Academic journal article International Journal of Child and Adolescent Health

Assessment and Treatment of Youth Firesetting: A Clinical Perspective

Academic journal article International Journal of Child and Adolescent Health

Assessment and Treatment of Youth Firesetting: A Clinical Perspective

Article excerpt

Introduction

Only a few empirical articles have been published on fire starting in the last decade (1). This is true despite 19% of all mental health out-patient treatment visits and 35% of in-patient stays serve children and adolescents admitting to deliberate firesetting behaviors (2). Children and adolescents that engage is firesetting behavior is not harmless child-play. In fact, data provided by the American National Fire Incident Reporting System indicates that the majority of all child fire-related injuries and deaths are directly related to children's own fire involvement (3).This article will review the current literature about children and adolescent firesetting and assist the clinician in developing a thorough assessment and intervention plan for such clients.

Firesetting behaviors among children and adolescents are serious and have associated with it, serious individual and societal costs. In studies dating from 1961 to the present, the following behaviors have found to be associated with firesetting among children and adolescents.

· Kaufman and colleagues (4) found chronic hyperactivity in more than 66% of their sample of fire setters. These same authors argue that child and adolescent fire setters also have greater sexual problems, anger toward parents, and more frequently diagnosed as having conduct disorder (5,6).

· Child and adolescent fire setters suffered more school-related difficulties than non-fire setters. Firesetters were truant more often, experienced a greater number of classroom behavioral difficulties, and often were found to have learning problems and poor academic performance overall as compared to their same age peers (7).

· A recent study found that the experience of peer rejection was associated with an increased risk of firesetting, even after adjusting for traits of shyness and aggressiveness among children and adolescents (7).

· The relationship between fire starting, antisocial personality traits and delinquent behavior is the most studied correlate in the current literature. From a clinical perspective, for example, firesetting has been shown to be a strong predictor of the continuation of conduct disorder (8) characteristics of which often culminate in a label of antisocial personality disorder in adulthood. Furthermore, clinicians report more pronounced delinquent and hyperactive behaviors (9-11), more extreme externalizing symptoms, and the possession of fewer social skills (12) than their same age peers engaged in similar mental health treatment but without documented firesetting activity.

· Becker et al (13) found a strong link between firesetting and later delinquency. Even when controlling for conduct disorder severity, child and adolescent fire setters were found to be referred for clinical evaluation and treatment three times more than those referred for nonviolent and violet offenses. Becker and his colleagues concluded that firesetting may be conceptualized as accompanying an earlier pattern of serious and expanding versions of antisocial behavior. In spite of these studies, the DSM- V does not necessarily relate pyromania to delinquency or antisocial personality disorder in a definitive manner (14).

Prevalence, development, and life course

The population prevalence of pyromania is not known but as a primary diagnosis,pyromania appears to be very rare. Among a sample of persons reaching the criminal system with repeated firesetting, only 3.3% had symptoms that met full criteria for pyromania. Even though firesetting often does not meet the full criteria for pyromania, firesetting among children and adolescents is a major problem. Over 40% of those arrested for arson offenses in the United States (US) are under the age of 18 years (15).Even though the juvenile firesetting is a serious destructive behavior pattern, juvenile it is often viewed by clinicians as a co-occurring disorder with conduct disorder, attention-deficit, hyperactivity disorder, and/or an adjustment disorder which complicates the clinical picture. …

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