Massachusetts Youth Screening Instrument-Second Version Research Articles

Evaluating the Clinical Utility of the MAYSI-2 Among African American Male Juvenile Offenders

This study examined the clinical utility of the Massachusetts Youth Screening Instrument-Second Version (MAYSI-2) among African American (AA) incarcerated youth and used White incarcerated youth as a comparison group. Data were analyzed for 314 incarcerated youth (193 AA offenders and 121 White offenders) of ages 13–17 years that were adjudicated delinquent from a Southeastern United States medium security residential facility. Seven logistic regression and receiver operating characteristic curve (ROC) models were built to determine whether the MAYSI-2 subscales accurately identify committed AA male incarcerated youth who have mental illnesses on file. Analyses also examined how well the MAYSI-2 subscales identify specific mental illnesses among AA-committed male incarcerated youth. Results demonstrated that no MAYSI-2 subscales accurately identified and categorized AA-committed male incarcerated youth that have mental disorders, and only two subscales (Alcohol/Drug Use, Depressed/Anxious) identified and categorized White committed male incarcerated youth that have mental disorder. Additional results and implications for research and practice are provided.

The relation between mental health problems and future violence among detained male juveniles

BackgroundDetention personnel may assume that mental health problems heighten the likelihood of future violence in detained youth. This study explored whether brief mental health screening tools are of value for alerting staff to a detained youth’s potential for future violent offending.MethodBoys (n = 1259; Mean age = 16.65) completed the Massachusetts Youth Screening Instrument-Second Version (MAYSI-2) and the Strengths and Difficulties Questionnaire (SDQ) as part of a clinical protocol. Official records were collected to index past and future violent offending.ResultsA few significant positive and negative relationships between MAYSI-2 and SDQ scale scores and future violent offending were revealed, after controlling for age, past violent offending, and follow-up time. These relations were almost entirely dissimilar across the ethnic groups, even to the extent of finding opposite relations for boys in different ethnic groups.ConclusionsThe small number of relations and their small effect sizes suggest little likelihood that screening for mental health problems in boys who are detained in the Netherlands offers any potential for identifying youth at risk for committing future violent crimes. The current findings also suggest that ethnic differences in the relation between mental health problems and future criminality must be considered in future studies.

Diagnostic performance and optimal cut-off scores of the Massachusetts youth screening instrument-second version in a sample of Swiss youths in welfare and juvenile justice institutions

BackgroundThere is a growing consensus about the importance of mental health screening of youths in welfare and juvenile justice institutions. The Massachusetts Youth Screening Instrument-second version (MAYSI-2) was specifically designed, normed and validated to assist juvenile justice facilities in the United States of America (USA), in identifying youths with potential emotional or behavioral problems. However, it is not known if the USA norm-based cut-off scores can be used in Switzerland. Therefore, the primary purpose of the current study was to estimate the diagnostic performance and optimal cut-off scores of the MAYSI-2 in a sample of Swiss youths in welfare and juvenile justice institutions. As the sample was drawn from the French-, German- and Italian-speaking parts of Switzerland, the three languages were represented in the total sample of the current study and consequently we could estimate the diagnostic performance and the optimal cut-off scores of the MAYSI-2 for the language regions separately. The other main purpose of the current study was to identify potential gender differences in the diagnostic performance and optimal cut-off scores.MethodsParticipants were 297 boys and 149 girls (mean age = 16.2, SD = 2.5) recruited from 64 youth welfare and juvenile justice institutions (drawn from the French-, German- and Italian-speaking parts of Switzerland). The MAYSI-2 was used to screen for mental health or behavioral problems that could require further evaluation. Psychiatric classification was based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children, Present and Lifetime version (K-SADS-PL). The MAYSI-2 scores were submitted into Receiver-Operating Characteristic (ROC) analyses to estimate the diagnostic performance and optimal ‘caution’ cut-off scores of the MAYSI-2.ResultsThe ROC analyses revealed that nearly all homotypic mappings of MAYSI-2 scales onto (cluster of) psychiatric disorders revealed above chance level accuracy. The optimal ‘caution’ cut-off scores derived from the ROC curve for predicting (cluster of) psychiatric disorders were, for several MAYSI-2 scales, comparable to the USA norm-based ‘caution’ cut-off scores. For some MAYSI-2 scales, however, higher optimal ‘caution’ cut-off scores were found.ConclusionsWith adjusted optimal ‘caution’ cut-off scores, the MAYSI-2 screens potential emotional or behavioral problems well in a sample of Swiss youths in welfare and juvenile justice institutions. However, as for choosing the optimal ‘caution’ cut off score for the MAYSI-2, both language as well as gender seems to be of importance. The results of this study point to a compelling need to test the diagnostic performance and optimal ‘caution’ cut-off scores of the MAYSI-2 more elaborately in larger differentiated language samples in Europe.

Relationship between Massachusetts Youth Screening Instrument-second version and psychiatric disorders in youths in welfare and juvenile justice institutions in Switzerland.

BackgroundThere is growing evidence that it is important to have well-standardized procedures for identifying the mental health needs of youths in welfare and juvenile justice institutions. One of the most widely used tools for mental health screening in the juvenile justice system is the Massachusetts Youth Screening Instrument-second version (MAYSI-2). To contribute to the body of research examining the utility of the MAYSI-2 as a mental health screening tool; the first objective of the current study was to examine the relationship between the MAYSI-2 and the Schedule for Affective Disorders and Schizophrenia for School-Age Children, Present and Lifetime version (K-SADS-PL) in a sample of Swiss youths in welfare and juvenile justice institutions using a cross-sectional design. Secondly, as the sample was drawn from the French-, German- and Italian-speaking parts of Switzerland, the three languages were represented in the total sample and consequently differences between the language regions were analyzed as well. The third objective was to examine gender differences in this relationship.MethodsParticipants were 297 boys and 149 girls (mean age = 16.2, SD = 2.5) recruited from 64 youth welfare and juvenile justice institutions in Switzerland. The MAYSI-2 was used to screen for mental health or behavioral problems that could require further evaluation. Psychiatric classification was based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children, Present and Lifetime version (K-SADS-PL). Binomial logistic regression analysis was used to predict (cluster of) psychiatric disorders from MAYSI-2 scales.ResultsThe regression analyses revealed that the MAYSI-2 scales generally related well to their corresponding homotypic (cluster of) psychiatric disorders. For example, the alcohol/drug use scale identified the presence of any substance use disorder and the suicide ideation scale identified youths reporting suicide ideation or suicide attempts. Several MAYSI-2 scales were also related to heterotypic (cluster of) psychiatric disorders. For example, the MAYSI-2 scale alcohol/drug use, was positively related to any disruptive disorder. Furthermore, the results revealed gender differences in the relationship between the MAYSI-2 and K-SADS-PL (e.g., in the boys’ subsample no MAYSI-2 scale was significantly related to any affective disorder; whereas, in the girls’ subsample the MAYSI-2 scales depressed-anxious and somatic complaints were significantly related to any affective disorder).ConclusionsOverall, The MAYSI-2 seems to serve well as a first-stage screen to identify service needs for youths in welfare and juvenile justice institutions in Switzerland. Its effectiveness to identify the presence of (cluster of) psychiatric disorders differs between genders.

Examination of the importance of age of onset, callous-unemotional traits and anger dysregulation in youths with antisocial behaviors.

Age of onset, callous-unemotional (CU) traits and anger dysregulation have separately been proposed as relevant factors in explaining the heterogeneity of antisocial behaviour (ASB). Taking a dimensional perspective, this study examined the specific contributions and the mutual influences (i.e., interactions) of these three characteristics on specific dimensions of ASB (i.e., criminal behaviours and externalizing symptoms). Assessments were conducted on 536 youths from institutions with the youth psychopathic traits inventory (CU traits), the Massachusetts youth screening instrument-second version (anger dysregulation), the criminology questionnaire (criminal behaviours) and the child behavior checklist (externalizing symptoms), rated by both the youths and their carers. Using Bayes as estimators, the results revealed that the number and frequency of crimes (and, more specifically, damage to property, property offenses and media crimes) were explained by a specific contribution of each factor (age of onset, CU traits and anger dysregulation). Additionally, the interactions between age of onset and CU traits or anger dysregulation were relevant predictors of some types of crimes (i.e., damage to property, property offences and media crimes). Furthermore, when rated by youths, externalizing symptoms were explained by CU traits and anger dysregulation. However, when rated by the carer, anger dysregulation was more important in explaining externalizing symptoms. This study highlights the importance of considering these factors altogether and the value of using a dimensional perspective when examining the structure of ASB in youths. Consequently, future classifications should take into account the mutual account of these characteristics, which were previously studied separately.

Massachusetts Youth Screening Instrument for mental health needs of youths in residential welfare/justice institutions: identifying gender differences across countries and settings

This study examines the use of the Massachusetts Youth Screening Instrument-Second Version (MAYSI-2) for mental health needs among 1643 youngsters in residential welfare/justice institutions in Europe and the USA, identifying gender differences across countries and settings. Overall, the MAYSI-2 appeared to be a reliable instrument among these youngsters, with only some scales falling (slightly) below the threshold of acceptable internal consistency. Girls (vs. boys) in Belgian/USA justice institutions and Swiss mixed welfare/justice institutions displayed higher scores for the angry–irritable, depressed–anxious, somatic complaints, suicide ideation scales. Also, detained girls from Belgium and Switzerland reported higher scores for traumatic experiences. No gender differences were revealed among adolescents in German welfare institutions. Our findings suggest that the MAYSI-2 may serve as a useful mental health screening instrument among youngsters in welfare/justice institutions and that girls in justice institutions and mixed welfare/justice institutions form a particularly vulnerable population with regard to mental health problems.

Standardized Screening for Mental Health Needs of Detained Youths from Various Ethnic Origins: The Dutch Massachusetts Youth Screening Instrument-Second Version (MAYSI-2).

In the U.S., the Massachusetts Youth Screening Instrument-Second Version (MAYSI-2) has been shown to be a reliable and valid tool to identify youth with mental health needs upon entry in detention facilities. The present study examined the factor structure, internal consistency, and convergent validity of the Dutch MAYSI-2 administered as part of routine clinical assessments in up to 955 detained male adolescents. Standardized mental health screening questionnaires (Youth Self-Report and Strengths and Difficulties Questionnaire) were used to test the convergent validity of the Dutch MAYSI-2. Confirmatory factor analyses showed that the factor structure of the original MAYSI-2 could be replicated with the Dutch MAYSI-2. Internal consistency indices showed that the Dutch MAYSI-2 provides a reliable screening of mental health needs. In addition, the Dutch MAYSI-2 scales were related with conceptually parallel measures of the same targeted mental health needs in the total group. With a few exceptions, the internal consistency and convergent validity was supported across ethnic groups as well. Overall, these results suggest the psychometric properties of the Dutch MAYSI-2 to be promising. Implications and limitations of the current study’s findings and directions for future research are discussed.

Jeugddelinquentie en psychische klachten

Youth delinquents and mental complaints: A study with the revised Massachusetts Youth Screening Instrument (MAYSI-2) with Flemish juvenile boys International research indicates that psychopathology is more common in juvenile delinquents compared to the general population. Research in Belgium is scarce. We screened for mental problems with the Massachusetts Youth Screening Instrument-Second Version (MAISY) in 67 juvenile male delinquents and 96 regular school going boys. The results showed that juvenile delinquents scored significantly higher than school going youth on all the MAYSI-2 scales with exception of the somatic complaints scale. In four of the six scales (Alcohol/Drug Use, Angry/Irritable, Depressed/Anxious and Suicide Ideation) the juvenile delinquents scored more often in the ‘caution zone’ that requires clinical attention. The results indicate that psychopathology prevalence is significantly elevated in Belgian juvenile delinquents compared to school going youth. Instruments such as the MAYSI-2 can be useful to screen for mental problems and timely initiation of treatment.

Suicidality, Psychopathology, and Gender in Incarcerated Adolescents in Austria

Delinquent juveniles are at extreme risk for suicide with death rates 4 times higher than in the general population. Whereas psychopathologic risk factors for suicidal behavior in nonforensic adolescent populations are well defined, psychopathologies associated with suicidality in delinquent juveniles are not yet clear. The objective of this study was to determine gender-specific psychopathologic profiles associated with suicidality in detained juveniles. The Massachusetts Youth Screening Instrument-Second Version, the Youth Self-Report, and the Mini-International Neuropsychiatric Interview for children and adolescents were used to investigate juveniles in an Austrian pre-trial detention facility. The study sample consisted of all juveniles entering the system between March 2003 and January 2005. Of the 370 eligible participants, 319 completed the study (53 girls and 266 boys; age range, 14 to 21 years; mean = 16.67, SD = 1.45 years). We found significantly higher prevalence rates of both current (p < .01) and lifetime (p < .001) suicidality in girls than in boys. Suicidal boys exhibited more psychopathology and a wider range of psychopathology compared to nonsuicidal boys. For suicidal girls, psychopathologies appeared more circumscribed (all relevant p values < .04). Using signal detection methods, major depressive disorder, attention-deficit/hyperactivity disorder, and social phobia identified boys at highest risk of suicidality, while a diagnosis of posttraumatic stress disorder identified girls at highest risk. Suicidality levels are high in delinquent adolescents, especially in girls. Psychopathologic risk factors seem to be gender specific in this population. Not only depression, but also psychopathologies that usually do not arouse strong suspicion for an association with suicidal behavior, i.e., social phobia and ADHD in boys and PTSD in girls, might increase suicide risk. Further research in other countries is needed to replicate our results with respect to sociocultural influences.

Teaching adolescents and adults about adjudicative proceedings: A comparison of pre- and post-teaching scores on the MacCAT-CA.

The current study investigated whether teaching was associated with improved legal understanding among adolescents and adults. Participants included 927 youth and 466 young adults, who completed the MacArthur Competence Assessment Tool-Criminal Adjudication, the Massachusetts Youth Screening Instrument-Second Version, and the Wechsler Abbreviated Scale of Intelligence. Adolescents aged 13 and younger were less likely than older individuals to improve with teaching. IQ score was positively associated with improvements following teaching, and individuals from ethnic minority groups showed greater improvements following teaching than non-Hispanic Caucasians. The implications of these findings are discussed.

A Rasch Differential Item Functioning Analysis of the Massachusetts Youth Screening Instrument

The juvenile justice system needs a tool that can identify and assess mental health problems among youths quickly with validity and reliability. The goal of this article is to evaluate the racial/ethnic and gender differential item functioning (DIF) of the Massachusetts Youth Screening Instrument-Second Version (MAYSI-2) using the Rasch Model. Data are presented from 3,906 assessments of male and female juvenile offenders between 13 and 17 years of age who are incarcerated in the California Youth Authority. DIF is identified in some items, raising concerns about the Suicide Ideation subscale as well as the Traumatic Experiences subscale that may require some further examination and revision.

Paper and Voice MAYSI-2

The authors examine the comparability of paper and voice formats of the Massachusetts Youth Screening Instrument-Second Version (MAYSI-2) as well as each format's concordance with the Voice Diagnostic Interview Schedule for Children (DISC) among adjudicated youth. Comparability is assessed among 248 youths admitted to a South Carolina Assessment Center. Mean scores and alpha coefficients are calculated, and area under the curve and positive and negative predictive values are used to compare concordance to the DISC. Paper and voice formats are significantly correlated, have similar alpha coefficients, and have comparable concordance with the DISC, suggesting that the MAYSI-2 paper and voice formats are comparable instruments. The voice format may be preferable to the paper format for screening justice youth for mental health problems because it may reduce incomplete data and increase reporting of stigmatized behaviors and because of its ability to automatically generate scored reports and aggregate data.

Screening for Emergent Risk and Service Needs Among Incarcerated Youth: Comparing MAYSI-2 and Voice DISC-IV

To examine associations between the Massachusetts Youth Screening Instrument-Second Version (MAYSI-2) and Diagnostic Interview Schedule for Children-Present State Voice Version (DISC-IV) and the extent to which they overlap in identifying youths with mental health concerns. Among 325 New Jersey and South Carolina correctional youths, associations were examined using receiver operating characteristic analyses and logistic regression (binomial and multinomial). MAYSI-2 subscales generally mapped best onto homotypic DISC-IV disorders; however, many subscales mapped almost as well onto heterotypic disorders. Alcohol/Drug Use and Suicide Ideation, respectively, identified youths reporting substance disorder and recent attempt; other subscales did not identify parallel DISC-IV disorders as well. MAYSI-2 identifies some DISC-IV disorders better than others. Lack of overlap may result from MAYSI-2's combining diagnostic constructs into single subscales. Substantial percentages of disordered youths were not identified by corresponding subscales. In systems with multiple avenues of referral, the MAYSI-2 is a useful intake screen, but its utility as the sole means for identifying diagnoses for treatment purposes is limited. The authors differentiate between screening for emergent risk and service needs, recommending best practices for a comprehensive approach to mental health assessment among justice youth.

Massachusetts Youth Screening Instrument for Mental Health Needs of Juvenile Justice Youths

This report describes the development of the Massachusetts Youth Screening Instrument-Second Version (MAYSI-2), a brief screening measure to identify youths with potential mental, emotional, or behavioral problems at entry points in the juvenile justice system. This 52-item self-report measure, with content relevant to common mental health problems in delinquent populations, was administered to 1,279 male and female youths, aged 12 to 17, in Massachusetts juvenile justice facilities. A subsample of youths also received the Millon Adolescent Clinical Inventory (MACI) and the Youth Self-Report (YSR). The instrument was subsequently administered to 3,804 male and female youths in California Youth Authority custody. Factor analyses of the 52 items identified seven scales that were conceptually associated with various mental, emotional, and behavioral problems of youths, which were generally confirmed by separate factor analyses with the California sample. The scales manifested adequate internal consistency and test-retest reliability. Most scales were substantially correlated with conceptually similar scales in the MACI and YSR, and they identified most youths who scored at clinically significant levels on those instruments. The MAYSI-2 shows promise as a reliable and valid screening tool to assist juvenile justice staff in identifying youths who may need an immediate response to mental or emotional problems.