Aggression, substance use disorder, and presence of a prior suicide attempt among juvenile offenders with subclinical depression.

Abstract

Juvenile justice agencies often use the presence of a Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnosis as a criterion for offenders' eligibility for mental health treatment. However, relying on diagnoses to sort offenders into discrete categories ignores subclinical disorders-impairment that falls below the threshold of DSM criteria. The current study used structured clinical interviews with 489 juvenile offenders to examine aggression, presence of a prior suicide attempt, and substance use disorders among juvenile offenders with subclinical depression compared with juvenile offenders with major depression or no mood disorder. Analyses demonstrated that juvenile offenders with subclinical depression reported significantly more aggression, abuse of substances, and the presence of a prior suicide attempt compared to juvenile offenders with no mood disorder, but did not differ significantly on aggression and substance abuse compared with juvenile offenders with major depression. These results have implications for correctional agencies' policies through which offenders are offered mental health treatment, and provide a first step in identifying early signs of problematic behavior before it worsens. Specifically, the results support the notion that depressive disorders should be viewed along a continuum when determining how to allocate services.

Gender differences in the trends and correlates of major depressive episodes among juvenile offenders in the United States

“…This association was not found for female offenders; however, female offenders with MDE were more likely to report binge drinking. This finding supports the well-documented connection between substance use and depression in adolescents [55,56], especially in the offender population [30,57,58], as well as research suggesting that delinquent activity in adolescence is associated with a risk of alcohol and illicit drug use in young adulthood [59]. Though previous studies suggest that adolescents with depression may self-medicate with substances [39,40], there is disagreement as to the direction of the relationship between depression and substance use [60,61].…”

Heterogeneity in long-term trajectories of depressive symptoms: Patterns, predictors and outcomes

“…Individuals with MDD represent the severe end of that spectrum, but examining trajectories of depression in the entire population will likely result in a more accurate representation of the true underlying continuum of the disorder. From a public health standpoint, subclinical depressive symptoms are relevant both because they predict future clinical illness (Horwath, Johnson, Klerman, & Weissman, 1994; Laborde-Lahoz et al, 2015; Pietrzak et al, 2013) and because they themselves are associated with significant morbidity (Chachamovich, Fleck, Laidlaw, & Power, 2008; Kang, Eno Louden, Ricks, & Jones, 2015) and negative outcomes (Allen, Chango, Szwedo, & Schad, 2014; Grabovich, Lu, Tang, Tu, & Lyness, 2010). In addition, studies of depressive symptom trajectories in general population samples of children and adolescents can speak to the role of depressive symptoms in normal child/adolescent development, something that studies restricted to patient samples would be unable to do.…”

Sind depressive Menschen aggressive Menschen? Unterschiede zwischen Allgemeinbevölkerung und depressiven Patienten

“…Die in dieser Untersuchung erhaltenen Ergebnisse sind vergleichbar mit denen von Kang et al [22], welche eine Gruppe von jugendlichen Straftätern mit subklinisch ausgeprägten depressiven Symptomen, eine Gruppe jugendlicher Straftäter mit Major-Depression sowie eine Gruppe von jugendlichen Straftätern ohne jegliche affektiven Störungen verglichen. Auch hier wiesen die Gruppen mit subklinischer depressiver Symptomatik sowie mit Major-Depression eine höhere Aggression auf als die Gruppe ohne affektive Störungen, während sich die Gruppen mit subklinisch ausgeprägter depressiver Symptomatik und mit einer Major-Depression hinsichtlich ihrer Aggression nicht signifikant voneinander unterschieden.…”