Table Of ContentResearch in Criminology
Series Editors
Alfred Blumstein
David P. Farrington
Research in Criminology
Understanding and Controlling Crime: Toward A New Research Strategy
D.P. Farrington, L.E. Ohlin and J.Q. Wilson
The Social Ecology of Crime
J.M. Byrne and R.J. Sampson (Eds.)
The Reasoning Criminal: Rational Choice Perspectives on Offending
D.B. Cornish and R.Y. Clarke (Eds.)
The Social Contex,ts of Criminal Sentencing
Martha A. Myers and Susette M. Talarico
Predicting Recidivism Using Survival Models
Peter Schmidt and Ann Dryden Witte
Coping. Behavior. and Adaptation in Prison Inmates
Edward Zamble and Frank Porporino
Prison Crowding: A Psychological Perspective
Paul B. Paulus
Off School. In Court: An Experimental and Psychiatric Investigation of Severe
School Attendance Problems
I. Berg, I. Brown and R. Hullin
Policing and Punishing the Drinking Driver: A Study of General and Specific
Deterrence
Ross Homel
Judicial Decision Making. Sentencing Policy. and Numerical Guidance
Austin Lovegrove
Delbert S. Elliott
David Huizinga
Scott Menard
Multiple Problem Youth
Delinquency, Substance
Use, and Mental Health
Problems
Springer-Verlag
N ew York Berlin Heidelberg
London Paris Tokyo
Delbert S. Elliott
David Huizinga
Scott Menard
Institute of Behavioral Science
University of Colorado at Boulder
Boulder, CO 80309, USA
Library of Congress Cataloging-in-Publication Data
Elliott, Delbert S.
Multiple problem youth: delinquency, substance use, and mental
health problems/Delbert S. Elliott, David Huizinga, Scott Menard.
p. cm.-(Research in criminology)
Bibliography: p.
ISBN-13:978-O-387-96925-l (a1k. paper)
l. Juvenile delinquency-United States. 2. Youth-United States-Drug
use. 3. Youth-United States-Mental health. 1. Huizinga, David. II. Menard,
Scott. III. Title. IV. Series.
HV9104.E447 1988
362.7/4/0973-dcI9 88-38132
Printed on acid-free paper
© 1989 by Springer-Verlag New York Inc.
All rights reserved. This work may not be translated or copied in whole or in part without the
written permission of the publisher (Springer-Verlag, 175 Fifth Avenue, New York, NY
10010, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use
in connection with any form of information storage and retrieval, electronic adaptation,
computer software, or by similar or dissimilar methodology now known or hereafter
developed is forbidden.
The use of general descriptive names, trade names, trademarks, etc. in this publication,
even if the former are not especially identified, is not to be taken as a sign that such names,
as understood by the Trade Marks and Merchandise Marks Act, may accordingly be used
freely by anyone.
Typeset by TCSystems, Inc.
9 8 7 6 5 4 3 2 1
ISBN -13 :978-0-387-96925-1 e-ISBN-13 :978-1-4613-9637-6
DOl: 10.1007/978-1-4613-%37-6
Contents
Preface ............................................................................... VI
Chapter 1 Introduction.............................. ........................... 1
Chapter 2 The Demographic Distribution of Delinquency and
ADM Problems..................................................... 24
Chapter 3 Prevalence and General Offending/Use Patterns:
The Joint Occurrence of Delinquent Behavior and
ADM Problems..................................................... 50
Chapter 4 Age, Period, and Cohort Effects .............................. 87
Chapter 5 Developmental Patterns ......................................... 118
Chapter 6 The Etiology of Delinquency and ADM Problems....... 137
Chapter 7 Prediction of Delinquent and ADM Behavior from
Other Delinquent and ADM Behavior....................... 169
Chapter 8 Summary and Implications ..................................... 191
References .......................................................................... 205
Appendix A Frequency of Alcohol Use .................................... 217
Appendix B Mental Health Measures ....................................... 219
Appendix C Prevalence and Offending/Use Rates for Multiple
Problem Types.................................................... 227
Appendix D Annual Transition Matrices for Problem Behavior
Types................................................................ 254
Author Index....................................................................... 256
Subject Index....................................................................... 260
Preface
In April 1984 the Alcohol, Drug Abuse, Mental Health Administration (ADAMHA) and
the Office of Juvenile Justice and Delinquency Prevention (OJJDP) held a State-of-the-Art
Research Conference on juvenile offenders with serious drug, alcohol, and mental health
problems. This conference reflected the growing concern over multiple-problem youth,
the possibility of a common set of underlying causes linked to these different forms of
problem behavior, and questions about how to identify multiple-problem youth and
develop treatment strategies that address this more complex pattern of problem behavior
and its precipitating causes. This book attemps to address the major epidemiological and
etiological issues raised at this conference and is an extended version of a paper presented
there by the first two authors (Elliott & Huizinga, 1984).
It seems particularly appropriate that the data and analyses presented here rely heavily
on the National Youth Survey, a ten-year longitudinal study involving a national sample
of adolescents, which has been jointly funded by the National Institute of Mental Health,
the National Institute of Drug Abuse, the Office of Juvenile Justice and Delinquency
Prevention, and The National Institute of Justice. This funding pattern reflects the
common interest in the relationship between these forms of problem behavior and the
complex set of issues that confront us in our efforts to deal with mUltiple-problem youth.
We would like to acknowledge the contributions of the many persons associated with
the National Youth Survey (NYS) and those who contributed directly and indirectly to the
preparation of this volume. Linda Kuhn and Judy Armstrong-Laurie (NYS Field Super
visors) are largely responsible for our success in obtaining high quality interviews and
maintaining a high participation rate over the ten years of the NYS. Bertha Thomas (the
NYS Librarian), more than any other person, is responsible for the quality and
documentation of the NYS data set. Her standards for accuracy and completeness are
unexcelled in survey research. Although too numerous to mention by name, we also wish
to thank our field staff, trackers and interviewers, and the research assistants who were
responsible for the collection, editing, and coding of our interviews.
Other members of the NYS research team contributed to the analyses and in
terpretations offered here. In particular, we acknowledge the contributions of Frank
Dunford, Barbara Morse, and Finn Esbensen. Phyllis O'Meara and Dorothy Watson
assisted in the preparation of the manuscript and stuck with us through the many revisions
of text and tables. We are also grateful for the encouragement and assistance of Dr. Jim
Breiling, our Project Monitor at the Antisocial and Violent Behavior Branch of the
National Institute of Mental Health.
Finally, we wish to thank the members of the NYS youth panel, who have been willing
to share their experiences, perceptions, and beliefs, their failures and successes, and their
hopes for the future. In the final analysis, it was their willingness to stick with us over ten
years of their lives and 'endure multiple, repeated interviews that made this volume
possible.
Del Elliott, David Huizinga, Scott Menard
1
Introduction
Study Objectives
Historically, the study of adolescent problems and disorders has involved
independent inquiry into specific problems such as delinquent and
antisocial behavior, substance (tobacco, alcohol, and illicit drug) use and
abuse, suicide, teenage pregnancy, runaway, and mental illness. This
division emerged out of the traditional interests and specializations of the
various academic disciplines and has been perpetuated by the present
organization of federal and state agencies supporting research and
program development in these areas and by the current organization of
federal, state and community treatment and support services for adoles
cents with these problems. Yet there is reason to question the usefulness
ofthis division in the light of recent research (Bachman, 1987; Donovan &
Jessor, 1985; Elliott, Huizinga, & Ageton, 1985; Huba & Bentler, 1984;
Jessor & Jessor, 1977, Osgood et aI, 1988) in which it is suggested that
these adolescent problems may have a common etiology and frequently
involve concomitant forms of behavior. Should this be the case, there
would be a compelling reason to question the appropriateness of the
present organization of social control and treatment agencies that tend to
focus rather narrowly on a particular problem form with little coordi
nation between agencies and little attention to the more general nexus of
problems that characterize clients.
Although there is a fairly extensive body of knowledge about each of
these problem behaviors, relatively little is known about their joint
distributions in the adolescent population, their temporal ordering or
developmental progression into multiproblem patterns, and whether these
problems are causally related to one another, have independent causal
antecedents, or are different manifestations of a common causal syn
drome.1 Baseline epidemiological and etiological data are critical to
I Several recent studies involving national samples have focused on one or more
of these issues (see Bachman, 1987; Donovan & Jessor, 1985; Osgood et al.,
2 1. Introduction
the development of new prevention and intervention strategies and to
a more effective integration and coordination of existing services and
strategies to deal with youth who exhibit mUltiple forms of problem
behavior
Our objective in this book is to present national baseline epidemiolog
ical and etiological data on the joint occurrence of delinquent behavior
and alcohol, drug, and mental health (ADM) problems. Specifically, we
propose to address each of the following questions.
1. What patterns of joint delinquent-ADM problems are found within the
adolescent population?
2. What proportion of youth exhibit each mUltiple problem pattern, and
how are youth exhibiting these patterns distributed in the general
population by age, sex, race, class, and place of residence?
3. How do these patterns differ with regard to the frequency of each type
of behavior?
4. Is there a particular temporal order or developmental sequence in the
onset of these behaviors or disorders that is more likely than others?
5. Can we identify a common set of causes for these problems?
6. What is the predictive effect of joint involvement in these behaviors on
subsequent long-range "career" or chronic involvement in crime or
ADM disorders? (For example, does the presence of heavy drug use
with crime during adolescence increase the risk of a long-range
criminal career and, if so, is the effect additive or interactive?)
In addressing the epidemiological issues above we have relied upon
data from the National Youth Survey (NYS), an ongoing longitudinal
study involving a national probability sample of U.S. adolescents. In the
discussion of the etiological issues and risk factor models we will review
both the results of predictive analyses involving NYS data and the
findings from other predictive studies based upon large representative
samples. Our general approach can be described as involving general
population surveys employing self-reported measures of delinquency and
ADM problems. After describing the NYS and the unique suitability of
this study for assessing the relationship between delinquent behavior and
ADM problems behaviors over the adolescent and early adult years, we
will review a number of issues involved in the measurement of delin
quency and ADM problems and then present the specific measures
employed in the NYS.
1988). These studies and several others involving local samples (Huba & Bentler,
1984; Nurco, Shaffer, Ball and Kinlock, 1984; Zabin et aI., 1986) will be reviewed
in later chapters, where their findings are relevant to particular issues being
addressed.
The National Youth Survey 3
The National Youth Survey
The National Youth Survey, funded primarily by the U.S. Department of
Health and Human Services through the National Institute of Mental
Health (NIMH) with supplemental funding from the U.S. Department of
Justice through the Office of Juvenile Justice and Delinquency Prevention
(OJJDP) and the National Institute of Justice (NIJ), is a projected
longitudinal study of delinquent behavior, alcohol and drug use, and
problem-related substance use in the American youth population.2 To
date, seven waves of data have been collected on this national youth
panel covering the period from 1976 to 1986. The data reported here are
limited to the first six waves of data and cover the 7-year period from 1976
to 1983.
The NYS employed a probability sample of households in the continen
tal United States based upon a self-weighting, multistage, cluster
sampling design. The sample was drawn in late 1976 and contained 2,360
eligible youth aged 11-17 at the time of the initial interview. Of these,
1,725 (73%) agreed to participate in the study, signed informed consents,
and completed interviews in the initial (1977) survey. An age, sex, and
race comparison between nonparticipating eligible youth and participat
ing youth indicates that the loss rate from any particular age, sex, or racial
group appears to be proportional to that group's representation in the
population. Further, with respect to these characteristics, participating
youth appear to be representative of the total 11- through 17-year-old
youth population in the United States as established by the U.S. Census
Bureau (Elliott, Ageton, Huizinga, Knowles, & Canter, 1983).
Respondent loss over the six surveys was relatively small (13%).
Comparisons of participants across the six waves indicated that loss by
age, sex, ethnicity, class, place of residence, and reported delinquency
did not substantially influence the underlying distributions on these
variables. It was thus concluded that the representativeness of the sample
with respect to these variables was not affected in any serious way by the
losses over the six surveys. For a more detailed analysis of attrition see
Elliott et al. (1983).
Annual involvement in delinquent behavior and specific ADM problem
2 The work reported here was supported by a series of grants (MH27552) from the
Center for Studies of Crime and Delinquency, NIMH, for the period June 1975
through May 1986. Supplemental funding (78-JN-AX-0003) for the second and
third years of the study was received from OnDP and supplemental funding
(83-IJ-CX-0063) for the collection of arrest data was received from the NIJ. The
points of view or opinions expressed here are those of the authors and do not
necessarily represent the official position or policies of the Department of Health
and Human Services or the Department of Justice.
4 1. Introduction
behaviors was self-reported by members of the youth panel in confiden
tial, personal (face-to-face) interviews. In most instances these interviews
occurred in the respondent's home. Ifthe situation at home was such that
privacy could not be guaranteed, arrangements were made to conduct the
interview in some other setting where privacy was assured. Respondents
were guaranteed that any information they provided in the interview was
confidential and could not be released to any person or agency without
their written consent. All data collected were protected by a Privacy
Certification from the U. S. Department of Justice or a Certificate of
Confidentiality from the U.S. Department of Health and Human Services.
The NYS is well suited to address both the epidemiological and
etiological questions posed. The study was specifically designed to obtain
baseline epidemiological data and to test an integrated theoretical model
explaining delinquency and drug use (Elliott, Huizinga, & Ageton, 1985);
it involves a representative national sample with adequate representation
of all adolescent age groups; comprehensive measures of delinquent
behavior as well as substance use and problem use are available,
providing both prevalence and frequency estimates of each behavior and
their joint occurrence annually over a 5-year period (1976-1980) and
comparable data for 1983; and the longitudinal design affords the opportu
nity to examine the temporal ordering of the onset of specific behaviors or
problems over the adolescent years. Although adolescent mental disor
ders were not a primary focus in the early years of this study, measures of
several mental health problems were obtained as predictors of delin
quency and problem use of alcohol and drugs and are available for the first
5 years of the study. More attention was given to mental disorders on the
sixth wave of the study, which incorporated parts of the NIMH Diagnos
tic Interview Schedule (Hesselbrock, Stabenau, Hesslebrock, Mirkin &
Mey 1982; Robins, 1981; Robins, Helzer, Croughan, Williams, & Spitzer,
1981a,b) and a major set of questions on the use of mental health services.
THE MEASUREMENT OF DELINQUENT BEHAVIOR
AND ADM PROBLEM BEHAVIORS.
Although self-reported survey measures of delinquency, substance use,
and mental illness have come to dominate epidemiological research in
these areas, some important limitations of self-reported measures need to
be addressed. Self-reported survey measures were initially developed as
an alternative to measures obtained from clinical records or from police or
court records. Both conceptual and methodological problems were asso
ciated with the use of clinical and law enforcement records to identify
persons involved or not involved in these problems or to estimate the
frequency and distribution of these forms of deviant behavior in any
specific population. Conceptually, theories of deviance made an impor-
