Adolescence and criminality: forensic psychiatric perspectives

Why are adolescents vulnerable to criminality?

High negative emotionality predisposes to low threshold for anger or frustration so that reacts forcefully to situations others would find mildly bothersome. Distorted cognitive process leads to unwarranted alarm about environmental threats, feels impelled by some force to hurt others, erroneous beliefs about entitlement to impose one’s will on others. High anxiety triggers avoidance or escape behaviours that can injure others. Inadequate impulse control disrupts response selection so that aggression has precedence over alternatives. Abnormal development impairs the acquisition of coping behaviours and self-regulatory capabilities that normally suppress dyscontrolled outbursts.

Criminality

Criminality is a legal term, not a medical or psychiatric diagnosis, illness or syndrome.

Webster’s Dictionary: “The quality or state of being a criminal; criminal activity.” Criminal is defined as “relating to, involving or being in a crime; relating to crime or to the prosecution of suspects in a crime; guilty of crime; also of or befitting a criminal; disgraceful.”

It is a pattern of human behaviour or a specific act violating a law.

Criminality simply may be the most obvious sign of a wide variety of mental disorders and environmental stressors, the final common pathway of which is aggression.

Mental illness and criminality

It is true that most patients with mental illness are not violent. However, studies indicate that violence is more common in seriously mentally ill individuals. Severe mental illness causes perceptual distortion, suspiciousness, extremes of emotion, impaired impulse control. When made uneasy by their surroundings, they often lash out to defend themselves against real and/or imagined threats and wind up in jail more often than in the therapeutic settings.

Prevalence of violence is five times higher for individuals who meet Axis I diagnosis (schizophrenia, major depression, bipolar disorders 11-13%; and alcoholism and substance abuse 25-35%). Episodic violence may be seen in posttraumatic stress disorder (PTSD) (in relation to flashbacks) and dissociative identity disorders. Impulse control disorders (e.g. fire setting) in children where aggression and covert offences (lying, stealing) may be seen as correlates. Oppositional defiant disorder (ODD) and conduct disorder where most frequent comorbidities are attention deficit hyperactivity disorder (ADHD), major depression, substance abuse, that again leads to aggression.Traumatic brain injury in childhood causing frontal lobe damage may lead to misinterpretation of neutral expressions as that of disgust and fear as it results in a fear printed amygdala lacks intact frontal lobe connections. Violence may occur during aura and interictal period in epilepsy. Acute confusional migraine may lead to episodic extreme violence, even homicide.

Social factors

They include poor socioeconomic conditions, social disorganization, lack of social support, poor nutrition and safety, failure to establish secure childhood attachments, increased gang membership, gun availability, drug dealing and drug use, lack of religious convictions or practices, lack of effective law enforcement.

Environmental stressors

Intrauterine and perinatal influences: Noxious prenatal influences e.g. maternal alcoholism and substance abuse, may lead to childhood maladaptation. Psychological stressors and anxiety also has a detrimental effect.

Nurturing: Mother-infant relationships during first few months of life affect subsequent aggressiveness. Disorganised attachment leads to lags in cognitive development. During the first years of life, when the frontal lobes are developing rapidly, infants cannot modulate arousal levels; the caregiver must respond to signs of stress and restore a sense of safety. The apparent lack of empathy shown by some antisocial adolescents may be a reflection, in part, of their failure to have created the dendritic circuits associated with healthy attachments.

Genetic factors

Mice experiments: By 2006, 36 genes contributing to mouse aggression had been identified. Genetically engineered mice that lack cytochrome P450 19 aromatase show a complete loss of aggressive behaviour toward intruder mice; which could be partially reversed by administering estradiol soon after birth. Female mice lacking the gene for synthesis of nitrous oxide (NO) from L-arginine and molecular oxygen demonstrate impaired maternal aggression. Monoamine oxidase A (MAO-A) knockout mice demonstrate increased intermale aggression. Mice deficient for catechol-O-methyltransferase (COMT) increased aggression.

Studies on primates (rhesus macaques): Revealed polymorphous serotonin transporter gene with long and short alleles. Monkeys with short allele are not different from siblings carrying long alleles if reared by mothers but are more aggressive if reared with peers only.

David Farrington’s Cambridge Study of Delinquent Development: Presence of convicted father, mother, brother or sister was associated with child’s convictions. Having an older criminal sibling was more associated with criminality than younger criminal sibling. Same sex relationships were found to be more associated with criminality than opposite sex relationships.

Daniel Lord Smail hypothesised the existence of groups or cultures whose levels of dopamine and serotonin averaged across a month are distinctly lower and whose stress hormone (glucocorticoids) levels are higher than more favoured groups.

Biological factors

Anabolic-androgenic steroids stimulate aggression; associated with psychosis, disinhibition, aggression and acts of violence. Down regulation of 5-HT1b receptor density in hippocampus and medial globus pallidus and up regulation of 5-HT2 receptors in the nucleus accumbens, affecting brain response to serotonin. Also affects receptors in hypothalamus, amygdala and various cortical regions.

Estrogen promotes dendritic formation and formation of synapses.

Testosterone, progesterone and glucocorticoids are neuroactive steroids or neurosteroids. Behavioural effects include sedative, anaesthetic and anxiety reducing properties.They are believed to mediate gender related behavioural differences.

Neurotransmitters: ‘Serotonin theory of aggression modulation’

Relationship between low levels of cerebrospinal fluid (CSF) 5-hydroxyindoleacetic acid (5-HIAA) in impulsive, aggressive individuals. Tryptophan depleted males are more aggressive. Higher levels of free L-tryptophan are seen in antisocial offenders. Positive correlation of blood serotonin levels with aggression. MAO levels lower than normal in aggressive individuals. There is relationship connecting low socioeconomic status, low prolactin response to fenfluramine and aggression. There is association between violence and abnormalities of dopaminergic system in the form of abnormal ratios of homovanillic acid (HVA) to 5-HIAA.

Decreased oxytocin (OT) in paraventricular nucleus (PVN) of rodents increases maternal aggression. Increased OT in amygdala decreases rodent maternal aggression.

Child abuse

Cerebral volumes of abused subjects are seven per cent smaller. Damage to brain from abuse leads to hyperactivity, impulsiveness, diminished intellectual ability, poor judgement. Lesser degree of neglect results in retarded cognitive and motor development while complete emotional deprivation may cause failure to thrive or even to death. According to American Academy of Child and Adolescent Psychiatry:

Neglect: Failure to meet nutritional, supervisional and medical needs.

Physical abuse: Intentional injury of a child e.g. shaking, beating, or other forms of violence that leads to injury, and frequently occurs in the context of discipline.

Sexual abuse: Sexual behaviour between child and adult, or between two children when one of them is significantly older or uses coercion.

Psychological abuse: When an adult repeatedly conveys to a child that he or she is worthless, defective, unloved or unwanted.

Ongoing maltreatment activates amygdala and hypothalamic pituitary adrenal (HPA) axis, causing release of catecholamines and cortisol. Excessive exposure to glucocorticoids leads to loss of hippocampal neurons and damage to cerebellar vermis. Stress decreases levels of brain neurotrophic factor messenger ribonucleic acid (mRNA) in hippocampus, leading to atrophy.

Not only are children the victims of many of the same crimes that victimise adults, they are subject to other crimes, like child abuse and neglect, that are specific to childhood. The impact of these crimes on young victims can be devastating, and the violent or sexual victimisation of children can often lead to an intergenerational cycle of violence and abuse. Victims are more likely to involve in intimate partner violence, and to experience teen parenthood.

Media

Media influences behaviour through modelling, disinhibition, desensitisation, arousal of aggressive feelings and encouragement of risk taking. Fourteen per cent of music videos contain overt interpersonal violence, and in more than 80% of these the attractive role models were the aggressors. It has short-term stimulating effect on aggressive behaviours in all age groups. It portrays the world as a more hostile place than it is. It justifies violence (40% of violent acts are performed by heroes) and stimulates aggressive ideas.

Video games: Eighty nine per cent of the top selling games contain violence. Ninety per cent of children in U.S. in age group two to 17 years play video games and spend on average 20-33 minutes per day.

Subtypes of offences

Status offence: Regarded so only because of the individual’s age e.g. driving below 16 years, drinking below 21 years.

Authority defying offences: Trespassing, not adhering to curfews.

Covert offence: Lying, stealing, truancy, running away from home.

Overt offence: Violent behaviours e.g. vandalism, fire-setting, assault, fighting, use of weapons, threats of violence against a person.

Adolescent substance abuse

Rapid situation assessments (RSA) by the United Nations Office on Drugs and Crime (UNODC) in 2002 of 4648 drug users showed that cannabis (40%), alcohol (33%) and opioids (15%) were the major substances used.[Kumar 2007]

Risk factors

They are parental belief in the harmlessness of substances, lack of closeness and involvement of parents with children’s activities, maternal passivity, academic difficulties, comorbid psychiatric disorders like conduct disorder and depression, parental and peer substance use, impulsivity, early onset of cigarette smoking.

Cyber crime

Information Technology (IT) gave birth to the cyber space. Increase in the number of netizens and misuse of technology in cyberspace gave birth of cyber crimes.

Cyber crimes against persons: Harassment by emails, cyber stalking, dissemination of obscene material, defamation, hacking, cracking, email spoofing, sms spoofing, carding, cheating and fraud, child pornography, assault by threat.

Crimes against person’s property: Intellectual property crimes, cyber-squatting, cyber-vandalism, hacking computer system, transmitting virus, cyber trespass, internet time theft.

Crimes against Govt.: Cyber terrorism, cyber warfare, distribution of pirated software, possession of unauthorised information.

Crimes against society: Child pornography, financial crimes, online gambling, forgery

Juvenile sexual offences

The sexual behaviours that bring youth into clinical settings can include events as diverse as sharing pornography with younger children, fondling a child over the clothes, grabbing peers in a sexual way at school, date rape, gang rape, or performing oral, vaginal, or anal sex on a much younger child. Offenses can involve a single event, a few isolated events or a large number of events with multiple victims. The following information about juvenile sex offenders as based on data collected by the National Incident-Based Reporting System (NIBRS) in the United States for 2004:

35.6% of those who committed sex offence against minors are below age of 18 years. Thirty eight per cent are between ages 12 and 14, and 46% are between ages 15 and 17. Early adolescence is peak age for offence against younger children and mid to late adolescence is peak age for offence against teens. The clinical literature has generally considered teenage and preteen offenders as different offender types: Teenage sex offenders are predominately male (more than 90 per cent), whereas a significant number of preteen offenders are female.[Silovsky and Niec 2002] Most offenders have had history of childhood sexual abuse[Lambie et al. 2002] but most sexual abuse victims do not become offenders.[Widom and Ames 1994] Some offences occurring in conjunction with mental disorders; some are compulsive but more often impulsive or reflects poor judgement. There are important motivational, behavioural and prognostic differences between juvenile sex offenders and adult sex offenders. They have favourable prognosis compared to adults: 85-90% of sex offending youth have no arrests or reports for future sex crimes; but are more likely to commit nonsexual offences.[Alexander 1999, Caldwell 2002, Reitzel and Carbonell 2007]

Teen dating violence

Definition: The negative act between two adolescents that result in a mental, physical and emotional situation that harms one or both people in the relationship.

Both males and females are victims, but boys and girls are abusive in different ways: Girls are more likely to yell, threaten to hurt themselves, pinch, slap, scratch, or kick; boys injure girls more severely and frequently.

Approximately one in five female high school students are physically and/or sexually abused by a dating partner. Half of the reported date rapes occur among teenagers. Eighty one per cent of parents surveyed either believe teen dating violence is not an issue or admit they don’t know if it’s an issue.

Prevention: Parental awareness, teen awareness and incident reporting.

Gangs

Youth gangs mainly tend to be made up of school drop-outs with limited education and lack of work skills restrict their economic opportunities. Youngsters who join gangs become more aggressive than they were on their own. Individuality is submerged and it becomes easier to stereotype, even dehumanise and harm strangers.

Criminal responsibility

The crime (objectionable act) must have two components: (i) voluntary conduct (actus reus) and (ii) evil intent (mens rea). The perpetrator must understand what they are doing and that it is wrong. Most young children are too immature to fully appreciate the difference between right and wrong. The domestic laws of all countries have laid down a minimum age below which a child cannot be held criminally responsible for their actions. The rationale for such exemption is absence of mens rea. According to Indian Penal Code (IPC):

Section 82. Act of a child under seven years of age

Nothing is an offence which is done by a child under seven years of age.

Section 83. Act of a child above seven and under 12 of immature understanding

Nothing is an offence which is done by a child above seven years of age and under 12, who has not attained sufficient maturity of understanding to judge of the nature and consequences of his conduct on that occasion.

Section 84. Act of a person of unsound mind

Nothing is an offence which is done by a person who, at the time of doing it, by reason of unsoundness of mind, is incapable of knowing the nature of the act, or that he is doing what is either wrong or contrary to law.

Juvenile legislation – different view

The focus of juvenile legislation is on the juvenile’s reformation and rehabilitation so that he may also have a chance to opportunities enjoyed by other children.

Moderate/capitalist/conservative

Believe that man is born with a natural capacity for good or evil absolute moral values to form an individual of good character and moral values. Individuals of ill-formed character and defective moral values responsible for crime, not socio-economic conditions. Incarceration of the criminal necessary to assure the victims that their loss taken seriously by society. Removal of criminal from society is best guarantee for future security and safety of the community.

Radical/Marxist/liberal

Focuses on the social conditions that define and encourage juvenile crime. Concentrates on changing the juvenile system to eliminate the injustices it perpetuates. Capitalist class societies use power to shape criminal laws and criminal justice policy to serve its own aims. Implies that juvenile delinquency problems cannot be solved within the framework of capitalist society. Delinquency stems from our ineffectual responses to intolerable economic conditions. Advocates eliminating status and victimless offenses from jurisdiction of juvenile court, instituting determinate sentencing, granting all the procedural protections to juveniles that are afforded to adults, and adhering to the principle of the least restrictive alternative. Critical importance to rehabilitation.

The age of criminal responsibility in United Kingdom is set at 10. The principal aim of the Youth Justice System is to prevent offending by children below 18 years of age. The legislative overhaul of Youth Justice is bridging the gap between residential and community treatments and to involve families using Youth Offending Teams to meet these needs. But public demand to remove antisocial youths from the streets has led to the implementation of Antisocial Behaviour Orders. The Children’s National Service Framework for Children, Young People and Maternity Services holds the view that a young person in contact with the criminal justice system, whether in custody or in the community, should have the same access to this comprehensive service as any other child or young person within the general population.

History

Juvenile legislation in India has attempted to balance ‘welfarism’ and ‘justice’ with the conceptualisation of a welfare court that provides a child his constitutional and procedural safeguards at the inquiry stage, and thereafter decides his treatment mode keeping in mind the child’s interest and his comprehensive rehabilitation.

Madras Children Act 1920 was the first children act to be enacted closely followed by Bengal and Bombay in 1922 and 1924 respectively. Though enacted four years later than the Madras Children Act, the Bombay Children Act was the first act to become functional. The first Juvenile Court was established in Bombay in 1927.

Children Act, 1960 was passed by the Govt. of India to “provide for the care, protection, maintenance, welfare, training, education and rehabilitation of neglected or delinquent children and for the trial of delinquent children in the Union Territories.” Under this act, a child is boy below 16 years and girl below 18 years.

Child Welfare Board handled neglected children, and Children’s Court the delinquents. Section 27 of Criminal Penal Code (CrPC) 1973 states: “Jurisdiction in case of juveniles -- Any offence not punishable with death or imprisonment for life, committed by any person who at the date when appears or is brought before the Court is under the age of 16 years, may be tried by the Court of a Chief Judicial Magistrate, or by any Court specially empowered under the Children Act, 1960, or any other law for the treatment, training and rehabilitation of youthful offenders.”

The States’ Children Acts brought within its ambit two categories of children viz. (i) youthful offenders and (ii) destitute children. Both these categories of children were to be handled by juvenile courts. The State Governments not only enacted their separate legislations, but they also varied in provisions, and even in the definitions of ‘child.’

On 29th November, 1985 the General Assembly adopted the UN Standard Minimum Rules for the administration of Juvenile Justice where for the first time the word ‘juvenile’ was used and the term ‘juvenile justice’ was coined. This change in the terminology reflected in domestic law with passing of the Juvenile Justice Act in 1986. Both categories, ‘delinquents’ and ‘neglected children,’ were kept in same Observational Homes pending their inquiries before respective competent authorities.

Juvenile Justice Act, 2000 made provision for two categories of children to be kept separately to curtail the corruption of ‘innocent’ children from the influence of the criminal juvenile. By passing of this act, ‘juvenile delinquents’ came to be known as ‘juveniles in conflict with law’ and ‘neglected children’ came to be known as ‘children in need of care and protection.’

The Juvenile Justice Care and Protection Act, 2000

A special approach towards care and prevention of juvenile in conflict with law: Section 2(l) of the Juvenile Justice (Care and Protection of Children) Act, 2000 defined ‘juvenile in conflict with law’ as a juvenile who is alleged to have committed an offence and has not completed 18th year of age as on the date of commission of such offence.

Distinct custodial, adjudicatory and sentencing mechanism

Severity of offence is of no consequence. ‘Apprehension’ is used instead of ‘arrest.’ For determination of age, Birth Certificate and School Leaving Certificate are only documentary evidence. Medical examination is to determine age in other cases. Case transferred and police instructed to file charge sheet before Juvenile Justice Board (JJB). JJB consists of a Metropolitan Magistrate or a First Class Judicial Magistrate in non-metropolitan area; and two social workers, who function as a bench, together.

Under Section 15 of JJA, 2000: “Where a board is satisfied on inquiry that a juvenile has committed an offence, then, notwithstanding anything to the contrary contained in any other law for the time being in force, the Board may, if it so thinks fit:

a) Allow the juvenile to go home after advice or admonition following appropriate inquiry parent or the guardian and the juvenile.

b) Direct the juvenile to participate in group counselling and similar activities.

c) Order the juvenile to perform community service.

d) Order the parent of the juvenile or the juvenile himself to pay a fine, if he is over 14 years of age and earns money.

e) Direct the juvenile to be released on probation of good conduct and placed under the care of any parent, guardian or other fit person, on such parent, guardian or other fit person executing a bond, with or without surety, as the Board may require for the good behaviour and well being of the juvenile for any period not exceeding three years.

f) Direct the juvenile to be released on probation of good conduct and placed under the care of any fit institution for the good behaviour and well-being of the juvenile for any period not exceeding three years.

g) Make an order directing the juvenile to be sent to a special home for a period of three years:

Provided that the Board may, if it is satisfied that having regard to the nature of the offence and the circumstances of the case, it is expedient so to do, for reasons to be recorded, reduce the period of stay to such period as it thinks fit.”

Section 21 of the Juvenile Justice (Care and Protection of Children) Act, 2000 (56 of 2000) as amended by the Juvenile Justice (Care and Protection of Children) Amendment Act, 2006 (33 of 2006), states that:

“Prohibition of publication of name, etc., of juvenile or child in need of care and protection involved in any proceeding under the Act (1) No report in any newspaper, magazine, news-sheet or visual media of any inquiry regarding a juvenile in conflict with law or a child in need of care and protection under this Act shall disclose the name, address or school or any other particulars calculated to lead to the identification of the juvenile or child shall nor shall any picture of any such juvenile or child shall be published: Provided that for any reason to be recorded in writing, the authority holding the inquiry may permit such disclosure, if in its opinion such disclosure is in the interest of the juvenile or the child. (2) Any person who contravenes the provisions of sub-section (1), shall be liable to a penalty which may extend to twenty-five thousand rupees.”

Based on a resolution passed in year 2006 and reiterated again in 2009 in the Conference of Chief Justices of India, several High Courts have constituted “Juvenile Justice Committees” which are monitoring committees headed by sitting Judges of High Courts, which supervise and monitor implementation of Juvenile Justice Act in their Jurisdiction.

Rajya Sabha passed the Juvenile Justice (Care and Protection of Children) Amendment Bill, 2010, which will end the segregation of disease-hit children from other occupants of juvenile homes.

The problem of malingering

Prevalence of malingering in clinical practice is only about one per cent, its prevalence sharply rises to five to 10% when dealing with people who are to appear for trial in court of law.

Text revision of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR): Intentional production of false or grossly exaggerated physical or psychological symptoms, motivated by external incentives such as avoiding military duty, avoiding work, obtaining financial compensation, evading criminal prosecution, or obtaining drugs.[American Psychiatric Association 2000]

Tenth revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10): Z76.5 Malingerer [conscious simulation]

Person feigning illness (with obvious motivation).[World Health Organization 1992]

Statistics of juvenile crimes in India

According to data from the National Crime Bureau Register 2009, there has been an increase in juvenile crimes in the last decade as depicted in the table below: