Table Of ContentCHILDHOOD ABUSE AND ADVERSE EXPERIENCE IN
ADOLESCENTS WHO HARM OTHERS
(Rebecca Louise Doyle, BA PGDip MSc)
Thesis submitted to the University of Nottingham for the
degree of Doctor in Forensic Psychology (D.Foren.Psy)
(July 2014)
Abstract
This thesis explores the effects of adverse childhood experience, including
childhood abuse and neglect, on adolescents. More specifically, it explores
these effects in relation to offending behaviour. A literature review
considered research investigating differences between sexual and non-
sexual offenders. More consistent differences were identified for
adolescents who sexually offend against children, as opposed to those who
offend against peers / adults, when compared to other groups of
offenders. Studies in this area are, however, subject to methodological
limitations. Following this, an empirical research project investigates the
prevalence and characteristics of adverse childhood experience in a
sample of mixed sex adolescents detained in a medium secure specialist
psychiatric hospital, alongside psychopathological traits. Male sexual
offenders differed from violent offenders on a number of variables,
including experiences of sexual abuse and a diagnosis of a Learning
Disability (LD). Then, a single case study is highlighted which investigates
and demonstrates the influence of adverse childhood experience and
cognitive impairment on vulnerabilities and offending behaviour in an
adolescent male detained in the aforementioned secure psychiatric
hospital. The effectiveness of the intervention, designed to address this
individual’s difficulties with emotional recognition and regulation, is
demonstrated by changes in psychometric assessments scores and via
clinical observation of behaviour. Finally, a critique is presented of the
Coping Responses Inventory – Youth Form (CRI-Y) (Moos, 1993). This is a
psychometric measure designed to measure styles of coping in
adolescents. It is critically evaluated to demonstrate its psychometric
properties, and its validity for clinical settings. This thesis emphasises the
importance of considering developmental experience in the onset of
offending behaviour, and the importance of engineering more
comprehensive, systemic, and targeted early intervention programmes for
individuals deemed at risk of committing particular offences or becoming
delinquent in adolescence.
II
Preface / Overview
This thesis aims to explore the effects of childhood abuse and adverse
childhood experience in terms of their application to offending behaviour in
adolescence. Sexually offensive behaviours, violence, and general
delinquency are considered. A developmental approach is used to consider
the effects of such experiences on the onset of offending behaviour, such
as by disrupting childhood attachments and causing vulnerabilities,
including poor coping styles and poor interpersonal skills.
Chapter One explores and critically examines empirical studies that have
investigated childhood abuse and adverse childhood experience in
adolescents who have sexually offended against others whilst comparing
them to adolescents who have either not done so, but have offended in
another way, or who have not offended. This review used comprehensive
search strategies and stringent inclusion criteria for studies conducted
between 1975 and 2012. Methodological limitations of these studies are
considered. This review informed Chapter Two’s empirical research
project’s selection of variables pertaining to adverse childhood experience,
and its classification of sexual offenders according to victim (i.e. offences
against children or offences against peers / adults).
Chapter Two is an empirical research project that explores adverse
childhood experience in a sample of inpatient adolescents who are
detained in a specialist medium secure psychiatric hospital. A
retrospective systematic file review of patient records was conducted to
establish the presence of variables of interest. 45 adolescents (32 male
and 13 female) consented to take part. Data were used to establish
whether a relationship existed between adverse childhood experience and
type of offences committed. Psychopathological traits upon detention in
hospital were also observed amongst groups of offenders. A number of
differences are identified between groups. Methodological limitations and
III
avenues for future research are discussed. Furthermore, clinical
implications are also highlighted.
Chapter Three explores, in a single case study format, the assessment,
formulation, and intervention for an adolescent male characterised by
adverse childhood experience and cognitive impairment. This individual is
detained in the same specialist secure hospital described above. A
psychological formulation and discussion clearly highlights the influence of
these factors on the onset and continuation of offending behaviour, as
theorised in Chapter Two. The intervention used cognitive-behavioural
affective education, simplified and collaborative functional analyses, self-
monitoring of emotions, and the encouragement of adaptive coping skills
to address risk-related difficulties.
Chapter Four provides a critique of the Coping Responses Inventory –
Youth Form (CRI-Y) (Moos, 1993). This measure is critically evaluated in
terms of its development, its psychometric properties, and normative
data. Further application and research with adolescents who have
offended against others is also considered, in light of theoretical literature
pertaining to the influence of poor coping on vulnerabilities theorised to be
present in some adolescent offenders, such as social isolation and sexual
offending, as highlighted in previous Chapters.
Finally, Chapter Five concludes this thesis. It provides an overview and
discussion of the work and findings presented in previous chapters, as well
as considering how they influence each other. Limitations are noted, as
well as considerations for further research and implications for practice.
IV
Acknowledgements
Thank you to Kevin Browne and Shihning Chou, my supervisors at
the University of Nottingham. My thanks also to my practice
supervisors Sally Falkner, Lesley Cohen, Lucy Warner, and Emma
Marks for their unwavering support and for teaching me more about
the practice of Forensic Psychology then I ever could have hoped
for. Furthermore, as always, I would like to express heartfelt thanks
and gratitude to my family and friends. Thank you for everything.
I would also like to extend my thanks to Michael Seto, Stephen
Butler, Anton van Wijk, Adam Brown, David Burton, Michael Miner,
Chi Meng Chu, David Day, and Charles Borduin for kindly
responding to my requests for further information regarding the
empirical studies considered in my literature review, and for their
words of encouragement.
Finally, I would like to express my gratitude to the staff and
especially the patients who assisted my with my empirical research
project and case study within the specialist medium secure service
for adolescents that is discussed within these papers. They could not
have been completed without you.
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Table of Contents
Page
Introduction 1
Chapter One: Childhood abuse and adverse childhood 10
experiences in adolescents who sexually offend
against others compared to those who do not: A
literature review following a systematic
approach
Chapter Two: A comparative empirical investigation: Adverse 62
childhood experience and psychopathology in
inpatient adolescents who have harmed others
Chapter Three: A single case study investigating emotional 101
recognition and regulation in an adolescent
characterised by adverse childhood experience
and cognitive impairment
Chapter Four: A critique and review of a psychometric 162
assessment: The Coping Responses Inventory –
Youth Form (CRI-Y) (Moos, 1993)
Chapter Five: Discussion 181
References 194
Appendices 220
VI
Table of Appendices
Page
Chapter One
Appendix One: Literature review search strategies 221
Appendix Two: Quality assessment form 230
Appendix Three: Data extraction form 235
Chapter Two
Appendix Four: Participant information sheet for research 239
participation
Appendix Five: Participant consent form for research 245
participation
Appendix Six: File review coding system for empirical 247
research project
Chapter Three
Appendix Seven: Consent form for case study participation 254
Appendix Eight: HCR-20 report template 256
Appendix Nine: Behavioural Monitoring scoring criteria 261
Appendix Ten: Pre-intervention psychometric raw data 263
Appendix Eleven: Examples of materials used during 268
intervention
Appendix Twelve: Post-intervention psychometric raw data 274
VII
List of Tables
Page
Chapter One
Table One: Definitions of inclusion and exclusion Criteria 25
Table Two: Characteristics of studies examining prevalence 39
and type of abuse in adolescent sex offenders
and comparison group(s)
Table Characteristics of studies examining adverse 43
Three: experience in adolescent sex offenders and
comparison group(s)
Chapter Two
Table One: Chi-square analyses and Fisher’s exact tests of 84
adverse childhood experiences across broad
male offender groups
Table Two: Fisher’s exact tests of adverse childhood 85
experiences across male offender groups
including sexual subcategories
Table Fisher’s exact tests of adverse childhood 86
Three: experiences across female offender groups
Table Four: Chi-square analyses and Fisher’s exact tests of 87
mental health variables across male offender
groups
Chapter Three
Table One: Full Wechsler Adult intelligence Scale (Fourth 124
Edition) results, including subscales
Table Two: Pre-intervention Barratt Impulsiveness Scale 126
results
Table Three: Pre-intervention Culture Free Self-Esteem 129
Inventory results
Table Four: Pre-intervention Beck Youth Inventories results 130
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Table Five: Functional analysis: Not listening to staff / Not 139
complying with staff requests
Table Six: Functional analysis: Over-tactile behaviour 139
(Including play-fighting and hugging)
Table Seven: Post-intervention Barratt Impulsiveness Scale 147
results
Table Eight: Post-intervention Culture Free Self-Esteem 148
Inventory results
Table Nine: Post-intervention Beck Youth Inventories 149
results
Chapter Four
Table One: The Coping Responses Inventory (Youth Form) 166
scales
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List of Figures
Page
Chapter One
Figure One: The search and study selection process 27
Chapter Three
Figure One: The Tripartite model of the impact of the 107
family in children’s emotional regulation and
adjustment (Morris et al., 2007)
Figure Two: Pre-intervention Coping Responses Inventory 128
(Youth Form) scores
Figure Three: Psychological formulation of Patient 1’s 136
presenting problems
Figure Four: Formulation based on the ‘Developmental 137
Model of Delinquency’ (Patterson, DeBaryshe,
& Ramsey, 1990)
Figure Five: Post-intervention Coping Responses Inventory 148
(Youth Form) scores
Figure Six: Patient 1’s behaviours not meeting the rules of 152
the unit before and during intervention
Figure Seven: Patient 1’s behaviours not meeting the 152
expectations of the unit before and during
intervention
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Description:Doyle, Rebecca Louise (2014) Childhood abuse and adverse experience in adolescents who harm others. DForenPsy thesis, University of
