Framing Public Policy and Prevention of Chronic Violence in Youth

Kenneth A. Dodge

Presentation to the Norwegian Center for Child Behavioral Development

October 26, 2010

Support is appreciated from from NIMH, NIDA, and DoE.

Framing the Problem of Chronic Violence in Youth

“On the horizon… are tens of thousands of severely morally impoverished juvenile super-predators …doing homicidal violence in ‘wolf packs’” (John Dilulio, 1996)

“Much of public policy toward the disadvantaged starts from the premise that interventions can make up for genetic…disadvantages, and that premise is overly optimistic.” (Herrnstein & Murray, The Bell Curve, 1994)

Framing the Solution to theProblem of Chronic Violence

Dramatic public response and change in policy away from prevention and toward restraint:

The Violent Youth Predator Act of 1996 required certain juveniles to be tried in adult court

Zero-tolerance policies in schools (Expulsion)

Metal detectors and School Resource Officers (SROs)

"most massive prison expansion in American history" (Hayden, 1995, p. B13)

Theses of this Talk

1. Metaphors and frames influence how we conceptualize a problem, its cause, and its solution.

2. The metaphors used to characterize adolescent offenders have been incite-ful but not insightful.

3. Science can inform the accuracy of a frame.

4. Prevention efforts that are based in a scientifically accurate frame can be effective.

Framing Problems in Public PolicyStudy of metaphors in human communication:

Anthropology (Bateson)Linguistics (Lakoff)Cognitive psychology (Schank; Tversky & Kahneman )Public policy (Goss)

Metaphors succeed when they lead to:

1. Assimilation recognizable to listener2. Accommodation reframe to broader schema3. Action evoke response4. Accuracy science supports

The “Super Predator” Frame

1. AssimilationAnimal-like, inevitable, vicious, no bounds

2. Accommodation Biological/genetic defect, unchangeable

3. ActionConstrain and “track” foreverMurray & Herrnstein: Advocate policy to “manipulate

fertility” of poor families

4. Accuracy?

The Genomic Revolution

Framing of Genetic Causes

Francis Collins (June, 2000): “We have caught our first glimpse of our own instruction bookpreviously known only to God.”

James Watson: “Our fate is in our genes.”

Nelkin (2001, Science): "The meaning of genes for human development and even for complex diseases requires an understanding of their social and developmental context."

Types of Gene x Parenting Interactions

I. Parenting context buffers or mutes the causal effect of genes on behavior

II. Genetic context alters the causal effect of parenting on behavior

III. Dynamic cascades

Parenting Buffers theCausal Impact of Genes

GABRA2 (Gamma-aminobutyric acid receptor α2)

-- A major inhibitory neurotransmitter

-- Single nucleotide polymorphisms (# copies risk allele) in larger haplotype block have been associated with alcohol dependence, antisocial personality, and conduct disorder (Dick et al., 2006, Behavior Genetics)

Hypothesize that high parental supervision could buffer effect of risk allele frequency

Child Development Project Research Design

(with Jack Bates, Greg Pettit, Jennifer Lansford; NICHD, NIMH, NIDA)

Community sample of 585 preschoolers-- 51% male; 19% African American; 3 sites-- diverse income; 50% live with single parents

Start in 1987 and follow through age 26, with 90% providing data in last three waves

Annual assessments by parents, teachers, peers, partners, self, tests, archival records, observations in home and school, lab tasks

GABRA2 Exerts Main Effect on Externalizing Disorder at Ages 11-16

(Dick, Latendresse, Lansford, Buddle, Goate, Dodge, Pettit, & Bates, 2009, Archives of General Psychiatry)

0

5

10

15

20

25

30

0 copies 1 copy 2 copies

Per

cent

E

xter

naliz

ing

Dis

orde

r

Parental Supervision Buffers Effect of GABRA2 on Externalizing Disorder

(Dick, Latendresse, Lansford, Buddle, Goate, Dodge, Pettit, & Bates, 2009,Archives of General Psychiatry)

Types of Gene X Parenting Interactions

I. Environmental context buffers or mutes the causal effect of genes on behavior

II. Genetic context alters the causal effect of parenting on behavior

III. Dynamic cascades

Transposing the Framing of Genes and Environment

Genes can be the context, not just the text.

Environment can be the more direct cause of externalizing disorder.

Figure and Ground in Genes and the Environment.

MotherGenes

FatherGenes

Figure and Ground in Genes and the Environment

.

Drink from the Environmental Goblet

The Effect of Child Maltreatment on Adolescent Behavior Problems

(Lansford et al., Archives of Pediatrics and Adolescent Medicine, 2002)

0

10

20

30

40

50

60

Maltreated

NotMaltreated

Per

cent

Arrest GradeRetained

SpecialEd

Expulsion GangMember

Pregnancy

Control Variables To Account for Maltreatment Effects

1. Ethnicity2. Family poverty and education3. Single-parent headed household4. Family stressors5. Maternal social support6. Family values endorsing violence7. Child’s exposure to domestic violence8. Child’s exposure to neighborhood violence9. Difficult infant temperament10.Medical problems at birth11.Gender12.Parents’ use of harsh discipline in adolescence

MAOA in Disruptive Behavior Problems

MAOA is an enzyme that selectively degrades serotonin, norepinephrine, and dopamine.

When faced with threat or provocation, humans naturally experience fear and an impulse to react aggressively with rage, but the MAOA enzyme (presumably following from the MAOA gene) enables us to titrate and regulate that response.

MAO x Maltreatment in Conduct Disorder

So we hypothesize…

1. Severe and chronic maltreatment leads to conduct disorder,

2. But only in a genetic context in which serotonin, norepinephrine, and dopamine are not degraded by high levels of MAOA activity.

3. Hypotheses: main effect of maltreatment, plus G x E interaction

Main Effect of Early Maltreatment on Adult Arrest in CDP

(Edwards, Dodge, et al., 2010, Journal of Child Psychology & Psychiatry)

01020304050607080

No Yes

Early Physical Abuse

% Ar

rested

by A

ge 22

MAOA Buffers Maltreatment Effect on Arrest in CDP

(Edwards, Dodge, et al., 2010, Journal of Child Psychology & Psychiatry)

01020304050607080

No Yes

Early Physical Abuse

% Ar

rested

by A

ge 22

Low MAOAHigh MAOA

III. Dynamic Cascade Models

Genes (and the individual) operate through symbiotic transactions with environment:

1. Infant elicits parent response.2. Parent response elicits child adaptation,3. Which elicits new parent response.4. Pattern continues across development.

A Cascade Model of the Development of Disruptive Behavior Disorder

Behavior Problems

Early Difficultness

Genetic Context

Disruptive Behavior Disorder

A Cascade Model of the Development of Disruptive Behavior Disorder

Adverse Environment

Behavior Problems

Early Difficultness

Maltreatment

Genetic Context

Disruptive Behavior Disorder

Poor Monitoring & Supervision

Harshness

A Cascade Model of the Development of Disruptive Behavior Disorder

Adverse Environment

Behavior Problems

Early Difficultness

Maltreatment

Genetic Context

Disruptive Behavior Disorder

Poor Monitoring & Supervision

Harshness

A Cascade Model of the Development of Disruptive Behavior Disorder

Adverse Environment

Behavior Problems

Early Difficultness

Maltreatment

Genetic Context

Disruptive Behavior Disorder

Poor Monitoring & Supervision

Harshness

Parenting Disruptions in the Cascade

Enriched Environment

No Behavior Problems

Early Difficultness

MoreConsistent

Reinforcement

Genetic Context

NoDisruptive Behavior Disorder

Better Monitor & Supervision

Frames in Youth ViolenceFrame Cause Policy Accuracy

Super predator genetic eugenics & nodestiny tracking

The “Moral Defect” Frame

William Bennett wrote: Body Count: Moral Poverty… (1996)

John Dilulio (Weekly Standard, 11-27-95):“moral poverty…creates super-predators”

Solution?“My one big idea is….called religion.”

Scientific Status of Moral Defects as Cause for Youth Violent Behavior

Situational Stimulus

AggressiveBehavior

Processing Step DysregulatoryProcess

1. Encoding Selective attention2. Interpretation Attributional bias3. Affect and goal setting Anger & self defense4. Response generation Access to aggression5. Response evaluation Endorse aggression6. Enactment

Procedure for Assessing Social Information Processing

Social Information-Processing Patterns inAggressive and Non-Aggressive Children

(Dodge et al., 1986, SRCD Monographs; Dodge et al., 1996, JAP)

-0.2-0.1

00.10.20.30.40.50.60.70.8

Encoding Interpretation ResponseGeneration

ResponseEvaluation

Non-Aggressive

Aggressive

Social-Information-Processing Patterns inMaltreated and Non-Maltreated Children

(Dodge et al., SRCD, 2001

-0.10

0.10.20.30.40.50.60.70.8

Encoding Interpretation ResponseGeneration

ResponseEvaluation

Not MaltreatedMaltreated

Frames in Youth ViolenceFrame Cause Policy Accuracy

Super Predator biology incarceration no

Moral Defect sin religion no

Frames in Youth ViolenceFrame Cause Policy Accuracy

Super predator biology incarceration no

Moral defect sin religion no

Contagious disease illness quarantine partial

Permanently broken defect of death in prison nocharacter

Frames in Prevention: Vaccine

September 2005: Robert L. Johnson, M.D., a Rutgers University pediatrician and chair of the Panel for the NIH State-of-the-Science Conference on Preventing Violence in Adolescence, interrupted the proceedings to blurt out his exasperation with the prevention models currently in practice by asking:

“Why can’t there be a ‘vaccine’ for violence prevention?”

Frames in Prevention of ViolenceFrame Policy Action Accuracy

Vaccine Early inoculation noCorrective Surgery Home removal inadequateChronic disease Harm reduction maybeCardiovascular disease Multi prevention perhapsPreventive dentistry Ongoing perhaps

Illiteracy Education promising

Framing Prevention of Violence as a Literacy Issue

Universal schooling for at least 13 years (K-12)

Growing appreciation for importance of early development

Extra support for children with difficulty (special education)

Family shares responsibility; Community support necessary

Role of national government and media

Consequences of failure are not incarceration

Framing an InterventionModel for Conduct Disorder

Early Starter

Conduct Disorder

ParentingPeer relationsSIPAcademics

Intervention

Birth to Age 5 Age 5-14 Adolescence

Empirical Questions in Prevention of Violence

1. Can a comprehensive program alter proximal mechanisms (i.e., parenting, peer relations, social-cognitive skills, academics)?

2. Can a comprehensive program alter important life outcomes?

A. Lifetime prevalence?B. Equal efficacy across severity of risk levels?C. Do returns to investment cumulate across development?

The Fast Track Study1. 1991-3: screen 9,341 kindergarteners at 4 sites, 3 cohorts

-- Identify early starters (n=891)-- 69% male; 45% African American; low SES

2. Randomly assign, by school cluster, to intervention

3. Implement ten-year program to address:* Parenting skills training* Peer relations skills training* Social Information Processing (skills training)* Academic skills training

4. Follow up through annual data collection (grade 12, 85%)

School-Entry TransitionContinuing SupportMiddle School TransitionContinuing Support

FAST TRACK TIMELINEYEAR (1991-

1993)

ScreeningImplementationOutcome/Mediators

INTERVENTION

ASSESSMENTGrade K 1-3 4-5 6-7 8-10 11 12 19 20

Fast Track Intervention ComponentsParenting (weekly groups, biweekly home visits)

* Behavior management, warmth, monitoring

Peer Relations (universal, friendship groups, coaching)* Behavioral and social skills, prosocial groups

Social Information Processing (skills training)* Problem solving and attributions

Academics (tutoring, after-school groups)* Reading and organization skills

Continuously over 10 Years

Question 1: Intervention Efficacy in Parenting

-0.2

-0.1

0

0.1

0.2

Observer-RatedAppropriateDiscipline

Use of PhysicalPunishment

Intervention

Control

Intervention Effects in Peer Relations

0

0.2

0.4

0.6

Peer-Nominated Rejection Deviant Peer Association

Intervention

Control

Intervention Effects in Social Cognition

-0.3

-0.2

-0.1

0

0.1

0.2

0.3

EmotionRecognition

HostileAttibutional Bias

AggressiveResponseGeneration

AggressiveRetaliation

Intervention

Control

Intervention Effects in Academic Skills

-0.1

0

0.1

0.2

0.3

0.4

0.5

Gr 1 Standard Spache Reading Gr 3 Special Education Diagnosis

Intervention

Control

Lifetime Prevalence of Conduct Disorder: Significant Interaction of Intervention x Initial Risk Level

(CPPRG, Child Development, in press)

0

0.1

0.2

0.3

0.4

0.5

Life

time

Prev

alen

ce

Risk Group

NMod

CMod

IHiC I

HiI

Intervention Effects on Violent Arrests (Murder, Rape, Kidnapping, Arson, Assault w/ Weapon):

Sig Interaction of Intervention x Initial Risk Level, p<.04 (CPPRG, Journal of Experimental Criminology, 2010)

0

0.1

0.2

Prop

ortio

n A

rres

ted

Risk Group

HiC

HiI

Intervention Effect on Cumulative Juvenile Arrest Index (weighted Severity), Age 14-18

Significant Main Effect of Intervention (p < . 05)(CPPRG, Journal of Experimental Criminology, 2010)

1

2

3

4

Wei

ghte

d In

dex

Risk Group

Con IntNorm

Cumulative Prevalence of Conduct Disorder

(Highest-Risk Group)

0

0.1

0.2

0.3

0.4

0.5

Grade 3 Grade 6 Grade 9 Grade 12

ControlIntervention

Economic Analysis of Fast Track

Each chronic criminal costs society 1.25 million dollars (Cohen, 1998)

Fast Track costs about $58,000/child.

If Fast Track reduces prevalence of chronic criminals by > 5% points, benefit-cost ratio is +.

Assignment to intervention reduces lifetime prevalence of conduct disorder by 21% points.

Cost Savings Due to Intervention, Per Child

-100,000

-50,000

0

50,000

100,000

150,000C

ost S

avin

gs P

er C

hild

, in

Dol

lars

Low 90% Top 5-10% Top 5%

Public Policy Conclusions

1. Educational framing of development and prevention of chronic violence has support

2. Early screening is crucial, and assignment to intervention reaps new benefits each year.

3. Intervention may be a wise investment if administered to the highest-risk children and continued over time.

4. Early starters are not destined for lives of crime.

Components of a National Strategy to Prevent Interpersonal Violence

1. Implement top-down strategy

Framing for mediaFraming for funders/policy makers

2. Implement evidence-based programs

Build local infrastructureBuild scientific basis