Using the MAYSI-2 Outline to Measure Anxiety and Depression

Introduction

Anxiety and depression affect individuals in all strata of society including children and adults, criminals and law-abiding citizens. Psychologists have long searched for a definitive explanation for anxiety and depression, as well as a definitive method of measuring these psychological disorders in offender populations.

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Spielberger defined anxiety as a complex psychological cluster of cognitive, somatic, emotional, and behavioral components that together create an unpleasant feeling of apprehension, or worry (Spielberger, 1972). Spielberger also characterized anxiety as comprised of both temporary or state elements, as well as more widespread and consistent elements, or trait characteristics (Spielberger, 1972). Spielberger attributed anxiety as the overall result of specific characteristics of personality traits that influence an individual’s behavior; these include habitual behaviors, thoughts, and emotions (Spielberger, 1972).

Some theorists believe anxiety to be the confluence of several different childhood experiences that continue into adulthood. Theorists including Sullivan, Leary, Kiesler, Spielberger, Bonta and Andrews have attempted to locate one specific and definitive measure or hypothesis with which to study anxiety effectively; however, as of 2011, none have yet been successful. Meanwhile, others theorists have attempted to expand upon previous theories to explain the cause of anxiety; however, as of 2011, no consensus among theorists exists.

Messier and Ward defined depression as a psychological disorder that affects an individual’s mood, social interactions, and physical functions (Messier & Ward, 1998). Bradshaw and Dia pointed to the important role that “negative affectivity” plays in the development of anxiety and depression in adolescents (Bradshaw & Dia, 2008).

In the case of many juvenile offenders, the anger and aggression that often leads to criminal activity can itself stem from anxiety experienced in the social context. Arslan described the classic case of juvenile anger triggered by anxiety herein:

Adolescents are angered when their physical or social activities are prevented or in the case of an attack on their personalities, positions, or status in society. An adolescent may display anger when he or she is criticized, embarrassed, underestimated, or ignored and perceive such situations as threats to his/her already extremely sensitive personality (Arslan, 2009).

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Thus, a complex interplay exists between anxiety, depression, criminal behavior, and recidivism, particularly in young offenders with antisocial personal disorder. The current study intends to investigate the relationship between anxiety, depression and criminal behavior and activity in juvenile offenders, using the Massachusetts Youth Screening Instrument Version-2 or MAYSI-2 to quantify anxiety and depression in both first time young offenders and repeat young offenders. The goal of the study is to determine the effectiveness of the MAYSI-2 in predicting the likelihood of the juvenile offender committing a second or third offense, based on the analysis of the MAYSI-2 results. This researcher seeks to employ the criminogenic need principle in order to determine the contribution that anxiety and depression make to the tendency for recidivism in juvenile offenders.

Measurement

There are many different psychological tests and assessment tools used to measure anxiety. Spielberger, Gorsuch, Lushene, Vagg and Jacobs developed one of the most common measuring tools that researchers use to study and appraise anxiety in individuals, the State-Trait Anxiety Inventory (Spielberger et al., 1983). This unidimensional tool gauges anxiety as a distinct or global psychological structure and has been used widely since its invention (Spielberger et al., 1983). The State-Trait Anxiety Inventory will be discussed in detail in the literature review. An individual who scores low may indicate an emotional reaction to immediate events where as individuals that score medium and high scores may indicate enduring problems (Grisso & Barnum, 2000).

Background of the Study

The California Family Code defines a juvenile as any person who is under the age of 18 years when he or she violates any law of this state, or of the United States, or any ordinance of any city or county (2009 California Family Code, 2009). Juveniles that offend and internalize conflict tend to act out; therefore, they tend to have lower levels of anxiety and depression (Grisso & Barnum, 2000).

When juveniles are booked in to the juvenile detention center, each juvenile offender is administered the MAYSI-2 (Grisso & Barnum, 2000). A juvenile is administered the MAYSI-2 on their first offense; a juvenile commits his or her first offense once her or she has been convicted for the first time of an offense against the law. Juveniles are also administered the MAYSI-2 when and if they return to juvenile detention center on multiple offenses; once a juvenile has committed two or more previous crimes, he or she will be defined as a repeat offender (Grisso & Barnum, 2000).

Mental health professionals use the MAYSI-2 assessment tool to analyze the different scores that juvenile offender record upon entrance into the juvenile detention center (Grisso & Barnum, 2000). Juvenile mental health professionals will pay attention to the warning and caution levels determined by the MAYSI-2 in order to ascertain the cases that require immediate attention (Grisso & Barnum, 2000). Low scores in anxiety and depression can predict whether an individual is more likely to commit more crimes; this interpretation also concurs with the finding based on the criminogenic need principle (Andrews & Bonta, 1998; Bonta & Andrews, 2007; Grisso & Barnum, 2000).

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The criminogenic need principle states that criminogenic individuals with low anxiety and depression traits tend to be repeat offenders, whereas non-criminogenic people with high anxiety and depression scores demonstrate a normal reaction and may possibly commit one crime or no crimes (Bonta & Andrews, 1998). Therefore, instead of assessing high levels of depression and anxiety traits, juveniles entering the juvenile detention center need to be screened for low anxiety and depression traits. In this way, intervention strategies that target repeat juvenile offenders may provide immediate help and prevent future offenses, based on the criminogenic need principle (Bonta & Andrews, 1998).

Statement of the Problem

As of 2011, juvenile offenders that enter juvenile detention facilities are screened for mental health problems using three levels on the MAYSI-2 assessment tool (Grisso & Barnum, 2000). Bonta and Andrews (1998) argued that offenders who demonstrate low levels of anxiety and depression are more likely to reoffend due to static and dynamic traits, as per the criminogenic need principle. This differs from offenders with high levels of anxiety and depression traits, since that is considered a more normal reaction and indicates a higher likelihood that the offender will not commit another crime (Bonta and Andrews, 1998). Therefore, in order to prevent criminogenic individuals from reoffending and ending up back in the juvenile facilities, mental health professionals in the Juvenile Justice System must look at juvenile offenders that record low scores on the anxiety and depression scale. Mental health professionals in the Juvenile Justice System use the MAYSI-2 results more fruitfully when they immediately treat the low anxiety and depression group, rather than the individuals who record high scores on the anxiety and depression spectrum.

Literature Review

Antisocial Personality Disorder

People who are diagnosed with Antisocial Personality Disorder or APD generally report lower levels of anxiety then do individuals without APD (Bare, Hopko, & Armento, 2004). People with Antisocial Personality Disorder are more likely to commit multiple offenses, whereas people who do not have APD may commit one offense (Bare, Hopko, & Armento, 2004). Individuals without APD tend to have higher levels of anxiety and depression, since high anxiety and depression are considered a normal reaction to a stressful and uncommon situation (Bare, Hopko, & Armento 2004).

Alcohol and drug abuse and dependency factors significantly in those individuals with antisocial personality disorder; diagnoses of Antisocial Personality Disorder have been frequently considered when evaluating the juvenile’s openness to treatment. The researchers Bonta and Andrews (1998) describe Antisocial Personality Disorder as follows:

With respect to criminal behaviour, we refer specifically to an antisocial personality pattern. Antisocial personality pattern is not limited to the psychiatric diagnostic category of Antisocial Personality Disorder or the forensic label of psychopathy. It is more comprehensive and captures the history of generalized rule violation and trouble, some of the personality factors that function as criminogenic needs…e.g., impulsivity, self-centeredness…and responsivity factors…e.g., need for excitement, shallow affect (Andrews & Bonta, 1998).

Bonta and Andrews (2007) also suggested that criminal behavior will result “when the rewards and costs for crime outweigh the rewards and costs for prosocial behaviour” (p. 14). For juvenile offenders, particularly those with Antisocial Personality Disorder, “rewards and costs can be delivered by others…family, friends, teachers, employers and co-workers…[or] they can be produced from within” such as pride, power, or the excitement produced when the juvenile successfully commits a crime and receives no punishment (Bonta & Andrews, 2007, p. 21).

Results

The research hypothesis asserted that the MAYSI-2 measurement will be useful in the detection of low depression and anxiety scores, which in turn can predict the likelihood of reoffending in juveniles. The sample size used for the research is 3246 participants. These study subjects are juveniles of both genders between the ages of 12 and 17. In the study, a total of 980 females and 3717 males were measured. All of the participants were chosen from San Diego County Probations, and all of them entered the San Diego juvenile detention system between 2009 and 2010. The participants had all been measured using the MAYSI-2 one or more times and their tests results were taken from the San Diego County Probations archival database that the probations department made available for this study. The current study measured the depression and anxiety scores of the first time offenders and compared them to the repeat offenders. Further delineation in testing occurred when the male and female offenders were measured separately.

In the results that follow, DA refers to the depression and anxiety scale. This is the dependent variable in the tests..00 measures a first time offender, whereas 1.0 denotes a repeat offender, as indicated in Table 1. The results of the tests indicate that first time offenders reported significantly higher levels of anxiety (M=1.78) compared to repeated offenders (M=1.62), t ( 3715)=2.487, p <.05. However, the effect was negligible according to Cohen’s criteria ( ) d =.08.

Research Objective

The current study sought to investigate the relationship between anxiety and depression scores using the MAYSI-2 for first time offenders, multiple offenders, male juvenile offenders and female juvenile offenders. The goal of the study was to determine the relationship between these scores and criminal behavior and activity in juvenile offenders, using the Massachusetts Youth Screening Instrument Version-2 or MAYSI-2 to quantify anxiety and depression in both first time young offenders and repeat young offenders. Further delineation occurred between male offenders and female offenders.

The goal of the study is to determine the effectiveness of the MAYSI-2 in predicting the likelihood of the juvenile offender committing a second or third offense, based on the analysis of the MAYSI-2 results. This researcher seeks to employ the criminogenic need principle in order to determine the contribution that anxiety and depression make to the tendency for recidivism in juvenile offenders.

The test results indicate that first time offenders reported significantly higher levels of anxiety (M=1.78) compared to repeated offenders (M=1.62), t ( 3715)=2.487, p <.05. However, the effect was negligible according to Cohen’s criteria d =.08.

The first test measured a sample of 3246 juvenile offenders..00 denoted a first time offender on the depression/anxiety scale, while 1.0 applied to a juvenile who had committed multiple offenses. The researcher conducted a Levenes test of equality of variance that showed a significance of.135. This measurement is not significant and indicates homogeneity of variance.

The T-test for equality of means assumed equal variance t=1.894, DF= 3244, and significance=.058, with a mean difference of.151..058 is not considered significant; therefore, according to the scores obtained, no significance exists between multiple offenders and first time offender.

The DA warn scale showed 0 female= n=705, with a mean of.32, whereas for males the results were 1-male=n=2541, with a mean of.17. These results demonstrate an opposite direction in the mean. The Levenes test of equality showed.000, no homogeneity, and the T-test for equality of means showed.000. There was a significant variance of p<.01 observed. These results indicate that according to the scores measured on the DA warn scale, the female juvenile offenders scored significantly higher than the male juveniles.

The DA scale showed 0-female with a mean of 2.68 and 1-Male with a mean of 1.72. The Levene’s test showed a significance of.000, which indicates no homogeneity and no equal variance. The t-test for equality of means demonstrated that the female juvenile offenders scored significantly higher on the depression and anxiety scale compared to their male counterparts.

When the male and female juvenile offenders were tested separately, female offenders were measured 0-1 on the DA warn scale. First time juvenile female offenders showed.00 for single offenders, with a mean of.31. For multiple female juvenile offenders, the score was 1.0 with a means of.32, which indicates no difference. In the Levene’s equal variance test, the score was.607; this indicates a lack of significance and homogeneity. The T-test for equality of means similarly demonstrated a significance reading of.797, which is not significant. These results indicate that both first time juvenile female offenders and those who have committed multiple offenses score the same on the DA warn scale. The researcher concluded therefore that regardless of the number of offenses they commit, female offenders do not differ on DA warn scale. Equally, on the DA scale, the female juvenile offenders measured 0-8, with first time offenders scoring.00 with a mean of 2.61, and multiple offenders showing a mean of 2.49. The Levene’s equal variance test showed a score of.167; this is not significant and demonstrates homogeneity of variables. Lastly, the T-test of equality of means scored a significance rating of 4.06, which again is not significant. Therefore, on the depression and anxiety scale, female juvenile offenders do not differ significantly, regardless of the number of offenses that they commit.

When the male juvenile offenders were tested separately, they scored 0-1 on the DA warn scale, with first time offenders measuring.00, a mean of.18, and multiple offenders scoring 1.0 with a mean of.16. These results demonstrate no significance. On the Levene’s test however, a significant non-homogeneous, unequal variance score of.003 was observed. On the T-test, the equal variances not assumed score was not significant at.137. The research indicates therefore that regardless of the number of offenses male juvenile offenders commit, they do not differ on the DA warn scales.

On the depression and anxiety scale, the male juvenile offenders scored 0-8; first time offenders scored.00 with a mean of 1.78, while multiple offenders scored 1.0 with a mean of 1.62. On the Levene’s test, the significance reading was.063, which is not significant and demonstrates a homogeneous, equal variance reading. However, on the T-Test equality means, an equal variance of.013 P<.05 was observed. These results indicate that first time male offenders scored significantly higher than their multiple offender counterparts on the depression and anxiety scale. These results demonstrate that male juvenile offenders may require earlier intervention.

Clinical and Social Implications

The criminogenic need principle states that criminogenic individuals with low anxiety and depression traits tend to be repeat offenders, whereas non-criminogenic people with high anxiety and depression scores demonstrate a normal reaction and may possibly commit one crime or no crimes (Bonta & Andrews, 1998). Therefore, the results from a number of studies consistently suggest that rather than assessing high levels of depression and anxiety traits in juveniles entering the juvenile detention center, these individuals need to be screened for low anxiety and depression traits as an indication of recidivism. The results of this study support the view that a key difference exists between female juvenile offenders and male juvenile offenders in terms of how they score on the depression and anxiety scale each time they commit an offense. In the San Diego juvenile detention system, every juvenile offender that enters into the system must take the MAYSI-2 test by reading the test questions and responding yes or no. The test is administered regardless of how many times the juvenile offender commits a crime. The results of this study indicate that a change occurs in the male population of juvenile offenders with each subsequent arrest. While the female juvenile offenders showed no statistical difference in scores on the depression and anxiety scale, regardless of the number of offenses that they had committed, the same was not true of the male juvenile offenders who had committed multiple offense. Depression and anxiety scores decreased with the male juvenile multiple offenders.

There are a number of social and clinical implications for this discovery. The researcher inferred from these results that each arrest hardens the male juvenile offenders and inures him to the reality of the criminal life, as indicated by the lower depression and anxiety scores among the multiple offenders in the male category. As indicated earlier in the research, lower scores in the depression and anxiety scales have correlated with an increase in repeat criminal offenses. Therefore, the results of this research suggest that there may be a critical window for male juvenile offenders between the first offense and the subsequent offense through which intervention strategies can have an impact. The results of the study indicate that this window narrows significantly with each subsequent entry into the juvenile detention system.

In this way, clinical intervention strategies that target repeat male juvenile offenders may need to intervene immediately, after the first arrest, and clinical officials must understand the critical timing required to reach a male juvenile offender before he begins to accept that he possesses a criminal nature and to accept incarceration as a normal part of his life. The same does not appear to be true in the female category. Repeat female juvenile offenders demonstrate consistent levels of anxiety and depression with each arrest, a finding which suggests that female juvenile offenders may be reached at any point in the criminal continuum, and that the hope exists to turn them around much later than their male counterparts. Clinical implications indicate that in order to provide immediate help and prevent future offenses for male juvenile offenders, based on the criminogenic need principle, intervention must occur must faster than with their female counterparts in order to be effective (Bonta & Andrews, 1998).

Research Limitations

The main limitations of this research include the sample size and the environment of incarceration. In the case of the former, the sample size may be too small to effectively generalize across the majority of male and female juvenile offenders. In the case of the latter, the stress of the arrest may skew the results of the MAYSI-2, since it is administered as the juvenile offenders enter the system, thus their depression and anxiety levels may be elevated due to the fear and dismay attendant to that situation.

Future Research

Insight into the child and adolescent disorders that may predict criminal behaviour remains a key goal for researchers in order to intervene appropriately and effectively in the lives of high risk adolescents before they become too inured to the criminal life. Several studies consistently show the long-term effect of antisocial personality disorder and conduct disorder to be developmental forerunners of criminal conduct in later life (Groholt et al., 2011; Hakkanen-Nyholm et al., 2009). In addition, a number of studies conducted on inmates in western prisons demonstrate a link between conduct disorder or antisocial personality disorder and incarceration (Groholt et al., 2011; Hakkanen-Nyholm et al., 2009; Latessa & Lowenkamp, 2011).

Male juvenile offenders who commit multiple offenses appear to change significantly from their first arrest to any subsequent arrests. Numerous explanations for this phenomenon exist, based on the criminogenic needs theory. Males tend to be overrepresented in criminal activity, an observable fact that may speak to the cultural and social beliefs that males harbor more natural aggression, more propensities for violence, and tend to associate more with and gain more access to the criminal underworld than females do. The research indicates that because criminal activity is more expected behavior, they may embrace it as part of their identity much more rapidly and readily than their female counterparts. The results of this study indicate that first time male and female juvenile offenders do not differ in terms of their depression and anxiety scores, yet with each subsequent arrest and test the male juvenile offenders demonstrate less anxiety and less depression. In essence, the experience of incarceration becomes more normalized for them, whereas for the females each experience remains uniquely stressful and abnormal.

Suggestions for future research include the effect of intervention strategies on male juvenile offenders on the subsequent infraction following their initial offense. In addition, future research should study the timing of intervention strategies that focus on dynamic criminogenic needs such as peer groups in the interim between the first and second offense in male juvenile offenders.

References

Andrews, D.A. & Bonta, J. (1998). The psychology of criminal conduct. Cincinnati: Anderson.

Arslan, C. (2009). Anger, self-esteem, and perceived social support in adolescence. Social Behavior and Personality: An International Journal, 37 (4), 555-564.

Bonta, J., & Andrews, D.A. (2007). Risk-need-responsively model for offender assessment and rehabilitation. Ottawa: Public Safety Canada.

Bradshaw, W., & Dia, D. A. (2008). Cognitive risk factors to the development of anxiety and depressive disorders in adolescents. Child & Adolescent Social Work Journal, 25 (6), 469-481.

California Code (2009). 2009 California Code.

Galanter, C.A., & Jensen, P. S. (2009). DSM-IV-TR casebook and treatment guide for child mental health. Arlington, VA: American Psychiatric Publishing.

Grisso, T., & Barnum, R. (2000). Massachusetts youth screening instrument: Second version. Massachusetts: Sage.

Groholt, B. et al. (2011). The impact of ADHD and conduct disorder in childhood on adult delinquency: A 30 years follow-up study using official crime records. BMC Psychiatry, 11(57), 1-10.

Hakkanen-Nyholm, H. et al. (2009). Psychopathic traits and offender characteristics – a nationwide consecutive sample of homicidal male adolescents. BMC Psychiatry, 9(18), 1-11.

Latessa, E. J., & Lowenkamp, C. (2011). Community corrections research and best practices: What are criminogenic needs and why are they important? Mind-Body Awareness Project. Web.

Messier, L.P., & Ward, T.J. (1998). The coincidence of depression and high ability in delinquent youth. Journal of Child and Family Studies,7(1),97-105.

Searight, H. R. et al. (2001). Conduct disorder: Diagnosis and treatment in primary care. American Family Physician, 63(8), 1579-1589.

Spielberger, C.D. (1972). Anxiety as an emotional state. In C.D. Spielberger (Ed), Anxiety: Current trends in theory and research (Vol. 1, pp.23-49), New York: Academic Press.

Spielberger, C. D., Gorsuch, R. L., Lushene, R. E., Vagg, P., & Jacobs, G. (1983). Manual for the state-trait anxiety inventory. Palo Alto, CA: Consulting Psychologists Press.

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