Mental health, aggression, suicidal ideation and substance use among institutionalised children


Original Article 

Mental health, aggression, suicidal ideation and substance use among institutionalised children 

Abhishek Banga,1 G.S. Kaloiya,2 Vikas Sharma3 

1Ph.D. Scholar, Faculty of Behavioural Sciences, SGT University, Gurugram 

2Professor of Clinical Psychology, NDDTC, AIIMS, New Delhi 

3Associate Professor and Head, Department of Clinical Psychology, SGT University Address for Correspondence: Email: gkaloiya@aiims.edu 


ABSTRACT 

Objective: The framework of Juvenile Justice Act (Care and Protection of Children), 2015, provides a set of guidelines to prevent further chances of recidivism by opting rehabilitative approach (care and protection of juveniles) rather than relying on punitive approaches being followed by judicial systems among children in conflict with law. In purview of this, institutionalisation has is recommended as the last step in the direction of  rehabilitation and  reintegration of these individuals.  Method: The present study explored the patterns and relationships between mental health issues, aggression, suicidal ideation, and substance use among Children in Conflict with the Law (CCL) from a Delhi-based detention centre. Results: Findings of the current study suggest that CCLs older in age are more likely to be accused of committing heinous offences. It was also found that towards the presence of severe mental health problems, such as depression and anxiety, being prevalent among CCLs accused of heinous offences in comparison to CCLs accused of serious offences. Also, higher levels of proactive and reactive aggression were observed indicating towards the presence of mental health problems. Alcohol and tobacco were widely prevalent among this sample along with cannabis, and street opioids (smack), being notably high among CCLs accused of heinous offences, suggesting a need effective psychological interventions. Conclusion: Based on the results, it is highly recommended  for  developing effective  evidence  based  targeted mental  health  and substance use interventions to meet the needs of institutionalized CCLs and further reduce the likelihood of recidivism. 

Keywords: Children  in  conflict  with  law,  juvenile,  offence,  detention,  mental health, aggression, substance use, suicidal ideation.  


INTRODUCTION 

As  per  Juvenile  Justice Act  (Care  and Protection of Children), 2015, any individual who is  found  to  be  alleged  or  accused  of  having committed an act that is considered as an offence according to  Indian  Penal Code (IPC)  or any other law in force is known as Child in Conflict with law or simply abbreviated as CCL(s) (JJ Act, 2015). This framework provides a set of guidelines  to  prevent  further  chances  of  recidivism  by  opting  rehabilitative approach (care  and  protection  of juveniles) rather  than relying on punitive approaches being followed by Judicial systems. 

Several reasons  for  delinquent  behaviour have been suggested like poor economic condi- tions, revenge, accidental incidents, and careless- ness, dissatisfaction with reality, temptation and curiosity. However, “accidental incidents” have been reported as the most  frequent reason for juvenile delinquency highlighting impulsivity and extemporaneous patterns of CCLs (Chung et al., 2020). This study suggests the need of developing effective  psychosocial interventions  to  target delinquent behaviour and chances of recidivism in children in conflict with law. 

A significant proportion of  CCLs are at greater  risk  of  developing  mental  health problems. About 70% of these individuals have atleast one diagnosable mental health problem and profound scores for problems like depression, anxiety and substance use  have been reported among rest of the population (Gisin et al., 2012). Addressing these mental health issues is of prime importance for effective rehabilitation and reinte- gration of CCLs into society. 

Another  common  problem  seen  in  such individuals is the presence of non-suicidal self- injury (NSSI) that has been found to be signifi- cantly associated with mental  health &  beha- vioural problems including depression, conduct problems and substance use disorders (SUDs) further posing a high risk of suicide (Lüdtke et al., 2018). This highlights the presence of under- lying  psychopathologies  in  institutionalised CCLs which further necessitates comprehensive psychological  assessment  and  psychosocial interventions. 

However, a lower proportion of individuals having other internalising problems apart from post-traumatic stress disorder symptoms (32% of sample) and suicidal ideation (20%) have been reported in a study. Such internalising problems stemming from the institutionalisation, maltreat- ment and conduct problems in  childhood and family risk factors  including parental conflict, absence of a father figure, lack of parental control and family substance addiction (Lemos & Faísca, 2015). 

In a study, a sample of 175 institutionalised male juveniles from Brazil was recruited for a survey study using Beck Depression & Anxiety Inventory (BDI  & BAI)  along  with short-self rating questionnaire containing questions about substance use. In findings, it was reported that about 28% of the participants showed moderate to severe score on depression and about 34.28% of the participants showed moderate to severe scores  on  anxiety.  However,  the  emo- tional distress was found to be independent of substance use among this population (da Silva et al., 2021). 

In  another  study,  institutionalised  male adolescents belong to the  age range of  14-17 years were recruited  within 48 hours of  their arrival within the detention  centre. Data  was collected  studying  anger  and  depression  at baseline of 1 month and 2 months. It was found that participants scoring higher for anger were more likely to offend within institution. Interac- tions  between  depression  and  anger  were reported. Emotional  distress  was  found to  be having a significant relationship with violent and non-violent offending (Kelly et al., 2019). 

Heirigs et al. (2019) studied the association between  psychopathy  and  suicidal  thoughts among incarcerated juveniles. Psychopathy was found  to  be  a  significant  risk  factor  for  the presence of suicidal thoughts being mediated by the presence of lifetime depressive symptoms. 

In a study, a total of 3156 adolescents were studied at a Juvenile detention centre in Ohio. Among this population, adverse life experiences (sexual abuse, homelessness, running away and substance  abuse in  family) were found  to be contributing  to  mental  health  problems  like suicidal  ideation. About  19%  of  participants reported  suicidal  ideation  and  about  11.9% attempted  suicide  during  their life time. Also, participants  experiencing  all  four  types  of adverse experiences found to be more prone to the  risk  of  attempting suicide  (Bhatta  et  al., 2014). 

In a study, Chung et al, (2020) studies the prevalence rates and relationships among ADHD, suicidal ideation, depression, anxiety, self-esteem and alcohol problems in 251 Korean participants (149  with  juvenile  delinquency and 102 from comparison group). The findings  of the study revealed  higher  levels  of  suicidal  ideation comorbid with depression, anxiety and alcohol use problems (Chung et al., 2020). 

However,  despite  of  extensive  research mental health problem of children in conflict with law,  there  seems  to  be  a  paucity  of  studies exploring relationships between mental  health problems,  aggression,  suicidal  ideation  and substance  use  particularly  among  insti- tutionalised CCLs like observation home(s)/place of safety/special home(s) setup as per model rules of JJ act 2016 (Model Rules, 2016). Such gaps provided motivation to researchers for conduct- ing this pilot study for studying interrelationships between aforementioned  variables  for making informed choices in terms of developing effective psychosocial interventions (Anwar et al., 2023; Heirigs et al., 2019). 

The aim of the current study was to investi- gate the prevalence and existence of interrelation- ships among mental health problems, aggression, suicidal ideation and substance use in children in conflict with law from a Delhi based detention centre. The objectives for this current study was to study depression, anxiety and stress in children in conflict with law from a Delhi based detention centre; aggression in children with conflict with law;  patterns  of substance  use  in  children in conflict with law and  the patterns of  suicidal ideation in children in conflict with law. 

METHODS 

This pilot study used  purposive  sampling and cross-sectional design to assess mental health problems,  anger, illicit  drug  use  and suicidal ideation  among  children  in  conflict  with  law (CCLs). 

Participants 

The participants consisted on 20 institutionalised CCLs within the age range of 15 to 26 Years. They were from a Delhi based detention centre. They were in detention for their involve- ment in petty, serious or heinous offences as per the Indian Penal Code or any other related law in force. 

Tools 

1. Depression, Anxiety  and  Stress  Scale 

(DASS-Y): It is a Psychometric tool designed to assess depression, anxiety and stress in adolescents and young adults adapted from the original DASS 42 items test. The scoring included rating of all items on 4-point Likert scale. The overall score for each subscale is calculated by summing up the scores on items and then multiplying it by 2 as per the norms developed for DASS-42 item Scale. This test demonstrated  higher  internal  consistency with Cronbach’s alpha coefficients for each subscale higher  than  0.90. The scale  has good construct validity (Szabo & Lovibond, 2022). 

2. Peer Conflict Scale (PCS) (Marsee et  al., 2004)): This is 40 item  scale based on 4- point Likert Scale to measure four dimen- sions of aggression (Reactive overt, Reactive relational, Proactive  overt and  Proactive relational aggression). Scores are obtained for each subscale by summing the relative items. PCS has demonstrated a good internal consistency   with  Cronbach’s   alpha coefficients generally exceeding 0.80 for all subscales. The scale has also shown strong construct validity.  

Procedure 

Each participant  completed the  DASS Y, PCS, SIDAS and NIDA version 2 in a single session. Most of the CCLs had a deficiency of basic reading and writing skills. To compensate for  this,  the  researcher  provided  necessary assistance to ensure the homogeneity in data. 

Data analysis 

Data analysis was carried out using Jamovi (The Jamovi  Project,  2022).  Descriptive  and inferential statistics including mean, standard deviations, frequency distributions, and correla- tions  coefficients  were  computed  to  study associations  between  mental  health problems (depression, anxiety and stress), anger, suicidal ideation and substance use. 

RESULTS 

Table 1 provides sociodemographic details 

Table 1 Descriptives (Sociodemographic variables) 


of the participants i.e. children in conflict with law categorised by type of offence: Serious and Heinous.  Mean,  standard  deviation  (SD), Variance,  skewness  and  kurtosis  have  been described for each variable. 

Age: The mean age of CCLs who were under the enquiry for committing  heinous offence is higher  (Mean  age  =18.8  years,  SD  = 1.776, Variance = 3.1544) compared to the ones under the enquiry for serious offences (Mean age = 17.33 years, SD = 0.577, Variance = 0.333). The higher standard deviation and variance in heinous group indicates higher variability in ages. Both groups showed positive skewness (right-skewed distribution). Heinous group showed  a higher kurtosis  value,  indicating  a  more  peaked distribution in comparison to CCLs under the enquiry for serious offences. 

Religion: This variable showed no variation in serious offence group (mean = 1, SD = 0, vari- ance = 0)  suggesting homogeneity. In  second group, a slight variability  has  been  observed (mean = 1.29, SD = 0.47, Variance = 0.221), with skewness close to +1 (right-skewed distri- bution). The negative kurtosis (-1.166) indicates flatter   distribution   compared   to   a   normal distribution. 

Education: The education level is slightly higher  in  serious group (mean  =  5.33, SD  = 0.577,  variance  =  0.333)  in  comparison  to heinous group (mean = 5, SD = 0.866, variance =  0.75).  The  heinous  group  showed  higher variability  in terms of SD and variance.  Both groups showed right-skewed distributions with heinous offence group showing higher kurtosis (more peaked distribution). 

Occupation of the Head of the family: No variability in the occupation of the head of the family for serious offence group (mean=2, SD = 0, variance = 0). Heinous offence group shows significant variability (mean=4.29, SD = 2.443, variance  =  5.971). Furthermore,  for  heinous group,  right-skewed  distribution  is  observed along with negative kurtosis (flatter distribution). Education  of  the  head  of  the  family: Homogeneity  has  been  observed  in  serious offence group (mean = 1, SD = 0, variance = 0). The heinous offence group (mean=2.12, SD = 1.269, variance = 1.61) showed more variability with  higher  positive  skewness  (1.833)  and kurtosis (4.736) indicating right-skewed peaked distribution. 

Total  Monthly  income  of  the  family: Serious offence group (mean = 2.33, SD = 0.577, variance = 0.333) reported a lower total monthly income  in  comparison  to  the  heinous  offence group (mean = 4.18, SD = 3.046, variance = 9.279) with higher variability in terms of SD and variance. Both group showed positive skewness while having higher peak in heinous group. 

Socioeconomic  class:  There  exists  no variability  in  socioeconomic class  of serious offence group (mean = 4, SD = 0, variance = 0). The heinous offence group (mean=3.47, SD = 0.8, variance = 0.64) had lower mean with slight variability. The negative skewness was observed (indicating left-skewed distribution) and negative kurtosis (flatter distribution). 

Table 2 

Frequencies of Education 


Table 2 presents the distribution of education levels of CCLs based on type of offence (serious or heinous). About 20% (n=4) of CCLs belonging to the group of heinous offence completed high school. A significantly higher percentage of CCLs from  heinous  offence  group  reached  middle school (11, 55%). Furthermore, a small percent- age of CCLs involved in serious offence reached upto  primary education (1, 5%). None of the CCLs involved in serious offence were illiterate, while about 10% (n=2) of those under the enquiry of heinous offence were found to be illiterate. 

Table 3 

Frequencies of Total monthly income of the family 


Table 3 summarises the frequency of total monthly income of the family categorised as per the  type  of crime. The  majority  of the  CCLs belong to the lower income families. A significant proportion of CCLs (35%) involved in heinous crimes  belong  to  the  slab  of  ¹6,175-18,496 income suggesting potential link between lower income and the severity of the offence. About 25% of the CCLs from heinous offence group belong to high income slabs (¹46,129 and above). 

Table  4  presents  levels  of  depressive symptoms (DASS-Y) among CCLs categorised as  per the type of  offence. About 10% of  the CCLs  (serious  offence)  and  25%  of  CCLs (heinous  offence)  showed  normal  depressive symptoms  on  DASS-Y.  Milder  forms  of depression were present in CCLs with serious offences and present in only 5% of those involved in heinous offences. Moderate depression levels was absent in CCLs involved in serious offences but present in 25% of those involved in heinous offences. Extremely severe depression levels were 

 

Table 4 

Frequencies of Depression Levels in CCLs 

present in only 5% of CCL involved in serious offences but 25% of CCLs involved in heinous offences  reported  extremely  severe  forms  of depression indicating a significant  proportion experiencing  problems  of  depression  and  its interlinkage with heinous offences. 

Table 5 

Frequencies of Anxiety Interpretation 

Table 5 presents the levels of anxiety levels in CCLs. Equal levels of anxiety (10% of the sample in each) were seen in both the groups. Milder forms of anxiety levels were absent in CCLs involved in serious offences and only 5% of CCLs involved in heinous offences showed milder levels of anxiety. A significant proportion of CCLs involved in heinous offences showed moderate  (15%)  and  extremely severe  levels (50%) of anxiety on DASS-Y. 

Table 6 

Frequencies of Alcohol Use 

Table 6 presents frequencies of alcohol con- sumption among CCLs in both groups. A sig- nificant proportion of CCLs involved in heinous offences reported for alcohol use on NIDA. A smaller proportion (10%) of CCLs involved in serious offences reported the use of alcohol. 

Table 7 

Frequencies of Tobacco Smoke 

Table 7  presents the tobacco  use  among CCLs  in  both  groups. About  75%  of  CCLs involved in heinous offences reported for tobacco smoking in contrast with a smaller proportion of CCL (15%) involved in serious offences. 

Table 8 

Frequencies of Tobacco Smokeless 

Table  8  presents  frequency  of  smokeless tobacco users  in  both  groups.  No  smokeless tobacco user for found among CCLs involved in serious  offences. About  15%  of  smokeless tobacco  users  were  found  among  CCLs  in heinous offences. 

Table 9 

Frequencies of Cannabis 

 

Table 9 presents the frequency of cannabis users in both groups. About 10% of cannbis users belong to the group of serious offenders and 30 % of  them  belonged  to the  group  of heinous offenders. 

Table 10 

Frequencies of Inhalant 



Table 10 presents the frequency of inhalant users in both groups. Inhalant use was absent among  serious  offenders and present in  only about 5% CCLs involved in heinous offences. 

Table 11 

Frequencies of Sleeping Pills Sedatives 

 

Table 11 presents the frequency of sleeping pill users in both groups. Use of sleeping pills was absent in serious offenders but present in heinous offenders (10%). 

Table 12 

Frequencies of Street Opioid 

 

Table 12 presents the frequency of street opioids (smack use) in both groups. Use of street opioids was absent among serious offenders but present in 20% of heinous offenders. 

Table 13 describes the scores for aggression among CCLs measured on Peer Conflict Scale aggression levels  and variability compared  to serious offences, highlighting the need for targeted interventions  to  address severe aggressive behaviours. 

Table 13 

Score for Aggression on Peer Conflict Scale  


Table 14 

Frequency distribution of Suicidal Ideation


Table 14 presents the frequency distribution of suicidal ideation on SIDAS categorised by type of offence. Suicidal ideation was absent in serious (PCS)  categorised  by the type  of offence and aggression type - Proactive overt (PO), Proactive relational (PR), Reactive Overt (RO) and Reac- tive Relational (RR). For serious offences, the mean aggression scores range from 2.00 (RR) to 8.33 (RO), with positive skewness indicating infrequent high aggression scores. Heinous offen- ces show higher mean scores, ranging from 3.65 (PO) to 7.76 (RO), with similarly positive skew- ness.  Standard  deviations  and  variances  are notably higher for Reactive Overt aggression and PCS Total scores,  indicating significant vari- ability. Overall, heinous offences show greater offenders while 4 cases (20%) involved heinous offences  were  having  suicidal  ideation. This indicates a potential link between the se- verity of offence and the presence of suicidal ideation. 

The  significant  correlations  between variables are summarized below: 

Proactive overt (PO) and Proactive relational (PR) aggression (rho = 0.843, p < .001) have strong  positive  correlation  suggesting  that individuals  showing PO  aggression are  more likely to develop PR aggression. 

Proactive Overt (PO) and Reactive Overt (RO) aggression (rho = 0.833, p < .001) have strong  positive  correlation  suggesting  that individuals  showing PO  aggression are  more likely to develop RO aggression. 

Proactive  Overt  (PO)  and  Reactive Relational (RR) aggression (rho = 0.724, p < .001) have strong positive correlation suggesting that individuals showing PO aggression are more likely to develop RR aggression. 

Proactive  Relational  (PR)  and  Reactive Overt (RO) aggression (rho = 0.828, p < .001) have strong positive correlation suggesting that individuals showing  PR aggression  are  more likely to develop RO aggression. 

Proactive  Relational  (PR)  and  Reactive Relational (RR) aggression (rho = 0.804, p < .001) have strong positive correlation suggesting that individuals showing PR aggression are more likely to develop RR aggression. 

Reactive  Overt  (RO) and Reactive  Rela- tional (RR) aggression (rho = 0.727, p < .001) have strong positive correlation suggesting that individuals showing  RO aggression are more likely to develop RR aggression. 

Proactive Relational (PR) aggression and Depression (rho = 0.571, p = 0.008) suggesting mod- erate positive correlation indicating that higher levels of PR aggression are linked with higher levels of depression. 

Proactive Relational (PR) aggression and Anxiety (rho = 0.413, p = 0.07) suggesting that marginal  positive  correlation  indicating  that increased proactive relational aggression may be linked with higher levels of anxiety. 

Reactive  Relational  (RR) aggression  and Depression (rho = 0.63, p = 0.003) suggesting that strong positive correlation indicating higher levels of RR aggression are linked with higher levels of depression. 

Reactive Relational (RR) and Anxiety (rho = 0.582, p = 0.007) suggesting that moderate posi- tive correlation indicating that higher levels of RR aggression linked with higher levels of anxiety. 

Reactive Relational (RR) and Stress (rho = 0.513,  p  =  0.021)  suggesting  that  moderate positive correlation indicating that higher levels of  RR aggression  are  associated  with higher levels of stress. 

SIDAS total and Reactive Relational (RR) aggression (rho = 0.515, p = 0.02) suggesting that moderate positive correlation indicating that higher levels of suicidal ideation are linked with higher levels of RR aggression 


Table 15 : Correlation Matrix




DISCUSSION 

The aim of the current study was to study the prevalence and relationships between mental health problems, aggression, suicidal ideation, and  substance use in children in conflict  with the  law (CCL)  from  a Delhi-based  detention centre. The results obtained from this pilot study provide useful information about psychological profiles of institutionalized CCLs, paving the path for tailored interventions and future large scale studies. There exists a significant variabil- ity in sociodemographic characteristics, mental health status, and substance use patterns among accused CCLs for serious and heinous offences. 

As per the sociodemographic data, the mean age of CCLs accused of heinous offences was higher,  suggesting  that  older  CCLs  are more prone to committing heinous offences. Variability in age was also higher in this group, suggesting a a  wider range of  age for coming  in conflict with law under heinous offences. Homogeneity in religion  and family  head’s  occupation was observed  among  CCLs  accused  with  serious offence while the other group (heinous offence) showed slight variability for these areas. These details provide clues about potential effects of sociodemographic factors on the type of offences and its severity among CCLs. 

Mental health problems were assessed by using DASS-Y (depression, anxiety, and stress Scale for youth) in this study. Moderate to extre- mely severe levels of depression and anxiety were observed among  CCLs  accused  with heinous offences making an explicit about the existence of a strong linkage between severe mental health problems  and  heinous offences (Chung et al., 2020;  Lüdtke  et  al., 2018). The  presence  of extreme depressive symptoms among CCLs ac- cused with heinous offence aligns with previous research (da Silva et al., 2021). 

Levels of aggression were measure by using Peer  Conflict  Scale  (PCS). The  scores  were significantly  higher among CCLs  accused of hein-ous offences. Strong positive correlations were  observed  between  different  forms  of aggression (proactive  and reactive)  indicating towards the presence of psychological problems being manifested as different forms of aggression (Kelly et al., 2019). 

Children  in  conflict with  law accused of heinous offences reported higher rates of alcohol, tobacco, cannabis, and street opioids (smack) use in comparison to the other group. The findings are consistent with previous studies based on the exploration of link between drug use and offences (Gisin et al., 2012; Heirigs et al., 2019). This suggests the need for the development of effective interventions  for  targeting substance use  and further chances of recidivism among institutiona- lised CCLs. 

Suicidal ideation was  measured  by using SIDAS  scale  revealing  presence  of  suicidal thoughts and wishes in 20% of CCLs accused of heinous offences, while it was absent in the other group. Findings are in line with previous studies indicating towards the existence of association between suicidal ideation and committed offences (Bhatta et al., 2014). The existence of moderate positive correlation between suicidal ideation and reactive  relational  (RR)  aggression  further indicates towards the presence of mental health issues among this population necessitating a need for intervention  and  planning and conducting large scale studies. 

Furthermore,  strong  positive correlations exist between different forms of aggression. Also positive correlations exists between aggression (both proactive and reactive) and mental health issues (depression, anxiety, and stress) suggesting that  addressing mental  health problems  could potentially  reduce aggressive  and  offences or vice-versa (Lemos & Faísca, 2015). 

CONCLUSION 

The current study has its own challenges and limitations including: small sample size due to which  findings  cannot  be  generalised  to  the broader population; the statistical power of statis- tical packages used in such small scale studies is usually low due to which it makes difficult comment  upon  significant relationship  status between variables; data collection from only one centre of Delhi marked by unique challenges like regional bias  and  institutional specificity and social desirability of participant responses which includes  modification  or  manipulation  of responses particularly in  context of fast-track adjudication by Juvenile Justice Boards. This is generally  seen  in  terms  of  fear  of  negative consequences, influences of authority figures and lack of trust on researcher regarding confiden- tiality and anonymity related to the data collec- tion. 

The results of the study however suggest that CCLs older in age are more likely to be accused of committing heinous offences. The results also indicate towards the presence of severe mental health problems, such as depression and anxiety, being prevalent among CCLs accused of heinous offences  in  comparison  to  CCLs  accused  of serious offences. Also, higher levels of proactive and reactive aggression were observed indicating towards the presence of mental health problems. Alcohol  and  tobacco  were  widely  prevalent among  this  sample along with  cannabis,  and street opioids (smack), being notably high among CCLs accused of heinous offences, suggesting a need effective psychological interven-tions. It is suggested for developing effective evidence based targeted mental health and substance use inter- ventions to  meet the needs  of institutionalized CCLs  and  further  reduce  the  likelihood  of recidivism. 

Conflict of Interest: There is no conflict of interest. 

Source of Funding: Authors received  no financial support for conducting this study. 

REFERENCES 

Anwar,  Z.,  Arzeen,  N.,  Arzeen,  S.,  & Muhammad, H. (2023). Personality Traits, Psychological Distress, and Locus of Control among Drug Abusers and Non-Drug users: Personality Traits, Psychological Distress and Locus of Control. Pakistan Journal of Health Sciences, 135–139. https://doi.org/ 10.54393/pjhs.v4i05.289 

Bhatta,  M.P.,  Jefferis,  E.,  Kavadas,  A., Alemagno, S.A., & Shaffer-King, P. (2014). Suicidal Behaviors among Adolescents  in Juvenile  Detention: Role of Adverse Life Experiences.  PLOS ONE,  9(2),  e89408. https://doi.org/10.1371/journal.pone. 0089408 

Chung, Y.R., Hong, J.W., Kim, B.B., Kim, J.S., Noh, I.S., Wee, J.H., Kim, N.H., Bae, S.M., &  Lim,  M.H.  (2020). ADHD,  suicidal ideation, depression,  anxiety, self-esteem, and  alcohol  problem  in  Korean  juvenile delinquency.  Medicine,  99(11),  e19423. https://doi.org/10.1097/MD.00000000000 19423 

da Silva, M.C., Cruz, A.P.M., & Teixeira, M.O. (2021). Depression, anxiety, and drug usage history indicators among institutionalized juvenile  offenders of Brasilia.  Psicologia, reflexaoe  critica  :  revista  semestral  do Departamento  de  Psicologia da  UFRGS, 34(1),  17. https://doi.org/10.1186/s41155- 021-00184-x 

Gisin, D., Haller, D.M., Cerutti, B., Wolff, H., Bertrand, D., Sebo, P., Heller, P., Niveau, G., & Eytan, A. (2012). Mental health of young offenders in Switzerland: Recognizing psychiatric  symptoms  during  detention. Journal of  Forensic  and Legal  Medicine, 19(6),  332–336.  https://doi.org/10.1016/ j.jflm.2012.02.013 

Heirigs, M.H., DeLisi, M., Fox, B., Dhingra, K., & Vaughn, M.G. (2019). Psychopathy and  Suicidal  Thoughts  and  Behaviors Revisited:  Results  From  a  Statewide Population  of  Institutionalized Youth. International journal of offender therapy and comparative criminology, 63(6), 874–895. https://doi.org/10.1177/0306624X18812533 

Juvenile  Justice  (Care  and  Protection  of Children) Act, 2015.  (2015). Ministry of Law  and  Justice,  Government  of  India. Available at: https://cara.wcd.gov.in/PDF/ JJ%20act%202015.pdf 

Juvenile Justice (Care and Protection of Children) Model Rules, 2016 (Ministry of Women & Child  Development). Available at: https:// cara.wcd.gov.in/PDF/english%20model% 20rule.pdf  Kelly, E.L.,  Novaco, R.W., & Cauffman, E. (2019). Anger and depression among incarcerated male youth: Predictors of violent and nonviolent offending during adjustment  to  incarceration.  Journal  of consulting and clinical psychology, 87(8), 693–705.  https://doi.org/10.1037/ccp0000 420 

Khetarpal,  S.K., Auster,  L.S.,  Miller,  E.,  & Goldstein, T.R. (2022). Transition age youth mental  health:  addressing  the  gap  with telemedicine.  Child  and  adolescent psychiatry and men- tal health, 16(1),  8. https://doi.org/10.1186/s13034-022-00444-3 

Lemos, I., & Faísca, L. (2015). Psychosocial adversity, delinquent pathway and interna- lizing  psychopathology  in  juvenile  male offenders. International journal of law and psychiatry, 42- 43, 49–57. https://doi.org/ 10.1016/j.ijlp.2015.08.007

Lüdtke, J., In-Albon, T., Schmeck, K., Plener, P.L., Fegert, J.M., & Schmid, M. (2018). Non-  suicidal  Self-Injury  in Adolescents Placed in Youth Welfare and Juvenile Justice Group Homes: Associations with  Mental Disorders  and  Suicidality.  Journal  of abnormal child psychology, 46(2), 343–354. https://doi.org/10.1007/s10802-017-0291-8 

Marsee, M.A.,  Kimonis,  E.R., &  Frick,  P.J. (2004).  Peer conflict scale. Psychological Assessment. 

Oga, E.A., Mark, K., Peters, E.N., & Coleman- Cowger, V.H.  (2020).  Validation  of  the NIDA- modified ASSIST as a screening tool for prenatal drug use in an urban setting in the  United  States.  Journal  of  addiction medicine, 14 (5), 423-430. 

Ridenour, T.A.,  Bray,  B.C.,  &  Cottler, L.B. (2007).  Reliability  of  use,  abuse,  and dependence  of  four  types  of  inhalants  in adolescents  and  young  adults.  Drug  and Alcohol Dependence, 91(1), 40-49. 

Szabo, M., & Lovibond, P.F. (2022). Develop- ment  and  psychometric  properties  of  the DASS-Youth (DASS-Y): an extension of the depression anxiety stress scales (DASS) to adolescents  and  children.  Frontiers  in Psychology, 13, 766890. 

Van Spijker, B.A., Batterham, P.J., Calear, A.L., Farrer, L., Christensen, H., Reynolds, J., & Kerkhof, A.J. (2014). The Suicidal Ideation Attributes Scale (SIDAS): Community based validation  study  of  a  new  scale  for  the measurement  of suicidal ideation. Suicide and Life  Threatening Behavior, 44(4), 408- 419.  



Journal of Society for Addiction Psychology | Volume 1 | Issue 1 | March 2024 Page 60 - 73