Northwestern Juvenile Project

FacultyLinda A. Teplin, Ph.D. (PI)

Karen M. Abram, Ph.D.Leah Welty, Ph.D.

Former Graduate StudentsAmy Lansing, Ph.D.

Julie Harnisher, Ph.D.Devon King, Ph.D.

Katherine Elkington, Ph.D.Jeanne Choe, Ph.DLeah Paskar, Ph.D.Erin Romero, Ph.D.

Naomi Abrams, Ph.D.Kristin Emanuel, Ph.D.

Current Graduate StudentsElena De La Garza Bassett

Nichole OlsonJennifer Hershfield

Anna HarrisonMarquita Stokes

Nicole Azores-GococoLauren Potthoff

Northwestern University Feinberg School of MedicineHealth Disparities & Public Policy

Delinquency Cases Disposed, 1985-2009

1-Day Count of Juvenile Offenders in Custody, 1991-2006 (in 1,000s)

1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 20100

20

40

60

80

100

120

76 79

91

105 107 10497

9387

71

count(in 1000’s)

Why Study Detained Youth?Disproportionate Minority Confinement

% of African Americans in US population (13%)

Proportion of Poor, Inner-City African American Youth Arrested by Age 18

Participants• Race/Ethnicity*

– African American = 1005– Hispanic: = 524– Non-Hispanic White = 296– Other = 4

• Gender– Male = 1172– Female = 657

• Age (mean = 14.9)

• Legal Status– Adult court = 275– Juvenile court = 1554

Hispanic

Non-Hispanic White African

American

10 11 12 13 14 15 16 17 18

age

Methods

• Stratified Random Sample, N=1829

• Sampled from Cook County Detention Center

• Followed up in Community or Correctional Facility

Disorders Assessed Over Time

Internalizing Disorders Any Affective Disorder: Major Depression

Dysthymia

Mania

Hypomania

Any Anxiety Disorder: Generalized Anxiety

Posttraumatic Stress

Panic

Externalizing Disorders Any Behavioral Disorder: Conduct a

Oppositional Defiant a

Antisocial Personality b

Any Substance Use Disorder: Alcohol

Drug

a If < 18 years b If > 18 years

Prevalence of Psychiatric Disorders at theBaseline Interview

(N=1,829)

FemalesMales

%

Prevalence of Psychiatric Disorders Among Males, Baseline

non-Hispanic whiteHispanicAfrican American

Prevalence of Psychiatric Disorders Among Females, Baseline

non-Hispanic whiteHispanicAfrican American

12

Comorbid Types of Disorder Among Males

16.4%

14.6%

3.2%

2.1%

6.9%

1.6%

1.4%

1.2%

1.1%

1.0%

0.7%

6.7%

2.0%

2.1%

4.3%

Affective 17.9%

Substance 49.8%

Anxiety 21.1%

ADHD/ Behavioral 41.7%

None of the Listed Disorders

34.8%

13

Comorbid Types of Disorder Among Females

4.8%

1.2%2.2%

2.3%

2.0%

2.0%

2.9% 6.0%

9.6%

4.9%

3.9%

Substance 44.5%

6.7%

7.6%14.0%

2.6%

Anxiety 31.5%Affective 26.4%

None of the Listed Disorders

27.2%

ADHD/ Behavioral 46.3%

OTHER DRUG(Total = 2.44%)

MARIJUANA(Total = 44.95%)

ALCOHOL(Total = 25.27%)

No Substance Use Disorder (50.09%)

a Percentages do not total to 100% due to rounding

Single and Multiple Substance Use Disorders Among Males (N = 1143) a

23.63%(Marijuana only)

19.42%(Alcohol + Marijuana)

4.59% (Alcohol only)

0.51%(Other only)

0.03%(Alcohol + Other)

1.23%(Alcohol + Marijuana + Other )

0.67%(Marijuana + Other)

OTHER DRUG(Total = 5.47%)

MARIJUANA(Total = 40.51%)

ALCOHOL(Total = 24.73%)

No Substance Use Disorder (55.02%)

a Percentages do not total to 100% due to rounding

Single and Multiple Substance Use Disorders Among Females (N = 631) a

18.45%(Marijuana only)

17.25%(Alcohol + Marijuana)

3.82% (Alcohol only)

0.53%(Other only)

0.13%(Alcohol + Other)

3.53%(Alcohol + Marijuana + Other )

1.28%(Marijuana + Other)

Proportion of Sample by IQ (KBIT)Above Average

Average

Below Average

Well Below Average

Lower Extreme

Comorbid Types of Disorder Among Males

25%

3%

6%

11%

11%

1%

2%

14%2%

11%

8%

1%

4%

5%

Baseline Time 2

Substance 31.2%Internalizing 11.7%

Behavior 24.1%

Substance 53.4%Internalizing 22.2%

Behavior 25.8%1 Percentages have been rounded up.2 Internalizing disorders combine any affective disorder and any anxiety disorder.3 Overall percentages do not match percentages within Venn diagram due to weighting

Comorbid Types of Disorder Among Females

Time 2

6%

7%16%

5%

5%

10%

14%

8%3% 9%

2%

1% 3%

8%

Baseline

Substance 46.8%Internalizing 32.3%

Behavior 34.2%

Substance 17.3%Internalizing 12.7%

Behavior 13.9%1 Percentages have been rounded up.2 Internalizing disorders combine any affective disorder and any anxiety disorder.3 Overall percentages do not match percentages within Venn diagram due to weighting

Comorbid Types of Disorders Among Males at Time 2 by Incarceration Status

Not Incarcerated Past Year Incarcerated in Past Year

Substance 7.0%Internalizing 8.8%

Behavior 9.3%

8% 5%

7%

1%

0%

1%

0.4%

Substance 34.3%Internalizing 11.8%

Behavior 21.1%

16%

5%

2%

6%

11%

5%

1%

0 500 1000 1500 2000 2500 3000 3500 4000 45000

10

20

30

40

50

Prevalence of Specific Substance Use Disorders in Males

Alcohol Use Disorder

Marijuana Use Disorder

Other Drug Use Disorder

%

Baseline 3 Years 5 Years 6 Years 8 Years 12 Years

0 500 1000 1500 2000 2500 3000 3500 4000 45000

10

20

30

40

50

Prevalence of Specific Substance Use Disorders in Females

Alcohol Use Disorder

Marijuana Use Disorder

Other Drug Use Disorder

%

Baseline 3 Years 5 Years 6 Years 8 Years 12 Years

0 500 1000 1500 2000 2500 3000 3500 4000 45000

5

10

15

20

25

30

Other Drug Use Disorders in Males by Race/Ethnicity

Non-Hispanic White

Hispanic

African American

%

Baseline 3 Years 5 Years 6 Years 8 Years 12 Years

0 500 1000 1500 2000 2500 3000 3500 4000 45000

5

10

15

20

25

30

Other Drug Use Disorders in Females by Race/Ethnicity

Hispanic

Non-Hispanic White

African American

%

Baseline 3 Years 5 Years 6 Years 8 Years 12 Years

Trajectories of SUDs

• SUDs are prevalent and persistent

• BUT, not all youth follow the same course of disorder

• Trajectory analyses examine patterns of change within individuals over time

Aggregated Statistics

baseline follow-up

10/50 =20%

10/50 =20%

10/50 =20%

10/50 =20%

Preliminary Data

0.0

0.2

0 2 4 6 8 10 12years since baseline

0.4

0.6

0.8

1.0

late desisters (19%)

early desisters (54%)

initial

escalators (

27%)prob

abili

ty

probability of any SUDn = 1382

Trajectories of SUD

Preliminary Data

0.0

0.2

0 2 4 6 8 10 12years since baseline

0.4

0.6

0.8

1.0

prob

abili

ty

n = 1382

Trajectories of SUDprobability of comorbid/other SUD

late desisters (19%)

early desisters (54%)

initial escalators

(27%)

Positive Outcome Domains

• Educational attainment• Employment and/or education• Desistance from criminal activity & arrests• Nonviolent personal relationships• Residential stability• Psychological well-being

How Many Participants were Subsequently Incarcerated by the 5 Year Follow-up?

Preliminary Data

%

non-Hispanic white

Hispanic

African American

non-Hispanic white

African American

Hispanic

Youth Achieving Global Positive Outcomes

Doing moderately well(3-4 positive outcomes)

Doing very well(5-6 positive outcomes)

Doing poorly(0-2 positive outcomes)

9%

41%50%

Preliminary Data

33

Disproportionate Burden of HIV/AIDS Among African Americans

44%57%

0%20%40%60%80%

100%

% of New Cases of HIV, General Population% of New Cases of HIV, <age 25 years

% of African Americans in the U.S.

(13%)

What Proportion of Prisoners Have HIV/AIDS?

0

1

2

3

HIV/AIDS 2006

%

FemalesMales

35

What % of Participants Engaged in 10 or More HIV/AIDS Risk Behaviors?

56

66

45

40

0 20 40 60 80 100

3.5 YearFollow-up

Baseline

Preliminary Data

Females Males%

Recent HIV/AIDS Risk Behaviors in Males (%)

Living Situation, Time 2

Community (%) Corrections (%) Multiple partners (> 3 sexual partners) 15.9 0.3

Unprotected sex 78.8 4.2

Unprotected vaginal sex 67.7 2.9

Unprotected oral sex 53.6 1.7

Unprotected anal sexf 7.4 1.3

Shared needles or works for IDU or tattooing 0.2 0.0

Deaths: n=120Age Race/Ethnicity Gender Cause of Death Age Race/Ethnicity Gender Cause of Death15 Hispanic Male Electrocution, believed accidental 22 African American Male Train striking pedestrian16 African American Male Single gunshot wound, possible accident 22 Hispanic Male Gunshot wound and auto accident16 White Male Isobutane overdose 22 White Female Unknown, possible overdose16 African American Male Single gunshot wound 22 Hispanic Female Possible drowning16 African American Female Single gunshot wound 22 African American Male Multiple gunshot wounds16 Hispanic Male Single gunshot wound 22 African American Male Unknown16 African American Male Gunshot wound to the back 22 African American Male Semi-tractor striking pedestrian16 Hispanic Male Suicide, Russian roulette 23 African American Male Multiple gunshot wounds16 African American Male Multiple gunshot wounds 23 African American Male Single gunshot wound16 Hispanic Male Single gunshot wound 23 Hispanic Male Suicide, gunshot wound to the head16 White Male Multiple gunshot wounds 23 Hispanic Female Drug overdose17 Hispanic Male Multiple gunshot wounds 23 African American Female Crushed by mob17 Hispanic Male Single gunshot wound 23 Hispanic Male Single gunshot wound17 African American Male Multiple gunshot wounds 23 African American Female Unknown, IDPH prohibits disclosure17 African American Female Single gunshot wound 23 African American Male Gunshot wound to the chest17 African American Male Multiple gunshot wounds 24 Hispanic Male Multiple gunshot wounds17 African American Male Multiple gunshot wounds 24 Hispanic Male Auto accident17 African American Female Gunshot wound to the neck 24 Hispanic Male Methadone overdose17 African American Male Single gunshot wound 24 Hispanic Male Multiple gunshot wounds18 White Male Suicide, gunshot wound to the head 24 White Male Sarcoidosis and opiate overdose18 Hispanic Male Auto accident 25 African American Male Multiple gunshot wounds18 Hispanic Male Multiple gunshot wounds 25 Hispanic Male Multiple gunshot wounds18 Hispanic Male Single gunshot wound 25 African American Male Suicide, hanging18 Hispanic Female Multiple gunshot wounds 25 White Male Head injury from assault18 White Male Heroin overdose 25 African American Male Multiple gunshot wounds18 African American Male Gunshot wound to the back 25 White Male Methadone overdose18 African American Female Auto accident, alcohol involved 25 African American Male Gunshot wound to the back18 White Male Motorcycle accident 25 African American Male Multiple gunshot wounds18 African American Male Multiple gunshot wounds 26 African American Female Auto striking pedestrian18 African American Male Single gunshot wound 26 Hispanic Female Opiate overdose18 African American Male Multiple gunshot wounds 26 African American Female Complications from AIDS18 African American Male Multiple gunshot wounds 26 African American Male Multiple gunshot wounds18 Hispanic Male Single gunshot wound 27 African American Male Multiple gunshot wounds18 African American Male Gunshot wound, accidental 27 White Male Auto homicide, run down by car18 Hispanic Male Multiple gunshot wounds 27 Hispanic Male Suicide, gunshot to the head18 Hispanic Male Single gunshot wound 27 African American Female Gunshot wound18 Hispanic Male Multiple gunshot wounds 27 White Male Multiple gunshot wounds19 Hispanic Female Heroin overdose 27 African American Female Acute lymphoma and leukemia19 African American Male Single gunshot wound 27 African American Female Multiple stab wounds19 Hispanic Male Multiple gunshot wounds 28 Hispanic Male Stab Wound to the Abdomen20 White Male Single gunshot wound 28 White Male Multiple gunshot wounds20 African American Male Single gunshot wound 28 White Male Opiate and Cocaine Overdose20 Hispanic Female Gunshot wound, possible suicide 28 African American Male Multiple gunshot wounds20 Hispanic Male Single gunshot wound 28 African American Male Gunshot wound to the abdomen20 African American Male Multiple gunshot wounds 28 Hispanic Male Cocaine, opiate, alcohol overdose20 White Male Suicide, gunshot wound to the head 29 African American Male Gunshot wound to the abdomen20 Hispanic Male Gunshot wound to the head 29 African American Female Cardiac arrhythmia20 African American Male Single gunshot wound 29 African American Female Multiple gunshot wounds20 African American Female Multiple stab wounds 29 African American Male Multiple gunshot wounds20 African American Female Stab Wound to the Neck 29 African American Male Multiple Stab Wounds20 Hispanic Male Multiple gunshot wounds 30 African American Male Gunshot wound to the chest21 White Female PMA overdose 30 African American Female Suicide by hanging21 Hispanic Male Multiple gunshot wounds 31 White Male Motor Vehicle Accident21 African American Male Multiple gunshot wounds 31 African American Male Multiple gunshot wounds21 African American Male Multiple gunshot wounds 31 African American Female Complications from childbirth21 Hispanic Male Gunshot wound to the face 32 African American Male Multiple gunshot wounds* African American Male Heart Condition & Asthma * White Male Shovelling Snow* African American Female Hit & Run * Hispanic Male Suicide* African American Female Cancer * African American Female Complications from Childbirth* White Male Cancer * Hispanic Male Cancer

*Unconfirmed

NJP Males NJP Females0%

50%

100%

Homicide: Firearm; 84%

Homicide: Firearm; 28%

Homicide: Other; 6%

Homicide: Other; 20%

Other; 5%

Other; 24%

Drug Overdose; 18%

Motor Vehicle; 10%

NJP Sample: Cause of Death, Ages 15-29 by Gender*

*Standardized on Cook County Juvenile Temporary Detention Center population

Motor Vehicle, 1%Drug Overdose, 1%Suicide, 2%}

Preliminary data

Delinquent Males General Population Males0%

50%

100%

Homicide: Firearm; 85%

Homicide: Firearm; 49%

Homicide: Other; 5%

Homicide: Other; 4%

Other; 5%

Other; 25%

Suicide; 4%Drug Overdose; 5%

Motor Vehicle; 13%

Cause of Death: Males Ages 15-29*

*Standardized on Cook County Juvenile Temporary Detention Center population*Standardized on Cook County Juvenile Temporary Detention Center population*Standardized on Cook County Juvenile Temporary Detention Center population

Motor Vehicle, 1%Drug Overdose, 1%Suicide, 2%}

0 1 2 3 4 5 6 7 8

Series1

MalesMortality Among Males Ages 15-29:

Delinquent Sample vs. General Popula-tion*

Risk Ratios and Associated 95% CIs

African American

Hispanic

Non-Hispanic White

*Standardized on Cook County Juvenile Temporary Detention Center population

0 1 2 4 6 8

Homicide: Firearm, 30%

Homicide: Firearm, 11%

Homicide: Other, 14%

Homicide: Other, 8%

Suicide, 5%

Suicide, 6%

Drug Overdose, 16%

Drug Overdose, 5%

Motor Vehicle, 9%

Motor Vehicle, 10%

Other, 26%

Other, 60%

0%

50%

100%

Delinquent Females General Population Females

Cause of Death: Females Ages 15-29*

*Standardized on Cook County Juvenile Temporary Detention Center population*Standardized on Cook County Juvenile Temporary Detention Center population*Standardized on Cook County Juvenile Temporary Detention Center population*Standardized on Cook County Juvenile Temporary Detention Center population

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

Series1

FemalesMortality Among Females Ages 15-29:Delinquent Sample vs. General Popula-

tion*Risk Ratios and Associated 95% CIs

African American

Hispanic

Non-Hispanic White

*Standardized on Cook County Juvenile Temporary Detention Center population

0 1 5 10 20 30

(Unable to estimate)

Survivalby Drug Dealing at Year 3

0.9

00

.95

1.0

0

Prob

abili

ty o

f Sur

viva

l

1 5 2 0 2 5

Age

Yes

No

Preliminary data

Survivalby Alcohol Use Disorder at Year 30

.90

0.9

51

.00

Prob

abili

ty o

f Sur

viva

l

1 5 2 0 2 5

Age

Yes

No

Preliminary data

p<.05