17th international congress of escap geneva july, …...regular end of yw measure (n=15) irregular...

17th International Congress of ESCAPGeneva

July, 11th, 2017

Delinquency in the long term outcome of institutionalized children

Jörg M. Fegert, Claudia Dölitzsch, Nils Jenkel, Klaus Schmeck, Marc Schmid

… for clarification and goal-attainment in youth welfare and juvenile justice institutions (MAZ.)

Funded by the Federal Office of Justice in Switzerland

Involved study sites: Basel, Lausanne, Ulm

Measures:

• Epidemiology (t1): anamnesis, mental health (dimensionally and categorically), goal attainment

• Evaluation after one year (t2)

• Criminal records

Swiss study …

2007 Summer 2009 2011

MAZ. 2MAZ. 1

German Speaking Part German Speaking Part

French Speaking Part

Italian Speaking Part

Time-line

MAZ. 1 MAZ. 2 MAZ. 1 & 2

German German French Italian TOTAL

institutions 31 19 20 6 64

subjects 329 100 102 61 592

age (sd) 17.2 (2.7) 15.4 (2.7) 14.6 (2.9) 14.0 (3.3) 16.1 (3.1)

male 244 (74%) 62 (62%) 63 (62%) 33 (54%) 402 (68%)

female 85 (26%) 38 (38%) 39 (38%) 28 (46%) 190 (32%)

placement

civil 145 (45%) 67 (70%) 69 (68%) 31 (51%) 312 (54%)

penal 112 (35%) 10 (10%) 26 (26%) - 148 (26%)

Description of sample

6-month-prevalence of diagnoses (ICD-10)

74%

26%

at least one disorder no disorder

N=483

Top 12 diagnoses

Category Diagnosis / Group n %

F91 Conduct disorders 81 16.9%

F90.1 Hyperkinetic conduct disorder 64 13.3%

F92 Mixed disorders of conduct and emotions 63 13.1%

F12.1/ F12.2 Mental and behavioral disorders due to use of cannabinoids 53 11.0%

F61 Mixed and other personality disorders 42 9.6%

F40 Phobic anxiety disorders 37 7.7%

F90.0 Disturbance of activity and attention 28 5.8%

F32 Depressive episode 24 5.0%

F60.3 Emotionally unstable personality disorder, borderline type 19 4.3%

F43.2/ F43.8 Adjustment disorders/ Other reactions to severe stress 20 4.2%

F43.0/ F43.1 Reaction to severe stress/ PTSD 19 4.0%

F10.1/F10.2 Mental and behavioural disorders due to use of alcohol 17 3.5%

N=483/439

Self-reported potentially traumatic experiences (ETI)

Traumatic experiences Prevalence

Death of an important personViolent attack (unknown person)*Violent attack (known person)*Serious diseaseSerious accident, fire, or explosionNeglect*ImprisonmentNatural disasterSexual abuse (unknown person)*Sexual abuse (known person)*Stay in a war zoneTorture

42.9%31.5%30.2%28.6%28.1%23.6%17.9%17.0%12.8%8.8%2.8%2.1%

Any experienceInterpersonal experience

77.1%55.7%

Number of traumatic experiences M=2.4 (SD=2.1)

* interpersonal traumatic experiences

2007 Summer 2009 2011

MAZ. 2MAZ. 1

German Speaking Part German Speaking Part

French Speaking Part

Italian Speaking Part

Follow up of criminal records 5-9 years after MAZ study

2016:

Request of criminal records of all participants of the MAZ.

study and of the participants of a school sample from the Federal Statistical Office,

Switzerland

Results

At least one offense: MAZ. vs. school sample

52%

38%

25% 23%20%

4%

12%

4% 2% 3%5%

0%0%

10%

20%

30%

40%

50%

60%

70%

any offense² propertyoffense

violentoffense

drug offense traffic offense sexual offense

MAZ. (N=592) School (N=477)

*** *** *** *** *** ***.435 .430 .351 .324 .229 .136Cramer‘s V

*** p<.001² Property offenses, violent offenses, drug offenses, traffic offenses, sex offenses, other offenses

Proportion of participants of the MAZ. study / of the school sample who were judged for at least one of the listed offenses

Recidivism: MAZ. vs. school sample

54%

30%

20% 22% 23%

1%

25%

2%6% 6%

15%

2%0%

10%

20%

30%

40%

50%

60%

70%


violentoffense


MAZ. (N=244) School (N=48)

.216 .235 .137 .148 .072 .046Cramer‘s V

* p<.05² Property offenses, violent offenses, drug offenses, traffic offenses, sex offenses, other offenses

Proportion of participants of the MAZ. study / of the school sample who were judged for at least one of the listed offenses after the end of MAZ. / after answering questionnaire in school and were judged for any offense before the end of MAZ. / before answering questionnaire in school

*** *** * *

At least one offense: gender

59%

43%

33%29% 28%

6%

36%

26%

9% 11%

4%0%

0%

10%

20%

30%

40%

50%

60%

70%

80%


violentoffense


male (N=402) female (N=190)

.219 .166 .249 .199 .280 .141Cramer‘s V

² Property offenses, violent offenses, drug offenses, traffic offenses, sex offenses, other offenses

*** *** *** *** *** ***

*** p<.001

Proportion of males/females who were judged for at least one of the listed offenses

Recidivism: gender

58%

32%

22% 24%28%

1%

40%

22%

15% 15%

5%0%

0%

10%

20%

30%

40%

50%

60%

70%

80%


violentoffense


male (N=189) female (N=55)

.153 .091 .079 .099 .221 .049Cramer‘s V


* ***

* p<.05 , *** p<.001

Proportion of males/females who were judged for at least one of the listed offenses after the end of MAZ. and were judged for any offense before the end of MAZ.

At least one offense: earlier out-of-home placements

45%

30%

20% 20%16%

4%

62%

48%

33%29%

25%

4%

0%

10%

20%

30%

40%

50%

60%

70%

80%


violentoffense


no out-of-home pl. (N=342) at least one out-of-home pl. (N=242)

.166 .178 .154 .105 .113 .008Cramer‘s V


*** *** *** * *

*** p<.001

Proportion of participants with/without earlier out-of-home placements who were judged for at least one of the listed offenses


45%

30%

20% 20%16%

4%

56%

39%

22%27%

23%

4%

66%

55%

43%

31%27%

5%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%


violentoffense


no out-of-home pl. (N=342) 1 out-of-home pl. (N=112)

> 1 out-of-home pl. (N=130)

.178 .208 .217 .109 .117 .019Cramer‘s V


*** *** *** * *

*** p<.001



45%

30%

20%

56%

39%

22%

65%

50%

37%

58%52%

35%

69%

62%

46%

79%

71%67%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

any offense² property offense violent offense

0 (N=324) 1 (N=112) 2 (N=62) 3 (N=13) 4 (N=13) 5 (N=24)

.190 .222 .250Cramer‘s V


*** *** ***

*** p<.001


Recidivism: earlier out-of-home placements

56%

29%

19%

41%

27%

12%

46%

20% 20%

50%

19%25%

67%

50% 50%

89%

61%

44%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


0 (N=117) 1 (N=49) 2 (N=35) 3 (N=16) 4 (N=6) 5 (N=18)

.241 .228 .222Cramer‘s V


* * *

* p<.05

Proportion of participants with/without earlier out-of-home placements who were judged for at least one of the listed offenses after the end of MAZ. and were judged for any offense before the end of MAZ.

At least one offense: dropouts

47%

28%23%

19%

7% 5%

62%

49%

37%33%

26%

5%

0%

10%

20%

30%

40%

50%

60%

70%

80%


violentoffense


regular end of yw measure (N=43) irregular end of yw measure (N=92)

* **.145 .198 .136 .145 .223 .016Cramer‘s V

* p<.05, ** p<.01² Property offenses, violent offenses, drug offenses, traffic offenses, sex offenses, other offenses

Proportion of participants with regular/irregular ends of youth welfare measures who were judged for at least one of the listed offenses

Recidivism: dropouts

47%

13% 13%

27%

7%

0%

63%

38% 37%31%

23%

0%0%

10%

20%

30%

40%

50%

60%

70%

80%


violentoffense


regular end of yw measure (N=15) irregular end of yw measure (N=52)

.143 .223 .209 .037 .173Cramer‘s V


Proportion of participants with regular/irregular ends of youth welfare measures who were judged for at least one of the listed offenses after the end of MAZ. and were judged for any offense before the end of MAZ.

At least one offense: any traumatic experience (ETI)

42%

29%

21%17% 15%

2%

53%

37%

22% 22%19%

4%

0%

10%

20%

30%

40%

50%

60%

70%


violentoffense


no traumatic experience (N=84) any traumatic experience (N=336)

.090 .070 .006 .053 .034 .037Cramer‘s V


Proportion of participants with/without any traumatic experience who were judged for at least one of the listed offenses

Recidivism: any traumatic experience (ETI)

46%

25%21%

7%

14%

4%

50%

26%

16%21% 23%

0%0%

10%

20%

30%

40%

50%

60%

70%


violentoffense


no traumatic experience (N=28) any traumatic experience (N=139)

.024 .008 .056 .132 .173 .079Cramer‘s V


Proportion of participants with/without any traumatic experience who were judged for at least one of the listed offenses after the end of MAZ. and were judged for any offense before the end of MAZ.

At least one offense: any psychiatric disorder (Kiddie-SADS/SCID)

23%

7% 6%10%

6%1%

31%

16%10% 11%

13%

1%0%

10%

20%

30%

40%

50%

60%

70%


violentoffense


no diagnosis (N=124) any diagnosis (N=359)

* *.085 .107 .058 .017 .106 .014Cramer‘s V


Proportion of participants with/without any psychiatric disorder who were judged for at least one of the listed offenses

Recidivism: any psychiatric disorder (Kiddie-SADS/SCID)

29%

13%

6%

19%

6%

0%

52%

29%

20% 18%

24%

1%0%

10%

20%

30%

40%

50%

60%

70%


violentoffense


no diagnosis (N=31) any diagnosis (N=153)

*.169 .135 .130 .017 .158 .033Cramer‘s V


*

Proportion of participants with/without any psychiatric disorder who were judged for at least one of the listed offenses after the end of MAZ. and were judged for any offense before the end of MAZ.

At least one offense: cluster of psychiatric disorders (Kiddie-SADS/SCID)

14%

0%3% 3%

7%

0%

38%

23%

13% 14% 16%

1%

35%

16% 15% 13% 14%

0%0%

10%

20%

30%

40%

50%

60%

70%


violentoffense


emotional d. (N=58) behavioral d. (N=156) emotional & behavioral d. (N=95)

***.193 .230 .126 .125 .099 .056Cramer‘s V

** p<.01, *** p<.001² Property offenses, violent offenses, drug offenses, traffic offenses, sex offenses, other offenses

**

Proportion of participants with emotional, behavioral, or emotional and behavioral disorders who were judged for at least one of the listed offenses

At least one offense: number of psychiatric disorders (Kiddie-SADS/SCID)

40%

21%

11%

44%

31%

19%

55%

42%

23%

61%

44%

33%

61%

48%

35%

50%

38%

50%

0%

10%

20%

30%

40%

50%

60%

70%

80%


0 (N=124) 1 (N=145) 2 (N=109) 3 (N=66) 4 (N=31) 5 (N=8)

.159 .199 .211Cramer‘s V


* ** ***

* p<.05,** p<.01, , *** p<.001

Proportion of participants with 0 to 5 different diagnoses who were judged for at least one of the listed offenses

• Sample with a high impact of traumatic experiences (77%), especially interpersonal experiences (56%) and high prevalence of psychiatric disorders (74%), often comorbid diagnoses (60%; 26.5% with a combination of emotional and externalizing diagnoses), and several out-of-home-placements (51% at least one, 31% at least two).

Accumulation of risk factors for delinquency and recidivism.

Several risk factors raise the probability of delinquency and recidivism and need to be addressed during institutional education to prevent negative outcomes.

Conclusions

• 52% of the participants of MAZ. offended at least once.

• 54% of the participants with a conviction during MAZ. recidivated at least once.

• A vast difference in the proportion of convictions and recidivism compared to a school sample.

• Males commit more offenses than females (all categories). Only two significant differences in regard to recidivism: any offense, traffic offense.

• The more earlier-out-of placements, the higher the risk for delinquent behavior.

• Higher risk for offending and recidivism in participants with irregular ends of youth welfare measures (drop outs) compared to participants with regular termination of youth welfare measures.

Conclusions

• Traumatic experiences and recidivism: the probability for drug offenses is three times as high for participants with any traumatic experience than for those without (not significant).

• Traumatic experiences and delinquency: being the victim of interpersonal traumatic experiences significantly raises the probability for violent offenses.

• Psychiatric disorders raise the probability for committing property offenses and traffic offenses as well as the probability for recidivism of traffic offenses and any offense.

• No difference between the groups with behavioral disorders with and without comorbid emotional disorders.

• Increasing probability for committing offenses with increasing number of diagnoses.

Conclusions

Klinik für Kinder- und Jugendpsychiatrie / Psychotherapie des Universitätsklinikums Ulm

Steinhövelstraße 589075 Ulm

www.uniklinik-ulm.de/kjpp

Ärztlicher Direktor: Prof. Dr. Jörg M. Fegert

Thank you very much for your attention!

17th international congress of escap geneva july, …...regular end of yw measure (n=15) irregular...

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