Post-traumatic stress and related symptoms among juvenile detention residents: Results from intake screening

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.

Association between negative life events through mental health and non-suicidal self-injury with young adults: evidence for sex moderate correlation

BACKGROUND

Non-suicidal self-injury (NSSI) has exhibited an increasing trend in recent years and is now globally recognized as a major public health problem among adolescents and young adults. Negative life events (NLEs) are positively associated with NSSI. We sought to explore (1) whether sex plays a role in the risk of NLEs leading to NSSI and (2) the role played by mental health (MH).

METHODS

We adopted a multi-stage cluster sampling method to select college students across four grades from May to June 2022. Generalized linear models were used to evaluate the relationships between NLEs, sex, MH and NSSI, presented as incidence-rate ratios (RRs) with 95% confidence intervals (CIs). We examined the complex relationship between these variables using the PROCESS method for moderation analysis.

RESULTS

Following the exclusion of data that did not meet the study requirements, data from 3,578 students (mean age: 20.53 [± 1.65] years) were included. Poisson regression results indicate that high-level NLEs (RR = 0.110, 95%CI: 0.047-0.173) are associated with increased NSSI. Furthermore, interaction effects were observed among sex, NLEs and NSSI. MH and sex moderated the relationship between NLEs and NSSI.

CONCLUSION

Identifying risk factors for NSSI is also important when exploring the interaction between NLEs and MH given the potential for NSSI to significantly increase the risk of later psychopathological symptoms and substance abuse problems. In addition, the significance of sex differences in risk factors for NSSI should be determined. This study evaluated how the impact of NLEs on NSSI can be reduced among adolescents from multiple perspectives.

The Risk for Readmission to Juvenile Detention: The Role of Trauma Exposure and Trauma-related Mental Health Disorders

The purpose of this study was to examine the impact of childhood trauma exposure, posttraumatic stress disorder, and trauma-related comorbid diagnoses on the risk for readmission to juvenile detention among youth in a large metropolitan area (N = 1282). The following research questions were addressed: 1) Does a greater number of childhood traumas increase the risk for readmission to detention following release? 2) Does the risk for readmission differ by type of trauma? 3) Do PTSD and other co-morbid diagnoses increase the risk for readmission? and 4) What role do demographic factors play in the relationship between trauma-related variables and risk for readmission? This study utilized the screening results of 1282 youth who were voluntarily screened for PTSD, depressive symptoms and substance use during their initial intake to detention. More than half of the sample was readmitted during the three-year study period, with readmissions most likely to occur within one year of release. Returning to detention within one year was also associated with increased risk for multiple readmissions. Youth readmitted to detention were more likely to have a history of sexual abuse and problematic substance use. No other significant relationships were found between risk for readmission and trauma-related variables. Although trauma-related symptoms may be crucial targets for treatment, focusing solely on trauma exposure and traumatic stress symptoms without considering the impact of other risk factors may not be enough to decrease the likelihood of readmission for youth of color in a large urban environment.

Bullying Victimization and Comorbid Patterns of PTSD and Depressive Symptoms in Adolescents: Random Intercept Latent Transition Analysis

Many studies have examined post-traumatic stress disorder (PTSD) or depressive symptoms in adolescents under the background of school bullying, but not their comorbidities and changes over time. This study used random intercept latent transition analysis (RI-LTA) to examine the transitions in comorbid patterns of PTSD and depressive symptoms among 815 adolescents (45.0% boys; Mage-baseline = 13.69, SD = 1.60), who reported their symptoms in a 3-year longitudinal study. Three comorbid patterns were found: low symptoms, predominantly PTSD symptoms, and symptoms of comorbidity. Among these patterns, five trends were found through 3 years: stable low symptoms, stable PTSD symptoms, improving symptoms, worsening symptoms, and an inverted-U pattern. Age, time that parents spend with their child, being an only child, family income and experiencing relational bullying were predictors of these transitions. These suggest that patterns of PTSD and depressive symptoms are heterogeneous and may change over time since trauma events. Developing targeted interventions based on underlying factors through distinct patterns and transitions may help us better optimize and utilize intervention resources to alleviate symptoms from bullying victims.

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.

Is Violence, Violence no Matter Where it Strikes? Adjudicated Boys, Thwarted Belongingness, Perceived Burdensomeness, and Acquired Capability for Suicide

This study explores treating violence against others as a precursor to self-directed violence. It tests the utility of including violence against others in the measure of acquired capability to test assumptions from the interpersonal theory of violence. Four theoretical hypotheses are assessed that are consistent with the theory: (1) thwarted belongingness (parental abandonment and rejection) and perceived burdensomeness (exposure to parental interpersonal violence and child abuse) independently increase the likelihood of suicidal ideation; (2) the interaction of thwarted belongingness and perceived burdensomeness increases the likelihood of suicidal ideation controlling for other pertinent variables; (3) the three-way interaction of thwarted belongingness, perceived burdensomeness, and acquired capability (violence against others and prior suicidal attempts) increases the likelihood of suicidal attempts controlling for other pertinent variables; and (4) self-harm responds to the theoretical variables and similarly, to attempts. Subjects are court-adjudicated males (ages 13-18) who were residents for up to 1 year at the Ocean Tides School and rehabilitation center from 1975-2019. The data span 44 years and include 2195 youth. Depression, drug/alcohol use, race, ethnicity, socioeconomic status, and interaction terms between SES and race and SES and ethnicity are also examined. Backward conditional logistic regression analyses find mixed support for the hypotheses, but strong support for including violence against others in the concept of acquired capability. Support is also found for conceptualizing child abuse and exposure to parental interpersonal violence as perceived burdensomeness in tests of this theory as well as measures of depression. Major implications for programming in the treatment and rehabilitation of delinquent boys include conceptualizing and approaching violence against others as a precursor to suicidal attempts and other self-directed harm.

Diagnoses and Treatment in Juvenile Detention Before and After Evaluation by Facility-Based Mental Health Service

As of 2018, more than 37,000 American youth were residing in juvenile detention or residential placement facilities.¹ Prevalence studies have demonstrated high rates of psychiatric illness in this population, with estimates ranging from 50% to 75%.^2,3 Comorbidity is common: Abram et al. found that 75% of juvenile detainees meeting criteria for one disorder met criteria for two or more disorders.⁴ Compared to psychiatric morbidity in justice-involved youth, there is a paucity of data describing mental health services within juvenile justice settings, treatments delivered by these services, or outcomes following treatment. We performed a retrospective study to compare diagnoses and medications prescribed to youth in the community prior to detention with those received after evaluation by the facility-based juvenile justice mental health service (JJMHS) staffing secure detention facilities in New York, NY.

Program evaluation of trauma-informed yoga for vulnerable populations

BACKGROUND

Trauma is highly prevalent among vulnerable populations, including those who are incarcerated, in treatment for substance use, or seeking mental health services. Trauma-informed yoga seeks to create a safer yoga practice for individuals with a trauma history and may improve emotional and physical wellbeing. Thus, we conducted an evaluation of a trauma-informed yoga program to gain insight into participant experiences.

METHODS

Trauma-informed yoga classes were led by trained volunteers and held in three sectors that work with vulnerable populations: corrections and reentry, substance use treatment and recovery, and community and mental health. Data were collected via anonymous survey using a retrospective pre-post design. The survey instrument captured reasons for student participation and perceived effects of yoga on emotional and physical wellbeing.

RESULTS

Students were motivated to participate in yoga classes by expectations of physical, mental, and spiritual benefit. Students reported perceived improvements in emotional and physical wellbeing and greater use of self-regulation skills after starting yoga.

CONCLUSION

Our findings suggest trauma-informed yoga is perceived as beneficial by vulnerable individuals, especially those in the correctional system or recovering from substance use. Our results support the value of offering trauma-informed yoga in institutionalized and community settings. Improvements in emotional and physical wellbeing warrant formal study.

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.