Minimization of Childhood Maltreatment Is Common and Consequential

Childhood maltreatment has diverse, lifelong impact on morbidity and mortality. The Childhood Trauma Questionnaire (CTQ) is one of the most commonly used scales to assess and quantify these experiences and their impact. Curiously, despite very widespread use of the CTQ, scores on its Minimization-Denial (MD) subscale—originally designed to assess a positive response bias—are rarely reported. Hence, little is known about this measure. If response biases are either common or consequential, current practices of ignoring the MD scale deserve revision. 

Therewith, we designed a study to investigate 3 aspects of minimization, as defined by the CTQ’s MD scale: 1) its prevalence; 2) its latent structure; and finally 3) whether minimization moderates the CTQ’s discriminative validity in terms of distinguishing between psychiatric patients and community volunteers. Archival, item-level CTQ data from 24 multinational samples were combined for a total of 19,652 participants. Analyses indicated: 1) minimization is common; 2) minimization functions as a continuous construct; and 3) high MD scores attenuate the ability of the CTQ to distinguish between psychiatric patients and community volunteers. 

Overall, results suggest that a minimizing response bias—as detected by the MD subscale—has a small but significant moderating effect on the CTQ’s discriminative validity. Results also may suggest that some prior analyses of maltreatment rates or the effects of early maltreatment that have used the CTQ may have underestimated its incidence and impact. 

We caution researchers and clinicians about the widespread practice of using the CTQ without the MD or collecting MD data but failing to assess and control for its effects on outcomes or dependent variables.

Below:  Percentages of Clinical and Community Samples in CTQ Severity Quartiles

Full article at:   http://goo.gl/5cJT4g

By:  

Kai MacDonald, Michael L. Thomas, Beacher Schneider, Katherine Pappas, Murray B Stein

Department of Psychiatry, University of California San Diego, San Diego, California, United States of America

Andres F. Sciolla

Department of Psychiatry & Behavioral Sciences, University of California Davis, Davis, California, United States of America

Gijs Bleijenberg, Marianne Heins, Hans Knoop

Expert Center Chronic Fatigue, Radboud University Medical Center, Nijmegen, Netherlands

Martin Bohus

Universität Heidelberg, Central Institute of Mental Health, Heidelberg, Germany

Bradley Bekh

Atlanta VA Medical Center, Atlanta, Georgia, United States of America

Bradley Bekh

Department of Psychiatry, Emory University, Atlanta, Georgia, United States of America

Linda Carpenter

Brown University, Providence, Rhode Island, United States of America

Alan Carr

University College Dublin, Dublin, Ireland

Udo Dannlowski

Department of Psychiatry, University of Münster, Münster, Germany

Martin Dorahy

Department of Psychology, University of Canterbury, Christchurch, New Zealand

Claudia Fahlke

Department of Psychology, University of Gothenburg, Gothenburg, Sweden

Ricky Finzi-Dottan, Tobi Karu

Bar Ilan University, Ramat Gan, Israel

Arne Gerdner

School of Health Sciences, Jönköping University, Jönköping, Sweden

Heide Glaesmer

Department of Medical Psychology and Medical, University of Leipzig, Leipzig, Germany

Hans Jörgen Grabe

Department of Psychiatry and Psychotherapy, Helios Hospital Stralsund, Stralsund, Germany

Hans Jörgen Grabe

Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany

Dianna T Kenny

University of Sydney, Sydney, Australia

Daeho Kim

Department of Psychiatry, Hanyang University Medical School, Seoul, South Korea

Jill Lobbestael

Department of Clinical Psychology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands

Christine Lochner

University of Stellenbosch, MRC Unit on Anxiety & Stress Disorders, Department of Psychiatry, Stellenbosch, South Africa

Grethe Lauritzen, Edle Ravndal

Norwegian Institute for Alcohol and Drug research (SIRUS), and Norwegian Centre for Addiction Research (SERAF), University of Oslo, Oslo, Norway

Shelley Riggs

University of North Texas, Denton, Texas, United States of America

Vedat Sar

Koç University Medical School, Istanbul, Turkey

Ingo Schäfer

Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

Nicole Schlosser

Research Department, Evangelical Hospital Bielefeld, Bielefeld, Germany

Melanie L Schwandt

National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland, United States of America

Claudia Subic-Wrana

Department für Psychosomatic Medicine and Psychotherapy, University Medical Center of Mainz University, Mainz, Germany

Mark Vogel

Division of Substance Use Disorders, Psychiatric Hospital of the University of Basel, Basel, Switzerland

Katja Wingenfeld

Department of Psychiatry, Charité University Berlin, Campus Benjamin Franklin, Berlin, Germany

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Impact of Childhood Maltreatment on Recidivism in Youth Offenders

The purpose of the study is to examine the impact of childhood maltreatment on youth offender recidivism in Singapore. The study used case file coding on a sample of 3,744 youth offenders, among whom about 6% had a childhood maltreatment history. The results showed that the Youth Level of Service/Case Management Inventory 2.0 (YLS/CMI 2.0) ratings significantly predicted recidivism for nonmaltreated youth offenders, but not for maltreated youth offenders. Using propensity score matching, the result from a Cox regression analysis showed that maltreated youth offenders were 1.38 times as likely as their nonmaltreated counterparts to reoffend with a follow-up period of up to 7.4 years. The results implied that the YLS/CMI 2.0 measures were insufficient for assessing the risk for recidivism for the maltreated youth offenders, and that other information is needed to help assessors use the professional override when making the overall risk ratings.

...Specifically, the present study showed that the recidivism rate for maltreated offenders was higher at 57% as compared with 38% for nonmaltreated offenders. This pattern of higher recidivism rate among maltreated offenders was similar to previous studies. For example, the recidivism rate was 56% versus 41% among U.S. youth who were involved in both child protection and juvenile probation services as compared with those delinquency cases only (Huang et al., 2012). These results suggest that youth offenders with a childhood maltreatment history are at higher risk of reoffending than those without.

The current study also showed that the maltreated youth offenders had different profiles. For example, the maltreated offenders were arrested for the first time about half a year younger on average than the nonmaltreated offenders. This is consistent with previous research in that childhood maltreatment may “speed up the age” when an individual becomes involved in criminal activities (Widom, 1989). In addition, previous studies have found that earlier engagement in criminal activities is one of the strongest predictors of recidivism (Barrett, Katsiyannis, & Zhang, 2010; Benda, Corwyn, & Toombs, 2001; Cottle et al., 2001; K. C. Thompson & Morris, 2013). Prevention programs can thus focus on dealing with the youth’s early entry into the juvenile justice system, especially for the maltreated children, by promoting effective parenting skills and increasing family supervision (Borum, 2003). It is also important that existing policies relating to youth services ensure that these maltreated youth are promptly provided with the relevant treatment services to address trauma-related problems.

On top of the differences pertaining to personal traits, the current research showed that more maltreated youth offenders were from a background with household and parental problems. These findings suggest that children from certain families are more likely to be maltreated and such differences in their background may confound the true relationship between childhood maltreatment and recidivism. Unlike most of the previous studies that gauge childhood maltreatment effect without a proper control group, the present study used nonmaltreated youth offenders with similar backgrounds as control. Controlling for other variables and differences in the follow-up period, the maltreated youth offenders were 1.38 times as likely to reoffend as the nonmaltreated offenders. In other words, childhood maltreatment was a unique contributor of youth offender recidivism even after controlling for their YLS/CMI 2.0 Overall Risk Ratings, as well as another 15 risk factors relating to their personal characteristics, household environment, and parental background.

There is a possibility that maltreated youth offenders might have developed distinct characteristics that made them more prone to future criminal behavior. Specifically, maltreated youth offenders had significantly higher levels of criminogenic needs in terms of antisocial personality. This suggests that the link between childhood maltreatment and delinquency may be mediated by personality traits... 

Below:  Survival curve for maltreated and nonmaltreated youth offenders with different risk levels of recidivism in the full sample

Full article at:   http://goo.gl/HekxwQ

By:  Dongdong Li, Chi Meng Chu, Joseph Teck Ling Goh, Irene Y. H. Ng, and Gerald Zeng

Joseph Teck Ling Goh, Ministry of Social and Family Development;

Contributor Information.

Dongdong Li, Centre for Research on Rehabilitation and Protection, Ministry of Social and Family Development, 512 Thomson Road, #12-00 MSF Building, Singapore 298136, Singapore; e-mail: gs.vog.fsm@gnodgnod_il.

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Intergenerational Continuity of Adverse Childhood Experiences in Homeless Families: Unpacking Exposure to Maltreatment Versus Family Dysfunction

Despite the expanding research on adverse childhood experiences (ACEs) and corpus of studies on intergenerational maltreatment in high-risk families, studies have not examined intergenerational ACEs more broadly, much less in severely disadvantaged families. 

This study investigated the intergenerational continuity of ACEs in mothers and young children aged 4 to 6 years living in emergency homeless shelters. It also examined whether unpacking ACEs into categories of exposure to maltreatment versus family dysfunction affected intergenerational continuity patterns or child socioemotional problems in school. 

Negative parenting, in the form of observed inept coercive discipline with children, and cumulative sociodemographic risk were examined as additional predictors of child ACEs and socioemotional problems. 

Mothers (N = 95; aged 20-45; 64.2% African American, 3.2% African Native, 11.6% Caucasian, 7.4% biracial/multiracial, and 13.6% other) completed questionnaires on parent and child ACEs and cumulative risk factors. They participated in videotaped parent-child interactions rated for observed coercive discipline, and teachers provided reports of children's socioemotional problems. 

Results indicated that higher parental ACEs predicted higher child ACEs, with higher numbers of parental ACEs in either category (maltreatment or family dysfunction) predicting higher levels of child ACEs in both categories. However, child exposure to maltreatment, but not family dysfunction, significantly predicted elevations in children's socioemotional problems. 

Findings underscore the role of intergenerational childhood adversity in homeless families and also emphasize that unpacking ACEs in children may illuminate key areas of vulnerability for school adjustment. 

Purchase full article at:   http://goo.gl/j7fVf3

By:  Narayan AJ, Kalstabakken AW, Labella MH, Nerenberg LS, Monn AR, Masten AS.

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High School Incompletion and Childhood Maltreatment among Street-Involved Young People in Vancouver, Canada

While the link between educational attainment and future health and wellness is well understood, little investigation has considered the potential impacts of distinct forms of childhood maltreatment on high school completion. 

In the present study, the relationship between five categories of childhood maltreatment (physical, emotional, and sexual abuse, and physical and emotional neglect) and completion of high school education were examined using the Childhood Trauma Questionnaire (CTQ). From September 2005 to May 2013, data were collected for the At-Risk Youth Study (ARYS), a cohort of street-involved young people who use illicit drugs in Vancouver, Canada. We used logistic regression to examine the relationship between childhood maltreatment and high school completion, while controlling for a range of potential confounding variables. Specifically, five separate models for each category of maltreatment and two combined models were employed to examine the relative associations between, and cumulative impact of, different forms of childhood maltreatment and educational attainment. 

Among 974 young people, 737 (76%) reported not completing high school. In separate multivariable analyses physical abuse, emotional abuse, physical neglect, and emotional neglect remained positively and independently associated with an incomplete high school education. In a combined multivariable model with all forms of childhood maltreatment considered together, emotional abuse (adjusted odds ratio = 2.08; 95% confidence interval: 1.51-2.86) was the only form of maltreatment that remained significantly associated with an incomplete high school education. The cumulative impact assessment indicated a moderate dose-dependent trend where the greater the number of different forms of childhood maltreatment the greater the risk of not completing a high school education. 

These findings point to the need for trauma-informed interventions to improve educational attainment among vulnerable young people, as well as evidence-based prevention programmes, such as the Nurse-Family Partnership, aimed at supporting at-risk families before maltreatment occurs.

Purchase full article at:   http://goo.gl/YsT9yn

By:   Barker B^1,2, Kerr T^1,3, Dong H¹, Wood E^1,3, DeBeck K^1,4.

¹Urban Health Research Initiative, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.

²Interdisciplinary Studies Graduate Program, University of British Columbia, Vancouver, British Columbia, Canada.

³Division of AIDS, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.

⁴School of Public Policy, Simon Fraser University at Harbour Centre, Vancouver, British Columbia, Canada. 

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Suicide Attempts and Childhood Maltreatment among Street Youth

BACKGROUND:

Although suicide is a known leading cause of death among street youth, few prospective studies have explored childhood experiences as risk factors for future suicide attempt in this population. We examined the risk of attempted suicide in relation to childhood maltreatment among street youth.

METHODS:

From September 2005 to November 2013, data were collected from the At Risk Youth Study (ARYS), a prospective cohort of street youth in Vancouver, Canada. Inclusion criteria were age 14 to 26 years, past-month illicit drug use, and street involvement. Participants completed the Childhood Trauma Questionnaire, an instrument measuring self-reported sexual, physical, and emotional abuse and physical and emotional neglect. Suicide attempts were assessed semiannually. Using Cox regression, we examined the association between the 5 types of maltreatment and suicide attempts.

RESULTS:

Of 660 participants, 68.2% were male and 24.6% were Aboriginal. Median age was 21.5 years. The prevalence of moderate to extreme childhood maltreatment ranged from 16.8% (sexual abuse) to 45.2% (emotional abuse). Participants contributed 1841 person-years, with suicide attempts reported by 35 (5.3%) individuals (crude incidence density: 1.9 per 100 person-years; 95% confidence interval [CI]: 1.4-2.6 per 100 person-years). In adjusted analyses, types of maltreatment associated with suicide attempts included physical abuse (adjusted hazard ratio [HR]: 4.47; 95% CI: 2.12-9.42), emotional abuse (adjusted HR: 4.92; 95% CI: 2.11-11.5), and emotional neglect (adjusted HR: 3.08; 95% CI: 1.05-9.03).

CONCLUSIONS:

Childhood maltreatment is associated with subsequent risk of suicidal behavior among street youth. Suicide prevention efforts should be targeted toward this marginalized population and delivered from a trauma-informed perspective.

Below:  Associations of Childhood Maltreatment With Suicide Attempts During Follow-up: ARYS (Vancouver, British Columbia; 2005–2013)

Full article at:   http://goo.gl/roaQzI

By:   Hadland SE1, Wood E2, Dong H3, Marshall BD4, Kerr T2, Montaner JS2, DeBeck K5.

• 1Division of Adolescent/Young Adult Medicine, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts;
• 2British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, British Columbia, Canada; Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada;
• 3British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, British Columbia, Canada;
• 4Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island; and.
• 5British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, British Columbia, Canada; School of Public Policy, Simon Fraser University, Vancouver, British Columbia, Canada uhri-kd@cfenet.ubc.ca. 

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Maltreatment, Child Welfare, and Recidivism in a Sample of Deep-End Crossover Youth

Although research has oft-documented a maltreatment-delinquency link, the effect of involvement in-and timing of-child welfare system involvement on offending has received less attention. We examine whether the timing of child welfare involvement has differential effects on recidivism of deep-end juvenile offenders (youth who have been adjudicated delinquent by the court and placed in juvenile justice residential programs). 

The current study uses a large, diverse sample of 12,955 youth completing juvenile justice residential programs between 1 January 2010 and 30 June 2013 in Florida (13 % female, 55 % Black, 11 % Hispanic). Additionally, we explore the direct effects of childhood traumatic events on delinquency, as well as their indirect effects through child welfare involvement using structural equation modeling. 

The findings indicate that adverse childhood experiences fail to exert a direct effect on recidivism, but do exhibit a significant indirect effect on recidivism through child welfare involvement, which is itself associated with recidivism. This means that while having exposures to more types of childhood traumatic events does not, in and of itself, increase the likelihood of re-offending, effects of such experiences operate through child welfare placement. 

Differences in the effects of maltreatment timing and of adverse childhood experiences are observed across sex and race/ethnicity subgroups. Across all racial subgroups, exposures to adverse childhood experiences have a significant effect on the likelihood of child welfare placement, yet child welfare placement exerts a significant effect on recidivism for White and Hispanic youth, but not for Black youth. Only Hispanic female and White male youth with overlapping child welfare and juvenile justice cases (open cases in both systems at the same time during the study period) were more likely to recidivate than their delinquent-only counterpart youth. 

Crossover status (child welfare and juvenile justice involvement, whether prior or open cases) was essentially irrelevant with respect to the re-offending of Black youth completing juvenile justice residential programs. 

The findings indicate the effects of exposure to adverse childhood experiences, and child welfare system and juvenile justice system involvement on re-offending are not uniform across subgroups of youth but that earlier child welfare involvement is more detrimental than concurrent child welfare system involvement when it does matter.

Purchase full article at:   http://goo.gl/ltBD85

By:   Baglivio MT1, Wolff KT2, Piquero AR3, Bilchik S4, Jackowski K5, Greenwald MA6, Epps N7.

• 1G4S Youth Services, LLC, 6302 Benjamin Rd., Suite 400, Tampa, FL, 33625, USA. Michael.Baglivio@us.g4s.com.
• 2John Jay College of Criminal Justice, 524 West 59th St., New York, NY, 10019, USA. kwolff@jjay.cuny.edu.
• 3University of Texas at Dallas, 800 W. Campbell Rd., GR31, Richardson, TX, 75080, USA. apiquero@utdallas.edu.
• 4Center for Juvenile Justice Reform, 3300 Whitehaven St. NW, R. 5045, Washington, DC, 20007, USA. Shay.bilchik@gmail.com.
• 5G4S Youth Services, LLC, 6302 Benjamin Rd., Suite 400, Tampa, FL, 33625, USA. Katherine.Jackowski@us.g4s.com.
• 6Florida Department of Juvenile Justice, 2737 Centerview Drive, Tallahassee, FL, 32399, USA. Mark.Greenwald@djj.state.fl.us.
• 7Florida Department of Juvenile Justice, 2737 Centerview Drive, Tallahassee, FL, 32399, USA. Nathan.Epps@djj.state.fl.us.

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Appetitive Aggression & Adverse Childhood Experiences Shape Violent Behavior in Females Formerly Associated with Combat

This study investigated the impact of violent experiences during childhood, posttraumatic stress disorder (PTSD) and appetitive aggression on everyday violent behavior in Burundian females with varying participation in war. Moreover, group differences in trauma-related and aggression variables were expected. 

Appetitive aggression describes the perception of violence perpetration as fascinating and appealing and is a common phenomenon in former combatants. Semi-structured interviews were conducted with 158 females, either former combatants, supporters of armed forces or civilians during the civil war in Burundi. The PTSD Symptom Scale Interview was used to assess PTSD symptom severity, the Appetitive Aggression Scale to measure appetitive aggression and the Domestic and Community Violence Checklist to assess both childhood maltreatment and recent aggressive behavior. 

Former combatants had experienced more traumatic events, perpetrated more violence and reported higher levels of appetitive aggression than supporters and civilians. They also suffered more severely from PTSD symptoms than civilians but not than supporters. The groups did not differ regarding childhood maltreatment. Both appetitive aggression and childhood violence predicted ongoing aggressive behavior, whereas the latter outperformed PTSD symptom severity. 

These findings support current research showing that adverse childhood experiences and a positive attitude toward aggression serve as the basis for aggressive behavior and promote an ongoing cycle of violence in post-conflict regions. Female members of armed groups are in need of demobilization procedures including trauma-related care and interventions addressing appetitive aggression.

Below:  Differences between the three groups regarding (A) childhood violence, (B) traumatic event types, (C) perpetrated event types, (D) posttraumatic stress disorder (PTSD) symptom severity and (E) appetitive aggression.  ^∗p < 0.05, ^∗∗p < 0.01, ^∗∗∗p < 0.001.

Full article at:  http://goo.gl/SvzMAl

By:  Mareike Augsburger,1,* Danie Meyer-Parlapanis,1 Manassé Bambonye,2 Thomas Elbert,1,2 and Anselm Crombach1,2

¹Department of Psychology, University of Konstanz, Konstanz, Germany

²Department of Psychology, University Lumière, Bujumbura, Burundi

Edited by: J. P. Ginsberg, Dorn VA Medical Center, USA

Reviewed by: Eric C. Porges, University of Florida, USA; Michelle Dow Keawphalouk, Harvard–MIT, USA

*Correspondence: Mareike Augsburger, ed.znatsnok-inu@regrubsgua.ekieram

This article was submitted to Psychology for Clinical Settings, a section of the journal Frontiers in Psychology

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Understanding Addiction as a Developmental Disorder: An Argument for a Developmentally Informed Multilevel Approach

Substance abuse and drug addiction are two of the most common psychopathologies among the general population. While a host of risk factors are associated with the onset of drug abuse and drug addiction, there is a growing body of evidence pointing to the powerful influence of early adverse experiences, both child neglect and maltreatment, as well as drug use and abuse in parents and/or primary caretakers. We consider the case for drug addiction as a developmental disorder, outlining the need to consider the role of genetic, epigenetic, and neurobiological factors alongside experiences of adversity at key stages of development. Such a multilevel approach within a developmental framework has the potential to reframe our understanding of how addiction emerges and is maintained, and is essential if we are to identify the mechanisms underlying this disorder to better inform effective treatment and prevention across the generations.

… Substance abuse and drug addiction are two of the most common psychopathologies among the general population. Across potential drugs of abuse, prevalence estimates in adult populations for drug abuse and dependence range from 1.4 % for 12-month to 7.7 % for lifetime drug abuse [1]. When the behavioral addictions are also considered (e.g., gambling, overeating), there is significant overlap in natural history, comorbidity, response to treatment, and etiologic mechanisms with drug use and abuse [2]. Many addictions begin in adolescence, which appears to be an especially vulnerable time for the onset of drug use and abuse and the transition to addiction [3]. There are also robust associations between the age of onset of drug use and abuse and the severity and chronicity of addiction [4]. While there are a host of risk factors associated with the onset of drug abuse and drug addiction, there is a growing body of evidence pointing to the influence of early adverse experiences, both child neglect and maltreatment, as well as drug use and abuse in parents and/or primary caretakers. Taken together, each of these lines of evidence suggest that drug addiction (and perhaps addictions more generally) may be construed as developmental disorders, that is, as disorders with experiential and gene by experience antecedents relating to early caregiving and exposure to adverse and/or contexts characterized by deprivation….

Full article at: http://goo.gl/P6RzfR

By: E. J. McCrory and L. Mayes

Developmental Risk and Resilience Unit, Division of Psychology and Languages Sciences, University College London, 26 Bedford Way, London, UK

Yale Child Study Center, 280 S. Frontage Road, New Haven, CT 06519 USA

E. J. McCrory, Phone: + 44 (20) 7679 7560, Email: ku.ca.lcu@yrorccm.e.

   

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Childhood Maltreatment and Revictimization in a Homeless Population

We examined the hypothesis that exposure to childhood maltreatment increases the vulnerability to Adult Victimization (AV) in a homeless population (N = 500). We also investigated the effects of specific types (emotional, physical, and sexual) and cumulative experience of childhood maltreatment on AV, and whether gender moderates these relationships. 

All three groups with AV experience (emotional, physical, and sexual) indicated higher exposure to childhood abuse and cumulative maltreatment, and those who were sexually victimized as an adult showed higher exposure to childhood neglect. In addition, exposure to childhood maltreatment had type-specific and cumulative effects on AV. Exposure to all types of childhood abuse maintained a strong direct association with AV, regardless of demographic characteristics, including age, ethnicity, marital status, education level, and housing situation. In addition, exposure to physical neglect showed a significant relationship with Adult Sexual Victimization. 

Cumulative experience of childhood maltreatment was consistently associated with cumulative risk of experiencing AV. Gender had no significant effect on these relationships. Findings suggest that intervention programs in homeless population should consider the history of childhood maltreatment and its characteristics to increase the effectiveness of intervention strategies for AV in this population.

Via:  http://ht.ly/RXwFC 

By: Edalati H1, Krausz M2, Schütz CG2.

• 1University of British Columbia, Kelowna, Canada hanie.edalati@ubc.ca.
• 2University of British Columbia, Vancouver, Canada.

Multiple Victimizations Before & After Leaving Home Associated with PTSD, Depression, and Substance Use Disorder Among Homeless Youth

Exposure to multiple forms of maltreatment during childhood is associated with serious mental health consequences among youth in the general population, but limited empirical attention has focused on homeless youth-a population with markedly high rates of childhood maltreatment followed by elevated rates of street victimization. This study investigated the rates of multiple childhood abuses (physical, sexual, and emotional abuse) and multiple street victimizations (robbery, physical assault, and sexual assault) and examined their relative relationships to mental health outcomes (meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, criteria for post-traumatic stress disorder [PTSD], depression, and substance use disorder) among a large (N = 601) multisite sample of homeless youth. 

Approximately 79% of youth retrospectively reported multiple childhood abuses (two or more types) and 28% reported multiple street victimizations (two or more types). Each additional type of street victimization nearly doubled youths' odds for meeting criteria for substance use disorder. Furthermore, each additional type of childhood abuse experienced more than doubled youths' odds for meeting criteria for PTSD. Both multiple abuses and multiple street victimizations were associated with an approximate twofold increase in meeting depression criteria. Findings suggest the need for screening, assessment, and trauma-informed services for homeless youth who consider multiple types of abuse and victimization experiences.

Via: http://ht.ly/RXwiP 

By: Bender K1, Brown SM2, Thompson SJ3, Ferguson KM4, Langenderfer L2.

• 1Graduate School of Social Work, University of Denver, Denver, CO, USA kimberly.bender@du.edu.
• 2Graduate School of Social Work, University of Denver, Denver, CO, USA.
• 3School of Social Work, University of Texas, Austin, TX, USA.
• 4City University of New York, Silberman School of Social Work at Hunter College, New York, NY, USA.

Gendered Pathways: Violent Childhood Maltreatment, Sex Exchange, and Drug Use

Below:  Parameter Estimates for Direct-Indirect Effects Model in Women and Men

Note: Unstandardized regression weights (and standard errors) for women are left of the diagonal and in bold; estimates for men are right of the diagonal and in regular font. Correlations between the independent variables are not shown, but are similar to those reported in Table 1.

First, structural equation modeling revealed that childhood sexual and physical abuse were related to increased drug engagement in women and men, respectively, above the influence of early childhood contextual variables (e.g., neighborhood, family) and age. Second, sexual abuse was related to sex exchange, which in turn was related to drug use symptoms in women but not men.

These data provide empirical support for distinct trauma-related pathways to drug use problems in men and women, which has implications for gendered explanations and prevention approaches.

Via:   http://ht.ly/QngMt  HT @USouthFlorida