Abstract Children who have exposure to child sexual abuse (CSA) are at particular risk for developing substance abuse in adolescence, but the extent to which CSA may shape patterns of adolescent ...substance use remains uncertain. The aim of this paper is to characterize the variations in patterns of adolescent substance use and to examine the association between CSA and qualitatively distinct patterns of adolescent substance use. Latent class analyses identified homogenous groups of adolescents with similar patterns of substance use using a sample of 1019 adolescents (mean age: 15.9 years; range: 13–18) who were selected from five publicly funded service systems. Different patterns of latent class structures were identified in boys and girls (a 4-class solution for girls and a 3-class solution for boys). CSA was associated with an increased risk of being a heavy polysubstance user in girls, even after adjustment of age, race/ethnicity, parental substance use, sibling use, peer use, psychopathology and other forms of childhood maltreatment including physical abuse and neglect. Findings indicate that female victims of CSA who are involved with public service systems are at high risk for developing multiple-substance use in adolescence.
Each year, numerous children testify in the United States in either criminal, civil, or juvenile court cases. Typically, children who testify are alleged victims of sexual or physical abuse or ...neglect, witnesses to violent crime, or subjects in custodial hearings in civil court. As more maltreatment cases are prosecuted and child custody is contested, an increasing number of children are being called as witnesses in court. Many of these children have already been traumatized by the experiences that led to their need to testify, and participation in the court process can have additional negative effects. This article describes the development and recent formative evaluation of a court preparation program that provides psychoeducation and utilizes components of evidence‐based trauma treatment approaches, such as relaxation and in vivo exposure, to support child witnesses and reduce the risk of retraumatization. Children and adolescents participating in the program attend group sessions conducted by mental health clinicians and complete a court‐related anxiety measure before and after each session. Results from 175 participants are reported. Findings indicated significant decreases in court‐related anxiety with large program effects. Challenges encountered by the program and future directions are discussed.
The title for this Special Section is APPLIED AND TRANSLATIONAL RESEARCH ON TRAUMA‐RESPONSIVE PROGRAMS AND POLICY edited by Todd Herrenkohl, Joshua Mersky, James Topitzes, Nicole Allen
Highlights
Children's testimony is often necessary for the successful prosecution and resolution of criminal, civil, or juvenile court cases.
We describe the development and evaluation of a trauma‐informed, comprehensive model for court preparation and education.
The program incorporates trauma‐focused treatment aspects into the court preparation process and provides court‐related psychoeducation to children and their caregivers.
Results indicated significant decreases in children's court‐related anxiety with large program effects.
The perinatal period provides unique opportunities to identify and intervene with the co-occurrence of perinatal depression, intimate partner violence (IPV), and substance use problems. Psychosocial ...screening recommended for women seen in maternal child health settings tends to target single rather than multiple risk factors; there is limited research examining the co-occurrence of these issues especially in racially and ethnically diverse women across the perinatal period. These analyses explore the relationships of sociodemographic, psychosocial, and behavioral characteristics in a large, diverse sample of women.
Women receiving perinatal services at routinely scheduled visits, including the 6-week postpartum visit, were recruited from 10 community obstetric/gynecologic clinics. Data were collected on perinatal depression, IPV, maternal substance use, and sociodemographic characteristics by bilingual, bicultural research assistants.
A total of 1868 women were screened, 1526 (82%) Latina, 1099 (58.8%) interviewed in Spanish; 20.4% (n=382) screened positive for depressive symptoms based on an Edinburgh Postnatal Depression Scale score of 10 or above, 20.9% reported harmful drinking, 4.3% reported drug use, 23% reported substance use problems, and 3.5% reported current or recent IPV. Women who were Black, Asian, Pacific Islander, or other race/ethnicity had greater odds for depressive symptoms relative to women who were Hispanic or Latino (odds ratio OR=1.81, p=0.005). Women reporting substance use problems (OR=2.37, p<0.0001) and IPV (OR=3.98, p<0.0001) had higher odds for depressive symptoms.
In a predominately Latina sample, 1 in 5 mothers (20.4%) screened positive for depressive symptoms and over one third (36.7%) reported one or more psychosocial issues during the perinatal period. Screening for multiple risk factors rather than just one can help clinicians tailor interventions for the successful management of psychosocial issues.
Objective To examine differences in caregiver and youth reported mental health symptoms for youth initiating mental health treatment through phases of the Coronavirus Disease (COVID-19) pandemic, ...compared with symptomology reported the prior year. Study design This retrospective study analyzes group differences in mental health symptoms (Pediatric Symptom Checklist; PSC-35) based on 7874 youth seeking treatment in publicly funded mental health treatment programs during California's Stay-At-Home order (March-May, 2020) and the prolonged pandemic (May-December, 2020) phases of the COVID-19 pandemic as compared with matching groups in 2019. Results Youth entering mental health treatment services, and their caregivers, reported significantly increased internalizing, externalizing, and attention-related symptoms during the prolonged pandemic phase, but not during the acute stay-at-home phase of the COVID-19 pandemic, and with small effect sizes. Group comparison analyses did not detect a significantly larger effect for Sexual and Gender Diverse (SGD) youth who identify as lesbian, gay, bisexual, asexual, transgender, Two-Spirit, queer, and/or intersex, and Black, Indigenous, People of Color (BIPOC). Conclusions A large-scale comparison of youth mental health symptoms before and during the COVID-19 pandemic suggests that mental health was disrupted for youth seeking treatment as the pandemic prolonged throughout 2020.
This study examined experiences with intimate partner violence in 292 Latina women classified as U.S. born, immigrant, or migrant-seasonal workers. High lifetime rates of violence were found, with ...33.9% reporting physical violence, 20.9% reporting sexual coercion, and 82.5% reporting psychological aggression. Rates of violence in the preceding year were also high, with 18.5% experiencing physical violence, 14.4% experiencing sexual coercion, and 72.6% experiencing psychological aggression. Participants' marital status and partners' substance use were associated with victimization. The present findings suggest the need for screening for intimate partner violence and associated risk factors in settings that serve Latina women.
A commonly emphasized component of trauma-informed care is the practice of building cross-system collaboration (CSC). While existing research on CSC states numerous benefits and barriers associated ...with increasing collaboration between systems, there is limited empirical understanding on how to define and measure collaboration between county systems of care. The current study presents the psychometric evaluation of scores from the Perceptions of Overarching Cross-System Collaboration-Child Welfare and Behavioral Health Systems (POCSC-CW/BH), a 6-item self-report instrument completed by system administrative leadership and direct service providers, administered within child welfare and children's behavioral health systems in 6 California counties. Psychometric analysis demonstrated good support of internal consistency, as well as the factorial, convergent, and discriminant validity of scores produced by the tool. There was also evidence for content validity. System-level analyses showed within-county child welfare, and children's behavioral health system staff reported similar perceptions of CSC in 5 of 6 counties, whereas POCSC-CW/BH scores across counties showed variability. Exploratory results revealed CSC scores varied by staff role in each system. In general, the POCSC-CW/BH is a promising instrument that adds to a limited array of practical empirically supported measurement tools for measuring CSC between child welfare and children's behavior health systems. The study limitations and implications for CSC measurement and trauma-informed practice are discussed.
OBJECTIVE: Full and partial posttraumatic stress disorder (PTSD)
following trauma exposure were examined in a community sample in order to
determine their prevalence and their relative importance and ...functional
significance. METHOD: A standardized telephone interview with a series of
trauma probes and a DSM-IV PTSD checklist was administered to a random
sample of 1,002 persons in a midsized Midwestern Canadian city. The authors
determined current (i.e., 1- months) prevalence rates of full PTSD, i.e.,
all DSM-IV criteria, and partial PTSD, i.e., fewer than the required number
of DSM-IV criterion C symptoms (avoidance/numbing) or criterion D symptoms
(increased arousal). Additional questions about interference with
functioning were also posed. RESULTS: The estimated prevalence of full PTSD
was 2.7% for women and 1.2% for men. The prevalence of partial PTSD was
3.4% for women and 0.3% for men. Interference with work or school was
significantly more pronounced in persons with full PTSD than in those with
only partial symptoms, although the latter were significantly more
occupationally impaired than traumatized persons without PTSD. CONCLUSIONS:
These findings in an epidemiologic sample underscore observations from
patient and military groups that many traumatized persons suffer from a
subsyndromal form of PTSD. These persons with partial PTSD, although
somewhat less impaired than persons with the full syndrome, nonetheless
exhibit clinically meaningful levels of functional impairment in
association with their symptoms. This subthreshold form of PTSD may be
especially prevalent in women. Additional study of partial PTSD is
warranted.
Objective: The purpose of this study was to determine the prevalence and correlates of intimate partner violence among female caregivers of children reported to child protective services.
Method: ...Data were derived from the National Survey of Child and Adolescent Well-Being, a national probability study of children investigated for child abuse and neglect in the United States. Caregivers were interviewed about demographic characteristics, mental health, substance use, and physical violence by a partner.
Results: The lifetime and past year prevalence of intimate partner violence was 44.8 and 29.0%, respectively. Caregiver major depression and history of prior reports of child maltreatment were strongly associated with violence against women.
Conclusions: The findings highlight the need for effective screening and identification of intimate partner violence in families in which child maltreatment has occurred.
Objectif: Le but de cette étude fut de connaı̂tre la prévalence et les facteurs relatifs à la violence entre conjoints qui seraient reliés, dans une population de femmes dont les enfants à leur charge ont été rapportés aux autorités de la protection de l’enfance.
Méthode: Les données ont été puisées dans une enquête nationale sur le bien-être des enfants et des adolescents, laquelle est une étude sur la probabilité que des enfants feront l’objet d’une enquête pour cause de mauvais traitements et de négligence aux États Unis. Des personnes ayant des enfants à leur charge ont été interviewées pour obtenir des renseignements sur leurs caractéristiques démographiques, leur santé mentale, leur usage de drogues ou d’alcool et la violence par leur conjoint.
Résultats: La prévalence de la violence durant leur vie entière et durant l’année précédente fut respectivement de 44,8 pour cent et de 29 pour cent. La dépression et des incidents de mauvais traitements dans le passé sont des facteurs associés à la violence contre les femmes.
Conclusions: Les constats soulignent le besoin de bien déceler la violence entre conjoints dans des familles où il existe une incidence de mauvais traitements envers les enfants.
Objetivo: Determinar la prevalencia y los correlatos de la violencia de pareja entre mujeres con hijos/as que han sido notificados a los Servicios de Protección Infantil.
Método: Los datos fueron obtenidos a partir de una Encuesta Nacional sobre el Bienestar de Niños y Adolescentes que constituye un estudio de probabilidad nacional sobre casos de niños/as sobre los que se ha llevado a cabo un estudio sobre la existencia de una situación de maltrato o abandono. Las cuidadoras fueron entrevistadas sobre caracterı́sticas demográficas, salud mental, uso de sustancias tóxicas y violencia fı́sica por parte de la pareja.
Resultados: La prevalencia de la violencia de pareja en el pasado año y a lo largo de la vida fue, respectivamente, del 44.8% y del 29.0%. La violencia sufrida por las mujeres estaba fuertemente asociada con una situación de depresión mayor y con una historia previa de notificaciones de maltrato infantil.
Conclusiones: Los hallazgos subrayan la necesidad de una evaluación efectiva y de una identificación de situaciones de violencia de pareja en familias en las que se dan situaciones de maltrato infantil.
The purpose of this article is to identify profiles of maltreatment experiences in a sample of high-risk adolescents and to investigate the relationship between the derived profiles and psychological ...adjustment. Participants are 1,131 youth between the ages of 12 and 18 years involved with publicly funded mental health and social services. Information on physical, sexual, and emotional maltreatment and psychological symptoms are obtained in interviews with adolescents and their primary caregivers. Using latent profile analysis, three maltreatment profiles are identified: “sexual + physical + emotional maltreatment,” “physical + emotional maltreatment,” and “low maltreatment.” Adolescents in the two maltreatment profiles generally have significantly higher scores on symptom scales compared with those in the “low maltreatment” profile, but scores in the two maltreatment profiles do not differ. Findings highlight the need for agencies to identify and provide appropriate intervention for youth who experience multiple types of maltreatment.
We examined the relationship between women's experiences with intimate partner violence and their reports of child behavior problems.
Data were from the National Survey of Child and Adolescent ...Well-Being, a national probability study of children who were the subjects of child abuse and neglect investigations. The sample consisted of 2020 female caregivers of children between the ages of 4 and 14 years who were interviewed about demographic characteristics, child behavior problems, female caregiver mental health, parenting behaviors, experiences with intimate partner violence, and community characteristics. Information on child abuse and neglect was obtained in interviews with child protective services workers. Multiple-regression analyses were used to investigate the association between caregiver victimization and child behavior problems while controlling for the effects of child, family, and environmental characteristics. The potential moderating effects of caregiver depression and parenting practices on the relation between intimate partner violence and child behavior problems were examined also.
Severe intimate partner violence was associated with both externalizing and internalizing behavior problems when other risk factors were controlled. Use of corporal punishment and psychological aggression were significant moderators, but maternal depression did not moderate the relation between intimate partner violence and behavior problems.
This study adds to the evidence that maternal caregivers' experiences with intimate partner violence are related to child functioning. The findings suggest that systematic efforts are needed to ensure that mental health needs are identified and addressed appropriately in children exposed to this violence.
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