Poly-victimization among juvenile justice-involved youths

Operational Definitions of Poly-Victimization: A Scoping Review

Throughout the last two decades, research on poly-victimization (PV) has evolved from examinations of a core set of past-year victimization types in youth samples to investigations of a broad range of victimization types experienced during variable time intervals in diverse samples of varying ages. As the concept of PV expands, greater clarity regarding the definition and measurement of PV is needed to advance understanding of its risk and protective factors as well as its associated outcomes. This scoping review aimed to (a) identify approaches used to operationally define and measure PV across studies and (b) synthesize empirical findings concerning risk factors and outcomes associated with PV. A systematic search of peer-reviewed research published before 2022 across 12 databases yielded 98 studies that met inclusion criteria. Study characteristics including the research design, sample type, victimization timeframe, operational definition(s) of PV, measurement of PV, analytic methods, and key findings were synthesized across studies. Findings indicated that the majority of reviewed studies were cross-sectional investigations that utilized categorical measures of lifetime PV in samples of youth. Results also demonstrated that PV is robustly associated with a broad range of predictors, including mental health symptoms and diagnoses as well as family- and community-level factors. PV is also associated with numerous adverse outcomes including depression, anxiety, suicidality, substance use, and delinquency across diverse study types and populations. Future research that examines the conditional effects of PV is needed to identify subgroups of individuals at higher risk of adverse outcomes following PV and modifiable targets for interventions.

Type of Victimization Exposure, Perpetrator Type, and Timing of Victimization: The Impact on Behavioral Health Outcomes

The effect of abuse victimization in correctional samples has been researched previously, particularly with an eye toward these experiences on justice-involved youth and prison samples' offending and recidivism behavior. The role of this type of victimization, including physical abuse, sexual abuse, and polyvictimization, is less studied in jail populations. The effect of abuse victimization is also less researched among other outcomes, including behavioral health disorders (BHDs) and substance use disorder (SUD). While the effect of abuse, generally, has been examined, less is known about how abuse perpetrator type and timing of abuse impact justice-involved individuals' outcomes. Using logistic regressions, we examined the influence of abuse perpetrator type (non-stranger or stranger) and timing (before childhood, after childhood, or before and after childhood) in a population of jailed adults from one state (n = 4,713). Outcomes studied included internalizing BHDs, externalizing BHDs, and severe SUD. Results indicated that abuse perpetrated by a non-stranger yielded a greater impact on mental illness compared to abuse perpetrated by a stranger. In contrast to abuse experienced as an adult, childhood abuse was more consistently associated with internalizing and externalizing disorders but was not related to severe SUD, with an exception of physical abuse. Further, BHDs and SUD were strongly associated with each other. Overall, polyvictimization had the strongest effect on the outcomes compared to either physical abuse or sexual abuse alone. Our findings suggest that screening for abuse experiences as a potential destabilizing factor in justice-involved populations could improve case management and interventions for people incarcerated in jails. Results also highlight the importance of distinguishing between the perpetrator type of abuse and timing of abuse.

Toward a Contextually Sensitive Understanding of Polyvictimization: A Latent Class Analysis of Violence, Risks, and Protections Among South African Adolescents From Highly Deprived Settings

South African adolescents experience a high prevalence of violence victimization alongside the health and economic burdens of HIV/AIDS and poverty. Polyvictimization is a useful theory and framework that allows for a nuanced understanding of lived adolescent experience patterns. Polyvictimization examinations are further enriched by person-centered analytical approaches. This study used latent class analysis to differentiate a sample of South African adolescents from highly deprived communities by their polyvictimization profiles and contextual violence risk and protective factors. Adolescents were sampled twice (2010/2011; 2011/2012), and data reflected their lifetime (sexual abuse) or recent (all other forms of assessed abuse/violence) violence victimizations, as well as individual, household, and community characteristics. Model fit indices supported a seven-class model with adolescents in high, moderate, and low polyvictimization classes. Adolescents in the high polyvictimization classes experienced a heavy burden of poverty and multiple forms of violence across contexts and were distinguished by HIV/AIDS and disability. Adolescents in the low polyvictimization class experienced relatively little violence, despite living in violent communities, and low household and individual burdens of HIV/AIDS and disability. Findings emphasize the importance of considering adolescent violence through a contextually sensitive polyvictimization lens to understand the complex web of violence that adolescents experience. This work supports previous research in low-resource South African settings highlighting the interconnected nature of violence, poverty, disability, and HIV/AIDS. Future research should explore these complex violence patterns and their effects, while program and policy actions must target and prevent adolescent violence especially for those impacted by poverty, disability, and HIV/AIDS.

Adverse childhood experience trajectories and individual high risk-behaviors of sexual offenders: A developmental victimology perspective

BACKGROUND

Developmental victimology theory suggests that developmental features of risk and impact stemming from various types of victimization depend on the age of the child or adolescent.

OBJECTIVE

A next step is studying the developmental victimization trajectories of individuals involved in sexual crimes by focusing on traumatic events occurring during childhood and adolescence respectively. Building on the developmental victimology perspective, the study's specific aims encompass two key objectives: 1) exploring the diverse trajectories of Adverse Childhood Experiences (ACEs) within a sample of individuals involved in sexual crimes, and 2) assessing whether these ACEs trajectories influence the emergence of distinct high-risk behaviors.

PARTICIPANTS AND SETTING

252 individuals convicted of sexual crimes were selected from a federal penitentiary in Quebec, Canada.

METHODS

Semi-structured interviews with a computerized questionnaire produced data on numerous aspects of the participant's life history, criminal career, and victimization experiences that were analyzed via latent class modeling.

RESULTS

Four classes (no ACEs trajectory, poly exposure and victimization trajectory, childhood exposure trajectory, and poly victimization trajectory) were identified.

CONCLUSIONS

Consistent with hypotheses, developmental ACEs trajectories are heterogeneous and associated with the criminal careers, adolescent problematic behaviors, substance use disorders, and violence history among individuals involved in sexual offending.

Strengthening Prevention Systems to Address the Overdose Crisis Through the HEAL Prevention Cooperative and HEAL Preventing Opioid Use Disorder Research Program

The HEAL Prevention Cooperative (HPC), a subset of the HEAL Preventing Opioid Use Disorder (OUD) Research Program, addresses the evidence gap of interventions for populations at higher risk for opioid use initiation, escalation, and disorder. Designed to yield programs that can be scaled up for dissemination, the studies address topics critical to systematic implementation including data harmonization, intervention costs, culturally responsive services, community engagement, working across the continuum of care, and bringing interventions to market. Ideally, interventions found to be effective will be considered for adoption by community stakeholders. However, the introduction and sustained use of evidence-based approaches remain challenging across the prevention field. Using SAMHSA/CSAP's framework for describing a modern and effective prevention system (Early Action, Easy Access, Effective Delivery, and Equitable Opportunities - the 4Es), this commentary describes ways to engage states, jurisdictions, territories, tribes, and communities to apply the lessons learned and pre-position their respective prevention systems for broad-scale implementation of HPC interventions.

Nonintimate Polyvictimization and the Severity of Intimate Partner Violence Experienced by Men

There is a dearth of research on the relation of men's cumulative experiences of nonintimate victimization (polyvictimization) to their victimization in intimate relationships. This study examines the association between nonintimate polyvictimization (including being abused as a child, cyberbullied, stalked, physically assaulted, and experiencing property crime) and the severity of intimate partner violence victimization in men. The sample of 8,784 men in current married/common-law relationships was drawn from a random sample of the 2014 Canadian General Social Survey. About 3% of the men (an estimate of about 265,000 men in Canada) experienced the most severe forms of partner abuse, including the combination of emotional abuse and controlling behaviors, physical violence, and the resulted injuries. Among these severely abused men, about one-third were polyvictims. As expected, a nonintimate polyvictimization predicted the increased severity of male partner abuse victimization, controlling for sociodemographic variables. These findings highlight the importance of preventing nonintimate polyvictimization of men that can help reduce their partner violence victimization.

Disrupting the Trauma- To - Prison Pipeline For Justice-Involved Young Women Victimized By Violence

Background

Rates of aggressive offending among Justice-Involved Young Women (JIYW) have increased over the past few decades. Yet, there is little discourse, research, or intervention to address it among young women.

Aims/hypotheses

This study hypothesized that a higher capacity for self-restraint measured on the Weinberger Adjustment Inventory (WAI) scale among 14-18-year-old JIYW would moderate the relationship between the exposure to violence and serious aggressive offending.

Methods

The pathways to desistance project, a multi-site, longitudinal study, included a sample of JIYW aged 14-18 years old (n = 184). The baseline data were analyzed using linear multiple regression.

Results

After controlling for two variables, race and neighborhood conditions, the overall model was significant (F = 8.31 (df = 7,176), p = .001). The predictor variables (exposure to violence and self-restraint) explained 25% of the outcome variable (level of aggressive offending). The moderation result was significant such that higher self-restraint weakens the relationship between exposure to violence and aggressive offending (B = - 0.01, t (176) = -2.39, p = .018).

Conclusions/implications

This study highlights the need to disrupt the trauma- to- prison pipeline by enhancing positive social skills in a trauma-responsive manner, which could mitigate the effect of exposure to violence among JIYW.

Why We Need a Developmentally Appropriate Trauma Diagnosis for Children: a 10-Year Update on Developmental Trauma Disorder

Developmental Trauma Disorder (DTD) was proposed almost two decades ago as a psychiatric diagnosis for children who have been traumatically victimized and whose attachment bonding with primary caregivers has been compromised. DTD was designed to complement and extend post-traumatic stress disorder (PTSD) by addressing forms of trauma-related biopsychosocial dysregulation not included in PTSD, many of which are attributed to other psychiatric disorders. In the past decade, evidence from clinician surveys and research field trial studies has provided evidence of DTD's validity and potential clinical utility. The growing evidence base for DTD is summarized and clinical rationales for the proposed DTD symptoms are described. DTD shows promise as a developmentally-attuned traumatic stress diagnosis for traumatized children.

Disruptive behaviors, antisocial attitudes, and aggression in young offenders: Comparison of Adverse Childhood Experience (ACE) typologies

BACKGROUND

Adverse Childhood Experiences (ACE) are associated with many deleterious outcomes in young offenders. There is a dearth of studies examining its effects on young offenders' antisocial attitudes, disruptive behaviors and aggression, risk factors for delinquency and reoffending.

OBJECTIVE

This study examined ACE patterns and their association with the above factors in young offenders.

PARTICIPANTS AND SETTING

1130 youth offenders (964 males; M_age = 17.57 years), provided self-reports on ACEs, antisocial attitudes, disruptive behavior ratings and aggression.

METHOD

Latent Class Analysis was performed on 12 self-reported ACEs, followed by Analyses of Covariance on each of the measures.

RESULTS

Four classes - Low ACE, Indirect Victims, Abusive Environment, and Polyvictimized - were identified. Polyvictimized youths had the highest levels of conduct problems (M = 70.35, ps < .05) and proactive aggression (M = 0.45, ps < .05) but did not differ from youths in Abusive Environment in reactive aggression (M = 1.02, p = .69), oppositional problems (M = 65.15, p = .18), and antisocial attitudes (M = 26.95, p = .21). Indirect Victims had lower levels of conduct problems (M = 64.80, p < .05) and antisocial attitudes (M = 24.35, p < .05) than Polyvictimized youths but higher levels of these outcomes than the Low ACE group.

CONCLUSIONS

Our findings showed that ACEs patterns vary in their effects on antisociality and disruptive behaviors. The novel finding was that childhood victimization does not have to be direct, as indirect victimization significantly impacted factors important to delinquency and reoffending.

Development, acceptability, and perceived effectiveness of a trauma-informed adolescent self-regulation intervention

Youth who have experienced trauma often face challenges with self-regulation and can have diminished health outcomes, including those related to sexual and reproductive health. We developed a 12-session blended e-learning intervention for youth involved in juvenile justice systems to encourage healthy sexual decision-making by improving self-regulation skills. This paper describes the development of the program, e-Practice Self-Regulation, as well as an assessment of program acceptability and perceived effectiveness among youth participants. Data were collected using a feedback survey from youth who both completed (n = 95) and did not complete (n = 80) the intervention. Program acceptability was high among all participants, and over 70 % of both completers and non-completers would recommend e-Practice Self-Regulation to peers. Youth reported positive interactions with facilitators and described sessions as helpful, interesting, and educational. The most common criticism was online session length. A majority in both groups reported perceived effectiveness related to sexual health and self-regulation, which increased with more sessions completed. Results suggest e-Practice Self-Regulation is acceptable to youth participants, who reported learning skills necessary for self-regulation and sexual health and intended to use these skills to avoid unplanned pregnancy.

The PTSD Symptom Presentation and the Effect of Polytrauma on PTSD Symptom Clusters Among Young People Who Have Experienced Commercial Sexual Exploitation and Trafficking

Purpose

The purpose of this study was to describe the PTSD symptom presentation (including dissociative symptoms) of PTSD using the Diagnostic and Statistical Manual of Mental Disorders 5 th Edition diagnostic criteria and explore associations between the symptom severity for each of the four PTSD symptom clusters and polytrauma, defined as multiple exposures to different categories of potentially traumatic events.

Methods

This is a secondary analysis of cross-sectional program evaluation data among 95 young people (aged 11-19) at therapy initiation in a southeastern state in the U.S. We used descriptive statistics and multivariable linear regression to test study objectives.

Results

Eighty-one respondents (90.0%) experienced a potentially traumatic event in ≥ 2 trauma categories, in addition to experiencing CSE/T. Approximately two-thirds of respondents experienced clinically significant PTSD symptoms for each symptom cluster. Of the 31 young people who met full criteria for PTSD, 9 met criteria for the standard PTSD diagnosis, while 22 met criteria for the dissociative subtype of PTSD. On average, experiencing additional trauma categories was associated with substantively higher PTSD symptom cluster scores for each cluster.

Conclusions

These findings support the need for a comprehensive assessment of trauma symptoms that includes cluster-specific PTSD symptoms. They also underscore the need to assess the full breadth and chronicity of trauma experiences to guide treatment planning and delivery, targeting specific domains of trauma impact. These findings can also inform the tailoring and adaptation of evidence-based interventions and strategies to better meet the needs of young people who have experienced CSE/T.

Does Gender Really Matter: Childhood Trauma, Trait Anger, and Suicide Risk in Early Adulthood

Background: Previous studies have reported mixed findings regarding gender differences in suicidal behavior. This discrepancy may be partly attributable to common predictors of suicide risk, such as childhood trauma and anger, and may also be independent of gender. Objectives: The present study investigated gender differences in the impact of childhood trauma and current trait anger on suicide risk, in a group of young Turkish adults. We hypothesized that trait anger would mediate the association between childhood trauma and suicide risk, independently of gender. Participants and Setting: Participants were 589 university students (84.3% women) aged 18-34 years (M = 21.43, SD = 1.82). Methods: Gender group differences in suicide risk, history of childhood trauma, and trait anger as well as possible covariates (i.e., self-rated socio-economic status and academic performance) were assessed. Possible predictors of suicide risk in gender groups were examined. The role of trait anger as a mediator of the relationship between childhood trauma and suicide risk was also examined. Results: Results showed that men reported a higher suicide risk, history of childhood trauma, and trait anger than women. Early childhood trauma and current trait anger scores were significant predictors of suicide risk in both gender groups. Trait anger significantly mediated the relationship between early trauma history and risk for suicide, independently of gender. Conclusions: Study findings support early reports of the effects of childhood trauma and trait anger on suicide risk. It was suggested that preventive interventions for suicidal behavior and monitoring risk groups with aggressive tendencies and childhood trauma history may be important.

Patterns of Childhood Adversities and Their Associations With Adult Victimization Among Incarcerated Men and Women in Spanish Prisons

Adverse childhood experiences (ACEs) are prevalent and have long lasting effects. There is evidence of gender differences in exposure to different types of ACEs, with women experiencing higher levels of sexual abuse and cumulative adversity than men. Despite this, most research examining patterns of adversities have used joint samples, assuming that men and women have comparable profiles. The current study examines if distinct profiles of childhood adversities exist for men and women and analyzes their associations with multiple forms of interpersonal victimization during adulthood. Participants were 2,709 residents (91.6% men and 8.4% women) from eight prisons in Spain, who completed a self-administered survey. Latent Class Analysis revealed different patterns of childhood adversities for men and women. For both groups, higher adversity was associated with interpersonal harm during adulthood.

Violence - suicide and suicidal ideation as sequelae of trauma in substance use disorder inpatients

Experience with psychological trauma is overrepresented among substance use disorder (SUD) patients. SUDs may also be a risk factor for violent behaviors, suicidal ideation and suicide. This study proposes a link between these phenomena. Based on data from the EuropASI clinical interview of 137 SUD inpatients we computed a composite variable of trauma experience from being abused. We report descriptive data and cross tabulated problems controlling violent behavior, suicidal ideation or suicide attempts variables with trauma experience. Hypothesizing an association between experienced trauma and the outcome variables. We also examined the correlation between three outcome variables in inpatients. Our data suggested high incidents of experienced psychological trauma in the sample (66.7%). Chi-square tests suggested a significant difference in controlling violent behavior, suicidal ideation and suicide attempts, dependent on trauma experience. Spearman Roh correlations suggested asscociations between suicdal ideation and suicide attempts, and suicdal ideation and problems controlling violent behavior, but not with suicide attempts. Our data suggests that past trauma is a risk factor for violent and suicidal behaviors in the SUD population. Based on our findings we propose that former trauma should be considered in risk assessments and help guide treatment interventions.

Clustering of adverse and positive childhood experiences: The nature and correlates of risk and protective factors

BACKGROUND

Despite the increased attention paid to the separate effects of cumulative stress and protection on offending, the extent to which distinct clusters of risk and protective factors exist and have unique effects on justice-related outcomes is under-studied.

OBJECTIVE

The current study examines for unique clustering of Adverse Childhood Experiences (ACE) and Positive Childhood Experiences (PCE) and the extent to which they predict juvenile recidivism.

PARTICIPANTS AND SETTING

The sample consists of a cohort of youth adjudicated delinquent in Florida who received a community-based sanction.

METHODS

The study first utilized latent-class analysis to identify distinct classes based upon the youths' ACE and PCE exposures. Next, two sets of regression models were estimated; the first investigated correlates of class membership and the second assessed whether class membership predicted recidivism.

RESULTS

Seven distinct classes of ACE/PCE clusters were found, composing 9.9 % to 20.5 % of the sample each. Relative to the class with low ACE and low PCE, those with low ACEs and high PCE evidenced 27.5 % lower rearrest rates, as did the Moderate Risk/Moderate Protection group.

CONCLUSIONS

Not only do distinct groupings of ACE and PCE exposures exist, but these groups have different likelihoods of future offending, where a youth's cumulative protection appears to be more important than their risk level. This has important policy implications as it offers further support for the use of strength-based treatment approaches.

Associations Between Adverse Childhood Experiences and Trauma Among Young People Who Offend: A Systematic Literature Review

This systematic review synthesized current knowledge about the prevalence of adverse childhood experiences (ACEs) among young people known to have offended and examined evidence of associations between ACEs, trauma symptoms, and offending behavior. A systematic search of English-language, peer-reviewed studies published from the year 2000 onwards was conducted. A final pool of 124 studies that reported quantitative data were included in the review. The Cambridge Quality Checklist for the assessment of studies on offending was used to assess methodological quality of included studies. Pooled data indicated that almost 87% of justice-involved young people across 13 countries experienced at least one traumatic event. The odds of experiencing at least one ACE were over 12 times greater for justice-involved young people compared with nonjustice-involved young people. Prevalence of individual ACEs ranged from 12.2% for childhood sexual abuse to 80.4% for parental separation among justice-involved young people. Those who reported both a higher number and multiple types of ACEs were more likely to be diagnosed with post-traumatic stress symptoms. However, when considering only high-quality studies, there was minimal evidence to suggest that a higher incidence of ACEs predicted trauma symptoms or that trauma symptoms mediated the association between ACEs and offending behavior. Further research is needed to elucidate factors that differentiate young people exposed to ACEs who go on to offend from those who do not. This research is essential to understanding whether ACEs and trauma are drivers of offending behavior and for informing prevention and intervention strategies.

Positive Caregiving Styles Attenuating Effects of Cumulative Trauma Among Youth Who Commit Sexual Crimes

Among youth who commit sexual crimes, childhood trauma experiences have been linked to a host of outcomes including trauma symptom expression. Furthermore, research has begun assessing differential rates of cumulative adverse childhood experiences (ACEs) between youth who commit sexual and non-sexual crimes. Yet, few studies have comparatively examined rates of cumulative traumatic events using more robust measures of adversity. There is scant research on outcomes associated cumulative trauma among youth who commit sexual crimes including linkages to trauma symptoms and how positive parenting styles (PCSs) can attenuate in this relationship. This study aims to compare cumulative trauma experiences between youth who commit sexual (n = 112) and non-sexual crimes (n = 224). Among youth who commit sexual crimes, we test how PCSs mitigate or moderate the effects of cumulative trauma on trauma symptoms. Results from independent samples t-tests revealed significant group differences on singular and cumulative traumatic experiences, and trauma symptomatology, where youth who commit sexual crimes had higher rates of all. Stepwise linear regressions revealed mitigating effects of maternal PCSs and tests of moderation revealed main and interaction effects, where intermediate positive maternal caregiving styles for youth with higher cumulative trauma were associated with greater trauma symptomatology. Implications and limitations are discussed.

At-School Victimization and Alcohol Use Among Minoritized U.S. Youth, 2009-2017

INTRODUCTION

Sexual minority and/or racial/ethnic minority youth may use alcohol at school as a form of minority stress-based coping. Polyvictimization is particularly prevalent among sexual minority and/or racial/ethnic minority youth and may be a useful proxy measure for minority stressors.

METHODS

Data from local administrations of the Youth Risk Behavior Survey were pooled across 42 jurisdiction years (biennially, 2009-2017) and analyzed in 2022, resulting in a sample of 118,052 U.S. youth. The prevalence of alcohol use at school was examined by sexual identity, race/ethnicity, and their intersections, stratified by sex. Multivariable logistic regression models were built to examine the disparities in alcohol use at school and the impact of school-based polyvictimization.

RESULTS

At the intersections of race/ethnicity and sexual identity, 25 of 30 sexual minority and/or racial/ethnic minority subpopulations had greater odds of alcohol use at school than their White heterosexual same-sex peers. Hispanic/Latinx not-sure males (AOR=9.15; 95% CI=5.97, 14.03) and Hispanic/Latinx lesbian females (AOR=11.24; 95% CI=6.40, 19.77) were most likely to report alcohol use at school. After adjusting for polyvictimization, the magnitude of association was attenuated for most sexual minority and/or racial/ethnic minority subpopulations; however, all but 2 significant associations remained.

CONCLUSIONS

Sexual minority and/or racial/ethnic minority youth were more likely than White heterosexual peers to use alcohol at school, with the greatest odds among multiply marginalized and polyvictimized youth. Interventions should consider addressing more than school-based victimization alone because disparities persisted, although at a lower magnitude, after accounting for polyvictimization. Future longitudinal studies are warranted to further explore the associations between multiply marginalized identities, school-based polyvictimization, and alcohol use at school.

Polyvictimization and Psychosocial Outcomes Among Trauma-Exposed, Clinic-Referred Youth Involved in the Juvenile Justice System

Polyvictimization is a robust predictor of emotional and behavioral problems and is linked to involvement in juvenile justice and other public sector systems. This study extends prior research by employing person-centered methods for identifying polyvictimization patterns among trauma-exposed, clinic-referred, justice-involved youth (n = 689; ages 12-18 years) and how identified classes differ on psychosocial outcomes and demographic characteristics. Most participants had experienced multiple traumatic event (TE) types. Latent class analyses identified three classes: mixed trauma/bereavement exposure group (55.1%; Mean = 3.0 TE types); maltreatment polyvictimized group (29.3%; Mean = 5.7 TE types); and maltreatment plus extreme violence polyvictimized group (15.7%; Mean = 9.3 TE types). Polyvictimized youth were more likely to be female, in out-of-home placements, and experiencing negative psychosocial outcomes (e.g., Posttraumatic Stress Disorder). Hispanic/Latino youth were overrepresented in the extreme polyvictimized subgroup. Results underscore the need for cross-system coordination of trauma-informed, comprehensive services for clinic-referred, justice-involved youth.

Typologies of Stressful Life Events and Their Association With Sexual Risk Behaviors and Communication Among Justice-Involved Males and Their Female Sex Partners

Stressful life events are prevalent among justice-involved populations and are associated with sexual risk behaviors and partner communication regarding safe-sex practices. We describe patterns of stress exposure for heterosexual couples (where males are under community supervision) and how stress patterns are associated with sexual risk behaviors and communication (460 individuals; 230 couples). Latent class analysis identified patterns of stress. Multinominal logistic regression models identified associations between sex, race, ethnicity, and stress classes. Multilevel Poisson regression models described relationships between sexual risk behaviors and frequency of communication about condoms/HIV, and stress classes. We found four classes that differed by sex, race, and ethnicity and were associated with the number of sexual partners, condom use self-efficacy, discussing condoms with partner, and discussing HIV prevention with partner. Partner class was associated with the number of sexual partners. Findings inform future assessment/interventions for sexual health that consider patterns of stress and demographics.

Trauma Exposure and Mental Health Needs Among Adolescents Involved With the Juvenile Justice System

Justice-involved adolescents typically report high levels of lifetime trauma exposure, although research on juvenile justice system-wide screenings is limited. Further, there is little evidence from research on the psychological and substance abuse treatment related needs of youth relative to the trauma levels or types of trauma experienced by justice-involved adolescents. We documented lifetime exposure to traumatic events and its relation to psychological and substance use concerns in a sample of adolescents admitted to custody in the New Jersey Juvenile Justice Commission. This study examined lifetime exposure to traumatic events experienced by justice-involved adolescents (N = 627) using negative binomial regression modeling and zero-inflated negative binomial regression modeling to identify which adolescents have the greatest trauma exposure, and determine how cumulative types of trauma relate to youths' mental health and substance use needs. Adolescents reported experiencing an average of 4 of 17 traumatic exposures on the Life Events Checklist. The most common traumas experienced directly and indirectly were physical assault and assault with a weapon. Considering particular traumas, there were differences in exposures based on race and ethnicity, sex, child welfare involvement, and gang affiliation. Higher levels of some types of traumatic exposure were consistently related to higher levels of mental health needs. Results indicate that adolescents enter the juvenile justice system with high levels of polytraumatization. These adverse events are associated with elevated mental health and substance use needs that should be considered in case planning.

Pathways to Suicidal Behavior in Children and Adolescents: Examination of Child Maltreatment and Post-Traumatic Symptoms

Suicide in youth exacts significant personal and community costs. Thus, it is important to understand predisposing risk factors. Experiencing adverse childhood experiences (ACEs), such as child maltreatment (CM-ACE), and the presence of post-traumatic stress disorder has been identified as a risk factor of suicidal behaviors among adults. Theoretical models of suicide suggest that the presence of painful experiences such as CM-ACEs increase the risk of suicidal behaviors. The relation between child maltreatment, post-traumatic stress symptom clusters (PTSS) and suicidal behaviors has not been explicitly examined among youth. The present study examined the relations between CM-ACEs, PTSS clusters, and suicidal behaviors in a clinical population of children. Children, male, ages 6 to 14, enrolled in a residential treatment program completed self-report measures to evaluate variables of interest. Path analyses revealed statistically significant direct effects of CM-ACEs and PTSS clusters on suicidal behaviors. Significant total indirect effects and marginally significant individual indirect effects of intrusion and avoidance symptoms were observed for the relation between CM-ACEs and suicidal behavior. Findings suggest that symptoms associated with specific PTSS clusters might help explain the relation between CM-ACEs and suicidal behavior, and therefore, present important implications for clinical practice and future research.

Environmental Predictors of Within-Person Changes in Callous-Unemotional Traits among Justice-Involved Male Adolescents

OBJECTIVE

Youth who display elevated callous-unemotional (CU) traits are at risk for negative developmental outcomes. Previous studies demonstrate that environmental conditions contribute to elevated levels of CU traits, but the majority of this work focuses on a single source of environmental influence. To better understand how environmental conditions contribute to changes in CU traits during adolescence, the current study examined the time-varying relation between CU traits, parent, peer, and community conditions.

METHOD

Using data from the longitudinal Pathways to Desistance study (N = 1,026 males, Mage = 15.98, SD = 1.16; 40.94% Black, 34.11% Latino, 20.66% White, 4.29% Other), full-factorial fixed effect regression models were implemented to examine how parental hostility, antisocial peers, community violence, and neighborhood disorder are individually and interactively associated with within-person changes in CU traits during adolescence (15-21 years).

RESULTS

Results indicated that proximal conditions (i.e., negative parenting, antisocial peers) had more consistent associations with CU traits than distal conditions (i.e., neighborhood disorder, community violence). Affiliation with antisocial peers was not significantly related to CU traits when youth were simultaneously exposed to high community violence and low neighborhood disorder. Further, the association between CU traits and impact of living in high disordered, high violence neighborhoods was stronger for younger youth.

CONCLUSION

Results indicate that the association among parents, peers, and CU trait development is more nuanced than previously suggested, such that the risk that each environmental condition poses is moderated by a youth's age and their exposure to distal conditions.

Sexual Trauma Informed Understanding of Longitudinal Depression among Repeat Juvenile Offenders

Childhood sexual assault (CSA) victimization and depression are global public health concerns that disproportionately affect youths involved in the juvenile justice system. Little research has examined the influence of CSA on the stability of depressive symptoms among repeat juvenile offenders. The present study tested a gendered model of the association between lifetime CSA victimization and depression for three time points: baseline juvenile assessment entry; second reentry; and third reentry. Further, covariate analyses were conducted to explore the impact of socio-demographics on CSA victimization and depression. Results indicate that CSA victimization was associated directly with baseline depression and indirectly with depression at second reentry for both male and female justice-involved youths. For white, male youth, there were significantly higher rates of depression over time, than other males. However, age, African American or Hispanic race/ethnicity, living situation, and urbanity were not significantly associated with CSA victimization at baseline or depression over time. These findings underscore the need for juvenile justice services that address exposure to childhood trauma and mental illness more effectively.

Childhood Abuse Classes for Incarcerated Men and Women: Are There Unique Gender Patterns in Abuse Classes?

Childhood adversity is predictive of poorer health and behavioral health outcomes in adulthood. Males and females are known to experience different types of childhood adversity, with females experiencing more sexual and emotional harm in childhood. Latent class analysis (LCA) has been used to identify patterns among types of childhood adversity. These studies have constructed class structures using single gender or blended gender samples. Class structures based on blended gender samples, however, may misrepresent the nuances of gender-specific adversity histories through averaging, potentially distorting the relative need for gender-specific types of intervention. This study investigated whether latent class structures of childhood abuse are equivalent for incarcerated males and females. Our sample included 4,204 residents (3,986 males, 218 females) drawn from a single prison system. Residents completed an hour-long audio computer-assisted self-interview that included questions on 10 types of childhood abuse, depression, and anxiety symptoms, the Beck Hopelessness Scale (BHS), Buss-Perry Aggression Questionnaire, and Criminal Sentiments Scale-Modified (CSS-M). Overall, female residents were both more likely to experience childhood abuse and have more extensive victimization experiences. Small subgroups of males, however, had even more extensive victimization experiences. Abuse patterns for males and females, while optimally clustering in four classes, are rather unique, especially for higher abuse classes, in terms of distribution of membership and types of abuse. These differences may matter in terms of identifying the relative need for therapeutic intervention among incarcerated males and females and targeting those interventions in ways that reflect the gradient and density of therapeutic need. The next step is to test whether using blended or gendered latent class structures matters in terms of predicting outcomes, such as prison-based behavioral health problems, suicidality, and victimization.

Patterns of Maltreatment Co-Occurrence in Incarcerated Youth in Australia

Child maltreatment research is increasingly recognizing the need to capture patterns of co-occurrence between different types of abuse/neglect and to consider their associations with psychosocial functioning. Few studies have examined these issues in justice-involved youth despite the fact that rates of maltreatment and trauma-related psychopathology are disproportionately high among this population. This study examined profiles of self-reported child physical abuse, sexual abuse, emotional abuse, and neglect among incarcerated juveniles in Victoria, Australia, using latent class analysis. We also investigated associations between maltreatment profiles and mental health and behavioral problems. Data pertaining to juveniles' experiences of maltreatment and mental health and behavioral functioning were collected from interviews, questionnaires, files, and administrative datasets. A three-class solution provided the best fit for the data and was conceptually meaningful: a "low/rare maltreatment" class (41%); "high physical and emotional abuse" class (23%); and a "poly-victimization" class (36%). Youth in the "poly-victimization" class experienced especially serious mental health and behavioral disturbances, including higher rates of mental illness, greater severity of internalizing and externalizing symptoms, impulsivity, substance abuse, self-harm and suicidal behavior, irritability, and early-onset violence. Results suggest there may be benefit in considering screening and assessment procedures in youth justice settings to identify poly-victimized youth in need of more intensive monitoring and treatment to address their complex clinical and behavioral profiles.

Transgender and Gender Diverse Community Connection, Help-Seeking, and Mental Health Among Black Transgender Women Who Have Survived Violence: A Mixed-Methods Analysis

Black transgender women are disproportionately affected by violence and poor care-delivery, contributing to poor mental health. Little is known regarding the effect of transgender and gender diverse (TGD) community connection (TCC) on health. This analysis (a) explores relationships between TCC, polyvictimization, and mental health and (b) analyzes how TCC influenced help-seeking following violent experiences among Black transgender women. Mixed-methods data from 19 Black transgender women were analyzed using correlational and thematic content analyses. Findings suggest that TCC is associated with improved help-seeking and mental health among Black transgender women, highlighting a need for longitudinal research to identify approaches for leveraging TCC.

Beyond Trauma Exposure: Discrimination and Posttraumatic Stress, Internalizing, and Externalizing Problems Among Detained Youth

According to the race-based traumatic stress model, racial discrimination is proposed to comprise a traumatic experience that results in posttraumatic stress symptoms, as well as internalizing and externalizing problems among youth. Accordingly, a significant body of research has emerged that supports the associations among these constructs. However, the majority of these empirical studies have not accounted for the potential role of traditionally defined traumatic events in these associations. This study investigated whether self-reported racial discrimination was related to posttraumatic stress symptoms, internalizing, and externalizing symptoms above and beyond the impact of other trauma exposures in a sample of 266 detained youth (79% boys, 60% identified as an ethnic minority). Results of hierarchical linear regressions demonstrated that, after accounting for youths' other trauma exposures, racial discrimination accounted for significant variance in the models predicting delinquency and risk-taking but no other externalizing and internalizing problems, or posttraumatic stress symptoms. These findings indicate that racial discrimination may be particularly important for understanding offending behavior among detained youth.

A Trauma-Informed Approach to Assessment, Case Conceptualization, and Treatment Planning for Youth Exposed to Intimate Partner Violence

Children’s exposure to intimate partner violence (IPV) is a prevalent public health problem that can result in serious mental health impairments, including traumatic stress. These can emerge early and persist across development. IPV early in life has also been described as a “gateway exposure” to other forms of adversity and trauma. Children and families impacted by IPV have complex needs that complicate assessment and intervention. This paper highlights these issues and reviews best practices in assessment, case conceptualization, and treatment planning as they pertain to the treatment of IPV-exposed children. A case vignette illustrates the complex nature of IPV and application of best practices by telling the story of Isaiah, a 13-year-old boy with an extensive history of IPV exposure and co-occurring adversity and trauma.

Relationships among adverse childhood experience patterns, psychological resilience, self-esteem and depressive symptoms in Chinese adolescents: A serial multiple mediation model

Adverse childhood experiences (ACEs) and adolescent depression are both prevalent social problems that can increase the risk of several negative health consequences throughout life. The original definition of ACEs misdirects the focus of intervention efforts for ACEs to only family dysfunction and parenting practices. We used a broader definition of ACEs and a latent class analysis (LCA) model to examine ACE patterns, aiming to overcome the shortcomings of cumulative and single adversity approaches based on the special social context of China. The data were derived from a middle school in Huaibei City of Anhui Province in 2019 and 2020, which was a prospective study involving 1687 junior high school students. At the initial evaluation (T1), ACEs, psychological resilience, self-esteem, and depressive symptoms were assessed by the students. At Time 2 (T2), the depressive symptoms of students were assessed. LCA and mediation analyses were conducted with Mplus version 8.2. The LCA identified the following three heterogeneous ACE classes: "low adversity" (36.4%), "moderate adversity" (44.2%), and "high adversity" (19.4%). The mediation analysis showed that the ACE patterns affected depressive symptoms through the following two mediation paths only in the moderate but not in the high adversity class: self-esteem alone and a path combining psychological resilience and self-esteem. Psychological resilience separately did not mediate the association between ACE patterns and depressive symptoms. To reduce depressive symptoms, interventions for students with ACEs need to improve self-esteem through many channels.

Mental Health Care of Detained Youth Within Juvenile Detention Facilities

Mental health treatment of juvenile offenders and undocumented immigrant youth in detention provides a unique opportunity for treatment providers. Although the work may be challenging, the clinical needs and opportunities for early and meaningful interventions are significant. One of the best clinical experiences a psychiatrist can have is working with extremely high-risk youth to help them find safer and better developmental pathways. Few settings can offer such an opportunity to leverage clinical skills to improve the lives and futures of children and adolescents as are afforded to those professionals lucky enough to work in juvenile justice settings.

The Co-Occurrence of Child Maltreatment and Intimate Partner Violence in Families: Effects on Children's Externalizing Behavior Problems

Children exposed to maltreatment are at risk of experiencing intimate partner violence (IPV) and behavioral problems. This study examined different forms of family violence that co-occur and their relationship to children's externalizing behaviors across developmental stages (early childhood, middle childhood, adolescence). Longitudinal data (N = 1,987) at baseline and 18 months and 36 months post-baseline from the NSCAW II were used. Mixture modeling was employed in which latent class models estimated subgroups of children who experienced co-occurring forms of family violence; regression models estimated which subgroups of children were at risk of externalizing behaviors. Three latent classes were identified across developmental stages: high family violence, low family violence, and child physical abuse and psychological aggression. For children in early childhood, a fourth class was identified: partner and child physical abuse and child psychological aggression. Results from regression models revealed differences in externalizing scores by class membership across developmental age groups and over time. That distinct classes of child maltreatment and IPV co-occur and differentially impact children's behavior suggests a need for strong prevention and intervention responses to address children's dual maltreatment and IPV exposure.

Identifying Poly-Victimization Among Prisoners: An Application of Latent Class Analysis

Research suggests that people in prison may be especially vulnerable to victimization and may be more likely to report exposure to multiple types, known as poly-victimization. However, the literature surrounding patterns of victimization among prisoners is limited. Before we can fully understand the variation in victimization experiences among prisoners, a necessary first step is to identify victim profiles within prisons. The current study utilizes data from the 2004 Survey of Inmates in State and Federal Correctional Facilities and employs latent class analysis to identify unique victim profiles among prisoners to understand the variation in victimization experiences, with a focus on identifying those exposed to poly-victimization. The findings of this study indicate (a) that there are four distinct victim profiles-poly-victimization (2%), physical victimization in adulthood (31%), physical victimization in childhood (17%), and low/no victimization (49%); (b) that some prisoners experience poly-victimization, although this consists of a small proportion of prisoners; and (c) that there are clear demographic differences between the latent classes, with some of the largest differences among those in the poly-victimization profile. The findings of the current study are important because they add more depth to the knowledge regarding poly-victimization among prisoners, a topic that has received little attention from researchers. The current study suggests that correctional policy may need to be tailored in a way that recognizes the different needs of prisoners who have been exposed to different forms of victimization.

Longitudinal effects of adverse childhood experiences on substance use transition patterns during young adulthood

BACKGROUND

Few studies have investigated how adverse childhood experiences are associated with substance use patterns during young adulthood, a crucial developmental period.

OBJECTIVE

The objective of this study was to extend current knowledge on the association between adverse childhood experiences and patterns of substance use among young adults. We also sought to understand how current mental health status and biological sex influences these patterns.

PARTICIPANTS AND SETTING

The current study utilized wave 8-wave 11 data of a longitudinal cohort study (N = 2880).

METHODS

We used latent transition analysis (LTA) to understand stability and transition patterns of substance use across participants who reported adverse childhood experiences (ACEs+) versus those who did not (ACEs-). Latent class regression was used to assess contemporaneous effects of mental health and sex on classes over time.

RESULTS

Both groups had similar patterns of substance use emerge at each timepoint: High all; Binge, tobacco, cannabis; and Steady/increasing binge drinking. ACEs+ had a higher proportion of youth in the High all class and much higher stability in this class, compared to the ACEs- group. Those in the ACES+ group were less likely to transition out of a riskier class. Mental health and sex showed differential effects across ACEs groups.

CONCLUSION

Results point to increased risk of polysubstance use, including opioids and prescription medications, among those who reported adverse childhood events. Future work may explore protective, malleable, factors that may confer reduced risk of long-term polysubstance use.

Associations Among Trauma Exposure, Posttraumatic Dissociation, Reckless/Self-Destructive Behavior, and Adolescent Offending

Previous research has established that trauma exposure and subsequent posttraumatic stress symptoms confer risk for adolescent offending and involvement in the juvenile justice system. However, recent research and theory have called attention to the contributions of specific posttraumatic reactions, including posttraumatic dissociation (PD) and reckless or self-destructive behavior (RSDB), to offending behavior among adolescents. Therefore, this study investigated direct and indirect associations among trauma exposure, PD, RSDB, and offending in a sample of justice-involved adolescents. Participants were 301 adolescents (Mage = 16.03, SD = 1.24; 21% girls) recruited from a detention center in the Mountain West. The sample was racially and ethnic diverse, with 63% identifying as a racial or ethnic minority. Youth completed self-report measures of trauma exposure, PD, RSDB, and offending. As hypothesized, results of multiple mediation analysis demonstrated a significant indirect effect linking trauma exposure and offending through PD and RSDB. Results testing an alternative multiple mediation model were non-significant. These findings suggest that PD and RSDB may serve as key links accounting for the association between trauma exposure and offending behavior and reinforce the value of incorporating trauma-informed practices within juvenile justice systems.

Understanding the relations among adverse childhood experiences (ACE), substance use, and reoffending among detained youth

BACKGROUND

System-involved youth experience elevated rates of exposure to adverse childhood experiences (ACE), which is related to reentry in the criminal legal system and increased risk of using substances, but there is little research on the indirect role of substance use in the relation between adversity and offending in youth offenders. Notably, the majority of youth report exposure to multiple adverse events and these experiences vary by gender.

OBJECTIVE

The present study aimed to expand upon current literature by evaluating gender differences in the relations among cumulative ACEs, substance use severity, and reoffending in a sample of rural detained youth (N = 417).

METHODS AND RESULTS

Using Poisson (count) regression analyses, cumulative adversity significantly predicted reoffending among girls and boys. Additionally, there was a significant indirect effect of ACEs on reoffending via substance use. Girls reported higher exposure to adversity and substance use, and gender significantly interacted with ACEs to predict substance use and reoffending.

CONCLUSIONS

These findings demonstrate the importance of cumulative experiences of adversity in childhood and substance use as predictors of youth reentry into the criminal legal system. Understanding the role of substance use in the relation between ACEs and reoffending has the potential to contribute to our knowledge of detained youth's treatment needs and reoffending risk.

Advancing Our Understanding of the Risk Factors Associated with Crossover Youth in the Child Welfare and Juvenile Justice Systems: A Trauma-Informed Research Agenda

Previous research has provided robust evidence demonstrating that a notable proportion of youth become involved in both the child welfare (CW) system and the juvenile justice (JJ) system, a population often referred to as crossover youth. Prior work has identified a number of risk factors associated with crossing over between these systems. However, there are limitations to the extant literature, key among which is a lack of systematic attention to the influence of trauma exposure and posttraumatic sequelae on the crossover trajectory. In contrast, viewing this research through a trauma-informed lens promises to enhance our ability to integrate findings across studies and to derive theoretically derived hypotheses about underlying mechanisms which will better inform future research and the development of effective prevention and intervention efforts. Accordingly, the purpose of this article is to present a trauma-informed research agenda that would strengthen future research in the field. After providing a brief critique of the existing studies that has documented known risk factors associated with the crossover population, we outline ways in which future research could apply relevant theoretical trauma-informed approaches, including developmental traumatology, to further advance our knowledge of risk factors and mechanisms associated with the crossover trajectory. We conclude by discussing policy and system-wide implications related to the proposed research agenda.

"It Changed My Life": Traumatic Loss, Behavioral Health, and Turning Points Among Gang-Involved and Justice-Involved Youth

An especially vulnerable population to traumatic loss, violence exposure, and posttraumatic stress symptoms are those involved in the juvenile justice system. However, justice-involved youth are not a homogeneous group. Research looking at subpopulations within juvenile justice systems highlight the diverse backgrounds and treatment needs of justice-involved youth such as those who are also gang-involved. The current study seeks to address the interrelated issues of behavioral health, traumatic grief, loss, and self-reported turning points among a sample of formerly incarcerated youth who report extensive juvenile justice histories (N = 62). All youth participated in an extensive survey interview. Just over half (56.5%) of the youth reported being gang-involved. Chi-square analyses revealed that gang- and justice-involved youth were significantly more likely to have experienced traumatic loss compared with their justice-only peers (χ² = 4.265, p < .05). Gang involvement approximately doubled youth's exposure to community violence, both direct and witnessed, and there were significant differences in the levels of posttraumatic stress symptoms and substance use, between the gang- and justice-involved youth compared with the justice-only youth. When asked to describe a turning point in their lives, 15% of the sample described significant loss and how it affected their lives, for better or worse. Findings lend support for a focus on supporting posttraumatic growth and increasing access to trauma-focused treatment, with an emphasis on grief and loss, for those who are both gang- and justice-involved.

Profiling COVID-related experiences in the United States with the Epidemic-Pandemic Impacts Inventory: Linkages to psychosocial functioning

The COVID-19 pandemic has had a profound impact on the lives of individuals, families, and communities around the world with constraints on multiple aspects of daily life. The purpose of the present study was to identify specific profiles of pandemic-related experiences and their relation to psychosocial functioning using the 92-item Epidemic-Pandemic Impacts Inventory (EPII). Data were collected as part of a cross-sectional, online survey of adults (18+) residing in the Northeast region of the United States (N = 652) and recruited via online advertisements. Person-centered latent class analysis (LCA) was applied to 38 pandemic-related experiences that showed a significant bivariate correlation with perceived stress. Measures of psychosocial risk were also obtained. Results revealed five unique profiles of respondents based on patterns of pandemic-related experiences. Three profiles representing about 64% of the sample were characterized by moderate to high exposure to adverse experiences during the pandemic and were more likely to screen positive for depression, anxiety, and posttraumatic stress. These profiles were differentiated by sociodemographic differences, including age, caregiving, and employment status. Two profiles differentiated by age and caregiver status represented about 36% of the sample and were characterized by relatively low exposure to adverse experiences and lower risk for psychosocial impairment. Findings support the EPII as an instrument for measuring tangible and meaningful experiences in the context of an unprecedented pandemic disaster. This research may serve to identify high-risk subpopulations toward developing public health strategies for supporting families and communities in the context of public health emergencies such as the COVID-19 pandemic.

The association between adverse childhood experiences and mental health problems in young offenders

High rates of adverse childhood experiences (ACEs, e.g., abuse and neglect) have been found in young offenders. Furthermore, ACEs seem to increase the risk of developing relevant mental health problems, in non-offending juveniles and adults. However, this association has only seldomly been addressed in offending juveniles and young adults. The present study aimed at evaluating the prevalence of ACEs and mental health problems as well as their association within a sample of male and female young offenders. Altogether, 161 adolescent and young adult offenders (16.8% females) from the youth detention center Worms (Germany) filled out questionnaires concerning ACEs and mental health problems with a focus on attention-deficit/hyperactivity disorder and intermittent explosive disorder. Considerable rates of mental health problems were found, e.g., a prevalence of 35.9% was found for intermittent explosive disorder. Furthermore, a greater proportion of the female offenders fell into the clinically significant category for somatic complaints, anxiety/depression, and attention problems than the male offenders. Female young offenders also reported more frequently about all forms of ACEs compared to the male offenders. Latent class analysis defined three subtypes of young offenders depending on their individual ACE patterns: (1) low ACEs, (2) mainly neglectful ACEs, and (3) multiple ACEs. ACEs were significantly associated with the occurrence of both internalizing and externalizing mental health disturbances, with the multiple-ACE subtype being most likely to report about significant mental health problems. The results of the present study point towards the relevance to routinely assess ACEs in young offenders to identify possible precursors of mental health problems and of future criminal behaviors.

Relationship between Adverse Childhood Experiences and substance use in youth offenders in Singapore

BACKGROUND

Adverse Childhood Experiences are associated with worse outcomes in delinquency and substance use.

OBJECTIVE

Current research is overwhelmingly from Western perspectives, leaving a gap in non-Western, low crime-rate jurisdictions. Moreover, there exists a gap in characterizing the effect of ACE frequency on delinquency. We extend existing research by examining relationships between ACE and substance use in youth offenders in Singapore.

PARTICIPANTS AND SETTING

The study included 790 youth offenders (669 males, M_age = 17.59 years) from a longitudinal study on youth offending.

METHODS

Multiple regression was performed to examine relationships between self-reported ACEs and substance use. Latent Class Analysis was conducted to identify classes of substance use onset. The relationship between these classes and cumulative ACEs and ACE frequency were then tested using multiple regression.

RESULTS

Youth offenders who consume alcohol (B = 0.66, p = .002) and illicit drugs (B = 0.38, p = .02) had more cumulative and more frequent ACEs than those who do not. Moreover, we found a positive relationship between ACEs and substance use frequency. Those who started taking substances in childhood had significantly more ACEs and had worse drug dependency problems than those who started later (t = 5.93, p < .0001). Additionally, there was a positive relationship between ACEs and drug use dependency (B = 0.11, p = .03).

CONCLUSIONS

Our findings highlight the importance of ACEs as risk factors for substance use. This underscores the need for comprehensive screening and treatment of ACEs and substance use in the rehabilitative context.

Co-occurrence subgroups of child sexual abuse, health risk behaviors and their associations among secondary school students in China

BACKGROUND

Little is known on the co-occurrence and heterogeneity of child sexual abuse (CSA) or health risk behavior (HRB) prevalence nor the associations among the victims.

OBJECTIVES

To detect the prevalence and subgroups of adolescents reporting CSAs or HRBs, and to examine the association between the subgroups.

METHODS

Participants were secondary school students in a national survey in China (N = 8746). Self-reported CSA and HRB experiences were collected through a computer assisted questionnaire. Prevalence and confidence intervals were calculated. Multigroup latent class analysis (LCA) was used to examine latent subgroups of CSA and HRB. Dual latent class regression analysis was used to examine the association between CSA and HRB classes.

RESULTS

A total of 8746 students participated in our study. The prevalence of having ever experienced any of the reported seven CSA items was 12.9%. The preferred LCA model consisted of a three-class CSA latent variable, i.e. "Low CSAs"(95.7% of the total respondents), "Verbal or exhibitionism CSAs"(3.3%), and "high multiple CSAs" (1.1%); and a three-class HRB latent variable, i.e. "Low HRBs"(70.5%), "externalizing HRBs" (20.7%), and "internalizing HRBs" (8.7%). Students in the "Verbal or exhibitionism CSAs" or "high multiple CSAs" classes had higher probabilities of being in "externalizing HRBs" or "internalizing HRBs" classes. The probabilities were higher in "high multiple CSAs" class(male externalizing OR 4.05, 95%CI 1.71-9.57; internalizing OR 11.77, 95%CI 4.76-29.13; female externalizing OR 4.97, 95%CI 1.99-12.44; internalizing OR 9.87, 95%CI 3.71-26.25) than those in "Verbal or exhibitionism CSA"(male externalizing OR 2.51, 95%CI 1.50-4.20; internalizing OR 3.08, 95%CI 1.48-6.40; female externalizing OR 2.53, 95%CI 1.63-3.95; internalizing OR 6.05, 95%CI 3.73-9.80).

CONCLUSIONS

Prevalence of CSA items varies. Non-contact CSAs are the most common forms of child sexual abuse among Chinese school students. There are different latent class co-occurrence patterns of CSA items or HRB items among the respondents. CSA experiences are in association with HRB experiences and the associations between latent classes are dose-responded. Multi-victimization has more significantly negative effects. The results could help identify high-risk subgroups and promote more nuanced interventions addressing adverse experiences and risk behaviors among at-risk adolescents.

Maladaptive coping, victimization, and recidivism among Japanese adolescents and emerging adults

BACKGROUND

Substance use and victimization are known to be related to juvenile recidivism. Self-harm, a factor that commonly accompanies substance use and victimization, is not known to be related to said recidivism but may be so in a welfare-oriented juvenile justice system as found in Japan.

OBJECTIVE

We examine the extent to which maladaptive coping, comprising substance use and self-harm, increases the rate of persistence in correctional institutions in light of other well-replicated factors of youth recidivism. The study, too, investigates the role of maladaptive coping in explaining the impact of victimization on correctional recidivism.

METHODS

We draw from a sample of 348 adolescents and emerging adults, between ages 12-19 years, who were initially detained at a Juvenile Classification Home and followed-up for an average of 3.35 years.

RESULTS

Findings indicate that maladaptive coping is significantly related to persistence in the system, although history of probationary supervision and gang membership also were significant explanatory factors. In addition, the direct effect of victimization was larger than the indirect effect of victimization through maladaptive coping.

CONCLUSIONS

Unlike previous studies, self-harm is significantly related to recidivism. This suggests that recidivism reflects a need for help more so than for punishment. The wider implications are that juvenile justice systems characterized as punitive seem outdated in managing detained young people as they lack adequate prevention supports.

The impact of poly-traumatization on treatment outcomes in young people with substance use disorders

BACKGROUND

It is believed that clients with psychological trauma experiences have a poor prognosis with regard to treatment participation and outcomes for substance use disorders. However, knowledge on the effect of the number of trauma experiences is scarce.

METHODS

Using data from drug use disorder (DUD) treatment in Denmark, we assessed the impact of having experienced multiple potentially traumatic experiences on DUD treatment efficacy. Baseline and follow-up data from 775 young participants (mean age = 20.2 years, standard deviation = 2.6) recruited at nine treatment centers were included in analyses.

RESULTS

Analyses showed that participants who were exposed multiple trauma experiences also reported a significantly higher intake of cannabis at treatment entry, and a lower well-being score than participants who reported less types or no types of victimization experiences. During treatment, patients with multiple types of trauma experiences showed a slower rate of reduction of cannabis than patients with few or no trauma experiences. The number of trauma types was not associated with number of sessions attended or the development of well-being in treatment.

CONCLUSION

Overall, the results show that although traumatized youth in DUD treatment show up for treatment, helping them to reduce substance use during treatment is uniquely challenging.

TRIAL REGISTRATION

ISRCTN88025085 , date of registration: 29.08.2016, retrospectively registered.

Child Victimization and Polyvictimization Among Young Adults in Northern Chile

This study examined the prevalence of victimization and polyvictimization and gender differences in young adults from Arica in northern Chile. In all, 718 college students participated (46.9% men, 53.1% women), aged between 17 and 28 years old (M = 21.6; SD = 4.11). The Spanish version of Juvenile Victimization Questionnaire ( JVQ) was used to access five categories of child victimization (conventional crime, child maltreatment, peer and siblings victimization, sexual victimization, and indirect victimization). In total, 98.7% of young adults reported at least one type of victimization throughout their life. In general, males are more exposed to victimization for conventional crimes and indirect victimization and women to sexual victimization and bullying. A total of 89.1% of the sample was considered polyvictims (i.e., experienced five or more forms of victimization). This research provides information about the epidemiology of victimization and polyvictimization in young adults in the international context, and is the first study from this point of view in a South American country. The results show that young adults in northern Chile experience a high level of victimization, even mostly higher than others studies realized in the international context. Gender is a variable that has a significant influence and must be taken into account in the analyses of this complex subject of study.

A Bayesian Structural Equation Modeling Factor Analysis of the UCLA Posttraumatic Stress Disorder Reaction Index for DSM-5 in a Polyvictimized Sample of Adolescents

The revised criteria for posttraumatic stress disorder (PTSD) in the fifth edition of the Diagnostic and Statistical Manual necessitated the development of new screening tools for youth, one of the most widely used of which is the UCLA Posttraumatic Stress Disorder Reaction Index for DSM-5 (RI-5). Thus far, the few studies that have investigated the RI-5's factor structure have supported a four-factor model. However, to date this research has been limited to youth with histories of exposure to single-event traumatic stressors, a significant limitation as evidence suggests many trauma-exposed youth report exposure to multiple types of traumatic stressors, or polyvictimization. It is imperative to determine the generalizability of previous factor models to specific populations which they are purported to represent. We investigated whether the RI-5's four-factor model replicated in a sample of 455 polyvictimized justice-involved adolescents. Initial confirmatory factor analysis demonstrated that the four-factor model did not converge. Therefore, we utilized Bayesian Structural Equations Modeling (BSEM) to determine why the previously proposed factor structure did not converge. The BSEM model suggested that the global factor structure was acceptable and did not require addition or subtraction of any factor or cross-factor loadings. However, small and moderate residual covariances resulted in model misspecification, suggesting there may be additional associations not captured by the current DSM-5 model for polyvictimized youth. Future work should continue examining the RI-5's factor structure in order to better understand whether the current results are unique and how measurements assessing DSM-5 PTSD symptom criteria perform in diverse trauma-exposed youth populations.

Predictors of substance use in a clinical sample of youth seeking treatment for Trauma-related mental health problems

Child maltreatment and traumatic events are well established risk factors for adolescent substance use problems, but little is known about the unique contributions of etiological factors on trauma-exposed youths' pre-treatment substance use in clinical settings. This study examined associations between substance use and risk and protective factors measured across multiple ecological levels among a unique sample of youth seeking treatment for trauma-related mental health problems in child advocacy centers. Participants were adolescents (N = 135; 85% female; 60% white, 31% black) aged 13-17 years (M = 15.4) with ≥ 1 experience of child maltreatment or other interpersonal violence, current substance use, and ≥5 PTSD symptoms. Youth and caregivers completed validated questionnaires and clinical interviews at a pre-treatment assessment in a randomized controlled trial of a treatment for co-occurring traumatic stress and substance use. Negative binomial regression models identified different patterns of risk and protective factors for alcohol and cannabis. Clinical implications of these results are discussed, including the potential targets for integrated psychotherapies that address co-occurring substance use and traumatic stress in youth.

Polyvictimization and Substance Use Among Sexual Minority Cisgender Women

Violent victimization and substance use are higher among sexual minority cisgender women (SMCW) than heterosexual cisgender women. Unknown, however, is how polyvictimization-experiencing multiple types of violent victimization-affects substance use among SMCW. Purpose/Objectives: This study explores the relationship between polyvictimization and substance use among a small sample of SMCW. Methods: An exploratory secondary data analysis was conducted on data from a convenience sample of 115 SMCW currently in relationships (70.4% lesbian, 73.9% non-Hispanic white) via a cross-sectional survey. Lifetime physical, sexual, and crime-related violent victimization were measured via the Trauma History Questionnaire. Past-year substance use was measured via the Drug Abuse Screening Test (DAST-10). Mann-Whitney U testing and linear regression modeling were used to examine differences in substance use by victimization status (victimized/non-victimized) and the association between polyvictimization and substance use. Results: Lifetime prevalence of violent victimization was high with 60.9% of the sample reporting at least one type of victimization: 10.4% experienced physical, 22.6% experienced sexual, and 22.6% experienced crime-related violent victimization. Substance use was significantly greater for victimized participants than non-victimized participants. Modeling showed that as violent victimization increased by one unit, substance use scores increased by .30 units. Conclusion/Importance: Preliminary evidence suggests that increase in violent victimization was associated with increased substance use among SMCW. Findings indicate a need for additional confirmatory research with more representative samples and longitudinal data. Behavioral health practitioners are urged to consider the implications of these findings and assess for past cumulative violence and current risk of substance use disorder, to appropriately facilitate treatment planning.