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

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

PTSD and dissociation symptoms as mediators of the relationship between polyvictimization and psychosocial and behavioral problems among justice-involved adolescents

Polyvictimization (PV) has been shown to be associated with psychosocial and behavioral impairment in community and high risk populations, including youth involved in juvenile justice. However, the mechanisms accounting for these adverse outcomes have not been empirically delineated. Symptoms of posttraumatic stress disorder (PTSD) and dissociation are documented sequelae of PV and are associated with a wide range of behavioral/emotional problems. This study used a cross-sectional research design and bootstrapped multiple mediation analyses with self-report measures completed by a large sample of justice-involved youth (N = 809, ages 12–19 years old, 27% female, 46.5% youth of color) to test the hypothesis that PTSD and dissociation symptoms mediate the relationship between PV and problems with anger, depression/anxiety, alcohol/drug use, and somatic complaints after controlling for the effects of exposure to violence and adversities related to juvenile justice involvement. As hypothesized, PTSD symptoms mediated the relationship of PV with all outcomes except alcohol/drug use problems (which had an unmediated direct association with PV). Partially supporting study hypotheses, dissociation symptoms mediated the relationship between PV and internalizing problems (i.e., depression anxiety; suicide ideation). Implications are discussed for prospective research demarcating the mechanisms linking PV and adverse outcomes in juvenile justice and other high risk populations