than twice as likely to report internalizing problems (33%) in the clinical range, compared to normative youth (16%). Risk of exhibiting externalizing behaviors was also elevated, with 20% of the sample scoring in the clinical range. Exposure to community violence, in particular, was also supported as a risk factor for psychological problems, as the high group demonstrated more of both types of psychopathology than the low group (as demonstrated by significant differences in intercept in the growth model). Comparison of trajectories (slopes) indicated that both internalizing and externalizing problems declined over time, a finding that was only partially supportive of our hypothesis. Additionally, negative trajectories for both outcomes were found in both the low and high exposure to violence groups, although the decline in internalizing problems was of greater magnitude for the high exposure to violence group, compared to the low group. No between-group differences in slope were found for externalizing problems. Results provide some support for the theory that youth that are exposed to rates of severe community violence that increase with age may avoid expressions of internalizing problems. However, clear support was not found for the hypothesis that these youth turn to externalizing behaviors as an alternative way of expressing psychological distress. Alternative hypotheses and explanations for our findings are discussed. Robust differences in findings were also found by reporter and are discussed.
Exposure to community violence is a pervasive problem among urban youth and has been associated with both internalizing and externalizing disorders. The mechanisms through which exposure to community violence impacts adolescent adjustment are unclear. A change in adolescent schemas has been proposed as a mechanism through which the impact occurs. The goals of this study were to develop a measure of relevant adolescent schemas and examine their relation to exposure to community violence. A sample of 320 5th and 8th graders were assessed and confirmatory factor analyses of the measure supported a three factor model, including self-schemas, world schemas and use of violence schemas. Exposure to community violence, including victimization and witnessing violence, was associated with more negative adolescent schemas. Witnessing violence and victimization had distinct relations with schemas highlighting the need to examine these types of exposure independently. Overall, this study provides preliminary support for the importance of studying adolescent schemas within the context of community violence. The measure developed represents an initial step in this process given what is available in the literature. However, additional work on the measure is needed to ensure that it accurately samples the schema domains that are relevant for youth in this context.
One of the myths about families in inner-city neighborhoods is that they are characterized by poor parenting. Sociologist Frank Furstenberg and his colleagues explode this and other misconceptions about success, parenting, and socioeconomic advantage in Managing to Make It. This unique study—the first in the MacArthur Foundation Studies on Successful Adolescent Development series—focuses on how and why youth are able to overcome social disadvantages. Based on nearly 500 interviews and case studies of families in inner-city Philadelphia, Managing to Make It lays out in detail the creative means parents use to manage risks and opportunities in their communities. More importantly, it also depicts the strategies parents develop to steer their children away from risk and toward resources that foster positive development and lead to success. "Indispensible to anyone concerned about breaking the cycle of poverty and helplessness among at-risk adolescents, this book has a readable, graphic style easily grasped by those unfamiliar with statistical techniques." —Library Journal