Swedish adolescent girls in special residential treatment: A person-oriented approach to the identification of problem syndromes

The purpose of this series of three cross-sectional studies was to identify typical syndromes of self-reported externalizing and internalizing problems, and examine their overlap, among adolescent girls and young women in Swedish special residential homes for young people (N=713). The associations with some family background factors were also investigated. Data came from a research register at the Swedish National Board of Institutional Care and concerned structured interviews with all girls admitted to these homes from 1997 to 2001. An advanced clustering procedure was applied and significant syndrome structures were retrieved in both the externalizing and internalizing area. Among the nine externalizing syndromes were a low-problem syndrome and two multiple-problem syndromes, one combining aggressive behavior, alcohol use/abuse and criminality, and the other combining drug abuse with property/drug offenses. Among the seven internalizing syndromes were a low-problem syndrome, an anxiety/depression syndrome and a generalized internalizing syndrome with particularly high rates of physical and sexual abuse. Results supported the theoretical assumption, made within a holistic-interactionistic paradigm, that adjustment problems would co-occur in a limited number of syndromes. When the overlap between externalizing and internalizing syndromes was considered, good adjustment was generalized between the two areas, whereas there appeared to be an increased risk of having an internalizing syndrome among girls with externalizing syndromes related to aggressive behavior. It is of great importance to consider the full problem pattern of girls with externalizing adjustment problems, including internalizing problems and histories of physical and sexual abuse, when considering subgroups in need of different treatment regimes.