Abstract
It is unknown if the DSM-oriented (DSM) scales of the Youth Self-Report (YSR) are useful to determine what kind of narrowly-focused psychiatric assessment is needed, and how well these scales serve as a triage tool in real-world forensic settings. To address this knowledge gap, the YSR and diagnostic interviews were administered to 405 detained boys as part of a clinical protocol. Continuous DSM scale scores (e.g., Conduct Problems) were moderately to highly accurate in predicting their corresponding disorder (e.g., conduct disorder), whereas dichotomized DSM scale scores were not. To test the DSM scales’ usefulness for triage purposes, the sensitivity and specificity of being in the borderline range of one or more DSM scales were calculated. Almost all boys who did not have a disorder were in the normal range of at least one DSM scale (high specificity). However, many boys with a disorder would have been missed if such a decision rule was used for triage purposes (low sensitivity). In conclusion, their relations with the corresponding disorders support the construct validity of the DSM scales in an applied forensic setting. Nevertheless, the findings also warrant against the use of these scales for planning further narrowly-focused assessment or for triage purposes.
Highlights
Notwithstanding that the prevalence of psychiatric disorders among detained boys is high (e.g., [1]), juvenile detention facilities all too often lack budgets, time, and/or qualified personnel to perform in-depth psychiatric assessments
May have a special interest in mental health screening tools that can provide concrete directions on how to plan further narrowly-focused psychiatric assessments
For the purpose of this study, data for 443 boys who completed the Youth Self-Report (YSR) between July 2009 and August 2011 were made available to the author (All detained boys who entered the two facilities in this time span were asked to complete the YSR, which implies that YSR administration did not depend on certain inclusion criteria such as presenting symptoms or results from previous tests)
Summary
Notwithstanding that the prevalence of psychiatric disorders among detained boys is high (e.g., [1]), juvenile detention facilities all too often lack budgets, time, and/or qualified personnel to perform in-depth psychiatric assessments. May have a special interest in mental health screening tools that can provide concrete directions on how to plan further narrowly-focused psychiatric assessments (e.g., only ascertain the presence of major depression disorder if the youth is high on a scale that screens for depressive feelings). The YSR was designed to be useful in many contexts, including juvenile justice settings [4], and its DSM scales comprise items identified as being very consistent with specific DSM-IV disorders [4]. Even though these DSM scales were not intended to be a perfect equivalent of the disorder(s) under consideration, they still may provide concrete directions for further assessment
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