Trauma histories among justice-involved youth: findings from the National Child Traumatic Stress Network.

BackgroundUp to 90% of justice-involved youth report exposure to some type of traumatic event. On average, 70% of youth meet criteria for a mental health disorder with approximately 30% of youth meeting criteria for post-traumatic stress disorder (PTSD). Justice-involved youth are also at risk for substance use and academic problems, and child welfare involvement. Yet, less is known about the details of their trauma histories, and associations among trauma details, mental health problems, and associated risk factors.ObjectiveThis study describes detailed trauma histories, mental health problems, and associated risk factors (i.e., academic problems, substance/alcohol use, and concurrent child welfare involvement) among adolescents with recent involvement in the juvenile justice system.MethodThe National Child Traumatic Stress Network Core Data Set (NCTSN-CDS) is used to address these aims, among which 658 adolescents report recent involvement in the juvenile justice system as indexed by being detained or under community supervision by the juvenile court.ResultsAge of onset of trauma exposure was within the first 5 years of life for 62% of youth and approximately one-third of youth report exposure to multiple or co-occurring trauma types each year into adolescence. Mental health problems are prevalent with 23.6% of youth meeting criteria for PTSD, 66.1% in the clinical range for externalizing problems, and 45.5% in the clinical range for internalizing problems. Early age of onset of trauma exposure was differentially associated with mental health problems and related risk factors among males and females.ConclusionsThe results indicate that justice-involved youth report high rates of trauma exposure and that this trauma typically begins early in life, is often in multiple contexts, and persists over time. Findings provide support for establishing trauma-informed juvenile justice systems that can respond to the needs of traumatized youth

Community Violence and Youth: Affect, Behavior, Substance Use, and Academics

Community violence is recognized as a major public health problem (WHO, World Report on Violence and Health,2002) that Americans increasingly understand has adverse implications beyond inner-cities. However, the majority of research on chronic community violence exposure focuses on ethnic minority, impoverished, and/or crime-ridden communities while treatment and prevention focuses on the perpetrators of the violence, not on the youth who are its direct or indirect victims. School-based treatment and preventive interventions are needed for children at elevated risk for exposure to community violence. In preparation, a longitudinal, community epidemiological study, The Multiple Opportunities to Reach Excellence (MORE) Project, is being fielded to address some of the methodological weaknesses presented in previous studies. This study was designed to better understand the impact of children’s chronic exposure to community violence on their emotional, behavioral, substance use, and academic functioning with an overarching goal to identify malleable risk and protective factors which can be targeted in preventive and intervention programs. This paper describes the MORE Project, its conceptual underpinnings, goals, and methodology, as well as implications for treatment and preventive interventions and future research

Post-traumatic stress disorder in children

Children and psychic trauma: a brief review of contemporary thinking. Children traumatized by witnessing acts of personal violence: homicide, rape, or suicide behavior. Children traumatized in small groups. Children traumatized by catastrophic situations. Children traumatized by Central American warfare. Post-traumatic stress disorder in children with cancer. Children traumatized by physical abuse. Post-traumatic symptoms in incest victims. Interaction of trauma and grief in childhood

Witness to Violence: The Child Interview

In this paper, we present a widely applicable technique of interviewing the traumatized child who has recently witnessed an extreme act of violence. This technique has been used with over 200 children in a variety of clinical settings including homicide, suicide, rape, aggravated assault, accidental death, kidnapping, school and community violence. The easily learned, three-stage approach allows for proper exploration, support and closure within a 90-minute initial interview. The format proceeds from a projective drawing and story telling, to discussion of the actual traumatic situation and the perceptual impact, to issues centered on the aftermath and its consequences for the child. Our interview format is conceptualized as an acute consultation service available to assist the child, the child's family, and the larger social network in functioning more effectively following the child's psychic trauma

Mental health consultation to a preschool following the murder of a mother and child.

The murder of a five-year-old boy and his mother disrupted the entire small community of the preschool he had attended. A two-stage mental health intervention consisting of separate group sessions with the preschoolers, teachers, and parents was initiated to help them work through their grief and fear and to reverse their increasing isolation from one another. The reassuring presence of adults who were not struggling with the crisis and the creation of a supportive milieu relieved the children's anxiety, enabling them to discuss their fears and fantasies about the deaths, and alleviated the anxious mistrust and sense of lost personal security of the teachers and parents. The teachers were able to resume their professional functioning, and the parents were better able to assist their affected children