摘要：Objective. We identified gender differences in psychiatric disorders among youths at probation intake. Methods. We measured disorders with the Voice Diagnostic Interview Schedule for Children among 991 randomly selected youths (200 girls) at probation intake in 8 Texas counties. Logistic regression analyses predicted diagnostic clusters by gender, adjusting for demographics and offense characteristics. Results. Demographic and offense characteristics explained small but interpretable and specific variance in diagnostic profile. Girls’ rates of anxiety and affective disorders were higher than boys’ (odds ratios = 0.59 and 0.32, respectively). Girls with violent offenses, compared with other groups, were 3 to 5 times as likely to report anxiety disorders. Conclusions. Among youths with conduct problems, girls demonstrated an elevated risk for co-occurring anxiety or affective disorder. Antisocial behavior is far more characteristic of boys than of girls: girls’ conduct disorder (CD) rates are approximately half boys’ rates 1 ; across all types of criminal activity, only 28% of arrested youths are female. 2 This gender disparity has led some 3 to propose a “gender paradox,” whereby the gender group less likely to be disordered has a more severe form or presentation of the disorder. This theory suggests that antisocial girls will be more impaired across co-occurring dimensions than are antisocial boys and, accordingly, may have elevated mental health problems. 5, 8 Although community samples report moderate co-occurrence of internalizing (anxiety and affective) and externalizing (disruptive behavior and substance use) disorders in both genders, 9 and sometimes higher co-occurrence in adolescent and young adult female subjects than in male subjects, 10, 11 even stronger associations might be expected when conduct problems are sufficiently severe to result in justice system contact. 11 Associations between conduct and mood symptoms or diagnoses increase with age, particularly for female patients, perhaps reflecting secondary adverse mental health consequences for antisocial girls. 9 A growing body of literature, predominantly focusing on male subjects, considers the epidemiology of psychiatric disorder among youths in justice settings. 12 With few exceptions, 13 little is known about the mental health status and service needs among the increasing proportion of girls with justice system contact. Recently, Teplin et al. 13 reported higher disorder rates for girls than for boys in juvenile detention, consistent with studies of adult female detainees. 14 Recently, we 12 reported high levels of psychiatric disorder among incarcerated male youths. Here, we extend these findings to study girls in the justice system, comparing their rates of disorder to those of boys at probation intake and examining the contribution of both demographic and justice-related characteristics to the presence and co-occurrence of disorder. We hypothesize that prevalence of disorder, beyond that expectably related to delinquency (disruptive behavior and substance use), will be higher in girls, whereas externalizing disorders will occur at similar rates for boys and girls.
