A Rare Case of Child Abuse: Multiple Hypodermic Needles Inserted into a Child’s Body

Interpersonal Trauma Exposure, Trauma Symptoms, and Severity of Substance Use Disorder among Youth Entering Outpatient Substance Abuse Treatment Abstract A substantial body of literature has found associations between interpersonal victimization, trauma symptoms, and substance use disorders (SUD) among adolescents. Secondary data analysis was conducted on structured interview data collected by treatment providers as 172 adolescents (ages 12–19) entered outpatient substance abuse treatment. Results indicate high prevalence rates of interpersonal trauma exposure: 71.5% self-reported trauma exposure, specifically direct physical abuse or assault, sexual abuse or assault, and/or witnessing intimate partner violence of a parent. Severity of SUD, as measured by number of DSM-5 criteria endorsed, was not only associated with the number of types of criterion A events for Posttraumatic Stress Disorder but also more self-reported internalizing problems. There was no significant relationship between the severity of SUD and the severity of trauma symptoms at treatment intake, gender, or attention problems. Ongoing assessment of possible trauma symptoms is recommended throughout substance abuse treatment with youth who have reported trauma exposure, as well as continued screening of trauma exposure.

Examining the Differing Effects of Economic Hardship and Poor Maternal Wellbeing on Cumulative Exposure to Adverse Childhood Experiences Abstract Extensive research supports a strong and cumulative relationship between adverse childhood experiences (ACEs) and risky adult behaviors, mental health disorders, diseases, and health status. Additional factors, such as poor maternal wellbeing and economic hardship, compound the detrimental health and wellbeing implications associated with childhood exposure to ACEs. However, limited research has explored the differentiating effects of economic hardship and maternal wellbeing on a child’s cumulative ACE exposure. This study examined the differing effects of poor maternal wellbeing and economic hardship on a child’s exposure to ACEs. This study used a random sub-sample (n = 4000) from the 2011 to 2012 National Survey on Children’s Health (NSCH), a nationally representative cross-sectional study of children (N = 95,677) between birth and 17 years old. Confirmatory factor analysis results revealed greater economic hardship had a significant direct effect on a child’s ACE exposure and poorer maternal wellbeing. Poor maternal wellbeing had a significant mediation-like effect on the relationship between economic hardship and a child’s cumulative ACE exposure. Practice and policy implications include early ACE assessments tailored to identify children and families experiencing adversity across multiple domains.

Screening for Trauma Symptoms in Child Welfare-Involved Young Children: Findings from a Statewide Trauma-Informed Care Initiative Abstract Young children who experience abuse, neglect, domestic violence, and other interpersonal forms of trauma are at risk for developing complex psychological trauma. Timely referrals by child welfare services for trauma evaluation and intervention is critical, particularly during the developmentally-sensitive period of birth to three. However, few screening instruments exist that are feasible for implementation in child welfare services and none have reported psychometric data for children under three. The aim of this exploratory, retrospective study was to examine developmental differences in detection rates of two brief trauma screening scales, comparing outcomes for toddlers (age 1 and 2 years) and preschoolers (age 3 to 6 years), using the evaluation data from a statewide child welfare demonstration project. The sample included 151 children ages 1 to 6 participating in evidence-based trauma treatment with their caregivers. More than 80% of children, regardless of age group, met the cut-off on one of the screeners; children who met the cut-off on either screener were significantly more likely to have experienced domestic violence, physical abuse or poly-victimization. Implications for future research are discussed.

Expanding the Original Definition of Adverse Childhood Experiences (ACEs) Abstract We report two studies examining psychometric properties of an expanded measure of adverse childhood experiences (ACEs) that combined the original ACEs items with items from the Juvenile Victimization Questionnaire. In Study 1, we examined its factorial structure, internal consistency, and concurrent validity in undergraduates (N = 1479). In Study 2, we also examined replicability of frequencies of ACEs, test-retest reliability, and convergent and predictive validity. Results suggested a model with four inter-related factors: maltreatment, household dysfunction, community dysfunction, and peer dysfunction/property victimization. Internal consistency, test-retest reliability, concurrent and convergent validity were acceptable, and findings were replicated across samples. We suggest that this expanded measure is assessing early experiences of victimization and helplessness in the face of perceived intentional emotional and physical threats or actual harm by others, and that although they may not all be “traumatic,” their cumulative impact is associated with poor mental health in young adults.

Foster Care Alumni Achievement in Higher Education: the Role of Trauma Abstract Foster care alumni lag behind the general population in post-secondary academic achievement. This cross-sectional study uses a random sample of forty-six foster care alumni from a Midwestern public university to explore the relationship between exposure to trauma and post-secondary academic achievement (14.5% response rate; age range 17–24). While no significant relationship was found between trauma exposure and GPA or failing classes, participants who experienced increased exposure to trauma were more likely to have withdrawn from a class because it was too difficult or the semester was too overwhelming. More research is needed to further understand these findings.

Gangs and Adolescent Mental Health: a Narrative Review Abstract This study presents a narrative review of the literature on gang culture and its association with mental health, including an in-depth overview of the topic area and reference to key systematic reviews and meta-analyses. This review will define gang culture, discuss the multiple interacting reasons (biological, psychological and social) why some young people may be attracted to gangs; and the psychiatric morbidities associated with being part of a gang. Gang culture and some adolescent mental health problems are intricately linked. This paper highlights ways in which research, practice and policy could be extended to minimise the injurious effects of gang culture on adolescent mental health.

Child-Centered Play Therapy for Youths Who Have Experienced Trauma: a Systematic Literature Review Abstract This systematic review examines the literature on the effectiveness of child-centered play therapy (CCPT) for youths who have experienced traumatic events. Two independent reviewers conducted the search procedures, as well as all data extraction and coding. Seven peer-reviewed articles reporting treatment outcomes were included in the review. As the focus of the review was on CCPT, treatment methods were similar across the seven articles (e.g., use of similar materials). There was also some consistency in findings regarding outcomes related to internalizing problems, self-concept, and self-competence. However, there was significant variability in the outcome measures used to evaluate effects, as well as limitations regarding the study methods that impact the overall conclusions regarding the use of CCPT to treat children that have experienced traumatic events. Treatment recommendations and suggestions for future research are discussed.

The Relationship Between Trauma, Recidivism Risk, and Reoffending in Male and Female Juvenile Offenders Abstract Elevated rates of traumatic experience in the juvenile justice population are well established. Nevertheless, the role of trauma and its application to rehabilitation and recidivism in a criminal justice context remains hotly debated, particularly for female youth. The Risk-Need-Responsivity framework, the predominant model for risk assessment and case management in juvenile justice, does not consider trauma to be a risk factor for offending. This study examined– Posttraumatic Stress symptomology, maltreatment history, and childhood adversity – in relation to RNR risk factors for reoffending (criminogenic needs) and recidivism in a sample of female and male juvenile offenders. Rates of PTS symptomology, maltreatment, and childhood adversity were significantly higher in this sample compared to prevalence in the general population. Females were more likely to have experienced maltreatment. Several maltreatment and childhood adversity types were significantly related to criminogenic needs. PTS symptomology and adversity were not significant predictors of recidivism when entered alongside criminogenic needs; however, maltreatment was the strongest predictor of recidivism for both male and female youth in a model that included criminogenic needs. Gender did not moderate the relationship between maltreatment and recidivism. The importance of considering youths’ maltreatment history in their rehabilitative care is discussed.

#freemind: Young Women Using Mindfulness Meditation to Cope with Life in a Juvenile Justice Institution Abstract The purpose of this study was to introduce mindfulness meditation, a recommended adjunctive treatment for trauma in juvenile justice-involved youth, to incarcerated young women and collect narrative commentary about their experiences to answer the following research questions: What is the experience of incarcerated young women who participate in Internet-based mindfulness meditation classes? How do incarcerated young women apply mindfulness meditation to life in a juvenile justice facility? Participants attended bi-weekly guided meditation sessions and wrote about their experiences after each session in a journal. Three coders used open-coding content analysis to identify topics and themes across 38 journal entries. The primary theme, found in 61% of entries, described the difficulties of living in a juvenile justice facility, providing context for the descriptions found in 58% of entries regarding the usefulness of mindfulness meditation to cope with those difficulties. This study highlights the challenges of living in a correctional institution as a young woman and the barriers such settings pose to the wellbeing and healthy development of their residents. It also points to mindfulness meditation as an operative method of supporting these highly traumatized young women until that time when alternatives to incarceration can be identified.