Trauma and Adolescents Who Engage in Sexually Abusive Behavior: A Review of the Literature

ABSTRACT

While recent research has established the abuse and victimization histories of youth who engage in sexually abusive behavior, there is still debate regarding the significance of trauma and abuse as developmental antecedents to sexual offending in adolescence. Moreover, research has not conclusively identified the types, context, and timing of adverse experiences that act as catalysts for subsequent sexual perpetration. The present comprehensive literature review has one primary aim: Explore the adverse childhood experiences of youth who engage in sexually abusive behavior, considering whether trauma may be a consistent developmental antecedent to offending. Search method, inclusion criteria, and screening protocol are described, and the articles included in the review (N = 13) are qualitatively analyzed using thematic coding. Findings indicate that traumatic experiences and symptoms may be of developmental and etiological significance for subsequent sexually abusive behavior in adolescence. Implications for research, treatment, and policy are discussed, with the hope the findings will act as impetus to develop and deliver targeted treatment and prevention programs to sexually abusive youth who have histories of victimization.     

Racial/ethnic disparities in prior mental health service use among incarcerated adolescents

Research on racial and ethnic disparities in mental health and substance abuse service use among incarcerated youth in the U.S. is inconclusive. This cross-sectional study adds to our understanding of racial and ethnic disparities by examining the prior use of mental health and substance abuse services among incarcerated juveniles. Guided by Andersen's behavioral model of health service utilization, a series of logistic regression analyses were conducted on a non-probability sample of 13–19 year-old youth in two residential facilities for juvenile offenders in Western Pennsylvania (N = 181). Black and Hispanic youth were less likely than White youth to have used mental health and substance abuse services, even when controlling for predisposing, enabling, and need factors. Additional analyses revealed that these differences did not hold across all service types, specifically with regards to outpatient service use. Significant differences did exist, however, in the prior use of inpatient mental health and substance abuse services. This suggests that White youth are often funneled into the mental health system, while youth of color enter the justice system. Implications for racial/ethnic disproportionality in service use and justice system involvement are discussed.     

Peer contagion among youth in Medicaid-funded residential mental health treatment programs

This paper examined juvenile justice encounters among youth with mental health needs who received care in residential treatment settings. The focus is on peer effects, and whether delinquent peers negatively affected youth. Matched data from Florida Medicaid and Juvenile Justice were used to examine the association between peer delinquency in a residential treatment setting and juvenile justice encounters during and after the treatment episode. Fifteen percent of youth had justice encounters during residential out-of-home treatment, while the rate was lower in the six months after (23.0%) treatment than the six months before (33%). Support for peer contagion was found as youth treated in Medicaid-funded residential mental health treatment programs were more likely to have JJ encounters when the other youth in the facility had histories of delinquency.     

Parents' perceptions of juvenile probation: Relationship and interaction with juvenile probation officers,parent strategies,and youth's compliance on probation

In the past several years, there has been a growing movement toward family-driven initiatives in many child-serving agencies, including the juvenile justice system. These initiatives underscore the importance of parental involvement in successful rehabilitation of at-risk and offending youth and highlight the unique role of parents to influence and inspire their child's behavior. Despite a growing consensus on the importance of parental involvement in juvenile justice processes, little empirical research has explored the nature of parental involvement in the juvenile justice system. This study examined parents' (n = 87) perceptions of relationship quality and interaction with probation officers, parenting strategies, and how these factors related to youth's compliance on probation. Findings revealed that parents generally had positive relationships with probation officers characterized as supportive, fair, respectful, and helpful toward youth. Most parents also employed practices such as use of reminders and encouragement to promote youth's compliance on probation. Parents' perceptions of probation officers' helpfulness toward youth were associated with decreased used of parenting practices that encourage probation compliance. However, parents' perceptions of supportive, respectful, and fair relationships with probation officers were associated with increased use of parenting practices that promote probation compliance. Supportive, fair, and respectful relationships with probation officers were also linked to fewer counts of technical violations of probation, but not new delinquent offenses, among offending youth. Implications for research, practice, and policy around the potential of collaborative relationships between parents and probation officers in facilitating successful probation outcomes are discussed.     

Factors Associated with Drug Treatment Entry Patterns Among Hispanic Women Injection Drug Users Seeking Treatment

SUMMARY

This paper examines patterns of drug treatment entry and factors that are associated with these patterns among 1,849 Hispanic women injection drug users (IDUs). The data analyzed originates from a statewide drug-treatment database covering seven years, 1996–2002. Through the use of logistic regression analyses, the study identified significant differences in predisposing, need and enabling factors in the use of detoxification only, residential treatment, or methadone maintenance. Compared to other Hispanics, Puerto Rican women were 40 percent less likely to use only detoxification services and one and a half times more likely to use methadone maintenance. Having health insurance was an especially important factor associated with methadone treatment utilization. Two of the most important factors associated with residential treatment use were history of mental health services utilization and involvement with the criminal justice system. This article discusses specific social work practice implications including the need for social work practitioners to promote services such as residential treatment, to be trained in treatment of co-occurring mental health disorders, especially among women in residential treatment, and the need to establish close linkages with the mental health and criminal justice systems.     

Crossover Children: Examining Initial Criminal Justice System Contact Among Child Protection-Involved Youth

ABSTRACT

Child protection-involved youth face increased risk of criminal justice system contact. Such “crossover children” experience earlier police involvement and more serious criminal justice sanctions, yet little is known about their early offending. Using a cross-sectional sample of 300 crossover children before three Victorian Children's Courts in 2016–17, this mixed-methods study examines the nature and context of children's initial police charges. Findings indicate that crossover children are initially charged with disproportionately violent offending, and often incur first police charges around the time of initial care placement. For many, initial criminal justice contact occurred in the context of conflict with caregivers, ongoing maltreatment, and household adversity, or emotional and behavioural regulation challenges. Efforts towards preventing offending for child-protection-involved youth should focus on preventing childhood maltreatment, alongside targeting parent–child relationship challenges, and strengthening community and care system responses that address the impacts of complex trauma, mental health problems, and neurodisability.

IMPLICATIONS

• Compared to all sentenced children, those from statutory child protection backgrounds are charged with more serious offending at their first criminal court adjudication.

• Among “crossover children”, earlier police charges were seen for Indigenous children, those experiencing greater cumulative maltreatment, and children with emotional or behavioural challenges related to trauma, mental health, and neurodisability.

• Crossover children are most often first charged by police in the year before, and after, their first out-of-home care placement.

     

Behavioral health correlates of exposure to community violence among African-American adolescents in Chicago

AimsThough public health researchers are more aware of behavioral health concerns among African American youth, few studies have explored how exposure to community violence may be related to adverse youth concerns. This study examines the relationship between exposure to community violence and mental health problems, substance use, school engagement, juvenile justice involvement, and STI risk behaviors.MethodsA total of 638 African American adolescents living in predominantly low-income, urban communities participated in the study by completing self-report measures on exposure to community violence, mental health, school engagement proxies, substance use, delinquency markers and sexual risk behaviors.ResultsAdolescents who reported higher rates of exposure to community violence were significantly more likely to report poorer mental health, delinquent behaviors, a history of juvenile justice involvement, lower school bonding and student-teacher connectedness. These youth were also significantly more likely to use alcohol, cigarettes, and illicit substances, and engage in sexual risk behaviors.ConclusionsFindings suggest that there is a critical need for culturally relevant prevention and intervention efforts for African American adolescents who are frequently exposed to community violence.     

Placement type matters: Placement experiences in relation to justice system involvement among child welfare-involved youth and young adults

Out-of-home placement in the child welfare system is related to justice system involvement. Yet, few studies address the similarities and differences of child welfare placement types in relation to justice system involvement within the same sample of youth, which can provide a more nuanced understanding of the relationship between the two. Utilizing a sample of child welfare youth with substantial out-of-home placements (N = 794), we investigate trajectory group experiences on each of three child welfare placement types, and cross-tabulate each with justice system trajectory groups to examine subgroups. The five-group model fits best for foster homes and group homes; four groups for residential facilities. Relationships between justice system groups and placement types were significant. Youth with chronic justice system involvement had more experiences in group homes and residential facilities; youth with less justice system contact tended to have foster home experiences. Implications for policy and practice are presented.     

An Evaluation of Mechanisms of Change in Multisystemic Therapy for Juvenile Justice‐Involved Youths A Decade Following Treatment

Although researchers have identified the more immediate mechanisms of change in family‐based treatments for juvenile justice‐involved youths, it is not known whether these same mechanisms continue to prevent criminal offending into adulthood. The present study evaluated whether caregiver‐directed improvements in family relations, youth prosocial peer relations, and youth academic performance during multisystemic therapy (MST) for serious and violent juvenile offenders had an impact on young adult involvement in criminal activity and sentencing 10.2 years following treatment. The results showed that improvements in family relations were associated with reduced odds of criminal outcomes a decade later for former MST participants. Furthermore, improvements in youth prosocial peer relations and academic performance were also related to lower odds of long‐term criminal activity. These results are consistent with the underlying theory of change in family‐based treatments and demonstrate that caregivers are critical to achieving and sustaining decreased antisocial behavior for youths with serious and violent criminal histories.     

Personal Trauma and Risk Behaviors Among Youth Entering Residential Treatment

The focus of this study was to determine the prevalence and types of traumas experienced by adolescents prior to admission to long term mental health residential care and the impact of these traumas on their risk behaviors. The research was conducted at a state-supported residential mental health treatment facility functioning under the authority of the Department of State Health Services. Client level data was extracted from social assessment forms (N = 457) in case records of clients. Results confirmed that exposure to trauma was pervasive among adolescents admitted to the facility. Findings also revealed a link between trauma and risk behaviors among youth entering residential treatment facilities. Increased trauma exposure significantly impacted the risk behaviors of youths entering the residential treatment facility. The results indicate that the total number of traumas experienced was a greater predictor of risk behaviors among these youth than the specific traumas experienced. Internalizing behaviors such as self-harm and suicide attempts also increased with the number of traumas experienced by the adolescent. The study demonstrates the need for further exploration of the complex relationship between personal trauma, mental health, and social development in adolescents.     

Caregiver drug use and arrest as correlates of child trauma exposure

This study proposed to determine the prevalence of substance use and drug-related arrests among caregivers of children referred to Child Protective Services (CPS), examine the relationship between substance use and arrests among caregivers, and examine the main effects and interaction of substance use and arrests in predicting child trauma exposure. Secondary data was collected from CPS files for a randomly selected group of 1127 children. Findings indicated that rates of caregiver substance misuse and arrests were higher than the general population, which was expected. When controlling for demographic and other variables, there was a main effect of substance use and arrests on child trauma exposure, but no significant interaction. Implications for caregivers engaged in substance use and/or involvement with the criminal justice system are discussed, as well as clinical and research implications for children exposed to trauma related to caregiver behaviors.     

Exploring the Moderating Influence of Delinquent Peers on the Link Between Trauma, Anger, and Violence Among Male Youth: Implications for Social Work Practice

This study’s objective was to explore the influence of delinquent peer exposure, on the relationship between male youths’ histories of trauma, anger, and violent behavior. Using a nationally representative sample of male adolescents aged 12–17 and self report interviews, information was gathered on their levels of exposure to violence, stressful life events (SLE), anger, depression, delinquent peer exposure, and violent behavior. Results of a moderation analyses revealed that youth who reported higher levels of exposure to trauma, anger, and delinquent peers were at an increased risk for anger and for violent offending. Delinquent peer exposure exerted a significant interaction effect on the relationship between anger and violent offending. The implications for prevention and intervention efforts are delineated.     

Latina and African‐American Girls in the Juvenile Justice System: Needs,Problems, and Solutions

This review focuses on Latina and African‐American girls in the juvenile justice system with a special emphasis on their mental health, substance abuse, and treatment needs. Like many young women in the juvenile justice system, Latina and African‐American girls often have histories of neglect, abuse, and trauma, which contribute to later mental health and substance abuse issues. Despite these histories, juvenile justice professionals sometimes rely on stereotypes rooted in cultural deficit thinking to explain Latina and African‐American girls' delinquency. Relying on gendered, racialized, and classed stereotypes and assumptions can result in decisions that negatively impact Latina and African‐American girls' access to mental health, substance abuse, and other types of treatment. Policy and practice implications for better addressing the needs of Latina and African‐American girls are discussed.     

Parental Perspectives on the Emotional,Relational and Logistical Impacts on Siblings of Youth Who Sexually Offend

This qualitative study explored parents’ perspectives on the collateral consequences of youth sexual offending on siblings through the analysis of interview data among 16 caregivers from 10 Canadian families. Using thematic coding procedures, findings indicated that parents identified a range of safety, emotional and interpersonal impacts on siblings beginning with the criminal justice and child welfare investigations of the sexual offending and extending to siblings’ relationships with the offending youth, their caregivers and other relatives. Results demonstrate the need for greater acknowledgement of, and parent‐informed interventions that specifically address the impact of youth sexual offending on siblings by professionals and non‐professionals (e.g. relatives) alike.     

Understanding dissociation in relation to child trauma,mental health needs,and intensity of services in child welfare: A possible missing link

Abstract

While there is limited research on the role of dissociation among children and adolescents, emerging evidence links child trauma history, dissociation, risk behaviors, and other negative outcomes among youth. This study examined dissociation in relation to mental health needs and intensity of services among a large sample of youth in Illinois child welfare, upon entry into care and in residential treatment settings. The Child and Adolescent Needs and Strengths (CANS), a comprehensive, trauma-informed assessment strategy and information integration/planning tool was the primary measure. This study included two overall samples of child welfare-involved youth, ages 3–18: at entry into care (N?=?27,737) and in residential treatment (N?=?5,758). Findings indicated that rates of clinically significant dissociation were generally highest among younger youth (under age 14) and among youth with more cumulative and severe trauma. Dissociative youth were significantly more likely to exhibit several risk behaviors (e.g., fire setting and self-harm) and mental health symptoms (e.g., psychosis and somatization). Those youth with significant dissociation at entry into care were more likely to be psychiatrically hospitalized, placed into residential treatment, with greater likelihood of placement disruptions within the 2 years following entry into care. Implications of these findings are discussed in terms of the value of identifying and assessing dissociation and other trauma-related symptoms that may be less recognized but can be linked to high-risk behaviors and other negative outcomes within child welfare and across child-serving systems. Understanding dissociation may be an important component of training, service/treatment planning, and clinical care within child-serving systems.     

Language impairments among youth offenders: A systematic review

Low levels of verbal intelligence have long been associated with risk for early onset antisocial behavior, however considerably less is known about the deficits in specific language skills that may characterize antisocial youth. Youth offenders represent a particularly high priority group for research into such deficits, as the juvenile justice system involves a range of high-stakes situations that rely upon the application of language skills. Our aim was to conduct a systematic review of the evidence currently available regarding the discrete language skills of youth offenders, spanning structural, pragmatic, expressive and receptive language domains. Seventeen studies meeting search criteria were identified, 16 of which reported on independent samples. Findings from these studies provide considerable evidence that youth offenders perform poorly on language measures relative to age matched peers. Study results are examined in relation to three key questions: (1) How strong is the association between language impairments and youth offending? (2) Are some language skills or modalities more impaired than others in youth offender populations; and (3) What biopsychosocial factors have been shown to influence the relationship between language impairments and youth offending? Implications for policy and practice are discussed, along with directions for future research.     

Running away from child welfare placements: Justice system entry risk

A growing body of research indicates that running away from foster care increases the probability of subsequent involvement in the juvenile and/or adult justice system, especially for males. Using administrative data from the Michigan Department of Health and Human Services, this study examined the characteristics and behavior of a sample of 371 child welfare youth in Wayne County who ran away from foster care with a propensity scored matched sample of youth who did not run away. Youth were followed in administrative records of the MDHHS and justice system for eight years. The correlates of involvement in the juvenile and/or the adult justice systems included age at first child welfare placement, years in placement, number of placements, total length of time in residential care, running away from placement, as well as gender and legal status. Overall, 42% had at least one juvenile and/or adult conviction. Running away from foster care had the largest effect on subsequent justice system contact.     

Risk and protective factors for depression and substance use in an adolescent child welfare sample

Research on the mental health needs of maltreated youth in out-of-home care remains limited. The goal of the current study was to examine two common mental health concerns (i.e., depression, substance use) among 122 12-15 year olds in out-of-home placements. Specifically, we investigated potential risk and protective factors among socio-demographic, maltreatment, youth, family, and community variables. We relied on data collected through the AAR-C2, a Canadian needs assessment and outcome monitoring tool. Approximately 4 in 10 (39.2%) youth endorsed at least one mental health problem, which we defined as the youth scoring at least one standard deviation above the sample mean for the depression items and the youth indicating the presence of alcohol and/or substance use over the past year. Almost 1 in 10 (8.3%) reported struggling with both mental health issues. Results from logistic regressions indicated that adolescent females were at higher risk of experiencing depression than males, and increasing age was associated with increased risk for substance use. Turning to protective factors, results indicated that the greater the perceived quality of the youth-caregiver relationship, the lower the risk for mental health difficulties (i.e., depression, substance use). Moreover, participation in extracurricular activities appeared to protect youth against depression or substance use. Results imply that the youth-caregiver relationship and involvement in extracurricular activities are important areas to consider to promote the well-being of maltreated youth in out-of-home care.     

Ethnicity versus Ethnic Identity: What Predicts Substance Use Norms and Behaviors?

ABSTRACT

Although researchers often incorporate various measures of ethnicity and ethnic identity (EI) into research about substance use, the relationships among ethnicity, EI, and substance use remain unclear (Marsiglia, Kulis, & Hecht, 2001; Phinney, 1996). This paper explores whether ethnicity and three EI instruments are useful in predicting substance use outcomes among three samples of ethnically diverse middle school youth. Findings include that age, gender, and/or racial or ethnic group membership influenced the strength of EI and that age, sex, and strength of EI influence substance use norms and behaviors. In each case where significant effects were obtained, a stronger sense of EI as measured by two of the instruments predicted more negative attitudes toward, and less use of, alcohol, cigarettes, and marijuana. Implications for preventing substance use among middle school youth by building on and strengthening ethnic identity are provided.