Taking a toy gun to school: a consideration of the determinants of adolescent forensic behavior in the aftermath of the Sandy Hook shooting

Timothy R. Rice; Leon Hoffman

doi:10.1515/ijamh-2015-5016

Article

Taking a toy gun to school: a consideration of the determinants of adolescent forensic behavior in the aftermath of the Sandy Hook shooting

Timothy R. Rice and Leon Hoffman

Published/Copyright: November 20, 2014

Published by

Become an author with De Gruyter Brill

Submit Manuscript Author Information Explore this Subject

From the journal International Journal of Adolescent Medicine and Health Volume 27 Issue 2

Abstract

Adolescent forensic behavior can have a variety of meanings. A consideration of the range of meanings can inform the practice of the psychiatric forensic evaluation. This case report describes the history of an adolescent in individual treatment for disruptive and self-defeating behaviors who brought a concealed toy gun into his high school in the aftermath of the Sandy Hook shooting. The overdetermined nature of this act, as well as a consideration of its multiple meanings in the context of the young man’s psychology, his educational and family systems, and his relationship with his treatment provider, will be described and developed. The discussion will broaden to consider the parameters of indicated therapeutic programs to address this subset of adolescent forensic behaviors. The role of deficient implicit emotion regulation capacities in adolescents and the corrective measures to target these neurobehavioral deficits will be described. The report concludes with implications for primary prevention of future adolescent forensic behaviors.

Keywords: adolescents; forensic evaluation; implicit emotion regulation; primary prevention; regulation-focused psychotherapy

Corresponding author: Timothy R. Rice, MD, Department of Psychiatry, The Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, Box 1230, New York, NY 10029, USA, E-mail: timothy.rice@mssm.edu

References

1. Flannery DJ, Modzeleski W, Kretschmar JM. Violence and school shootings. Curr Psychiatry Rep 2013;15:331.10.1007/s11920-012-0331-6Search in Google Scholar PubMed

2. Insel TR. The NIMH Research Domain Criteria (RDoC) Project: precision medicine for psychiatry. Am J Psychiatry 2014;171:395–7.10.1176/appi.ajp.2014.14020138Search in Google Scholar PubMed

3. Rice TR, Hoffman L. Defense mechanisms and implicit emotion regulation: a comparison of a psychodynamic construct with one from contemporary neuroscience. J Am Psychoanal Assoc 2014;62:693–708.10.1177/0003065114546746Search in Google Scholar PubMed

4. Rice T, Hoffman L. Regulation focused psychotherapy for children with externalizing behaviors. J Am Psychoanal Assoc 2014; in press.10.4324/9781315736648Search in Google Scholar

5. Achenbach TM. Integrative guide for the 1991 CBCL/4-18, YSR and TRF profiles. Burlington: Department of Psychiatry, University of Vermont, 199.Search in Google Scholar

6. Achenbach TM, Rescorla LA. The manual for the ASEBA school-age forms and profiles. Burlington: University of Vermont, Research Center for Children, Youth, and Families, 2001.Search in Google Scholar

7. Birmaher B, Khetarpal S, Brent D, Cully M, Balach L, et al. The Screen for Child Anxiety Related Emotional Disorders (SCARED): scale construction and psychometric characteristics. J Am Acad Child Adolesc Psychiatry 1997;36:545–53.10.1097/00004583-199704000-00018Search in Google Scholar PubMed

8. Radloff LS. The CES-D Scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1977;1:385–401.10.1177/014662167700100306Search in Google Scholar

9. Wolraich ML, Lambert W, Doffing M, Bickman L, Simmons T, et al. Psychometric properties of the Vanderbilt ADHD Diagnostic Parent Rating Scale in a referred population. J Pediatr Psychol 2003;28:559–67.10.1093/jpepsy/jsg046Search in Google Scholar PubMed

10. Swanson JM. School-based assessments and interventions for ADD students. Irvine: KC Publishing, 1992.Search in Google Scholar

11. Olfson M, Blanco C, Liu SM, Wang S, Correll CU. National trends in the office-based treatment of children, adolescents, and adults with antipsychotics. Arch Gen Psychiatry 2012;71:81–90.10.1001/archgenpsychiatry.2012.647Search in Google Scholar PubMed

12. Maayan L, Correll CU. Weight gain and metabolic risks associated with antipsychotic medications in children and adolescents. J Child Adolesc Psychopharmacol 2011;21:517–35.10.1089/cap.2011.0015Search in Google Scholar PubMed

13. Correll CU. Safety and tolerability of antipsychotic treatment in young patients with schizophrenia. J Clin Psychiatry 2011;72:e26.10.4088/JCP.9101tx5cSearch in Google Scholar PubMed

14. Pringsheim T, Gorman D. Second-generation antipsychotics for the treatment of disruptive behaviour disorders in children: a systematic review. Can J Psychiatry 2012;57:722–7.10.1177/070674371205701203Search in Google Scholar PubMed

15. Hazell P. Review of attention-deficit/hyperactivity disorder comorbid with oppositional defiant disorder. Australas Psychiatry 2010;18:556–9.10.3109/10398562.2010.498049Search in Google Scholar PubMed

16. Scotto Rosato N, Correll CU, Pappadopulos E, Chait A, Crystal S, et al. Treatment of maladaptive aggression in youth: CERT guidelines II. Treatments and ongoing management. Pediatrics 2012;129:e1577–86.10.1542/peds.2010-1361Search in Google Scholar PubMed

17. Kernberg PF, Chazan SE. Children with conduct disorders: a psychotherapy manual. New York: Basic Books, 1991.Search in Google Scholar

Received: 2014-7-1

Accepted: 2014-8-15

Published Online: 2014-11-20

Published in Print: 2015-5-1

You are currently not able to access this content.

Articles in the same Issue

https://doi.org/10.1515/ijamh-2015-5016

Keywords for this article

adolescents; forensic evaluation; implicit emotion regulation; primary prevention; regulation-focused psychotherapy