Psychopathic Traits of Dutch Adolescents in Residential Care: Identifying Subgroups

The present study examined whether a sample of 214 (52.8% male, M age = 15.76, SD = 1.29) institutionalized adolescents could be classified into subgroups based on psychopathic traits. Confirmatory Factor Analyses revealed a relationship between the subscales of the Youth Psychopathic traits Inventory (YPI) and the three latent constructs of the original model on which it is based. Latent Class Analyses showed that adolescents showing psychopathic traits could be classified into three subgroups. The first group showed low scores on the grandiose/manipulative dimension, the callous/unemotional dimension, and the impulsive/irresponsible dimension (normal group). The second group scored moderate on the grandiose/manipulative dimension and the callous/unemotional dimension and high on the impulsive/irresponsible dimension (impulsive, non-psychopathic-like group). The third group scored high on all three dimensions (psychopathy-like group). The findings revealed that the impulsive, non-psychopathic like group scored significantly higher on internalizing problem behavior compared to the normal group, while the psychopathy-like and the impulsive, non-psychopathic-like group both scored higher on externalizing problem behavior compared to the normal group. Based on a self-report delinquency measure, it appeared that the psychopathy-like group had the highest delinquency rates, except for vandalism. Both the impulsive and psychopathy-like group had the highest scores on the use of soft drugs

Change over time: the use of seclusion in secure residential youth care in The Netherlands

Seclusion can be harmful for children and adolescents. Hence, all locations for secure residential youth care in the Netherlands are committed to reduce its use by implementing monitoring and feedback as a seclusion reduction intervention. This study examined change over time in the use of seclusion in secure residential youth care in the Netherlands using a broad conceptualization of seclusion and by analyzing four variables (frequency, duration, room, reason). During two six months periods, seclusions were registered in 19 locations. Every month, all locations received feedback on the use of seclusion. Negative binomial mixed model analyses were used to investigate change over time in frequency and duration of seclusion. Logistic mixed model analyses were used to identify change over time in reason for use and type of room used for seclusion. Results showed that seclusion frequency significantly decreased (RR = 0.92, p <.001). Further, duration of placement in a seclusion room significantly increased (RR = 1.04, p <.001). This change was only significant in seclusion in response to aggression (RR = 1.06, p <.001). The results emphasize the need for future studies to examine reduction using a broad conceptualization of seclusion

Effectiveness of game-based meditation therapy on neurobiological stress systems in adolescents with posttraumatic symptoms: a randomized controlled trial

Many adolescents in residential care have experienced traumatic events and suffer from posttraumatic stress. Prolonged activation of neurobiological stress systems as the autonomic nervous system (ANS) and the hypothalamic-pituitary-adrenal (HPA) axis can result in long-lasting maladaptive alternations. This study investigated the effectiveness of Muse, a game-based meditation intervention, on the sympathetic nervous system (SNS), parasympathetic nervous system (PNS), and cortisol basal activity and reactivity to acute stress among adolescents with posttraumatic symptoms in residential care. The intervention consisted of two gameplay sessions a week, for 6 consecutive weeks. Seventy-seven adolescents with clinical levels of posttraumatic symptoms (10–18 years old) received either Muse as an addition to treatment as usual (n = 40) or treatment as usual alone (n = 37). We expected reduced basal activity for the SNS and cortisol and increased basal activity for the PNS. As for the response to acute stress, we expected decreased PNS and increased HPA axis reactivity. The Muse group exhibited lower basal activity for the SNS and increased HPA reactivity to acute stress. There were no differences between conditions on SNS and HPA axis activity during rest and on SNS and PNS reactivity to acute stress. Game-based meditation therapy is a promising intervention for the treatment of adolescents with posttraumatic symptoms in residential care. Implications for clinical relevance and trauma-focused treatment purposes are discussed

Compulsory residential care: An examination of treatment improvement of individual and family functioning

The aim of the present study was to examine the treatment progress of both adolescent's and their families' functioning in a new compulsory residential treatment program. The sample consisted of 339 admitted adolescents (56.3% boys). The mean age at time of entry was 15.69 (SD = 1.30). Adolescents stayed on average 9.42 months (SD = 4.66) in a new residential treatment program. Data on adolescents' internalizing and externalizing problems were assessed using self-reports, parent reports, and group care worker reports. In addition, adolescents reported their substance use and delinquency and parents also reported family functioning and level of perceived parental stress. The findings revealed a significant decrease in adolescents' self-reported internalizing and externalizing problems, delinquency, and substance use. According to parent ratings, a significant improvement was found concerning adolescents' problem behaviors during treatment. However, according care worker ratings, adolescents showed no improvement on internalizing problems and showed an increase in externalizing problems. Concerning families, although there was no improvement in family functioning, parental stress significantly improved over time. Further research should examine whether improvements experienced during treatment are maintained after treatment.Compulsory residential treatment program Internalizing problems Externalizing problems Adolescents families

Nieuw Zorgaanbod: Gesloten jeugdzorg voor adolescenten met ernstige gedragsproblemen

Tot voor kort werd een toenemend aantal jongeren met ernstige gedragsproblemen in jeugdgevangenissen geplaatst. Deze jongeren, ook wel ‘civielrechtelijke’ jongeren genoemd, werden niet geplaatst vanwege veroordelingen voor criminele activiteiten, maar omdat zij beschermd dienden te worden tegen zichzelf danwel tegen de omgeving. In 2004 werd in opdracht van het Ministerie voor Volksgezondheid, Welzijn en Sport (VWS) door het Nederlands Jeugdinstituut (NJI) onderzoek gedaan naar deze groep civielrechtelijke jongeren in jeugdgevangenissen. Op basis van de bevindingen van dit onderzoek werd besloten een nieuw residentieel zorgaanbod te ontwikkelen, waarbij de door het NJI onderzochte groep de beoogde doelgroep vormde voor het nieuwe zorgaanbod. In de huidige studie is deze beoogde doelgroep vergeleken met de groep jongeren die daadwerkelijk binnen het nieuwe zorgaanbod is opgenomen. Om de kenmerken van de doelgroep te meten zijn de dossiers geanalyseerd van 317 jongeren (63% jongens). De gemiddelde leeftijd van de jongeren was 15.68 (SD = 1.32). Wanneer de beoogde en daadwerkelijke doelgroep worden vergeleken, dan blijkt dat er verschillende significante verschillen zijn op zowel individueel, gezins-, als omgevingsniveau. De jongeren binnen het nieuwe zorgaanbod vertonen meer externaliserend, internaliserend probleemgedrag en suïcide/automutilatie, hebben meer politiecontacten, gebruiken vaker soft drugs en geweld binnen het gezin komt significant vaker voor vergeleken met de beoogde doelgroep. Ondanks dat het nieuwe zorgaanbod specifiek is ontwikkeld voor jongeren met ernstige gedragsproblemen en hun gezinnen, maken de ernst en verscheidenheid aan problematiek het creëren van betere toekomstperspectieven moeilijk

Small groups in youth care: an exploratory study

In the Netherlands in 2018, almost 43,000 children and adolescents aged under 18 were removed from their parental homes (Statistics Netherlands, 2019). Around 18,000 of these young people ended up in residential children’s homes, usually living in relatively large groups of eight to ten children. However, there is increasing societal interest in developing small groups. Small groups are groups of at most four youngsters and a limited number of professionals. This means there are more possibilities for providing a sound, safe basic pedagogical climate that is appropriate for the complex problems that children removed from the parental home typically have. The current study explores the initial experiences of young people and professionals with small groups in residential youth care. Interviews with young people (n = 9) and professionals (n = 11) plus a quality-of-life survey (n = 754) at two institutions for residential youth care (n = 6 small groups) were used to investigate what it is like to live or work in a small-scale group and to identify potential workable elements and problem areas. The results show that small groups appear to be a promising form of care, offering more possibilities for a safe and sound basic pedagogical climate. Several potential workable elements were identified when compared with larger residential groups: 1) there is more space for building trust between the professionals and the young people, and among the young people themselves; 2) coordination among the professionals and between the professionals and the young people is better and smoother; 3) the youngsters and the professionals experience the group as safer and calmer; 4) there are more possibilities for creating normality; and 5) the environment is more positive. Even so, the institutions experience tension between on the one hand the aim of limiting the number of professionals in the groups and on the other hand the feasibility, vulnerability and affordability of these small groups

Alterations of autonomic nervous system and HPA axis basal activity and reactivity to acute stress: a comparison of traumatized adolescents and healthy controls

Alterations in neurobiological stress systems such as the autonomic nervous system (ANS) and hypothalamic-pituitary-adrenal (HPA) axis contribute to the development and maintenance of psychological and behavioral problems after traumatic experiences. Investigating neurobiological parameters and how these relate to each other may provide insight into the complex mechanisms at play. Whereas the preponderance of studies focuses on either the ANS or the HPA axis separately, the current study is the first to evaluate relations between posttraumatic stress and both basal activity during rest and stress reactivity of the ANS as well as the HPA axis in a sample of traumatized adolescents and healthy controls. The traumatized sample (n = 77), based on clinical levels of posttraumatic stress, was a convenience sample that was recruited within residential institutions, was compared to a healthy control sample (n = 48) recruited within the general community. For the ANS, we expected increased SNS and decreased PNS activity during rest and increased SNS and decreased PNS reactivity to social stress among traumatized adolescents compared to healthy controls. Regarding the HPA axis, we expected increased basal cortisol levels and decreased cortisol reactivity to stress in the traumatized sample. Compared to healthy controls, traumatized adolescents exhibited significantly higher sympathetic and lower parasympathetic activation during rest and increased sympathetic reactivity to acute stress (ANS parameters). Outcomes on the HPA axis (i.e. cortisol) indicated that traumatized adolescents showed increased cortisol levels during rest and blunted cortisol reactivity to acute stress. Implications for clinical relevance and trauma-focused treatment purposes are discussed

Kleinschalige groepen binnen de jeugdhulp: een eerste verkenning

In the Netherlands in 2018, almost 43,000 children and adolescents aged under 18 were removed from their parental homes (Statistics Netherlands, 2019). Around 18,000 of these young people ended up in residential children’s homes, usually living in relatively large groups of eight to ten children. However, there is increasing societal interest in developing small groups. Small groups are groups of at most four youngsters and a limited number of professionals. This means there are more possibilities for providing a sound, safe basic pedagogical climate that is appropriate for the complex problems that children removed from the parental home typically have. The current study explores the initial experiences of young people and professionals with small groups in residential youth care. Interviews with young people (n = 9) and professionals (n = 11) plus a quality-of-life survey (n = 754) at two institutions for residential youth care (n = 6 small groups) were used to investigate what it is like to live or work in a small-scale group and to identify potential workable elements and problem areas. The results show that small groups appear to be a promising form of care, offering more possibilities for a safe and sound basic pedagogical climate. Several potential workable elements were identified when compared with larger residential groups: 1) there is more space for building trust between the professionals and the young people, and among the young people themselves; 2) coordination among the professionals and between the professionals and the young people is better and smoother; 3) the youngsters and the professionals experience the group as safer and calmer; 4) there are more possibilities for creating normality; and 5) the environment is more positive. Even so, the institutions experience tension between on the one hand the aim of limiting the number of professionals in the groups and on the other hand the feasibility, vulnerability and affordability of these small groups

The associations between structural treatment characteristics and post-treatment functioning in compulsory residential youth care

Contains fulltext : 102944.pdf (publisher's version ) (Open Access)In 2005 a new compulsory residential treatment program was developed for adolescents in need for protection against themselves or their environment. The aim of the present study was to examine the association of structural treatment characteristics of this new residential treatment program (i.e., duration of treatment, discharge status, and group composition in terms of sex) with post-treatment functioning. Additionally, the number of pre-treatment risk factors was included in the model. A total of 301 adolescents (174 boys, 127 girls), with a mean age at time of admittance of 15.50 (SD = 1.26) participated in this study. The number of risk factors was derived from treatment files of the adolescents at time of entrance. Six months after discharge, adolescents participated in a telephone interview to measure ten post-treatment variables indicating how well they were doing. The results showed that duration of treatment was related to post-treatment living situation, in that adolescents who were in treatment for shorter durations were more likely to live on their own after treatment. For discharge status, findings suggested that adolescents who were regularly discharged had more frequent contact with their family; however, they also showed higher alcohol consumption 6 months after treatment. Group composition was related to the girls' official offending, indicating that girls placed in mixed-sex groups showed significantly fewer official police contacts than did girls in girls-only treatment groups. Overall, structural treatment characteristics were hardly related to the adolescents' functioning after treatment. Suggestions for future research are discussed.20 p

Friends' and Adolescents' delinquency. The Moderating Role of Social Status and Reciprocity of Friendships

Contains fulltext : 90384.pdf (publisher's version ) (Closed access)The current study examined the role of friends' delinquency, in terms of violent and property offenses and vandalism. Data were collected from 1,025 adolescents and their best friends in 19 Dutch secondary schools. Concerning violent offenses, cross-sectional analyses showed that adolescents with a high-status friend were more likely to commit violent offenses themselves, whereas adolescents with a low-status friend engaging in vandalism had a greater likelihood of perpetrating vandalism than the adolescents with a high-status friend. The adolescent's violent delinquency and vandalism were positively related to the friend's delinquency only when the friendship was reciprocal. Longitudinally, adolescents with a high-status friend perpetrating vandalism were more likely to engage in vandalism, whereas those with a low-status vandalistic friend showed a decrease. Finally, having a reciprocal friend who committed property offenses increased the adolescent's risk of committing similar offenses, whereas adolescents with a unilateral friend showed a decreased risk over time