Impact of DSM-5 Changes Regarding Diagnosis and Treatment of Juvenile Offenders (Tyler Clark)

BTSpReportThe American Psychiatric Association’s top diagnostic and classification tool used to help treat patients is the Diagnostic and Statistical Manual of Mental Disorders. Currently in the 5th edition (2013), this comprehensive guide is commonly referred to as the DSM-5.

DSM-5Among the recent changes to the DSM-5 is the categorization and treatment approach to personality disorders as they would apply to teenagers and children. Before the recent updates, personality disorders and adolescents were not as well understood, nor were they an option as a diagnosis. Now that the guide allows professionals to explore personality disorders in juveniles in greater depth, there will be a clearer path to the diagnosis and treatment of personality disorders in youth populations on a case-by-case basis. While not all juvenile offenders have personality disorders, the new diagnosis can have a big impact on our understanding of juvenile offenders and how to best help them.

What is Personality Disorder?
To better understand how personality disorder changes in the new DSM-5 affect the industry’s understanding of juvenile offenders, it’s helpful to understand more about personality disorders in general.

This group of mental disorders is identified by maladaptive behaviors that deviate from acceptable cultural norms. Until recently, many believed individuals diagnosed with personality disorders were unable to benefit from therapy. The good news is that, with advances in therapeutic approaches, early intervention and continued study and research, those diagnosed with personality disorders are getting the help they need with impressive and effective results. This certainly includes children and teens.

Linked to high distress, disability and trauma, personality disorders can cause people to have difficulty cultivating healthy relationships and cause isolation and bad behavior. Youths with personality disorders can be violent, aggressive, lacking in empathy, self-centered and emotionally stunted. Overall, those diagnosed with personality disorders have a much more difficult time making social connections and sustaining relationships in a healthy way.

The DSM-5 currently lists 10 personality disorders. (Prior to the DSM-5 disorders like these could not have been officially diagnosed in someone under the age of 18.) The ten categories are:

1. Paranoid
2. Schizoid
3. Schizotypal
4. Antisocial
5. Borderline
6. Histrionic
7. Narcissistic
8. Avoidant
9. Dependent
10. Obsessive-compulsive

Personality Disorders and Juvenile Offenders
Until recently, juvenile offenders were not necessarily evaluated for mental health issues. Their bad behavior was attributed to broken homes, typical teen rebellion, poverty and any number of causes. Now, with everything experts have learned about personality disorders in the past few decades, a different and clearer picture is emerging in the evaluation of mental health issues and juvenile offenders.


A recent study assessed hundreds of juvenile offenders that were incarcerated for personality disorders; they found extremely high rates of mental illness. These at-risk youths were more likely to experience typical personality disorder symptoms, like irritability, aggression, delinquency and more. This study, and others like it, show that, because the presence of mental illness and personality disorders is so much higher than in the average adolescent population, experts must take aggressive steps and approach early intervention, treatment, and even incarceration, with more effective methods.

The odds of repeated crimes with juvenile offenders with personality disorders was found to be high, leading experts to believe that intensive therapy and treatment for the personality disorders might reduce recidivism. In short, providing treatment for troubled teenagers’ specific mental illnesses could have more positive and long lasting effects than simply punishing them for their criminal offenses alone.

Impact of Diagnosis and Therapy for Juvenile Offenders
Now that teens can be diagnosed with personality disorders, the structure and scope of therapy can be better tailored for more effective impact. Therapy for personality disorders includes group and individual therapy, developing control over impulses, boosting social skills, examining emotions and much more.

Research has shown that some of the most effective therapy for those with personality disorders involves the strengthening of social connections and teaching troubled teens and juvenile offenders how to maintain healthy relationships, better connect with others, and integrate more fully into society as a contributing member. These behavioral therapy steps are often combined with some medication therapy for long-term positive effects.

As experts learn even more about personality disorders and juvenile offenders, the more effective treatments will help keep troubled teens from repeating offenses and reduce the possibility of them developing into adults with personality disorders. ###

Liahona-logo-transparentTyler Clark is a researcher & writer focusing on parenting troubled teens with experience as the content and outreach coordinator for Liahona Academy, a residential treatment center for troubled teen boys. His areas of focus include parenting, education, addiction, and issues facing troubled teen now.


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