ARE DISTURBED AND NORMAL ADOLESCENTS EQUALLY COMPETENT TO MAKE DECISIONS ABOUT MENTAL-HEALTH TREATMENTS

This study uses a structured vignette procedure to assess competency t o make treatment decisions in two groups of adolescents, one at risk f or institutional placement and the other a matched community sample. S cores on Factual Understanding (the ability to recall facts), Inferent ial Understanding (the ability to make inferences about those facts), and Reasoning (the ability to weigh risk and benefits of various treat ment options and to make choices based on that reasoning) were compare d. Results showed that while at-risk adolescents and their community c ounterparts did not differ in their factual and inferential understand ing abilities, the at-risk adolescents did significantly less well tha n the community adolescents in reasoning. This difference could not be fully explained by differences in verbal IQ. Girls, no matter what th eir risk status, scored higher than boys on the Reasoning scale. Impli cations for legal policies concerning adolescents are discussed.