Impact of Childhood Adversity and Out-of-Home Placement for Male Adolescents Who Have Engaged in Sexually Abusive Behavior

Exploring the Nexus of Adverse Childhood Experiences and Aggression in Children and Adolescents: A Scoping Review

A strong relation between adverse childhood experiences (ACE) and aggression has been established in adult populations, with less research examining this relation earlier in development. The purpose of this study was to complete a scoping review of the current evidence available on the relation between ACE and aggression and subtypes of aggression within a child and adolescent population. Inclusion criteria for the review included publications in English between 1998 and 2023, use of a child/adolescent population, and peer-review and quantitative publications. Databases searched included PubMed, APA PsycINFO, Scopus, and EBSCO, and search terms included words related to ACE and aggression. Initial selection was based on title and abstract, with 32 papers meeting eligibility criteria for inclusion. Two authors extracted the relevant characteristics of the studies independently and conferred on any disagreements. The overall findings from the scoping review suggest that there is a strong link between aggression and ACE; however, this link may not be as strong for specific subtypes of aggression. Additionally, characteristics of ACE may play role in understanding this relation, but little research is available within a child and adolescent population. A few studies have attempted to examine potential mediators and moderators of this relation; however, none have been replicated within a child and adolescent population. The findings from this review support the need for additional research in this area and identify significant gaps in the literature that need to be addressed within a child and adolescent population.

Mood Disorders and Aggressive Traits Mediate Effects of Reported Childhood Adversity on Suicide Attempt Risk

BACKGROUND

Childhood adversity (CA) is linked to suicidal behavior as well as to mood disorders and aggressive traits. This raises the possibility that depression and aggressive traits mediate the relationship of childhood adversity to suicide risk. Moreover, it is not known if they operate independently or interactively.

AIMS

To determine whether, and how, mood disorders and aggressive traits mediate the effects of reported physical and sexual abuse on future suicidal behavior.

METHODS

Five hundred and forty-eight subjects, offspring of parents with mood disorders, were interviewed at baseline and at yearly follow-ups with questionnaires assessing aggression, mood disorders, and suicidal behavior. The mediation analysis involved a three-step process, testing the relationships between (1) CA and attempt; (2) CA and putative mediators; and (3) putative mediators and suicide attempt, adjusting for CA.

RESULTS

Aggressive trait severity and mood disorder onset each mediated the relationship between CA and future suicide attempts. Greater aggression severity also raised the hazard of the development of a mood disorder. If aggressive trait severity was clearly elevated, then onset of mood disorder did not increase further the hazard of the suicide attempt. Including family as a random effect had a much bigger effect on attempt outcome for physical abuse compared with sexual abuse.

CONCLUSIONS

Amelioration of aggressive traits and treatment of mood disorders in CA-exposed offspring of a parent with a mood disorder may prevent future suicide attempts and may reduce the risk of mood disorder. Familial factors influence the impact of childhood physical abuse but not sexual abuse. HIGHLIGHTSChildhood Adversity (CA) predicted future mood disorder and aggression severity.Depression and aggression mediate the relationship between CA and suicide attempts.When one mediator is present, the presence of the other does not increase the hazard.Between family variation contributed much more to suicidal behavior outcomes relative to the effect of physical abuse, but sexual abuse contributed to suicidal outcomes more than family variation.

The transition of Chilean adolescents from the child welfare system to the adolescent justice system: a continuation or an accumulation of adverse factors?

Research on juvenile delinquency and adolescent maladjustment indicates that the beginning of these processes is found in the relationship between multiple risk factors at the individual, family and community levels in this population. The objective of this research was to analyze the risk factors related to the transition from the child welfare system to the adolescent justice system in a group of Chilean male adolescents (n = 108), aged 14-18 years, grouped according to their membership in the child welfare system, the adolescent justice system or both systems. Through a quantitative methodology, variables associated with risk factors were examined by means of the Risk and Resource Evaluation Form FER-R and the Risk and Criminogenic Needs Inventory IRNC instruments. Logistic regression analysis found that the adolescent population within the child welfare system was more likely to enter the adolescent justice system if the following risk factors were present: weak family supervision, consumption of drugs, socially maladaptive peer relationships, and risky free time. These results emphasize that child welfare system interventions should focus on parental support and the management of socio-community networks to prevent re-entry of the adolescent population into the justice system.

Associations Between Self-Regulation, Experiences of Childhood Adversity, and Problematic Sexual and Aggressive Behaviors

Problems with self-regulation are often theoretically and empirically linked to sexually abusive behavior, as is also true of experiences of early childhood abuse and maltreatment. Questions remain regarding how indicators of dysregulation and self-regulatory deficits interact and are associated with prior maltreatment. In the current study, a range of variables potentially indicative of emotional, cognitive, interpersonal, and behavioral dysregulation and adverse childhood experiences (ACEs) were examined using the frame of the multimodal self-regulation theory among 156 adult men residing in secure forensic care who were receiving treatment for prior sexual offenses. Data were subjected to principal components analysis, resulting in four components that described varying aspects of dysregulated behavior and experiences: Problematic Sexual Behavior (PSB)-Impulsivity, Serious Mental Illness (SMI)-Aggression, ACEs-Suicidality, and Paraphilic Interests-Behavioral Stability. One component comprised of variables associated with maltreatment was associated with impulsivity and PSBs, as well as SMI and violence via linear regression analysis. Theoretical and clinical implications are discussed.

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.

A Longitudinal Examination of Developmental Covariates of Sexual Behavior Problems among Youth Referred to Child Protection Services

Little is known about the development of childhood sexual behavior problems (SBP) in terms of continuity and discontinuity into adolescence. Prior studies have espoused a nondevelopmental approach focusing on the clinical profiles of these youths at the time of their referral. To address this gap, the current study proposes an examination of the developmental covariates involved in the continuity of SBP among a sample of 340 children and adolescents referred to Child Protection Services (CPS) in Quebec, Canada. Children's CPS contacts from birth up to age 17 were inspected, allowing to recreate the life history of social and familial adversities during that period. Logistic regression models were performed and helped to identify developmental covariates of childhood-onset SBP and its persistence into adolescence. Findings suggest that children with childhood-onset SBP that persisted into adolescence have experienced various life adversities. The study findings provide some preliminary evidence of the developmental pathways of SBP.

Adverse childhood experiences in Australian youth adjudicated for sexual offences and non-sexual violent offences

This study examines the differential childhood adversities experienced by two samples of Australian adolescents involved in the juvenile justice system: male youth who had been adjudicated for sexual offences and their counterparts who had been adjudicated for nonsexual violence. The sample is comprised of clients referred to a service that explicitly prioritises cases identified to be high risk, high need, and living in rural or remote areas. Male youth who had committed a sexual offence were more likely than their counterparts to have experienced emotional and sexual abuse and neglect in their childhoods. Alternatively, the childhoods of the comparison group were marked by characteristics of more general household dysfunction. Potential explanations for these findings are provided. The onset of sexual offending is presented as a possible consequence of poor attachment and emotional dysregulation and the impact of vicarious violence, and a chaotic family life are considered in the development of subsequent nonsexual violence. The implications of these findings for both clinical practice and future research are discussed.

Pathways to delinquent and sex offending behavior: The role of childhood adversity and environmental context in a treatment sample of male adolescents

BACKGROUND

Exposure to greater Adverse Childhood Experiences (ACEs) has been associated with increased likelihood of general and sex offending behaviors. However, few studies consider both the impact of varied ACE exposures and other early experiences on pathways to offending behaviors in adolescents who have engaged in sexually abusive behaviors.

OBJECTIVE

The purpose of this study was to examine the impact of ACEs and sexual boundary problems within the home on the development of delinquent and sexually abusive behavior.

PARTICIPANTS & SETTING

Data were collected from archival records of male adolescents (N = 285) who had received treatment for sexually abusive behavior at a youth facility.

METHODS

This study investigated the effects of individual adverse experiences on delinquent nonsexual and sexually abusive behaviors through structural equation modeling.

RESULTS

Structural equation modeling revealed a three-factor model for ACEs. Direction and significance of paths between ACEs and the onset, persistence, and nature of maladaptive behaviors differed. Household dysfunction was related to an earlier onset (β = 1.19, p = 0.013) and more persistent nonsexual delinquent offending (β = 1.05, p = 0.048) and contact sexual offending (β = 1.19, p = 0.010). Conversely, sexual abuse and exposure to sexual boundary problems were associated with an earlier onset of sexually abusive behavior (β = -1.08, p = 0.038) as well as indicators of adolescent-onset (β = -1.30, p = 0.002), less persistent (β = -1.53, p = 0.001), and nonviolent (β = -1.89, p = 0.001) delinquency.

CONCLUSIONS

Findings suggest variations in ACE exposures differentially influence the onset, severity, and persistence of delinquent and sexually abusive behaviors among these youths.

Adverse Childhood Experiences Associated with Children's Patterns of Out of Home Placement Over Time and Subsequent Negative Outcomes During Adolescence

Background

Out of home placement (OOHP) of welfare involved children is a critical problem associated with child abuse and neglect and household dysfunction. Few studies have also implicated greater instability in OOHP with more negative outcomes. However, several gaps remain.

Objectives

Objectives were twofold. To identify combinations of adverse childhood experiences that are associated with OOHP - based on both duration of OOHP and change in actual placement during each time point, among welfare involved youth. The second objective was to understand long-term negative outcomes during adolescence that are associated with greater placement instability.

Methods

Data come from the National Survey of Child and Adolescent Wellbeing (n = 1,657). Multinomial logistic regression was used to evaluate adverse childhood experiences that were associated with specific patterns of OOHP. Multivariate regression models were estimated to evaluate delinquency, aggression as well as depressive and trauma symptoms during adolescence that were associated with specific patterns of OOHP.

Results

There were six categories of OOHP found in the sample: 1) no OOHP, 2) OOHP one time, 3) OOHP two times, 4) OOHP two times with change in placements, 5) OOHP three times, and 6) OOHP three times with change in placement. Longer duration of OOHP was associated with more adversity exposure. Longer duration and more change in placement were associated with the most negative outcomes.

Conclusions

Findings demonstrate the need for future testing of these findings in prevention trials.

Early life adversities and polyvictimization in young persons with sexual behavior problems: A longitudinal study of child protective service referrals

There is scarce research on children and youth with sexual behavior problems (SBP) and their developmental antecedents and the research that does exist is mostly retrospective and correlational. While prior research focused on the central role of sexual victimization, recent research suggests that young persons with SBP are exposed to a series of adversities not limited to child sexual victimization and require multifaceted assessment and intervention using a developmental life course perspective. The current study includes an examination of the complete longitudinal sequence of child protective service (CPS) investigations involving young persons with SBP. The study is based on a sample of 957 youth referred to the CPS in Quebec, Canada. The data include their longitudinal sequence of referrals from birth to age 18. Semi-parametric analyses identified four trajectories of referrals with significant differences in terms of onset, frequency, types of life adversity, and polyvictimization. The trajectories suggest that a range of developmental profiles characterize young persons with SBP, with SBP often occurring after CPS contacts for compromising issues other than sexual victimization, especially parental neglect and serious behavior problems. Of importance, polyvictimization was relatively common for this group throughout childhood and adolescence, which highlights the multiintervention needs of this population.