Child Psychiatry and Human Development

, Volume 6, Issue 4, pp 198–213 | Cite as

Diagnostic evaluation of the juvenile offender

Toward the clarification of often overlooked psychopathology
  • Dorothy Otnow Lewis
Articles

Abstract

On the basis of previously reported findings that a high percentage of court-referred children suffered from serious psychopathology other than sociopathy, attention is called to some essential, though often overlooked, elements of the diagnostic evaluation of delinquents. Emphasis is on a meticulous history, including careful attention to the significances of family histories of serious psychiatric and/or neurological disorders. The importance of a detailed perinatal and medical history, with emphasis on determining a possible history of significant insult to the central nervous system, is stressed. A systematic mental status evaluation is strongly recommended. Techniques for assessing the existence of significant hallucinatory and delusional experiences in children are suggested. The uses of psychological and neurological evaluations to augment the psychiatric are discussed. The poor social situation from which many delinquents come as well as the obvious intrafamilial psychodynamic factors influencing delinquent behavior are recognized as frequent impediments to the search for less obvious psychotic and/or organic vulnerabilities in the juvenile offender. Case histories of several children who had previously been dismissed as merely sociopathic, illustrate the thesis of the paper.

Keywords

Nervous System Central Nervous System Family History Medical History Mental Status 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Lewis DO, Balla DA, Sacks HL, et al: Psychotic symptomatology in a juvenile court clinic population.J Amer Acad Child Psychiat 12:660–674, 1973.PubMedGoogle Scholar
  2. 2.
    Lewis DO, Balla DA: Sociopathy and its synonyms: Inappropriate diagnoses in child psychiatry.Amer J Psychiat, in press.Google Scholar
  3. 3.
    Shaw CR, McKay HD:Juvenile Delinquency and Urban Areas. Chicago, University of Chicago Press, 1969.Google Scholar
  4. 4.
    Cloward RA, Ohln LE:Delinquency and Opportunity: A Theory of Delinquent Gangs. New York, Macmillan (Free Press), 1960.Google Scholar
  5. 5.
    Merton RK: Social structure and anomie.Amer Sociol Rev 3:672–682, 1938.Google Scholar
  6. 6.
    Glueck S, Glueck E:Unraveling Juvenile Delinquency. Cambridge, Mass., published for the Commonwealth Fund by Harvard University Press, 1950.Google Scholar
  7. 7.
    Matza D:Delinquency and Drift. New York, John Wiley & Sons, 1964.Google Scholar
  8. 8.
    Johnson AA: Sanctions for superego lacunae of adolescents. In KR Eissler (Ed),Searchlights on Delinquency. New York, International Universities Press, 1949.Google Scholar
  9. 9.
    Aichorn A:Wayward Youth. New York, Viking Press, 1935.Google Scholar
  10. 10.
    Jenkins RL, Hewitt L: Types of personality structure encountered in child guidance clinics.Amer J Orthopsychiat 14:84, 1944.Google Scholar
  11. 11.
    Glueck S, Glueck E:Toward a Typology of Juvenile Offenders: Implications for Therapy and Prevention. New York, Grune & Stratton, 1970.Google Scholar
  12. 12.
    Schmideberg M: The psychoanalysis of delinquents.Amer J Orthopsychiat 23:13, 1953.PubMedGoogle Scholar
  13. 13.
    Guze SB, Goodwin DW, Crane JB: Criminality and psychiatric disorders.Arch Gen Psychiat 20:583–591, 1969.PubMedGoogle Scholar
  14. 14.
    Healy W, Bronner A-F:Delinquents and Criminals, Their Making and Unmaking: Studies in Two American Cities. New York, Macmillan, 1926.Google Scholar
  15. 15.
    Oltman JE, Friedman S: A psychiatric study of 100 criminals: With particular reference to the psychological determinants of crime.J Nerv Ment Dis 93:16–41, 1941.Google Scholar
  16. 16.
    Koenigsberg D, Balla D, Lewis D: Subsequent criminality and psychiatric treatment in a group of former delinquents. Unpublished manuscript, 1975.Google Scholar
  17. 17.
    Lewis DO, Sacks HL, Balla DA, et al: Introducing a child psychiatric service to a juvenile justice setting.Child Psychiat Hum Dev 4:98–114, 1973.Google Scholar
  18. 18.
    Cravioto J, Delicardie ER: Mental performance in school age children: Findings after recovery from severe malnutrition.Amer J Dis Child 120:404–410, 1970.PubMedGoogle Scholar
  19. 19.
    Bender L: Psychopathic behavior disorders in children. In RM Lindner & RV Seliger (Eds),Handbook of Correctional Psychology. New York, Philosophical Library, 1947.Google Scholar
  20. 20.
    Silverman D: Electroencephalography: Use in penologic practice. In RM Lindner & RV Seliger (Eds),Handbook of Correctional Psychology. New York, Philosophical Library, 1947.Google Scholar
  21. 21.
    Lurie LA: The role of endocrine factors in delinquency.Amer J Orthopsychiat 23:21, 1953.PubMedGoogle Scholar
  22. 22.
    Pasamanick B: Pregnancy experience and the development of behavior disorders in children.Amer J Psychiat 112:613–617, 1956.PubMedGoogle Scholar
  23. 23.
    Douglas JWB: Premature children at primary schools.Brit Med J 1:1008–1013, 1960.Google Scholar
  24. 24.
    Drillien CM:The Growth and Development of the Prematurely Born Infant. London, Livingstone, 1964.Google Scholar
  25. 25.
    Kohen-Raz R, Assael M: EEG and Rorschach findings in a group of juvenile delinquents suspect of organic brain disorder.Acta Paedopsychiat 33:251–258, 1966.Google Scholar
  26. 26.
    Wender PH: The minimal brain dysfunction syndrome in children.J Nerv Ment Dis 155:55–71, 1972.PubMedGoogle Scholar
  27. 27.
    Pontius AA: Neurological aspects in some type of delinquency, especially among juveniles.Adolesc 7:284–308, 1972.Google Scholar
  28. 28.
    Mark VH, Ervin FR:Violence and the Brain. New York, Evanston, London, Harper & Row, 1970.Google Scholar
  29. 29.
    Pincus J, Tucker G:Behavioral Neurology. New York, Oxford University Press, 1974.Google Scholar
  30. 30.
    Lewis DO: Delinquency, psychomotor epileptic symptomatology, and paranoid symptomatology in a delinquent population, A Triad.Amer J Psychiat, in press.Google Scholar
  31. 31.
    Glaser G:EEG and Behavior. New York, Basic Books, 1963.Google Scholar
  32. 32.
    Hanvik LJ, Nelson SE, Hanson HB, et al: Diagnosis of cerebral dysfunction as made in a child guidance clinic.Amer J Dis Child 101:364–375, 1961.PubMedGoogle Scholar
  33. 33.
    Robins LN:Deviant Children Grown Up: A Sociological and Psychiatric Study of Sociopathic Personality. Baltimore, Williams & Wilkins, 1966.Google Scholar

Copyright information

© Human Sciences Press 1976

Authors and Affiliations

  • Dorothy Otnow Lewis
    • 1
    • 2
  1. 1.Yale UniversityUSA
  2. 2.Child Study Center and Department of PsychiatryYale UniversityNew Haven

Personalised recommendations