Aggression, substance use disorder, and presence of a prior suicide attempt among juvenile offenders with subclinical depression

Abstract

Juvenile justice agencies often use the presence of a Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnosis as a criterion for offenders' eligibility for mental health treatment. However, relying on diagnoses to sort offenders into discrete categories ignores subclinical disorders-impairment that falls below the threshold of DSM criteria. The current study used structured clinical interviews with 489 juvenile offenders to examine aggression, presence of a prior suicide attempt, and substance use disorders among juvenile offenders with subclinical depression compared with juvenile offenders with major depression or no mood disorder. Analyses demonstrated that juvenile offenders with subclinical depression reported significantly more aggression, abuse of substances, and the presence of a prior suicide attempt compared to juvenile offenders with no mood disorder, but did not differ significantly on aggression and substance abuse compared with juvenile offenders with major depression. These results have implications for correctional agencies' policies through which offenders are offered mental health treatment, and provide a first step in identifying early signs of problematic behavior before it worsens. Specifically, the results support the notion that depressive disorders should be viewed along a continuum when determining how to allocate services.