Krystel Tossone

The role of sexual abuse in trauma symptoms, delinquent and suicidal behaviors, and criminal justice outcomes among females in a juvenile justice diversion program

Female juvenile justice–involved (JJI) youth experience more sexual abuse (SA) than their non-JJI counterparts or their male JJI counterparts. This study examines SA’s role among JJI females (N = 1,307) in a behavioral health diversion program. Results indicate that SA increases the risk of psychological trauma, particularly posttraumatic stress and depression. SA also increases the odds of suicidal behavior, running away, and substance use. SA females have the same odds of successfully completing behavioral health diversion and being charged with any offense or misdemeanor after termination as non-SA females. Implications of research and future directions are discussed.

Examining the Concurrent Validity of the Trauma Symptoms Checklist for Children

Objective: The aim of this study is to examine the concurrent validity of the Trauma Symptom Checklist for Children (TSCC) using associated behavioral health diagnoses. Methods: The sample included 2,544 youth participating in a juvenile justice diversion program for youth with behavioral health issues. Youth received a full diagnostic assessment and completed the TSCC. Analyses of variance examined the relationship between TSCC subscale scores and behavioral health diagnoses. Results: The TSCC subscales were often able to differentiate between youth with and without Diagnostic and Statistical Manual of Mental Disorders diagnoses of different classes. For example, youth diagnosed with generalized anxiety disorder (GAD) reported significantly higher means on the TSCC Anxiety Scale than did youth without GAD. Conclusions: The TSCC is a popular trauma symptomatology screening tool, and the current study provides support for its concurrent validity with behavioral health diagnoses. The TSCC provides helpful information that can serve to reinforce clinical decisions around diagnoses and treatment planning.

Social Support among Pregnant Adolescent and Young Adults during Prenatal Ultrasound Study in A Single Tertiary Level Hospital

Introduction: Prenatal care and support is essential to improving birth outcomes for teen pregnancy. Pregnant teens and young adults have access to a variety of support people. The study evaluated the identity of personal social support of pregnant adolescents and young adults (AYA) during prenatal ultrasound study. Methods: We conducted a descriptive retrospective observational study from a tertiary OBGYN referral center from August 2010 to April 2013; participants were pregnant women 21 years of age or younger referred for ultrasound study. The main outcome measure was documentation of social support person(s) accompanying the patient. Results: A total of 517 patients with an age range of 13 to 21 (mean 17.75) underwent 1,058 ultrasound studies. The father of the baby was the most frequent person accompanying the patient (33.4%), followed by the patient’s mother (25.2%). Age was significantly associated with type of support person, with older AYA more likely to present with the father of the baby. Finding an abnormality on ultrasound did not result in increased follow-up or a change in support person. Discussion: The majority of adolescents and young adults will show to an ultrasound study accompanied by one or more individuals as social support. Patient’s age is the strongest variable affecting who will be the social support person.

Expectant inner-city women: attitudes about contraception given infant feeding choice

Abstract Purpose: We sought to examine whether low-income inner-city expectant women who intend to breastfeed make different contraceptive choices than those who intend to formula feed. Materials and methods: This cross-sectional pilot study surveyed expectant women age 14 years and older receiving prenatal care at MacDonald Women’s Hospital, Cleveland Ohio (01 November 2016–15 January 2017). Questions assessed knowledge and attitudes regarding infant feeding and contraception options, and postpartum feeding and contraceptive intentions. Results: We enrolled 223 expectant women, mean age 25.6 years at a median of 30 weeks gestation; 192 (86.5%) were African–American and 171 (75%) were multiparous. Women intending to breastfeed had 0.44 times the odds of intending to use birth control after delivery (95% CI [0.19–1.05], p = .06), while women intending to feed formula had 2.26 times the odds of intending to use birth control after delivery (95% CI [0.95–5.40]). Contraceptive attitudes significantly impacted intent to use contraception (p = .007), with every point higher on the contraception attitudes scale equating to a 7% increase in odds of postpartum contraception use. Conclusions: Postpartum contraceptive intentions do not differ significantly between women intending to breastfeed and those intending formula feeding. Contraception attitudes do not significantly change this association, but were significantly related to contraceptive intent. Findings highlight the importance of providing comprehensive birth control education to all expectant mothers, regardless of feeding intention. Our study is unique in addressing interactions between maternal contraceptive and feeding intentions among expectant women at high risk for both not breastfeeding and unintended short interval pregnancy.

Measuring the Impact of Psychological Trauma Change on Recidivism Among Juvenile Justice–Involved Youth

Population heterogeneity and intra-individual change are often overlooked in recidivism research. This study employs latent transition analysis of psychological trauma from intake into a juvenile justice diversion program until termination, followed by modeling of recidivism. A comparison model of a logistic regression without latent variables is also presented, to answer whether the same results would have been achieved without using latent variable modeling. Results indicate that juvenile justice–involved (JJI) youth are assigned into four psychological trauma classes at intake, and three at termination. Latent status membership predicts 6-month recidivism (p = .03). Those who begin in classes that have Depression, Post-Traumatic Stress, and Anger have higher odds of recidivating than those who demonstrate generally high or low trauma symptoms at intake. The comparison regression model found no significant relationship between the five trauma symptom domains and recidivism. Implications for employing latent variable modeling and person-centered analyses for recidivism research are discussed.