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Research ArticleRegular Articles

Psychiatric and Substance-Related Problems Predict Recidivism for First-Time Justice-Involved Youth

Marina Tolou-Shams, Johanna B. Folk, Evan D. Holloway, Catalina M. Ordorica, Emily F. Dauria, Kathleen Kemp and Brandon D. L. Marshall
Journal of the American Academy of Psychiatry and the Law Online March 2023, 51 (1) 35-46; DOI: https://doi.org/10.29158/JAAPL.220028-21
Marina Tolou-Shams
Dr. Tolou-Shams is Professor, Dr. Folk is Assistant Professor, Dr. Holloway is Postdoctoral Fellow, and Ms. Ordorica is Clinical Research Coordinator, University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, San Francisco, CA. Dr. Dauria is Assistant Professor at University of Pittsburgh, Department of Behavioral and Community Health Sciences, Pittsburgh, PA. Dr. Kemp is Assistant Professor at The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI. Dr. Marshall is Associate Professor at Brown University School of Public Health, Department of Epidemiology, Providence, RI.
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Johanna B. Folk
Dr. Tolou-Shams is Professor, Dr. Folk is Assistant Professor, Dr. Holloway is Postdoctoral Fellow, and Ms. Ordorica is Clinical Research Coordinator, University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, San Francisco, CA. Dr. Dauria is Assistant Professor at University of Pittsburgh, Department of Behavioral and Community Health Sciences, Pittsburgh, PA. Dr. Kemp is Assistant Professor at The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI. Dr. Marshall is Associate Professor at Brown University School of Public Health, Department of Epidemiology, Providence, RI.
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Evan D. Holloway
Dr. Tolou-Shams is Professor, Dr. Folk is Assistant Professor, Dr. Holloway is Postdoctoral Fellow, and Ms. Ordorica is Clinical Research Coordinator, University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, San Francisco, CA. Dr. Dauria is Assistant Professor at University of Pittsburgh, Department of Behavioral and Community Health Sciences, Pittsburgh, PA. Dr. Kemp is Assistant Professor at The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI. Dr. Marshall is Associate Professor at Brown University School of Public Health, Department of Epidemiology, Providence, RI.
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Catalina M. Ordorica
Dr. Tolou-Shams is Professor, Dr. Folk is Assistant Professor, Dr. Holloway is Postdoctoral Fellow, and Ms. Ordorica is Clinical Research Coordinator, University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, San Francisco, CA. Dr. Dauria is Assistant Professor at University of Pittsburgh, Department of Behavioral and Community Health Sciences, Pittsburgh, PA. Dr. Kemp is Assistant Professor at The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI. Dr. Marshall is Associate Professor at Brown University School of Public Health, Department of Epidemiology, Providence, RI.
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Emily F. Dauria
Dr. Tolou-Shams is Professor, Dr. Folk is Assistant Professor, Dr. Holloway is Postdoctoral Fellow, and Ms. Ordorica is Clinical Research Coordinator, University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, San Francisco, CA. Dr. Dauria is Assistant Professor at University of Pittsburgh, Department of Behavioral and Community Health Sciences, Pittsburgh, PA. Dr. Kemp is Assistant Professor at The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI. Dr. Marshall is Associate Professor at Brown University School of Public Health, Department of Epidemiology, Providence, RI.
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Kathleen Kemp
Dr. Tolou-Shams is Professor, Dr. Folk is Assistant Professor, Dr. Holloway is Postdoctoral Fellow, and Ms. Ordorica is Clinical Research Coordinator, University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, San Francisco, CA. Dr. Dauria is Assistant Professor at University of Pittsburgh, Department of Behavioral and Community Health Sciences, Pittsburgh, PA. Dr. Kemp is Assistant Professor at The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI. Dr. Marshall is Associate Professor at Brown University School of Public Health, Department of Epidemiology, Providence, RI.
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Brandon D. L. Marshall
Dr. Tolou-Shams is Professor, Dr. Folk is Assistant Professor, Dr. Holloway is Postdoctoral Fellow, and Ms. Ordorica is Clinical Research Coordinator, University of California, San Francisco, Department of Psychiatry and Behavioral Sciences, San Francisco, CA. Dr. Dauria is Assistant Professor at University of Pittsburgh, Department of Behavioral and Community Health Sciences, Pittsburgh, PA. Dr. Kemp is Assistant Professor at The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI. Dr. Marshall is Associate Professor at Brown University School of Public Health, Department of Epidemiology, Providence, RI.
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    Figure 1.

    Distribution of number of new charges during two-year follow-up period.

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    Figure 2.

    Interaction between psychiatric symptoms and alcohol related problems.

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    Table 1

    Descriptive Statistics of the Total Sample and Stratified by Recidivism Status

    VariableTotal Sample (N = 361) M(SD)/%Youth Who Recidivated (n = 129) M(SD)/(%)Youth Who Did Not Recidivate (n = 232) M(SD)/(%)
    Demographic Factors
        Sex (Male)56.0%60.5%53.4%
        Age14.57 (1.54)14.49 (1.55)14.62 (1.54)
        Race/Ethnicity
        White non-Latinx33.0%28.7%35.3%
        Black non-Latinx11.4%10.9%11.6%
        Other non-Latinx7.8%6.2%8.6%
        Multi-racial non-Latinx6.9%8.5%6.0%
        Latinx41.0%45.7%38.4%
        Out-of-home placement10.2%12.4%9.1%
    Legal Factors
        Offense Type (Delinquent)51.0%63.6%44.0%
    Psychiatric Factors
        Inpatient Hospitalization12.7%14.0%12.1%
        Internalizing Problems (Clinical)14.1%13.2%21.2%
        Externalizing Problems (Clinical)18.3%26.4%19.8%
    Substance Use Factors
        Alcohol-Related Problems0.89 (2.39)1.16 (2.79)0.75 (2.13)
        Cannabis-Related Problems1.24 (2.58)1.64 (3.23)1.02 (2.12)
    • View popup
    Table 2

    Results of Stepwise Regression Models Predicting Recidivism

    Model 1Model 2Model 3Model 4
    B (SE)95% CIX2B (SE)95% CIX2B (SE)95% CIX2B (SE)95% CIX2
    Demographic Factors
        Sex (Male)−0.46 (0.24)−0.92, 0.013.71†−0.39 (0.23)−0.84, 0.062.89†−0.29 (0.23)−0.74, 0.161.61−0.48 (0.23)−0.93, -0.034.44*
        Age−0.12 (0.08)−0.27, 0.022.67−0.17 (0.74)−0.31, -0.025.22*−0.13 (0.07)−0.28, 0.013.16†−0.22 (0.07)−0.36, -0.078.47**
        Race/Ethnicitya
        Black non-Latinx0.82 (0.38)0.08, 1.564.70*0.68 (0.37)−0.05, 1.403.35†0.72 (0.36)0.01, 1.433.93*0.96 (0.37)0.24, 1.686.82**
        Other non-Latinx−0.46 (0.48)−1.40, 0.490.90−0.53 (0.48)−1.47, 0.401.25−0.46 (0.47)−1.38, 0.460.97−0.08 (0.47)−1.01, 0.840.03
        Multi-racial non-Latinx0.54 (0.45)−0.33, 1.421.490.76 (0.44)−0.09, 1.623.06†0.78 (0.43)−0.07, 1.623.27†1.12 (0.43)0.29, 1.966.94**
        Latinx0.50 (0.26)−0.00, 1.013.83*0.30 (0.26)−0.21, 0.811.340.33 (0.26)−0.17, 0.831.680.63 (0.26)0.12, 1.135.96*
        Out-of-home placement0.53 (0.35)−0.15, 1.202.320.35 (0.34)−0.32, 1.021.050.29 (0.34)−0.37, 0.950.740.37 (0.32)−0.27, 1.001.26
    Legal Factors
        Offense Type (Delinquent)–––0.84 (0.23)0.38, 1.3012.87***0.67 (0.24)0.20, 1.137.91**0.81 (0.23)0.35, 1.2711.99**
    Psychiatric Factors
        Inpatient Hospitalization––––––0.10 (0.33)−0.55, 0.740.090.17 (0.32)−0.46, 0.790.27
        Internalizing Problems––––––−0.78 (0.35)−1.47, -0.094.91*−0.75 (0.35)−1.44, -0.064.54*
        Externalizing Problems––––––0.54 (0.26)0.03, 1.064.25*0.54 (0.26)0.03, 1.054.37*
    Substance Use Factors
        Alcohol-Related Problems–––––––––1.17 (0.39)0.42, 1.939.29**
        Cannabis-Related Problems–––––––––0.43 (0.36)−0.28, 1.141.43
    Model Fit
        Deviance275.25277.34280.96280.01
        Pearson X2382.30454.52477.70323.71
        df352351348346
    • Note.

    • ↵† p < .10;

    • ↵* p < .05;

    • ↵** p < .01;

    • ↵*** p < .001;

    • ↵a Reference group=White, non-Latinx.

    • View popup
    Table 3

    Results of Interaction Models Examining the Effects of Co-Occurring Mental Health and Substance Use Factors on Recidivism

    Model 1Model 2Model 3Model 4
    B (SE)95% CIX2B (SE)95% CIX2B (SE)95% CIX2B (SE)95% CIX2
    Demographic Factors
        Sex (Male)−0.45 (0.18)−0.79, -0.106.24*−0.43 (0.18)−0.78, -0.085.79*−0.44 (0.18)−0.79, -0.096.08*−0.44 (0.18)−0.78, -0.096.04*
        Age−0.21 (0.06)−0.32, -0.0912.52***−0.22 (0.06)−0.34, -0.1114.11***−0.21 (0.06)−0.33, -0.1012.88***−0.21 (0.06)−0.33, -0.1013.04***
        Race/Ethnicitya
        Black, non-Latinx0.95 (0.28)0.40, 1.5011.32***0.93 (0.28)0.38, 1.4810.81**0.93 (0.28)0.38, 1.4811.05***0.93 (0.28)0.38, 1.4810.81**
        Other, non-Latinx−0.09 (0.39)−0.86, 0.690.47−0.10 (0.39)−0.87, 0.680.06−0.12 (0.39)−0.89, 0.650.09−0.12 (0.39)−0.90, 0.650.10
        Multi-racial, non-Latinx1.09 (0.33)0.44, 1.7410.84**1.05 (0.33)0.40, 1.7010.11**1.05 (0.33)0.40, 1.7010.10**1.05 (0.33)0.40, 1.6910.09**
        Latinx0.67 (0.20)0.27, 1.0710.68**0.66 (0.20)0.26, 1.0610.59**0.64 (0.20)0.24, 1.049.90**0.63 (0.20)0.24, 1.039.80**
        Out-of-home placement0.39 (0.25)−0.09, 0.872.490.39 (0.25)−0.09, 0.872.510.39 (0.25)−0.09, 0.872.530.39 (0.25)−0.09, 0.872.53
    Legal Factors
        Offense Type (Delinquent)0.77 (0.18)0.41, 1.1317.93***0.79 (0.18)0.43, 1.1518.61***0.76 (0.18)0.40, 1.1117.43***0.75 (0.18)0.40, 1.1117.14***
    Psychiatric Factors
        Inpatient Hospitalization0.23 (0.24)−0.24, 0.710.920.20 (0.24)−0.28, 0.680.650.22 (0.24)−0.26, 0.700.820.22 (0.24)−0.26, 0.700.78
        Internalizing Problems−0.78 (0.29)−1.35, 0.217.25**−0.88 (0.29)−1.45, -0.319.07**−0.85 (0.30)−1.43, -0.278.17**−0.88 (0.29)−1.45, -0.319.05**
        Externalizing Problems0.54 (0.20)0.16, 0.937.74**0.56 (0.19)0.18, 0.948.34**0.55 (0.19)0.17, 0.938.02**0.56 (0.20)0.17, 0.958.07**
    Substance Use Factors
        Alcohol-Related Problems1.27 (0.32)0.65, 1.9016.02***1.40 (0.33)0.75, 2.0617.58***1.12 (0.31)0.52, 1.7213.48***1.10 (0.31)0.50, 1.7012.98***
        Cannabis-Related Problems0.46 (0.29)−0.10, 1.022.580.40 (0.29)−0.17, 0.961.910.44 (0.29)−0.14, 1.022.250.45 (0.32)−0.17, 1.082.03
    Interaction Terms
        Internalizing × Alcohol−1.50 (0.81)−3.09, 0.093.40†–––––––––
        Externalizing × Alcohol–––−1.29 (0.59)−2.45, -0.124.70*––––––
        Internalizing × Cannabis––––––−0.23 (0.76)−1.73, 1.260.09–––
        Externalizing × Cannabis–––––––––−0.14 (0.58)−1.29, 1.000.06
    Model Fit
        Deviance400.63399.78404.30404.33
        Pearson X2494.88494.85520.67520.76
        df346346346346
    • Note.

    • ↵† p < .10;

    • ↵* p < .05;

    • ↵** p < .01;

    • ↵*** p < .001;

    • ↵a Reference group=White, non-Latinx.

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Journal of the American Academy of Psychiatry and the Law Online: 51 (1)
Journal of the American Academy of Psychiatry and the Law Online
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1 Mar 2023
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Psychiatric and Substance-Related Problems Predict Recidivism for First-Time Justice-Involved Youth
Marina Tolou-Shams, Johanna B. Folk, Evan D. Holloway, Catalina M. Ordorica, Emily F. Dauria, Kathleen Kemp, Brandon D. L. Marshall
Journal of the American Academy of Psychiatry and the Law Online Mar 2023, 51 (1) 35-46; DOI: 10.29158/JAAPL.220028-21

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Psychiatric and Substance-Related Problems Predict Recidivism for First-Time Justice-Involved Youth
Marina Tolou-Shams, Johanna B. Folk, Evan D. Holloway, Catalina M. Ordorica, Emily F. Dauria, Kathleen Kemp, Brandon D. L. Marshall
Journal of the American Academy of Psychiatry and the Law Online Mar 2023, 51 (1) 35-46; DOI: 10.29158/JAAPL.220028-21
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  • juvenile justice
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