Carly B. Dierkhising

Trauma histories among justice-involved youth: findings from the National Child Traumatic Stress Network

Background Up to 90% of justice-involved youth report exposure to some type of traumatic event. On average, 70% of youth meet criteria for a mental health disorder with approximately 30% of youth meeting criteria for post-traumatic stress disorder (PTSD). Justice-involved youth are also at risk for substance use and academic problems, and child welfare involvement. Yet, less is known about the details of their trauma histories, and associations among trauma details, mental health problems, and associated risk factors. Objective This study describes detailed trauma histories, mental health problems, and associated risk factors (i.e., academic problems, substance/alcohol use, and concurrent child welfare involvement) among adolescents with recent involvement in the juvenile justice system. Method The National Child Traumatic Stress Network Core Data Set (NCTSN-CDS) is used to address these aims, among which 658 adolescents report recent involvement in the juvenile justice system as indexed by being detained or under community supervision by the juvenile court. Results Age of onset of trauma exposure was within the first 5 years of life for 62% of youth and approximately one-third of youth report exposure to multiple or co-occurring trauma types each year into adolescence. Mental health problems are prevalent with 23.6% of youth meeting criteria for PTSD, 66.1% in the clinical range for externalizing problems, and 45.5% in the clinical range for internalizing problems. Early age of onset of trauma exposure was differentially associated with mental health problems and related risk factors among males and females. Conclusions The results indicate that justice-involved youth report high rates of trauma exposure and that this trauma typically begins early in life, is often in multiple contexts, and persists over time. Findings provide support for establishing trauma-informed juvenile justice systems that can respond to the needs of traumatized youth.

Developmental patterns of adverse childhood experiences and current symptoms and impairment in youth referred for trauma-specific services

By the time children reach adolescence, most have experienced at least one type of severe adversity and many have been exposed to multiple types. However, whether patterns of adverse childhood experiences are consistent or change across developmental epochs in childhood is not known. Retrospective reports of adverse potentially traumatic childhood experiences in 3 distinct developmental epochs (early childhood, 0- to 5-years-old; middle childhood, 6- to 12-years-old; and adolescence, 13- to 18-years-old) were obtained from adolescents (N = 3485) referred to providers in the National Child Traumatic Stress Network (NCTSN) for trauma-focused assessment and treatment. Results from latent class analysis (LCA) revealed increasingly complex patterns of adverse/traumatic experiences in middle childhood and adolescence compared to early childhood. Depending upon the specific developmental epoch assessed, different patterns of adverse/traumatic experiences were associated with gender and with adolescent psychopathology (e.g., internalizing/externalizing behavior problems), and juvenile justice involvement. A multiply exposed subgroup that had severe problems in adolescence was evident in each of the 3 epochs, but their specific types of adverse/traumatic experiences differed depending upon the developmental epoch. Implications for research and clinical practice are identified.

Child Maltreatment Reporting Patterns and Predictors of Substantiation: Comparing Adolescents and Younger Children

Adolescents, and especially male adolescents, make up a disproportionately smaller portion of maltreatment reports compared to younger children. This study used the National Child Abuse and Neglect Data System to better understand the characteristics of adolescents reported to Child Protective Services (CPS), to examine whether these characteristics changed over time, and to determine whether certain child or CPS report characteristics predicted CPS involvement. Although adolescents were the focal group, younger children were also analyzed for comparison. Between 2005 and 2010, reports of neglect and the proportion of children of Hispanic and unknown racial/ethnic origins increased. Concurrently, the proportion of cases resulting in CPS involvement declined. Although race/ethnicity predicted CPS involvement, this pattern was not consistent across all age groups or races/ethnicities. The type of alleged maltreatment did not typically predict CPS involvement; however, allegations of sexual abuse among school-aged children and adolescents, particularly among girls, were more likely to result in CPS involvement. These findings can assist child welfare professionals in determining appropriate services tailored to families and developing prevention programs targeting adolescents.

Brief report: Piloting the Positive Life Changes (PLC) program for at-risk adolescents

The purpose of this study was to pilot the Positive Life Changes (PLC) program, a comprehensive cognitive-behavioral intervention for at-risk adolescents that aims to promote social competencies and to prevent aggression. The program was piloted in 4 intervention groups with a sample of 31 self-referred adolescents (M age 15.64) attending an alternative high school. Questionnaires at pretest and 6-week posttest included five social competencies that represent an expansion of social information-processing (SIP) skills, a measure of aggressive behavior, and a new measure of aggression propensity. Three-level hierarchical linear models showed increases in three social competencies and reductions in physical and verbal aggression propensity from pretest to posttest. Number of program sessions attended did not moderate pretest-posttest change. Findings are discussed in the context of program implementation and future research in school and community settings.

Pilot Evaluation of a University-Based Training in Trauma-Informed Services for Gang Intervention Workers

ABSTRACT The purpose of this pilot study was to investigate the feasibility and efficacy of a course designed to bring trauma-informed practices into community-based intervention programming for gang-involved youth and families. There have been no formally evaluated trauma trainings for gang intervention workers to date. Thirty gang intervention workers completed a University-based course on trauma, which aimed to raise the level of knowledge regarding trauma exposure and its effects on youth, increase intervention workers’ confidence in their ability to identify and respond to posttraumatic stress reactions among clients, and build resilience among staff. Pre-post results revealed that participants significantly improved in their knowledge related to trauma and confidence in their ability to respond to trauma among clients. Participants also rated themselves significantly higher on these domains compared to gang intervention workers who did not take the course. Participants rated the course positively on dimensions that are associated with staff members’ willingness to implement evidence-based interventions following training. The findings indicate a number of important recommendations for supporting gang intervention workers and integrating trauma-informed practices into gang intervention services.

Preventing Adolescent Maltreatment: A Focus on Child Welfare, Juvenile Justice, and Sexual Exploitation

Compared to young children, fewer resources have been devoted to examining the etiology and circumstances related to maltreatment experienced by adolescents. This is unfortunate given adolescents have been found to experience similar, and sometimes higher, rates of maltreatment. This chapter discusses the prevalence of adolescent maltreatment, explores the need to develop interventions and prevention strategies for adolescent maltreatment within alternative contexts, and identifies emerging strategies and necessary next steps for improving the collective response to adolescent maltreatment prevention. The authors focus specifically on how practices and policies within the child welfare, foster care, and juvenile justice systems, and the response to sexually exploited youth present opportunities for targeting and improving treatment and prevention efforts among adolescents.

System Backgrounds, Psychosocial Characteristics, and Service Access Among Dually Involved Youth: A Los Angeles Case Study

Dually involved youth are youth who are concurrently involved in both the child welfare and juvenile justice systems. Dually involved youth require a broader array of services compared to single-system youth though less is known about what types of services youth ultimately access while under the supervision of both systems. The current study examines the juvenile justice and child welfare histories, psychosocial characteristics, and predictors of rearrest among the dually involved population in Los Angeles County (N = 718) as well as the services youth are referred to and utilize among a subsample of dually involved youth tracked postdisposition (n = 152). Findings reveal an increased representation of females and an overrepresentation of African Americans among the sample. In fact, African American youth in Los Angeles County are disproportionately dually involved at a rate almost 6 times their general population numbers (7.4% vs. 43%). Youth histories show significant involvement in both systems with 33% of the sample having been arrested prior to the current referral, and youth having an average of 10.8 referrals to child welfare in their past. Youth exhibited high levels of behavioral health issues, which were associated with rearrest. Youth were referred to a broad range of services, though not all of them were accessed. Placement changes and contact with probation officers were identified as both challenges to and facilitators of service access in unique ways.

Developmental timing of polyvictimization: Continuity, change, and association with adverse outcomes in adolescence

Children who experience polyvictimization (i.e., exposure to multiple and varied traumatic stressors) are at heightened risk for psychopathology. While polyvictims generally have worse outcomes than those with fewer types of traumatic experiences, not all polyvictims experience significant, or similar, impairment suggesting that polyvictims are a heterogeneous group. This variation in outcomes among polyvictimized children, may be due to differences in how polyvictimization is operationalized and measured. The current study examines a clinically-referred sample of adolescents (N = 3754) aged 13-18 (M = 15.3, SD = 1.4) to examine whether polyvictimization in early developmental age periods predict polyvictimization in later periods and whether there are differences in severity of adolescent psychopathology based on variations in timing of polyvictimization in childhood and adolescence. Results from latent class analysis (LCA) reveal the greater the number of developmental periods in which adolescents were classified as polyvictims, the greater the severity of PTSD, externalizing problems, and internalizing problems. In addition, there was variation in the relation between developmental timing of polyvictimization and different types of adolescent psychopathology.