Mental health correlates of victimization classes among homeless youth

Literature reports high rates of street victimization among homeless youth and recognizes psychiatric symptoms associated with such victimization. Few studies have investigated the existence of victimization classes that differ in type and frequency of victimization and how youth in such classes differ in psychiatric profiles. We used latent class analysis (LCA) to examine whether classes of homeless youth, based on both type and frequency of victimization experiences, differ in rates of meeting diagnostic criteria for major depressive episodes and posttraumatic stress disorder (PTSD) in a sample of homeless youth (N = 601) from three regions of the United States. Results suggest youth who experience high levels of direct and indirect victimization (high-victimization class) share similarly high rates of depressive episodes and PTSD as youth who experience primarily indirect victimization only (witness class). Rates of meeting criteria for depressive episodes and PTSD were nearly two and three times greater, respectively, among the high victimization and witness classes compared to youth who never or rarely experienced victimization. Findings suggest the need for screening and intervention for homeless youth who report direct and indirect victimization and youth who report indirect victimization only, while prevention efforts may be more relevant for youth who report limited victimization experience.     

Lifetime assessment of poly-victimization in a national sample of children and youth

ObjectiveTo use a lifetime assessment of victimization experiences to identify children and youth with high cumulative levels of victimization (poly-victims). Also to compare such children to other victims and non-victims, and assess the contribution of cumulative victimization to levels of psychological distress.DesignA national sample of 1,467 children aged 2–17 recruited through random digit dialing and assessed via telephone interviews (with caretakers and youth themselves) about a comprehensive range of 33 types of victimization experiences in the previous year and at any time in their lives.ResultsNearly 80% of the children and youth reported at least one lifetime victimization. The mean number of lifetime victimizations was 3.7 and the median 2.6. The total number of different lifetime victimizations was highly predictive of symptoms of current distress. The best linear prediction of distress on the basis of cumulative victimization entailed weighting child maltreatment and sexual assault by factors of 4 and 3 respectively compared to other victimizations. We proposed classifying poly-victims as those 10% of children and youth with the highest victimization scores, and calculating different thresholds for children at different ages. Poly-victims designated in this way had significantly more distress, more non-victimization adversities than other youth and were less likely to come from an intact family.ConclusionLifetime assessment of victimization has value as a means of identifying groups of highly victimized children and youth.Practice ImplicationsThis paper describes a procedure under which practitioners can assess for a group of children, termed “poly-victims,” who have a very high burden of lifetime victimization. These children merit identification because they have high levels of psychological distress, some of the most serious victimization profiles, and a presumed vulnerability for further victimization.     

Perpetrators of early physical and sexual abuse among homeless and runaway adolescents

OBJECTIVE: To examine abuse specific variables among homeless and runaway adolescents and to look at perpetrators of childhood abuse. METHOD: A total of 372 homeless and runaway adolescents were interviewed using a systematic sampling strategy in metropolitan Seattle. Young people were interviewed on the streets and in shelters by outreach workers in youth service agencies. RESULTS: Approximately one-half of these young people reported being physically abused and almost one-third experienced sexual abuse. Females experienced significantly higher rates of sexual abuse compared to males, and sexual minority youth experienced significantly higher rates of physical and sexual abuse compared to heterosexual youth. Average duration of physical and sexual abuse was 5 and 2 years, respectively. Both types of abuse were rated as extremely violent by more than half of those who were abused. The average number of different perpetrators of physical and sexual abuse was four and three, respectively. Biological parents were the majority of perpetrators for physical abuse whereas nonfamily members most often perpetrated sexual abuse. Average age of perpetrators was late 20s to early 30s and the majority of perpetrators were male for both types of abuse.CONCLUSIONS: The pattern of exploitation and victimization within the family may have serious and cumulative developmental consequences for these youth as they enter the street environment. Early intervention programs are needed to break the cycle of exploitation and abuse that adolescents experience within the family. Without intervention, many of these youth may be at risk of future exploitation and re-victimization out on the street.     

Multiple victimization experiences of urban elementary school students: associations with psychosocial functioning and academic performance

OBJECTIVE: This study explored the victimization experiences of urban elementary school students to determine whether subsets of youth emerged with similar victimization profiles (e.g., no victimization, multiple types of victimization). It also evaluated whether multiple victimization was associated with greater psychological distress and lower academic performance. METHODS: Participants were 689 fifth grade students from an urban, ethnically diverse school district in the Northeast. Youth completed self-report measures in school about bullying victimization, victimization in the home and community, and psychosocial functioning. RESULTS: Cluster analysis suggested the existence of three distinct youth profiles: those with minimal victimization, those victimized primarily by their peers, and those with multiple types of victimizations. As hypothesized, youth with multiple victimizations experienced more psychological distress and earned lower grades than their peers. CONCLUSIONS: Findings highlight the heterogeneity of youth victimization experiences and their relations to functioning, and have implications for treatment planning among practitioners working with youth.     

Post-traumatic stress as a pathway to psychopathology among adolescents at high-risk for victimization

ObjectiveVictimization by violence elevates adolescents’ risk for developing internalizing and externalizing psychopathology. Recent findings suggest that disruptions in developmental processes associated with post-traumatic stress (PTS) reactions may partially account for the relationship between victimization and the subsequent development of psychopathology during adolescence. The present study tested the temporal sequencing of these associations using multi-informant measurements in a large, diverse sample of adolescents at high-risk for victimization.MethodData were collected from a multi-site consortium of prospective studies, the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). Information about 833 youth’s victimization experiences (i.e., direct, indirect, familial, and non-familial violence), PTS, and affective, anxiety, attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) symptoms were gathered from youth and their caregivers during biannual face-to-face interviews when youth were between the ages of 4 and 14 years, and continuously from official child protective services records.ResultsStructural equation modeling revealed that cumulative victimization contributed to elevations in youth and caregiver reported late childhood and early adolescent psychopathology. While PTS mediated the association between victimization and youth reported ADHD, ODD, CD, major depressive, and generalized anxiety symptoms during adolescence, it only mediated the association between victimization and caregiver reported affective symptoms.ConclusionsPTS reactions following childhood victimization partially accounted for escalations in psychopathology during the transition to adolescence. These findings underscore the importance of integrating trauma-informed assessment and intervention approaches with at-risk adolescents. Researchers should determine whether trauma-focused interventions sufficiently ameliorate other psychopathology among victimized adolescents or if additional interventions components are necessary.     

Online social support as a buffer against online and offline peer and sexual victimization among U.S. LGBT and non-LGBT youth

In today's technology-infused world, we need to better understand relationships youth form with friends online, how they compare to relationships formed in-person, and whether these online relationships confer protective benefits. This is particularly important from the perspective of peer victimization, given that social support in-person appears to reduce the odds of victimization in-person. To address this literature gap, data from a sample of 5,542 U.S. adolescents, collected online between August 2010 and January 2011, were analyzed. The main variables of interest were: online and in-person peer victimization (including generalized and bullying forms) and online and in-person sexual victimization (including generalized and sexual harassment forms). Lesbian, gay, bisexual, and transgender (LGBT) youth were more likely than non-LGBT youth to have online friends and to appraise these friends as better than their in-person friends at providing emotional support. Peer victimization and unwanted sexual experiences were more commonly reported by LGBT than non-LGBT youth. Perceived quality of social support, either online or in-person, did little to attenuate the relative odds of victimization for LGBT youth. For all youth, in-person social support was associated with reduced odds of bully victimization (online and in-person) and sexual harassment (in-person), but was unrelated to the other outcomes of interest. Online social support did not reduce the odds of any type of victimization assessed. Together, these findings suggest that online friends can be an important source of social support, particularly for LGBT youth. Nonetheless, in-person social support appears to be more protective against victimization, suggesting that one is not a replacement for the other.     

Victimization and adversity among children experiencing war-related parental absence or deployment in a nationally representative US sample

This study compares children and youth who have experienced lifetime war-related parental absence or deployment with those having no such history on a variety of victimization types, non-victimization adversity, trauma symptoms, and delinquency; and assesses whether cumulative adversity and victimization help to explain elevated emotional and behavioral problems among children of parents who have experienced war-related absence or deployment. The National Surveys of Children’s Exposure to Violence (NatSCEV) are comprised of three cross-sectional telephone surveys conducted in 2008, 2011, and 2014. Data were collected on the experiences of children aged one month to seventeen years. In each survey, interviews were conducted with youth 10–17 years old and with caregivers of children 0–9 years old. The analyses use pooled data from all three U.S. nationally-representative samples (total sample size of 13,052). Lifetime parental war-related absence or deployment was a marker for elevated childhood exposure to a wide array of victimization and adversity types. Cumulative past year exposure to multiple forms of victimization and adversity fully explained elevated trauma symptoms and delinquency in this population of children. Given the breadth of victimization and adversity risk, children with histories of parental war-related absence or deployment, as well as their families, represent important target groups for broad-based prevention and interventions to reduce exposure and ameliorate consequences when it does occur.     

Protective factors promoting resilience in the relation between child sexual victimization and internalizing and externalizing symptoms

Sexual victimization has been one of the most frequently studied forms of child victimization. Its effects are common and diverse; however, not all children and youth exposed to sexual victimization eventually develop adjustment problems. A total of 1105 children and youth (590 male and 515 female) aged between 12 and 17 from northeastern Spain were assessed regarding their experiences of sexual victimization, symptoms of psychopathology, and protective factors. The results showed that all forms of sexual victimization were associated with higher levels of emotional and behavioral problems. However, the presence of a low Negative Cognition, high Social Skills and high Confidence seem to act buffering internalizing problems. Additionally, a significant interaction between Sexual Victimization and low Negative Cognition was observed (p < 0.5), so that, low Negative Cognition was related to a lower risk of being in the clinical range for internalizing problems. Likewise, high scores on Empathy/Tolerance, Connectedness to School, Connectedness to Family and low Negative Cognition acted as promotive factors in relation to externalizing symptoms, in this case without any interaction effect. The strong relationship found with emotional and behavioral problems highlights the importance of continuing the research on the protective factors underlying resilience in the relationship between sexual victimization and psychopathological symptoms. The findings also support the multi-dimensional and specific nature of resilience and identify some of the protective factors that should be regarded as key intervention targets in adolescents with a history of sexual victimization.     

Childhood adversity and the risk of substance use and delinquency: The role of protective adult relationships

Youth involved in the child welfare system experience multiple early adversities that can contribute to increased risk of substance use and delinquency. Although adverse childhood experiences (ACEs) have been associated with poorer behavioral outcomes among youth, less is known about the possible protective factors that may influence the relationship between early adversity and risk-taking behavior. This study examined whether protective adult relationships moderated the link between cumulative ACEs and substance use and delinquency after controlling for demographic characteristics in child welfare-involved youth. The sample included 1054 youth, ages 11–17, from the National Survey of Child and Adolescent Well-Being II who were in the first wave of data collection. Results showed that protective adult relationships moderated the relationship between ACEs and substance use, but not for delinquency. Specifically, under lower levels of protective adult relationships, cumulative ACEs related to increased substance use among youth. Implications for child welfare practices to target youths' support systems are discussed.     

The Juvenile Victimization Questionnaire: reliability, validity, and national norms

OBJECTIVE: To assess the utility and performance of the 34-item Juvenile Victimization Questionnaire (JVQ) in eliciting the recent victimization experiences of a national sample of children ages 2-17. METHOD: The JVQ was administered in a national random digit dial telephone survey about the experiences of 2,030 children. The experiences of children 10-17 years old were assessed through youth self-report on the JVQ, and the experiences of children 2-9 assessed through JVQ caregiver proxy report. RESULTS: Large numbers of recent victimizations were disclosed using the JVQ (71% of the sample reporting at least one victimization in the last year, with an average of 2.63 victimizations per child). There were few indicators of respondent confusion and little resistance to even the most sensitive questions. In a test of construct validity, endorsements of JVQ items correlated well with measures of traumatic symptoms. The instrument showed adequate test-retest reliability in a 3 to 4 week re-administration. Large numbers of victimizations were reported across the spectrum of ages, and there were no major discontinuities between the self-reports and proxy reports, suggesting that caregivers provided generally adequate and comparable information to child self-reports about the experiences of children under the age of 10. CONCLUSION: The JVQ has potential for use in future epidemiological research as well as clinical evaluation concerning the victimization of children.     

Kid's stuff: the nature and impact of peer and sibling violence on younger and older children

OBJECTIVE: It is widely presumed that when children are hit by peers or siblings, it is not as serious as similar acts between adults or older youth, which would be termed, "assaults" and "violent crimes". The goal of this study was to compare the violent peer and sibling episodes of younger children to those of older youth in terms of their seriousness and association with symptoms that might indicate traumatic effects. METHOD: The study collected reports of past year's violent victimizations and childhood symptoms in a national probability telephone sample of 2030 children and youth ages 2-17. The experiences of 10-17-year olds were obtained via self-reports and those of the 2-9-year olds from caregivers. RESULTS: The younger children's peer and sibling victimizations were not less serious than the older youth on the dimensions of injury, being hit with an object that could cause injury or being victimized on multiple occasions. Younger children and older youth also had similar trauma symptom levels associated with both peer and sibling victimization. CONCLUSION: There was no basis in this study for presuming peer and sibling victimizations to be more benign when they involve younger children. The findings provide justification for being concerned about such peer and sibling violence in schools and families and for counting such victimizations in victimization inventories and clinical assessments.     

Victimization Disparities Between Heterosexual and Sexual Minority Youth From Ages 9 to 15

Mental health disparities between heterosexual and sexual minority youth are partly explained by the higher rates of victimization experienced by sexual minority youth. The onset and progression of these victimization disparities, however, are poorly understood. Using multirater longitudinal data, trajectories of victimization starting at age 9 were compared among youth who did and did not report same-sex attraction at age 15 (N = 310). Self and teacher, but not primary caregivers, reported victimization was significantly higher among sexual minority youth starting at age 9, but did not vary across time. The findings underscore the importance of understanding homophobic experiences of sexual minority youth during late childhood and early adolescence in order to inform prevention programs.     

Child and adolescent abuse and subsequent victimization: a prospective study

OBJECTIVE: We investigated the possible reciprocal relationship between victimization experiences and psychological functioning by assessing abuse experiences in childhood, adolescence, and during a 2-month follow-up period. METHOD: At the beginning of the study (Time 1), abuse histories, trauma and depressive symptoms, and interpersonal functioning were assessed in 551 college women. Subsequent victimization experiences and psychological outcomes were assessed at the follow-up (Time 2). RESULTS: Path analyses indicated that verbal abuse by the mother and father were predictive of various psychological outcomes as measured at Time 1 and emerged as the only significant predictors of adolescent dating violence. Adolescent dating violence subsequently predicted the experience of dating violence during the 2-month follow-up period. Paternal physical abuse predicted adolescent sexual victimization which subsequently predicted all symptom measures at Time 1. Conversely, the experience of adolescent physical dating violence was not predictive of any of the symptom measures at Time 1. For those women who experienced dating violence during the follow-up, however, the severity of their abusive experiences was related to both depression and interpersonal problems assessed at Time 2. In comparison, for those women who experienced sexual victimization during the follow-up period, the severity of their abusive experiences was related to trauma symptoms. Interpersonal problems emerged as both an aftereffect of adolescent sexual victimization experience and a predictor of a subsequent sexual victimization experience during the follow-up. CONCLUSIONS: Given that emotional abuse emerged as a predictor of adolescent dating violence and psychological outcomes, researchers and clinicians need to continue to explore this problem. Further, it is important to assess how interpersonal problems contribute to the risk of subsequent sexual victimization and to try to break the cycle between adolescent abuse experiences and subsequent physical and sexual assaults.     

African-American women who use crack cocaine: a comparison of mothers who live with and have been separated from their children

OBJECTIVE: This study examined factors that influenced caregiver status for African-American mothers who use crack cocaine but are not receiving drug treatment and participated in an HIV prevention study in North Carolina. METHOD: Caregiver mothers who were living with at least one of their children at intake (n = 257) were compared with non-Caregivers who were separated from all of their children (n = 378). Bivariate analyses and logistic regression were used to compare these mothers at intake on current drug use, risky sex practices, psychological symptoms, victimization, and aggression. RESULTS: Compared with Caregiver mothers, non-Caregivers reported higher frequencies of drug use, risky sex practices, psychological distress, and victimization experiences. Caregiver mothers were more likely than non-Caregiver mothers to have health insurance, but were less likely to have received drug treatment. Logistic regression found that non-Caregiver mothers were significantly more likely than Caregiver mothers to be older, to have been physically abused as children, to trade sex more frequently, to be homeless, and to have no health insurance. Recent crack use, psychological symptoms, and victimization were not significantly related to caregiver status. CONCLUSIONS: Findings that socio-environmental factors were more strongly associated with caregiver status than crack use underscore the importance of contextual issues such as housing, victimization history, and resources in serving maternal crack users. Community outreach and interventions that engage mothers who use drugs and live with their children may be more effective strategies than formal office-based services to link mothers who use crack and their children to needed drug treatment and family and child services.     

Differences between peer victimization in cyber and physical settings and associated psychosocial adjustment in early adolescence

The increasing use of cyberspace as a social networking forum creates a new medium for youth to become victims of peer aggression. This study used factor analysis techniques to confirm whether survey questions about frequency of cyber victimization formed a distinct latent construct from questions about relational and overt victimization information in a large (N = 1,665) sample of middle school students. A secondary goal was to relate experiences of cyber victimization to symptoms of depression and social anxiety. Results indicate that cyber victimization is separate latent factor from overt and relational victimization. Experiences of cyber victimization were weakly associated with symptoms of social anxiety, but not depression. These results signify that cyber victimization deserves future empirical and clinical attention. © 2009 Wiley Periodicals, Inc.     

The effects of exposure to violence and victimization across life domains on adolescent substance use

This study uses longitudinal data from the Project on Human Development in Chicago Neighborhoods (PHDCN) to examine the effects of exposure to school violence, community violence, child abuse, and parental intimate partner violence (IPV) on youths’ subsequent alcohol and marijuana use. We also examine the cumulative effects of being exposed to violence across these domains. Longitudinal data were obtained from 1,655 adolescents and their primary caregivers participating in the PHDCN. The effects of adolescents’ exposure to various forms of violence across different life domains were examined relative to adolescents’ frequency of alcohol and marijuana use three years later. Multivariate statistical models were employed to control for a range of child, parent, and family risk factors. Exposure to violence in a one-year period increased the frequency of substance use three years later, though the specific relationships between victimization and use varied for alcohol and marijuana use. Community violence and child abuse, but not school violence or exposure to IPV, were predictive of future marijuana use. None of the independent measures of exposure to violence significantly predicted future alcohol use. Finally, the accumulation of exposure to violence across life domains was detrimental to both future alcohol and marijuana use. The findings support prior research indicating that exposure to multiple forms of violence, across multiple domains of life, negatively impacts adolescent outcomes, including substance use. The findings also suggest that the context in which exposure to violence occurs should be considered in future research, since the more domains in which youth are exposed to violence, the fewer “safe havens” they have available. Finally, a better understanding of the types of violence youth encounter and the contexts in which these experiences occur can help inform intervention efforts aimed at reducing victimization and its negative consequences.     

A Meditational Model Linking Witnessing Intimate Partner Violence and Bullying Behaviors and Victimization Among Youth

A growing body of research documents that various forms of violence exposures are interrelated. This paper presents a conceptual model, which accounts for the relationship between youth witnessing intimate partner violence (IPV) at home and their subsequent engagement in bullying behaviors and victimization by peers. A comprehensive search of major databases was conducted within a 12-year period (1999–2011). Based on this review, we provide empirical evidence, which documents that youth who witness IPV are at increased risk for bullying behaviors and peer victimization. Next, we posit a mediational model, which suggests that the relationship between witnessing IPV and bullying behavior and peer victimization is mediated by psychological problem behaviors, lower school success, and problematic peer interactions. We also explore potential moderating factors that may exacerbate or buffer the effects of witnessing IPV, such as age, gender, race/ethnicity, parenting practices, and peer relationships. This overall conceptual model should be empirically tested and has important implications for guiding future research on the relationship between IPV and bullying behaviors and victimization among youth.     

Disentangling the mental health impact of childhood abuse and neglect: A replication and extension study in a Brazilian sample of high-risk youth

Childhood maltreatment is a key predictor of mental health problems across the life span. Yet, how maltreatment types independently and jointly influence the risk for psychiatric problems remains unclear. The aim of the study was two-fold: first, to replicate recent findings regarding the impact of maltreatment types on youth psychiatric symptoms, based on a Brazilian sample of high-risk adolescents (n = 347; age range = 11–17 yrs), and second, to extend existing findings by examining whether this relationship is mediated by bullying victimization and/or perpetration. Measures included self-report ratings of childhood maltreatment and peer victimization, as well as multi-informant reports of internalizing and externalizing symptoms. Consistent with prior research, we found that: (i) maltreatment types often co-occurred; (ii) there was a linear association between number of maltreatment types experienced and symptom severity (i.e. cumulative effect); and (iii) emotional abuse emerged as the most consistent independent predictor of poor mental health across domains, raters, and gender. Additionally, this study extends previous findings by showing that the influence of maltreatment on psychiatric outcomes is partially mediated by peer victimization, but not by bullying perpetration. In conclusion, these findings expand our understanding of the heterogeneity in individual responses to maltreatment as well as highlighting emotional abuse as an important predictor of poor mental health.     

Post-traumatic stress problems among poly-victimized Spanish youth: Time effect of past vs. recent interpersonal victimizations

The cumulative effect of lifetime interpersonal victimization experiences (e.g., child maltreatment, sexual victimizations, conventional crime, witnessing indirect victimization, peer and sibling victimizations) on posttraumatic stress (PTS) symptoms is an important topic in the scientific literature. The objectives of the present study were: (a) to analyze the relationship between lifetime interpersonal victimizations and PTS symptoms, (b) to determine the most prevalent specific PTS symptoms among poly-victimized adolescents, and (c) to establish the time-based effect of interpersonal victimization experiences that occurred in the last year versus those that occurred years before on current level of PTS symptoms. Gender differences were taken into account for each of these objectives. Participants were 823 Spanish adolescents (63% girls and 37% boys) between 14 and 18 years of age recruited from May 2010 to November 2011 from schools in Barcelona, Spain. The majority (87.6%) was of Spanish nationality. The results highlighted the cumulative effect of interpersonal victimizations on PTS symptoms. Among poly-victims adolescents, the most prevalent PTS symptom was intrusive thoughts, but some differences were observed according to gender. The time-based effect of interpersonal victimizations showed a different pattern for girls and boys. For girls, the victimizing events occurring in past years had more explanatory power of the current PTS symptoms than those that occurred more recently. In boys, the interpersonal victimizing events occurring in the last year had the greater explanatory power. These results may have clinical and therapeutic value.     

Gender differences in Brazilian street youth's family circumstances and experiences on the street

OBJECTIVES: It has been proposed that homeless street girls are more likely to be from dysfunctional families and exhibit psychological distress than homeless street boys, reflecting cultural factors that result in differential norms for male and female behavior. The current analysis examined whether male and female street youth in a mid-sized Brazilian city differed in their family circumstances and day-to-day functioning on the street. METHODS: The opportunity sample consisted of 33 male (mean age 14.3, range 10-17 years) and 33 female (mean age 14.6, range 11-18 years) street youth who participated in a sentence completion task and structured interview examining family experiences and ability to meet daily needs on the street. RESULTS: Consistent with the cultural hypothesis, girls described more negative family backgrounds than boys (e.g., they were more likely to have left home because of conflict or abuse, and reported more negative relationships with their parents). However, girls' functioning on the street was similar to, and in some cases more positive than, that of boys (e.g., fewer girls reported police violence and begging to earn money). CONCLUSIONS: The few gender differences that emerged in this study offer little support for the cultural hypothesis. The findings make sense if local factors, such as services available for male and female youth and public response to street youth, are considered. It appears that street youth differ in their experiences depending on local circumstances, highlighting the need for caution in generalizing about the situation of street youth in different countries.