The 2012 Summer Newsletter is now available by clicking hereRead More...
As we are entering the 44th year of the American Society for Adolescent Psychiatry, our organization has proven to be a viable, stable and valued member in the world of psychiatric and mental health organizations. Despite challenges ahead, we will continue to grow our organization and, with your participation, make substantial contributions to the field of adolescent mental health and advocacy.
Our recent yearly Annual Meeting in March 2011, was an indication of the continuing success of our organization. The venue, again at Day Top Village in New York City, was professionally handled and catered. Our presenters were among the most respected members in the field of psychiatry. The William Schonfeld Memorial Award and Lecture was given to Dr. Glenn Saxe for his innovations in the study of childhood traumatic stress. Ms. Frances Roton Bell, ASAP’s Executive Director, was awarded the Herman Staples award for her incalculable dedication and contribution to our organization’s welfare. Presented topics included discussion of DSM V proposed changes, disaster psychiatry, cannabis abuse, autism research, childhood trauma and PTSD, high conflict divorce, generational psychiatry, increasing publication skills and panels on eating disorders and dialectical behavioral therapy. We have posted abstracts for some of these presentations on our website, and expect to publish original papers by some of our presenters in our journal, Adolescent Psychiatry.
Our organization has made a number of important developments that serve our goals of education, advocacy, and professional networking. Past President Dr. Joseph Kenan redesigned our website, to make a user-friendly, exciting internet interface, understanding well that our future lies in fostering and improving our web presence which has become the mainstay for contemporary communications and informational resources. In that regard, we have also developed an adolescent pscyhiatry group on LinkedIn, with plans to develop a Facebook page, and further develop our website with forums for discussion, and tabs presenting information to healthcare professionals and community members alike. These pages might serve to provide quick and easy communications between members, discussion regarding various topics, and allow the distribution of important news that affects our field to professionals and the community. Webinars too, are being considered, that will allow members throughout the country to participate in recorded presentations. Dr. Kenan already pioneered our use of videoconferencing for our periodic Board meetings, allowing us more frequent contact as a result of the practical convenience that meeting method provides.
On our publishing front, Dr. Gregory Barclay continues his editorship of our outstanding Newsletter, providing brief updates about our organization, and timely articles. Past President, Dr. Lois Flaherty has negotiated an arrangement with Bentham Science for a new journal on Adolescent Psychiatry, which will serve as the official journal of the American Society for Adolescent Psychiatry. First issue highlights included articles on borderline personality disorder in adolescents, shame in psychotherapy, and overcoming resistance in therapy. An upcoming issue will feature highlights and original papers from our Annual Meeting. Members are afforded special arrangements with the publisher for subscription. Peer reviewers, article submission, and editorial help are always welcomed.
ASAP has many plans to keep our organization up to date and competitive. Some potential ideas include financial incentives for referring new members, mentoring programs, and action groups to deal with the issues faced by teens in today’s world. We know you will not want to miss these events.
Few fields are as underserved, and in need of public education as ours. A recent news article noted a report by the Substance Abuse and Mental Health Services Administration showing that in excess of 60 percent of adolescents suffering from major depression were not receiving treatment during the study period. This is, of course, only one example of teen mental health needs within our rapidly changing society. Sociopolitical and medical model changes, global unrest, war, substance abuse, economic instability, and globalization of media and communication are just some of the factors that contribute to a unique future landscape. We are the only national academic psychiatric organization dedicated solely to the mental health and well being of adolescents. It is incumbent upon us, as clinicians and leaders in the field to light the torch, dispelling darkness around us. It is my honor to serve this organization, and follow in the footsteps of the leaders who have tread the path before me. I encourage you all to take an active role in this process and join us in these most worthy endeavors. See you on the web, and at next year’s Meeting.
Dean De Crisce, MD, FAAFS
Letters to the Editor
A nice edition of the Newsletter (July, 2010). As an ASAP member going back many, many years, I found it very informative, interesting, and refreshing. I must say that Joe Kenan’s note brought me back to over 20 years ago, when those of us on the Executive Council (I am a Past President) expressed very similar feelings – hemorrhaging funds and members and concern about whether ASAP would last. Many of the past issues appear to have been resolved – non-physician members, less expensive meetings, less frequent publication of the Annals. Hopefully (and likely) membership (in the early 80′s we were over 1000 members) will reverse itself. I say likely because we have managed to get through bad times and we still exist. Thanks also to Lois Flaherty for her continuing work on the Annals.
Alex Weintrob, MD
Just a brief note to say that I thought the Summer 2010 ASAP Newsletter was the best I’ve seen in a long time. In fact, it was so interesting, I essentially read it from cover-to-cover when I had only planned to skim through it!
Other than the picture of me making me appear to be chubbier than my internal self-image, I enjoyed the contents and the format. Keep up the good work!
Perry Bach, M.D.
Hi and thanks for the published article. Nice work on the newsletter.
However, none of the references are shown in the text.
Dean De Crisce, MD
Editor’s note: We deeply apologize for this oversight. For those interested in a copy of Dr. DeCrisce’s complete article, with foot-noted text references, please contact me directly at email@example.com.Read More...
Megan’s Law for Kids; Have We Gone Too Far?
Dean De Crisce, MD
All states, influenced by highly publicized sexual crimes, have created sex offender legislation to protect the public from sexual victimization.[i] Mandated registration of sexual offenders and community notification are outgrowths of this trend.
The Jacob Wetterling Act of 1994 provided national requirements for the registration of sexual offenders in all states. This was later amended by Megan’s Law in 1996, which required that sexual offenders not only be registered, but that the public be advised about offenders in their community (referred to as community notification).[ii] The purpose of such notification laws is to “facilitate public access to information about persons who have committed a sex offense” to enable appropriate precautionary protective measures against convicted sex offenders who might prove a threat to the safety of those in the community.[iii]
Recent legal reforms occurring in many states have allowed for mandated minimum sentencing guidelines for sexual crimes, public access to sexual offender hearing records, and juvenile sexual offender cases to be waived to adult court. As of 2009, 39 states mandate Megan’s Law registration for juvenile and child sexual offenders.[iv] Only 15 states provide for a statutory lower age limit for such registration, and allow for registration of children as young as 7; other states may have no lower age limit for the application of these laws.[v]
It is important to understand the varied crimes to which Megan’s Law may be applied. Registration may be mandated in the case of a 17 year old boy that violently raped a series of adult women in brutal home invasions. Likewise, an 11 year old boy that touched a sibling or schoolmate on a single occasion or a 15 year old that exposes himself in a prank (“mooning”) may be subject to Megan’s Law provisions.
As community stigma associated with sexual offending is enormous, the application of Megan’s Law to juvenile and child offenders may be counterproductive and lead to harmful consequences to young offenders and their families. Registration may be mandated until the age of adulthood or indefinitely.
Megan’s Law is generally applied through a “tiering” mechanism, based on the nature of the offense and the age of the victim. Tier 1 offenders generally continuously verify their address to law enforcement agencies. Tier 2 offenders may undergo day care center, summer camp, and community organization notification. Tier 3 offenders often require school and public notification, including publically accessible internet listing of the names and addresses of offenders. All three tiers allow some community knowledge of the offender and offense.
Tiering is determined, based on jurisdiction, by statute, judicial discretion or by the use of actuarial methods. Popular juvenile sex offender actuarial risk assessment instruments have little known studied, reliable predictive power; in fact, they provide numerical scores which have not been validated in outcomes studies to be predictive of risk. They are not equivalent to actuarial measures such as the Static 99, which are used in adults and provide valid actuarial prediction of risk. Relatively few studies have been done adequately on juvenile groups of offenders.
Laws such as community notification fail to consider various developmental, etiological, and risk factors with regard to juvenile and child offenders. Sexual offenders are comprised of a heterogeneous group. The development of inappropriate sexualized behaviors in youth is the result of a complex series of interacting interpersonal, biological, social, psychiatric and psychological factors.
Clearly, not all offenders who have committed a sexual offense suffer from a sexual disorder. The case of a juvenile who “moons” other students at a school dance does not necessarily indicate compulsive sexual pathology. Studies indicate that judgment and impulse control governed by prefrontal cortex development, does not reach adult levels until the early twenties.[vi] In fact, the diagnosis of a Paraphilia may not be made in a child less than 16 years of age (DSM IV-TR, 2000). Further, it is estimated that very low rates of juvenile offenders go on to offend as adults, especially after having received appropriate treatment.[vii] Rates for juvenile sexual reoffense are significantly lower than rates of recidivism for other delinquent behaviors.[viii]
The application of Megan’s law to juveniles or children must incorporate the following considerations and potential effects.
Sex offenses carry the greatest degree of social stigma. The stigma of “sex offender” carries with it a connation of “rapist,” regardless of the actual behaviors. Megan’s Law registration will follow a juvenile or child offender in any potential relocation with family over an indefinite number of years. Continued registration might be seen to reinforce the child’s identification as a sexual offender to the community, when the offense might otherwise diminish in its community impact over time.
A juvenile or child sexual offender might already have some social impairment and therefore could be expected to suffer significant rejection by teachers, peers or even family members. Depending on the tiering applied, the offender’s own school might be subject to public notification about the juvenile’s status. This might be expected to occur throughout the formative adolescent years when social interaction is paramount. That is, even after the completion of any mandated treatment, the child would likely have to disclose this status to potential employers, college applications, healthy dating opportunities and friendships. Privacy of registration could not reasonably be expected to be upheld. Appropriate social relationships are a protective factor against a child’s future risk; Megan’s law would significantly interfere with healthy social skills development as a result of likely further rejection.
Children are amenable to treatment with an excellent prognosis.[ix] Megan’s Law legislation is seen to be counter productive, as an effectively punitive measure rather than providing for rehabilitation geared to produce a successful member of society. Again, the constant reinforcement of self identification as a sexual offender might be seen to add to the risk for depression and hopelessness, thereby contributing to potential further recidivism, other behavioral disturbance and suicidality.
Registration and community notification may be harmful to the family of the offender. Such families might be identified as “harboring a sex offender,” or in some way seen as “soiled.” Even if the family moved to a different location, this judgment might reasonably be expected to follow them. This potential isolation from the community may be severely damaging to a family that is otherwise law-abiding and active in their community. The offender might also suffer from the family stressor, diminishing the otherwise protective factor of family support. In cases where the victims are siblings, victims might also be seen as representing some sort of danger to other children and families in the community.
y,Registration and community notification might present a risk of physical harm to the offender and their family, who might suffer attacks from vigilantes seeking “revenge.” This adds a potential catastrophic stressor to a family that has already suffered damage within itself. The reality of the situation is illustrated by the fact that the New Jersey registration website, for example, announces “Any actions taken against the individual named in the notification, including vandalism or property, verbal or written threats of harm, or physical violence against this person, his or her family, or employer, will result in arrest and prosecution for criminal acts. Vigilantism is not only a crime but an action that will undermine the efforts of those who have worked hard to enact this law.”[x]
The application of Megan’s Law to juvenile and child sexual offenders is a complex issue with potential widespread negative consequences for the youth and society. Although its primary purpose is to protect the public, it may be applied based on statute without regard for true community risk and without consideration of developmental factors, effectiveness, and consequences. The American Society for Adolescent Society, lying at the forefront for adolescent advocacy, should endorse proper exploration of these matters, and a reasoned, studied approach to their usefulness and outcomes.
Editor’s note: The ASAP Governing Board is presently considering the development of a position statement with regard to Megan’s Law and welcomes input and views from its membership. Please forward any comments to firstname.lastname@example.org.
[ii] Freeman-Longo, R. Prevention or problem. Sexual Abuse: A Journal of Research & Treatment, 8:2, 1996
[iii] New Jersey Office of the Attorney General, Megan’s Law registration website, 2010.
[iv] Szymanski, L. Megan’s Law: Juvenile Sex Offender Lower Age Limits. NCJJ Snapshot, 14:8. National Center for Juvenile Justice. Pittsburgh, PA 2009
[vi] Gogtay, N, Giedd, J, Lusk L, et. al. Dynamic Mapping of Human Cortical Development during Childhood Through Early Adulthood, Proceedings of the National Academy of Sciences of the USA, 101(21):8174-8179, 2004
[vii] Association for the Treatment of Sexual Abusers. The effective legal management of offenders. ATSA 3:2000
[viii] Chaffin M, Bonner B, Pierce K. NCSBY Fact Sheet: What Research Shows About Adolescent Sex Offenders. Center on Child Abuse and Neglect, University of Oklahoma Health Sciences Center. 2007
[x] New Jersey Office of the Attorney General, Megan’s Law registration website, 2010Read More...