title: High impulsivity as a risk factor for the development of internalizing disorders in detained juvenile offenders.
abstract: BACKGROUND
  Whilst impulsivity is most commonly linked to the development of internalizing disorders, high levels of impulsivity, anxiety, and depression have been found in detained juvenile offenders. We therefore sought to determine whether impulsivity is associated with the development of self-reported anxiety or depression in a sample of detained juvenile offenders.
  
  
  METHODS
  323 male juvenile offenders and 86 typically developing controls, aged 15-17 were assessed. The Schedule for Affective Disorder and Schizophrenia for School-Age Children Present and Lifetime (SADS-PL) was used to assess psychiatric diagnoses, the Barratt Impulsivity Scale (BIS-11) was used to measure impulsivity, and the Screen for Child Anxiety Related Emotional Disorders (SCARED) and the Birleson Depression Self-Rating Scale (DSRS) were used to assess self-reported anxiety and depression respectively.
  
  
  RESULTS
  Compared to controls, juvenile offenders had significantly higher scores on the BIS-11 total, as well as on the motor and nonplanning subscales (all p values <0.001), as well as higher DSRS (p<0.001) and SCARED (p<0.05) scores. Within the juvenile offender group, scores on the SCARED correlated positively with BIS-11 total, attention subscale, motor subscale, and total DSRS (all p values <0.01). DSRS scores correlated positively with BIS-11 total, attention subscale, nonplanning subscale, and total SCARED scores (all p values <0.01). Participants were then categorized low, middle or high impulsivity according to scores on the BIS-11. One-way ANOVAs demonstrated a significant difference between these tertiles on DSRS [F(2,320)=4.862, p<0.05] and SCARED total scores [F(2,320)=3.581, p<0.05]. Specifically, post-hoc analyses found that the high impulsivity tertile scored significant higher than the remaining tertiles on both DSRS (16.1 ± 0.3 vs. 14.0 ± 0.6, p<0.05) and SCARED (23.3 ± 0.9 vs. 18.4 ± 1.4, p<0.05) scores. Using multiple linear regression, BIS-11 attention scores, number of months served in custody, age, and BIS-11 nonplanning scores predicted higher levels of anxiety, whilst only BIS-11 attention and nonplanning scores predicted higher levels of depression.
  
  
  CONCLUSIONS
  In detained juvenile offenders, high impulsivity may be an important risk factor not only for the externalizing disorders, but also for anxiety and depression. Results of this study, therefore, suggest that specific facets of impulsivity may represent one mechanism underlying the emergence of anxiety and depression in this population.
authors.affiliation: Mental Health Institute of The Second Xiangya Hospital, Hunan Province Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan, 410011, China.
authors.forename: Jiansong
authors.initials: J
authors.lastname: Zhou
authors.affiliation: University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford, OX3 7JX, UK.
authors.forename: Katrina
authors.initials: K
authors.lastname: Witt
authors.affiliation: Mental Health Institute of The Second Xiangya Hospital, Hunan Province Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan, 410011, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Chen
authors.affiliation: Mental Health Institute of The Second Xiangya Hospital, Hunan Province Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan, 410011, China.
authors.forename: Simei
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Mental Health Institute of The Second Xiangya Hospital, Hunan Province Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan, 410011, China.
authors.forename: Yingdong
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Mental Health Center, West China Hospital, Sichuan University, Chengdu, 610041, China.
authors.forename: Changjian
authors.initials: C
authors.lastname: Qiu
authors.affiliation: Guangzhou Psychiatric Hospital, 36 Mingxin Road, Guangzhou, 510370, China.
authors.forename: Liping
authors.initials: L
authors.lastname: Cao
authors.affiliation: Mental Health Institute of The Second Xiangya Hospital, Hunan Province Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, Hunan, 410011, China. Electronic address: xyjw6@aliyun.com.
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology*; D016022:Case-Control Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology*; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000175:diagnosis / Q000523:psychology*; D006801:Humans; D007389:Internal-External Control; D007604:Juvenile Delinquency / Q000523:psychology*; D008297:Male; D011329:Prisoners / Q000523:psychology*; D011594:Psychometrics