Risk of Injury to Others: The Development of an Algorithm to Identify Children and Youth at High-Risk of Aggressive Behaviours

Youth violence is considered one of the most preventable causes of morbidity and premature mortality. Various risk factors have previously been identified, however, there is presently a crucial need to develop effective decision-support tools in order to identify children and youth at increased risk for violence. The current study utilised data collected from the interRAI Child and Youth Mental Health Screener (ChYMH-S), within the province of Ontario, to develop and validate a methodology for the purpose of identifying young persons who were at greater risk of harm to others. Additional data from 59 mental health agencies validated the algorithm, and it was found to be a strong predictor of harmful behaviour toward others. The RIO algorithm provides a valuable decision-support tool with strong psychometric properties that may be used to identify young persons who exhibit signs or symptoms associated with increased likelihood of harm toward others, in order to provide early intervention efforts for these vulnerable youth, thereby reducing the likelihood of future aggressive behaviours.

Navigating the Boundaries of Youth Violence Prevention and Reduction: Reflections on Power in Community Engaged Scholarship

Community-engaged scholars grapple with power asymmetries in community-university partnerships, generally working from the assumption that deliberate practices are required to moderate the researchers’ power vis-a-vis that of the community. In this article, we suggest that this dyadic framing masks the complexity of power dynamics within communities, of which the university is just one part, and examine how power is negotiated in the boundary zones of a partnership. We use Third Generation Cultural Historical Activity Theory (CHAT) as a conceptual framework to analyse the structural and cultural dimensions of the boundary zone in which research, learning and action in our partnership occurred (Engeström 1996). A brief story sheds light on our boundary work which uses research and data to span, broker and shake institutional boundaries for the purpose of youth violence prevention and intervention. Our analysis illuminates the potential and limitations of our power to foster transformational change. It also allows us to show that underestimating power differentials and the diversity of values and cultures within an organisation and between a university and a community partner, and certainly across multiple institutions in the case of a cross-sector partnership, can slow down and even thwart work to address societal problems.

CRIMINOLOGICAL ASPECT OF YOUTH VIOLENCE

There is no society and time epoch in the development of a civilization that was not characterized by violence and aggression. Once upon a time it was justified as a global and desirable characteristic of a society and a state, today, aggression and violence is a phenomenon that should be opposed in all ways. Incriminated in almost all laws of modern states, violent behavior and aggression require a multidisciplinary approach in explanation, etiology, phenomenology, and ways of confrontation. The aim of this paper is to point out the problem of youth violence, which is expanding and which affects all aspects of children's existence, starting with the family, school, social environment and society as a whole. The consequences of violent and aggressive behavior of young people will also be discussed, regardless of whether they are in the role of the perpetrator of a violent crime or a victim, as well as the possibilities and needs of preventive action. We will try to answer several important questions regarding youth violence, such as: are young people more victims of violence or committing acts of violence themselves, what are the main causes of violence among young people and what are the most common forms of youth violence.

(Re)Thinking Young Men's Violence: a Discursive Critique of Dominant Constructions

<p>Legitimated and thereby dominant knowledges of youth violence that aim to explain its causes and develop ways of responding are primarily informed by a positivist scientifically-based mainstream psychology. The purpose of this thesis is to offer ways of (re)thinking youth violence outside of an objectivist paradigm. By examining the significant contextual issues and numerous complexities involved for young men who have been violent, this research critically analyses normative notions of youth violence. The theoretical and methodological foundation for this research employed a critical psychology framework along with a discourse analysis approach informed by poststructural concepts derived, primarily, from Michel Foucault. This research foundation has enabled the dominant constructions of youth violence that are reflected and (re)produced by mainstream psychology to be disrupted and hence the modernist assumptions in the positivist scientific basis of mainstream psychology are questioned. The participants in this study were seven young New Zealand men, aged between 14 and 17, who were incarcerated for violent offences. A poststructural discourse analysis of interviews with these young men critically examined the ways they spoke about their violence, their explanations for it as well as their ideas about intervention. My analysis shows that dominant constructions of youth violence that are (re)produced in mainstream psychology theories as taken-for-granted truths, can position violent young men as 'abnormal', 'deviant' and 'dangerous'. However, participants resisted these pathologising and demonising positions. Instead, they embraced the rational position of 'man'. Dominant discourses around traditional masculinity were identified as being of paramount importance to these young men and showed that successfully performing the subject position of 'man' took precedence for them. Being violent acted as a means for participants to achieve 'being a man'. Against this, therapeutic intervention designed to prevent future violence was viewed as irrelevant to these young men. In addition, the 'therapeutic subject' position made available within discourses of intervention did not enable young men to perform 'man' correctly. Contradictions are highlighted in this thesis, showing the multiple subjectivities of the participants, along with various effects of the differing discourses. This was most pronounced in the differences revealed in participants' talk of their general violence compared to their sexual violence. Since general violence was constructed as a way of 'getting it right as a man', participants spoke in considerable detail about their activities. However, participants were reluctant to talk about their sexual violence and silences predominated. As an alternative, they took up an 'unknowing' position about why they were sexually violent. Sexual violence was constructed as irrational and therefore unknowable. In contrast to not wanting intervention for their general violence, participants talked of a willingness to engage with therapeutic intervention. They positioned intervention experts as being able to make rational sense of their sexual violence and spoke of expectations that this would stop them from being sexually violent again. The limitations of traditional approaches to youth violence have been highlighted in this research. Such approaches are unable to attend to the contextual issues presented here or the complexities of multiple subjectivities. The construction of violence as a way to perform 'man' contests discourses of 'abnormality' that positions young men who have been violent as 'disordered' and 'deviant'. Future theorising about youth violence and subsequent intervention approaches require attending to the significance that normative notions of 'manhood' have in the (re)production of violence.</p>

(Re)Thinking Young Men's Violence: a Discursive Critique of Dominant Constructions

<p>Legitimated and thereby dominant knowledges of youth violence that aim to explain its causes and develop ways of responding are primarily informed by a positivist scientifically-based mainstream psychology. The purpose of this thesis is to offer ways of (re)thinking youth violence outside of an objectivist paradigm. By examining the significant contextual issues and numerous complexities involved for young men who have been violent, this research critically analyses normative notions of youth violence. The theoretical and methodological foundation for this research employed a critical psychology framework along with a discourse analysis approach informed by poststructural concepts derived, primarily, from Michel Foucault. This research foundation has enabled the dominant constructions of youth violence that are reflected and (re)produced by mainstream psychology to be disrupted and hence the modernist assumptions in the positivist scientific basis of mainstream psychology are questioned. The participants in this study were seven young New Zealand men, aged between 14 and 17, who were incarcerated for violent offences. A poststructural discourse analysis of interviews with these young men critically examined the ways they spoke about their violence, their explanations for it as well as their ideas about intervention. My analysis shows that dominant constructions of youth violence that are (re)produced in mainstream psychology theories as taken-for-granted truths, can position violent young men as 'abnormal', 'deviant' and 'dangerous'. However, participants resisted these pathologising and demonising positions. Instead, they embraced the rational position of 'man'. Dominant discourses around traditional masculinity were identified as being of paramount importance to these young men and showed that successfully performing the subject position of 'man' took precedence for them. Being violent acted as a means for participants to achieve 'being a man'. Against this, therapeutic intervention designed to prevent future violence was viewed as irrelevant to these young men. In addition, the 'therapeutic subject' position made available within discourses of intervention did not enable young men to perform 'man' correctly. Contradictions are highlighted in this thesis, showing the multiple subjectivities of the participants, along with various effects of the differing discourses. This was most pronounced in the differences revealed in participants' talk of their general violence compared to their sexual violence. Since general violence was constructed as a way of 'getting it right as a man', participants spoke in considerable detail about their activities. However, participants were reluctant to talk about their sexual violence and silences predominated. As an alternative, they took up an 'unknowing' position about why they were sexually violent. Sexual violence was constructed as irrational and therefore unknowable. In contrast to not wanting intervention for their general violence, participants talked of a willingness to engage with therapeutic intervention. They positioned intervention experts as being able to make rational sense of their sexual violence and spoke of expectations that this would stop them from being sexually violent again. The limitations of traditional approaches to youth violence have been highlighted in this research. Such approaches are unable to attend to the contextual issues presented here or the complexities of multiple subjectivities. The construction of violence as a way to perform 'man' contests discourses of 'abnormality' that positions young men who have been violent as 'disordered' and 'deviant'. Future theorising about youth violence and subsequent intervention approaches require attending to the significance that normative notions of 'manhood' have in the (re)production of violence.</p>

Interpersonal violence

Interpersonal violence results in 404,000 deaths annually and substantial health and economic costs. Although there is an element of genetic susceptibility, its use largely a social construct and thus inherently preventable. Interpersonal violence encompasses child maltreatment, peer violence, youth violence, physical, sexual, emotional, and economic intimate partner violence, sexual violence, and elder abuse. While these appear as a disparate set of acts of violence, they are actually very closely interrelated and perpetrators of one form are at greater risk of perpetrating others, and may also have been victims. This chapter uses an ecological approach to understanding common risk factors and underlying causes and reveals the importance of individual-level, interpersonal- or relationship-level, community-level, and societal factors. Evidence of the preventability of interpersonal violence is demonstrated in the United States, where the prevalence of all forms has declined since 1990. This has not been convincingly attributed to any one intervention, and further suggests that a complex and multilevel programme of interpersonal violence prevention is required, targeting risk factors, and encompassing effective health responses to support victims.

Implementation of a youth violence prevention programme in primary care

Background and objectivesYouth violence is an alarming public health problem, yet, violence screening and interventions are not systematically offered in primary care (PC). This paper describes data from a pilot effectiveness-implementation trial of an efficacious youth violence prevention programme (SafERteens).MethodsThe study was conducted in two PC clinics: a university-affiliated satellite clinic and a community health centre. In phase 1, we obtained stakeholder feedback to customise the SafERteens package and enrolled a comparison group of adolescents (age 14–18) seeking care in two clinics. In phase 2, clinical staff delivered the SafERteens-PC intervention with adolescents, which is a single, behavioural health therapy session delivered one-on-one from clinic providers to youth patients, followed by text message (TM) reminders. In phase 3, we assessed planned maintenance. All participants reported past-year violent behaviour at intake and completed a 3-month follow-up assessment.ResultsBased on stakeholder interviews (n=13), we created a web-based SafERteens-PC programme package, including a three-item past-year violence screen, 30 min motivational interviewing-based brief intervention delivery tool, training videos and 2 months of TM boosters. We enrolled a comparison group (n=49) first, then an intervention group (n=61). Intervention delivery characteristics varied by clinic, including completion of intervention (75.9%; 62.5%), modality (100% delivered via telehealth; 60% via telehealth/40% in-person) and enrolment in TMs (81.8%; 55.0%); 91.8% completed the follow-up. Using an intention-to-treat approach, the intervention group showed significantly greater reductions in severe peer aggression (p<0.05), anxiety (p<0.05) and substance use consequences (p<0.05) relative to the comparison group. Participant and staff feedback were positive and identified challenges to long-term implementation, such as lack of availability of reimbursement for youth violence prevention.ConclusionsIf these challenges could be addressed, routine provision of behavioural health services for violence prevention in PC could have high impact on health outcomes for adolescents.