In addition, the psychiatrist must respond to questions, such as dangerousness and the potential for further violence, that are not usually raised in other juvenile cases. Thus, they must modify the standard assessment. Violent juveniles may receive one or more of many diagnoses including psychoses, conduct disorders, mental retardation, personality disorders, and sexual disorders. The clinician must assess the youth's personality structure and biopsychosocial history, mental status at the time of the crime, the victim-offender relationship, the dynamics of the crime, the presence of alcohol or other drugs, the role of third parties, and the possibility that the symptoms are being faked. About 7 to 10 percent of the general forensic population are malingerers, but the percentage for juveniles is likely to be lower. Predicting dangerousness is difficult, with a history of violence the best predictor and a pattern of escalating violence providing greater cause for concern. The clinician should clearly specify the youth's needs, leaving the decisions on how and where to meet those needs to the judge. 10 references