Adolescent exposure to violence and adult physical and mental health problems

Evidence on the relationship of adolescent exposure to violence (AEV) with adult physical and mental health problems is limited, with studies often focusing on earlier childhood rather than adolescence, and also on short term rather than long term outcomes. Information specifically on the relationship of AEV to seeking help for mental health problems in adulthood from either formal sources such as mental health professionals or informal sources such as friends and clergy is even more difficult to find. The present study investigates how adolescent exposure to violence (AEV), in the form of parental physical abuse, witnessing parental violence, and exposure to violence in the neighborhood, are related to self-reported adult physical problems and seeking formal or informal assistance with mental health, controlling for more general adolescent violent victimization and for self-reports and parent reports of mental health problems in adolescence. This study adds to the literature on AEV and adult physical problems, and provides a rare look at the relationship of AEV to adult help-seeking for mental health problems. The results suggest that AEV is associated with mental health problems in adolescence for both females and males, that for females AEV is related to physical problems and to seeking help for mental health problems in adulthood, but for males the only significant relationship involves inconsistent reports of witnessing parental violence and adult physical problems.     

Patterns of victimization: A person-centered approach to physical and sexual violence in a representative sample of Danish youth

Professionals and policy makers have only recently begun to recognize the extent to which different types of victimization are interconnected. To enhance our knowledge of the co-occurrence of physical and sexual violence across childhood and adolescence/early adulthood, the present study investigated distinct typologies of victimization in a sample of adolescents and young adults and explored the relationship between victimization typologies and gender, age, and mental health. Data from the Danish 2013 National Health Survey (“How are you?”) were used. Latent class analysis (i.e., a person-centered approach) was used to identify typologies of physical and sexual victimization in a representative sample of 3812 adolescents and young adults aged 16–24 years. Five distinct victimization typologies emerged: a normative, non-victimization group (76%), a physical victimization in adolescence/early adulthood group (13%), a physical revictimization group (5%), a poly-victimization group (4%), and a physical victimization in childhood group (2%). Physical revictimization, poly-victimization, and physical victimization in childhood were highly associated with poor mental health status. Using a latent variable modeling approach, we identified meaningful subgroups of the victimized population. Two subgroups (i.e., physical revictimization and poly-victimization), which comprised a third of all individuals in the victimization subgroups, had a high probability of exposure to multiple traumatic events and poor mental health. These study findings underscore the need to promote interventions addressing the co-occurrence of physical and sexual victimization and the persistence of victimization over time.     

The prevalence and impact of child maltreatment and other types of victimization in the UK: Findings from a population survey of caregivers,children and young people and young adults

Objectives

To measure the prevalence of maltreatment and other types of victimization among children, young people, and young adults in the UK; to explore the risks of other types of victimization among maltreated children and young people at different ages; using standardized scores from self-report measures, to assess the emotional wellbeing of maltreated children, young people, and young adults taking into account other types of childhood victimization, different perpetrators, non-victimization adversities and variables known to influence mental health.

Methods

A random UK representative sample of 2,160 parents and caregivers, 2,275 children and young people, and 1,761 young adults completed computer-assisted self-interviews. Interviews included assessment of a wide range of childhood victimization experiences and measures of impact on mental health.

Results

2.5% of children aged under 11 years and 6% of young people aged 11–17 years had 1 or more experiences of physical, sexual, or emotional abuse, or neglect by a parent or caregiver in the past year, and 8.9% of children under 11 years, 21.9% of young people aged 11–17 years, and 24.5% of young adults had experienced this at least once during childhood. High rates of sexual victimization were also found; 7.2% of females aged 11–17 and 18.6% of females aged 18–24 reported childhood experiences of sexual victimization by any adult or peer that involved physical contact (from sexual touching to rape). Victimization experiences accumulated with age and overlapped. Children who experienced maltreatment from a parent or caregiver were more likely than those not maltreated to be exposed to other forms of victimization, to experience non-victimization adversity, a high level of polyvictimization, and to have higher levels of trauma symptoms.

Conclusions

The past year maltreatment rates for children under age 18 were 7–17 times greater than official rates of substantiated child maltreatment in the UK. Professionals working with children and young people in all settings should be alert to the overlapping and age-related differences in experiences of childhood victimization to better identify child maltreatment and prevent the accumulative impact of different victimizations upon children's mental health.     

Resilience and psychopathology among victimized youth in residential care

This study examines the role of several resilience resources in the relationship between lifetime victimization and mental health problems among adolescents in care. The sample comprised 127 adolescents (53.% females, aged 12–17 years) from residential care facilities in Catalonia, Spain. The Juvenile Victimization Questionnaire, the Youth Self-Report, and the Adolescent Resilience Questionnaire were used to assess victimization, psychological symptoms, and resilience respectively. Results indicated that poly-victimization was associated with fewer resources, and with an increased risk of mental health problems. Self-resources mediated the relationship between victimization and internalizing and externalizing symptoms; community support mediated the relationship between victimization and internalizing symptoms. Self, school and peer support moderated the relationship between victimization and externalizing symptoms. Adolescents with fewer self-resources and less school support reported more externalizing symptoms, as did those with more peer support. However, poly-victimized youths reported symptoms within the clinical range, regardless of their level of resources. The findings stress the importance of preventing poly-victimization and of empowering poly-victimized adolescents, who appear to present low levels of resources. Researchers and clinicians should continue to study the poly-victimization/psychopathology relationship, and also design interventions and prevention programs which incorporate the most relevant resilience resources.     

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.     

Association of child maltreatment and depressive symptoms among Puerto Rican youth

This article compares multiple types of child maltreatment among Puerto Rican youth. We seek to expand the limited knowledge of the effects of multiple types of maltreatment on depressive symptoms in a specific Latino population as emerging studies indicate that children who are exposed to one type of maltreatment are often exposed to other types. This study examines the predictive strength of different and multiple types of lifetime child maltreatment (i.e., physical, sexual, and emotional abuse; and neglect), and the effect of youth support from parents, youth coping, youth self-esteem, and place of residence on depressive symptoms among Puerto Rican youth. Secondary data analyses were performed using three annual waves (2000–2004) of data from the Boricua Youth Study. The analytic sample consists of 1041 10–13 year old Puerto Rican youth living in New York and Puerto Rico. Results indicate that: (1) youth who experienced ‘sexual abuse only’, ‘multiple maltreatment’ (2 or more types of maltreatment), ‘physical abuse only’ have a significant increase in depressive symptoms (75.1%, 61.6%, and 40.5% respectively) compared to those without maltreatment; and (2) place of residence, exposure to violence, and mental disorders were significant risk factors. When developing psychosocial interventions, professionals should particularly focus on youth who report past lifetime experience with child maltreatment. Particular attention should be given to children living in the Bronx, New York and similar urban low-income areas who report past lifetime experience with multiple types of child maltreatment and who present symptoms or a diagnosis of co-occurring mental health problems.     

Early life adversities and polyvictimization in young persons with sexual behavior problems: A longitudinal study of child protective service referrals

There is scarce research on children and youth with sexual behavior problems (SBP) and their developmental antecedents and the research that does exist is mostly retrospective and correlational. While prior research focused on the central role of sexual victimization, recent research suggests that young persons with SBP are exposed to a series of adversities not limited to child sexual victimization and require multifaceted assessment and intervention using a developmental life course perspective. The current study includes an examination of the complete longitudinal sequence of child protective service (CPS) investigations involving young persons with SBP. The study is based on a sample of 957 youth referred to the CPS in Quebec, Canada. The data include their longitudinal sequence of referrals from birth to age 18. Semi-parametric analyses identified four trajectories of referrals with significant differences in terms of onset, frequency, types of life adversity, and polyvictimization. The trajectories suggest that a range of developmental profiles characterize young persons with SBP, with SBP often occurring after CPS contacts for compromising issues other than sexual victimization, especially parental neglect and serious behavior problems. Of importance, polyvictimization was relatively common for this group throughout childhood and adolescence, which highlights the multiintervention needs of this population.     

Effects of the child–perpetrator relationship on mental health outcomes of child abuse: It's (not) all relative

The present study was conducted to better understand the influence of the child–perpetrator relationship on responses to child sexual and physical trauma for a relatively large, ethnically diverse sample of children and youth presenting for clinical evaluation and treatment at child mental health centers across the United States. This referred sample includes 2,133 youth with sexual or physical trauma as their primary treatment focus. Analyses were conducted to ascertain whether outcomes were dependent on the perpetrator's status as a caregiver vs. non-caregiver. Outcome measures included psychiatric symptom and behavior problem rating scales. For sexual trauma, victimization by a non-caregiver was associated with higher posttraumatic stress, internalizing and externalizing behavior problems, depression, and dissociation compared to youth victimized by a caregiver. For physical trauma, victimization by a non-caregiver was also associated with higher posttraumatic symptoms and internalizing behavior problems. The total number of trauma types experienced and age of physical or sexual trauma onset also predicted several outcomes for both groups, although in disparate ways. These findings are consistent with other recent studies demonstrating that perpetration of abuse by caregivers results in fewer symptoms and problems than abuse perpetrated by a non-caregiving relative. Thus, clinicians should not make a priori assumptions that children and adolescents who are traumatized by a parent/caregiver would have more severe symptoms than youth who are traumatized by a non-caregiver. Further exploration of the role of the perpetrator and other trauma characteristics associated with the perpetrator role is needed to advance our understanding of these findings and their implications for clinical practice.     

Sibling and peer victimization in childhood and adolescence

This study examined how victimizations by either a sibling or peer are linked to each other and to mental health in childhood and adolescence. The data were from the National Survey of Children's Exposure to Violence which includes a sample of children aged 3–9 (N = 1,536) and adolescents aged 10–17 (N = 1,523) gathered through telephone interviews. An adult caregiver (usually a parent) provided the information for children while self-reports were employed for adolescents. Fifteen percent of each age group reported victimization by both a sibling and peer. Victimization by a sibling alone was more common in childhood than adolescence. Victimization by a sibling was predictive of peer victimization. Children and adolescents victimized by both a sibling and peer reported the greatest mental distress. This work establishes that for some children and adolescents, victimization at the hands of other juveniles happens both at home and school. Programs should consider the role of siblings and target parents and siblings to encourage the development and maintenance of constructive sibling interactions.     

Ecological momentary assessment of contextual variables,satisfaction, and emotional and behavioral states of adolescents by level of victimization

The harmful effects of victimization on mental health have been demonstrated in several age groups, cultures, and populations, but there is wide variability in the resulting psychopathology. Ecological momentary assessment (EMA) allows the expression of an emotional state to be recorded at any given time and linked to a situation or context.This study aimed to analyze the contextual variables (where, with whom, and what), momentary satisfaction, and perception of momentary emotional and behavioral symptoms in a cohort of adolescents by the level of victimization, using EMA. We explored the everyday symptom profiles and the contexts in which events took place among 100 adolescents over a one-week period. Sociodemographic data were collected and assessment was done using the EMA (as a smartphone application) and the Juvenile Victimization Questionnaire (to assess childhood and adolescent victimization). In this study, regarding contextual variables, the group with the highest level of victimization (top 10%) showed a significant relationship with being away from home and being with friends other than classmates, and not being with parents or relatives. There was also an unexpectedly higher frequency of sporting engagement in this group. A relationship existed between emotional and behavioral problems and higher levels of victimization. In conclusion, the different groups of victimized subjects present a relatively high level of satisfaction in relation to the daily contexts and show low levels of emotional and behavioral symptomatology.     

The association between childhood maltreatment experiences and the onset of maltreatment perpetration in young adulthood controlling for proximal and distal risk factors

The evidence for association between child maltreatment victimization and later maltreatment perpetration is both scant and mixed. The objective of the present study was to assess the association between childhood maltreatment experiences and later perpetration of maltreatment in young adulthood controlling for proximal young adult functioning, prior youth risk behaviors, and childhood poverty. The study included 6,935 low-income children with (n = 4,470) or without (n = 2,465) maltreatment reports prior to age 18 followed from ages 1.5 through 11 years through early adulthood (ages 18–26). Administrative data from multiple regional and statewide agencies captured reports of maltreatment, family poverty and characteristics, system contact for health, behavioral risks and mental health in adolescence, and concurrent adult functioning (crime, mental health and poverty). After controlling for proximal adult functioning, repeated instances of neglect or mixed type maltreatment remained associated with young adult perpetration. Females and subjects with adolescent history of runaway, violent behaviors or non-violent delinquency also had higher risk. Greater caregiver education remained associated with reduced risk. The study concludes that prevention of recurrent neglect and mixed forms of maltreatment may reduce risk of maltreatment for future generations. Intervening to increase parental education and decrease adolescent risk behaviors may offer additional benefit.     

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.     

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.     

Childhood adversity and behavioral health outcomes for youth: An investigation using state administrative data

This study aimed to measure the relative contribution of adverse experiences to adolescent behavioral health problems using administrative data. Specifically, we sought to understand the predictive value of adverse experiences on the presence of mental health and substance abuse problems for youth receiving publicly funded social and health services. Medicaid claims and other service records were analyzed for 125,123 youth age 12–17 and their biological parents. Measures from administrative records reflected presence of parental domestic violence, mental illness, substance abuse, criminal justice involvement, child abuse and/or neglect, homelessness, and death of a biological parent. Mental health and substance abuse status of adolescents were analyzed as functions of adverse experiences and other youth characteristics using logistic regression. In multivariate analyses, all predictors except parental domestic violence were statistically significant for substance abuse; parental death, parental mental illness, child abuse or neglect and homelessness were statistically significant for mental illness. Odds ratios for child abuse/neglect were particularly high in both models. The ability to identify risks during childhood using administrative data suggests the potential to target prevention and early intervention efforts for children with specific family risk factors who are at increased risk for developing behavioral health problems during adolescence. This study illustrates the utility of administrative data in understanding adverse experiences on children and the advantages and disadvantages of this approach.     

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.     

The child protection and juvenile justice nexus in Australia: A longitudinal examination of the relationship between maltreatment and offending

There is convincing evidence that many young people who are in the justice system have had contact with child protection services and that victims of childhood maltreatment are at increased risk of subsequent youth justice involvement. In Australia, however, there have been few longitudinal studies that have examined these associations and relatively less is known in this area. This study examines the overlap between the child protection and youth justice involvement in South Australia, and determines how substantiated maltreatment and variations in these experiences (e.g., the type, timing and recurrence of maltreatment) relate to criminal convictions as a youth. The results show that although the majority of child-protection involved youth do not become convicted offenders, the odds of subsequent convictions are significantly greater both for those with notifications and substantiated maltreatment and for those who had been placed in out-of-home care. Multivariate analyses revealed that the strongest predictors for receiving a conviction among maltreated youth were: male gender, Aboriginal and Torres Strait Islander ethnicity, experiences of physical abuse and emotional abuse, a greater number of substantiations (recurrence), experiencing maltreatment that commenced in childhood and continued into adolescence, and placement in out-of-home care. The mechanisms through which maltreatment might be linked with behavior are then considered, along with directions for future research in this area.     

Re-victimization patterns in a national longitudinal sample of children and youth

OBJECTIVE: To understand to the degree to which a broad variety of victimizations, including child maltreatment, conventional crime, peer, and sexual victimizations, persist for children from 1 year to the next. DESIGN: A national sample of 1467 children aged 2-17 recruited through random digit dialing and assessed via telephone interviews (with caretakers and youth themselves) about a comprehensive range of victimization experiences in the previous year, and then re-assessed (72.3% of baseline sample) after a 1-year interval. RESULTS: The risk for re-victimization in Year 2 was high for children victimized in Year 1, with risk ratios ranging from 2.2 for physical assault to 6.9 for sexual victimization. Victimization of any one type left substantial vulnerability even for different types of subsequent re-victimization (e.g., property crime victimization was associated with higher risk of sexual victimization the next year). Children with four or more types of victimization in Year 1 ("poly-victims") were at particularly high risk of persisting poly-victimization. Persisting poly-victimization was more likely for children who scored high on anger/aggression and who had recent life adversities. Desistence from poly-victimization was associated with having more good friends. Onset of poly-victimization in Year 2, in contrast to persistence from Year 1, was associated with violent or maltreating families, family problems such as alcohol abuse, imprisonment, unemployment and family disruption. Having more older siblings acted as both a risk factor and a protective factor for different groups of youth. CONCLUSION: Children previously victimized in 1 year are at higher risk of continued victimization, and the poly-victims are at particular risk. These findings suggest the potential merit of identifying these high-risk children and making them priority targets for prevention efforts.     

Patterns of childhood maltreatment and intimate partner violence,emotion dysregulation,and mental health symptoms among lesbian,gay, and bisexual emerging adults: A three-step latent class approach

BackgroundChildhood abuse and neglect (CAN) and intimate partner violence victimization (IPV) is prevalent among lesbian, gay, and bisexual individuals (LGB). Identification of distinct patterns of childhood and adult victimization, including technology-mediated and face-to-face IPV, and their cumulative relations to mental/behavioral health challenges, among LGB people is needed to facilitate identification of at-risk individuals.ObjectiveUsing latent class analysis, we first sought to identify patterns of lifetime interpersonal victimization, primarily five types of CAN and IPV in LGB emerging adults. Second, we examined if LGB-status and race/ethnicity predicted class-membership; third, we assessed differences between the latent classes on emotion dysregulation, depressive and anxiety symptoms, and alcohol use.ParticipantsParticipants were 288 LGB adults between 18–29 years (M = 25.35, SD = 2.76; 41.7% gay/lesbian) recruited via Amazon MTurk.Methods and resultsThe 3-step LCA identified five-latent classes: high victimization, childhood emotional abuse and neglect, cybervictimization, adult face-to-face IPV, and lower victimization. People of color (including Hispanics) were more likely to be in the high victimization class, and bisexual individuals, especially bisexual women, in the childhood emotional abuse and neglect class. High victimization and childhood emotional abuse and neglect classes had elevated emotion dysregulation levels and depression and anxiety symptoms, and the high victimization class reported the highest levels of alcohol use.ConclusionFindings suggest a detrimental effect of cumulative interpersonal victimization on emotion dysregulation and the mental/behavioral health of LGB emerging adults, with bisexuals and LGB-people of color at heightened risk of cumulative victimization and of related mental/behavioral health challenges.     

The relation between dimensions of maltreatment,placement instability,and mental health among youth in foster care

Youth in foster care with maltreatment experiences often demonstrate higher rates of mental and behavioral health problems compared to youth in the general population as well as maltreated youth who remain at home. Previous research has demonstrated that dimensions of maltreatment (type, frequency, and severity) and placement instability are two prominent factors that account for high rates of psychopathology (e.g., depression, anxiety, and disruptive behavior disorders). The present study sought to clarify the relation between maltreatment and mental health among youth in foster care by studying both the isolated dimensions of maltreatment and cumulative maltreatment, and to determine whether the effects of maltreatment on mental health operated indirectly through placement instability. Information on youth in foster care’s (N = 496, M_age = 13.14) mental and behavioral health, maltreatment history, and placement changes were obtained from state records and primary caregivers. Using a SEM framework, the results suggest that maltreatment and placement instability each independently relate to mental and behavioral health problems. Further, none of the maltreatment types predicted greater placement instability in the current models. These findings suggest that placement stability is critical for mental health for youth in foster care, regardless of the type, severity, or frequency of their maltreatment experiences. Results also indicated that, although cumulative maltreatment predicted both internalizing and externalizing symptoms, maltreatment frequency and severity had direct relations to externalizing symptoms only. These findings underscore the utility of comprehensive maltreatment assessment, encouraging researchers and clinicians to assess and carefully consider the relation between maltreatment dimensions and outcomes.     

Exploratory two-level analysis of individual- and school-level factors on truant youth emotional/psychological functioning

Research on samples of truant adolescents is limited, with little known about mental health problems among truant youths. This study provided an exploratory, multilevel examination of mental health problems for a sample of 300 truant adolescents. Confirmatory factor analysis indicated a single factor of multiple mental health problems at the individual level, but the structure of these problems was not the same at the school level. A number of covariate effects were found at the individual level on the mental health factor. Further, youths attending middle school were more likely to report attention deficit hyperactivity disorder (ADHD) problems than those in high school. Service and practice implications of better understanding school and mental health issues of truant youth are discussed.