Advertisement

Polyvictimization, Emotion Dysregulation, Symptoms of Posttraumatic Stress Disorder, and Behavioral Health Problems among Justice-Involved Youth: a Latent Class Analysis

  • Ruby Charak
  • Julian D. Ford
  • Crosby A. Modrowski
  • Patricia K. Kerig
Article

Abstract

Among the 90% of adolescents involved in juvenile justice who have experienced traumatic victimization, a sub-group may be at highest risk due to histories of multiple types of interpersonal and non-interpersonal trauma, termed polyvictims. Latent class analyses (LCA) have identified polyvictimized subgroups in several studies of adolescents and adults, but only one study of traumatic victimization has been conducted with justice-involved youth (Ford et al. 2013). The current investigation replicates and extends that study’s findings using LCA to assess a wider range of victimization- and nonvictimization-related adversities and emotion dysregulation, DSM-5 symptom clusters of posttraumatic stress disorder (PTSD), and behavioral health problems, such as substance use, anger, depression, somatic complaints, and suicide ideation. In a sample of juvenile detainees three latent classes were identified: mixed adversity (MA; n = 327), violent environment (VE; n = 337), and polyvictimization (PV; n = 145). In contrast to MA youth, PV youth were more likely to report exposure to all forms of adversity, and in contrast to both MA and VE youth, exposure to maltreatment and family violence, and higher levels of emotion dysregulation, PTSD, and depression/anxiety symptoms, somatic complaints, and suicidality. VE youth (vs. MA youth) were more likely to report exposure to violence and non-interpersonal traumas, and were higher on some forms of emotion dysregulation, PTSD symptoms, anger and substance use. Findings suggest that most justice-involved youth have experienced substantial adversity, with almost one in five identified as a polyvictim having experienced multiple adversities, including impaired caregivers, and evidencing the most severe problems in emotion dysregulation and PTSD, internalizing, and externalizing symptoms.

Keywords

Polyvictimization Latent class analysis Emotion dysregulation PTSD MAYSI-2 Juvenile justice Adolescents 

Notes

Funding

This study was in part supported by grants from the National Science Foundation (HRD-1463991, Ruby Charak), the Department of Health and Human Services (SAMHSA 1 SM080013–01 National Child Traumatic Stress Network Center for Trauma Recovery and Juvenile Justice, Julian Ford, PI), a National Science Foundation Graduate Research Fellowship (1256065) awarded to Crosby Modrowski, and the National Institute of Justice (Grant # 2014–90914-UT-IJ, Patricia Kerig, PI). Any opinions, findings, and conclusions or recommendations are those of the authors, and do not necessarily reflect the view of the granting agencies.

Compliance with Ethical Standards

Conflict of Interest

Drs. Charak and Kerig, and Ms. Modowski have no known conflicts of interest associated with this publication. Dr. Ford is the co-owner of Advanced Trauma Solutions, Inc, the soledistributior of the TARGET curriculum licensed by the copyright holder, the University of Connecticut.

Ethical Approval

Study procedures were approved by the Institutional Review Boards of the University of Utah and the Utah Department of Human Services.

Informed Consent

Legal guardians of the participants provided signed informed consent, and participants provided signed assent.

References

  1. Abram, K. M., Teplin, L. A., Charles, D. R., Longworth, S. L., McClelland, G. M., & Dulcan, M. K. (2004). Posttraumatic stress disorder and trauma in youth in juvenile detention. Archives of General Psychiatry, 61, 403–410.  https://doi.org/10.1001/archpsyc.61.4.403.CrossRefPubMedPubMedCentralGoogle Scholar
  2. Adams, Z. W., Moreland, A., Cohen, J. R., Lee, R. C., Hanson, R. F., Danielson, C. K., … Briggs, E. C. (2016). Polyvictimization: Latent profiles and mental health outcomes in a clinical sample of adolescents. Psychology of Violence, 6, 145–155. doi:  https://doi.org/10.1037/a0039713.
  3. Anda, R. F., Butchart, A., Felitti, V. J., & Brown, D. W. (2010). Building a framework for global surveillance of the public health implications of adverse childhood experiences. American Journal of Preventive Medicine, 39, 93–98.  https://doi.org/10.10163/j.amepre.2010.03.015.CrossRefPubMedGoogle Scholar
  4. Bennett, D. C., & Kerig, P. K. (2014). Investigating the construct of trauma-related acquired callousness among delinquent youth: differences in emotion processing. Journal of Traumatic Stress, 27, 415–422.Google Scholar
  5. Bennett, D. C., Modrowski, C. A., Kerig, P. K., & Chaplo, S. D. (2015). Investigating the dissociative subtype of posttraumatic stress disorder in a sample of traumatized detained youth. Psychological Trauma: Theory, Research, Practice and Policy, 7, 465–472.  https://doi.org/10.1037/tra0000057.CrossRefGoogle Scholar
  6. Bennett, D. C., Modrowski, C. A., Chaplo, S. D., & Kerig, P. K. (2016). Facets of emotion dysregulation as mediators of the association between trauma exposure and posttraumatic stress symptoms in justice-involved adolescents. Traumatology, 22, 174–183.  https://doi.org/10.1037/trm0000085.CrossRefGoogle Scholar
  7. Berzenski, S., & Yates, T. (2011). Classes and consequences of multiple maltreatment: A person centered analysis. Child Maltreatment, 16, 250–261.  https://doi.org/10.1177/1077559511428353.CrossRefPubMedGoogle Scholar
  8. Calkins, S. D., & Howse, R. B. (2004). Individual differences in self-regulation. Implications for childhood adjustment. In P. Philippot & R. S. Feldman (Eds.), The regulation of emotion (pp. 307–332). Mahwah: Lawrence Erlbaum Associates Publishers.Google Scholar
  9. Charak, R., & Koot, H. M. (2015). Severity of maltreatment and personlaity pathology in adolescents of Jammu, India: A latent class approach. Child Abuse and Neglect, 50, 56–66.  https://doi.org/10.1016/j.chiabu.2015.05.010.CrossRefPubMedGoogle Scholar
  10. Charak, R., Koot, H. M., Dvorak, R. D., Elklit, A., & Elhai, J. D. (2015). Unique versus cumulative effects of physical and sexual assault on patterns of adolescent substance use. Psychiatry Research, 30, 763–769.  https://doi.org/10.1016/j.psychres.2015.11.014.CrossRefGoogle Scholar
  11. Charak, R., Byllesby, B. M., Roley, M. E., Claycomb, M. A., Durham, T. A., Ross, J., et al. (2016). Latent classes of childhood poly-victimization and associations with suicidal behavior among adult trauma victims: Moderating role of anger. Child Abuse & Neglect, 62, 19–28.  https://doi.org/10.1016/j.chiabu.2016.10.010.CrossRefGoogle Scholar
  12. Cicchetti, D., Ganiban, J., & Barnett, D. (1991). Contributions from the study of high-risk populations to understanding the development of emotion regulation. In J. Garber & K. A. Dodge (Eds.), The development of emotion regulation and dysregulation (pp. 15–48). Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  13. Cohen, J. (1988). Statistical power and analysis for the behavioral sciences (2nd ed.). Hillsdale: Lawrence Erlbaum Associates.Google Scholar
  14. Cole, P. M., Michel, M. K., & Teti, L. O. (1994). The development of emotion regulation and dysregulation: A clinical perspective. Monographs of the Society for Research in Child Development, 59, 73–100.  https://doi.org/10.1111/j.1540-5834.1994.tb01278.x.CrossRefPubMedGoogle Scholar
  15. D'Andrea, W., Ford, J. D., Stolbach, B., Spinazzola, J., & van der Kolk, B. A. (2012). Understanding interpersonal trauma in children: Why we need a developmentally appropriate trauma diagnosis. American Journal of Orthopsychiatry, 82, 187–200.  https://doi.org/10.1111/j.1939-0025.2012.01154.x.CrossRefPubMedGoogle Scholar
  16. van Dijke, A., Ford, J. D., Frank, L. E., & van der Hart, O. (2015). Association of childhood complex trauma and dissociation with complex posttraumatic stress disorder symptoms in adulthood. Journal of Trauma and Dissociation, 16, 428–441.  https://doi.org/10.1080/15299732.2015.1016253.CrossRefPubMedGoogle Scholar
  17. Finkelhor, D., Ormrod, R. K., & Turner, H. A. (2007a). Poly-victimization: A neglected component in child victimization. Child Abuse and Neglect, 31, 7–26.CrossRefPubMedGoogle Scholar
  18. Finkelhor, D., Ormrod, R. K., & Turner, H. A. (2007b). Polyvictimization and trauma in national longitudinal cohort. Development and Psychopathology, 19, 149–166.  https://doi.org/10.1016/j.chiabu.2006.06.008.CrossRefPubMedGoogle Scholar
  19. Finkelhor, D., Ormrod, R. K., & Turner, H. A. (2009). Lifetime assessment of poly-victimization in a national sample of children and youth. Child Abuse and Neglect, 33, 403–411.  https://doi.org/10.1016/j.chiabu.2008.09.012.CrossRefPubMedGoogle Scholar
  20. Finkelhor, D., Turner, H. A., Shattuck, A., & Hamby, S. L. (2015). Prevalence of childhood exposure to violence, crime, and abuse: Results from the national survey of children's exposure to violence. JAMA Pediatrics, 169, 746–754.  https://doi.org/10.1001/jamapediatrics.2015.0676.CrossRefPubMedGoogle Scholar
  21. Ford, J. D. (2017). Polyvictimization. In B. M. Heubner (Ed.), Oxford bibliographies in criminology. New York: Oxford University Press.Google Scholar
  22. Ford, J. D., Connor, D. F., & Hawke, J. (2009). Complex trauma among psychiatrically impaired children: A cross-sectional, chart-review study. Journal of Clinical Psychiatry, 70(8), 1155–1163.  https://doi.org/10.4088/JCP.08m04783.CrossRefPubMedGoogle Scholar
  23. Ford, J. D., Elhai, J. D., Connor, D. F., & Frueh, B. C. (2010). Poly-victimization and risk of posttraumatic, depressive, and substance use disorders and involvement in delinquency in a national sample of adolescents. Journal of Adolescent Health, 46, 545–552.  https://doi.org/10.1016/j.jadohealth.2009.11.212.CrossRefPubMedGoogle Scholar
  24. Ford, J. D., Grasso, D. J., Hawke, J., & Chapman, J. F. (2013). Poly-victimization among juvenile justice-involved youths. Child Abuse and Neglect, 37, 788–800.  https://doi.org/10.1016/j.chiabu.2013.01.005.CrossRefPubMedGoogle Scholar
  25. Ford, J. D., Kerig, P. K., Desai, N., & Feierman, J. (2016). Psychosocial interventions for traumatized youth in the juvenile justice system: Clinical, research, and legal perspectives. Journal of Juvenile Justice, 5, 31–49.Google Scholar
  26. Gagnon, K. L., Lee, M. S., & DePrince, A. P. (2017). Victim-perpetrator dynamics through the lens of betrayal trauma theory. Journal of Trauma and Dissociation, 18, 1–10.  https://doi.org/10.1080/15299732.2017.1295421.CrossRefGoogle Scholar
  27. Ghosh-Ippen, C., Ford, J. D., Racusin, R., Acker, M. Bosquet, B., Rogers, C., & Edwards, J. (2002). Trauma events screening inventory-parent report revised. San Francisco.Google Scholar
  28. Grasso, D. J., Dierkhising, C. B., Branson, C. E., Ford, J. D., & Lee, R. (2016). Developmental patterns of adverse childhood experiences and current symptoms and impairment in youth referred for trauma-specific services. Journal of Abnormal Child Psychology, 44, 871–886.  https://doi.org/10.1007/s10802-015-0086-8.CrossRefPubMedGoogle Scholar
  29. Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the Difficulties in Emotion Regulation Scale. Journal of Psychopathology and Behavioral Assessment, 26, 41–54.  https://doi.org/10.1023/B:JOBA.0000007455.08539.94.CrossRefGoogle Scholar
  30. Gratz, K. L., Weiss, N. H., & Tull, M. (2015). Examining emotion regulation as an outcome, mechanism, or target of psychological treatments. Current Opinion in Psychology, 3, 85–90.  https://doi.org/10.1016/j.copsyc.2015.02.010.CrossRefPubMedPubMedCentralGoogle Scholar
  31. Grisso, T., & Barnum, R. (2006). Massachusetts youth screening instrument version 2:User’s manual and technical report. Sarasota: Professional Resource Press.Google Scholar
  32. Hamby, S. L., Finkelhor, D., Ormrod, R. K., & Turner, H. A. (2004). The Juvenile Victimization Questionnaire (JVQ): Administration and Scoring Manual. Durham, NH: Crimes against Children Research Center.Google Scholar
  33. Jensen, S. A., Fabiano, G. A., Lopez-Williams, A., & Chacko, A. (2006). The reading grade level of common measures in child and adolescent clinical psychology. Psychological Assessment, 18, 346–352.  https://doi.org/10.1037/1040-3590.18.3.346.CrossRefPubMedGoogle Scholar
  34. Kerig, P. K. (2013). Trauma-informed assessment and intervention. Los Angeles: National Center for Child Traumatic Stress.Google Scholar
  35. Kerig, P. K., & Becker, S. P. (2012). Trauma and girls delinquency. In S. Miller, L. Leve, & P. K. Kerig (Eds.), Delinquent girls: Context, relationships, and adaptation (pp. 119–143). New York: Springer Books.  https://doi.org/10.1007/978-1-4614-0416-6_8.CrossRefGoogle Scholar
  36. Kerig, P. K., & Schindler, S. R. (2013). Engendering the evidence base: A critical review of the conceptual and empirical foundations of gender-responsive interventions for girls delinquncy. Laws, 2, 244–282.  https://doi.org/10.3390/laws2030244.CrossRefGoogle Scholar
  37. Kerig, P. K., Ward, R. M., Vanderzee, K. L., & Moeddel, M. A. (2009). Posttraumatic stress as a mediator of the relationship between trauma and mental health problems among juvenile delinquents. Journal of Youth and Adolescence, 38, 1214–1225.  https://doi.org/10.1007/s10964-008-9332-5.CrossRefPubMedGoogle Scholar
  38. Kerig, P. K., Bennett, D. C., Thompson, M., & Becker, S. P. (2012). "nothing really matters": Emotional numbing as a link between trauma exposure and callousness in delinquent youth. Journal of Traumatic Stress, 25, 272–279.  https://doi.org/10.1002/jts.21700.CrossRefPubMedGoogle Scholar
  39. Kerig, P. K., Bennett, D. C., Chaplo, S. D., Modrowski, C. A., & McGee, A. B. (2016). Numbing of positive, negative, and general emotions: Associations with trauma exposure, posttraumatic stress, and depressive symptoms among justice-involved youth. Journal of Traumatic Stress, 29, 111–119.  https://doi.org/10.1002/jts.22087.CrossRefPubMedGoogle Scholar
  40. Kuyken, W., & Dalgleish, T. (2011). Overgeneral autobiographical memory in adolescents at risk for depression. Memory, 19, 241–250.  https://doi.org/10.1080/09658211.2011.554421.CrossRefPubMedGoogle Scholar
  41. Lansing, A. E., Washburn, J. J., Abram, K. M., Thomas, U. C., Welty, L. J., & Teplin, L. A. (2014). Cognitive and academic functioning of juvenile detainees: Implications for correctional populations and public health. Journal of Correctional Health Care, 20, 18–30.  https://doi.org/10.1177/1078345813505450.CrossRefPubMedPubMedCentralGoogle Scholar
  42. Mersky, J. P., Janczewski, C. E., & Topitzes, J. (2017). Rethinking the measurement of adversity. Child Maltreatment, 22, 58–68.  https://doi.org/10.1177/1077559516679513.CrossRefPubMedGoogle Scholar
  43. Mrug, S., & Windle, M. (2010). Prospective effects of violence exposure across multiple contexts on early adolescents internalizing and externalizing problems. Journal of Child Psychology and Psychiatry, 51, 953–961.  https://doi.org/10.1111/j.1469-7610.2010.02222.x.CrossRefPubMedGoogle Scholar
  44. Nylund, K., Asparouhov, T., & Muthén, B. O. (2007). Deciding on the number of classes in latent class analysis and growth mixture modeling: A Monte Carlo simulation study. Structural Equation Modeling, 14, 535–569.  https://doi.org/10.1080/10705510701575396.CrossRefGoogle Scholar
  45. Oshri, A., Sutton, T. E., Clay-Warner, J., & Miller, J. D. (2015). Child maltreatment types and risk behaviors: Association with attachment style and emotion regulation dimensions. Personality and Individual Differences, 73, 127–133.  https://doi.org/10.1016/j.paid.2014.09.015.CrossRefGoogle Scholar
  46. Pynoos, R. S., & Steinberg, A. M. (2014). UCLA child/adolescent PTSD reaction index for DSM-5. Los Angeles: University of California at Los Angeles.Google Scholar
  47. Russell, J. D., Marsee, M. A., & Ryals, J. S. (2017). Identifying mental health issues in detained youth: Testing the structure and invariance of the Massachusettts youth screening inventory-version 2 (MAYSI-2). Psychological Assessment, 29, 720–726.  https://doi.org/10.1037/pas0000410.CrossRefPubMedGoogle Scholar
  48. Rutter, M. (1979). Protective factors in children’s responses to stress and disadvantage. In M. W. Kent & J. E. Rolf (Eds.), Primary prevention of psychopathology (Vol. 3: Social competence in children, pp. 49–74). Hanover: University of New England Press.Google Scholar
  49. Steinberg, A. M., Brymer, M. J., Decker, K. B., & Pynoos, R. S. (2004). The University of California at Los Angeles post-traumatic stress disorder reaction index. Current Psychiatry Reports, 6, 96–100.  https://doi.org/10.1007/s11920-004-0048-2.CrossRefPubMedGoogle Scholar
  50. Turner, H. A., Shattuck, A., Finkelhor, D., & Hamby, S. (2016). Polyvictimization and youth violence exposure across contexts. Journal of Adolescent Health, 58(2), 208–214.  https://doi.org/10.1016/j.jadohealth.2015.09.021.CrossRefPubMedGoogle Scholar
  51. Vasilev, C. A., Crowell, S. E., Beauchaine, T. P., Mead, H. K., & Gatzke-Kopp, L. M. (2009). Correspondence between physiological and self-report measures of emotion dysregulation: A longitudinal investigation of youth with and without psychopathology. Journal of Child Psychology and Psychiatry, 50, 1357–1364.  https://doi.org/10.1111/j.1469-7610.2009.02172.x.CrossRefPubMedGoogle Scholar
  52. Weiss, N. H., Tull, M. T., Lavender, J., & Gratz, K. L. (2013). Role of emotion dysregulation in the relationship between childhood abuse and probable PTSD in a sample of substance abusers. Child Abuse and Neglect, 37, 944–954.  https://doi.org/10.1016/j.chiabu.2013.03.014.CrossRefPubMedGoogle Scholar
  53. Williams, D. P., Cash, C., Rankin, C., Bernardi, A., Koenig, J., & Thayer, J. F. (2015). Resting heart rate variability predicts self-reported difficulties in emotion regulation: A focus on different facets of emotion regulation. Frontiers in Psychology, 6, 261.  https://doi.org/10.3389/fpsyg.2015.00261.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Psychological Science, ELABN 361The University of Texas Rio Grande ValleyEdinburgUSA
  2. 2.Department of PsychiatryUniversity of Connecticut Health CenterFarmingtonUSA
  3. 3.Department of PsychologyThe University of UtahSalt Lake CityUSA

Personalised recommendations