Perspective Chapter: The Assessment of Youth Violence

Abstract

Youth violence is a growing public health phenomenon that plagues communities both nationally and internationally, leading to billions of dollars in costly consequences. Youth violence ranks among the top five causes of death among youth in the United States. The development of violence risk assessment tools that identify at-risk youth measures risk factors that lead to violent behavior. In addition, some risk assessment tools identify risk-reduction interventions used to reduce the risk of future or chronic violence. More recent research has focused on individual differences in risk and resilience factors of youth. Moreover, researchers have identified both gender and ethnic differences in risk and resilience models utilized for risk reduction. However, the development and evolution of risk assessment for future violence among youth should not stagnate, as gender and ethnic differences should be incorporated into revised and new assessment tools. After carefully considering the available research, violence assessments should be refined to include gender and culturally relevant considerations to become a reliable and valid resource that is both gender and culturally inclusive and unbiased.

1. Introduction

Youth violence in the United States is a growing public health concern as it affects thousands of young individuals and their victims while also impacting their families, schools, and communities. The CDC defines youth violence as the intentional use of physical force to harm or threaten harm by young individuals between 10 and 24 years of age [1]. Young individuals can become involved in youth violence through perpetration, becoming the victim, or witnessing a violent act. Types of youth violence can include violent threats, fighting, bullying, sexual violence, gang violence, and even threats and physical harm with a deadly weapon. Even though youth violence can vary in type and concentration, it still negatively impacts all communities, including rural, suburban, urban, and even tribal. The CDC reports that $21 billion annually is spent on medical costs and loss of productivity due to physical assault-related injuries and homicide among youth in the United States. These costs do not include financial burdens on the criminal justice system, losses to victims, families due to psychological and social consequences, and damages to communities [1].

2. Youth violence

In the United States in 2019, out of an estimated 696,620 youth crimes, 154,060 were violent crimes [2]. However, due to the new definition of rape in the FBI database, sexual crimes are not included in the 2019 statistics. In addition, juvenile aggravated assaults and simple assaults have increased by 40% since 2010, indicating an ever-increasing problem with youth violence in the United States [2].

2.1 Estimated number of juvenile arrests, 2019

Most serious offense	Number of juvenile arrests	Percent change
		2010-2019	2015-2019	2018-2019
All offenses	696,620	−58%	−24%	−4%
Murder and nonnegligent manslaughter	860	−15%	10%	−6%
Rape	NA	NA	NA	NA
Robbery	16,080	−41%	−13%	−7%
Aggravated assault	27,070	−40%	−6%	−3%
Burglary	20,700	−68%	−42%	−7%
Larceny-theft	83,690	−70%	−46%	−10%
Motor vehicle theft	13,610	−14%	−7%	−8%
Arson	1800	−61%	−33%	−2%
Simple assault	126,130	−40%	−4%	1%
Forgery and counterfeiting	850	−50%	−17%	−18%
Fraud	3690	−36%	−18%	−22%
Embezzlement	540	22%	−8%	−7%
Stolen property (buying, receiving, possessing)	8940	−39%	−14%	−4%
Vandalism	31,950	−59%	−23%	4%
Weapons (carrying, possessing, etc.)	16,080	−49%	−17%	−6%
Prostitution and commercialized vice	290	−73%	−51%	9%
Sex offenses (except rape & prostitution)	NA	NA	NA	NA
Drug abuse violations	81,320	−52%	−18%	−10%
Gambling	190	−86%	−60%	7%
Offenses against the family and children	3060	−19%	−11%	−8%
Driving under the influence	5570	−54%	−16%	2%
Liquor laws	26,650	−72%	−38%	1%
Drunkenness	3470	−73%	−37%	6%
Disorderly conduct	53,990	−65%	−24%	−7%
Vagrancy	350	−84%	−68%	−49%
All other offenses (except traffic)	144,160	−51%	−14%	3%
Curfew and loitering	14,650	−85%	−67%	−33%

Law Enforcement & Juvenile Crime [2].

In the United States, an estimated 20,030 male and female youth were placed into residential placement in 2019 [3]. Almost half (9797) were due to a violent crime (e.g., aggravated assault, sexual assault, etc.). Even though, to a lesser degree, female youth were responsible for 27% of violent crimes resulting in residential placement [3].

2.2 Juveniles placed in residential placement in 2019

Offense	Total	Male	Female	Total	Male	Female
Criminal homicide	941	858	83	100%	91%	9%
Sexual assault	2362	2327	35	100%	99%	1%
Robbery	4131	3883	248	100%	94%	6%
Aggravated assault	3427	2938	489	100%	86%	14%
Simple assault	3067	2231	836	100%	73%	27%
Offense	Total	Male	Female	Total	Male	Female
Burglary	2540	2350	190	100%	93%	7%
Theft	1576	1307	269	100%	83%	17%
Auto theft	1782	1491	291	100%	84%	16%
Arson	204	183	21	100%	90%	10%

Kang et al. [3].

The CDC reports that a staggering number of youth in the United States, as many as 1000 daily, are treated in emergency departments for assault-related injuries [1]. However, data indicates that violence is disproportion among specific populations. For example, research suggests that compared to heterosexual youth, sexual minority youth are at a much higher risk of experiencing multiple types of violence. In addition, while compared to white youth, African-American youth are at a much higher risk of physical forms of violence. Furthermore, homicide is the third leading cause of death among African-American youth [1].

3. Risk assessment of youth violence

Risk assessments are designed to evaluate the probability of an individual committing future acts of violence. Before the 1990s, predicting future acts of violence was comparable to flipping a coin, as it was based on unguided clinical judgment [4]. Today risk assessments have become more thorough when assessing the individual’s risk of violence. While there are various tools for assessment, the Child and Adolescent Risk/Needs Evaluation (CARE-2) has the greatest validity when predicting future acts of violence [4]. When assessing, it is imperative to address an individual’s environmental, individual, familial, and societal risk factors to have a multifaceted assessment [5]. Using risk assessments to evaluate violence, can predict in an individual will commit future acts of violence.

3.1 History

Over several decades, risk assessments have been adapted and redefined to portray the prediction of future acts of violence more accurately. The use of risk assessments dates to the early 1900s and was primarily used in criminal justice agencies. Before the 1990s, risk assessments were based on the individual’s marital status, employment history, and history of violence [5]. Additionally, the risk assessments were conducted solely on mentally ill, adult males who are incarcerated or in residential housing, excluding adolescent and female participants [4]. In the early 1990s, the Canadian government funded the development of more sophisticated risk assessments. The evolution of risk assessments consists of three generations, which build upon each other to create accurate and reliable data.

The first generation of risk assessments was based on professional judgments. This led to professionals relying on the training or their individual experiences to make professional judgments. Objectivity and reliability were a concern, as professional judgment can be subject to human error or biases [6]. Moving into the second generation came a more objective and structured assessment that lacks the consideration that an individual can change over time. While the early risk assessments were said to have high inter-rater reliability, they lacked Receiver Operating Characteristics (ROC) and had moderate validity [5]. However, research began to suggest that combining dynamic and static risk factors, within the assessments, is a more accurate indicator than using static factors alone. This led to the beginning of the third generation of risk assessments. Incorporating static and dynamic factors assist with the development of a treatment plan, as the dynamic factors are changeable characteristics and can be improved upon over time or through intervention. While increasing the validity of risk assessments, the more recent risk assessments prove to be harder to score and may hold less statistical value to the study of risk in youth. This implies that the development of a better scoring system for static and dynamic factors would be beneficial in providing more in-depth information [7].

During the beginning of the third generation, several conflicts began to present themselves. Researchers began to argue that less correlated items, should not be disregarded as they can assist in guiding violence reduction. This pushed the field of risk assessment to include static/dynamic factors such as intelligence versus lack of education, integrating clinical risk and resiliency items that do not equal predictability of future acts of violence [7]. Some of the current risk assessment tools include the Youth Level of Service/Case Management Inventory (YLS/CMI), Structured Assessment of Violence Risk in Youth (SAVRY), and Psychopathy Checklist: Youth Version (PCL:YV), which not only include static and dynamic factors, but interventions for adolescents. The evolution of risk assessments shifted the field toward a weighted scoring system, that allowed clinicians to assess the absence, chronicity, or severity of an individual’s risk of violence (Welsh et al., 2008). An assessment that consists of a weighted system and calculates the total risk score, is the Child and Adolescent Risk/Needs Evaluation (CARE-2).

Violent behavior is often learned in the early years of an individual’s life, which increases the need for awareness and prevention efforts to be in place for the youth and families. Adolescents became the focus of risk assessments, as research suggests that prevention among adolescents may reduce risk factors for violence while increasing resiliency tendencies [7]. While researching the youth risk levels, it was determined that there are three trajectories for those with violent tendencies. Youth that spends their lives in jail or rehabilitation programs are the first trajectory and has a recidivism rate of 60–80% in areas of criminal justice or substance abuse [7]. The second trajectory is short-term as the acts of these individuals generally start during the teen years and end in adulthood. Psychotherapy interventions are often beneficial for the teen trajectory group. Additionally, they also are generally not involved in chronic or severe acts of violence [7]. Youth that suffers from a psychotic disorder or autism spectrum disorders who have been untreated is the third, and most recently added, trajectory group of violent youth. While this group is not thought to be violent; however, research has shown that youth in this group can have serious emotional outbursts [7].

Along with the shift to focusing on adolescents, professionals began to focus on risk reduction in violence. Assessing risk reductions begins with the risk assessment using evidence-based tools and allows the practitioner to focus on reducing risk factors and building resiliency factors [8]. While individualized risk assessments have improved, there are not adequate cultural considerations within the research. This is due to most of the previous research being based primarily on white imprisoned males. Incorporating cultural considerations within the research can assist in providing a more tailored assessment and reduction plan.

3.2 Risk and resilience models

Resiliency in psychological terms is defined as having the ability to maintain normal function, during or after extreme life stressors [9]. Risk factors that develop during early development can harm the child’s well-being and health; however, resiliency factors can assist the child’s ability to negate the effects and increase the chances of healthy development. It is that ideation that formed the resiliency theory [9]. When seeking how risk and resilience interact, there are five main models that researchers use which include, the Compensatory Model, Risk-Protective Model, Protective-Protective Model, Challenge Model, and Inoculation Model.

The Compensatory Model states that promotive factors reduce the effects of risk factors through interactive effects [10]. In the Compensatory Model risk and protective factors combine to form an outcome; however, each variable has a direct and independent effect on the outcome [11]. An example of how this model can be utilized is by comparing a child with low-self esteem to a child with high-self esteem to determine if their exposure to violence increased their likelihood of aggressive or violent behavior.

The protective factor model indicates that promotive resources can impact the relationship between risk and promotive factors and outcomes. The model contains the risk-protective model and the protective-protective model. When using the risk-protective model the assumption of promotive factors reduces the association between the risks and negative outcomes, is utilized. An example is recognizing a child with high self-esteem has a lower probability of becoming aggressive, due to exposure to violence. However, within the protective-protective model enhancing the promotive factors can be used to reduce risk and negative outcomes [12]. Within the protective-protective model, a child with low self-esteem, whose guardian has high self-esteem should positively progress, reducing risk factors and lowering the chance of aggressive behavior.

The challenge model and the inoculation model both work off the assumption that risk factors are factors leading to a negative outcome and positive coping skills lead to protective factors [13]. An example of the challenge model can be seen in an individual who went through trauma but uses positive/healthy coping mechanisms to lower their risk of a negative outcome. However, the inoculation model follows the assumption that youth will grow into their ability to deal with continued adversity [13]. This model implies that exposure to low-level risk factors assists in building protective factors that allow healthy coping skills during life stressors.

3.3 Risk and resilience factors

With years of experimental studies and research, researchers that study risk and resilience factors broke it into five-group systems of risk factors. The groups include individual, peer interaction, family, school, and community [8].

3.3.1 Individual risk factors

Negative life events	Impulsivity
Negative Attitude Toward the Future	Risk-Taking/Sensation Seeking
Internalizing Behaviors (anxiety, withdrawal)	Beliefs Supportive of Violence
Externalizing Behaviors (nondelinquent problem behaviors)	Attributional Bias
Violence Involvement	Poor Problem solving
General Delinquency Involvement	Poor Concentration
Limited Involvement in Conventional Activities	Attention Deficits
Early Violent/Aggression	Low Intelligence
Involvement in Non-Violent Crime	Low Self-esteem
Conduct Disorder/Externalizing Disorders	Lack of Empathy
Drug and Alcohol Use	Poor Social Skills

3.3.2 Individual promotive/resilience factors

Positive Social Skills	Self-efficacy for Non-violence
Sense of Hope	Sense of Purpose

3.3.3 Peer risk factors

Characteristics of Peer Networks	Affective Dimension of the Network
Association with Delinquent Peers	Commitment to Delinquent Peers
Association with Aggressive Peers	Negative/Delinquent Peer Influences
Alienation	Absence of Positive Peers
Gang Involvement

3.3.4 Peer interaction promotive/resilience factors

Involvement with Pro-Social Peers	Role-Modeling
Positive Support

3.3.5 Family risk factors

Poor Parental Supervision	Severe Inconsistent Discipline
Poor Parental Monitoring	Parental Attitudes Regarding Crime, violence, and substance use
Parenting Style/Hostile Family Environment	Parental Criminality/Violence
Low Attachment to Parents/Family	Physical Abuse/Neglect
Sibling Antisocial behavior	Parental Conflict
Family Structure	Parental Separation
Family Deviance	Parent/Child Separation
Lack of Parental Monitoring	Low Parental Attachment/Bonding
Lack of Clear Parental Guidelines	Delinquent Siblings
Low Parental Involvement	Large Family Size
High Parental Permissiveness	Involvement of Supervisory Services

3.3.6 Family promotive/resilience factors

Parental Warmth	Nurture and Support
Parental Presence and Monitoring

3.3.7 School risk factors

Low Attachment to or Poor Relationships with Teachers	Low Educational Aspirations
Low School Attachment	Low Academic Achievement
Unsafe School Environment	Poor Academic Performance
Truancy	Suspension
Low Commitment to School	Frequent School Changes
Poor Quality School	Overcrowding
Poor Classroom Management

3.3.8 School promotive/resilience factors

School Achievement	Connections to School
Positive Teacher Connection

3.3.9 Community risk factors

Criminogenic Neighborhood Indicators (drug use, youth in trouble)	Neighborhood Residents in Poverty
Availability of Firearms	Victim of Violent Crime
High Crime Neighborhoods	Violence Exposure
Availability of Drugs and Firearms	Exposure to Racial Prejudice
Community Disorganization	Low Community Participation

3.3.10 Community promotive/resilience factors

Community Resources	Community Organization
Availability of Pro-Social Relationships	Community of Pro-Social Remodeling

While many have utilized the five-group risk/resilience factors categories, others have broken the factors into three domains including contextual, interpersonal, and individual-level domains [14]. Each of the domains includes various subcategories that encompass several levels of risk/resilience factors. Contextual factors consist of community characteristics including environment, socio-economic status, and safety. Interpersonal factors include styles of parenting and exposure to substance abuse, from peers or parents. Individual factors consist of their cognitive ability and substance use during developmental years [14]. However, other researchers use four primary risk factor domains, including individual, peer/school, family, and violent histories. The individual risk factors consist of anxiety, depression, hopelessness, high-stress level, low self-esteem, lack of self-control, inadequate coping skills, substance abuse, and high-risk behaviors. Destructive peer bonding, low level of school satisfaction, school goals not being met, inadequate peer support, and low sense of belonging, are all peer/school risk factors. Family risk factors include lack of family support, family distress, weak bonds with parent/guardian, and parental substance use. Violent history risk factors include victimization, violent behavior, or exposure to violence [15].

3.4 Conceptual patterns of individual resilience

In terms of resilience patterns, four conceptual patterns have been described in the literature dispositional, relational, situational, and philosophical [9]. Each conceptual pattern signifies different factors that may impact an individual’s resilience. Dispositional patterns of resilience focus on the ego-related psychosocial attributes and attributes that support healthy dispositions toward life stressors. Some of the attributes considered are an individual’s sense of autonomy, self-worth, good self-image, and being physically healthy. This pattern implies that a person with high self-esteem or a positive self-image can avoid environmental or situational risk factors. The relational pattern includes an individual’s role in society and social relationships while focusing on the individual’s perception of how others view them.

Situational patterns show that some adolescents can manage stress by using problem-solving skills and evaluating situations and responses. This is evaluated by pairing an individual and a stressful situation and noting their response to the situation. While the philosophical pattern focuses mainly on the individual’s belief system, such as their worldview or life paradigm. The individual’s belief system can power their response to stressful situations and possibly avoid risky behaviors or violent reactions.

Risk models have been utilized for various reasons; however, there are limitations to risk models as they often do not provide an accurate explanation of developmental processes and how to conduct problems develop. With that in mind, the biopsychosocial transactional development model has been suggested for at-risk youth, as it explores genetic predispositions including genetic predispositions of aggression, conduct disorder, and delinquency [16]. Among all species, males display more aggressive traits versus their female counterparts, which is an example of biopsychosocial predispositions. Another aspect of the biopsychosocial transactional development model is the socio-cultural factors including familial, neighborhood, and subcultural aspects of development [16]. There are several theories associated with risk assessment, which causes the conflict of what assessment more accurately predicts violence in low, medium, or high-risk individuals.

The Positive Youth Development (PYD) model is another risk and resilience model, that focuses on strength-based approaches and positive characteristics [17]. The developmental assets framework reinforces the PYD model by focusing on 40 developmental assets that assist in adolescents reaching their potential. The developmental assets consist of 20 external and 20 internal assets that set benchmarks for student outcomes. External assets include support, empowerment, boundaries, and expectations, that are experienced through positive interactions with other individuals and institutions. The internal assets encompass an individual’s characteristics that encourage positive internal growth including a commitment to learning, positive values, social competence, and positive identity [17]. Over the years the Positive Youth Development model has become more popular. Researchers have identified PYD as promising in reviewing programs to prevent teenage violence [18].

4. Youth subgroups

Adolescent risk factors may vary depending on their respective subgroups. A study completed internationally found that 5% of juvenile offenders committed more violent crimes when compared to adult offenders of violent crimes [19]. Additionally, 5% were more likely to be found in the lifelong trajectory of criminal activity, as it continues into adulthood. Within the 5% subgroup, there are specific family, peer, and individual risk factors that can contribute to recidivism. Family risk factors include uninvolved parenting styles, lack of empathy or support, and the absence of parents. The peer risk factors consist of peer rejection, peer deviance, and adolescent novelty seeking. Individual risk factors include low intelligence, current or previous violent behavior, personality characteristics, psychopathology, and substance abuse [19].

Adolescents involved in dating violence and victimization are another subgroup of violent youth offenders, which includes specific family, individual, and school-related risk factors [20]. A framework was constructed by Makin-Byrd et al. [20] that indicated risk factors and pathways to dating violence and victimization. Based on the framework, the first pathway suggests that adolescents who exhibit non-compliant and aggressive behavior that may lead to dating violence, have experienced harsh coercive parenting styles with a poor parent–child relationship. While the previously mentioned risk factors are still valid, the second pathway includes a generalized pattern of aggressive responses in school, which may lead to dating violence or victimization [20].

Exposure to violence is considered a core risk factor, as child abuse has an incident rate of 16% in the United States [21]. Experiencing or witnessing physical abuse during childhood can cause maladaptive thinking patterns and have a negative impact in adulthood, according to research [22]. An individual can be exposed to violence through direct victimization, physical/threatened abuse or witnessing victimization or violence. Being exposed to violence has correlated with socio-behavioral problems, including substance use, suicidal behavior/ideations, and aggressive/violent behavior [23]. Empirical evidence has shown that adverse childhood experiences, primarily physical abuse, and future violent behavior in adulthood, have a relationship [22]. Additionally, victims of physical abuse in childhood are twice as likely to abuse their intimate partners in adulthood which is an indicator of dating violence in adolescence.

Another risk factor for future acts of violence is attachment problems or disorders. This is due to the impact it can have on an individual’s empathy level. In early childhood, attachment supports the development of the brain, communication skills, and the ability to form relationships [24]. When an adolescent develops attachment, it allows the individual to learn social skills including cooperating as a group, following group rules, and adapting. However, two paths can disrupt the individual’s ability to develop attachment. If a child has suffered abuse or neglect or suffers from an untreated mental illness or autism, it can inhibit the individual from bonding with caregivers. Severe problems can develop when an attachment is disrupted such as concerns with skill development, self-concept, self-management, interpersonal skills, emotional regulation, and development of pro-social values [24].

It has been suggested that parental attachment plays a key role in predicting juvenile offenses [25]. The parental attachment has been established as a primary bond between a child and society, according to the control theory. The research suggests that strong affective bonds between child–parent can deter juvenile delinquency, poor bonding is associated with juvenile delinquency, and is also a predictor [24, 25]. The weak attachment has also been linked to inadequate empathy and the commission of acts of serial violence against others [24]. Additionally, exposure to violence was linked to poor parental attachment, future acts of violence, behavioral problems, impulsivity, sexual assault, attachment disorders, poor social skills, and school behavior problems [4].

4.1 Gender differences in risk and resilience

Data obtained from the 2017 Youth Risk Behavior Study, a self-report questionnaire used by the Center for Disease Control and Prevention, shows that 30% of boys, as compared to 17% of girls, report having been in a physical fight during the previous year [26]. This research is indicative of an almost 50% higher rate of violence among males than among females, a difference which is worth consideration, considering that males and females report many of the same risk factors toward violence [27]. Socializing agents have been shown to be different among males and females. This is seen when caretakers encourage certain behaviors in adolescents such as females being encouraged in caretaking and relationship management, versus males being encouraged in autonomy, instrumentality, and goal-directed behavior [28].

While there have many studies on the risk factors of adolescents and children, few have included an adequate sample of female subjects to draw conclusions concerning the moderating role of gender when the other, known risk factors remain constant [27]. Studies which do study gender tend to do so as a primary risk factor, rather than as a moderating risk factor in the commission of violent crimes. This remains true in recent literature, despite findings that certain risk factors, such as trauma, being the victim of a violent act and being involved in a dysfunctional relationship carry much more weight in females as a precursor to committing violent acts than they do among males [29]. The fact that few studies include an adequate representation of females or consider differences in how various risk factors affect females versus males lessens the validity of these studies when attempting to develop a theory of risk factors among females [30].

Among females, being the victim of violence in the home is likely to cause revictimization later in life, while in males, it is likely to lead to violence against others [29]. Female youth who grow up in a home with an absent or abusive father are much more likely to be the victim of dating violence as adolescents and young adults [31]. Males in the same situation are more likely to act out violently against others [31]. In single family or abusive/neglectful families, children are much more likely to become involved in alcohol or drugs, which increased the risk of behaving violently in both genders, and of female youth being victimized, particularly by a romantic or dating partner [31].

Males are often more likely to be perpetrators and victims of physical bullying than females [32]. Males are often socialized into coping with anger through aggression in an overt or physical way, while females often respond to anger by inflicting aggression on others personal relationships or psychological wellbeing [33]. This suggests that parents who reinforce aggression, physically or verbally, as a method of managing anger or negative emotions, can increase the chances the adolescent using aggression or violence in the future. However, research is limited on the correlation of cause of violent behavior and gender differences.

Poverty seems to affect both male and female youth negatively, but in different ways. While poverty-stricken male youth tend to act out violently against others, female youth are at an increased risk of being victimized by others [31]. This is particularly true if they are raised in a family where the father is either absent or is abusive to the mother and/or the children [31]. Females tend to internalize abuse, while males tend to act out against others when they have been the victims of abuse [31]. Females blame themselves; males blame the abuser—it affects them differently, but still makes both groups more likely to either abuse others or to be the victims of further abuse [31].

4.2 Ethnic differences in risk and resilience

When predicting future acts of aggression or violence, previous research lacked knowledge concerning risk and protective factors associated with racial or cultural differences. A recent study compared violent trends in adolescents among the Mexican, Puerto Rican, Cuban, Non-Latino Black, and Non-Latino White adolescents. The results indicated that White youth were at the lowest risk, while Puerto Rican youth are at the highest risk of perpetrating severe violence, compared to the other ethnicities included in the study [34]. While each ethnicity carries its own set of risk and protective factors, some factors can have an impact on all adolescents regardless of cultural or ethnic differences. Being a witness or victim of violence at home or among peers has proven to put youth at increased risk of involvement in acts of violence. Abuse in early childhood has been proven to desensitize youth to violence, making it appear appropriate to use violence as a solution to a conflict [35]. Additionally, adolescents with gang affiliations are more susceptible to violent acts, when compared to those without affiliations [35]. Seeley’s (2010) research also suggested that Latino youth are more likely to be involved in a gang, followed by Non-Latino Black, and Non-Latino White youth. The following sections will discuss the risk and resilience factors of African American, Latino, and White adolescents.

4.3 Risk and resilience factors in white youth

The risk and resilience factors White adolescents face are similar to those in other ethnic groups but are often overlooked. Adolescents who are from single-parent or abusive homes increase the possibility of violent behavior (CDCP, 2012). The chances are greater for acts of violence or gang involvement, in White adolescents who participate in drug or alcohol use. Additionally, white male adolescents in abusive or violent households can be an indicator of future violent behavior, while females are more likely to become involved in violent relationships (CDCP, 2012). The top indicator for future acts of violence among White adolescents is parental neglect/absence and violence (CDCP, 2012). Homicide is one of the leading causes of death among White adolescents [36]. White youth is less likely to die from homicide than African American or Latino youth, due to peer/gang violence. It is more likely for White youth to die because of familial abuse or neglect when compared [36].

4.4 Risk and resilience factors in African American youth

African American and Hispanic adolescents have a higher risk of being involved in acts of violence, resulting in social sequelae, negative health impacts, incarceration, and homicide, according to research [8]. Death is the leading cause of death in African American adolescents. A study published by Stoddard et al. [8], found that three-fourths of the urban youth population reported peer violence to the emergency department. Urban stress and mental health perspectives are that African American youth are affected because of discrimination, racism, and stress-inducing factors, including oppression, expansion of drugs, using violence as a solution to a problem, and greater exposure to violence [37]. Approximately 79% of violent crimes occur in urban communities, with 80–90% of urban youth witnessing or being a victim of a violent crime [37]. Youth exposed to abuse or violent crimes are more likely to present aggressive behaviors and potentially become victimizers. Along with a primary parental figure(s) having a substance abuse problem or neglectful can dramatic Discrimination and oppression have been a reoccurring risk factor for future acts of violence, in the African American culture. The impact of discrimination and oppression has resulted in many internalizing racist attitudes, leading to mutual disrespect, internal communal conflict, and Black-on-Black violence [38]. African Americans are not among the only minority populations to be victims of discrimination or oppression, but there is a lack of research on other ethnic groups and the impact it has made on their culture.

However, strong ethnic identity and high self-esteem have been identified as resilience factors. Resilience factors aid in reducing internalizing behaviors and create better-coping skills and problem-solving strategies. Additional resilience factors among the African American youth include strong family presence, spiritual/religious beliefs, and positive social involvement. Research has suggested that youth involved in extracurricular activities through the church, school, or community organizations is a positive deterrent from violent behavior in all cultures [39]. Many extracurricular activities involve guidelines or rules to be able to continue participation, holding the adolescents accountable for their actions or behaviors. Family, including extended family, plays a major role in many African American adolescents’ lives. Many reporting to have several caregivers throughout development, implying a strong support system [40]. Research has found that parenting style can be a risk or protective factor for chronic violence. For example, controlling parenting styles among African American households tend to be adaptive and protective within high-risk environments which suggests that a controlling parenting style may assist in African American youth to recover from committing assaultive behavior [41].

4.5 Risk and resilience factors in Latino youth

Within the research, the Latino/Hispanic populations are inadequately represented as many of the studies are broken down into Caucasian, African American, or Other. Individuals of the Latino population have their own distinct risk and protective factors. The Latino population is growing rapidly compared to other ethnic groups, due to immigration and the high rate of family growth (CDCP, 2012). Studies have suggested that acculturation and speaking Spanish at home are important protective factors to keep in mind when considering future acts of violence [42]. This is an important consideration due to some households only speak Spanish and do not learn the English language, this makes it difficult for their children in academic and social situations. Low academic achievements are commonly attributed to living in poverty, which increases the likelihood of being exposed to violence [36]. Latino adolescents who have positive role models of their own or from other cultures are less likely to become involved in violent behavior. Resilience factors among the Latino population include positive peer relations, academic achievements, communication skills, and living above poverty [34].

The Latino community has been identified as having high levels of parental involvement and belonging to peer groups, which unlike other ethnicities has been found to be a risk factor [43]. Studies suggest that many parents in the Latino community are reluctant to trust those of other cultures and resist accepting or seeking beneficial assistance for their children. However, the Latino youth has shown a greater acceptance of help, implying that parental involvement inhibits Latino youth from seeking help from non-Latino individuals or entities [44]. While a strong ethnic identity is important for the self-esteem it can be beneficial to Latino youth to interact with individuals of multiple cultures as it prevents involvement in violent behaviors, while promoting a sense of community. Research has suggested that large peer groups of predominantly one race can lead to an increased chance of gang involvement or other criminal behavior [44]. Homicide is the second leading cause of death among the Latino population, with accidental injury being the first (CDCP, 2012). Research must be continued to determine risk and protective factors among the Latino population and to form preventative measures for the betterment of the Latino population’s emotional and physical wellbeing.

5. Assessment measures for youth violence

There have been several assessments created for clinicians and researchers to predict future acts of violence within the youth. Prominent assessment tools include the ability to weigh strengths/weaknesses with multicultural factors considered, including age, culture, and gender, along with proven reliability and validity. While evaluating several risk assessments, the Child and Adolescent Risk/Needs Evaluation (CARE-2) is the strongest predictive tool, when comparing reliability/validity rates [4]. The following will discuss an overview of the more prominent risk assessments, that are currently available for predicting future acts of violence.

5.1 The child and adolescent risk/needs evaluation (CARE-2)

The child and adolescent risk/need evaluation (CARE-2) examines risk factors that may impact a child or adolescent’s development and assists in developing a plan for youth to grow into becoming pro-social members of society. The CARE-2 assessment model is based on an atheoretical risk-resilience model. Additionally, for a risk assessment tool to have validity, it should present a range between 75 and 85% Receiver Operating Characteristics (ROC). The CARE-2 assessment predictive validity has been reported at 75–94% (ROC) for males and 67–97% (ROC) for females, which is above the SAVRY, PCL-YV (male), PACT, and LS-CMI assessments predictive validity rate [4]. This assessment tool can assess by age group and gender while predicting chronic violence. The limitation behind this assessment is that it does not have a strong statistical foundation and does not address specific ethnic risk or resilience factors.

5.2 Youth level of service/case management inventory (YLS/CMI)

Youth Level of service/case management inventory (YLS/CMI) is a tool based on the atheoretical risk-resilience interaction model. It combines a risk/needs assessment and a case management tool into a system derived from the Level of Service Inventory-Revised (LSI-R) tool. The YLS/CMI is often utilized by probation officers, youth workers, psychologists, and social workers, as it identifies the youth’s needs, strengths, barriers, and incentives, allowing the professional to select appropriate goals for the individual, producing an effective case management plan (Hoge & Andrews, 2016). While the YLS/CMI system is a risk reduction tool based on research. However, the assessment does not assess by age or gender or incorporate ethnic risk or resilience factors. With the limitations in mind, the YLS/CMI would not be appropriate for predicting or assessing violent patterns [45]. The assessment does have moderate validity for recidivism.

5.3 Structured assessment of violence in youth (SAVRY)

The SAVRY is based on the Structured Professional Judgment model, and is not designed to be a formal test, but more a structured interview without statistical designation or scores. The SAVRY consists of three risk domains broken into 24 items, the domains include Historical Risk Factors, Social/Contextual Risk Factors, and Individual/Clinical Factors. The SAVRY assessment follows clear definitions of risk and protective factors, addressing the primary domains. Within the assessment, each risk factor is rated with a three-level structure, while the six protective factors are rated by present or absent, all of which have specific rating guidelines. Additionally, reactive, and proactive aggression is theoretically supported and emphasized [46]. Childs et al. [47], suggested that the SAVRY shows appropriate measures of reliability and validity; however, it does not take into account cultural considerations in youth. Another limitation is that SAVRY excludes children and young adolescents and focuses on risk and resilience in adolescents.

5.4 Psychopathy checklist: youth version (PCL:YV)

The Psychopathy Checklist: Youth Version (PCL:YV) was created by Robert Hare in the 1970s and has been revised into the PCL-R, which was published in 2003 and is often used as a tool to measure psychopathy that is used in research [48]. The PCL:YV assists with identifying patterns of cheating, fighting, bullying, and antisocial behaviors in adolescents/youth. Determining the patterns of traits can be crucial for the individuals developing into adulthood (Forth et al., 2016). The PCL:YV can be utilized to understand contributing factors to antisocial behavior and psychopathy in adulthood. Within the PCL:YV follows an expert-rater that emphasizes the need for multidomain and multisource information (Forth et al., 2016). While the PCL:YV tests high on validity standards, the focus is on predicting antisocial or sociopathic behaviors, assisting in predicting violent behavior in the future. However, there is a limit on youth age groups.

5.5 Screening tool for the assessment of young sexual offenders’ risk (STAYSOR)

The STAYSOR consists of 11 dichotomous and static-historical items and is considered a self-constructed risk assessment tool. The research emphasized that there is the relevance of psychological abnormalities in juvenile sexual offenders [49]. There are four items included in the assessment such as prior sexual offenses, current convictions of any offense, any stranger victim, and any male victim, which are adaptions from the STATIC-99 [50]. While the STRAYSOR has proven to be a useful tool for predicting sexual violence, however, it would not be a reliable tool for predicting nonsexual violent acts. This instrument relies on behaviors without considering risk or resilience factors, limiting the predictive ability of youth without previous convictions or offenses.

5.6 Structured assessment of protective factors for violence risk (SAPROF)

The SAPROF was developed specifically for assessing protective factors in adult offenders and is often used in addition to a risk-focused Structured Professional Judgment (SPJ) tool, such as the HCR-20 or HCR-20 V3. Included in the SAPROF are 17 protective factors, 15 of which are dynamic factors making them important treatment evaluation and target measures that are rated on a three-point scale. The SAPROF is suitable for previous violent and sexual offenders [51]. While the SAPROF assessment has shown to be inappropriate for children or youth, it proves to be a reliable predicting tool for adult offenses. However, the assessment has shown to have more validation when used on male offenders, as the research completed on the use with females lacks strong empirical evidence. Additionally, it focuses primarily on protective factors excluding many risk factors beneficial in predicting violence.

5.7 Reynolds adolescent adjustment screening inventory (RAASI)

The RAASI is a self-reported measuring tool indicating the clinical severity of domains of psychological adjustment problems and assessing the frequency and symptom of adjustment problems. 32 items within this assessment tool are derived from the Adolescent Psychopathology Scale (APS) [52]. The RAASI provides an Adjustment tool along with four factorial-derived scales that provide specificity to an adolescent’s Adjustment problem. The scales include antisocial behavior, anger control, emotional distress, and positive self. Generally, the RAASI is utilized in residential settings and has shown inappropriate for predicting violence in a community, home, or school setting.

5.8 The strengths and difficulties questionnaire (SDQ)

The Strengths and Difficulties Questionnaire measures emotional symptoms, conduct problems, attention/hyperactivity, peer relationship concerns, and prosocial behaviors, in youth ages 3–16 years old. The questionnaire can be used for screening, assessment, and evaluation, and can be completed and scored online [53]. This assessment tool is appropriate for screening violent behavior; however, it lacks multicultural considerations.

5.9 Youth violence risk assessment tools

The table below summarizes the leading Risk Assessment Tools by Aspect.

Aspect	CARE-2	YLS/CMI	PCL/YV	SAVRY	STAYSOR	SAPROF
Risk/resilience Factors based on research	X	X	X	X		X
Assesses by Age Group	X
Assesses by Gender	X
Risk Assessment/Reduction Tool	X	X	X		X	X
Predicts Chronic Violence	X		X
Incorporates Ethnic Risk Factors
Incorporates Ethnic Resilience Factors
Based on a 5 Domain Model
Atheoretical Risk-Resilience Interaction Model	X	X		X		X

6. Conclusion

Despite various research displayed, there is inadequate research regarding the risk and resilience factors for youth in various areas. Based on research provided the CARES-2 assessment tool is currently the most effective in predicting youth violence; however, it can be improved by adding cultural and ethnic considerations. Stripping the current weights of the CARE-2 assessment to better accommodate African American and White groups, while incorporating a method to determine gender variations among ethnicity and gender. Additionally, for the Latino group a recommendation is to complete a Spearman’s rho nonparametric correlation on the Latino group and evaluate the difference of risk and resilience factors within the CARE-2. Building new risk and resilience and reorganizing the CARE-2 into five subdomains including individual, peer interaction, family, school, and community, would allow a more detailed picture of the assessed individuals factors. The final recommendation is to develop new item within the CARE-2 that reflect ethnic-specific risk factors such as discrimination, oppression, racism, and stress inducing factors, along with resilience factors such as self-esteem and strength of their cultural identity. Developing an assessment that has proven reliability and validity for predicting violence will require more research. It is crucial when developing the assessment it causes no harm emotionally, legally, or physically.