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Schiff SJ, Meza J, Bath E, Lee SS. Commercially Sexually Exploited Adolescent Girls: The Association Between Externalizing Disorders and Parental Incarceration with Suicide Attempts. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01730-1. [PMID: 38935209 DOI: 10.1007/s10578-024-01730-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/12/2024] [Indexed: 06/28/2024]
Abstract
Commercial sexual exploitation (CSE) is a significant public health concern disproportionately affecting ethnoracially minoritized girls. Despite strong associations of CSE with suicide attempts, little is known about correlates of suicide among girls with CSE histories. Elevated rates of externalizing disorders (i.e., attention-deficit/hyperactivity disorder [ADHD], disruptive behavior disorders [DBD], conduct disorder [CD]) were observed among CSE youth, particularly in ethnoracially minoritized samples. Youth with CSE histories are frequently affected by parental incarceration, which is correlated with risk for suicide attempts. We tested cross-sectional simultaneous associations of externalizing disorders and parental incarceration with number of suicide attempts among 360 ethnoracially diverse girls affected by CSE (Mean age = 18.86). ADHD, DBD, and maternal incarceration were positively associated with number of suicide attempts. Findings implicate clinical/familial correlates of suicide attempts in this marginalized group, suggesting early suicide prevention efforts may improve traction on this problem by focusing on individual and family level factors.
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Affiliation(s)
- Sara J Schiff
- Department of Psychology, University of California Los Angeles, 502 Portola Plaza, Franz Hall, Los Angeles, CA, 90095-1563, USA.
| | - Jocelyn Meza
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Eraka Bath
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Steve S Lee
- Department of Psychology, University of California Los Angeles, 502 Portola Plaza, Franz Hall, Los Angeles, CA, 90095-1563, USA
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Helpingstine C, Kenny MC, Rubiales R. A pilot study of the outcomes of human trafficking survivors assessment with girls who have experienced commercial sexual exploitation. EVALUATION AND PROGRAM PLANNING 2024; 106:102462. [PMID: 38889549 DOI: 10.1016/j.evalprogplan.2024.102462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 06/13/2024] [Accepted: 06/13/2024] [Indexed: 06/20/2024]
Abstract
PURPOSE This study utilized the Outcome of Human Trafficking Survivors (OHTS) to monitor the progress of female victims of CSE over a year while they were enrolled in a comprehensive treatment program. METHODS Sixty-seven girls (M age 17.70 years) who were identified as confirmed victims of CSE (46 %) or at risk for CSE (54 %) and presented for treatment were administered the OHTS upon intake into the program and again at 90 day intervals resulting in four data points. Ratings were provided by staff members who interact with the member in each area assessed. A repeated-measures ANOVA was conducted comparing mean outcome differences across all four timepoints. RESULTS Results indicate that significant changes were found in the area of Housing and Education, with gains in Education over time. For this sample, Parenting and Immigration were domains of less relevance and data was not consistently obtained in these areas. Other categories assessed by the OHTS did not demonstrate significant changes over time. CONCLUSION The OHTS can be used to track progress of clients enrolled in treatment programming, but the goals of the program should align with the categories that are assessed in the OHTS. Repeated administration may be difficult due to high dropout rates in treatment and there may be rater bias.
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Affiliation(s)
| | - Maureen C Kenny
- Department of Psychology, Florida International University, USA.
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Hornor G, Hollar J, Landers T, Sherfield J. Healthcare Use and Case Characteristics of Commercial Sexual Exploitation of Children: Teen Victims Versus High-Risk Teens. JOURNAL OF FORENSIC NURSING 2023; 19:160-169. [PMID: 37590938 DOI: 10.1097/jfn.0000000000000402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The overall goal of this study was to provide further information about the characteristics of commercial sexual exploitation of children (CSEC) victims by comparing the characteristics of a known victim pool to high-risk patients identified. The specific objectives of this study were to describe patient demographic characteristics, pediatric healthcare use, familial psychosocial characteristics, and child sexual abuse case characteristics present in youth identified as high risk for CSEC victimization compared with a sample of known victims. METHODS A retrospective chart review was conducted on patients presenting to the emergency department or Child Advocacy Center for a concern of sexual abuse/assault at a midwestern U.S. academic pediatric medical center. Adolescents aged 12-21 years were included in the study. RESULTS In the current study, multiple CSEC risk factors were noted to increase odds for CSEC victimization: homelessness or life on the streets, runaway behavior, living with mother only, placement in a juvenile detention center, placement in a residential treatment center or group home, and number of living arrangements (four or greater). Multiple elements of high-risk sexual behavior increased odds of CSEC victimization: legally age-inappropriate sex, gonorrhea diagnosis, trichomonas diagnosis, other sexually transmitted infection (STI) diagnoses, number of STIs, and chlamydia diagnosis. DISCUSSION These findings suggest that age of sexual partners and number and types of STIs are associated with CSEC and should be validated in other groups. In addition, these data suggest that use of cocaine and opiates could serve as an important, yet underrecognized, risk factor.
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Affiliation(s)
- Gail Hornor
- Author Affiliations: International Association of Forensic Nurses
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Perry EW, Osborne MC, Kinnish K, Lee N, Self-Brown SR. The PTSD Symptom Presentation and the Effect of Polytrauma on PTSD Symptom Clusters Among Young People Who Have Experienced Commercial Sexual Exploitation and Trafficking. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:81-93. [PMID: 36776638 PMCID: PMC9908799 DOI: 10.1007/s40653-022-00474-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/08/2022] [Indexed: 06/18/2023]
Abstract
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.
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Affiliation(s)
- Elizabeth W. Perry
- School of Public Health, Georgia State University, Atlanta, GA USA
- National SafeCare Training and Research Center, Georgia State University, Atlanta, GA USA
- Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA USA
| | - Melissa C. Osborne
- Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA USA
- Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, GA USA
| | - Kelly Kinnish
- School of Public Health, Georgia State University, Atlanta, GA USA
- National Center On Child Trafficking, Georgia State University, Atlanta, GA USA
| | - NaeHyung Lee
- School of Public Health, Georgia State University, Atlanta, GA USA
| | - Shannon R. Self-Brown
- School of Public Health, Georgia State University, Atlanta, GA USA
- National SafeCare Training and Research Center, Georgia State University, Atlanta, GA USA
- Center for Research of Interpersonal Violence, Georgia State University, Atlanta, GA USA
- National Center On Child Trafficking, Georgia State University, Atlanta, GA USA
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Franchino-Olsen H, Martin SL. The Associations Between Gang Membership and Domestic Minor Sex Trafficking: Findings From a Nationally Representative Study. VIOLENCE AND VICTIMS 2022; 37:479-496. [PMID: 35577530 PMCID: PMC10765547 DOI: 10.1891/vv-2021-0070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Adolescent gang membership has been proposed as a risk factor that creates individual-level vulnerability for domestic minor sex trafficking (DMST) and/or a context in which DMST may occur. This study investigates the gang membership-DMST association using data from The National Longitudinal Study of Adolescent to Adult Health, a nationally representative sample of adolescents in the United States (n = 12,605). Bivariate results found gang-involved minors had 4.39 greater odds of experiencing DMST compared to non-gang-involved peers. Multivariable results found gang membership, violence victimization, delinquency, and certain demographic characteristics to be significantly associated with DMST. These findings emphasize the need to consider the context in an adolescent's life beyond DMST when designing policies and programs, and highlight the need for additional research into the gang membership-DMST association.
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Affiliation(s)
- Hannabeth Franchino-Olsen
- The University of Edinburgh, School of Social and Political Science Ringgold standard institution-Social Work, Chrystal Macmillan Building 15a George Square, Edinburgh EH8 9LD, United Kingdom of Great Britain and Northern Ireland
| | - Sandra L Martin
- University of North Carolina at Chapel Hill Gillings, School of Global Public Health Ringgold standard institution-Maternal and Child Health Chapel Hill, North Carolina, United States
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White WF, Burgess A, Dalgleish T, Halligan S, Hiller R, Oxley A, Smith P, Meiser-Stedman R. Prevalence of the dissociative subtype of post-traumatic stress disorder: a systematic review and meta-analysis. Psychol Med 2022; 52:1629-1644. [PMID: 35734787 DOI: 10.1017/s0033291722001647] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The dissociative subtype of post-traumatic stress disorder (PTSD-DS) was introduced in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and is characterised by symptoms of either depersonalisation or derealisation, in addition to a diagnosis of post-traumatic stress disorder (PTSD). This systematic review and meta-analysis sought to estimate the point prevalence of current PTSD-DS, and the extent to which method of assessment, demographic and trauma variables moderate this estimate, across different methods of prevalence estimation. Studies included were identified by searching MEDLINE (EBSCO), PsycInfo, CINAHL, Academic Search Complete and PTSDpubs, yielding 49 studies that met the inclusion criteria (N = 8214 participants). A random-effects meta-analysis estimated the prevalence of PTSD-DS as 38.1% (95% CI 31.5-45.0%) across all samples, 45.5% (95% CI 37.7-53.4%) across all diagnosis-based and clinical cut-off samples, 22.8% (95% CI 14.8-32.0%) across all latent class analysis (LCA) and latent profile analysis (LPA) samples and 48.1% (95% CI 35.0-61.3%) across samples which strictly used the DSM-5 PTSD criteria; all as a proportion of those already with a diagnosis of PTSD. All results were characterised by high levels of heterogeneity, limiting generalisability. Moderator analyses mostly failed to identify sources of heterogeneity. PTSD-DS was more prevalent in children compared to adults, and in diagnosis-based and clinical cut-off samples compared to LCA and LPA samples. Risk of bias was not significantly related to prevalence estimates. The implications of these results are discussed further.
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Affiliation(s)
- William F White
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK
| | - Aaron Burgess
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK
| | - Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | | | - Rachel Hiller
- Division of Psychology and Language Sciences, University College London, London, UK
- Anna Freud Centre for Children and Families, London, UK
| | - Anna Oxley
- Cambridgeshire Community Services NHS Trust, UK
| | - Patrick Smith
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London & Maudsley NHS Foundation Trust, UK
| | - Richard Meiser-Stedman
- Department of Clinical Psychology and Psychological Therapies, Norwich Medical School, University of East Anglia, Norwich, Norfolk, UK
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Fraga Rizo C, Wretman CJ, Luo J, Van Deinse TB, Sullivan N, Godoy SM, Meehan EA, Macy RJ. Human Trafficking in Correctional Institutions: A Survey of Correctional and Anti-Trafficking Leaders. JOURNAL OF HUMAN TRAFFICKING 2022; 10:135-152. [PMID: 38560350 PMCID: PMC10977664 DOI: 10.1080/23322705.2021.2011660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Growing awareness of the overlap between justice involvement and human trafficking victimization has led to calls for correctional institutions to prevent, identify, and respond to trafficking. However, it is unclear how correctional facilities (i.e., jails and prisons) are responding to such calls to action. To examine current efforts to address human trafficking in U.S. correctional facilities, this study surveyed correctional and anti-trafficking leaders (n = 46) about their perceptions and experiences with human trafficking screening, response, and training in correctional facilities. Although the majority of leaders (89%) agreed individuals in their state's correctional facilities have experienced human trafficking, they generally did not perceive that correctional staff were prepared to respond. Bivariate tests revealed that correctional and anti-trafficking leaders differed on their perceptions regarding correctional staffs' knowledge about human trafficking risk factors (p = .014), identification ability (p = .006), and response knowledge (p = .036), with anti-trafficking leaders perceiving correctional staff to be less prepared in these areas. Approximately 16% of leaders reported strategies to identify and respond to trafficking in correctional facilities, and about 27% reported human trafficking training for corrections staff. To promote a just society, study findings offer preliminary guidance for anti-trafficking correctional initiatives and future research.
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Affiliation(s)
- Cynthia Fraga Rizo
- School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro Street, CB# 3550, Chapel Hill, NC 27599
| | - Christopher J. Wretman
- School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro Street, CB# 3550, Chapel Hill, NC 27599
- The Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 725 Martin Luther King Jr. Blvd., CB# 7590, Chapel Hill, NC 27599
| | - Jia Luo
- School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro Street, CB# 3550, Chapel Hill, NC 27599
| | - Tonya B. Van Deinse
- School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro Street, CB# 3550, Chapel Hill, NC 27599
| | - Nicole Sullivan
- Reentry Program and Services, North Carolina Department of Public Safety, 3040 Hammond Business Place, Raleigh, NC 27699
| | - Sarah M. Godoy
- School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro Street, CB# 3550, Chapel Hill, NC 27599
| | - Erin A. Meehan
- School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro Street, CB# 3550, Chapel Hill, NC 27599
| | - Rebecca J. Macy
- School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro Street, CB# 3550, Chapel Hill, NC 27599
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Helpingstine C, Kenny MC, Malik F. Vicarious Traumatization and Burnout among Service Providers for Victims of Commercial Sexual Exploitation. JOURNAL OF CHILD SEXUAL ABUSE 2021; 30:722-745. [PMID: 34137346 DOI: 10.1080/10538712.2021.1938771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 03/08/2021] [Accepted: 05/16/2021] [Indexed: 06/12/2023]
Abstract
Victims of commercial sexual exploitation (CSE) are in need of multiple community services to aid in their recovery. Service providers are critical to ensuring these victims receive needed treatment. Given the complex trauma of these victims and the necessity of long-term treatment, these service professionals may experience vicarious trauma (VT) and burnout. This qualitative study interviewed 12 professionals who have provided direct services to victims of CSE about their experiences. They had on average about 8 years of experience and three were survivors of CSE. Almost all reported instances of burnout and VT but also had strategies for the prevention of such experiences. Most participants reported experiences of VT and burnout are inevitable when working with this population, but self-care strategies and peer support are essential to combatting these negative experiences. These results can inform agencies that provide services to victims of CSE so as to ensure their staff stay healthy and avoid burnout.
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Affiliation(s)
| | | | - Fayeza Malik
- Florida International University, Miami, FL, USA
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Helpingstine CE, Stephens DP, Kenny MC, Eaton AA. Adolescent girls with a history of Commercial Sexual Exploitation (CSE): Perceptions and characteristics of social networks. CHILD ABUSE & NEGLECT 2021; 115:105015. [PMID: 33662885 DOI: 10.1016/j.chiabu.2021.105015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 01/14/2021] [Accepted: 02/19/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Previous research has demonstrated that social support systems such as family, peers, or social services can play a role in adolescent girls' involvement in commercial sexual exploitation (CSE) (Hargreaves- Cormany & Patterson, 2016; Phillips, 2015, Reid & Piquero, 2016). OBJECTIVES Few studies have specifically explored the meanings adolescent girls with a history of CSE give to their social networks and how these may be associated with CSE vulnerability. The current study examines how important networks are labeled and characterized by these youth. PARTICIPANTS This study identifies the social networks used by eight racial/ethnic minority adolescent girls who have experienced CSE. METHODS Using individual interviews, participants were asked to identify individuals and systems with which they interact and provide meanings about these social supports' roles and value in their lives. Additionally, the degree to which participants viewed each source as influential was explored. Thematic analysis was used to analyze the data. Social Network Theory guided the analysis. RESULTS Two major themes emerged from the data: a) the social networks perceived as influential in the participants' daily lives and b) the perception of the social network's characteristics as negative or positive. Both positive and negative social networks contained some of the same members. CONCLUSION The current findings point to key social networks for racial/ethnic minority adolescent girls and the potential role of these networks regarding girls' CSE vulnerability. The duality of some network members illustrate the importance of viewing the role of social networks as both complex and dynamic for girls who have experienced CSE. Clinicians should take care to consider the role of intersectional factors when treating members of this community.
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