Loss Due to Death and its Association with Mental Disorders in Juvenile Detainees

• DOI: http://doi.org/10.1111/jfcj.12029
• Date: 01 June 2015
• Published date: 01 June 2015

Loss Due to Death and its Association with

Mental Disorders in Juvenile Detainees

By Julie Laken Harnisher, Karen Abram, Jason Washburn, Marquita Stokes,

Nicole Azores-Gococo, and Linda Teplin

ABSTRACT

This study investigated the prevalence of loss due to death and its association

with mental disorders in a random sample of 898 newly detained adolescents in

Chicago, Illinois. Nearly 90% of youth experienced the loss of an important person;

most had also experienced a “high-risk” loss (e.g., loss due to violence, sudden loss).

Minority youth were at particular risk. Youth with any loss or multiple losses were

more likely to have mood disorders and ADHD/behavioral disorders, respectively,

than youth who had no such losses. Interventions focusing on modifiable protective

factors following loss may increase positive outcomes in this vulnerable population.

INTRODUCTION

As people age, they learn to anticipate the death of older loved ones (Clark, Pynoos,

& Goebel, 1996; Sigelman & Rider, 2014). Loss of loved ones through death is difficult

for young people. This is particularly true when losses are sudden, due to violence, or

involve the loss of a caregiver. Such “high-risk” losses can complicate the mourning

process. They can evoke feelings of helplessness, anger, and horror, and increase the risk

for psychopathology (Cerel, Fristad, Verducci, Weller, & Weller, 2006; Kristensen,

Weisæth, & Heir, 2012; McClatchey & Vonk, 2005; Silverman & Worden, 1992). Losses

can also disrupt a youth’s sense of continuity and safety, triggering life changes such as

new household members, relocation, and a change in schools (Hooyman & Kramer, 2013;

Melhem, Moritz, Walker, Shear, & Brent, 2007; Nolen-Hoeksema, Larson, & Larson,

2013).

Loss can have a particularly adverse effect during adolescence, a critical develop-

mental period, already marked by cognitive, emotional, and biological changes (Balk &

Drs. Harnisher, Abram, Washburn, and Teplin and Ms. Stokes and Ms. Azores-Gococo are

affiliated with the Department of Psychiatry and Behavioral Sciences, Health Disparities and Public Policy

Program, Northwestern University Feinberg School of Medicine, 710 North Lake Shore Dr., Suite 900,

Chicago, IL 60611 (e-mail: healthdisparities@northwestern.edu).

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Juvenile and Family Court Journal 66, No. 3 (Summer) 1

© 2015 National Council of Juvenile and Family Court Judges

Corr, 2001; Blundell, 2001; Melhem, Porta, Shamseddeen, Walker Payne, & Brent,

2011; O’Halloran, Ingala, & Copeland, 2005). Detained youth may be at greater risk

than youth in the community for experiencing high-risk losses. Such youth are exposed

to greater violence by virtue of their criminal lifestyles, and many grow up in poverty and

in high-crime neighborhoods (Crimmins, Cleary, Brownstein, Spunt, & Warley, 2000;

Cuevas, Finkelhor, Shattuck, Turner, & Hamby, 2013; Morin & Welsh, 1996).

It is important to study loss among detained youth for three reasons. First, loss may

contribute to antisocial behavior and increase risk for criminal recidivism among youth

(Crimmins et al., 2000; Farrington, 2007; Juby & Farrington, 2001; Pitt-Aikens &

McKinnon, 2000). Understanding the scope and nature of loss among these youth will

help identify areas for supportive intervention, which may reduce criminal recidivism.

Second, detained youth are at high risk for mental disorders; between half to two-thirds

of juvenile detainees have at least one mental disorder (Colins et al., 2010; Fazel, Doll, &

Långström, 2008; Kates, Gerber, & Casey, 2014; Teplin, Abram, McClelland, Dulcan, &

Mericle, 2002; Wasserman, McReynolds, Lucas, Fisher, & Santos, 2002). Losses can

exacerbate existing mental disorders among these youth and, left unaddressed, can

impede treatment and recovery (Brown, Sandler, Tein, Liu, & Haine, 2007; Melhem

et al., 2011; Pillay & Descoins, 2006; Poijula, Dyregrov, Wahlberg, & Jokelainen, 2001).

Third, loss can greatly aggravate the risk of poor outcomes among detained youth, who

already face numerous risk factors for poor outcomes (Crimmins et al., 2000; Maschi,

2006; Pitt-Aikens & McKinnon, 2000). At-risk youth are less likely than youth in the

general population to receive supportive interventions (Stagman & Cooper, 2010), par-

ticularly following a loss (Dowdney et al., 1999).

Despite the need, no study has adequately documented the rates of loss among

detained youth. Past studies of loss among youth involved in the juvenile justice system

have had small samples (Morin & Welsh, 1996) or have focused on only the loss of one

type of loved one (Crimmins et al., 2000; Morin & Welsh, 1996; Pitt-Aikens &

McKinnon, 2000). None have examined the association of loss with mental disorders.

The current study examines the prevalence and patterns of loss and their association

with mental disorders in a large-scale, randomly selected, stratified sample of juvenile

detainees using a comprehensive measure of loss.

METHODS

Participants and Sampling Procedures

Participants were part of the Northwestern Juvenile Project, a longitudinal study of

1829 youth (aged 10-18 years) arrested and detained between November 20, 1995, and

June 14, 1998, at the Cook County (Illinois) Juvenile Temporary Detention Center

(CCJTDC) in Chicago (Teplin et al., 2002). The CCJTDC received approximately 8,500

admissions each year during the time data were collected (John Howard Association,

unpublished data, 1992). The CCJTDC is used solely for pretrial detention and for

offenders sentenced for fewer than 30 days. All detainees younger than 17 years are held

2 | JUVENILE AND FAMILY COURT JOURNAL / Summer 2015