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Meshelemiah JCA, Dellor E, Karandikar S, Munshi A, Barboza-Salerno G, Steinke HR. Adverse Childhood Experiences, Women Who Are Sex Trafficked, and Social Service Utilization: Implications for Social Work. SOCIAL WORK 2024; 69:265-275. [PMID: 38745387 DOI: 10.1093/sw/swae024] [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] [Received: 05/31/2023] [Revised: 02/09/2024] [Accepted: 03/17/2024] [Indexed: 05/16/2024]
Abstract
The aim of this study was to examine the associations between adverse childhood experiences (ACEs) and the high levels of social service usage by women who are sex trafficked. Fifty (N = 50) women who were sex trafficked were surveyed using purposive and snowball sampling methods. The ACEs score for respondents ranged from 2 to 10 with an average score of 7.4 (SD = 2.3). Emotional and sexual abuse tied at 88 percent as the most frequently cited ACEs among the women in this sample. The prevalence of ACEs was significantly higher in this sample compared with known estimates in similar populations, ranging from 20 percent to 54 percent (p < .001). Considering the well-established link between ACEs and poor health outcomes, these findings point to the need for innovative and targeted social service provisions to women who were formerly sex trafficked that take into consideration the high level of ACEs of the women. Given the sociodemographic diversity of this sample, there is a need for services that are trauma-informed, innovative, and culturally sensitive in a variety of social service settings.
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Affiliation(s)
- Jacquelyn C A Meshelemiah
- Jacquelyn C. A. Meshelemiah, PhD, is associate professor, College of Social Work, The Ohio State University, 325D Stillman Hall, 1947 North College Road, Columbus, OH 43210, USA
| | - Elinam Dellor
- Elinam Dellor, PhD, is an assistant professor, College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Sharvari Karandikar
- Sharvari Karandikar, PhD, is a professor, College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Additti Munshi
- Additti Munshi, MSW, is a doctoral student, College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Gia Barboza-Salerno
- Gia Barboza-Salerno, JD, PhD, is an assistant professor, College of Social Work, The Ohio State University, Columbus, OH, USA
| | - Hannah Ruth Steinke
- Hannah Ruth Steinke, BA, is a graduate research associate, College of Social Work, The Ohio State University, Columbus, OH, USA
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Gnaim-Mwassi N, Avieli H, Band-Winterstein T. Prostitution in the shadow of life-long sexual abuse: Arab women's retrospective experiences. J Elder Abuse Negl 2024; 36:117-147. [PMID: 38566491 DOI: 10.1080/08946566.2024.2331503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
The present study uses the life-course and intersectionality perspectives to explore the meaning that aging Arab women attribute to their lived experiences of life-long sexual abuse in the shadow of engaging in prostitution. Interpretive phenomenological analysis was used to analyze the narratives of 10 older Arab women in Israel who were engaged in prostitution. Four themes emerged: experiencing childhood in the shadow of sexual abuse, becoming a prostitute, being entrapped in prostitution, and settling accounts with the native culture. Women aging in prostitution experience a harsh reality of abuse and loss. The present study points to multiple channels of abuse throughout the life course, from childhood until old age.
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Affiliation(s)
- Nora Gnaim-Mwassi
- Minerva Center on Intersectionality in Aging, Department of Gerontology, University of Haifa, Haifa, Israel
| | - Hila Avieli
- Department of Criminology, Ariel University, Ariel, Israel
| | - Tova Band-Winterstein
- Minerva Center on Intersectionality in Aging, Department of Gerontology, University of Haifa, Haifa, Israel
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3
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Twis MK, Cimino A, Plunk M. Coping self-efficacy and social support as predictors of adolescent sex trafficking exit: Results of a secondary analysis. PLoS One 2024; 19:e0291207. [PMID: 38165974 PMCID: PMC10760720 DOI: 10.1371/journal.pone.0291207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 08/24/2023] [Indexed: 01/04/2024] Open
Abstract
INTRODUCTION Social work case management services are increasingly available to youth who want to exit commercial sexual exploitation (CSE). However, few empirical studies investigate the efficacy of such services, particularly whether these services promote an exit from CSE. Guided by ecological systems theory and the Intentions to Exit Prostitution (IEP) model, this study investigates the efficacy of social work case management services for youth CSE survivors. METHODS Youth survivors of CSE (n = 95) participated in a one-group, quasi-experimental double pre/posttest design study. Measures included the Multidimensional Scale of Perceived Social Support (MSPSS), Coping Self-Efficacy Scale (Cop-SE), and a modified version of the University of Rhode Island Change Assessment (URICA) surveys at zero- and six-months following study commencement. The research team also collected demographic and victimization data, the number and type of social work case management services received, and goal plan data. Analyses included repeated measures tests and linear and multinomial logistic regressions to determine if doses of social work case management are predictive of the positive short-term outcomes that are linked to increased readiness to exit CSE. RESULTS Youth CSE survivors experienced upward trends in perceived social support and coping self-efficacy scores between zero- and six-months following study commencement. Linear and logistic regressions demonstrated that variables like months of service time, trafficking classification, goal counts, race, and age can predict outcomes like survivor social support, coping self-efficacy, and intention to change behaviors that can lead to revictimization. IMPLICATIONS Results suggest social work case management services that improve coping self-efficacy and perceived social support can lead to cognitive changes that promote an exit from CSE. Practitioners should target services that adhere to dimensions of the IEP as these improvements are likely to support positive outcomes for youth survivors of CSE.
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Affiliation(s)
- Mary K. Twis
- Department of Social Work, Texas Christian University, Fort Worth, Texas, United States of America
| | - Andrea Cimino
- Danger Assessment Training and Technical Assistance Center, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Marilyn Plunk
- Department of Social Work, Texas Christian University, Fort Worth, Texas, United States of America
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Scaggs SJA, Starseed SC, Kluckman M, Tueller S, Yu L. A state-wide analysis of characteristics and predictors of dual system involvement among child victims of human trafficking. CHILD ABUSE & NEGLECT 2024; 147:106530. [PMID: 37979486 DOI: 10.1016/j.chiabu.2023.106530] [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: 04/28/2023] [Revised: 10/17/2023] [Accepted: 10/30/2023] [Indexed: 11/20/2023]
Abstract
BACKGROUND The child welfare system is pivotal in identifying and responding to child (younger than age 18) human trafficking victims. Children who have experienced human trafficking-or are at risk of victimization-are increasingly recognized as also being served in the juvenile justice system. Yet little is known about human trafficking victimization among children in the juvenile justice population or among children with child welfare and juvenile justice involvement. OBJECTIVE Building on previous research with child welfare-and juvenile justice-involved children, we investigated characteristics and system experiences among children who have experienced a human trafficking abuse allegation in Florida. PARTICIPANTS AND SETTING The overall study population included all children born on or after January 1, 1993, who had at least one DCF-documented maltreatment allegation before March 1, 2020. This study examined a total of 12,167 allegations in the first set of analyses and the first human trafficking allegation for each child (N = 9300) in the second set of analyses. METHODS Analyses are based on linked administrative data for a cohort of children involved with Florida's Departments of Juvenile Justice (DJJ) and/or Children and Families (DCF). We used descriptive and multivariate logistic regression analyses to document the characteristics of single and dual system-involved children and examine predictors of child welfare, juvenile justice, and dual system involvement. RESULTS (1) Nearly half of children with a human trafficking abuse allegation are involved in DCF at the time of the allegation, (2) females who experienced trafficking are more likely to be involved in DCF (with or without DJJ involvement) than involved in no system, (3) Black children with an alleged trafficking incident were more likely than White children to be involved in both systems compared with DCF only, and (4) children who experienced labor trafficking abuse allegations were less likely than those who experienced sex trafficking to be involved with either system. CONCLUSIONS This study depicts child victims of sex and labor trafficking who are involved with one or both systems in one state.
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Affiliation(s)
- Samuel J A Scaggs
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, United States.
| | - Stacey Cutbush Starseed
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, United States
| | - Marianne Kluckman
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, United States
| | - Stephen Tueller
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, United States
| | - Lilly Yu
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, United States
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Meshelemiah JCA, Thanises AC, Yeboah PO. Sex Trafficked Women, Drug Dealers, and Men Who Buy Sex: A Look at "Race". Violence Against Women 2023:10778012231216711. [PMID: 37997358 DOI: 10.1177/10778012231216711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
Black, Native American, Latinx, Asian, and Pacific Islander women all have histories of sexual violence in the United States. Their historical victimizations have set a precedence for contemporary commercial sex victimization. The purpose of this study was to examine the role of "race" in sex trafficking. Data from 50 women with sex trafficking histories resulted in three candidate themes and five subthemes that include (a) sex trafficked women (White women, Black women vs. White women, and all women with unique subthemes related to drug use and locations); (b) Black male traffickers; and (c) Black and White male customers.
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Laird JJ, Klettke B, Hall K, Hallford D. Toward a Global Definition and Understanding of Child Sexual Exploitation: The Development of a Conceptual Model. TRAUMA, VIOLENCE & ABUSE 2023; 24:2243-2264. [PMID: 35603675 DOI: 10.1177/15248380221090980] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Child sexual exploitation (CSE) is a serious and persistent global issue affecting up to 5% of the child and youth population worldwide; yet there is no universally accepted definition. To develop a theoretically robust definition of CSE, this review systematically synthesized literature examining CSE definitions aiming to develop a conceptual model and typology. Electronic databases were searched to February 2021, yielding 384 nonduplicative records. Inclusion criteria were peer-reviewed and grey literature investigations of sexual exploitation, with a mean sample age of 18 years or younger, available in the English language. Literature review and data extraction followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Sixty-six studies met final inclusion criteria. Two independent reviewers extracted relevant data and used an epistemological approach to thematically analyse meaning and patterns across CSE definitions. Key findings demonstrate that CSE nomenclature is widely inconsistent, and despite growing awareness of this severe form of abuse, language continues to perpetuate stigma and criminalisation, utilising terms such as 'adolescent or child prostitute'. Our findings propose a scientifically and trauma-informed definition and conceptualisation of CSE, based on the following four-dimensional components: (1) A child/young person; (2) sexual acts; (3) abuse; and (4) exploitation (abuse + exchange). In this systematic review, a unified definition and conceptual model aims to advance knowledge and understanding of CSE, contributing to the progression of social norms which embrace nuances of trauma-informed practice and support for the identification and recovery of children, young people and families affected by sexual exploitation.
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Affiliation(s)
- Jessica J Laird
- School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Bianca Klettke
- School of Psychology, Deakin University, Geelong, VIC, Australia
- Center for Social and Early Emotional Development, Deakin University, Burwood, VIC, Australia
| | - Kate Hall
- School of Psychology, Deakin University, Geelong, VIC, Australia
- Addictive and Anti-social behavior Research, Deakin University Centre for Drug Use, Burwood, VIC, Australia
| | - David Hallford
- School of Psychology, Deakin University, Geelong, VIC, Australia
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Murnan AW, Tscholl JJ, Ganta R, Duah HO, Qasem I, Sezgin E. Identification of Child Survivors of Sex Trafficking From Electronic Health Records: An Artificial Intelligence Guided Approach. CHILD MALTREATMENT 2023:10775595231194599. [PMID: 37545138 PMCID: PMC11000265 DOI: 10.1177/10775595231194599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
Survivors of child sex trafficking (SCST) experience high rates of adverse health outcomes. Amidst the duration of their victimization, survivors regularly seek healthcare yet fail to be identified. This study sought to utilize artificial intelligence (AI) to identify SCST and describe the elements of their healthcare presentation. An AI-supported keyword search was conducted to identify SCST within the electronic medical records (EMR) of ∼1.5 million patients at a large midwestern pediatric hospital. Descriptive analyses were used to evaluate associated diagnoses and clinical presentation. A sex trafficking-related keyword was identified in .18% of patient charts. Among this cohort, the most common associated diagnostic codes were for Confirmed Sexual/Physical Assault; Trauma and Stress-Related Disorders; Depressive Disorders; Anxiety Disorders; and Suicidal Ideation. Our findings are consistent with the myriad of known adverse physical and psychological outcomes among SCST and illuminate the future potential of AI technology to improve screening and research efforts surrounding all aspects of this vulnerable population.
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Affiliation(s)
- Aaron W Murnan
- College of Nursing, University of Cincinnati, Cincinnati, OH, USA
| | - Jennifer J Tscholl
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
- Division of Child and Family Advocacy, Center for Family Safety and Healing, Nationwide Children's Hospital, Columbus, OH, USA
| | - Rajesh Ganta
- Information Technology Research and Innovation, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
| | - Henry O Duah
- College of Nursing, University of Cincinnati, Cincinnati, OH, USA
| | - Islam Qasem
- College of Nursing, University of Cincinnati, Cincinnati, OH, USA
| | - Emre Sezgin
- Information Technology Research and Innovation, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
- Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA
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Godoy SM, Perris GE, Thelwell M, Osuna-Garcia A, Barnert E, Bacharach A, Bath EP. A Systematic Review of Specialty Courts in the United States for Adolescents Impacted by Commercial Sexual Exploitation. TRAUMA, VIOLENCE & ABUSE 2023; 24:1344-1362. [PMID: 35001766 PMCID: PMC9262992 DOI: 10.1177/15248380211061403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Nationwide efforts to enhance services for adolescents experiencing commercial sexual exploitation (CSE) in the judicial system have led to the emergence of specialty courts, including human trafficking and girls' courts. Given that prior research has documented competing stances on the effectiveness of specialty courts for CSE-impacted populations, we conducted a systematic review of the literature to identify key characteristics of programming, profiles of adolescents served, and effectiveness of these courts. To identify relevant research and information, we systematically searched scholarly databases and information sources, conducted reference harvesting, and forwarded citation chaining. Articles presenting primary data with quantitative, qualitative, or mixed methodologies or programmatic descriptions of specialty courts serving adolescents at risk or with confirmed histories of CSE that were published after 2004 were included. We identified 39 articles on 21 specialty courts serving adolescents at risk or with confirmed histories of CSE, including seven specialty courts with evaluation or outcome data. Across specialty courts, adolescents benefited from an increase in linkage to specialized services, improved residential placement stability, and reduction in recidivism-measured by new criminal charges. Specialty court participation was also associated with improved educational outcomes and decreased instances of running away. A lack of empirical data, specifically of evaluation studies, emerged as a weakness in the literature. Still, findings support that specialty courts can be an integral judicial system response to CSE. Multidisciplinary collaboration can help target and respond to the multifaceted needs of adolescents, encourage healthy behaviors, and promote their overall wellness.
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Affiliation(s)
- Sarah M. Godoy
- School of Social Work, University of North Carolina at Chapel Hill, Tate-Turner-Kuralt Building, 325 Pittsboro Street, Room 400-I, Chapel Hill, NC United States, 27599
| | - Georgia E. Perris
- Department of Psychiatry, David Geffen School of Medicine at UCLA, Jane and Terry Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, Room A8-232, Los Angeles, CA, United States, 90024
| | - Mikiko Thelwell
- Department of Psychiatry, David Geffen School of Medicine at UCLA, Jane and Terry Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, Room A8-232, Los Angeles, CA, United States, 90024
| | - Antonia Osuna-Garcia
- Health and Life Sciences Library, UCLA Science Libraries, 12-077 Center for Health Sciences, Los Angeles, CA, United States, 90095
| | - Elizabeth Barnert
- Department of Pediatrics, David Geffen School of Medicine at UCLA and Mattel Children’s Hospital, Los Angeles, CA, UCLA Pediatrics, Box 951752, 12-467 MDCC, Los Angeles, CA, United States, 90095-1752
| | - Amy Bacharach
- Center for Families, Children, and the Courts, Judicial Council of California, 455 Golden Gate Avenue, San Francisco, CA 94102
| | - Eraka P. Bath
- Department of Psychiatry, David Geffen School of Medicine at UCLA, Jane and Terry Semel Institute for Neuroscience and Human Behavior, 760 Westwood Plaza, Room A8-228, Los Angeles, CA, United States, 90024
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Gerassi LB, Cruys C, Hendry N, Del Carmen Rosales M. How Do Providers Assess Young People for Risk of Sex Trafficking? Observed Indicators, Follow-Up, and Assessment Questions from a Sample of Social Service Providers. CHILDREN AND YOUTH SERVICES REVIEW 2023; 148:106906. [PMID: 37065722 PMCID: PMC10104439 DOI: 10.1016/j.childyouth.2023.106906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
The extent to which service providers across systems identify and assess potentially sex trafficked youth is understudied. The purpose of this study is to determine whether and how providers observe relevant indicators and assess for sex trafficking risk among minors (ages 12-17), young adults (ages 18-29), and families of minors. A cross-sectional, web-based survey was disseminated to service providers, who represented child welfare, youth justice, and social services (e.g. runaway youth, sexual violence), in a region of a Midwestern state (United States). Participants (N=267) were asked whether they provided direct services to minors (ages 12-17, n=245), adults (ages 18-29, n=148), and/or families/foster families of minors (ages 12-17, n=163), resulting in three respective client groups. Survey items assessed the extent to which providers (1) identified possible sex trafficking indicators across 5 domains; (2) took follow up actions; and (3) asked risk assessment questions. T-tests were conducted to examine differences between those who reported receiving sex trafficking trainings, compared to those who did not. Results suggest that the most commonly identified indicators included depressive symptoms, shame and guilt, lack of social support. Least common indicators included torture, false IDs, hotel involvement. A third of minor-aged providers did not ask sex trafficking risk assessment questions. Providers reported asking fewer clients about online sex trading than in-person forms. There were statistically significant differences among providers who received training. Implications, including provider strategies for assessing online sex trading and organizational protocols to enhance sex trafficking identification, are discussed.
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Affiliation(s)
- Lara B Gerassi
- University of Wisconsin-Madison Sandra Rosenbaum School of Social Work
| | - Caro Cruys
- University of Wisconsin-Madison Sandra Rosenbaum School of Social Work
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10
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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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Malvaso CG, Cale J, Whitten T, Day A, Singh S, Hackett L, Delfabbro PH, Ross S. Associations Between Adverse Childhood Experiences and Trauma Among Young People Who Offend: A Systematic Literature Review. TRAUMA, VIOLENCE & ABUSE 2022; 23:1677-1694. [PMID: 33960233 DOI: 10.1177/15248380211013132] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
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.
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Affiliation(s)
- Catia G Malvaso
- University of Adelaide, Adelaide, South Australia, Australia
| | - Jesse Cale
- Griffith University, Southport, Queensland, Australia
| | - Tyson Whitten
- University of Adelaide, Adelaide, South Australia, Australia
| | - Andrew Day
- University of Melbourne, Melbourne, Victoria, Australia
| | - Sara Singh
- University of New South Wales, Sydney, New South Wales, Australia
| | - Louisa Hackett
- Department of Human Services, Youth Justice Directorate, Adelaide, South Australia, Australia
| | | | - Stuart Ross
- University of Melbourne, Melbourne, Victoria, Australia
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12
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A Single-Case Series Trial of Emotion-Regulation and Relationship Safety Intervention for Youth Affected by Sexual Exploitation. PSYCH 2022. [DOI: 10.3390/psych4030037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Child sexual exploitation (CSE) is a significant global problem. Interventions implemented with youth affected by CSE frequently target singular adjacent issues (e.g., substance misuse or running away); however, research indicates these interventions are most efficacious when they simultaneously treat CSE sequelae (e.g., emotion dysregulation) paired with relationship skill-building; yet few such interventions exist. Furthermore, the evidence-based reports on CSE research currently lacks rigorous research methods, such as the use of validated measures and the provision of robust outcome data. The current study aimed to implement a combined emotion regulation and safe-relationships intervention (ERIC + YR: emotion regulation, impulse control and ‘your relationships’) in a community service providing outreach for young women affected by CSE. A randomised single-case series design was used to test the effects of ERIC + YR on emotion regulation strategies, psychological wellbeing, relationship safety knowledge and behaviours, across repeated measurements for young women affected by CSE (N = 2; Mage = 18.00). Phase A consisted of baseline measures for two to three weeks. Phase B consisted of 8-sessions of ERIC + YR delivered across three to six weeks by practitioners who had undertaken ERIC + YR training. Data collection included pre/post intervention measures as well as a daily questionnaire delivered via a smartphone application. While results showed clinically significant and reliable improvements in psychological wellbeing, no other outcome measures showed change between pre and post-intervention. The current study contributes to the evidence-base as an initial step in illuminating how an empirically driven intervention can be delivered as an adjunctive treatment for youth affected by CSE. Implications inform the current evidence-base, with future directions for intervention research discussed.
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13
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Testa A, Jackson DB, Ganson KT, Nagata JM. Adverse Childhood Experiences and Criminal Justice Contact in Adulthood. Acad Pediatr 2022; 22:972-980. [PMID: 34752957 DOI: 10.1016/j.acap.2021.10.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 10/27/2021] [Accepted: 10/31/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To assess the relationship between adverse childhood experiences (ACEs) and formal criminal justice system processing during young adulthood and middle adulthood. METHODS Data are from the National Longitudinal Study of Adolescent to Adult Health (N = 8531). Logistic regression, multinomial logistic regression, and Poisson regression models were used to assess the relationship between accumulating ACEs (0, 1, 2, 3, or 4 or more) and criminal justice system processing during young adulthood (24-32) and middle adulthood (33-43). RESULTS Accumulating ACEs -especially 4 or more ACEs- was significantly associated with various forms of criminal justice contact during young and middle adulthood, including having been arrested, experiencing a greater number of arrests, having been incarcerated in adulthood, having been incarcerated multiple times, and having spent longer periods of time incarcerated. CONCLUSIONS This study documents that the association between ACEs and formal criminal justice extends into young and middle adulthood. Considering the consequences of both ACEs and criminal justice system contact for a variety of life domains, the findings suggest the need for developing and employing early interventions to disrupt pathways to criminal justice system involvement.
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Affiliation(s)
- Alexander Testa
- The University of Texas at San Antonio, San Antonio (A Testa), Tex.
| | | | - Kyle T Ganson
- University of Toronto, Toronto, Ontario (KT Ganson), Canada
| | - Jason M Nagata
- University of California, San Francisco (JM Nagata), Calif
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14
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Fraley HE, Subedi G. Confusing Terms: A Concept Analysis of Naming Youth Trafficking. JOURNAL OF FORENSIC NURSING 2022; 18:174-184. [PMID: 35293359 DOI: 10.1097/jfn.0000000000000382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Human trafficking is a growing population health problem. More than half of all persons experiencing trafficking are youth, with many in the United States unrecognized despite experiencing exploitation. Available peer-reviewed articles report a myriad of descriptions of trafficking, yet the concept and operational definition of youth trafficking, specifically, is lacking and unclear. Youth trafficking is described differently across multidisciplinary researchers and clinicians working with trafficked youth. Furthermore, labor trafficking of youth is largely excluded from the conversation surrounding trafficking. This article presents a concept analysis of naming trafficking of persons under the age of 18 years to clarify the concept specific to youth experiencing all forms of trafficking and approaches professionals can take with this specific subpopulation of trafficked persons and survivors.
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15
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Panlilio CC, Dierkhising CB, Richardson J, Runner J. Evaluating and Validating the Classification Accuracy of a Screening Instrument to Assess Risk for Commercial Sexual Exploitation of Child Welfare-Involved Children and Adolescents. Public Health Rep 2022; 137:73S-82S. [PMID: 35775915 DOI: 10.1177/00333549211065523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Identifying children and adolescents within child welfare at risk for commercial sexual exploitation (CSE) can ensure referrals to appropriate services. However, screening measures to understand the prevalence of CSE are missing in child welfare. We evaluated the classification accuracy of a screener developed for the purpose of this study, guided by the Sexual Exploitation among Youth (SEY) risk assessment framework used in practice with child welfare-involved young people, (1) to identify young people at high versus low risk for experiencing CSE and (2) to estimate the prevalence of CSE risk for child welfare-involved children and adolescents. METHODS We used extant data from the National Survey of Child and Adolescent Well-being study with a nationally representative sample of children and adolescents aged 11-17 years (n = 1054) investigated by child welfare from February 2008 to April 2009. The 26-item screener showed acceptable reliability (α = .73) and test-criterion validity evidence using a CSE proxy outcome (ie, narrowly defined as being paid for sexual relations). We used the receiver-operating curve to classify risk and calculate the optimal cutoff score. RESULTS Higher scores on the SEY screener (range, 0-20 points) increased the odds of experiencing CSE by 34%. The screener was good at discriminating CSE risk at the 6-point cutoff, with 26.7% of child welfare-involved young people identified as being at high risk for CSE. CONCLUSIONS Given the absence of accurate prevalence rates of CSE risk in the population, a theoretical cutoff index using an established method can provide an objective decision on how to distinguish risk levels. Prevalence estimates for CSE risk highlight the need for systematic screening in child welfare to identify and provide services for young people at risk.
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Affiliation(s)
- Carlomagno C Panlilio
- Department of Educational Psychology, Counseling, and Special Education, The Pennsylvania State University, University Park, PA, USA
| | - Carly B Dierkhising
- School of Criminal Justice and Criminalistics, California State University, Los Angeles, Los Angeles, CA, USA
| | - Jennifer Richardson
- Transition, Education, and Resources for Females (TERF) Program, New Directions, Winnipeg, MB, Canada
| | - Jane Runner
- Transition, Education, and Resources for Females (TERF) Program, New Directions, Winnipeg, MB, Canada
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16
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Pammenter A, Woodford ELE, Harris DA. Adverse childhood experiences in Australian youth adjudicated for sexual offences and non-sexual violent offences. CHILD ABUSE & NEGLECT 2022; 129:105678. [PMID: 35675724 DOI: 10.1016/j.chiabu.2022.105678] [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: 09/17/2021] [Revised: 03/28/2022] [Accepted: 05/17/2022] [Indexed: 06/15/2023]
Abstract
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.
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17
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Perry EW, Osborne MC, Lee N, Kinnish K, Self-Brown SR. Posttraumatic Cognitions and Posttraumatic Stress Symptoms Among Young People Who Have Experienced Commercial Sexual Exploitation and Trafficking. Public Health Rep 2022; 137:91S-101S. [PMID: 35775917 DOI: 10.1177/00333549211041552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES The impact of posttraumatic cognitions on the development and maintenance of posttraumatic stress symptoms (PTSS) is understudied among children and adolescents who have experienced commercial sexual exploitation/trafficking (CSE/T). The objectives of this study were to (1) explore posttraumatic cognitions among help-seeking young people aged 11-19 who have experienced CSE/T; (2) determine whether experiencing direct violence, witnessing violence, polyvictimization (ie, multiple exposures to different categories of potentially traumatic events), or demographic characteristics differentially affect whether these young people meet clinical criteria for posttraumatic cognitions using established cutoffs; and (3) explore associations between posttraumatic cognitions and PTSS among young people who have experienced CSE/T. METHODS This study is a secondary analysis of a baseline cross-sectional survey of 110 young people with substantiated CSE/T experiences who started trauma-focused cognitive behavioral therapy (mean [SD] age = 15.8 [1.5]) from August 1, 2013, through March 31, 2020, in a southeastern US state. We used descriptive statistics, adjusted modified Poisson regression, and adjusted linear regression to test study objectives. RESULTS Fifty-seven of 110 (51.8%) young people aged 11-19 met clinical criteria for posttraumatic cognitions. Increased age and a greater number of trauma categories experienced were significantly associated with meeting clinical criteria for posttraumatic cognitions. On average, higher posttraumatic cognition scores were associated with higher PTSS scores, controlling for demographic characteristics (β = 0.95; 95% CI, 0.64-1.26). CONCLUSIONS These findings underscore the importance of assessing comprehensive trauma history and PTSS of young people who have experienced CSE/T, with added usefulness of measuring cognitive appraisals to inform a therapeutic treatment plan. Measuring cognitive appraisals that may influence PTSS and therapeutic success can ensure an effective public health response for this population.
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Affiliation(s)
- Elizabeth W Perry
- 1373 School of Public Health, Georgia State University, Atlanta, GA, USA.,1373 Mark Chaffin Center for Healthy Development, Georgia State University, Atlanta, GA, USA.,1373 Center for Research on Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | - Melissa C Osborne
- 1373 Center for Research on Interpersonal Violence, Georgia State University, Atlanta, GA, USA.,1373 Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, GA, USA
| | - NaeHyung Lee
- 1373 School of Public Health, Georgia State University, Atlanta, GA, USA.,1373 Mark Chaffin Center for Healthy Development, Georgia State University, Atlanta, GA, USA.,1373 Center for Research on Interpersonal Violence, Georgia State University, Atlanta, GA, USA
| | | | - Shannon R Self-Brown
- 1373 School of Public Health, Georgia State University, Atlanta, GA, USA.,1373 Mark Chaffin Center for Healthy Development, Georgia State University, Atlanta, GA, USA.,1373 Center for Research on Interpersonal Violence, Georgia State University, Atlanta, GA, USA
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18
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Grady MD, Levenson JS, Glover J, Kavanagh S, Carter K. “Hurt people hurt other people”: The link between past trauma and sexual offending. SEXUAL OFFENDING 2022. [DOI: 10.5964/sotrap.7361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background
A growing body of research documents the high rates of trauma among individuals who have sexually offended. Yet the relationship between prior victimization and subsequent sexual offending remained unclear. Objective: By including the voices and perspectives of individuals convicted of sexual offenses, we sought to strengthen professionals’ understanding of the connection between victimization and offending.
Method
This qualitative study used an online survey to collect data from individuals convicted of sexual offenses (n = 195) with the aims of understanding their perceptions of the link between trauma and offending and what they would like sex-offense treatment providers to know about this connection.
Results
Using grounded theory, five major themes emerged from the data analysis: Relationship between Trauma Offending (n = 91), Acknowledging the Connection (n = 57), Specific Effects of Trauma (n = 48), Individualized Treatment (n = 34), and Recognition of Humanity (n = 26).
Conclusions
The participants perceived a strong connection between one’s own victimization and subsequent sexual offending. In addition, they offered specific recommendations for treatment providers, including individualizing treatment with an emphasis on humanity and compassion. Implications for trauma-informed practice and policy are discussed.
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19
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Child trafficking and exploitation: Historical roots, preventive policies, and the Pediatrician's role. Curr Probl Pediatr Adolesc Health Care 2022; 52:101167. [PMID: 35367130 DOI: 10.1016/j.cppeds.2022.101167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Pediatricians are uniquely and well positioned to recognize risk factors for and experiences of labor and sex trafficking in children. While clinical and social interventions are well discussed in the literature, the underlying mechanisms that cause and contribute to trafficking are poorly addressed among healthcare professionals. A "colorblind" or otherwise "apolitical" approach to trafficking prevention is ineffective and may be detrimental to the patient-practitioner relationship. Pediatricians must be historico-socially aware of the contexts in which they practice to improve the health of pediatric populations. This article addresses the relevant trafficking legal terminology that may be unfamiliar to most pediatricians and focuses on a few "ism"-schisms (capitalism, racism, sexism, cis-heteronormativity, nativism, and classism) that create vulnerability to trafficking in pediatric populations. The article closes with some intervention recommendations and many more prevention-measure recommendations.
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20
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Greenbaum J. Child Labor and Sex Trafficking. Pediatr Rev 2021; 42:639-654. [PMID: 34850175 DOI: 10.1542/pir.2020-001396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Regardless of their practice setting or subspecialty, pediatricians are likely to encounter children who have experienced sex or labor trafficking or who are at risk for exploitation. Only 24.1% of health professionals in one study reported receiving previous training on human trafficking; after a brief presentation on the topic, 39.6% indicated that they knew or suspected they had cared for a trafficked person in the past 3 months. Trafficked and exploited children can present with myriad physical or mental health conditions; most have experienced repeated, significant trauma; and few are likely to spontaneously disclose their exploitative situation. As a result, clinicians face challenges in recognizing and appropriately responding to potential human trafficking. Knowledge of common risk factors and potential indicators of exploitation can assist the pediatrician in recognizing affected and at-risk youth. However, health professionals report that existing training tends to focus on general information about trafficking, with relatively little time spent discussing the specifics of the trauma-informed approach to patient interactions. Given the critical importance of building patient trust, empowering patients to share their concerns, and engaging them in their own care and safety planning, this article focuses on the practical aspects of working with trafficked and exploited children. A brief overview of human trafficking is followed by an extensive discussion of rights-based, culturally sensitive, trauma-informed strategies for interacting with vulnerable patients.
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Affiliation(s)
- Jordan Greenbaum
- International Centre for Missing and Exploited Children, Alexandria, VA.,Institute on Healthcare and Human Trafficking, Stephanie V. Blank Center for Safe and Healthy Children, Children's Healthcare of Atlanta, Atlanta, GA
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21
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Kafafian M, de Vries I, Farrell A, Goldfarb S, Bouchard E. Understanding factors associated with re-referral of youth for commercial sexual exploitation. CHILD ABUSE & NEGLECT 2021; 117:105092. [PMID: 33992876 DOI: 10.1016/j.chiabu.2021.105092] [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: 09/22/2020] [Revised: 02/28/2021] [Accepted: 04/28/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Since the passage of the Victims of Trafficking and Violence Prevention Act of 2000 in the United States, awareness has increased about the problem of commercial sexual exploitation of children (CSEC). Moreover, United States Federal law calls upon child welfare agencies to establish policies and practices that help identify and provide services to minors at risk of CSEC. Although awareness has increased about the problem of CSEC, little attention has been paid to understanding why some youths are re-referred to CSEC programs after initial referral and intervention. OBJECTIVE The present study examines which factors drive re-referrals of youths for CSEC concerns. PARTICIPANTS AND SETTING Data about a population of high-risk youths (n = 416) referred to a CSEC-specific program in the Northeast of the United States between 2011 and 2018. METHODS Using logistic regression analyses, we investigate what factors are associated with youth having multiple referrals. RESULTS Youths with multiple referrals were more likely to have histories of missing from care (OR = 2.996, p < 0.001), substance misuse (OR = 2.802, p < 0.01), and greater agency involvement (OR = 1.260, p < 0.05). However, youths with multiple referrals were not at heightened risk of CSEC as compared to youths that were not re-referred. CONCLUSION The results demonstrate that re-referred youths meet the profile of a victim as depicted on screening and assessment instruments, which has important implications for victim services and referral systems dedicated to identifying CSEC and protecting youths who may experience re-victimization for CSEC.
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Affiliation(s)
- Matthew Kafafian
- Violence and Justice Research Laboratory, School of Criminology and Criminal Justice, Northeastern University, Boston, MA, 02115, United States.
| | - Ieke de Vries
- Institute of Criminal Law and Criminology, Leiden University, Leiden, The Netherlands.
| | - Amy Farrell
- School of Criminology and Criminal Justice, Northeastern University, Boston, MA, 02115, United States.
| | - Susan Goldfarb
- Children's Advocacy Center for Suffolk County, Boston, MA, 02215, United States.
| | - Elizabeth Bouchard
- SEEN Support to End Exploitation Now, Children's Advocacy Center of Suffolk County, Boston, MA, 02215, United States.
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22
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Weber LC, Ortega JC, Bastea S, Robitz RA, Mumma BE. Women Leading Healthy Change: A Reciprocal Learning Experience for Women in the Sex Trade and Medical Students. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2021; 17:11154. [PMID: 34041359 PMCID: PMC8113279 DOI: 10.15766/mep_2374-8265.11154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 03/08/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Service learning can teach medical students about the social determinants of health and prepare them to better serve marginalized populations, while people in the sex trade can serve as effective educators for their peers and health professions trainees. However, service-learning projects involving medical students and people in the sex trade are currently rare. METHODS We modified a curriculum from an author's prior institution to provide a unique service-learning experience for medical students and peer health education for women in the sex trade in a new city and new context. Medical students partnered with a local community organization to implement a 10-week course on physical and mental health for women in the sex trade. Coled by a medical student and a woman who had utilized the community partner's services, the course's instructional methods included in-class demonstrations, group discussion, games, and worksheets. RESULTS Ten women participated in the course, and six medical students facilitated its implementation. The participants demonstrated increased knowledge in physical and mental health topics and reported being more comfortable speaking with health care providers. The coleaders developed skills and confidence to pursue additional leadership opportunities. The medical student coleader gained a better understanding of addiction and was more prepared to work with patients with substance use disorders. DISCUSSION This mutual learning experience was a valuable health education opportunity for a local underserved community and helped medical students understand the barriers women in the sex trade face when seeking health care and how physicians can better meet their needs.
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Affiliation(s)
| | | | - Silvia Bastea
- Third-Year Medical Student, University of California, Davis, School of Medicine
| | - Rachel A. Robitz
- Assistant Clinical Professor, Department of Psychiatry and Behavioral Sciences, University of California, Davis, School of Medicine
| | - Bryn Elissa Mumma
- Associate Professor, Department of Emergency Medicine, University of California, Davis, School of Medicine
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23
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Martin L, Rider GN, Johnston-Goodstar K, Menanteau B, Palmer C, McMorris BJ. Prevalence of Trading Sex Among High School Students in Minnesota: Demographics, Relevant Adverse Experiences, and Health-Related Statuses. J Adolesc Health 2021; 68:1011-1013. [PMID: 33032931 DOI: 10.1016/j.jadohealth.2020.08.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 08/16/2020] [Accepted: 08/20/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE Youth who trade sex for something of value experience enduring harm and risk of being trafficked. This study provides empirically-based prevalence estimates to guide policy and practice. METHODS This secondary analysis of 2019 population-level surveillance data from high school students in Minnesota (N = 71,007) uses descriptive statistics and chi-square tests to analyze self-reports of trading sex by demographics, relevant experiences, and health indicators. RESULTS The prevalence of trading sex among high school students in Minnesota was 1.4%. Cisgender boys and girls had similar rates; transgender students were much higher (5.9%). Rates varied significantly across race/ethnicity (e.g., Native youth, 3.1%), school location, and economic indicators. Students indicating other relevant experiences, such as having been treated for alcohol or drug use (15.1%), reported elevated rates of trading sex. CONCLUSIONS Trading sex is a public health issue that affects high school students. The results show disparate rates of trading sex based on race/ethnicity and gender, with elevated rates among youth who engage in other risky behaviors and experienced other adverse experiences.
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Affiliation(s)
- Lauren Martin
- School of Nursing, University of Minnesota, Minneapolis, Minnesota.
| | - G Nic Rider
- Program in Human Sexuality, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota
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24
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Folk JB, Kemp K, Yurasek A, Barr-Walker J, Tolou-Shams M. Adverse childhood experiences among justice-involved youth: Data-driven recommendations for action using the sequential intercept model. AMERICAN PSYCHOLOGIST 2021; 76:268-283. [PMID: 33734794 PMCID: PMC8281579 DOI: 10.1037/amp0000769] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Justice-involved youth experience high rates of adverse childhood experiences (ACEs), placing them in great need of behavioral health treatment and risk for continued justice involvement. Policymakers, government agencies, and professionals working with justice-involved youth have called for trauma-informed juvenile justice reform. Yet, there is currently no available review of the literature on ACEs and their impact on justice-involved youths' psychological, legal, and related (e.g., academic) outcomes to rigorously guide such reform efforts. The current systematic scoping review synthesizes existing literature related to the impact of ACEs on justice-involved youth and offers recommendations for data-driven intervention along the Sequential Intercept Model, which describes five different points of justice system contact (i.e., first arrest, court diversion, detention, and community supervision) in which there is opportunity to intervene and improve youth behavioral health, legal, and associated outcomes. Eight unique studies were included in 40 articles examining ACEs among justice-involved youth; 38% were longitudinal or prospective analyses and none were intervention studies. Studies included delinquency (e.g., recidivism; n = 5), psychiatric (n = 4), substance use (n = 3), and other (n = 2; e.g., academic, pregnancy) outcomes, documenting high prevalence of ACEs and significant associations between ACEs and a variety of outcomes. Implications for clinical services (e.g., targeting youth dysregulation and aggression), agency context (e.g., training police officers in trauma-responsive practices), and system-level changes (e.g., intervening at the time of first ACE documentation such as parent's arrest) are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Johanna B Folk
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco
| | - Kathleen Kemp
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University
| | - Allison Yurasek
- Department of Health Education and Behavior, University of Florida
| | - Jill Barr-Walker
- Zuckerberg San Francisco General Library, Zuckerberg San Francisco General Hospital
| | - Marina Tolou-Shams
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco
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25
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Kim BKE, Gilman AB, Thompson N, De Leon J. Statewide Trends of Trauma History, Suicidality, and Mental Health Among Youth Entering the Juvenile Justice System. J Adolesc Health 2021; 68:300-307. [PMID: 32646825 PMCID: PMC7785530 DOI: 10.1016/j.jadohealth.2020.05.044] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 04/30/2020] [Accepted: 05/22/2020] [Indexed: 01/23/2023]
Abstract
PURPOSE This study used Washington statewide administrative data to document the prevalence and trend of trauma history, suicidality, and mental health problems among all youth ordered to probation for the first time between 2011 and 2015. We also examined the extent to which trauma and mental health problems were associated with youth suicide risk during this time. METHODS More than 16,500 youth started probation (2011-2015) and received a standardized risk assessment. We used descriptive statistics to assess the prevalence of trauma history, suicidality, mental health problems, and overall risk to reoffend. We then used multilevel logistic regression models (youth within counties) to assess each measure's association with suicidality. RESULTS About 80% of the youth had a history of at least one traumatic experience. As fewer youth started probation for the first time each year, the prevalence of trauma, suicidality, mental health problems, and overall risk to reoffend increased. Trauma, mental health, and overall risk were significantly associated with suicide risk among probation youth. CONCLUSIONS This epidemiological study is expected to motivate discussion around the best ways to integrate trauma-informed care and suicide prevention in the juvenile justice system.
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Affiliation(s)
- Bo-Kyung Elizabeth Kim
- University of Southern California, USC Suzanne Dworak-Peck School of Social Work, Los Angeles, California.
| | - Amanda B. Gilman
- Washington State Center for Court Research Administrative Office of the Courts, Post Office Box 41170, Olympia, WA 98504-1170 USA
| | - Nicole Thompson
- University of Southern California USC Suzanne Dworak-Peck School of Social Work, 669 West 34th St., Los Angeles, CA 90089 USA
| | - Jessenia De Leon
- University of Southern California USC Suzanne Dworak-Peck School of Social Work, 669 West 34th St., Los Angeles, CA 90089 USA
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26
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Logan-Greene P, Bascug EW, DiClemente RJ, Voisin DR. Heterogeneity of Sexual Risk Profiles Among Juvenile Justice-Involved African American Girls. CHILD & YOUTH CARE FORUM 2021. [DOI: 10.1007/s10566-020-09594-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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27
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Niu L, Brown J, Till Hoyt L, Salandy A, Nucci-Sack A, Shankar V, Burk RD, Schlecht NF, Diaz A. Profiles of Childhood Maltreatment: Associations with Sexual Risk Behavior during Adolescence in a Sample of Racial/Ethnic Minority Girls. Child Dev 2021; 92:1421-1438. [PMID: 33442867 DOI: 10.1111/cdev.13498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
This study examines associations between childhood maltreatment and developmental trajectories of sexual risk behaviors (SRBs) in a sample of 882 sexually active adolescent girls, predominantly Hispanic or Black, assessed every 6 months between 13 and 23 years. Latent profile analyses revealed four distinct maltreatment profiles: Low Maltreatment (76%), Moderate Emotional Neglect Only (15%), Severe Physical/Emotional Abuse (3%), and Severe Sexual Abuse (6%). Multilevel growth analyses showed the Moderate Emotional Neglect Only and Severe Sexual Abuse profiles exhibited more SRBs starting in late adolescence, and the Severe Sexual Abuse profile also exhibited a faster increase than the Low Maltreatment profile. Understanding heterogeneity within maltreated populations may have important implications for healthy sexual development.
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Affiliation(s)
- Li Niu
- Fordham University.,Mount Sinai Adolescent Health Center.,Icahn School of Medicine at Mount Sinai
| | | | | | | | | | | | | | - Nicolas F Schlecht
- Albert Einstein College of Medicine.,Roswell Park Comprehensive Cancer Center
| | - Angela Diaz
- Mount Sinai Adolescent Health Center.,Icahn School of Medicine at Mount Sinai
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28
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Cook MC, Talbert RD, Thomas B. A longitudinal study of justice characteristics among girls participating in a sex trafficking court program. HEALTH & JUSTICE 2021; 9:1. [PMID: 33404788 PMCID: PMC7789193 DOI: 10.1186/s40352-020-00127-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 12/16/2020] [Indexed: 05/25/2023]
Abstract
BACKGROUND Sex trafficking is a public health and social justice issue that has traditionally been addressed with criminal justice solutions. Because many sex trafficking survivors are incarcerated for crimes related to their exploitation, specialty, human trafficking courts were developed to offer resources and assistance to labor and sex trafficking survivors. This study assessed justice-involved youth participating in a specialty, anti-trafficking court program. The purpose of this study was to investigate justice-related outcomes of participants in a specialty court program. We examined: (1) the relationship between age at first citation and justice characteristics (number of bench warrants, number of citations, number placements, and number of times ran away); and (2) the number of months between first citation and enrollment into the program with the aforementioned justice characteristics. We used negative binomial models to estimate the relationships between age at first citation, number of months between first citation and program enrollment, with the four justice characteristics (n = 181). RESULTS Adjusted models showed that younger age at first citation was associated with significantly more bench warrants and citations while in the program. Likewise, fewer months between first citation and program entry was related to more bench warrants and citations. CONCLUSIONS There is a need to evaluate the appropriateness of specialty, trafficking court programs in reducing continued justice involvement and these programs ability to meet the evolving needs of sex trafficking survivors over time. We recommend universal screening for trafficking indicators for all systems-involved youth and relocating trafficking specialty courts out of juvenile courts to dependency courts.
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Affiliation(s)
- Mekeila C Cook
- Division of Public Health Practice, Meharry Medical College, 1005 Dr. DB Todd Blvd., Nashville, TN, 37209, USA.
| | - Ryan D Talbert
- Department of Sociology, University of Connecticut , Storrs, CT, USA
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29
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Graf GHJ, Chihuri S, Blow M, Li G. Adverse Childhood Experiences and Justice System Contact: A Systematic Review. Pediatrics 2021; 147:peds.2020-021030. [PMID: 33328338 PMCID: PMC7786827 DOI: 10.1542/peds.2020-021030] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/15/2020] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Given the wide-ranging health impacts of justice system involvement, we examined evidence for the association between adverse childhood experiences (ACEs) and justice system contact in the United States. OBJECTIVE To synthesize epidemiological evidence for the association between ACEs and justice system contact. DATA SOURCES We searched 5 databases for studies conducted through January 2020. The search term used for each database was as follows: ("aces" OR "childhood adversities") AND ("delinquency" OR "crime" OR "juvenile" OR criminal* OR offend*). STUDY SELECTION We included all observational studies assessing the association between ACEs and justice system contact conducted in the United States. DATA EXTRACTION Data extracted from each eligible study included information about the study design, study population, sample size, exposure and outcome measures, and key findings. Study quality was assessed by using the Newcastle-Ottawa Scale for nonrandomized trials. RESULTS In total, 10 of 11 studies reviewed were conducted in juvenile population groups. Elevated ACE scores were associated with increased risk of juvenile justice system contact. Estimates of the adjusted odds ratio of justice system contact per 1-point increase in ACE score ranged from 0.91 to 1.68. Results were consistent across multiple types of justice system contact and across geographic regions. LIMITATIONS Most studies reviewed were conducted in juvenile justice-involved populations with follow-up limited to adolescence or early adulthood. CONCLUSIONS ACEs are positively associated with juvenile justice system contact in a dose-response fashion. ACE prevention programs may help reduce juvenile justice system contacts and improve child and adolescent health.
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Affiliation(s)
| | - Stanford Chihuri
- Department of Anesthesiology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York; and
| | | | - Guohua Li
- Department of Epidemiology, Mailman School of Public Health and
- Department of Anesthesiology, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York; and
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De Vries I, Goggin KE. The Impact of Childhood Abuse on the Commercial Sexual Exploitation of Youth: A Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2020; 21:886-903. [PMID: 30305008 DOI: 10.1177/1524838018801332] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Scholars and practitioners have drawn attention to the issue of commercial sexual exploitation (CSE) of minors, yet we continue to lack a clear understanding of which factors increase a minor's risk to this type of victimization. The current article reviews the literature about the impact of sexual, physical, or emotional abuse on the risk of CSE. The study utilizes quantitative meta-analytical techniques to estimate an overall impact of prior abuse. Nineteen studies were selected after a comprehensive search of electronic databases covering the fields of social science, criminology, psychology, or related fields. To be included in the analyses, all articles had to measure the direct impact of sexual, physical, and/or emotional abuse on minor's risk to CSE, utilizing multivariate techniques and presenting statistical metrics to assess the impact of prior abuse. Key findings demonstrate that sexual abuse considerably increases the risk of exploitation, especially among female youth in the United States. Physical and emotional abuse show negligible or no significant independent impacts, even though a few studies have begun to suggest that experiencing multiple types of childhood abuse may aggravate a risk of sexual exploitation. Our findings can guide further research on the impact of prior victimizations and inform screening instruments that are being developed to identify youth at risk of CSE.
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Affiliation(s)
- Ieke De Vries
- Violence and Justice Research Laboratory, School of Criminology and Criminal Justice, Northeastern University, Boston, MA, USA
| | - Kelly E Goggin
- Violence and Justice Research Laboratory, School of Criminology and Criminal Justice, Northeastern University, Boston, MA, USA
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Coughlin CG, Greenbaum J, Titchen K. Educating paediatric health-care providers about human trafficking. J Paediatr Child Health 2020; 56:1335-1339. [PMID: 32815607 DOI: 10.1111/jpc.15116] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/02/2020] [Accepted: 07/17/2020] [Indexed: 11/26/2022]
Abstract
Human trafficking is a public health issue and humanitarian crisis. Most alarming is that children are especially at risk. Although many studies demonstrate that the majority of trafficked persons surveyed engage with the health-care system during the time in which they are trafficked, health-care practitioners lack the knowledge, tools and resources to assist these patients. The present efforts in training health-care professionals have been fragmented and largely ineffective. While prior training has produced short-term changes in knowledge or attitudes of health professionals, it has not produced sustained changes in knowledge and attitudes nor meaningful changes in screening or intervention. No training has demonstrated changes in patient outcomes. Trafficked persons, particularly children and survivors of labour trafficking, are inadequately served by our present training options for health-care practitioners, and evidence-based protocols are needed to care for this underserved, disenfranchised and traumatised population. To provide optimal care for trafficked youth, health-care practitioners may benefit from: (i) evaluating training for health care providers (HCP) rigorously and meaningfully; (ii) advocating for high-quality training for all HCPs; (iii) fostering partnerships with key stakeholders to inform training and practice; and (iv) designing HCP training that is comprehensive, spanning all forms of human trafficking and including all populations involved.
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Affiliation(s)
- Catherine G Coughlin
- Department of Medicine, Boston Children's Hospital, Boston, Massachusetts, United States.,Department of Pediatrics, Boston Medical Center, Boston, Massachusetts, United States
| | - Jordan Greenbaum
- Department of Pediatrics Emory School of Medicine, Global Child Health and Well Being Initiative, International Center for Missing and Exploited Children, Alexandria, Virginia, United States.,Stephanie V. Blank Center for Safe and Healthy Children, Children's Healthcare of Atlanta, Atlanta, Georgia, United States
| | - Kanani Titchen
- San Diego School of Medicine, Division of General Academic Pediatrics, Developmental Pediatrics, and Center for Community Health, University of California, La Jolla, California, United States
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Laird JJ, Klettke B, Hall K, Clancy E, Hallford D. Demographic and Psychosocial Factors Associated With Child Sexual Exploitation: A Systematic Review and Meta-analysis. JAMA Netw Open 2020; 3:e2017682. [PMID: 32960280 PMCID: PMC7509625 DOI: 10.1001/jamanetworkopen.2020.17682] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
IMPORTANCE Although research has examined factors associated with child sexual exploitation (CSE), consensus is lacking in regard to which factors should be prioritized, thereby hindering policy reform, prevention efforts, and development of early detection and intervention. OBJECTIVE To provide a meta-analytic synthesis of studies examining factors associated with CSE and to quantify their relative importance. DATA SOURCES Electronic databases searched to June 2019 included Medline, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature, EMBASE, and Informit, yielding 396 nonduplicative records. Literature search was performed in July 2019. STUDY SELECTION Inclusion criteria were quantitative investigations of sexual exploitation and mean sample age of 18 years or younger. DATA EXTRACTION AND SYNTHESIS Literature review and data extraction followed Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Thirty-seven studies met final inclusion criteria. Two independent reviewers extracted all relevant data. Random-effects meta-analyses were used to derive odds ratios (ORs) for each factor. Data were analyzed from September 1 to October 28, 2019, and prediction intervals calculated in June 2020. MAIN OUTCOMES AND MEASURES Child sexual exploitation, defined as coerced sexual acts between a child or a young person (aged ≤18 years) and an individual or a group in exchange for money, gifts, substances, or other commodities and associated factors. RESULTS Thirty-seven unique studies were included with a total of 67 453 unique participants (mean [SD] age of 16.2 [2.5] years; 49.9% female). Fifty-two factors associated with CSE were included in the meta-analysis. The strongest factors significantly associated with exposure to sexual exploitation were engagement in sexual risk behaviors (OR, 6.31 [95% CI, 3.12-12.76]; P < .001), having more than 5 sexual partners (OR, 5.96 [95% CI, 1.63-21.87]; P = .007), a diagnosis of posttraumatic stress disorder (OR, 5.29 [95% CI, 3.40-8.22]; P < .001), historical exposure to child pornography (OR, 5.50 [95% CI, 0.99-30.53]; P = .049), and a history of childhood sexual abuse (OR, 3.80 [95% CI, 3.19-4.52]; P < .001). A number of other potentially modifiable factors had moderate to strong associations. CONCLUSIONS AND RELEVANCE In this systematic review and meta-analysis, children and adolescents affected by sexual exploitation showed high levels of sexual risk taking, multiple sexual partners, posttraumatic stress disorder, exposure to child pornography, and childhood trauma. Accurate detection of CSE may prevent this type of sexual violence occurring to adolescents and/or provide opportunities for intervention and recovery. Therefore, prevention and intervention efforts will likely benefit from integrating these factors into screening, assessment, and treatment.
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Affiliation(s)
- Jessica J. Laird
- School of Psychology, Faculty of Health, Deakin University, Burwood, Australia
| | - Bianca Klettke
- School of Psychology, Faculty of Health, Deakin University, Burwood, Australia
- Center for Social and Early Emotional Development, Deakin University, Burwood, Australia
| | - Kate Hall
- School of Psychology, Faculty of Health, Deakin University, Burwood, Australia
- Addictive and Anti-Social Behaviour Research, Deakin University Centre for Drug Use, Geelong, Australia
| | - Elizabeth Clancy
- School of Psychology, Faculty of Health, Deakin University, Burwood, Australia
- Center for Social and Early Emotional Development, Deakin University, Burwood, Australia
| | - David Hallford
- School of Psychology, Faculty of Health, Deakin University, Burwood, Australia
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de Vries I, Kafafian M, Goggin K, Bouchard E, Goldfarb S, Farrell A. Enhancing the Identification of Commercial Sexual Exploitation Among a Population of High-Risk Youths Using Predictive Regularization Models. CHILD MALTREATMENT 2020; 25:318-327. [PMID: 31858831 DOI: 10.1177/1077559519889178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Despite an increasing awareness about the existence and harms of commercial sexual exploitation of children (CSEC), the identification of victims remains a challenge for practitioners, hindering their ability to provide appropriate services. Tools that gauge risk of CSEC support the identification of victims but are underdeveloped because most tools assess risk of CSEC within a general youth population. An understanding of what predicts actual CSEC victimizations among youths at higher risk of CSEC due to experiences of childhood adversities has been left unassessed. Research in this area is limited in part because traditional methods do not allow for an assessment of the unique impact of childhood adversities that tend to co-occur. To address these difficulties, the current study applied predictive regularization methods to identify the most decisive risk items for CSEC. Proximal risk of CSEC was assessed among 317 youths who were referred to a specialized program in the Northeast of the United States due to suspicion of CSEC. With an innovative methodological approach, this study seeks to prompt other scholars to examine risk utilizing novel techniques and provides a foundation for the development of concise tools that assess risk of CSEC among populations of youths at higher levels of risk.
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Affiliation(s)
- Ieke de Vries
- Violence and Justice Research Laboratory, School of Criminology and Criminal Justice, Northeastern University, Boston, MA, USA
| | - Matthew Kafafian
- Violence and Justice Research Laboratory, School of Criminology and Criminal Justice, Northeastern University, Boston, MA, USA
| | - Kelly Goggin
- Violence and Justice Research Laboratory, School of Criminology and Criminal Justice, Northeastern University, Boston, MA, USA
| | | | - Susan Goldfarb
- Children's Advocacy Center of Suffolk County, Boston, MA, USA
| | - Amy Farrell
- Violence and Justice Research Laboratory, School of Criminology and Criminal Justice, Northeastern University, Boston, MA, USA
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Bath E, Barnert E, Godoy S, Hammond I, Mondals S, Farabee D, Grella C. Substance Use, Mental Health, and Child Welfare Profiles of Juvenile Justice-Involved Commercially Sexually Exploited Youth. J Child Adolesc Psychopharmacol 2020; 30:389-397. [PMID: 32213099 PMCID: PMC7409582 DOI: 10.1089/cap.2019.0057] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objectives: To describe the substance use profiles of youth impacted by commercial sexual exploitation (CSE) and explore associations between substance use with mental health diagnoses and child welfare involvement. Methods: Data were systematically extracted from the court files of 364 youth who participated between 2012 and 2016 in Los Angeles County's Succeeding Through Achievement and Resilience (STAR) Court, a juvenile delinquency specialty court for youth impacted by CSE. Descriptive statistics and multivariate regression analyses were conducted to quantify associations between youths' substance use with mental health diagnoses and child welfare involvement. Results: Of the 364 youth impacted by CSE involved in the STAR Court, 265 youth had documented contact with a psychiatrist while in court-of whom, 73% were diagnosed with at least one mental health challenge. Before STAR Court participation, 74% of youth were the subject of one or more child welfare referral; of these youth, 75% had prior out-of-home care. Eighty-eight percent of youth reported substance use, the most prevalent illicit substances were marijuana (87%), alcohol (54%), and methamphetamine (33%). Controlling for age and race, youth impacted by CSE with a diagnosed general mood disorder had more than five times the odds of reporting substance use compared with those without a mood disorder diagnosis (adjusted odds ratio [AOR]: 5.80; 95% confidence interval CI: 2.22-18.52; p < 0.001); and youth impacted by CSE with prior child welfare placements had more than two times the odds of reporting substance use (AOR: 2.24; 95% CI: 1.04-4.86; p = 0.039) compared with youth without prior placements. The association between substance use and general mood disorder was significant and positive for all substance use types (AOR = 3.3, p = 0.033 marijuana; AOR = 4.01, p = 0.011 concurrent alcohol and marijuana; AOR = 9.2, p < 0.001, polysubstance use). Conclusions: High prevalence of substance use among juvenile justice-involved youth impacted by CSE combined with strong associations between substance use with both mental health diagnoses and child welfare system history underscores the need for comprehensive, specialized substance use treatment. Findings suggest an important opportunity for multidisciplinary collaboration among mental health providers, child welfare professionals, juvenile justice practitioners, and other care providers for these youth.
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Affiliation(s)
- Eraka Bath
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, California, USA
| | - Elizabeth Barnert
- Department of Pediatrics, David Geffen School of Medicine at UCLA and Mattel Children's Hospital, Los Angeles, California, USA
| | - Sarah Godoy
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, California, USA
| | - Ivy Hammond
- School of Social Welfare, UC Berkeley, Berkeley, California, USA
| | - Sangeeta Mondals
- Research Data Analyst, Stanford School of Medicine, Stanford, California, USA
| | - David Farabee
- Department of Population Health, Langone School of Medicine, New York University, New York, New York, USA
| | - Christine Grella
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
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Selitsky L, Markowitz N, Baxa DM, Kaljee L, Miree CA, Islam N, Burse C, Newaz R, Dankerlui D, Jacobsen G, Joseph C. Self-report of domestic violence and forced sex are related to sexual risk behaviors in a sample of juvenile detainees. HEALTH & JUSTICE 2020; 8:15. [PMID: 32577955 PMCID: PMC7313184 DOI: 10.1186/s40352-020-00116-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 06/04/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Justice-involved youth have higher rates of sexually transmitted infections (STIs), and a higher prevalence of the associated sexual risk behaviors. Sexual risk behaviors are also associated with alcohol and drug use. Research suggests that a history of trauma is an important predictor of alcohol and drug use in youth offenders, and therefore is a likely contributor to sexual risk behavior in this population. The objective of this analysis is to determine the association of trauma, specifically, domestic violence and forced sex, to six sexual risk behaviors and a history of chlamydia among detained youth. METHODS The analysis uses data from a convenience sample of detainees assenting to HIV testing conducted December 2016 - August 2017 using the state-certified Voluntary Counseling Testing and Referral (VCTR) process. RESULTS Of the 379 youth that received VCTR at the facility, 308 (81.3%) were used in this analysis. Report of domestic violence was significantly associated with sex under the influence of alcohol and was also significantly associated with sex under the influence of marijuana. Forced sex was associated with a sexual partner of unknown HIV status. CONCLUSIONS Traumatic experiences were related to sexual risk behaviors in this analysis, and substance use was strongly implicated in the association. Trauma is known to be a catalyst to sexual risk behaviors, substance use, and delinquency in adolescence. Results support the findings of other investigators and re-iterate the need for trauma-informed interventions that can improve the life trajectories of detained youth.
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Affiliation(s)
- Lea Selitsky
- Internal Medicine, Johns Hopkins Hospital, Baltimore, USA
| | - Norman Markowitz
- Division of Infectious Diseases, Henry Ford Health System and School of Medicine, Wayne State University, Detroit, USA
| | - Dwayne M. Baxa
- William Beaumont School of Medicine, Oakland University, Rochester, USA
- Division of Infectious Diseases, Henry Ford Health System, Detroit, USA
| | - Linda Kaljee
- Global Health Initiative, Henry Ford Health System, Detroit, USA
| | - Cheryl A. Miree
- Department of Public Health Sciences, Henry Ford Health System, 1 Ford Place, Detroit, Michigan USA
| | - Nishat Islam
- Department of Public Health Sciences, Henry Ford Health System, 1 Ford Place, Detroit, Michigan USA
| | - Chez Burse
- Global Health Initiative, Henry Ford Health System, Detroit, USA
| | - Rehnuma Newaz
- Department of Public Health Sciences, Henry Ford Health System, 1 Ford Place, Detroit, Michigan USA
| | - Doreen Dankerlui
- Global Health Initiative, Henry Ford Health System, Detroit, USA
| | - Gordon Jacobsen
- Department of Public Health Sciences, Henry Ford Health System, 1 Ford Place, Detroit, Michigan USA
| | - Christine Joseph
- Department of Public Health Sciences, Henry Ford Health System, 1 Ford Place, Detroit, Michigan USA
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Diamond-Welch B, Kosloski AE. Adverse childhood experiences and propensity to participate in the commercialized sex market. CHILD ABUSE & NEGLECT 2020; 104:104468. [PMID: 32247917 DOI: 10.1016/j.chiabu.2020.104468] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 02/28/2020] [Accepted: 03/17/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Previous research has tied adverse childhood experiences (ACEs) to a variety of deleterious mental health, physical, and behavioral outcomes. There has been some examination of the relationship between ACEs and selling sexual services, but not on the relation of ACEs to purchasing. OBJECTIVE We hypothesize a cumulative impact of ACEs on the propensity to purchase and buy and sell sex. We further hypothesize that childhood sexual abuse will have unique impacts on buying and selling. PARTICIPANTS & SETTING We recruited participants who had ever/never exchanged money or things of values for sex through Amazon MTurk (n = 930). METHODS Using logistic regression, we examined how cumulative ACEs and each separate ACE increased propensity to buy or sell sex. We controlled for sex, age, race, employment status, and sexuality. RESULTS Utilizing the analysis from cumulative ACEs found that the propensity to buy (odds ratio 1.11***) and sell sex (odds ratio 1.094**) increased as cumulative ACE score increased. Bisexuals had high propensity of both buying (odds ratio 2.12) and selling sex (odds ratio 2.74). Women (odds ratio 0.53) and people of color (odds ratio 0.65) where more likely to sell than others. For odds of buying sex, childhood sexual abuse (odds ratio 1.57) had the most impact. For selling sex, childhood sexual abuse (odds ratio 1.96) and household physical violence (odds ratio 2.73) increased propensity while household mental abuse (odds ratio 0.57) decreased propensity. CONCLUSIONS Understanding the impact of ACEs is important to understand participation as a buyer and seller in the commercialized sex market.
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Hammond I, Godoy S, Kelly M, Bath E. A transgender girl’s experience: sexual exploitation and systems involvement. INTERNATIONAL JOURNAL OF HUMAN RIGHTS IN HEALTHCARE 2020. [DOI: 10.1108/ijhrh-07-2019-0059] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe available research on specialized interventions for youth experiencing commercial sexual exploitation almost exclusively focuses on the impact and efficacy related to cisgender girls, despite the inclusion of youth who identify as transgender in these programs. This paper aims to present a case study on the experience of a transgender adolescent girl who experienced commercial sexual exploitation and provides a narrative of the multifarious challenges she faced while involved in institutional systems of care.Design/methodology/approachThis paper conducted an in-depth case review of all records on “Jade,” a white adolescent transgender girl who experienced commercial sexual exploitation, from a specialty court program in the juvenile justice system between 2012 and 2016. Her experiences throughout childhood exemplify many of the unique challenges that transgender girls and young women with histories of exploitation or trafficking may encounter within service delivery and socioecological systems. This paper applied concepts adapted from the gender minority stress theoretical model to understand how minority gender identity can shape the experiences and outcomes of the youth impacted by commercial sexual exploitation.FindingsJade’s narrative underscores the interplay of gender-based sexual violence, heteronormative structural barriers, transphobia and their intersectional impact on her experience while receiving specialized care. The intersectional hardships she experienced likely contributed to adverse biopsychosocial outcomes, including high rates of medical and behavioral health diagnoses and expectations of further rejection.Originality/valueThis paper highlights the extraordinary challenges and barriers faced by an often under-recognized and overlooked subset of the youth impacted by commercial sexual exploitation, who may receive services that do not account for their unique needs related to gender expression and identity. This paper exemplifies how internalized stigma along with expectations of further rejection and victimization have implications for clinical and multidisciplinary intervention settings. Jade’s case underscores the need for improved access to supportive services for youth with minority gender identities, including peer community-building opportunities. Finally, this paper identifies a critical gap in US legislation and social policy. This gap contributes to the structural harms faced by transgender and gender-nonconforming youth receiving services during or following experiences of commercial sexual exploitation.
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Bounds DT, Otwell CH, Melendez A, Karnik NS, Julion WA. Adapting a family intervention to reduce risk factors for sexual exploitation. Child Adolesc Psychiatry Ment Health 2020; 14:8. [PMID: 32099581 PMCID: PMC7029494 DOI: 10.1186/s13034-020-00314-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 01/30/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sexually exploited youth are disconnected from societal tethers and need support systems, which makes them some of the most vulnerable of youth. This heightened level of vulnerability increases their risk for violence, abuse, ongoing sexual exploitation and all its sequelae. The purpose of this study was to examine an evidence-based intervention called STRIVE (support to reunite, involve and value each other) that has been a successful family re-engagement strategy with newly homeless youth. We sought to explore its contextual relevance for youth with risk factors for sexual exploitation and identify necessary adaptations to reduce risk factors for sexual exploitation. We deliberately took an intersectional approach in conducting this study. METHODS Six community-based focus groups were conducted with youth at risk for sexual exploitation and their service providers. Each group was recorded, transcribed, coded, and thematically analyzed. RESULTS Results from 29 youth and 11 providers indicate that there are unique considerations that must be taken into account while working with youth at risk for sexual exploitation to ensure effective service delivery and/or ethical research. Emergent themes included: setting the stage by building rapport and acknowledging experiences of structural violence, protect and hold which balances youth's need for advocacy/support with their caregivers' need for validation/understanding, and walking the safety tightrope by assessing risks and safety planning. DISCUSSION Focus groups are an effective methodology when working with traditionally disempowered populations particularly in gaining a range of perspectives to meet unique needs/preferences. Youth at risk for commercial sexual exploitation needs require strengths-based, individualized, multi-systemic approaches.
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Affiliation(s)
- Dawn T. Bounds
- grid.240684.c0000 0001 0705 3621Department of Psychiatry and Behavioral Sciences, Section of Population Behavioral Health, College of Nursing, Community, Systems, & Mental Health Nursing, Rush University Medical Center, 1645 W. Jackson Blvd. Suite 600, Chicago, IL 60612 USA
| | - Caitlin H. Otwell
- grid.240684.c0000 0001 0705 3621Department of Psychiatry and Behavioral Sciences, Section of Population Behavioral Health, Rush University Medical Center, 1645 W. Jackson Blvd. Suite 600, Chicago, IL 60612 USA
| | - Adrian Melendez
- grid.240684.c0000 0001 0705 3621Department of Psychiatry and Behavioral Sciences, Section of Population Behavioral Health, Rush University Medical Center, 1645 W. Jackson Blvd. Suite 600, Chicago, IL 60612 USA
| | - Niranjan S. Karnik
- grid.262743.60000000107058297Department of Psychiatry & Behavioral Sciences, Rush Medical College, Rush University, 1645 W. Jackson Blvd. Suite 600, Chicago, IL 60612 USA
| | - Wrenetha A. Julion
- grid.240684.c0000 0001 0705 3621College of Nursing, Department of Women, Children and Family Nursing, Rush University Medical Center, 600 S. Paulina St. Suite 1080, Chicago, IL 60612 USA
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Ma C. Featured Counter Trafficking Program: Reclaim13's 'Cherish House'. CHILD ABUSE & NEGLECT 2020; 100:104130. [PMID: 31402057 DOI: 10.1016/j.chiabu.2019.104130] [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: 07/17/2019] [Accepted: 07/30/2019] [Indexed: 06/10/2023]
Abstract
This invited article is one of several comprising part of a special issue of Child Abuse and Neglect focused on child trafficking and health. The purpose of each invited article is to describe a specific program serving trafficked children. Featuring these programs is intended to raise awareness of innovative counter-trafficking strategies emerging worldwide and facilitate collaboration on program development and outcomes research. This article describes Cherish House, an Illinois residential treatment program for trafficked girls. Cherish House utilizes a trauma-focused, integrated model to provide for medical, mental health, educational and life-skill needs of sex trafficked girls.
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Landers M, Johnson MH, Armstrong MI, McGrath K, Dollard N. Exploring relationships as mediators of treatment outcomes among commercially sexually exploited youth. CHILD ABUSE & NEGLECT 2020; 100:104095. [PMID: 31466860 DOI: 10.1016/j.chiabu.2019.104095] [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: 02/28/2019] [Revised: 07/17/2019] [Accepted: 07/19/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Research indicates that youth exposed to commercial sexual exploitation tend to have extensive histories of trauma, including physical abuse, sexual abuse, and neglect, which increases their vulnerability to exploitation. Trauma literature finds youth who present to treatment with greater behavioral health needs tend to have higher trauma scores than youth with fewer behavioral health needs (Copeland et al., 2007; Finkelhor et al., 2007). OBJECTIVE There is, however, limited research on the role of youth strengths as a buffer against the outcomes associated with trauma. With this in mind, the purpose of this study was to examine the relationship between Adverse Childhood Experiences (ACE scores) and youth outcomes such as risk behaviors, behavioral needs, and impairment in functioning across major life domains. Secondly, we explored how this relationship might be better explained by examining youth strengths as mediators-specifically, peer relationships and the stability of significant relationships in the youth's life. PARTICIPANTS AND SETTING Data on clients served in a treatment program specialized for commercially sexually exploited youth were used for this research. RESULTS Results indicated that youth with higher ACE scores had a greater number of risk behaviors, behavioral needs, and impairment in functioning across major life domains. Findings of the mediation analysis provide some support that peer relationships and relationship stability, at least in part, mediates the relationship between ACEs and youth outcomes. Post hoc analyses indicated youth strengths mediated 9-18% of the total effect of ACE scores on youth outcomes. CONCLUSIONS Developing peer relationships and sustaining significant relationships can mitigate some of the adverse effects of trauma experienced by exploited youth.
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Affiliation(s)
- Monica Landers
- FMHI, University of South Florida, 13301 Bruce B. Downs Blvd., Tampa, FL 33612, United States.
| | - Melissa H Johnson
- FMHI, University of South Florida, 13301 Bruce B. Downs Blvd., Tampa, FL 33612, United States
| | - Mary I Armstrong
- FMHI, University of South Florida, 13301 Bruce B. Downs Blvd., Tampa, FL 33612, United States
| | - Kimberly McGrath
- Citrus Health Network, 4175 West 20(th) Avenue, Hialeah, FL 33012, United States
| | - Norín Dollard
- FMHI, University of South Florida, 13301 Bruce B. Downs Blvd., Tampa, FL 33612, United States
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Scott J, Ingram AM, Nemer SL, Crowley DM. Evidence-Based Human Trafficking Policy: Opportunities to Invest in Trauma-Informed Strategies. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2019; 64:348-358. [PMID: 31593298 PMCID: PMC8522583 DOI: 10.1002/ajcp.12394] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Human trafficking is a critical social issue characterized by chronic trauma among victims, and frequently preceded by traumatic experiences that contribute to risk of victimization. Therefore, the research-based practice of trauma-informed care is a highly appropriate lens for both prevention and intervention. This work examines federal legislation in the United States related to human trafficking for references to trauma, as well as how the use of research could implicitly direct public policy responses toward trauma-informed approaches. Legislation on human trafficking has risen substantially since 1989, and the use of research and trauma language within these policies has also observed substantial increases. While the use of trauma language was associated with limited progression in the policy process, legislation using research language was more likely to pass out of Committee and become enacted. Moreover, legislation may leverage research in ways that have the potential to bolster trauma-informed practice among human trafficking victims. Specifically, research can be used to describe the problem and causal mechanisms (e.g., impact of trauma), guide "best practice" for service delivery, and generate knowledge through studies and evaluations that guide future policy. Therefore, human trafficking legislation that implicitly guides trauma-informed practice via the use of research may be particularly promising for the field.
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Affiliation(s)
- J.Taylor Scott
- Edna Bennett Pierce Prevention Research Center, Penn State University, State College, PA, USA
| | | | | | - D. Max Crowley
- Edna Bennett Pierce Prevention Research Center, Penn State University, State College, PA, USA
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Bright MA, Huq MS, Spencer T, Applebaum JW, Hardt N. Animal cruelty as an indicator of family trauma: Using adverse childhood experiences to look beyond child abuse and domestic violence. CHILD ABUSE & NEGLECT 2018; 76:287-296. [PMID: 29175278 DOI: 10.1016/j.chiabu.2017.11.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 11/03/2017] [Accepted: 11/15/2017] [Indexed: 05/10/2023]
Abstract
Youth who engage in animal cruelty are known to be at increased risk of perpetrating violence on other people in their lives including peers, loved ones, and elder family members. These youths have often been exposed to family violence, including animal cruelty perpetrated on their beloved pets by violent adults. The current study utilizes a data set of 81,000 juvenile offenders whose adverse childhood experiences are known and includes 466 youth who self-report engaging in animal cruelty. Compared to the larger group of juvenile offenders, the children admitting to engaging in animal cruelty are younger at time of first arrest, more likely to be male, and more likely to be White. When looking at their reports of adverse childhood experiences (ACEs), they are more likely than other juvenile offenders to have an array of adverse experiences beyond family violence and to have four or more ACEs. Although the youth who are cruel to animals are already troubled, the fact that they present to law enforcement at early ages provides early opportunities for intervention. Service providers outside the law enforcement field, such as teachers, physicians, veterinarians and animal control officers may be able to identify these vulnerable youth, and refer them to needed services before violence is visited on other humans.
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Affiliation(s)
| | - Mona Sayedul Huq
- Department of Health Education and Behavior, University of Florida, USA
| | - Terry Spencer
- College of Veterinary Medicine, University of Florida, USA
| | | | - Nancy Hardt
- Departments of Pathology, Obstetrics and Gynecology, University of Florida, USA
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Franchek-Roa KM, Tiwari A, Connor ALO, Campbell J. Impact of Childhood Exposure to Intimate Partner Violence and Other Adversities. Soa Chongsonyon Chongsin Uihak 2017. [DOI: 10.5765/jkacap.2017.28.3.156] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Affiliation(s)
| | - Agnes Tiwari
- Li Ka Shing Faculty of Medicine, The University of Hong Kong School of Nursing, Hong Kong, China
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Rebbe R, Nurius PS, Ahrens KR, Courtney ME. ADVERSE CHILDHOOD EXPERIENCES AMONG YOUTH AGING OUT OF FOSTER CARE: A LATENT CLASS ANALYSIS. CHILDREN AND YOUTH SERVICES REVIEW 2017; 74:108-116. [PMID: 28458409 PMCID: PMC5404688 DOI: 10.1016/j.childyouth.2017.02.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Research has demonstrated that youth who age out, or emancipate, from foster care face deleterious outcomes across a variety of domains in early adulthood. This article builds on this knowledge base by investigating the role of adverse childhood experience accumulation and composition on these outcomes. A latent class analysis was performed to identify three subgroups: Complex Adversity, Environmental Adversity, and Lower Adversity. Differences are found amongst the classes in terms of young adult outcomes in terms of socio-economic outcomes, psychosocial problems, and criminal behaviors. The results indicate that not only does the accumulation of adversity matter, but so does the composition of the adversity. These results have implications for policymakers, the numerous service providers and systems that interact with foster youth, and for future research.
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Affiliation(s)
- Rebecca Rebbe
- University of Washington, School of Social Work, 4101 15 Avenue NE Seattle, WA 98105, USA
| | - Paula S. Nurius
- University of Washington, School of Social Work, 4101 15 Avenue NE Seattle, WA 98105, USA
| | - Kym R. Ahrens
- Seattle Children’s Hospital & Research Institute, 2001 Eighth Ave Seattle, WA 98121, USA
| | - Mark E. Courtney
- University of Chicago, School of Social Service Administration, 969 E. 60th Street Chicago, IL 60637, USA
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