Summary / Abstract

Title: Adolescents who murder

Synopsis: Although few in number, children and adolescents who murder attract much public attention. Following areview of the literature on aetiology, assessment, treatment programmes and outcomes, descriptive data on a 5-year cohort of 20adolescent murderers from England and Wales are presented. An outline is made of their pathway through the care and criminaljustice system together with a framework for ongoing individual therapy. Suggestions are made about refinement of categories ofjuvenile homicide, and increased information sharing between child and adolescent and adult forensic specialists and the relevanceof this group to the mainstream adolescent offenders. Crimes of violence of children differ little from place to placeand from epoch to epoch. In Britain approximately the same number of juvenile murderers and future privy councillors are born eachweek. Anger, shock, grief and self righteousness often demand certain punishments but sanctions thus motivated cannot be said tohave the efficacy of curative measures (Wilson, 1973). adolescent, murder, treatment, care, offenders, child, Bailey, violence, adolescent murderers, self, homicide, juvenile, offence, anger, crime, adult, criminal justice system, Psychiatry, homicidal act, assessment, literature, study population, mental illness, adolescent forensic service, mainstream adolescent offenders, first offence, treatment interventions, psychopathic disorder, aggression, therapists,

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journal adolescence 1996 19 19 39 adolescents murder susan bailey number children adolescents murder attract public attention review literature aetiology assessment treatment programmes outcomes descriptive data 5 year cohort 20 adolescent murderers england wales presented outline made pathway care criminal justice system framework ongoing individual therapy suggestions made refinement categories juvenile homicide increased information sharing child adolescent adult forensic specialists relevance group mainstream adolescent offenders crimes violence children differ little place place epoch epoch britain approximately number juvenile murderers future privy councillors born week anger shock grief self righteousness demand punishments sanctions motivated said efficacy curative measures wilson 1973 1996 association professionals services adolescents system criminal justice system constitutes multistage multifaceted process involving sequence interactions community offender social control agents children young adolescents convicted murder manslaughter remain unusual event smith 1965 fiddes 1981 cases focus relevant issues surrounding current care control treatment interventions extremely difficult disturbed young people adolescents dealt children young persons act 1993 section 53 first section 53 relates young people convicted crime murder 18th birthday convicted detained majesty pleasure placement determined home secretary care control treatment occurs difficult backdrop public debate young people incarcerated treatment worthwhile rights youngsters balanced victim victim family individual larva immature active changes pupa metamorphosis adult butterfly occurs silent protected inner world young person develops safely different circumstances attention wander like butterfly reprint requests correspondence addressed bailey adolescent forensic service mental health services bury new road prestwich manchester m25 3bl uk 0140 1971 96 01001921 12 00 0 1996 association professionals services adolescents 20 bailey spend hours concentrating dedicated pursuits adults appear pointless times dangerous time life course adolescence stage possibility promises worries attend possibility oyserman martois 1990 theorists described adolescent personality development perspectives psychosexual development ego development defensive operations identity formation cognitive development object relations selfpsychology development tasks adolescence centre autonomy connection rebellion development independence development identity distinction continuity childhood need know normal functioning development define safely intervene designated abnormal committed murderous act dealing self image major bodily changes impulse control emotional tone social relationships morals sexual attitudes family relationships mastery adaption adolescent immediate environment educational vocational goals normal adolescents characterized similarities differences hold diverse views psychological world possible selves self image normal adolescents subject limited generational change young person placed custody murder lays observer critical pathway relevant interwoven clues clues missed lack understanding personality development period elements self concept adolescent represent individual like afraid literature literature reveals children adolescents murder share constellation psychological cognitive neuropsychiatric educational family system disturbance amenable treatment interventions psychotherapy psychiatric hospitalization institutional placement psychopharmalogical treatments myers 1992 specific studies arrived widely varying aetiological understandings behaviour small samples main retrospective threatened killed comparison control groups studied group treatment interventions reviewed unusual clinician remain involved individual cases time placements broad categories children adolescents murder shown table 1 psychodynamic explanations adolescent aggression glover 1960 particular homicidal aggression bender curran 1940 satten et al 1960 easson steinhilber 1961 related murderous act powerful sense unconscious guilt primarily oedipal origin mccarthy 1978 early experiences deprivation leading underdeveloped ego vulnerable outbursts violence muler looney 1974 contributory sociocultural factors walsh brennan 1974 severe physical abuse lewis et al 1985 sexual abuse ressler et al 1985 lewis et al 1988 exposure 21 adolescents murder table 1 categories murders committed children adolescents involved 1 killing babies young children placed care 2 drownings arising group behaviour small children predominantly boys playing 3 killings family 4 sexual crimes 5 cases theft predominant motive 6 street killings result disorganized brawl organized gang activities 7 killings school 8 children treated mental disturbance commission crime 9 children killed repetitive extreme violence pfeffer 1980 parental mental illness hellsten katila 1965 gang participation busch et al 1990 recently increasing concern centred united states availability weapons particular guns aacap 1991 united states united kingdom quantity level exposure children media violence heath 1986 neurological abnormalities long associated adolescent murderers lewis 1988 stressing prevalence major neurological impairment population head injury eeg abnormality current past seizure disorders soft neurological signs homicidal adolescents fulfil criteria conduct disorder myers kemph 1990 associated learning difficulties language delay hays et al 1978 psychotic disorder reported unusual paranoid ideation uncommon cornell et al 1987 substance abuse particular alcohol abuse common labelle et al 1988 impaired moral reasoning described delinquent adolescents trevetnan walker 1989 reported specifically homicidal adolescents insecure attachment bowlby 1973 important risk factor development antisocial behaviour childhood deserving attention specific area adolescent violence homicide parental behaviours chronically inconsistent rejecting child constantly state uncertainty physical emotional availability parent resulting experience frequent intense anger time child learns model relationship anger insecurity core features unchanged hostile angry models relationships place child heightened risk problem behaviour aggression additionally enter adolescence young person view incompetent control contrast competent adolescents able seek autonomy ways meet needs respect needs adolescent underlying risk status risk ultimately expressed social context current study 1983 88 adolescent forensic psychiatrist working united kingdom child adolescent perpetrators serious crime assessment made 21 juveniles aged 5 18 committed murder possible engage 22 bailey 35 0 total study population 30 25 20 15 5 10 11 12 13 14 15 16 17 18 age years figure 1 age charged youngsters therapy follow system released maintain contact annual basis follows career pathway youngsters 23 adolescents murder maa 0 iq level intellectual functioning study population 50 40 30 20 10 aa ba dn figure 2 intelligence dn dull normal ba average average aa average maa average attempt understand pathway aetiology murderous behaviour description framework intervention lessons learnt prevention 24 bailey study population 0 schools types educational functioning 50 40 30 20 10 ms mm ma m r figure 3 educational settings ms mainstream mm multiple mainstream ma maladjusted m multiple special r residential characteristics group 20 participants 11 18 years old half aged 16 19 caucasian afrocaribbean 18 male two female 15 social class iv v shown figures 25 adolescents murder 0 sh type abuse level self substance abuse study population d 80 60 40 20 figure 4 history self substance abuse sh self harm d drugs solvents alcohol 1 7 adolescents came backgrounds characterized unstable family lives absent fathers history alcohol abuse psychopathic disorder violence home 26 bailey 0 md family illness type mental illness family study population ff fp af 35 25 10 20 30 15 5 figure 5 history mental illness family md mother 25 depressed fp father 25 psychotic psychopathic disorder af alcoholic fathers ff family forensic 27 adolescents murder 40 0 5 age separated parents 0f study population 10 15 5 10 25 35 30 20 15 10 5 figure 6 age young people parents absent significant period 6 months fathers mothers j community mothers showed history depressive illness increasing difficulties caring coping families children entered teens three mothers unable cope left children care relatives 28 bailey 40 0 5 age placed residential care 6 months study population 10 15 5 10 25 35 30 20 15 10 5 15 figure 7 history residential care 6 months substance abuse particular alcohol abuse higher offender groups seen adolescent forensic services bailey et al 1994 type self harm unusual extreme female simulating menstruation self immolation male attempted 29 adolescents murder hanging compared offender groups referred service group demonstrated disruptive behaviour school highest rate truancy reported increasing frustration school perceived unwillingness inability recognize difficulties found acquiring literacy numeracy adolescents spent significant periods residential care psychosexual development time offence female reached menarche four males reached puberty two males early onset puberty ages 8 9 respectively psychosexual development characterized early experience abuse five adolescents sexually abused female four male six male physically abused siblings sexually physically abused adolescent murderer subjected intensive deviant abuse males described uncertainty emerging sexuality identity negative experiences sexual experimentation similarly aged females inappropriate sexual experience older females males female longstanding ambivalence table 2 neuropsychological vulnerabilities event n aged 0 5 poor absent antenatal care 2 abnormal birth 2 cyanosis birth 2 need special neonatal care 3 admission hospital first 12 months life recurrent vomiting 1 b gastroenteritis 1 c failure thrive 1 delay development milestones 3 meningitis 1 febrile convulsions 2 aged 5 18 labelled clumsy child 1 learning difficulties 3 epilepsy 2 temporal lobe epilepsy 1 hearing deficit 1 identified post offence speech impediment 2 identified post offence tics 1 examination morphologically unusual 2 chromosomal investigation definite syndrome b klinefelters syndrome 1 identified post offence abnormal electroencephalogram eeg 5 2 pre offence 3 post offence 30 bailey 0 10 age first offence total study populataion 50 40 30 20 10 10 11 12 13 14 15 16 17 figure 8 age first offence gender highlights need explore fully adolescents nature course psychosexual development 31 adolescents murder 50 0 nature first offence study population ar 40 30 20 10 t m figure 9 nature first offence aggression sex offence ar arson t theft burglary m murder neuropsychological characteristics seven youngsters displayed neuropsychological vulnerabilities marked tendency professionals understandably light findings demonstrated figures 1 7 attribute difficulties experienced youngsters 32 bailey environmental factors careful assessment personal developmental histories past medical case notes neuropsychological neurological neurodevelopmental assessment adolescents whilst remand revealed data shown table 2 previous offence histories figures 8 9 offending started early previous offences violence sexual assault arson third group first conviction act homicide offence method eleven victims stabbed four beaten five strangled death comparison adult offenders gillies 1976 maccullock et al 1983 degree violence excessive half stabbed death received 16 knife wounds victim stabbed 70 times victims strangled subjected repeated strangulations third victims sexes sexually assaulted two bodies partially dismembered attempt blind victim table 3 motivation range single lapping motives motivation n i robbery 3 ii revenge 1 iii anger rage quarrel 10 iv avoid arrest 2 v heterosexual 5 vi homosexual 5 vii sadism 4 viii psychotic motive 2 table 4 cause cause n i teenage gang activity 1 ii control 7 home 3 b school 2 c community 2 iii alcohol 6 iv drugs 1 v mental illness 5 depression 1 b borderline personality disorder 2 c personality disorder type psychopathic 2 33 adolescents murder table 5 victims total number victims 22 male 11 female 11 number victims known adolescent 19 number victims related adolescent 4 nature relationship grandmother 1 mother 1 brother 1 daughter 1 features victims homosexual 5 learning disability 1 alcoholic 1 school peer 3 ethnic minority 2 features surrounding offence quarter youngsters watched excessive periods time week prior offence pornographic violent videos two youngsters made serious attempts kill 48 hours offence malmquist 1990 victim profiles victims male female victims equal number age distribution relationship sex nature offence interesting victims 10 female reportedly chosen relative physical weakness susceptibility led away secluded area group male victims aged 11 20 peers known assailants school social settings sexually assaulted deaths violent understandable terms extension normal adolescent behaviour 21 40 year old group male females died result robbery teenage gang activities domestic violence study victims ages 41 60 homosexual addition alcoholic learning disabled deaths involved sexual activities unwelcome sexual advance victim agreed sexual activity prior death victim murderer followed arguments remaining victims aged 60 94 female deaths initially presented robberies old ladies homes three cases adolescents sexually assaulted elderly victims two cases engaged sadistic activities process happens adolescents charged murder arrest allowed remain family open secure care 34 bailey social services psychiatric secure care remand prison young offenders institution adolescents experienced progression reactions feelings akin grief reaction hambridge 1990 majority initially dissociated reality offence situation gradually started grieve first loss freedom enforced separation family chaotic abusive family lastly grieve victim legal process delaying onset process adolescents control home community school clear indications hostile feelings similarly aged victims period 6 months prior offence seen cases active intervention agencies prevented murder group placed secure care treatment settings made considerable progress institution received controls emotional support educational input clearly required prior offence three adolescents dealt mental health act found guilty manslaughter grounds diminished responsibility girl progressed maximum secure health care two boys psychopathic disorder remained impervious intervention remained violent oppositional prison system returned community made little interventions offered convicted offence violence effect offender family devastating victim family macleod 1982 working families 20 adolescents disbelief followed rallying two cases 1 boy psychopathic disorder boy murdered brother family rejected adolescent supported contact family offender allows ventilate deal anger blame shame share feel offence intervention negotiated important family accept help view therapist intrusive undermining treatment group lived majority adolescent life span preventative detention seven group living entire adolescence remain adults custody two cases homicidal act time occurrence due presence extreme environmental stressors repeated regardless sentence treatment remainder detention provided allowance time neurodevelopmental cognitive emotional growth allowing adolescent gain better control emotional aggressive impulses irrespective available treatment model provided care custody institution parallel process education vocation avocation consistent role models continued family contact critical importance bullock et al 1994 parallel process best facilitated milieu characterized warmth harmony clear organization practicality high expectations harris et al 1987 allowing establishment positive staff adolescent staff staff adolescent adolescent relations waplington 1994 hollin 1993 described emerging success cognitive behavioural therapy serious delinquents stresses importance carefully targeted programmes 35 adolescents murder psychopharmacological treatment retained treatment primary illness e g epilepsy psychosis cases five current study clearly defined quantifiable means assessing efficacy eichelman 1988 clinician needs alert possibility emerging mental illness particular depression whilst adolescent serving sentence stewart et al 1990 psychotherapy child adolescent committed homicidal act important adjunctive treatment play central role therapy capacity form emotional attachments potentially allowing establishment working relationship clinician common indication treatability ability self examination insight qualities frequent severe aggression low intelligence poor capacity insight weigh reliance psychotherapy primary means treatment burgess et al 1990 described drawing painting sculpture juveniles accessing memory homicidal act allowing insights motivational dynamics act 1990 author able work conjunction art therapist aulich 1994 enabled adolescents face violent sadistic elements offence previous abuse cases spoken word painful destructive reminder pre trial trial process outset clear understanding patient therapist diad boundaries confidentiality expectation forensic psychiatrist comment level responsibility child adolescent hold offence give prediction future risk individual reaches stage sentence eligible parole supervised return community lead testing trusting relationship adolescent clinician rightly wrongly adolescent views clinician asked offer opinion central issue time served timing movement secure care prison sentence inevitable waxing waning outside pressures adolescent move safely process disbelief denial loss grief anger blame possible post traumatic stress syndrome arising participation homicidal act directly observing action co defendants arising past personal abuse addressing victim empathy saying sorry re attributing blame lead expression anger distress sessions sexualized form content emotion engenders spills outside sessions lead disruptive behaviour institution difficult adolescent carers turn lead rejecting dismissive therapists therapist make constructive parallel process care educational input peer group interactions help address specific offence work enable adolescent highly artificial environment cope psychosexual personality development enable adolescent attain safe autonomy tools available therapist first foremost empowerment statutory agencies placement family individual carry work baggage history accompanying adolescent depositions police evidence regarding offence therapist physically retracing events prior offence adolescents distorted memory time size geography events 36 bailey immediately preceding homicidal act effectively offence specific work component visited revisited adolescent developmentally cope relevant issues stage therapy important adolescent understands degree level public opinion arising offence newspaper media coverage adolescent approaches return community need reach safe resolution mechanism explaining gap life outside world particular future partner combination cognitive behaviour psychotherapy non verbal therapies particular art therapy offer group adolescents sadly 25 younger adolescents child murderers referred adolescent forensic services 1988 marked impulsivity limited ability acceptance therapists gone therapeutic gains come slowly summary common reviews studies children adolescents murder gardiner 1976 lewis et al 1985 cornell et al 1987 myers kemph 1988 busch et al 1990 present group 20 showed family backgrounds characterized mental illness violence family particular note violent fathers violence inconsistent nature shown adolescent early years third cases history sexual abuse previous studies labelle et al 1991 alcohol abuse adolescent group common particular group showed higher levels disruption school studies higher number victims known offender subgroup seven demonstrated wide spectrum neuropsychological vulnerabilities lewis et al 1988 spectrum identified serious sex offenders seen adolescent forensic service bailey et al 1994 compared adult offenders excessive violence particular cases sexual component act control group gave clear indications antagonism victim 6 months leading homicidal act clear implications prevention england wales 16 group adolescents main dealt remand umbrella child care legislation terms standards care placement author view treatment considerations remain secondary largely adult adversarial legal style pre trial remand actual trial review literature system u k presents stark united states lewis 1988 comments tragic lack resources needed evaluate youths subsequent lack mental health input correctional facilities focused cognitive behavioural psychotherapy combined non verbal therapies offered parallel process healthy role models consistent limit setting education vocational training allow sublimation aggressive drives provides context adolescent achieve safe autonomy develop 37 adolescents murder sustain positive relationships peers family sentence release group adolescent murderers currently compared offender groups specifically referred adolescent forensic service outpatients inpatients dolan et al 1995 non referred sample 200 adolescents attending city centre youth court bailey holloway 1992 areas particular interest past history bullied failure education issues trust emerging patterns verbal physical aggression feelings hostility paranoid reactions peers adults 25 child adolescent murderers assessed 1988 display characteristics worringly younger pre pubertal older group significant histories drug abuse sadistic sexual elements homicidal act need multicentre studies countries cultures continue look different categories juvenile homicide particular sexual homicide future hopefully knowledge gained treatment interventions young offenders committed grave crimes usefully shared professionals child mental healthcare services working preventatively aggressive antisocial child future forensic child adolescent psychiatrists work tandem gain fuller understanding attributional processes young offenders sort capabilities prominent age best therapeutic work sensitive periods negotiation issues undertaken point time young person longer peer group addressing issues supportive intrusive undermining working families offender group individual peer group intergenerational processes intertwined therapist maintain motivation child adolescent secure setting time time span life sentence i am listen opinion person expressed positively things problematic i goethe references american academy child adolescent psychiatry committee rights legal matters 1991 position statement firearm safety 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