**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**

#### *Perspective Chapter: The Assessment of Youth Violence DOI: http://dx.doi.org/10.5772/intechopen.106069*

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**

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

*Perspective Chapter: The Assessment of Youth Violence DOI: http://dx.doi.org/10.5772/intechopen.106069*

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.
