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Journal Article

Citation

Lewis DO, Shanok SS, Pincus JH, Glaser GH. Annual Progress in Child Psychiatry and Child Development 1980; 591-603.

Copyright

(Copyright © 1980)

DOI

unavailable

PMID

unavailable

Abstract

VioLit summary:

OBJECTIVE:
The aim of this research by Lewis et al. was to compare the neuropsychiatric, intellectual and educational status of incarcerated delinquent boys displaying varying levels of violent behavior, in order to determine if there existed any relationship between severity of antisocial behavior and psychiatric, neurological and psychoeducational conditions.

METHODOLOGY:
A quasi-experimental cross-sectional design was employed, with a on-probability sample of 97 delinquent boys who had been incarcerated in a correctional school in Connecticut during the 18-month duration of the study. Three independent investigators rated each of the boys on a scale of violence ranging from least violent (1) to most violent (4), by examining data about behaviors and offenses. An individual was assigned a 1 if he had not committed any offenses against a person or if he had not committed arson. Fist fights with peers were only included as a violent offense if hospitalization had been required or if a weapon had been used. 8 children were classified in this group. The second group included 11 boys, all of whom had displayed some indication of a potential for violence, such as isolated incidents of fire setting, threats of use of weapons or threats of violence. 55 of the subjects were classified as a 3, as they had actually committed serious offenses against a person, such as rape, assault and multiple episodes of arson. The remaining 23 boys were classified in the most violent group. These individuals had displayed extreme brutality towards others, such as serial rapes, brutal assaults and repeated use of a weapon. The subjects were evaluated by a child psychiatrist and a neurologist in order to provide a comprehensive psychiatric assessment. The evaluation was designed to determine the presence or absence of hallucinations or delusions, depression or paranoid ideation. Neurological assessment included examination of motor, sensory and reflex functions, tests of coordination and memory and calculation skill testing. Both professionals obtained a medical history about each child which included information about victimization or witnessing violence. Abuse was defined as being punched, being beaten with a stick, board, pipe or belt buckle, being beaten with a belt or a switch other than on the buttocks, or being deliberately cut, burned or thrown down the stairs or across the room. A child was defined as not having been abused if hit only with an open hand, if beaten with the leather part of a belt, or if beaten on the buttocks only with a switch. Psychological tests included the Wechsler Intelligence Scale for Children (Revised), the Bender-Gestalt Test and the Rorschach Test, and were administered by a child psychologist. A learning disabilities specialist evaluated the children for educational status. Analyses included examinations of frequencies and Chi-Square tests, as well as a multiple regression to determine the combination of factors that could best differentiate between the more violent and the less violent children.

FINDINGS/DISCUSSION:
A comparison of violent with nonviolent subjects found a number of significant differences between the two groups. More of the violent boys exhibited paranoid symptoms, more were rambling and illogical in their speech, and more were unable to remember four digits in reverse order (p=0.06). Although not significant, differences were found in other areas as well - more of the violent children had experienced both auditory and visual hallucinations, as well as olfactory and gustatory hallucinations. The violent children were less neurologically intact than the nonviolent group - more of the violent children exhibited major neurological problems or dysfunctions. Overall there were no differences between the two groups on measures of intelligence. Following these analyses, the data from the children were divided into two different groups - the less violent from classifications 1 and 2, and the more violent from the 3 and 4 groups. The findings paralleled those from the initial analysis - the more violent children exhibited more paranoid symptomatology, were more rambling and illogical in their speech, showed poorer mental functioning and were more likely to have experienced hallucinations. Depressive symptoms were found in both groups. The more violent group had higher levels of neurological impairment, and there was a weak tendency for the less violent to perform better on the intelligence tests. Significant differences were found in the histories of abuse for the two groups - the more violent boys reported victimization and exposure to violence significantly more than did the less violent children. The status of the family, whether intact or broken, did not differentiate between the two groups. The multiple regression analysis found that paranoid symptomatology and minor neurological abnormalities could account for 40% of the total variance, with each accounting for 29% and 11% respectively. The authors concluded the paranoid orientation of the violent children was related to their quick and brutal retaliation for real or imagined threats, and that their lack of verbal skills prohibited the children from putting aggressive thoughts into words rather than into actions.

AUTHORS' RECOMMENDATIONS:
The authors suggested that psychological, educational and medical programs be established to provide specifically for the needs of children who are multiply impaired. In order to reduce the incidence of violent behavior, programs are needed that not only focus upon socioeconomic and psychological factors, but that also take into account medical and neurological variables that can contribute to violence. The authors also suggested that the role of medications in the successful treatment of violent adolescents should be further researched.

EVALUATION:
This study provides an excellent basis for further research in the area of the violent juvenile, and it also addresses the issues of policy and treatment planning. The methodologies are generally sound, although possible bias in assessment of the children might have been present - the investigators would have known if the child was considered violent or not by virtue of the fact that the violent subjects lived and were assessed in the secure unit of the facility, whilst the less violent boys lived in more open settings. Also, the small, extreme and clinical nature of the sample precludes generalization to larger populations. Despite these limitations, the study provides valuable insight into the multiple complexities of the nature of the violent adolescent. (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 - Connecticut
KW - Juvenile Inmate
KW - Juvenile Male
KW - Juvenile Violence
KW - Juvenile Offender
KW - Male Inmate
KW - Male Offender
KW - Male Violence
KW - Offender Characteristics
KW - Offender Intelligence
KW - Neurological Factors
KW - Neuropsychological Factors
KW - Environmental Factors
KW - Biological Factors
KW - Educational Factors
KW - Psychological Factors
KW - Violence Causes
KW - Inmate Studies

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