[Show abstract][Hide abstract] ABSTRACT: To examine perceived barriers to mental health service use among male and female juvenile detainees.
The sample included 1,829 juveniles newly detained in Chicago. The Diagnostic Interview Schedule for Children and Children's Global Assessment Scale were used to determine the need for services. Service use and barriers to services were assessed with the Service Utilization and Risk Factors interview.
Approximately 85% of youths with psychiatric disorders reported at least one perceived barrier to services. Most common was the belief that problems would go away without help. Generally, attitudes toward services were remarkably similar across sex and race. Among females, significantly more youths with past service use or referral to services reported this barrier than did youths who had never received or been referred to services. Among males, significantly more youths who had been referred, but never received, services were unsure about where to go for help than youths with past service use. Significantly more youths with no past service use or referrals were concerned about the cost of services than youths with past service use.
Despite the pervasive need for mental health services, the findings of this study suggest that detained youths do not perceive the mental health system as an important or accessible resource. Youths who believe their problems can be solved without assistance are unlikely to cooperate with referrals or to independently seek mental health services. Service providers must be sensitive to clients' perceived barriers to mental health services and work to reduce negative perceptions of services.
Journal of the American Academy of Child & Adolescent Psychiatry 04/2008; 47(3):301-8. DOI:10.1097/CHI.0b013e318160b3bb · 7.26 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Antisocial personality disorder (APD) is a serious public and mental health concern. Understanding how well conduct disorder (CD) and other mental disorders predict the development of APD among youths involved in the juvenile justice system is critical for prevention. The authors used a stratified random sample of 1,112 detained youths to examine the development of APD at a 3-year follow-up interview. Nearly one fifth of male juvenile detainees later developed APD; approximately one quarter of male juvenile detainees with CD at baseline later developed APD. Significantly more males than females developed APD; no differences were found by race/ethnicity. Having 5 or more symptoms of CD, dysthymia, alcohol use disorder, or generalized anxiety disorder was significantly associated with developing modified APD (M-APD; APD without the CD requirement). Some disorders were strong predictors of APD; however, none were adequate screeners for identifying which detainees would later develop M-APD. The findings of this study have implications for interventions and further research in developmental psychopathology.
Journal of Consulting and Clinical Psychology 05/2007; 75(2):221-31. DOI:10.1037/0022-006X.75.2.221 · 4.85 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The core features of narcissism have been thoroughly discussed in the preceding chapters. What stands out from this discussion is the apparent impor-tance of interpersonal processes in the development and maintenance of nar-cissism. The interpersonal nature of narcissism stands in sharp contrast to other conceptualizations of self, such as global feelings of self-esteem, that largely involve internal thoughts and feelings (Washburn, McMahon, King, Reinecke, & Silver, 2004). Because an individual with low self-esteem may experience self-deprecating cognitions, depressive affect, and withdrawn behav-ior without ever interacting with others, the manifestations of high or low self-esteem do not require interaction with others. APPLICATION OF ECOLOGICAL SYSTEMS THEORY TO THE DEVELOPMENT OF NARCISSISM How are narcissistic traits influenced by social systems throughout the life span? Ecological systems theory, initially conceptualized by Urie Bronfen-brenner (1979), suggests that human development is influenced by multiple interpersonal and social systems. Bronfenbrenner proposed that four social systems influence child development: the microsystem, mesosystem, exosys-tem, and macrosystem. The microsystem includes people or organizations that have direct and immediate contact with the child (e.g., caregivers, siblings, school). The mesosystem is the interaction of two or more microsystems, such as a parent interacting with the school. The exosystem includes people or organizations with which the child does not often directly interact but that influence the child's development (e.g., community, parental workplace, extended family members). Finally, the macrosystem is the child's larger socio-cultural context, with which the child does not directly interact but that has an influence on the child nonetheless. This chapter examines and explores the development of narcissism within some of these systems (for a discussion of parental influences, see Chapter 7, this volume).