A Two-Week Psychosocial Intervention Reduces Future Aggression and Incarceration in Clinically Aggressive Juvenile Offenders

Abstract

Objective: There is a largely unmet need for evidence-based interventions that reduce future aggression and incarceration in clinically aggressive juvenile offenders serving probation. We addressed this gap using a group randomized controlled trial. Offenders both with and without clinical aggression were included, enabling comparison of intervention effects.

Method: Juveniles 13 to 17 years old (N = 310, mean = 16 years, 90% African-American, 66% male) on probation were assigned to a 2-week intervention targeting psychosocial factors implicated in risky behavior (e.g., learning strategies to manage "hot" emotions that prompt risk taking) or to an equally intensive health promotion control. Participants completed aggression measures at baseline, 6-, and 12-month follow-up and reported on incarceration at 12 months. Spline regression tested symptom change.

Results: Among clinically aggressive offenders (n = 71), the intervention arm showed significantly greater reductions in aggression over the first 6 months compared with controls. Juveniles from the intervention no longer met clinical criteria, on average, but clinically significant symptoms persisted in the control group. By 12 months, participants from the intervention appeared to maintain treatment gains, but their symptom levels no longer differed significantly from those in the control. However, the intervention group was nearly 4 times less likely than controls to report incarceration. Intervention effects were significantly stronger for offenders with clinical than with nonclinical (n = 239) baseline aggression.

Conclusion: A 2-week intervention expedited improvements in aggression and reduced incarceration in clinically aggressive juvenile offenders. The findings underscore the importance of directing intervention resources to the most aggressive youth. Clinical trial registration information-PHAT Life: Preventing HIV/AIDS Among Teens in Juvenile Justice (PHAT Life); https://ichgcp.net/clinical-trials-registry/NCT02647710" title="See in ClinicalTrials.gov">NCT02647710.

Keywords: aggression; incarceration; intervention; juvenile offenders; prospective.

Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Figures

Figure 1

Mean levels of total aggression, as measured by total score from the Aggressive Behaviors scale of the Youth Self-Report (YSR-AB) at baseline (n = 71), 6 months (n = 61), and 12 months (n = 62) among juvenile offenders with clinically significant baseline aggression.

Figure 2

Percentages of juvenile offenders with clinically significant aggression at baseline who reported having been incarcerated at 12-month follow-up in the intervention (n = 3/26) and control (n= 14/35). Note: Error bars indicate the standard error of the probability within the given group.