Commissioned Review: Sadistic and Violent Acts in the Young

Sadistic and Violent Acts

in the Young
Susan Bailey
This paper provides a review of the social impact, life course, and origins
o f violent and sadistic acts in children and adolescents. Origins of violent
acts include child-centred factors-temperamental, emotional, and
cognitive - family factors and contextual factors. Drawing from the
available adult forensic literature, the evolution of sadistic fantasy
culminating in sadistic violent acts is explored. The current range and
effectiveness of ps ychosocial, family- based, and ps ychodynamic
interventions are described. A possible programme for breaking the cycle
of violence is proposed, drawing on the knowledge and expertise of child
mental health care professionals.

Keywords: Violence; sadistic fantasy; children and adolescents; causation; interventions; prevention

lation (Snyder & Sickmund, 1995). The rate of grave

Introduction offences committed by children and young adolescents in
The 49th World Health Assembly declared that violence is Britain. particularly juvenile homicide, has not risen
a major contributor to premature death. disability, and to any significant extent (McNally, 1995; Shepherd &
injury, and is a leading world-wide public health problem. Farrington, 1993, 1996).
It requested that the Director General of the World
Health Organisation initiate public health activities to Juvenile crime, and violent crime in particular, is recog-
address the problem of violence and to present a plan of nised as one of the most important problems facing both
action for progress towards a science-based public health European countries and the United States, not least
approach to Liolence (WHO. 1996). because of its costs. Fear of crime at the hands of young
people is a n important and debilitating problem (Home
Office Standing Conference on Crime Prevention, 1989;
In Britain there has been a steady increase in reported Shepherd & Farrington, 1993, 1996). As well as crime,
crime. the peak incidence of which. in 1991. was at 18 psychosocial disorders that rise or peak in frequency
year5 of age for males and at 15 years of age for females during the years of adolescence and young adulthood are
(Home Ofice. 1993). Surveys of the general population suicide, suicidal behaviour, depression, eating disorder,
show that over 90 % of boys admit to acts that could have alcohol abuse, and drug abuse. Common disorders that
led to appearance in court: however, most are minor in may result in displays of violent, aggressive, sadistic, or
their nature. Delinquent acts by young children are less destructive behaviour inevitably involve serious mal-
frequent. but are more likely to be associated with function of individuals in their social setting. To under-
psychological abnormalities that are persistent and reflect stand how this arises there is a need to understand the
both social dysfunction and individual psychopathology. process of individual development and social conditions.
Traditional research concentrates on either individual
In the United States the arrest rate ofthose under 18 years differences o r developmental pathways. Rutter and Smith
of ape for murder and manslaughter rose by 60 YObetween (1995) argue cogently that in order to understand both
1981 and 1991 compared with a 5 % rise for those over 18 individual developmental processes and to specify the
years of age (Federal Bureau of Investigation. 1991). The causal mechanisms that account for change in the fre-
figures are influenced significantly by the ready availability quency of disorders in the community at large, it is
of firearms in the United States and the concentration of necessary to appreciate historical trends over time, and to
j u \ mile homicide within the African-American sub-popu- integrate causal explanations.

92
 Commissioned Review: Sadistic and Violent Acts in the Young

Violence Loeber and Hay (1994) argue that prevalence rates of

Thomas Hobbes in The Leviathan (1651) described the aggression and violence from pre-school age to young
human condition in its natural state as ‘solitary, poor, adulthood actually represent diverse groups of youth that
nasty, brutish and short’. At its extreme, violence ending can be broken down into four broad groups:
in death represents a severe disruption in the equilibrium
of any society. 1. Young people who desist from aggression.
2. Young people whose aggression is stable and continues
Violence is particularly subject to rhetoric, which is born at the same level.
largely out of factual ignorance and understandable fear. 3. Youth who escalate in the severity of their aggression
Sadistic vioient acts carried out by children and adoles- and make the transition to violence.
cents bring with them a surfeit of public and media 4. Youth who experience the onset of aggression stability.
interest. At times, these responses may become voyeuristic
ends in themselves. Violence occurs in the context of a The pivotal studies of Olweus (1988), replicated in many
system and in the context of individual differences. The subsequent longitudinal studies based on different forms
development of violent behaviour often involves a loss of of aggression, show that the average correlation between
sense of personal identifiability and uniqueness, a loss of early aggression in childhood or adolescence and later
the sense of personal value; the child or young person aggression is as high as the stability of intelligence over
engages in their actions without concern for future time. Continuity in the life course arises as much from
consequences or past commitments. stability in the environment as from stable dispositions of
the individual. Although the findings of researchers such
Early intervention is vital to prevent the development of as Olweus are striking evidence for the long-term con-
violent attitudes. What happens in the early years, sistency of features of temperament, other researchers are
particularly within the family and in schools, is most less convinced (Chess & Thomas, 1990).
influential in determining attitudes to violence through the
life course (Calouste Gulbenkian Foundation, 1995).
Origins
Although there is a massive literature on aggression and
violence (Weiler, 1995), and specific surveys on juvenile Conduct disorder and chronic juvenile offending
Recent reviews of the mass of available research (Smith,
violence and aggression (Coie & Dodge, in press), rela-
tively few make the link between early aggression and 1995) reveal that, for most juvenile offending and de-
delinquents who subsequently commit violent acts (Reiss linquency, there are three major risk areas : child-centred,
family-centred, and contextual. They have an interactive
& Roth, 1993). Loeber (1990) lays out a convincing
argument that a developmental approach to violence in effect on juvenile offending, providing support for a
juveniles ‘can open many avenues to knowledge’. Mean- proposed cumulative protection model of delinquency
prevention.
while the debate will no doubt continue as to whether it is
the genetic alphabet rather than cultural differences that
are the key determinants in the evolution, pattern, and act Antisocial behaviour is heterogeneous and for many is still
of violence. Whatever the balance, policies that follow a normal phenomenon, a deliberate principled act of
from social explanation will require money and political protect and of transient adolescent onset and cause. Those
will. Any underlying risk status, however it has arisen, is with early onset are at far higher risk in the adult life
ultimately expressed in the social context. Ongoing aca- course for development of antisocial personality disorder
demic and professional discussion of causation can so and of affective disturbance.
often be used and abused by the media to attribute and
reattribute blame with nonconstructive outcomes. All the The broad child-centred factors are genetic vulnerability,
above has important implications for the role of Child perinatal risk, male gender, cognitive impairment, school
Mental Health practitioners in their early assessment of underachievement, hyperactivity/inattention, and tem-
and intervention with violent children and younger perament. Family factors include criminality in parents
adolescents. Much can be learnt from and shared with our and siblings, family discord, lack of supervision, lack of
‘adult’ colleagues, to facilitate this early intervention and effective feeling, abuse, scapegoating, rejection, and neg-
preventative programmes. lect. Influential contextual factors include drug and
alcohol abuse, unemployment, crime opportunity, and
peer group interaction.
Transition of aggression into violence
The onset of boys’ aggression is often in the pre-school Important perpetuating factors include continued sub-
period. Throughout childhood and into adolescence stance abuse and unemployment. Significant turning
increasing numbers of boys experience the onset of points include the establishment and maintenance of a
aggression (Hacipasalo & Tremblay, 1994). More serious harmonious stable relationship, and the continuing po-
violence tends to increase with age, especially during tential for growth and developmental change in the
adolescence. individual.

Child Psvchology & Psychiutry Review Volume 2, No. 3, 1997

93
Commissioned Review: Sadistic and Violent Acts in the Young

Successful early preventative interventions for juvenile Genetic factors are most likely to be particularly im-
offending depend on the efficacy of parent training. portant in antisocial behaviour associated with early-
problem solving. school interventions. and pre-school onset pervasive hyperactivity. Adoption studies have
programmes that enable young children to understand suggested that the genetic component in violent crime is
more readily the consequences of their behaviour for self less than that in petty property crime. XYY anomaly,
and peers. critically helping them to make safe choices. In although not leading to violent behaviour, is associated
part. therefore. factors associated with manifestations of with behavioural features, increasing the likelihood of
aggressiveness are similar to those associated uith offend- antisocial acts but not causing them directly (Ratcliffe,
ing behaviour in general and. as such. those intervention 1994).
studies in the area of early identification and prevention
focused on 'chronic' general delinquency rather than Neurochemical mediation is being explored in relation to
aggression. pro\ iding an invaluable context for treatment dopamine and serotonin systems. The evidence suggests
intenentions ~ i t aggressive
h young people and a possible that serotonin plays a role in predisposition to violent
frarneu.ork for those who present specifically with violent behaviour and risk-taking behaviour that includes suicidal
sadistic acts (Yoshikawa. 1994). as well as antisocial acts (Virkunnen, Goldman, &
Linnoila, 1995).
T~l~l/~~r~l~?l~~llt
What is inherited may be a set of dispositions collectively
called temperament. This includes such basic features of A t ten tioii dlfJiculties
beha\ ioural and emotional responsiveness as activity Onset of attention problems (as described in attention
Ie\ el. attentiveness. adaptiveness to new situations. quality deficit hyperactivity disorder-ADHD) occurs during the
and intensity of mood expression. distress proneness. or pre-school period, the time when aggression itself appears
distractibility. The temperamental variable 'impulsive in some children. Longitudinal studies show that children
unsocialised sensation seeking' may underpin the de- with attention problems exhibit increased levels of ag-
Ielopnient of antisocial personality traits in adulthood.
gression in childhood, adolescence, and adulthood
Major achievements in early socialisation are control of (Campbell, 1990), but evidence that early attention prob-
anger and tolerance offrustrating situations: the emotion- lems without concurrent aggression are related to later
al response to aggression. frustration. and the subsequent aggression is debated (Magnusson & Bergman, 1990) but
contribution to \,iolent acts. in particular rage reactions, is supported by Mannuzza et al. (1993). It may be that
complex. Indi\,idual differences in temperament emerge hyperactivity rather than attention could be the factor
\ery early in life. pre-school children with 'difficult best predicting aggression.
temperament' (Thomas. Chess. & Birch. 1968) being
associated Lvith high rates of mother<hild conflict (Lee & Post-traumatic stress disorder ( P T S D )
Bates. 1985). \vhich is possibly an inborn dimension but There is evolving evidence in the field of PTSD (Pynoos &
influenced by very early social experiences (Emiole et al.. Nader. 1993) that children suffering the after-affects of
19Y2). Mothers respond in their control and discipline of traumatic stress can manifest this in later violence, this
their child to the temperament of the child per se. some violent behaviour sometimes mirroring the traumatic
children finding it particularly difficult to socialise suc- experience the young person has endured as a previous
cessfull> (Kochanska. 1993). Difficult temperament re- victim (Dodge, Bates, & Pettit, 1990). Perry (1994),
ported by parents is then associated with increased studying the neurological sequelae of childhood trauma
likelihood of aggression (Kingston & Prior. 1995: Sanson and their links to PTSD in children, suggests that
et 211.. 1993). However. the link between difficult tem- traumatic events may have a lasting effect on the neuro-
perament and later violent acts is less clearly understood. logical functioning of the individual, thereby having a
permanent effect on brain function. Le Daux (1994)
G I l ( ~I(,.)
1
suggests that 'changes in behaviour can be brought about
There is an accumulated body of evidence on the con- by controlling the fearful response rather than by elimi-
tribution of genetic factors to individual differences in nating the emotional memory itself'. Perry concludes that
antisocial b e h a ~ i o u rin general (Carey. 1994: Di Lalla & severe trauma during childhood can have a devastating
Gottcsman. 1989: Rutter. 1996). Older twin studies effect on all functions of the developing brain--emotional,
buggcst a stronger genetic component in adult crime than cognitive, behavioural, and physiological.
juvmile delinquency : however. the base rate for the latter
i j much higher.
Cognitive foctors
Genetic risk ma> operate through an effect on hyper- Children who display antisocial behaviour often have
acti! it?! inattention. impulsivity. and physiological re- accompanying academic problems. Boys' aggression
actiilty rather than aggression (Raine & Venables. 1992). scores are negatively related to cognitive ability (Sharp et
The efect could lie in neuropsychological or cognitive al.. 1995). Conduct problems in girls are, in contrast,
dysfunction (Moffitt. 1993). Genetic factors may operate associated positively with intelligence (Sonuga Barke et
h o q h an interaction with known environmental risks. al., 1994). Maguin and Loeber (1996), in a recent meta-
parciital attitude. role models. and lack of supervision. analysis, demonstrated that it is low intelligence and

94
 Commissioned Review: Sadistic and Violent Acts in the Young

attention problems rather than poor educational problems pline, physical control, and in particular shaming and
that predict later delinquency. From a study of poor and emotional degradation of the child.
normal readers followed through adolescence and into
early adulthood (Maughan et a]., 1996), reading disabled The social learning theories of Patterson are most specific
boys show high rates of inattentiveness in middle child- about interaction processes. Attachment theories specify
hood. At age 14 there was no excess of teacher-rated kinds of behaviour and do not rely on traits or types of
behaviour problems and no elevated rates of aggression. influence. The interactive effect of early mental insecure
Increased risk of juvenile offending amongst this specific attachment and chronically inconsistent or rejecting par-
group has been linked to poor school attendance rather ental behaviour was prominent in a series of 40 child and
than reading difficulties per se. Reading problems were adolescent murderers (Bailey, Dolan, & Smith, 1997).
associated with some increase in disruptive behaviour of Typically, the young person was left in a constant state of
girls in their teens. uncertainty about both the physical and emotional avail-
ability of the parent, in particular the mother, which led to
Substance abuse the experience of frequent and intense anger. Over time
Alcohol consumption can act as a short-term potent the relationship model has at its core anger and insecurity,
facilitator to aggression, and may specifically apply to leaving the child at heightened risk of aggression. Where
individuals with prior high levels of aggressive behaviour the attachment relationship between mother and child
and violent acts (Lang, 1993). After the onset of drug remained most insecure, violence was more likely to be
dealing, acceleration of the young person’s rates of violent committed against a more vulnerable family member.
acts has been described (Blumstein, 1995). Most adoles- Older children and young adolescents who killed outside
cents and adults who use illicit drugs do not commit the family had increasing difficulty in seeking and achiev-
predatory crimes. However, predatory offenders who ing safe autonomy in contrast to competent adolescents,
persistently and frequently use large amounts of multiple by whom they were rejected.
types of drugs commit crimes, including violent acts, at
significantly higher rates and over longer periods than do
less drug-involved offenders (Chaiken & Chaiken, 1990). Peer influences
Children who have frequent disagreements with peers
(Shantz & Hartup, 1992) do not become friends. Very
Family functioning
aggressive children are rejected by their peers, a process
Mother-infant inferaction that can start in the early school years (Pope, Bierman, &
Insecure attachment reIationships in infancy predict later Mumma, 1989). Aggressive children who are rejected
behavioural problems; in boys this shows itself in ag- show more diverse and severe conduct problems (Bierman,
gressive noncompliance. During pre-school years insecure Smoot, & Aumiller, 1993). Peer rejection promotes as-
girls may be either aggressive or especially compliant sociation with antisocial peers ; dyadic relationships are
(Greenberg et al., 1992). Insecure attachment is sometimes then formed that provide the focus for peer-directed
associated with maternal depression, which promotes aggression (Perry, 1994). Victims often lack social skills,
externalising problems (De Mulder & Radke-Yarrow, and can be aggressive themselves. Repeatedly victimised
1991) and an aggressive stance. juveniles are more likely to become aggressors as well
(Hotaling, Straus, & Lincoln, 1989). Aggressive young-
Family paradigms sters may make alliances, bullying others with the emerg-
The predominant factors within families that contribute ence of aggressive peer groups and gangs where the
to longer-term aggressiveness and risk of violence are in individual’s rate of violence usually increases (Thornberry
child-rearing and parenting styles (Farrington, 1995). et al., 1993). These groups may prove attractive to other
Against the background of ‘multiple deprivation’ the previously nonaggressive adolescents, adding to the group
following clusters emerge. First, the presence of criminal of late-onset aggressive adolescents.
parents and of siblings with behaviour problems. Second,
the day-to-day behaviour of primary caregivers. In ad-
dition to the parental conflict, inconsistent supervision,
Sadism
and physical and emotional neglect associated with the
risk for delinquency, some parents provide little direct Kraft-Ebbing (1886) suggested that mastering and posses-
reinforcement of presocial behaviours, reinforcing instead sing an absolutely defenceless human object is the key
coercive behaviours. Thus the child learns that their own element of sadism. Since Brittain’s (1970) classic paper
aversive behaviour serves to stop unwanted intrusions by The sadistic murderer, there has been a growing pro-
parents (Patterson, Capaldi, & Bank, 199I). Assaultative fessional awareness of the extent of sadistic and aggressive
adolescents have been shown to have lower rates of behaviour in normal populations and a growing under-
positive communication with their families, with aggres- standing of adult sadists. MacCulloch and colleagues
sive relations with peers (Perry, Perry, & Kennedy, 1992). (1983) argued that it is precisely the wish to control that is
the primary motivating force in sadism, defining it as the
The third cluster of family factors, linked with later ‘repeated practice of behaviour and fantasy which is
violence in the child, includes cruel authoritarian disci- characterised by a wish to control another person by

Child Psychology & Psychiutry Revieu’ Volume 2, No. 3, 1997

95
Commissioned Review: Sadistic and Violent Acts in the Young

domination, denigration or inflicting pain for the purpose childhood and early adolescence of rehearsals for a final
of producing mental pleasure and sexual arousal'. The violent sadistic act. Often because they were not overtly
range of controlling behaviour forms a continuum from sadistic or violent, the significance of apparently trivial
subtle verbal control through graduations of psycho- components of stealing had been overlooked, e.g. conduct
logical control to physical acts. ultimately rendering the disordered youngsters engaged in burglaries had retained
victim unconscious or dead. keys and photographs, using these as a focus for devel-
oping sadistic fantasies. Failing to make such connections
MacCulloch et al. (1983) teased out the following core of the thinking patterns and early fantasies of these
features from their own Special Hospital Series of sadistic youngsters had not been explored, with later grave
murders and from Brittain's original series. Develop- consequences. Liebert (1985) has pointed out the re-
mentally these men had had ambivalent relationships with sistance amongst clinicians to uncovering the sexual basis
their mother. authoritarian punitive fathers, and addition- for grave acts committed by young people, particularly
ally were themselves socially alienated from others. Their when conventional evidence for a sexual motivation may
personality development was one of introspection, soli- be lacking at the scene of the crime.
tariness, and obsessionality, rarely displaying actual vi-
olence but dwelling on hidden themes of aggression. They Evolution of sadistic,fantasy leading to violent acts
pre" to feel sexually inferior to other men and had Early and more recent psychodynamic explanations of
de\eloped a substitute rich and deviant fantasy life. Few child and adolescent aggression (Bailey & Aulich, 1996;
were described as psychotic but noticeably they displayed Glover, 1960) relate the violent act to a powerful sense of
increased anxiety and depression. interpreted as resistance unconscious guilt. McCarthy (1978) postulated that such
to increasingly violent, sadistic. and murderous drives. young people are not merely lacking impulse control, but
Critically. the grave offence often followed an episode of are acting out Oedipal guilt or expressing poorly con-
that had led to lowered self-esteem. The planning of the trolled rage. They are characterised by a vengeful narcis-
criminal act enabled them to feel superior, the actual crime sistic rage, expressed through violent acts as attacks on a
bringing with i t a sense of feeling better. with normal poorly integrated self-object, deprivation and rejection by
behaviour following the act. early objects providing the framework for the narcissistic
disturbance. In tracing the growth of healthy narcissism
Spitzer et al. (1991) carried out a survey of nearly 100 and regulation of self-esteem, Kohut (1972) stressed the
people with sadistic personality disorder who had been importance of the parent's availability for the self-
seen by forensic psychiatrists. The key criteria for di- enhancing mirroring process. More recent work from a
agnosis were the use of physical violencejcruelty to psychoanalytical perspective (Scharff & Scharff, 1994) has
achieve dominance over another, humiliation of people in integrated the conceptual frameworks of the early British
the presence of others. harsh treatment of those under object relations theorists, Fairburn, Klein, and Winnicott,
their care. pleasure in the act of psychological or physical relating this to research in relation to human development,
harm to animals or humans, lying to cause pain. control of trauma theory, and the origins of post-traumatic stress
others through fear, restriction of autonomy of those in a disorder and multiple personality disorder.
close relationship. and a fascination with violence.
weapons. injury. and torture. Ninety percent (87) had In violent sadistic youngsters, later parenting styles serve
childhoods characterised by a history of emotional abuse. only to perpetuate their narcissistic vulnerability and
One or both parental figures had repeatedly been hostile, feelings of shame and inadequacy. The violent act comes
demeaning. or neglecting. Seventy-six percent (74) had to represent not only an expression of immediate rage but
been physically abused. with multiple incidents resulting a defensive response to lowered self-esteem and an attempt
in bruises or permanent injury. Fifty-two percent (48) had a t repair of the self. The young person dehumanises the
experienced multiple losses, death. or abandonment by victim, allowing a pathological projection of an unac-
parental figures. consistent with the psychoanalytic view ceptable part of the self onto the victim. Narcissistic rage
of the importance of object loss in the development of the invokes not only a need for revenge but a compulsion to
disorder. Forty-one percent (30) had been sexually abused. pursue it, developed through the sadistic fantasy. The
violent act, loss of control, and sadistic fantasies serve to
Ressler. Burgess, and Douglas (1988). in their description restore omnipotence to the young person in a n attempt at
of 36 adult sadistic murderers. identified the following reparation of the self. The important implication for
most consistently reported internal factors over the three successful interventions with such children and adoles-
de\elopmental periods of childhood, adolescence. and cents is the need for a dual focus, not only on the
earl) adulthood : daydreaming, compulsive masturbation, evocation of the individual's rage but, if a safe resolution
social isolation. and poor body image. Most consistent is to be achieved, on the presence of the underlying
external behaviours over the same developmental periods narcissistic disturbance.
u.ere lying. rebelliousness, stealing. cruelty to children.
and assaults on others. The role of-fantasy in sadistic acts
Fantasy may be characterised as an elaborate thought
The adult literature points to an antecedent history in late with great preoccupation and, anchored in emotion, a

96
 Commissioned Review: Sadistic and Violent Acts in the Young

normal way for a child to obtain and maintain control of previous ‘offence’ behaviours of a violent, sadistic, and
an imagined situation. Rate of fantasy development and sexual nature. In a series of 121 juvenile sex offenders
frequency differs considerably and may either substitute (Dolan et al., 1996), a third had used physical violence or
for, or (critically for some) prepare for action. How many threats. Their sexual offences were not isolated incidents
young people activate sadistic fantasy and in what context involving normally developing adolescents. Many had a
remains uncertain (Crepault & Couture, 1980). Once a previous record of similar or less serious offences. The
fantasy builds to a point where inner stress is unbearable, psychiatric interview of young sex offenders in both non-
action may follow. Early expression of fantasy devel- contact and contact offences should always include an
opment is clearly seen in children’s play, and in ado- enquiry into the presence of rape fantasies and other con-
lescence thinking patterns emerge from and are influenced current violent behaviours, in addition to the paraphilias.
by earlier life experiences.
Over a short period of weeks the social interactions of this
In the latency period, violent and sadistic children start to vulnerable group typically deteriorate further. Issues of
demonstrate repetitive acting-out of the core aggressive mistrust, emerging patterns of verbal and physical ag-
fantasy, persistent themes emerging in their solitary play gression, feelings of hostility, and paranoid reactions
or in play with others. Secondary attempts at mastery and towards peers and adults reach a climax. Even then the
control over others appear in set situations, when the child who has gained a sense of power and pleasure from
repetition can often become a direct expression of an organised rehearsals accompanied by sadistic fantasies
original assault either against, or witnessed by, the may still have an expectation that adults will intervene to
younger child. A high degree of egocentricity evolves in stop them. If the cues presented to the outside world of
both fantasy and play and gradually other children, both adults and peers go unheeded, their rage explodes
family, and significant adults merge to become extensions onto a fragile victim in a chaotic, disorganised sadistic act.
of the child’s inner world.
Interventions with violent children
Adult sadists often report an absence of positive fantasies Terminology is important here. Violence denotes ‘the
in their early life. Whether they were never present, or they forceful infliction of physical injury’ (Blackburn, 1993).
became lost in very early negative experiences, is unclear. Aggression, in contrast, is a looser term describing harm-
What emerges is the overwhelming importance of the ful, threatening, or antagonistic behaviour (Berkowitz,
secret reality of the fantasies to the individual in ado- 1993). Most accounts of aggression are set in the context
lescence. The early aggressive behaviours serve to displace of the wider study of delinquent antisocial behaviour
anger onto the victim but, as fantasies elaborate, the (Farrington, 1995) and therefore caution should be taken
displayed aggression (whether still in play or against an in generalising findings to the specific field of violent and
individual) occurs with diminishing fear or anxiety about sadistic acts in the young. Longitudinal studies are
adult disapproval. Each subsequent act serves to allow invaluable in mapping out the range of factors and
increasingly intense emotions to be incorporated into their processes that contribute to the development of aggressive
imaginations, which in turn allows the intensity of violent behaviour and how they are causally related. However, in
thoughts to escalate. attempting to work with any individual young person who
has committed a violent act, the question to be answered
During adolescence the nature of the first sexual ex- is ‘why this individual has behaved in this unique fashion
perience may be crucial in determining sexual deviation on this occasion’ (Lipsey, 1995).
and the sexual component to subsequent sadistic acts.
Early general difficulties in social relationships are epito- Few external events lead to uniformity in violent acts. It is
mised after puberty by an inability to make any sort of important, therefore, to understand how the individual
appropriate approach to their preferred sex. In contrast, makes sense of them. Crick and Dodge (1994) describe a
through the pattern of fantasy in which the young person sequence of cognitive processes : encoding, representation,
controls their inner world, he or she becomes the success goal clarification, response construction, response, de-
they would like to be. Fantasy of successful control and cision, and enactment. Kendall (1991) showed that chil-
domination of the world becomes the key that unlocks the dren who are aggressive encode a range of environmental
increasing probability of its own recurrence, due to the cues, selectively attend to aggressive cues, attribute hostile
relief it provides from a previous sense of failure. The intent to others, more readily label internal states of anger,
stage is thus set for the violent sadistic act. select action-oriented rather than reflective solutions,
possess a more limited range of interactional skills, and
In a study of a series of child and adolescent murderers hold an ‘egocentric’ perspective in social problem solving.
(Bailey, 1996a), a third had been sexually abused. The Such models allow for the formulation of risk factors that
males described uncertainty about emerging sexuality and may be cumulative and interactive, and may contain
identity, negative experiences of sexual experimentation within them protective factors.
with age-similar peers, and inappropriate sexual ex-
perience with older females and males. In a third of cases Regarding interventions for young offenders in general,
there was both a sexual and sadistic motivation to the the 1980s saw a move away from a ‘nothing works’
offence, but, more importantly, there were undetected and towards a ‘what works?’ philosophy, A meta-analysis by

Child Psychology & Psychiatry Review Volume 2, No. 3, 1997 97

Commissioned Review: Sadistic and Violent Acts in the Young

Lipsey and Wilson (1993) of outcome studies of education tensive work in this area being undertaken by the Oregon
and psychotherapeutic intervention. and a major review Social Learning Center (Bank et al., 1991). Over 18
on the effectiveness of psychotherapy in reducing problem sessions, parents are exposed to a n approach that employs
behaviour in young people (Kazdin, 1995), suggested the a mixture of behavioural management techniques, prob-
importance of primary population-based preventative lem solving, and negotiation, with positive results in
intervention, secondary interventions focused on high- reduction of child aggressiveness in follow-up periods of
risk groups. and tertiary treatment-centred programmes. up to 3 years.

Functional family therapy

Context for intervention This involves determining which are the commonest
Whatever the treatment model. safe interventions have to sources of conflict between parents and children. Com-
be based on assessment that has established a global bining individual plus family approach has to date yielded
picture of the young person. This should include the the best results. In a comprehensive review of psychosocial
situations in which the behaviour occurs. specific triggers, treatments for conduct disorder in children, Kazdin (1997)
and quantification of frequency, intensity, and severity of concludes that improved triage of patients to treatments
the behaviour. Cognitive and emotional assessment has to that are likely to work will require understanding of
examine perceptions. thoughts, and feelings associated characteristics of children, parents, and families that will
with the behaviour. Interventions have to be applied with make them more or less amenable to current treatments.
continuous monitoring and evaluation of treatment out- He emphasised the need for new models of treatment
come on all aspects of the young person's life. delivery, the difficulties of retaining cases in treatment, the
problems of comorbidity, and still the relative paucity of
PSJchosocinl interveniions long-term follow-up evidence and of evidence for the
Social skills training enhances abilities in positive social clinical significance of change in the individual. Multi-
interaction. Behaviourally based tools include instruc- systemic therapy (Borduin et al., 1995) has given long-
tions, modelling. role playing, coaching, and feedback term benefits a t 4-year follow-up, not only with regard to
for children and young people who have previously reduced recidivism in the treated sample but, most
dealt with new social encounters through aggression importantly, in the high-risk juveniles who had already
(Goldstein, 1986). committed violent assaults.
Self-instructional training is designed to modify the Psjrhodsnarnic interventions
things children say to themselves, and modify the Realistically, psychodynamic therapy with young people
iiutonomic cognitive events that play a regulatory role who have committed sadistic acts of violence has to be
in everyday behaviour. Interventions containing cogni- tailored to the demands of the external environment and
t i b e elements have better outcomes than ones which do has to be approached cautiously. Motivational dynamics
not (Izzo & Ross, 1990). are complex and the monitoring of ongoing level of risk is
In social problem-solving training, an attempt is made critical, especially if the young person remains within the
to foster interpersonal problem-solving skills, in order community and with their family. The emergence of a
to lead to conflict avoidance and hence reduce the risk sense of guilt involves the appreciation for negative
of aggression X a z d i n , 1995) outcomes resulting from a n act of omission (often a key
Anger control training is a widely used form of agenda where two or more youngsters have been involved
cognitive behavioural work, combining self-instruc- in a sadistic act) or commission. A sense of shame is
tional methods with relaxation training into a model of associated with negative feelings on the basis of a self-
stress inoculation. Encouraging results have been perception of being unworthy or bad. Given the frequent
reported with aggressive adolescent inpatients with distortion of perception of self and others, the emergence
severe behaviour disorders (Feindler & Ecton, 1986). of a true sense of guilt and shame can be, and often is, a
slow, difficult, painful, and angry process.
Increasingly. combined multimodal treatment pro-
grammes have been employed. The most complex ap- Interventions for young people who have committed grave
proach to reduction of violent behaviour in young crimes and sadistic acts
offenders is the Aggression Replacement Training (ART), Within the U K this group of young people is liable to
which was formulated to meet the growing problem of periods of lengthy incarceration. Detention itself can
juvenile gang violence in the United States (Goldstein et provide time for further neurodevelopmental, cognitive,
a).. 1994). A R T brings together social skills training, self- and emotional growth, allowing the adolescent to gain
instructional/anger control training, and moral reasoning better control of his or her emotional and aggressive
enhancement, and is carried out in community- and impulses. Irrespective of the treatment model provided,
institutional-based settings. the parallel process of education, vocation, avocation,
consistent role models, and continued family contact are
Fani i / ~ , -based in icr ven iioiis of critical importance. This is best facilitated in a milieu
The possibility of training parents in improved child of warmth and harmony, with clear organisation, practi-
management skills emerged in the 1970s, the most ex- cality, and high expectations allowing for the estab-

98
 Commissioned Review: Sadistic and Violent Acts in the Young

lishment of positive staff-adolescent, staff-staff, and represent the first therapeutic effort to disentangle the
adolescent-adolescent relations (Harris, Cole, & Vipond, belief that another person is the cause from being
1987). responsible for one’s own rage. This can help the young
person come to terms with their own behaviour and their
The majority initially dissociate themselves from the sense of needing to seek revenge on vulnerable people.
reality of their act, but gradually experience a similar
progression of reactions and feelings akin to a grief Addressing victim empathy, saying sorry, and reattribut-
reaction (Hambridge, 1990). Their grief is initially about ing blame often leads to the expression of anger and
their own loss of freedom, enforced separation from distress within sessions that is often sexualised in both
family, and for their victim. The effect on the young form and content. When the emotion this engenders spills
person’s family can be as devastating as on the victim’s outside sessions it leads to disruptive behaviour within the
family (Macleod, 1982). Against the inevitable waxing institution. This is both difficult for the child and the
and waning of outside pressure the child has to move carers, and can in turn lead to both becoming collusively
safely through the process of disbelief, denial, loss, grief, rejecting and dismissive of the therapists. However,
and anger/blame. Post-traumatic stress disorder, arising disclosure and understanding is essential if safe resolution
from the participation in the sadistic act (either directly or is to be achieved and such youngsters can then be
having observed the actions of co-defendants) has to be reintegrated into the community.
treated, as does trauma arising from their own past
personal emotional, physical, and/or sexual abuse. A Conclusions
combination of verbal and nonverbal therapies has much The three theoretical frameworks of psychodynamic,
to offer those who have committed sadistic acts (Bailey & behavioural, and humanistic-existential perspectives share
Aulich, 1996). Qualities such as previous frequent and common threads and strands, despite having widely
severe aggression, low intelligence, and a poor capacity for divergent origins. Each points to a final common pathway
insight weigh against a positive safe outcome. The clinician of abnormal behaviour that arises from the young person’s
has to remain alert to the possibility of emerging formal maladaptive attempt, consciously or unconsciously, to
mental illness, in particular depression (Stewart, Myers, & deal with their own ultimate sense of personal failure.
Burket, 1990).
Breaking the cycle of violence-possible future strategies
To understand the role of violence and sadism in the It is important that child mental health professionals share
youngsters’ life one must understand the depth of their their wealth of research knowledge and clinical experience
sensitivity and reaction to a perceived threat (Bailey, to inform policy makers and to influence public opinion.
1996b). They may see threat and ridicule in many day-to-
day events. A related theme is saving face. As the young- Any proposed national action plan would, in the opinion
sters start to discuss their sadistic act, they may have to of the author, need to include:
confront past loss, trauma, and abuse. They may disclose
fears of being vulnerable; that therapy may bring about 1. Parenting becoming once more a priority, helping
change they do not like and above all cannot control. parents to deal with the difficulty of raising children,
in particular those with special needs.
Burgess and colleagues (Burgess, Hartman, & Hare, 1990) 2. The incorporation of child development and parent-
described the use of drawing, painting, and sculpture with ing skills courses into secondary school education.
juveniles in accessing memory of sadistic acts, allowing 3. Parental education about child abuse and neglect,
further insights into the motivational dynamics. Art both directly through courses for mothers and fathers
therapy (Aulich, 1994) makes easier the task of enabling and indirectly through educating children who might
the young person to face the most sadistic elements of be in abusive or potentially abusive situations.
his/her own acts and past abuse. This is particularly the 4. Provision of information, via the education system, to
case where the spoken word in adversarial criminal trials children about the effects of parental alcohol and drug
has become such a painful and destructive reminder of dependency to help children and adolescents learn to
how systems have dealt with them. Series of drawings can differentiate functional from dysfunctional families
give a potentially non-invasive way of providing infor- and to know that abuse and neglect are often a
mation and may allow the youngster to make contact with consequence of the latter.
gaps in their own emotional state. This can then help 5. Helping children and adolescents to access support
direct the intervention that will diminish rather than groups and professional help, in particular within our
escalate future risk. A range of motivational dynamics own field of mental health.
may become apparent, including victim provocation, the 6. Education could provide an ideal setting in which to
victim as a physical threat, and role reversal of victim and improve the communication skills of pupils, to in-
offender, with often gross size distortion. Victim and crease self-esteem, and to help learn peaceful methods
offender will often merge, and the drawings show a of conflict resolution and anger and stress manage-
remarkable variation in use of detail and colour. Some ment.
show clear attribution of blame and emotional expression. I. Support networks in school, linking in with other
The exposing of the distortions via nonverbal images can agencies including child mental health, that can help

Child Psychology & Psychiatry Review Volume 2, No. 3. 1997 99

Commissioned Review: Sadistic and Violent Acts in the Y0un.q

address social and psychological needs of children Berkowitz. L. (1993). Aggression: Its causes, consequences, and
and not just the pursuit of educational goals. enabling coirtro/. New York: McGraw-Hill.
them to relate within their place of social interaction Bierman. K.L., Smoot, D.L., & Aumiller, K. (1993). Charac-
i.c. education without resort to bullying a n d violent teristics of aggressive rejected, aggressive (non rejected) and
behaviour. rejected(n0naggressive) boys. Child Developnzent,64,139-151.
8. Local communities should play a pivotal role in Blackhurn. R. (1993). The psychologv of criminal conduct.
helping young people m ak e pro-social choices ( * I t Chichester. U.K.: Wiley.
takes a village t o raise a child'--Heide. 1995). Th e Blumstein. A. (1995). Young people and why the deadly nexus?
involvement of male a n d female mentors, part-time National Institute of Justice Journal, 229, 2-9.
employment. and training programmes via neigh- Borduin. C.M., Mann, B.J., Cone, L.T., Henggeler, S.W., Fucci,
bourhood businesses t o enable young people t o earn B.R.. Blaske, D.M., & Williams, R.A. (1995). Multisystemic
money legitimately t o acquire goods and services. treatment of services for juvenile offenders: Long term pre-
Adequate sports and relaxation facilities should be vention of criminality and violence. Journal of Consulting and
provided to give constructive activities t o those bored Clinical Psycholog?., 63, 569-578.
with life a n d / o r high on drugs and alcohol. Brittain, R.P. (1970). The sadistic murderer. Medicine, Science
9. .4t a national level. quality day-care for children and arid the Law, 10, 198-207.
promotion of a n attitude that encourages a n d sup- Burgess. A.W., Hartman, C., & Hare, C.W. (1990). Journal of
ports parents t o take time off work to care for Psychosocial Nursing, 28, 26-35.
children. Calouste Gulbenkian Foundation (1995). Children and violence.
10. An acceptance at a national level t h at programmes Report of' the Commission on Children and Violence. London:
aimed a t prevention an d early intervention may take Calouste Gulbenkian Foundation.
ii minimum of 10 years t o demonstrate direct results. Campbell. S.B. (1990). Longitudinal studies of active and
Denying mental health an d social services benefits t o aggressive preschoolers: Individual differences in early be-
children today to save money will ensure that in future haviour and in outcome. In D . Cichetti & S.L. Toth (Eds.),
the prison population will grow. Interria1i.ring and externalising expressions of' dysfunction (pp.
11. The media has available enormous potential and 57-90). Hillsdale, NJ : Erlbaum.
resources to halt the cycle of destructiveness via m o r e
Carey. G. (1994). Genetics and violence. In A.J. Reis, K.A.
socially responsible programming. Equally important
Miczek.. & J.A. Roth (Eds.), Understanding and preventing
is its capacity to raise public consciousness about
i,iolerice-biobehavioural influences 2 (pp. 21-58). Washington,
constructive solutions.
DC: National Academy.
12. Recognition of the importance of the power of any
Chaiken. J.M., & Chaiken, M.R. (1990). Drugs and predatory
one individual adult t o influence the life of any child.
crime. In M. Tonry & J.Q. Wilson (Eds.), Drugs and crime:
.4dults who. as children. were exposed to many o f the
Cririie and justice-a r e v i m of research, 13 (pp. 203-240).
risk factors of violence. but were resilient. frequently
Chicago, IL: University of Chicago Press.
acknowledge the importance of a n adult who. how-
Chess, S.. & Thomas, A. (1990). Continuities and discontinuities
ever briefly. communicated intentionally o r inad-
in temperament. In L. Robins & M. Rutter (Eds.), Straight and
iertently that they believed in the child. an d cared
ilriioiis pathnavs ,from childhood to adulthood. Cambridge :
about him or her.
Cambridge University Press.
Coie, J.D.. & Dodge, K.A. (in press). Aggression and antisocial
behaviour. In W. Damen & N. Eisenberg (Eds.), Handbook of
References child psj,chologjs 3: Social emotional and personality devel-
.Aulich. L. (1994). Fear and loathing: Art therapy. In 4I. Liebman upmerit.
( E d .). St,.\-qfleiiders arid gcrider irf art therap!, ~ , i t hoflkriilers. Crepault. C., & Couture, M. (1980). Men's erotic fantasies.
London : Jessica Kingsley. Archives of Sesual Behaviour, 9, 565-58 I .
Baile!. S. (1YY6a).Adolescents a h o murder. Journal of' Atlo- Crick, N.R.. & Dodge, K.A. (1994). A review and reformulation
of social information processing mechanisms in children's
Bailel. S. (19Y6h).Psychiatric assessment of the violent child and social adjustment. Psychological Bulletin, 115, 74101.
adolescent : Towards understanding and safe intervention. In De Mulder, E.K.. & Radke-Yarrow. M. (1991). Attachment and
V . Varnia (Ed.). Children and violence. London: Jessica affectively ill and well mothers: Concurrent behavioural
Kingsley. correlates. Developmental Psychopathology, 3 , 227-242.
Baile!. S.. D o h . M.. & Smith. C. (1997). P~j.c~horocia1 charac- Di Lalla. L.F., & Gottesman, 1.1. (1989). Heterogeneity of causes
rt'r-is tics of rinlt~rifqfienders referred to air Adalcscenr Foreifsic for delinquency and criminality lifespan perspectives. Devclop-
Seri.rc.r I I I rhe L . K . Paper presented to Annual Winter Meeting. menial Psrchoparhology, 1, 334-349.
Ro+l College of Psychiatrists. Cardiff. January, Dodge. K.A., Bates, J.E., & Pettit, G.S. (1990). Mechanisms in
Bank. L.. Marlowe. J.H.. Reid. J.B.. Patterson. G.R.. & Weinrott. the cycle of violence. Science. 250. 1678-1683.
h1.R (1991). A comparative evaluation of parent training Dolan. M.. Holloway, J., Bailey, S., & Kroll, L. (1996). The
inter\entions for families of chronic delinquents. Journal sf psychosocial characteristics of juvenile sex offenders. Medicine,
.4/Nlorl?ia/CI7ild Ps.l~chologV,19. 15-23. Science and the L a ir , 36

100
 Commissioned Review: Sadistic and Violent Acts in the Young

Emiole, R.N., Plomin, R., Robinson, J., Corley, R., & DeFries, J. Kazdin, A.E. (1997).Practitioner review. Psychosocial treatments
(1992). Temperament, emotion and cognition at fourteen for conduct disorder in children. Journal of Child Psychology
months: The MacArthur Longitudinal Twin Study. Child and Psychiatry, 38, 161-178.
Development, 63, 1437-1455. Kendall, P.C. (1991). Child and adolescent therapy. Cognitive
Farrington, D.P. (1995). The development of offending and behavioural procedures. New York : Guilford.
antisocial behaviour from childhood: Key findings from the Kingston, L., & Prior, M. (1995). The development of patterns of
Cambridge Study in Delinquent Development. Journal of Child stable, transient, and school age aggressive behaviour in young
Psychology and Psychiatry, 36,929-964. children. Journal ofArchives of Academic Child and Adolescent
Federal Bureau of Investigation (1992). Uniform crime reports f o r Psychiatry, 34, 348-358.
the United Stales: 1991. Washington, DC: US Government Kochanska, G. (1993). Towards a synthesis of parental social-
Printing Office. isation and child temperament in early development of con-
Feindler, E.L., & Ecton, R.B. (1986). Adolescent anger control: science. Child Development, 64, 325-341.
Cognitive-behaviourul techniques. Elmsford, NY : Pergamon. Kohut, H. (1972). Thoughts on narcissism and narcissistic rage.
Glover, E. (1960). The roots of crime. New York: International Psychoanalytic Study Child, 27, 36CL399.
Universities Press. Kraft-Ebbing, R. (1886). The psychopathia sexualis (Revised
Goldsmith, H.H., & Gottesman, I1 (1985). Heritable variability Edn., 1959). London: Panther.
and variable heritability in developmental psychopathology. In Lang, R. (1993). Alcohol related violence: Psychological per-
M.F. Lenzenweger & J.J. Haugaard (Eds.), Frontiers of de- spective. In S. Martin (Ed.), Alcohol and interpersonal violence:
velopmental psychopathology. New York: Oxford University Fostering interdisciplinary perspectives. NZAA Research Mono-
Press. gram, No. 24 (pp. 121-148). Washington, DC: Department of
Goldstein, A.P. (1986). Psychological skill training and the Health and Human Services.
aggressive adolescent. In S.J. Apter & A.P. Goldstein (Eds.), Le Daux (1994). Emotion, memory and the brain. Scientific
Youth violence: Program andprospects. New York: Pergamon American, June, 5(f57.
Press. Lee, C.L., & Bates, J.E. (1985). Mother-child interaction at two
Goldstein, A.P., Glick, B., Carthan, W., & Blancero, D.A. (1994). years and perceived difficult temperament. Child Development,
The prosocial gang implementing Aggression Replacement 50, 134325.
Training. Thousand Oaks, CA: Sage. Liebert, J.A. (1985). Contributions of psychiatric consultation in
Greenberg, M., Speltz, M.L., Deklyen, M., & Endruga, M. the investigation of serial murder. Interpersonal Journal of
(1992). Attachment security in preschoolers with and without Offender Therapy and Comparative Criminology, 29, 187-200.
externalising behaviour problems: A replication. Develop- Lipsey, M.W. (1995). What do we learn from 400 research studies
mentul Psychopaihology, 3, 413430. on the effectiveness of treatment with juvenile delinquents? In
Hacipasalo, J., & Tremblay, R.E. (1994). Physically aggressive J. McGuire (Ed.), What works: Reducing reoffending guidelines
boys from age 6 to 12: Family background, parenting from research and practice (pp. 63-78). Chichester, U.K. :
behaviour and prediction of delinquency. Journal of Consulting Wiley.
Clinical Psychology, 62, 10441052. Lipsey, M.W., & Wilson, D.B. (1993). The efficacy of psycho-
Hambridge, J.A. (1990). The grief process in those admitted to logical, educational, and behavioural treatment: Confirmation
Regional Secure Units following homicide. Journal ofForensic from meta-analysis. American Psychologist, 48, 118 1-1209.
Sciences, 35, 1149-1 154. Loeber, R. (1990). Development and risk factors of juvenile
Harris, D.P., Cole, J.E., & Vipond, E.M. (1987). Residential antisocial behaviour and delinquency. Clinical Psychological
treatment of disturbed delinquents. Description of centre and Revue, 10, 1-41,
identification of therapeutic factors. Canadian Journal of Loeber, R., & Hay, D.F. (1994). Developmental approaches to
Psychiatry, 32, 579-583. aggression and conduct problems. In M. Rutter & D. Hay
Heide, K.M. (1995). Violence in America. How can we save our (Eds.), Development through life: A handbook f o r clinicians.
children? Stanford Law and Policy Review, 7, 4 3 4 9 . Oxford: Blackwell Scientific.
Hobbes, T. (1651). The Leviathan. MacCulloch, M.J., Snowden, P.R., Wood, P.J.W., & Mills, H.E.
Home Office (1993). Criminal statistics, England and Wales 1991. (1983). Sadistic fantasy: Sadistic behaviour and offending.
London: HMSO. British Journal of Psychiatry, 143, 2CL29.
Home Office Standing Conference on Crime Prevention (1989). Macleod, R.J. (1982). A child is charged with homicide. His
Report of the working group on the fear of crime. London: family responds. British Journal of Psychiatry, 141, 199-201.
HMSO. Magnusson, D., & Bergman, L.R. (1990). A pattern approach to
Hotdling, G.T., Straus, M.A., & Lincoln, A.J. (1989). Intrafamily the study of pathways from childhood to adulthood. In L.
violence, and crime and violence outside the family. In L. Ohlin Robins & M. Rutter (Eds.), Straight anddeviouspathwaysfrom
& M. Tonry (Eds.), Family violence (pp. 315-375). Chicago, childhood to adulthood (pp. 101-1 15). Cambridge: Cambridge
IL: University of Chicago Press. University Press.
Izzo, R.L., & Ross, R.R.C. (1990). Meta-analysis of rehabili- Maguin, E. & Loeber, R. (1996). Academic performance and
tation programmes for juvenile delinquents. Criminal Justice delinquency. In M. Tonry & N. Morris (Eds.), Crime and
and Behaviour, 17, 134142. justice (pp. 145-264). Chicago, IL: Chicago University Press.
Kazdin, A.E. (1995). Conduct disorders in childhood and ado- Mannuzza, S., Klein, R.G., Bessler, A,, Malloy, P., & LaPadula,
lescence (2nd Edn). London: Sage Publications. M. (1993). Adult outcome of hyperactive boys. Educational

ChildPsychology & Psychiatry Review Volume 2, No. 3, 1997 101

Commissioned Review: Sadistic and Violent Acts in the Young

acliie\ement. occupational rank, and psychiatric status. Sanson. A,. Smart, D.. Prior, M., & Oberklau, F. (1993).
Arihrwr of Gc~n~rtrl P\whicrrrl.. 50. 565-576. Precursors of hyperactivity and aggression. Journal of the
Maughan. B.. Pickles. .4.. Hagell. A,. Rutter. M.. 61 Yule. W. Ainerican Acadeni,~of Child and Adolescent Psychiatry, 32,
( 1996). Reading problems and antisocial behaviour: Devel- 1207-1216.
opmenial trends in cornorbidit!. Joirrriul of Child P.s,1d7olog,1~ Scharff. JS.. & Scharff, D.E. (1994). Object relations theory of
mid f.\jdiiutr,t. 37. 4 0 5 4 1 8. plijsical and se-yual fraurno. New York: Jason Aronson.
McCarthy. J.B. ( 1978). Narcissism and the self in homicidal Shantz. C.U.. & Hartup. W.W. (1992). Conflict in child and
adolescents .Ariit,ricurr Jortrncil o / P.s~~chotrrial~~si.r. 38. 19-29. aciolesceiir development. Cambridge: Cambridge University
McNally. R.B (1995). Homicidal youth in England and Wales Press.
19112- 1992 : Profile and policy. f.s>.r~liolog!..Crime and Law. 1. Sharp. D.. Hay, D.F.. Pawlby, S., Schmucker, G., Allen, H., &
3.73 -342. Kuma, R. (1995). The impact of postnatal depression o n boys'
Moflirt. T.E. (1993) The neuropsychology of conduct disorder. intellectual development. Journal o j Child Psychology and
Dt'! c/U/JlrielltO/ PS~'chopcif/lo//~g,I'. 5. 135-1 5 1. ~ , 1315-1336.
P s j d i i a t r ~36.
Olueus. D. (198X). Environmental and biological factors in the Shepherd. J.P., & Farrington, D.P. (1993). Assault as a public
dewlopment ofaggressiye behaviour. In W. Blukhuisen & S.A. health problem. Journal of the Royal Society of' Medicine, 6 ,
Mediiick (Eds.). L.vpltriniq crrniiitol hehcwioirr. Leiden. The 89-92.
'Letherlands: E.J. Britt. Shepherd. J.P.. & Farrington, D.P. (1996). The prevention of
Patterson. G R.. Capaldi. D.. & Bank. L. (1991). An early starter delinquency. with particular reference to violent crime. Medi-
model for predicting delinquency. In D.J. Pepler & K.H. cine. Scierice and the Lair, 36, 331-336.
Rubin (Eds.). The dewlopriient cirid treufineiit of' childhood Smith. D.J. (1995). Youth crime and conduct disorders. In M .
u , q y c ' \ u o r t (pp. 139-168). Hillsdale. N J : Erlbaum. Rutter & D. Smith (Eds.), Psj.chosociu1 disorders in young
Perry. B.D. ( 1994). Neurobiological sequelae of childhood people. Chichester, U.K.: Wiley.
triiuiiiii : PTSD in children. In M. Murray (Ed.).fo.tr-truitniaric Snyder. H.N. & Sickmund, M . (1995). Juvenile offenders and
\ t w \ \ i l r . s o r d i ~Dnc2rgirig c'oitcept.s. Washington. D C : Ameri- viciiiits: A ito/ional report. Washington, D C : Office of Juvenile
c:in Psychiatric Press. Justice Delinquency Prevention.
Perr!. D.G.. Pcrr!. L.C.. & Kennedy. E. (1992).Conflict and the Sonuga-Barke, E.J.S., Lamparelli, M., Stevenson, J., Thompson,
de\elopmeiit of antisocial behaviour. In C.U. Shantz & W . W . M.. & Henry. A. (1994). Behavioural problems and preschool
H X I Ui~Eds.). C.nilf/ic I irr c~hiltltititici~ioleseei~r dewlopnient (pp. intellectual attainment: The associations of hyperactivity and
301 329). Cambridge: Cambridge University Press. conduct problems. Journal of'Child fsvchology and Psvcliiatr.~,
Pope. A.W.. Bierman. K.L.. & Mumma. G . H . (1989). Relations 35. 949-960.
brl\<t.cn h!perwti\e and aggressi\e behaviours and peer Spitzer. R.L.. Feister, S., Gray, M., & Pfohl, B. (1991). Results of
reIci1ioii5 at three elementar) grade levels. Jorrrritrl o/ .4bnorntd a survey of forensic psychiatrists on the validity of the sadistic
C h i i ~ Psi l clrolo,qi. 17. 753-167. personality disorder diagnosis. Aiwrican Journal o j f ,sychiatry,
P!noch K.S.. & Nader. K. (1993). Issues in the treatment ofpost- 148. 875-879.
traumatic stress in children and adolescents. In J.P. Wilson & Stewart. J.T.. Myers, W.C., & Burket, R.C. (1990). A review of
B Raphael ( E d i .1. /ntcriititi~niiilhuiidbook- of trurrnttrtic \tre\.\ the pharmacotherapy of aggression inchildren and adolescents.
, ( I iidrorrw.s. Ye\\ York : Plenum Press. Joirrriul of American Acadeemy of Child and Adolescent Psy-
Raiiie. .4.. & Venables. P.H. (1992). Antisocial behaviour: chicitr~~. 29. 269-277.
E\olution. genetics. neurops)chological and pskchophqsio- Thomas. A . . Chess, S., & Birch, H.G. (1968). Temperament and
lo^! In A. Gale & M.W. Eysenck (Eds.). Hniidbook o f ' behuiiour disorders in children. New York: NY Universities
iitili L rdirul t1iffo.c~itce.s: Biologicul perspectiws (pp. 2 8 - 3 1 I ) . Press.
Chichester. U.K : Wile). Thornberry. T.P., Krohn, M.D., Lizotte, A.J., & Chard-Wier-
RatcltRe. S.G. (1994). The psychosocial and psychiatric conse- schern. D. (1993). The role of juvenile gangs in facilitating
quences of LTY chromosomal abnornialities in children based in delinquent behaviour. Journal of Reseurch in Crime Delin-
population studies. In F. Poutska (Ed.). Basic upprociches to ~ I W ~ C J '30.
. 55-87.
g i ' i w r i c trml in~di~i~rrlur pcn'hiritr,~.(pp.
hiologicrrl dc.i~elopriierital Virkunnen. M.. Goldman. D., & Linnoila, L. (1995). Serotonin
99 127). Berlin: Quintrssenz. in alcoholic violent offenders. In Genetics of' criminal and anti-
R e i \ i A J . Rr Roth. J.A. (Eds.) (1993). ~ - l t ~ l t ~ r . \ t ~ r r i fmid
liii~ social behnriour (pp. 168 182). Chichester, U.K. : Wiley.
p w ! (viiiii.y I ioleiri
(a. Washington. D C : National Academy Weiler. R.M. (1995). Violence: An annotated bibliography of
Prc\\ selected publications and resources. Educational Psychology
Rcs\lr.r. R.K.. Buryss. A.W.. & Douglas. J.E. (198.8). S m m f Rerim.. 7. 125-1 34.
/ t c m i i < rdc puiferns tirid rizotiws. New York : Lexington Books. W H O (1996). Making violence prevention a public health
Rutler. I?..& Smith. D. (Eds.) (1995). f~l.cho.sociulrlirorcler.~iri priority. A programme for the World Health Organisation.
o i i i i y pi'opli,. Chichester. U.K. : Wile?. Washington, DC: WHO Task Force on Violence and Health.
Rutti.1. R . ( E d . ) (1996). Gerietri,J of' crirnintrl tiit(/ ciriti.tocicrl Yoshikawa. H. (1994). Preventions as cumulative prevention:
/ J < ' h O I ioirl' (Ciba Foundation Slmposium 1994). Chichester. Effects of early family support and education on chronic
L . K . Wile! delinquency and its risk. Psyhological Bulletin. 115, 28-54.

102