Racial/Ethnic Disproportionality in Psychiatric Diagnoses and Treatment in a Sample of Serious Juvenile Offenders
Racial/Ethnic Disproportionality in Psychiatric Diagnoses and Treatment in a Sample of Serious Juvenile Offenders
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DOI：
10.1007/s10964-016-0573-4
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发表时间：
2017-07-01
影响因子：
4.9
通讯作者：
Epps, Nathan
中科院分区：
文献类型：
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作者：
Baglivio, Michael T.;Wolff, Kevin T.;Epps, Nathan
事实证明，参与正义的青少年的精神疾病患病率明显高于普通人群的青少年。然而，在被捕青少年中，人们对疾病患病率的种族/族裔差异、创伤暴露在行为障碍诊断中的作用或向患有此类诊断的青少年提供的后续精神治疗的作用知之甚少。目前的研究考察了精神科诊断和与犯罪相关的行为障碍治疗中的种族/民族差异，控制了严重青少年犯罪者的创伤经历、行为指标和犯罪记录。采用逻辑回归来探讨佛罗里达州长期少年司法住院安置的 8763 名男性（57.7% 黑人，11.8% 西班牙裔）和 1,347 名女性（53.7% 黑人，7.6% 西班牙裔）行为障碍诊断和精神治疗提供中的种族/族裔不成比例。结果表明，即使考虑到创伤、行为指标和刑事犯罪，黑人男性被诊断为行为障碍的可能性比白人高 40%，黑人女性被诊断为行为障碍的可能性高 54%。黑人和西班牙裔男性被诊断出患有多动症的可能性比白人男性低约 40%，女性没有种族/民族差异。重要的是，黑人男性接受精神治疗的可能性比白人男性低 32%，白人和西班牙裔男性或任何女性亚群体之间没有差异。创伤性暴露会增加男性患对立违抗性障碍和多动症的几率，但不会增加行为障碍，尽管不良的童年经历与女性行为障碍诊断无关。
Psychiatric disorder prevalence has been shown demonstrably higher among justice-involved adolescents than youth in the general population. Yet, among arrested juveniles, little is known regarding racial/ethnic differences in disorder prevalence, the role of trauma exposure in the diagnosis of behavioral disorders, or subsequent psychiatric treatment provided to adolescents with such diagnoses. The current study examines racial/ethnic disparity in psychiatric diagnoses and treatment of behavioral disorders associated with delinquency, controlling for traumatic experiences, behavioral indicators, and prior offending among serious juvenile offenders. Logistic regression is employed to explore the racial/ethnic disproportionality in behavioral disorder diagnoses and psychiatric treatment provision among 8763 males (57.7 % Black, 11.8 % Hispanic) and 1,347 females (53.7 % Black, 7.6 % Hispanic) admitted to long-term juvenile justice residential placements in Florida. The results indicate Black males are 40 % more likely, and Black females 54 % more likely to be diagnosed with conduct disorder than Whites, even upon considerations of trauma, behavioral indicators, and criminal offending. Black and Hispanic males are approximately 40 % less likely to be diagnosed with ADHD than White males, with no racial/ethnic differences for females. Importantly, Black males are 32 % less likely to receive psychiatric treatment than White males, with no differences between White and Hispanic males, or any female subgroups. Traumatic exposures increased the odds of oppositional defiant disorder and ADHD, but not conduct disorder for males, though adverse childhood experiences were unrelated to behavioral disorder diagnoses among females.