Youth Homicide: A Review of

the Literature and a Blueprint for Action

Kathleen M. Heide

Abstract: This article first synthesizes the literature on clinical and empirical findings related
to youth homicide. Thereafter, it reviews the literature with respect to the treatment of juvenile
homicide offenders. Although a large body of literature exists, many questions regarding etiol-
ogy, associated risk factors, intervention strategies, and long-term outcomes remain unan-
swered. The article concludes with recommendations to guide future research efforts with the
aim of increasing understanding of etiological factors associated with juvenile homicide and
designing effective intervention strategies. Greater advances in knowledge will follow with the
implementation of enhanced methodological designs that examine juvenile homicide across
four distinct time frames: the years preceding the homicide, the time period immediately fol-
lowing the homicide, the incarcerative or treatment period, and the postrelease period.

Keywords: youth homicide; youth violence; juvenile homicide offenders; adolescent murderers;
teen killers; literature review; treatment; follow-up studies; recidivism

The issue of juvenile homicide has been headlined repeatedly in the news all over
the United States and abroad since the early 1990s. Although it is difficult to
assess the exact number of murders committed by juveniles because the age of the
killer is not specified by the arresting authority in as many as a third of the cases,
there is no question from available data that murders by young people have risen
during the past two decades (Snyder, 2001). Dramatic increases in youth being
arrested for homicide beginning in the early 1980s are apparent whether the frame
of reference being examined is youth younger than 18 (Fox & Zawitz, 2000;
Heide, 1999) or those in their middle to late teenage years (Feiler & Smith, 2000;
M.D. Smith & Feiler, 1995).
The term youth is a broad concept that encompasses both juveniles and adoles-
cents. Although these words are often used interchangeably in the media and in
the professional literature, they can be distinguished from each other. Juvenile or
minority status is determined on the basis of age and is a legislative decision
(Butts & Snyder, 1997). The federal government and the majority of the states, for
example, designate youth younger than 18 juveniles (Bortner, 1988; Sickmund,
1994.) The FBI (2001) classified arrests of “children 17 and under” as juvenile
arrests.

NOTE: Some material contained in this article was previously published in the author’s book, Young
Killers (Sage, 1999).
International Journal of Offender Therapy and Comparative Criminology, 47(1), 2003 6-36
DOI: 10.1177/0306624X02239272
 2003 Sage Publications
6

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Youth Homicide: Literature Review & Action Plan 7

Adolescence, in contrast to juvenile status, is based on human development

and varies across individuals. It is a stormy period characterized by hormonal
changes, growth spurts, psychological changes, and enhancement of intellectual
abilities and motor skills. According to child development experts, adolescence
begins with puberty, which typically commences by age 12 or 13 but may start
earlier (Solomon, Schmidt, & Ardragna ,1990; see also Lee, Lee, & Chen, 1995).
Adolescence extends through the teen years to ages 19 or 20 (Solomon et al.,
1990). The term children is commonly used to refer to prepubescent youth.
Analysis of crime patterns clearly indicates that youth involvement in homi-
cide remains a serious problem in the United States in the 21st century. Homicide
arrests of juveniles rose every year from 1984 through 1993. The juvenile murder
rate peaked in 1993 at 14 per 100,000 and was more than twice the level of the
early 1980s (6 per 100,000) (Snyder, 1997). The significant rise in murders com-
mitted by those younger than 18 during this time frame cannot be attributed to an
increase in the juvenile population during this period. In fact, the percentage of
young Americans during this time frame had generally been declining
(Blumstein, 1995; Ewing, 1990; Fox, 1996). Although the numbers of minors
arrested for murder decreased from 1994 through 2000, it would be wrong to con-
clude that the crisis in lethal violence by youth is over. The percentage of all homi-
cide arrests involving juveniles in 2000, after 7 years of decline, is still higher than
it was in 1984 when juvenile homicide was just beginning to increase.
In the 21st century, adults ask why youth kill just as they have for centuries.
The question, however, has become more urgent because available data suggest
that young people in the United States are killing more since the mid 1980s than in
previous generations. This article first synthesizes the literature on clinical and
empirical findings related to youth homicide. Thereafter, it reviews the literature
with respect to the treatment of juvenile homicide offenders (JHOs). The article
concludes with recommendations to guide future research efforts with the aim of
increasing understanding of etiological factors associated with juvenile homicide
and designing effective intervention strategies.

FACTORS ASSOCIATED WITH YOUTH HOMICIDE

Many clinicians and researchers have examined cases of youth killing during
the past 50 years in an effort to determine the causes of juvenile homicide. Two
excellent critiques of the literature by Cornell (1989) and Ewing (1990) have been
previously published. Both scholars cited a number of methodological problems
with most of the studies conducted on juvenile homicide through the late 1980s
and suggested that reported findings be viewed with caution.
Much of the difficulty with the available literature stems from the fact that most
published accounts of young killers consist of case studies. The cases reported

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8 International Journal of Offender Therapy and Comparative Criminology

were often drawn from psychiatric populations referred to the authors for evalua-
tion and/or treatment after the youth committed homicide. The conclusions drawn
from these cases, although interesting and suggestive, cannot provide us with pre-
cise explanations of why youth kill because it is unknown to what extent the youth
examined are typical of the population of juvenile murderers. In addition, in the
absence of control groups of any kind, it is unknown in what ways these young
killers differ from nonviolent juvenile offenders, violent juvenile offenders who
do not kill, and juveniles with no prior records.
Research on juvenile murderers has been primarily descriptive. It is not sur-
prising that psychogenic explanations (e.g., mental illness, defective intelligence,
childhood trauma) have largely predominated in the literature, given the profes-
sional background of many of the authors. Biopsychological explanations (e.g.,
neurological impairments, brain injury) have been investigated by some scien-
tists. Data on important sociological variables (e.g., family constellation, gang
involvement, drug and alcohol use, participation in other antisocial behavior, peer
associations) have been reported by some researchers. Sociological theories of
criminal behavior (e.g., strain and/or anomie, subcultural, social control, labeling,
conflict and radical theories; see Bynum & Thompson, 1999, for a discussion of
sociological theories), however, have not been systematically investigated in the
literature on youth homicide.
It is important to note that statements about juvenile murderers in the profes-
sional literature are typically about male adolescents who kill. Although some
studies of adolescent homicide have included both female and male youth (e.g.,
Dolan & Smith, 2001; Labelle, Bradford, Bourget, Jones, & Carmichael, 1991;
Malmquist, 1990), most research has focused on male adolescents because they
comprise the overwhelming majority of JHOs.

GIRLS WHO KILL

A few publications report case studies of girls who have murdered (see, for
e.g., Benedek & Cornell, 1989; Ewing, 1990; Gardiner, 1985; Heide, 1992;
McCarthy, 1978; Medlicott, 1955; Russell, 1986). These studies reveal that girls
are more likely than boys to kill family members and to use accomplices to effect
these murders. Girls are also more likely to perform secondary roles when the kill-
ings are gang related or occur during the commission of a felony, such as robbery.
Their accomplices are generally boys. Pregnant, unmarried girls who kill their
offspring at birth or shortly thereafter, in contrast, often appear to act alone. Girls’
motives for murder are varied. Instrumental reasons include ending abuse meted
out by parents, eliminating witnesses to a crime, and concealing pregnancy.
Expressive reasons include acting out psychological conflict or mental illness,
supporting boyfriends’ activities, and demonstrating allegiance to gang members
(Ewing, 1990).

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Youth Homicide: Literature Review & Action Plan 9

HOMICIDES INVOLVING YOUNG CHILDREN AS OFFENDERS

Research specifically investigating “little kids” who kill has also been sparse,
partly because of its low incidence and the difficulty of obtaining access to these
youth (see, e.g., Bender, 1959; Carek & Watson, 1964; Ewing, 1990; Goetting,
1989, 1995; Petti & Davidman, 1981; Pfeffer, 1980; Shumaker & Prinz, 2000;
Tooley, 1975). The importance of distinguishing between preadolescents and
adolescents in understanding what motivates youth to kill and in designing effec-
tive treatment plans was recognized by clinicians as early as 1940 (Bender &
Curran, 1940). Subsequent investigators, however, have not consistently used age
as a criterion in selecting samples of youth who kill (Easson & Steinhilber, 1961;
Goetting, 1989; Myers, Scott, Burgess, & Burgess, 1995; Sargent, 1962). In one
frequently cited report, for example, the young killers ranged in age from 3.5 to 16
years old (Sargent, 1962).
Although recent research suggests that preteen and adolescent murderers may
share some commonalities (Shumaker & Prinz, 2000), the differences between
the two groups cannot be ignored. Physically healthy children younger than 9 who
kill, in contrast to older youth, typically do not fully understand the concept of
death (Bender & Curran, 1940; Cornell, 1989; Heide, 1992; O’Halloran &
Altmaier, 1996). They have great difficulty comprehending that their actions are
irreversible (Bender & Curran, 1940). Prepubescent children who kill often act
impulsively and without clear goals in mind (see, e.g., Adelson, 1972; Carek &
Watson, 1964; Goetting, 1989). Preadolescent murderers are also more likely to
kill than older youth in response to the unstated wishes of their parents (see, e.g.,
Tooley, 1975; Tucker & Cornwall, 1977). In addition, the incidence of severe con-
flict (see, e.g., Bernstein, 1978; Paluszny & McNabb, 1975) or severe mental ill-
ness (Bender, 1959; Heide, 1992; “Incompetency standards,” 1984; Pfeffer, 1980;
Tucker & Cornwall, 1977; Zenoff & Zients, 1979) tends to be higher among youn-
ger children who kill than among their adolescent counterparts. Adolescent killers
are more likely to kill because of the lifestyles they have embraced or in response
to situational or environmental constraints they believe to be placed on them
(Heide, 1984, 1992, 1999; Sorrells, 1977; Zenoff & Zients, 1979).

CASE STUDY RESEARCH PERTAINING

TO ADOLESCENT MURDERERS
The literature that follows highlights findings from studies of youth who typi-
cally ranged in age from 12 to 17 years, although some research included adoles-
cents in their late teen years. In recognition of reporting practices in the profes-
sional literature, the terms juvenile and adolescent are treated as equivalent in the
discussion that follows. Similarly, the terms murder and homicide are used synon-
ymously, although the intended legal meaning is that of murder. Accordingly,
terms such as juvenile homicide offender, adolescent murderer, and young killer

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10 International Journal of Offender Therapy and Comparative Criminology

are used interchangeably throughout the remainder of this article. The following
sections address various areas covered in case studies of adolescent murderers. It
is important to keep in mind the caveats discussed previously regarding the short-
comings of this body of literature.

Psychological Disorder and Youth Homicide

Several scholars have also synthesized existing scientific publications relating
to various types of JHOs (Adams, 1974; Busch, Zagar, Hughes, Arbit, & Bussell,
1990; Cornell, Benedek, & Benedek, 1987b, 1989; Ewing, 1990; Haizlip, Corder,
& Ball, 1984; Lewis et al., 1985; Lewis, Lovely, et al., 1988; Myers, 1992; with
respect to preadolescent murderers, Shumaker & Prinz, 2000), including youth
who commit sexual murders (Myers, 1994; Myers, Burgess, & Nelson, 1998;
Myers et al., 1995). Much of the literature, particularly during the 1940s, 1950s,
1960s, and 1970s, suggested that psychodynamic factors propelled youth to kill
(Lewis et al., 1985). These factors included impaired ego development, unre-
solved Oedipal and dependency needs, displaced anger, the ability to dehumanize
the victim, and narcissistic deficits (Cornell, 1989; see, e.g., Bender & Curran,
1940; Mack, Scherl, & Macht, 1973; McCarthy, 1978; Malmquist, 1971, 1990;
Miller & Looney, 1974; Scherl & Mack, 1966; S. Smith, 1965; Washbrook,
1979).
Many studies have investigated the extent of severe psychopathology, such as
psychosis, organic brain disease, and neurological impairments (see Cornell,
1989; Ewing, 1990). The findings, particularly with respect to the presence of
psychosis among JHOs, are mixed and may be the result of how the samples were
generated. Individuals who are diagnosed as psychotic have lost touch with real-
ity, often experience hallucinations (seeing or hearing things that are not occur-
ring) and delusions (bizarre beliefs), and behave inappropriately. Most studies
report that JHOs are rarely psychotic (see, e.g., Bailey, 1994; Corder, Ball,
Haizlip, Rollins, & Beaumont, 1976; Cornell, 1989; Cornell et al., 1987b, 1989;
Dolan & Smith, 2001; Ewing, 1990; Hellsten & Katila, 1965; Kashani, Darby,
Allan, Hantke, & Reid, 1997; King, 1975; Labelle et al., 1991; Malmquist, 1971;
Myers et al., 1995; Myers & Kemph, 1988, 1990; Patterson, 1943; Petti &
Davidman, 1981; Russell, 1965, 1979; Shumaker & McKee, 2001; Sorrells,
1977; Stearns, 1957; Walshe-Brennan, 1974, 1977; Yates, Beutler, & Crago,
1983; with respect to adolescent mass murderers, see Meloy, Hempel, Mohandie,
Shiva, & Gray, 2001). Some studies, however, do posit a high incidence of psy-
chosis (see, e.g., Bender 1959; Lewis, Pincus et al., 1988; Rosner, Weiderlight,
Rosner, & Wieczorek, 1978; Sendi & Blomgren, 1975) or episodic psychotic
symptomatology (Lewis et al., 1985; Lewis, Lovely et al., 1988; Myers et al.,
1995; Myers & Scott, 1998) and other serious mental illness, such as mood disor-
ders (Lewis, Pincus et al., 1988; Malmquist, 1971, 1990).

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Youth Homicide: Literature Review & Action Plan 11

Several case reports have suggested that young killers suffered from brief psy-
chotic episodes, which remitted spontaneously after the homicides (see, e.g., Cor-
nell, 1989; McCarthy, 1978; Miller & Looney, 1974; Mohr & McKnight, 1971;
Sadoff, 1971; S. Smith, 1965). This phenomenon, initially introduced by the
renowned psychiatrist Karl Menninger and one of his colleagues 40 years ago is
known as episodic dyscontrol syndrome and is characterized by incidents of
severe loss of impulse control in individuals with impaired ego development
(Menninger & Mayman, 1956). Diagnosing psychosis in homicide offenders who
kill impulsively, brutally, and apparently senselessly, in the absence of clear psy-
chotic symptoms, has been strongly challenged by some of the leading experts on
juvenile homicide (see, e.g., Cornell, 1989; Ewing, 1990).
Examination of the literature indicates there is considerable variation in diag-
noses given to adolescent murderers within (see, e.g., Labelle et al., 1991;
Malmquist, 1971; Myers & Scott, 1998; Rosner et al., 1978; Russell, 1979) as
well as across studies. Personality disorders and conduct disorders rank among
the more common diagnoses (Bailey, 1994; Dolan & Smith, 2001; Ewing, 1990;
Labelle et al., 1991; Malmquist, 1971; Myers et al., 1995, 1998; Myers & Kemph,
1988, 1990; Rosner et al., 1978; Russell, 1979; Santtila & Haapasalo, 1997;
Schmideberg, 1973; Sendi & Blomgren, 1975; Sorrells, 1977; Yates et al., 1983;
with respect to preteen murderers, Shumaker & Prinz, 2000). Attention deficit
hyperactive disorder has also been noted with some frequency (Myers et al., 1995;
Myers & Scott, 1998; Santtila & Haapasalo, 1997; with respect to preteen murder-
ers, Shumaker & Prinz, 2000).

Neurological Impairment and Youth Homicide

Significant disagreement also exists with respect to the prevalence of neuro-
logical problems in juvenile killers (Cornell, 1989; Ewing, 1990), which may be
partly due to differences in assessment and reporting practices used by various cli-
nicians (Restifo & Lewis, 1985; see, e.g., Podolsky, 1965; Thom, 1949). Neuro-
logical impairment may be indicated by brain or severe head injuries, past and
present seizure disorders, abnormal head circumferences or electroencephalo-
gram (EEG) findings, soft neurological signs, and deficits on neurological testing
(Myers, 1992). Several researchers have found significant neurological impair-
ment or abnormalities among young killers (see, e.g., Bailey, 1996a; Bender,
1959; Busch et al., 1990; Lewis et al., 1985; Lewis, Lovely, et al., 1988; Michaels,
1961; Myers, 1994; Myers et al., 1995; Woods, 1961; Zagar, Arbit, Sylvies,
Busch, & Hughes, 1990), particularly those on death row (Lewis, Pincus, et al.,
1988). Others maintain that neurological difficulties are absent or rare among the
juvenile murderers assessed in their studies (see, e.g., Dolan & Smith, 2001;
Hellsten & Katila, 1965; Labelle et al., 1991; Petti & Davidman, 1981; Russell,
1986; Scherl & Mack, 1966; Walshe-Brennan, 1974, 1977).

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12 International Journal of Offender Therapy and Comparative Criminology

The Intelligence of Young Homicide Offenders

The findings with respect to intelligence are also mixed. Several studies
reported there were mentally retarded youth (IQ scores of less than 70) among
their samples of adolescent homicide offenders (Bender, 1959; Busch et al., 1990;
Darby et al., 1998; Labelle et al., 1991; Lewis, Pincus, et al., 1988; Patterson,
1943; Solway, Richardson, Hays, & Elion, 1981; Zagar et al., 1990). There is a
consensus across many studies, however, that few young killers are mentally
retarded.
In contrast, there is disagreement regarding the intelligence of the majority of
young killers (see, e.g., Ewing, 1990). Some researchers (Busch et al., 1990;
Darby et al., 1998; Hays, Solway, & Schreiner, 1978; Labelle et al., 1991; Lewis,
Pincus, et al., 1988; Petti & Davidman, 1981; Solway et al., 1981; Zagar et al.,
1990) reported that the average IQ scores of the JHOs in their samples were in the
below-average range (70-99). Others (Bender, 1959; Kashani et al., 1997; King,
1975; Patterson, 1943), however, have found that the IQ scores were typically in
the average to above-average ranges (100-129).
The literature on JHOs indicates that regardless of intelligence potential, many
struggle in educational settings. As a group, they tend to perform poorly academi-
cally (Bernstein, 1978; Hellsten & Katila, 1965; Myers et al., 1995; Myers &
Scott, 1998; Scherl & Mack, 1966; Sendi & Blomgren, 1975; Shumaker &
McGee, 2001; Stearns, 1957), have cognitive and language deficits (King, 1975;
Myers & Mutch, 1992), experience severe educational difficulties (Bailey, 1994;
Busch et al., 1990; Zagar et al., 1990), suffer from learning disabilities (Bender,
1959; Darby et al., 1998; Dolan & Smith, 2001; Hardwick & Rowton-Lee, 1996;
King, 1975; Lewis, Pincus, et al., 1988; Myers et al., 1995; Myers & Scott, 1998;
Patterson, 1943; Sendi & Blomgren, 1975), and engage in disruptive behavior in
the classroom (Bailey, 1996a; Myers et al., 1995).

Home Environments of Youth Who Murder

In-depth analyses of the families of young killers have been lacking (Crespi &
Rigazio-DiGilio, 1996). Case studies of adolescents who killed biological parents
and stepparents have appeared far more often in the professional literature than
have other types of JHOs (Ewing, 1990; Zenoff & Zients, 1979; see, e.g., Anthony
& Rizzo, 1973; Cormier, Angliker, Gagne, & Markus, 1978; Duncan & Duncan,
1971; Heide, 1992; Kalogerakis, 1971; Kashani et al., 1997; McCully, 1978;
Mones, 1985, 1991; Mouridsen & Tolstrup, 1988; S. Post, 1982; Russell, 1984;
Sadoff, 1971; Sargent, 1962; Scherl & Mack, 1966; Tanay, 1973, 1976; Wertham,
1941). These studies have indicated that youth who killed parents or stepparents,
particularly fathers or stepfathers, were typically raised in homes where child
abuse, spouse abuse, and parental chemical dependency were common (Heide,
1992, 1995). Research on the adopted child syndrome suggests that adopted
youth who kill their fathers may be driven by other psychodynamic factors,

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Youth Homicide: Literature Review & Action Plan 13

including unresolved loss, extreme dissociation of rage, hypersensitivity to rejec-

tion, and confusion about their identities (Kirschner, 1992).
With few exceptions (see, e.g., Fiddes, 1981; King, 1975), published research
and case studies report that the majority of adolescent homicide offenders are
raised in broken homes (Ewing, 1990; see, e.g., Darby et al., 1998; Easson &
Steinhilber, 1961; Labelle et al., 1991; McCarthy, 1978; Patterson, 1943; Petti &
Davidman, 1981; Rosner et al., 1978; Russell, 1986; Scherl & Mack, 1966; S.
Smith, 1965; Sorrells, 1977; Woods, 1961). Recent studies suggest that the major-
ity are likely to come from criminally violent families (Busch et al., 1990; Zagar
et al., 1990). Parental alcoholism, mental illness, and other indicators of parental
psychopathology are commonly found in the histories of juvenile murderers
(Ewing, 1990; see, e.g., Bailey, 1994, 1996a; Corder et al., 1976; Dolan & Smith,
2001; Heide, 1992; Hellsten & Katila, 1965; Labelle et al., 1991; Lewis et al.,
1985; Lewis, Lovely, et al., 1988; Lewis, Pincus, et al., 1988; Myers et al., 1995,
1998; Petti & Davidman, 1981; Santtila & Haapasalo, 1997; Sorrells, 1977).
Child maltreatment and spouse abuse are also repeatedly encountered in the
homes of adolescent homicide offenders (Dolan & Smith, 2001; Ewing, 1990;
Myers et al., 1995, 1998). Young killers as a group (see, e.g., King, 1975; Myers &
Scott, 1998; Woods, 1961), and youth who kill parents in particular (Corder et al.,
1976; Duncan & Duncan, 1971; Heide, 1992, 1994; Malmquist, 1971; Patterson,
1943; S. Post, 1982; Russell, 1984; Sargent, 1962; Tanay, 1976), have frequently
witnessed one parent, typically the mother, being abused by the other parental fig-
ure. Juvenile murderers (see, e.g., Bailey, 1994, 1996a; King, 1975; Lewis et al.,
1985; Lewis, Pincus et al., 1988; Myers et al., 1995; Myers & Scott, 1998; Santtila
& Haapasalo, 1997; Sendi & Blomgren, 1975), especially adolescent parricide
offenders (see, e.g., Corder et al., 1976; Duncan & Duncan, 1971; Heide, 1992,
1994; Malmquist, 1971; Scherl & Mack, 1966; Tanay, 1976), have often been
physically abused. Sexual abuse has also been documented in the lives of juvenile
murderers (see, e.g., Bailey 1994, 1996a; Corder et al., 1976; Dolan & Smith,
2001; Lewis, Pincus, et al., 1988; Sendi & Blomgren, 1975), including those who
kill parents (Heide, 1992, 1994).

Involvement in Other Antisocial Behavior

JHOs had engaged in several types of deviant behavior prior to committing
homicide (Ewing, 1990). Several studies have reported that the majority of ado-
lescent murderers have had prior arrests or offense histories (see, e.g., Bailey,
1996a; Cornell, Benedek, & Benedek, 1987a; Darby et al., 1998; Dolan & Smith,
2001; Ewing, 1990; Fiddes, 1981; Labelle et al., 1991; Myers et al., 1995, 1998;
Rosner et al., 1978; Sorrells, 1977). Findings regarding whether young killers
have had a lengthy history of fighting and other violent or antisocial behavior have
been mixed. Some researchers have reported extensive antisocial behavior (see,
e.g., Darby et al., 1998; Lewis et al., 1985; Lewis, Lovely, et al., 1988; McCarthy,
1978; Myers et al., 1995, 1998), others have uncovered little or none (Malmquist,

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14 International Journal of Offender Therapy and Comparative Criminology

1971; Patterson, 1943; Walshe-Brennan, 1974), and still others found that previ-
ous delinquency varied significantly by the type of juvenile homicide offender
(see, e.g., Zenoff & Zients, 1979) or the nature of the relationship between the
offender and the victim (Corder et al., 1976). Gang participation has also been
found among JHOs (Busch et al., 1990; Darby et al., 1998; Zagar et al., 1990).

Substance Abuse
The literature on substance abuse among JHOs has been sparse (Ewing, 1990).
Examination of available studies reveals that the percentages of JHOs who
reported abusing substances or were substance dependent have increased during
the past 20 to 30 years. Earlier studies indicated that between 20% and 25% of
young killers abused alcohol or drugs (Corder et al., 1976; Malmquist, 1971).
Cornell et al. (1987a) reported that more than 70% of the 72 juvenile murderers in
their Michigan sample reportedly drank alcohol or used drugs. Robert Zagar and
his colleagues (1990) compared alcohol abuse among 101 juvenile murderers
with 101 matched nonviolent delinquents in Cook County, Illinois. They reported
that juvenile murderers were significantly more likely to abuse alcohol than the
control group (45% versus 28%). Myers and Kemph reported in 1990 that half of
the 14 homicidal youth in their study were diagnosed as substance dependent. In a
later study of 18 juvenile murderers, Myers and Scott (1998) found that 50% were
substance dependent. Psychiatrist Susan Bailey reported in 1996 that of the 20
juvenile murderers in the United Kingdom whom she treated, 75% abused alcohol
and 35% abused drugs (Bailey, 1996a). Dolan and Smith (2001) found that 50% of
the 46 JHOs referred to an adolescent forensic unit in Britain during 1986 to 1996
had a history of alcohol abuse, manifested in binge drinking, and 39.1% had a his-
tory of illicit drug use. Researchers in Finland reported in 1997 that 10 of the 13
young homicide offenders in their study were dependent on alcohol (Santtila &
Haapasalo, 1997).
In addition to increases in substance abuse and dependence, there is evidence
that the percentage of those who indicated they were “high” at the time of the mur-
der has also risen since the 1970s. Sorrells’s (1977) study of juvenile murderers in
California indicated that approximately 25% (8 of 31) of JHOs were under the
influence of drugs and alcohol at the time of the homicidal event. Cornell et al.
(1987a) noted 10 years later that more than 50% (38 of 72) of their sample of juve-
nile killers had killed while they were intoxicated. A U.S. Department of Justice
study, also published in 1987, indicated that 42.5% of juvenile murderers were
under the influence of alcohol, drugs, or both at the time of the incident.
Fendrich, Mackesy-Amiti, Goldstein, Spunt, and Brownstein compared sub-
stance involvement among 16- and 17-year-old juvenile murderers with four dif-
ferent age groups of adult murderers incarcerated in New York state prisons in a
1995 publication. The groups were compared in terms of regular lifetime use, sub-
stance use during the week preceding the homicide, and substance use at the time
of the crime. In general, the juvenile murderers had relatively “lighter” use and

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Youth Homicide: Literature Review & Action Plan 15

lower levels of drug involvement than did adults in the sample. Of the 16 JHOs, 8
indicated they were “substance affected” (intoxicated, crashing, or sick or in need
of a substance) at the time of the murder. Of these 8, 5 acknowledged using alco-
hol and 3 used marijuana. Only 3 young killers reported using cocaine, heroin, or
psychedelics. The research team cautioned against concluding that substance use
does not present a special risk for violent, homicidal behavior among juveniles
(Fendrich et al., 1995).

Analysis of respondent substance use attribution patterns suggests that when 16-17
year old perpetrators use substances, the substances they use tend to have consider-
ably more lethal effects than they do on perpetrators in older age groups. Thus, our
study suggests that a focus on ingestion and involvement rates may underestimate
the risk posed by substances for homicidal behavior among juveniles. (Fendrich
et al., 1995, p. 1363)

Other Social Difficulties

Studies have indicated that a significant proportion of juvenile murderers do
not attend school regularly (Ewing, 1990) due to truancy (see, e.g., Bailey, 1994,
1996a; Dolan & Smith, 2001; Myers et al., 1998; Shumaker & McGee, 2001; S.
Smith, 1965), dropping out or suspension and/or expulsion (see, e.g., Cornell
et al., 1987a; Myers et al., 1998; Shumaker & McGee, 2001). Running away is a
common response of adolescent parricide offenders (see, e.g., Heide, 1992;
Sadoff, 1971; Scherl & Mack, 1966; Tanay, 1976). Enuresis (bed-wetting; see,
e.g., Dolan & Smith, 2001; Easson & Steinhilber, 1961; Michaels, 1961; Myers
et al., 1995; Russell, 1986; Sendi & Blomgren, 1975) and difficulties relating to
peers (see, e.g., Corder et al., 1976; Marten, 1965; Zenoff & Zients, 1979) have
been found in the histories of youth who kill.

Summary: A Case Study Portrait of Adolescents Who Kill

Given the methodological problems in the literature cited earlier, generaliza-
tions from many of these studies to the population of juvenile murderers must be
made with caution. Some consensus among the studies reported, however, sug-
gests that a portrait of the typical adolescent murderer can be drawn. Before
sketching a profile, it is important to note that many youth who possess these char-
acteristics do not commit murder. With this caveat in mind, available data suggest
that today’s young killer tends to be male and is unlikely to be psychotic or men-
tally retarded, to do well in school, or to come from a home where his biological
parents live together in a healthy and peaceful relationship. Rather, he is likely to
have experienced or to have been exposed to violence in his home and to have a
prior arrest record. He is increasingly more likely to use and/or abuse drugs and
alcohol than JHOs in the past.

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16 International Journal of Offender Therapy and Comparative Criminology

EMPIRICAL STUDIES OF JHOS

Well-designed empirical studies of juvenile murderers that attempt to compen-
sate for the weaknesses of case studies do exist. However, they are relatively few
in number and typically also suffer from methodological limitations related par-
ticularly to sample selection and size. Hence, generalizations from these studies
also must be made with caution.
In one study, for example, 71 adolescent homicide offenders were matched
with 71 nonviolent delinquents with respect to age, race, gender, and socioeco-
nomic class. Both groups were selected from a group of 1,956 juveniles referred
for evaluation by the juvenile court. The sample of juvenile murderers repre-
sented all youth convicted of homicide in the referral sample. The control group
was a subset of the larger sample. Accordingly, the samples were retrospective
and nonrandom and reflected the selection bias in the referral and adjudication
process.
Both groups were assessed on numerous educational, psychiatric and psycho-
logical, social, and physical dimensions. Four significant differences were found
between the two groups. Compared with nonviolent delinquents, JHOs were more
likely to come from criminally violent families, to participate in a gang, to have
severe educational deficits, and to abuse alcohol (Busch et al., 1990). The same
results were obtained when the study was repeated using different groups of juve-
niles obtained and matched in the same way (Zagar et al., 1990).
Lewis, a psychiatrist at New York University School of Medicine, and her col-
leagues (Lewis et al., 1985; Lewis, Lovely, et al., 1988; Lewis, Pincus, et al., 1988;
Lewis, Shanok, Grant, & Ritvo, 1983) have also conducted several investigations
of JHOs. Their research, although groundbreaking, often consisted of small sam-
ples of cases referred to Lewis and her team for evaluation. In one study, Lewis,
Lovely, et al. (1988) compared 13 juvenile murderers evaluated after the homicide
with 14 violent delinquents and 18 nonviolent youth. All three groups were incar-
cerated at the time of the evaluation and were compared with respect to a set of
neurological, psychiatric, psychological, and social variables. Analyses revealed
that the adolescent homicide offenders did not differ from violent delinquents.
However, the juvenile murderers were significantly more likely than the nonvio-
lent delinquents to be neuropsychiatrically impaired, to have been raised in vio-
lent homes, and to have been physically abused (Lewis, Lovely, et al., 1988).
A Finnish study was similarly designed to assess whether selected risk factors
would differentiate young murderers from other violent offenders and nonviolent
youth. Sample participants were recruited from among all Finnish male prisoners
born after a certain year and ranged in age from 18 to 22 at the time of the study.
The pool of volunteers was asked to indicate their prior criminal involvements on
a questionnaire. The respondents were then divided into groups from which study
participants were randomly chosen. The groups were small: 13 had committed
murder or attempted to do so, 13 had committed less serious assaults, and 11
reported no violent crimes in their offending histories. Several reliable differences

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Youth Homicide: Literature Review & Action Plan 17

were found. Members of the homicide group were significantly more likely to
admit having been cruel to animals than members of the two other groups. The age
at which members in the murderer group began abusing alcohol was significantly
younger than it was for those in the nonviolent group. Relative to the nonviolent
offenders, the homicide offenders were significantly more likely to have been
physically abused and dependent on harder drugs, such as cocaine, speed, stimu-
lants, and tranquilizers. Although other differences were observable among the
groups, the findings did not reach significance, which could have been due to the
small sample sizes (Santtila & Haapasalo, 1997).
Two studies published in 2001 explored differences between a group of juve-
nile murderers and control groups of violent offenders (Shumaker & McGee,
2001) and fire setters (Dolan & Smith, 2001) using retrospective case analyses. In
the first study, 30 male juveniles charged with murder were compared with 62
boys charged with other violent offenses. These individuals were all referred for
pretrial psychiatric evaluation between 1987 and 1997. This study was method-
ologically superior to earlier studies in several ways. It had a relatively large num-
ber of murderers, explored many clinical and offense-related variables, and used a
control group. In addition, the authors assessed potential differences as well as
differences between youth charged with murder and those charged with battery
with intent to kill. Comparisons of the two groups made from existing case files on
33 demographic, historical, clinical, offense, and forensic variables yielded only
three differences. Juvenile murderers were significantly less likely to have an
Axis I diagnosis of mental disorder than were other violent juveniles (63.3% ver-
sus 81.4%). Group differences in the types of diagnoses were discernible. Half of
the homicide group was diagnosed as having an adjustment disorder or a sub-
stance abuse disorder, whereas 69% of the violent group was diagnosed with a
chronic or organically based disorder such as conduct disorder, attention deficit
disorder, psychosis, or mood disorder. The homicide offenders were also signifi-
cantly more likely than the other violent offenders to have acted alone (46.7% ver-
sus 8.1%) and to have committed their crimes in a domestic setting (40% versus
6.5%) (Shumaker & McGee, 2001).
In the second study, 46 juvenile murderers were compared with 106 fire setters
who were referred to an adolescent forensic center for evaluation in England
between 1986 and 1996. The matching of the fire setters to the young killers on
age, ethnicity, socioeconomic data, and criminal history data was an obvious
strength of this study. The two samples were also matched in terms of referral to
the same unit for assessment on the basis of court adjudications during the same
period to ensure that the two groups were evaluated by the same team. Extensive
data on demographics, personal and family history, and medical and psychiatric
history were extracted from case files; offense-related characteristics were culled
from legal depositions and newspaper articles. Juvenile killers were significantly
more likely than arsonists to be male and to have histories of frequent changes of
school, alcohol abuse, and alcohol intoxication at the time of the murders. The
homicide group was significantly less likely than the fire-setting group to be diag-

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18 International Journal of Offender Therapy and Comparative Criminology

nosed as psychotic, to have had delayed developmental milestones, to have a his-

tory of being in care, and to have had previous contact with social and/or psycho-
logical and psychiatric services. A discriminant function analysis found that
psychotic illness, care history, prior psychology contact, and alcohol abuse at the
time of the crime successfully differentiated the two groups. Of these four, only
alcohol abuse at the time of the offense was more prevalent in the homicide group
(Dolan & Smith, 2001).
Other empirical studies have looked for distinguishing characteristics among
youth who commit murder (see, e.g., Corder et al., 1976; Cornell et al., 1987b;
Cornell, Miller, & Benedek, 1988). Billie Corder and her colleagues compared 10
youth charged with killing their parents with 10 youth charged with killing other
relatives or close acquaintances and 10 youth charged with killing strangers. In
addition to the groups’ being small in size, they were not randomly generated.
Individuals in the three groups had been sent to the hospital for evaluation and
were matched with one another by age, gender, intelligence, socioeconomic sta-
tus, and date of hospital admission. The three groups differed significantly from
one another on several variables. Those who killed parents, for example, were sig-
nificantly more likely than those who killed others to have been physically
abused, to have come from homes where their mothers were beaten by their
fathers, and to not recall the murder (Corder et al., 1976).

Typologies of Juvenile Murderers and Crime Classification

Several other researchers, as highlighted earlier, have proposed typologies of
youth who kill. Attempts to validate typologies of JHOs, however, have often
failed because they consisted of small samples or lacked control groups. In con-
trast, the typology proposed by Cornell et al. (1987b, 1989) has shown remarkable
promise. This scheme classifies JHOs into three categories based on circum-
stances of the offense: psychotic (youth who had symptoms of severe mental ill-
ness such as hallucinations or delusions), conflict (youth who were engaged in an
argument or dispute with the victim when the killing occurred), and crime (youth
who killed during the commission of another felony, such as rape or robbery).
The Cornell et al. (1987b, 1989) typology was tested using 72 juveniles charged
with murder and a control group of 35 adolescents charged with larceny. Both
groups were referred for pretrial evaluation and were assessed with respect to the
following eight composite categories: “family dysfunction, school adjustment,
childhood problems, violence history, delinquent behavior, substance abuse, psy-
chiatric problems, and stressful life events prior to the offense” (Cornell et al.,
1987b, p. 386). Based on information pertaining to the offense, 7% of the JHOs
were assigned to the psychotic subgroup, 42% to the conflict subgroup, and 51%
to the crime subgroup.
Analyses revealed significant differences on all eight composite categories
between the homicide group and the larceny group. In addition, a number of sig-
nificant differences emerged among the three subgroups of JHOs. Psychotic

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Youth Homicide: Literature Review & Action Plan 19

homicide offenders were significantly more likely to score higher on the psychiat-
ric history composite and lower on the index of criminal activity than
nonpsychotic groups. In relation to the conflict group, the crime group scored sig-
nificantly higher on school adjustment problems, substance abuse, and criminal
activity and lower on stressful life events. This study provided preliminary sup-
port that JHOs could be distinguished from other groups of offenders and from
one another. The authors correctly advised that further studies are needed to deter-
mine whether the differences among the homicide subgroups will hold up when
group assignment is not determined by offense circumstances (Cornell et al.,
1987b, 1989).
Subsequent research has found significant differences between the crime and
conflict groups. The crime group youth had higher levels of psychopathology on
the Minnesota Multiphasic Personality Inventory, an objective measure of per-
sonality (Cornell et al., 1988), than did the conflict group youth. The crime group
killers also had more serious histories of substance abuse and prior delinquent
behavior than did the conflict group murderers (Cornell, 1990). The crime group
adolescents were more likely to act with others and to be intoxicated on drugs at
the time of the murder than the conflict group youth. The crime group homicide
offenders also showed poorer object differentiation and more of a victim orienta-
tion in responses to the Rorschach (a projective measure of personality) than their
conflict group counterparts. The Rorschach responses suggest that crime group
youth are more likely to dehumanize other people, to respond violently when frus-
trated, and to have more severe developmental deficits than conflict group youth
(Greco & Cornell, 1992).
Distinctions also emerged within the conflict group between youth who mur-
dered parents and those who killed other victims, none of whom were family
members. Juvenile parricide offenders scored lower on school adjustment prob-
lems and prior delinquent history than did those who killed others but were higher
on a family dysfunction measure. Cornell’s (1990) findings with respect to youth
who kill parents are similar to conclusions reached in clinical case studies and
provide further empirical support that these youth may represent a distinct type of
homicide offender (see also Heide, 1992).
Myers and his colleagues classified 25 JHOs using the FBI Crime Classifica-
tion Manual. The murderers involved in their study included children and adoles-
cents. The sample size was too small to test differences among the four categories
of motives in the Crime Classification Manual. Accordingly, the cases were clas-
sified into only two categories: criminal enterprise and personal crime (Myers
et al., 1995).
Important findings from this study included characteristics common to the
young killers as well as those that differentiated the two groups from each other. A
total of 10 profile characteristics applied to more than 70% of the total sample.
These consisted of family dysfunction, previous violent acts toward others, dis-
ruptive behavior disorder, failure of at least one grade, emotional abuse by family

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20 International Journal of Offender Therapy and Comparative Criminology

member, family violence, prior arrests, learning disabilities, weapons of choice,

and psychotic symptoms (Myers et al., 1995).
Statistical analyses compared the two crime classification groups with respect
to psychiatric diagnoses, psychotic symptoms, biopsychosocial variables, and
crime characteristics. Statistically significant differences were found between the
criminal enterprise and personal cause groups with respect to victim age, victim
relationship, and physical abuse. Youth in the criminal group were more likely
than those in the personal group to have been abused and to have killed adult or
older victims whom they did not know. Personal group murderers tended to select
child or adolescent victims whom they knew (Myers et al., 1995).

THE TREATMENT OF YOUNG KILLERS

The literature on treating adolescent murderers is sparse and suffers from the
same problems as the general literature on juvenile homicide (Benedek, Cornell,
& Staresina, 1989; Myers, 1992) and violent juvenile delinquents (Tate,
Reppucci, & Mulvey, 1995). Most of the treatment results are based on clinical
case reports of a few cases referred to the author for evaluation and/or treatment
(see, e.g., Agee, 1979; Myers & Kemph, 1988; Petti & Wells, 1980; Washbrook,
1979). The extent to which these cases of juvenile murderers are representative of
the population of young killers is unknown (Cornell, 1989; Ewing, 1990). In addi-
tion, the interventions used are often not based on established therapeutic princi-
ples or empirically documented successes (Benedek et al., 1989; Tate et al., 1995).
Programs are also frequently not tailored to the type of juvenile murderer.
Despite the fact that most young killers will be released back into society, few
receive any type of mental health treatment following the homicides. In fact, the
likelihood of juvenile murderers receiving intensive psychiatric intervention
appears to diminish as they enter adolescence (Myers, 1992; see, e.g., Rosner
et al., 1978). Myers (1992), a University of Florida psychiatrist, summarized the
literature on the treatment of homicidal youth by focusing on the following four
main areas: psychotherapy, psychiatric hospitalization, institutional placement,
and the use of psychopharmacologic agents.
Psychotherapy with aggressive youth has generally been viewed with pessi-
mism (Myers, 1992; Tate et al., 1995). The overriding assumption among many
clinicians has been that JHOs are antisocial and hence are not good candidates for
psychotherapeutic interventions. It is important to remember, however, that not
all young killers have extensive delinquent or violent histories or antisocial char-
acter structures. Available evidence does indicate that psychotherapy can be
effective with some adolescents who have engaged in violence (Keith, 1984),
even murder (Bailey, 1996a; McCarthy, 1978; Myers & Kemph, 1988; Scherl &
Mack, 1966; S. Smith, 1965). Preliminary data suggest that psychotherapy may
be an effective treatment for conduct-disordered youth who meet the diagnostic

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Youth Homicide: Literature Review & Action Plan 21

criteria for the undifferentiated type have prior emotional relationships with their
victims, and are suicidal (Myers & Kemph, 1988).
Among those who have worked with JHOs, psychotherapy, including art ther-
apy, (Bailey, 1996a, 1996b; see, e.g., McGann, 1999) is generally considered to be
an important component of treatment with this population. Offenders likely to
benefit from interventions of this nature are higher maturity youth, particularly
those who are capable of self-examination and introspection and of forming emo-
tional relationships with others. Youth unlikely to do well with this approach
include those with low intelligence, limited insight, and aggressive behavioral
response patterns. Therapeutic gains typically do not come quickly, even among
those who are amenable to psychotherapy, because these youth generally have
been raised in chaotic and abusive environments and are slow to trust the therapist
(Bailey, 1996b; Myers, 1992).
Psychiatric hospitalization, although commonly used for little kids who kill, is
rarely used for adolescent murderers. Unlike the homicidal child who is typically
viewed as psychologically disturbed (Carek & Watson, 1964; Mouridsen &
Tolstrup, 1988; Pfeffer, 1980), the adolescent killer is generally regarded as anti-
social and is likely to be institutionalized in a facility for juvenile delinquents or
adult criminals. Adolescents are more likely to be hospitalized if they appear psy-
chotic, remain homicidal, or need intensive psychopharmacological manage-
ment. Inpatient treatment can be particularly helpful in stabilizing the youth, redi-
recting his homicidal impulses, and reducing his internal conflict (see, e.g.,
Haizlip et al., 1984). In addition, it can provide an optimal setting for evaluating
the youth, assessing his potential for continued violent behavior, and understand-
ing the family system of which he is a member (Myers, 1992).
Institutional placement in juvenile offender programs is a more typical dispo-
sition if the adolescent murderer is retained in the juvenile justice system rather
than transferred to the adult criminal justice system to stand trial. Mental health
care in juvenile facilities as well as adult prisons is typically minimal due to finan-
cial constraints and limited awareness of the psychological needs of this popula-
tion. Despite the lack of treatment, institutional placement appears to have been
effective in many cases, as measured by the lack of commission of serious crimes
after release (Myers, 1992; see, e.g., Gardiner, 1985; Russell, 1965).
Myers (1992) discussed four reasons for the apparent success of these “preven-
tive detention” programs. Two of these reasons involve normal maturational pro-
cesses. First, while the youth is institutionalized, “further neurodevelopmental,
cognitive, and emotional growth” may occur, thus enabling the adolescent to
acquire “better control of his emotions and aggressive impulses” (Myers, 1992,
p. 53). Second, youth who are contained in a safe and prosocial environment may
simply “outgrow” their antisocial behavior over time. Third, for some youth, the
homicidal violence was an atypical and isolated event, largely the result of
extreme circumstances and/or psychological difficulties, and “would never be
repeated” regardless of the court disposition or treatment provided. Fourth, for

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22 International Journal of Offender Therapy and Comparative Criminology

other youth, the program components, treatment agents, and therapeutic settings
had a positive effect on their character structure and behavioral responses. For
example, Gardiner (1985), a psychiatrist who worked extensively with homicidal
youth, found that those who made successful adjustments to society when
released had learned a vocation, had strong social support systems, had developed
meaningful relationships, and did not return to the unhealthy environments where
they lived prior to the killing (see also Myers, 1992).
Several researchers have expressed concern that institutional programs
emphasize behavioral control and conformity to the institutional regime as a mea-
sure of progress and success rather than individualized and specialized treatment
of youth offenders (Fiddes, 1981; Myers, 1992; Sorrells, 1981). Myers (1992) has
argued persuasively for the development of a “corrective emotional experience”
for a subgroup of juvenile murderers who have killed as a result of interpersonal
conflict (Cornell et al.’s (1989) conflict group) as opposed to furtherance of
another crime (Cornell et al.’s (1989) crime group). This subgroup consists “pri-
marily of youths with some degree of psychological problems (e.g., adjustment
disorders, depression), disturbed family functioning, and concomitant stressful
life events” (Myers, 1992, p. 55). He recommended placement of these youth in a
“therapeutically designed institution” staffed by sincerely interested, empathic,
and supportive adults who would function as “prosocial role models” and set
appropriate behavioral limits. The program should be tailored to ensure that all
youth receive quality mental health care and educational and vocational programs
that are consistent with their abilities (Myers, 1992).
Psychopharmacological management of some juvenile murderers holds prom-
ise, although empirical studies are lacking (Myers, 1992; Tate et al., 1995).
Researchers have hypothesized that several different neurological processes and
biological conditions are linked to violent behavior. These include genetic influ-
ences, neurophysiological abnormalities, and malfunctioning of neurotransmitter
systems and steroid hormones (Reiss & Roth, 1993; Roth, 1994). Psychotropic
medication as a component of treatment rather than as the sole type of treatment is
an appropriate intervention for youth who have an associated mental disorder that
is likely to respond to medication, such as Attention Deficit Hyperactive Disorder
(Scott, 1999; Yeager & Lewis, 2000). Myers (1992), noting that many JHOs are
conduct disordered, reviewed studies that evaluated the effectiveness of various
drugs in reducing aggressive symptoms among this population. There is some evi-
dence that haloperidol (an antipsychotic drug), methylphenidate (“Ritalin,” a
psychostimulant), imipramine (a tricyclic antidepressant), and propanolol (an
antihypertensive drug) as well as lithium and carbamazepine (both mood stabiliz-
ers) may be useful in treating certain conduct-disordered and aggressive children
and adolescents (Myers, 1992; see also Campbell et al., 1984; Kafantaris et al.,
1992; Kaplan, Busner, Kupietz, Wasserman, & Segal, 1990; R. M. Post, Rubinow,
& Uhde, 1984; Puig-Antich, 1982; Scott, 1999). For description of the types of
drugs, see the Physicians’Desk Reference, 2002). The newer class of antidepres-
sants, known as selective serotonin reuptake inhibitors (e.g., Prozac, Zoloft, and

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Youth Homicide: Literature Review & Action Plan 23

Paxil), also have been used with good results with violence-prone individuals
(Coccaro, 1995), although some caution is advised (Myers & Vondruska, 1998).
Benedek et al. (1989) discussed four classes of drugs that might be considered
in the treatment of the homicidal adolescent depending on the previous psychiat-
ric history of the youth and their current clinical functioning. These consist of
antidepressant, antianxiety, antipsychotic, and antimanic (mood stabilizers) med-
ications. The authors advised that these medications must be carefully monitored
for occasional paradoxical effects and for possible side effects. Lewis, a psychia-
trist who has studied violent juveniles for more than two decades, and her col-
leagues reported that their “greatest successes” occurred when they “targeted
underlying specific psychopathology rather than aggression per se. . . . The more
specifically directed the medication, the better the outcome will be” (Yeager &
Lewis, 2000, p. 807).
Benedek et al. (1989) indicated that other medications, including “beta- and
alpha-adrenergic blockers, anticonvulsants, calcium-channel blockers, and
antiandrogen hormones” (Benedek et al., 1989, p. 234), have not been proven to
be effective in the treatment of violent adolescents or adults (also see, e.g., Tupin,
1987). These authors advised that long-term use of psychotropic medication is
most appropriate for youth who are severely mentally ill. Short-term use of
antianxiety drugs may be correctly prescribed for youth who have killed due to
interpersonal conflict. Use of medication for youth who have killed during the
commission of a felony should be carefully considered in the context of a possible
history of drug abuse and addiction.
Myers (1992) maintained that each of these four different interventions can
play an important role in the treatment of young killers. He advised that effective
treatment planning for this population should include all of the possible factors
that lead to murder. The family systems as well as the adolescent homicide offend-
ers need to be thoroughly evaluated. Intervention needs to target chemical abuse
and/or dependency and neuropsychiatric vulnerabilities (e.g., language disorders,
learning disabilities, psychomotor seizures) where indicated.

LONG-TERM OUTCOMES OF JHOS

Benedek et al. (1989) summarized the pre-1990 literature with respect to long-
term outcomes of juvenile murderers (Corder et al., 1976; Cormier & Markus,
1980; Duncan & Duncan, 1971; Foster, 1964; Gardiner, 1985; Hellsten & Katila,
1965; Medlicott, 1955; Tanay, 1976). They concluded that “with few exceptions
the limited follow-up information is surprisingly positive” (Benedek et al., 1989,
p. 239). Young killers tend to make a satisfactory adjustment in prison and in the
community after release from custody and to relate well to their families.
The authors advised caution in extrapolating from these studies to the entire
population of JHOs. These case studies frequently report on criminally unsophis-
ticated youth who were involved in what appear to be isolated acts of violence,
often involving intense interpersonal conflict with the victim (Benedek et al.,

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24 International Journal of Offender Therapy and Comparative Criminology

1989). Many specifically involved family members as victims. Perusal of follow-

up reports on adolescent parricide offenders indicates they typically make a suc-
cessful reentry into society (Heide, 1992; Hillbrand, Alexandre, Young, & Spitz,
1999). Accordingly, Benedek and her colleagues (1989) hypothesized that the
outcomes for chronic delinquents who killed in the course of committing other
crimes would be much less favorable in terms of recidivism and readjustment to
society than they would for youth who killed in response to interpersonal conflict.
Extensive follow-up research on Canadian adolescent homicide offenders by
Toupin (1993) confirmed that the 18 participants in the crime group committed
significantly more offenses, violent offenses, and serious offenses than did the 23
youth in the conflict group per year of stay since return to the community.
Hagan (1997) conducted a follow-up study on 20 juveniles who had been con-
victed of homicide or attempted homicide and were sentenced to state custody. He
compared the homicide offenders (experimental group) with a control group of 20
juveniles who had been convicted of other nonhomicide offenses. Recidivism was
very similar for the two groups. More than half (60%) of the homicide offenders
and 65% of the control group were reconvicted of a crime after their release,
although none was involved in another homicide. The results indicated that a con-
viction for attempted homicide or homicide as a juvenile did not show that a per-
son was likely to be involved in another homicide upon return to the community.
Of the 60% of the experimental group who recidivated, 25% were convicted of
property crimes and 35% were convicted of crimes against persons. Hagan did not
explore the variables that were correlated with success or failure for either the
homicide group or the nonhomicide group.
The Texas Youth Commission evaluated the postrelease outcomes of youth
who were placed in the capital offender program at the Giddings State Home and
School in Texas. This program was specifically designed for juveniles who had
been convicted of murder. Recidivism was measured by comparing rearrest and
reincarceration rates of capital offender program participants with a control group
of untreated JHOs who were not treated due to space limitations at 1- and 3-year
intervals. Known initial differences in recidivism propensities were statistically
removed to ensure that differences between the groups were due to treatment
effects. The Texas Youth Commission reported in its first annual report released in
December 1996 that specialized treatment for JHOs reduced by 52.9% the likeli-
hood of capital offenders being arrested for a violent crime within a year after
release.
Subsequent data indicated that JHOs who received treatment were less likely
to be rearrested and reincarcerated than their nontreated counterparts at 1- and 3-
year follow-up periods. Compared with controls, treated capital offenders were
16% less likely to be rearrested at both 1-year and 3-year intervals. JHOs in the
treated group were 70% and 43% less likely to be reincarcerated within 1-year and
3-year periods, respectively, than untreated capital offenders (Heide, 1999; Texas
Youth Commission, 2002). The Texas Youth Commission (2002) has evaluated
personality changes of the youth while in the program and postrelease outcomes.

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Youth Homicide: Literature Review & Action Plan 25

Youth became significantly less hostile and aggressive, assumed more responsi-
bility, and had more empathy for their victims during program involvement.
A 2001 study provided follow-up data on 59 juveniles who were committed to
adult prison during a 2-year period in the early 1980s for one or more counts of
murder, attempted murder, or in a few cases, manslaughter. These youth, unlike
those in the Hagan (1997) study and the capital offender program, were incarcer-
ated in adult prisons where they received little or no treatment. Although many of
these adolescents received lengthy prison sentences, 73% had been released from
prison at the time of follow-up conducted 15 to 17 years later. Results indicated
that 58% of the 43 participants released from prison were returned to prison, and
most of those who failed did so within the first 3 years of release (Heide et al.,
2001).

CONCLUSIONS AND FUTURE DIRECTIONS

This article synthesizes studies on JHOs that span more than 50 years.
Although a large body of literature exists, many questions regarding etiology,
associated risk factors, intervention strategies, and long-term outcomes remain
unanswered. The established body of literature has been successful in elucidating
the phenomenon of youth homicide and in shedding light on the demographic,
medical and/or psychiatric, educational, social, familial, and behavioral charac-
teristics often associated with young killers. Greater advances in knowledge will
follow with the implementation of enhanced methodological designs that exam-
ine juvenile homicide across the following four distinct time frames: the years
preceding the homicide, the time period immediately following the homicide, the
incarcerative or treatment period, and the postrelease period. These areas are dis-
cussed as follows.

THE YEARS PRECEDING THE HOMICIDE

The available literature on JHOs is retrospective in nature. To say something
definitive about etiological factors associated with youth murder requires longitu-
dinal studies of children. Three ongoing longitudinal studies, known collectively
as the Program of Research on the Causes and Correlates of Delinquency, are
studying the developmental pathways to delinquency. This research effort sup-
ported by the Office of Juvenile Justice and Delinquency Prevention (OJJDP) rep-
resents the largest and most comprehensive effort undertaken to date to identify
the development of violence, other delinquency, and substance use. These studies,
which have collected many of the same variables and are well coordinated with
each other, began with a total of 4,500 inner-city youth across the three sites
located in Rochester, New York; Pittsburgh; and Denver. The youth ranged in age
from 7 to 13 years at the beginning of data collection in 1988. Youth who were
considered at high risk for delinquency were intentionally overrepresented in the

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26 International Journal of Offender Therapy and Comparative Criminology

three samples. Sample retention has been high across all sites. Interviews have
been conducted with the sample participants and their primary caretakers at either
6-month or 12-month intervals, depending on the site location. In addition to
interviews, data have been collected from schools, police, courts, and social ser-
vice agencies (Thornberry, Huizinga, & Loeber, 1995).
Youth who murdered have been identified across the three groups (Loeber,
2002). Although the numbers appear to be small, the prospective nature of this
study may enable the researchers to say something about the developmental path-
ways to murder by young people living in inner cities, where the largest percent-
age of JHOs occur. The strength of this methodological design is that researchers
can determine which factors preceded the homicide for youth in these three cities.
Recent accounts of youth murderers, particularly those involved in school
shootings, have underscored a fact that researchers, clinicians, and law enforce-
ment personnel have known for years: Not all young killers are poor kids from
inner-city areas. During the 10-year period from 1991 through 2000, for example,
10.6% of the homicide arrestees in suburban areas and 7.8% of those in rural areas
were younger than 18 (Heide, in press). Analysis of the young killers in the Pro-
gram of Research on the Causes and Correlates of Delinquency, although uncov-
ering the developmental pathways to murder for inner-city youth, may have little
relevance to more affluent youth living in suburban and rural areas. A longitudinal
study employing a design such as the one used by the National Longitudinal Study
on Adolescent Health would seem to be appropriate in this regard. This study con-
sisted of a nationally representative sample of youth who were in grades 7 through
12 as of 1994. Data were collected from the adolescents and from their parents,
siblings, friends, romantic partners, and school administrators. One of the areas of
health investigated included the youth’s participation in violent behavior. Several
waves of data collection at different periods involving subsamples have been
done. Juvenile murderers likely exist within this sample. Identifying their devel-
opmental pathways would be a first step to determining whether the findings from
the OJJDP sites can be replicated, and if the numbers are sufficient, whether dif-
ferent pathways can be identified for different types of murderers (see Resnick
et al., 1997; http://www.cpc.unc.edu/projects/lifecourse/adhealth.html).

THE TIME PERIOD IMMEDIATELY

FOLLOWING THE HOMICIDE
The second period that warrants systematic investigation is the homicidal inci-
dent. To the extent possible, exploration of the circumstances surrounding the
murder should be investigated thoroughly by speaking to the youth about what
happened as soon as possible. Questions should be designed to uncover the
youth’s mental states, conscious decisions they were making, conditions of which
they were aware, and circumstances that evolved or changes in the moments pre-
ceding the homicides. It may be that researchers should think in terms of charting

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Youth Homicide: Literature Review & Action Plan 27

probabilities of lethal outcomes rather than looking for precise causes of murder
(Cheatwood, 2002).1
Future research involving youth may wish to include attempted murderers
among its sample of murderers. Screening of cases using police reports and follow-
up interviews with youth charged with attempted murder would seem useful from
the standpoint of better understanding the phenomena of murderous behavior and
increasing sample size (see Heide, 1999; Heide et al., 2001). Frequently, what
determines a completed murder from an attempted murder is the marksmanship
of the offenders and the timeliness and quality of the medical response (Block,
1977).2 From the standpoint of research on the dynamics and pathways to youth
murder, it may make little sense to exclude youth convicted of attempted murder
from the pool of murderers.

THE INCARCERATIVE OR TREATMENT PERIOD

Youth need to be followed up at periodic intervals after the homicide, whether
they are incarcerated in prison or sent to a treatment facility. Follow-up at intervals
of 6- or 12-month periods may shed light on which factors are related to success-
ful adjustment in prison and to postrelease success. Information may be gathered,
for example, on contacts with family and significant others over time, program
participation, mental heath and drug-related services received, physical and men-
tal illnesses suffered during the period of confinement, disciplinary incidents, vic-
timizations, changes in perception, personality and behavioral changes, and so
forth. Control groups are needed to determine which sanctions or treatments and
which life experiences during this period of incarceration or treatment are corre-
lated with postrelease success and failure. Random assignment of JHOs to differ-
ent types of treatment programs would help determine which treatment programs
are successful with this population. Random assignment of young killers to prison
versus intensive treatment would allow researchers to determine which sanctions
hold more promise among youth involved in murderous activities.
Very few treatment programs target JHOs. Recidivism data discussed earlier
indicated that the capital offender program, located at Giddings State Home and
School in Texas, has shown remarkable promise in treating juveniles committed
for violent crimes, many of whom have been involved in homicide. Further pro-
grams modeled on this one may be in order, particularly if they build on compo-
nents known to be effective with serious, violent, and chronic offenders. A
recently published meta-analysis of 200 treatment programs is worth noting in
this regard. This study specifically examined whether intervention programs
could reduce recidivism among serious delinquents and explored which programs
were most successful with this population. The study found an overall 12%
decrease in recidivism among treated delinquents when compared with their con-
trol groups. The treatment programs that were most effective in reducing recidi-
vism varied to some extent between noninstitutionalized and institutionalized

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28 International Journal of Offender Therapy and Comparative Criminology

serious delinquents. The most effective treatment programs for noninstitutional-

ized serious juvenile offenders included individual counseling, interpersonal be-
havioral programs, and multiple services; for their institutionalized counterparts,
they included interpersonal skills, teaching family homes, behavioral programs,
community residential programs, and multiple services. Reduction in recidivism
was dramatic for both types of serious juvenile offenders. The researchers esti-
mated that the most effective treatment programs would reduce recidivism for the
noninstitutionalized offenders by 40% and for the institutionalized group, by 30%
to 35%. Lipsey and his colleagues (Lipsey & Wilson, 1999; Lipsey, Wilson, &
Cothern, 2002) concluded that the results of their study provided compelling data
that serious juvenile offenders could be helped and that intervention can reduce
recidivism. They maintained that new and better programs could be developed by
studying the characteristics of effective programs, implementing them, and evalu-
ating them.
In recent years, government leaders and policy makers have displayed a
heightened awareness of the need for effective treatment for violent youth, even as
they have argued for sanctions for wrongdoing and protection of the public. The
OJJDP maintained that effective programs for rehabilitating violent juvenile
offenders must be developed. OJJDP’s comprehensive strategy for serious, vio-
lent, and chronic offenders incorporated both prevention and intervention compo-
nents in an effort to reduce juvenile delinquency and to manage juvenile crime
more effectively (Howell, 1995). The experts who devised this initiative concep-
tualized an effective model for treating juvenile offenders as combining account-
ability and sanctions with increasingly intensive treatment and rehabilitation.

POSTRELEASE ADJUSTMENTS OF JHOS

Youth involved in homicidal incidents must be followed beyond the
incarcerative or treatment period. The high recidivism found by Heide et al.
(2001) indicates that more must be known about what occurs after individuals are
released from prison that leads to their reoffending. Follow-up interviews at 6-
month intervals, particularly during the first 3 years, seem critical. Charting the
life course of individuals who make good adjustments to society and understand-
ing the pathways that take offenders back to prison puts society in a position
where its agents and members can be proactive in reducing recidivism and future
violence.
Some might argue that in light of the recent decreases in juvenile murder, such
an extensive investigation of young homicide offenders hardly seems warranted.
Two recently released government reports concluded that despite the decreasing
trends, the stem of youth homicide and youth violence has not abated. In a January
2001 report on youth violence, the U.S. Surgeon General made the following
observations:

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Youth Homicide: Literature Review & Action Plan 29

Since 1993, when the epidemic peaked, youth violence has declined significantly
nationwide, as signaled by downward trends in arrest records, victimization data,
and hospital emergency room records. But the problem has not been resolved.
Another key indicator of youth violence—youths’ confidential reports about their
violent behavior—reveals no change since 1993 in the proportion of young people
who have committed physically injurious and potentially lethal acts. (American
Psychological Association, 2001, pp. 1-2)

In a March 2000 report, the Bureau of Justice Statistics noted that “despite the en-
couraging improvement since 1993, the levels of gun homicide by juveniles and
young adults are well-above those of the mid-1980’s” and “the levels of youth ho-
micide remain well-above those of the early and mid-1980’s” (Fox & Zawitz,
2000, pp. 1, 2). The report of the U.S. Surgeon General ended with the following
warning:

This is no time for complacency. The epidemic of lethal violence that swept the
United States from 1983 to 1993 was funneled in large part by easy access to weap-
ons, notably firearms. If the sizable numbers of youths still involved in violence
today begin carrying and using weapons as they did a decade ago, this country may
see a resurgence of the lethal violence that characterized the violence epidemic.
(American Psychological Association, 2001, p. 2)

NOTES

1. Many murders committed by juveniles, for example, occur in groups and are associated with
other criminal behavior. When a particular youth went out with his peers or gang members, did he
intentionally take his gun, and if so, for what purpose? Did he know that he was going to participate in a
robbery? Had he participated in a robbery before, and if so, what was the result to the victim or vic-
tims? When did he pull out his gun in the instant robbery? What was behind his pulling out his gun?
Was it in response to something his friends did or something the victim did? When he pulled out his
gun, what was he thinking or intending? Had the youth been drinking or using drugs prior to the shoot-
ing? Was the juvenile intoxicated or high? Had he ever pointed a gun at someone before, and if so, with
what result? Did he decide to pull the trigger? What was he thinking or intending? What happened in
the incident? Did the victim die? Subsequent investigation needs to determine whether the victim died
on the scene, the police response time, the timeliness of the emergency response team, and so forth.
2. If an offender fired five shots at a robbery victim and hit him in the shoulder, one could argue that
the victim survived because the youth was a lousy shooter. Similarly, if the youth fired multiple shots
into the victim and the emergency response team went to work on the victim until he arrived at a trauma
center, one could argue that the victim recovered because he received immediate, lifesaving surgery. In
both instances, the juvenile’s actions, consistent with his intention, appear to kill.

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Kathleen M. Heide, Ph.D.

Associate Dean for Faculty and Program Development
and
Professor of Criminology
University of South Florida
College of Arts and Sciences
4202 East Fowler Avenue
Tampa, Florida 33620-8100
USA

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