Sanna J. Thompson

Runaway and Pregnant: Risk Factors Associated with Pregnancy in a National Sample of Runaway/Homeless Female Adolescents

PURPOSE Homeless youth are at particularly high risk for teen pregnancy; research indicates as many as 20% of homeless young women become pregnant. These pregnant and homeless teens lack financial resources and adequate health care, resulting in increased risk for low-birth-weight babies and high infant mortality. This study investigated individual and family-level predictors of teen pregnancy among a national sample of runaway/homeless youth in order to better understand the needs of this vulnerable population. METHODS Data from the Runaway/Homeless Youth Management Information System (RHY MIS) provided a national sample of youth seeking services at crisis shelters. A sub-sample of pregnant females and a random sub-sample (matched by age) of nonpregnant females comprised the study sample (N = 951). Chi-square and t tests identified differences between pregnant and nonpregnant runaway females; maximum likelihood logistic regression identified individual and family-level predictors of teen pregnancy. RESULTS Teen pregnancy was associated with being an ethnic minority, dropping out of school, being away from home for longer periods of time, having a sexually transmitted disease, and feeling abandoned by ones family. Family factors, such as living in a single parent household and experiencing emotional abuse by ones mother, increased the odds of a teen being pregnant. CONCLUSIONS The complex problems associated with pregnant runaway/homeless teens create challenges for short-term shelter services. Suggestions are made for extending shelter services to include referrals and coordination with teen parenting programs and other systems of care.

Factors associated with trauma and posttraumatic stress disorder among homeless youth in three U.S. cities: The importance of transience†

Homeless youth experience disproportionately high rates of trauma and posttraumatic stress disorder (PTSD). This study examined correlates of trauma and PTSD among homeless youth with a focus on the impact of homeless culture, substance addiction, and mental health challenges. Homeless youth (N = 146) from Los Angeles, California, Denver, Colorado, and St. Louis, Missouri, were recruited from organizations providing services to homeless youth using comparable methods. Results indicate that 57% of respondents had experienced a traumatic event and 24% met criteria for PTSD. A multinomial logistic regression model revealed greater transience, alcohol addiction, mania, and lower self-efficacy predicted PTSD whereas trauma exposure was associated with alcohol addiction only. Findings have implications for screening and intervening with traumatized homeless youth across service settings.

Short-Term Outcomes for Youth Receiving Runaway and Homeless Shelter Services

Objective: Few studies have assessed the outcomes of runaway/homeless youth that seek assistance from shelter or crisis services, which would provide much needed documentation of intervention effectiveness and point to new directions for service provision. The goals of the current study were to: (1) assess short-term outcomes among runaway/homeless youth using emergency shelters and crisis services and (2) compare short-term outcomes achieved by runaway/homeless youth in crisis shelters with similar youth using other, longer-term treatment modalities. Method: The study sampled 261 youth using runaway/homeless shelters from four midwestern states at intake and six-weeks postdischarge and 47 high-risk youth using longer-term services at intake and six weeks postintake; ten key outcome variables were assessed. Results: Every outcome variable demonstrated improvement postintervention: days on the run, school suspension and/or detention, and sexual activity decreased; perceived family support and self-esteem increased; and youth were more likely to be currently employed and less likely to have been fired. In comparing runaway/homeless crisis shelter users with day treatment users on the ten outcome variables, there were no significant differences across any of the outcome variables. Conclusions: Despite limitations, the research provides evidence for the short-term effectiveness of crisis shelter services for runaway/homeless youth.

Common Themes of Resilience among Latino Immigrant Families: A Systematic Review of the Literature:

Although there is a plethora of research on resiliency, there are few studies that examine this concept in Latino immigrant families in the United States. Using key terms such as immigrant, Hispanic, Latino, and resiliency, a systematic literature review was conducted to identify characteristics of resilience and understand how these factors uniquely protect Latino immigrant families against stressors related to the migration and assimilation processes. Research on resilience among Latino immigrant families indicates 4 major domains: individual characteristics, family strengths, cultural factors, and community supports. A deeper understanding of how these risk and protective factors contribute to resilience with Latino immigrant families will increase the cultural competence of policy, practice, and research with this population. Implications for research and practice are discussed.

Correlates of Street-Survival Behaviors in Homeless Young Adults in Four U.S. Cities

This study assessed the prevalence and correlates of behaviors used by homeless young people to survive on the streets. Survival behaviors include prostitution, selling blood or plasma, dealing drugs, stealing, and panhandling. One hundred ninety-six homeless young adults from 4 metropolitan areas-Los Angeles, CA (n = 50); Austin, TX (n = 50); Denver, CO (n = 50); and St. Louis, MO (n = 46)-participated in individual, semistructured, face-to-face interviews. Researchers predicted that youth transience would be related to high rates of survival behaviors. Multivariate logistic regression was used to test a model predicting relationships between survival behaviors and transience, employment, substance use, and social support. Young adults who were transient, unemployed, drug-addicted, and reliant on peers for help were more likely to use these survival behaviors. In addition, among the transient subsample, being White, more reliant on peers for help, more transient, and having been victimized were associated with high use of these survival behaviors. Identification of the environmental and demographic factors associated with survival behaviors suggests that there may be value in combining harm-reduction strategies with efforts to reduce the transience of homeless young adults.

Factors Associated with Substance Use Among Homeless Young Adults

The purpose of this study was to investigate factors associated with substance use among homeless young adults. Multinomial logistic regression analyses examined the influence of social networks and economic factors among a group of homeless young adults with differing levels of alcohol and drug use. In addition, for those with an alcohol use disorder, the role of future time expectancies was examined. A sample (n = 185) of homeless young adults aged 18 to 23 were recruited from a community drop-in center and interviewed utilizing self-report instruments. Findings suggest that social networks, economic factors, and future expectancies are significant predictors of the level of substance use among homeless young adults. Being able to identify those areas that place homeless young adults at risk for substance abuse and dependence has implications for effective intervention.

Multiple Victimizations Before and 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.

Employment Status and Income Generation Among Homeless Young Adults Results From a Five-City, Mixed-Methods Study

This mixed-methods study identified correlates of unemployment among homeless young adults in five cities. Two hundred thirty-eight homeless young people from Los Angeles (n = 50), Austin (n = 50), Denver (n = 50), New Orleans (n = 50), and St. Louis (n = 38) were recruited using comparable sampling strategies. Multivariate logistic regression results indicate that homeless young adults were more likely to be unemployed if they had been on the streets longer, currently lived on the streets, earned an income from panhandling, and were addicted to drugs. Quantitative findings are expanded on with focus-group data from a group of homeless young people in Los Angeles regarding their challenges in locating and maintaining employment. Employment-related barriers for this population include prior homelessness, geographic transience, previous felonies, mental illness, and addiction. Findings suggest that homeless young adults’ employment status and use of specific income-generating activities may be influenced by demographic, environmental, and geographic contexts.

Estrangement factors associated with addiction to alcohol and drugs among homeless youth in three U.S. cities

Substance use is highly prevalent among homeless, street-involved young people. Societal estrangement is often associated with substance use, particularly among this population. The current study sought to identify four domains of social estrangement (disaffiliation, human capital, identification with homeless culture, and psychological dysfunction) in relation to alcohol and drug addiction. Homeless young adults were recruited from three disparate urban areas: Los Angeles, CA (n=50), Austin, TX (n=50) and St. Louis, MO (n=46) using comparable research methods and measurement instruments. Findings demonstrated that variables measuring psychological dysfunction and homeless culture predicted alcohol addiction, while institutional disaffiliation and homeless culture predicted drug addiction. Findings affirm distinct patterns of estrangement related to alcohol compared to drug addiction. Understanding these features and the heterogeneity of this population has strong potential for assisting development of programs targeting substance use among this underserved population.

Factors Associated with Trauma Symptoms Among Runaway/Homeless Adolescents

ABSTRACT Runaway/homeless youth often suffer from exposure to chronic family distress and confront numerous traumatic events that may produce symptoms of PTSD. This study evaluated runaway/homeless youths PTSD symptoms and associated factors. Data were collected at youth emergency shelters. Ninety-eight percent of participants had elevated PTSD symptom scores. Although use of inhalants and LSD was associated with PTSD symptoms, only depression, anxiety, and dissociation, mothers ecstasy or LSD use, youths worry about family relationships, and poor family communication predicted higher PTSD scores. Runaway/homeless youth entering emergency shelters services must be evaluated concerning trauma and associated comorbid symptoms.