Are Children Who Steal Different Those Who Are Aggressive?
from
Elizabeth Heath, MB, BS Robert Kosky, BSc, MD Adelaide Children's Hospital, South Australia
Data on 2181 children referred to a child psychiatry service were analyzed to determine if there were specific correlates for aggressive behavior and for stealing behavior. Compared with stealers, aggressive children tended to be younger and more immature males, and to come from stressed families with a history of mental illness. These findings support the notion that there are biological and reactive components to aggression.
ABSTRACT:
KEY WORDS: Antisocial; children; development; families.
Stealing and aggression are part of the collection of behaviors exhibited by some children which may be known to clinicians as antisocial conduct disorders and to the justice system as juvenile delinquency. It is generally assumed that they can lead to a potential life of crime. It is common to treat children who steal and children who are aggressive as though the nature of their disordered behavior is similar. For instance, non-aggressive stealers are found in juvenile prisons alongside residents who are violent and assaultive. They undertake the same punishment and rehabilitation regimes. They are, together, commonly referred to as "young offenders". Received March 13, 1992; For Revision April 8, 1992; Accepted May 14, 1992. We would like to acknowledge the assistance of Sven Silburn, M.Sc., from the Selby Clinic Child and Adolescent Psychiatric Services, West Australia, and Dr. Stephen Zubrick, Ph.D., from the Neurosciences Unit, Psychiatric Services Branch, West Australia, in the statistical analysis of this study. The study was supported by a grant from the Research Board, Royal Australian & New Zealand College of Psychiatrists. Reprint requests should be sent to Professor R. Kosky, Department of Psychiatry, Adelaide Children's Hospital, North Adelaide, South Australia. 5006. AUSTRALIA. Child Psychiatry and Human Development, Vol. 23(1), Fall 1992
9 1992HumanSciencesPress, Inc.
9
10
Child Psychiatry and Human Development
The problem of juvenile delinquency has led to considerable argument between psychiatrists, psychologists, sociologists and criminologists. Possible risk factors and various causal theories have been researched and debated. However, at present, there is no aetiological basis for our understanding of these behaviors and our attempts to classify them are confused and incomplete1'2. Clearly, delinquents are an heterogeneous population but there have been few attempts to divide them into smaller, more homogenous subgroups. Aggressive behavior has been most fully researched. The outcome for childhood aggressive behavior may be more benign than was originally thought and it seems that a proportion of aggressive children grow out of their disordered behavior by adulthood~'4. Stealing in childhood has received little research attention 4, despite evidence that it is a more robust predictor of future delinquency than aggression5 and the fact that stealing makes up 80% of all juvenile crime6,7. Some association between stealing and symptoms of depression have been noted in adults s,9, although in other areas of antisocial behavior, a relationship between symptoms of psychiatric disorder and offending has not been shown except in a nonspecific way TM. Although a number of authors have suggested that associations between emotional disorders and delinquency could exist in children and adolescents ,.3-7.H_~7,links between emotional disorders and stealing or aggression are not usually considered in the juvenile justice system, and a child's referral from courts for a psychiatric assessment and treatment is usually uncommon and relatively abitrary '8'19. In this study we investigated the rate of emotional symptoms among children who were stealers and those who were aggressive. The discovery of significant levels of emotional disorder may have implications for the management of delinquents. Our study also considers whether stealing in children and aggressive behaviors are distinct entities and whether they derive from distinct psychosocial circumstances. Following a review of the modern scientific literature on juvenile delinquency, Rutter & Geller ~ concluded that there were "only slender pointers to the possibility that aggressive disorders may constitute a syndrome or dimension of behavior that is relatively separate from stealing and related delinquent activities". However, if a distinction between stealing and aggression, as syndromes, were to prove valid, then more specific prevention and treatment programs could be designed for each problem behavior.
Elizabeth Heath and Robert Kosky
11
Method
In this retrospective study, we examined clinical data which had been previously collected on 2181 consecutive new referrals to the metropolitan child and adolescent psychiatry outpatient clinics provided by the Health Department in Perth, Western Australia, between 1981 and 1985. Predominantly the referrals were from parents, general practitioners and teachers with only 3% being direct referrals from the community welfare system and only 1% directly referred from the juvenile justice system. Demographic and family characteristics on patients and their families were collected by interviewing social workers and symptom check lists were collected by child psychiatrists at the time of initial psychiatric interviews. The data were recorded in a computer-based register. The data forms were based on those used at the Bethlem Royal and Maudsley Hospitals 2~ The methods of data collection have been described in detail elsewhere TM. The symptom check list used had an item for stealing. This was defined as "persistently taking items, not belonging to one, during the 12 months prior to the interview". There was also an item for aggressive behavior. This was defined as "fighting, bullying, aggressive behavior persistently during the 12 months prior to the interview". Cases which had a positive score on the symptom list for these items (either definitely present or minimally present) were identified and combined into a single positive score. Although no reliability studies were undertaken, it had been shown with other symptoms that combining 'minimally' and 'definitely' present categories did not significantly alter the results 2'. Nevertheless, the amount of 'variance' in our data attributable to this decision remains unestimated. Two hundred and one (9.2%) of the sample were stealers only, 436 (20%) were aggressors only, 236 (10.8%) were mixed and 1308 (60%) neither stole nor were aggressive. Data on these cases for the total group, and for specific age sub-groups shown in figure 1, were retrieved and analyzed using the Statistical Package for the Social Sciences 22. This analysis reported here was between the two groups "stealing only" and "aggression only", since a preliminary review suggested that the results in the "mixed" group simply reflected levels found in one or other of the single groups. The items were individually analyzed by Chi square tests. Bonferroni corrections of alpha for multiple inferences were used 23. Social class was recorded on a modified version of the scale proposed by Congalton as reported in a previous study 18. Results
Age and Sex Distribution F i g u r e I shows t h e a g e d i s t r i b u t i o n of s y m p t o m s of s t e a l i n g a n d a g g r e s s i o n a m o n g t h e clinical s a m p l e . T h e d i s t r i b u t i o n is q u i t e differ-
Child Psychiatry and Human Development
12
AGE DISTRIBUTION (PERCENTAGE OF AGE GROUP) 57,7%
57.2%
?o
STEALERS
I
AGGRESS
STEAL& AGGRESS
OTHERS
0-5YRS [ ] 6-11YRS ~12-15YRS
T O T A L CLINIC POPULATION n = 2181 Figure 1 Age Distribution of Symptoms of Stealing and Aggression Among the Clinical Sample ent in the three age groups. Stealing is rarely reported before age 5 years but shows increasing frequency with age. Aggression is reported early in life, reaches a peak during primary school years, and is then reported less commonly in adolescence. Males predominated in both groups. Among the general clinic sample the male/female ratio was 1.5:1.0. Among stealers it is 216 male:l.0 female; among aggressors it was 4.0 male:l.0 female (x 2 value p
from
Elizabeth Heath, MB, BS Robert Kosky, BSc, MD Adelaide Children's Hospital, South Australia
Data on 2181 children referred to a child psychiatry service were analyzed to determine if there were specific correlates for aggressive behavior and for stealing behavior. Compared with stealers, aggressive children tended to be younger and more immature males, and to come from stressed families with a history of mental illness. These findings support the notion that there are biological and reactive components to aggression.
ABSTRACT:
KEY WORDS: Antisocial; children; development; families.
Stealing and aggression are part of the collection of behaviors exhibited by some children which may be known to clinicians as antisocial conduct disorders and to the justice system as juvenile delinquency. It is generally assumed that they can lead to a potential life of crime. It is common to treat children who steal and children who are aggressive as though the nature of their disordered behavior is similar. For instance, non-aggressive stealers are found in juvenile prisons alongside residents who are violent and assaultive. They undertake the same punishment and rehabilitation regimes. They are, together, commonly referred to as "young offenders". Received March 13, 1992; For Revision April 8, 1992; Accepted May 14, 1992. We would like to acknowledge the assistance of Sven Silburn, M.Sc., from the Selby Clinic Child and Adolescent Psychiatric Services, West Australia, and Dr. Stephen Zubrick, Ph.D., from the Neurosciences Unit, Psychiatric Services Branch, West Australia, in the statistical analysis of this study. The study was supported by a grant from the Research Board, Royal Australian & New Zealand College of Psychiatrists. Reprint requests should be sent to Professor R. Kosky, Department of Psychiatry, Adelaide Children's Hospital, North Adelaide, South Australia. 5006. AUSTRALIA. Child Psychiatry and Human Development, Vol. 23(1), Fall 1992
9 1992HumanSciencesPress, Inc.
9
10
Child Psychiatry and Human Development
The problem of juvenile delinquency has led to considerable argument between psychiatrists, psychologists, sociologists and criminologists. Possible risk factors and various causal theories have been researched and debated. However, at present, there is no aetiological basis for our understanding of these behaviors and our attempts to classify them are confused and incomplete1'2. Clearly, delinquents are an heterogeneous population but there have been few attempts to divide them into smaller, more homogenous subgroups. Aggressive behavior has been most fully researched. The outcome for childhood aggressive behavior may be more benign than was originally thought and it seems that a proportion of aggressive children grow out of their disordered behavior by adulthood~'4. Stealing in childhood has received little research attention 4, despite evidence that it is a more robust predictor of future delinquency than aggression5 and the fact that stealing makes up 80% of all juvenile crime6,7. Some association between stealing and symptoms of depression have been noted in adults s,9, although in other areas of antisocial behavior, a relationship between symptoms of psychiatric disorder and offending has not been shown except in a nonspecific way TM. Although a number of authors have suggested that associations between emotional disorders and delinquency could exist in children and adolescents ,.3-7.H_~7,links between emotional disorders and stealing or aggression are not usually considered in the juvenile justice system, and a child's referral from courts for a psychiatric assessment and treatment is usually uncommon and relatively abitrary '8'19. In this study we investigated the rate of emotional symptoms among children who were stealers and those who were aggressive. The discovery of significant levels of emotional disorder may have implications for the management of delinquents. Our study also considers whether stealing in children and aggressive behaviors are distinct entities and whether they derive from distinct psychosocial circumstances. Following a review of the modern scientific literature on juvenile delinquency, Rutter & Geller ~ concluded that there were "only slender pointers to the possibility that aggressive disorders may constitute a syndrome or dimension of behavior that is relatively separate from stealing and related delinquent activities". However, if a distinction between stealing and aggression, as syndromes, were to prove valid, then more specific prevention and treatment programs could be designed for each problem behavior.
Elizabeth Heath and Robert Kosky
11
Method
In this retrospective study, we examined clinical data which had been previously collected on 2181 consecutive new referrals to the metropolitan child and adolescent psychiatry outpatient clinics provided by the Health Department in Perth, Western Australia, between 1981 and 1985. Predominantly the referrals were from parents, general practitioners and teachers with only 3% being direct referrals from the community welfare system and only 1% directly referred from the juvenile justice system. Demographic and family characteristics on patients and their families were collected by interviewing social workers and symptom check lists were collected by child psychiatrists at the time of initial psychiatric interviews. The data were recorded in a computer-based register. The data forms were based on those used at the Bethlem Royal and Maudsley Hospitals 2~ The methods of data collection have been described in detail elsewhere TM. The symptom check list used had an item for stealing. This was defined as "persistently taking items, not belonging to one, during the 12 months prior to the interview". There was also an item for aggressive behavior. This was defined as "fighting, bullying, aggressive behavior persistently during the 12 months prior to the interview". Cases which had a positive score on the symptom list for these items (either definitely present or minimally present) were identified and combined into a single positive score. Although no reliability studies were undertaken, it had been shown with other symptoms that combining 'minimally' and 'definitely' present categories did not significantly alter the results 2'. Nevertheless, the amount of 'variance' in our data attributable to this decision remains unestimated. Two hundred and one (9.2%) of the sample were stealers only, 436 (20%) were aggressors only, 236 (10.8%) were mixed and 1308 (60%) neither stole nor were aggressive. Data on these cases for the total group, and for specific age sub-groups shown in figure 1, were retrieved and analyzed using the Statistical Package for the Social Sciences 22. This analysis reported here was between the two groups "stealing only" and "aggression only", since a preliminary review suggested that the results in the "mixed" group simply reflected levels found in one or other of the single groups. The items were individually analyzed by Chi square tests. Bonferroni corrections of alpha for multiple inferences were used 23. Social class was recorded on a modified version of the scale proposed by Congalton as reported in a previous study 18. Results
Age and Sex Distribution F i g u r e I shows t h e a g e d i s t r i b u t i o n of s y m p t o m s of s t e a l i n g a n d a g g r e s s i o n a m o n g t h e clinical s a m p l e . T h e d i s t r i b u t i o n is q u i t e differ-
Child Psychiatry and Human Development
12
AGE DISTRIBUTION (PERCENTAGE OF AGE GROUP) 57,7%
57.2%
?o
STEALERS
I
AGGRESS
STEAL& AGGRESS
OTHERS
0-5YRS [ ] 6-11YRS ~12-15YRS
T O T A L CLINIC POPULATION n = 2181 Figure 1 Age Distribution of Symptoms of Stealing and Aggression Among the Clinical Sample ent in the three age groups. Stealing is rarely reported before age 5 years but shows increasing frequency with age. Aggression is reported early in life, reaches a peak during primary school years, and is then reported less commonly in adolescence. Males predominated in both groups. Among the general clinic sample the male/female ratio was 1.5:1.0. Among stealers it is 216 male:l.0 female; among aggressors it was 4.0 male:l.0 female (x 2 value p
