Multiple Victimizations Before and After Leaving Home Associated With PTSD, Depression, and Substance Use Disorder Among Homeless Youth

Abstract

Exposure to multiple forms of maltreatment during childhood is associated with serious mental health consequences among youth in the general population, but limited empirical attention has focused on homeless youth-a population with markedly high rates of childhood maltreatment followed by elevated rates of street victimization. This study investigated the rates of multiple childhood abuses (physical, sexual, and emotional abuse) and multiple street victimizations (robbery, physical assault, and sexual assault) and examined their relative relationships to mental health outcomes (meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, criteria for post-traumatic stress disorder [PTSD], depression, and substance use disorder) among a large (N = 601) multisite sample of homeless youth. Approximately 79% of youth retrospectively reported multiple childhood abuses (two or more types) and 28% reported multiple street victimizations (two or more types). Each additional type of street victimization nearly doubled youths' odds for meeting criteria for substance use disorder. Furthermore, each additional type of childhood abuse experienced more than doubled youths' odds for meeting criteria for PTSD. Both multiple abuses and multiple street victimizations were associated with an approximate twofold increase in meeting depression criteria. Findings suggest the need for screening, assessment, and trauma-informed services for homeless youth who consider multiple types of abuse and victimization experiences.

A group-based motivational interviewing brief intervention to reduce substance use and sexual risk behavior among homeless young adults

“…A survey of 419 homeless youth found that two-thirds reported past month alcohol use (68%), as well as use of one or more illicit drugs (e.g., 66% marijuana, 15% methamphetamine, 16% ecstasy, 9% injection drugs; Wenzel, Tucker, Golinelli, Green, & Zhou, 2010). In another sample of 601 homeless youth, 69% met diagnostic criteria for past year substance use disorder (Bender, Brown, Thompson, Ferguson, & Langenderfer, 2015), which is about four times higher than among 18–25 year olds in the general population (Center for Behavioral Health Statistics and Quality, 2015). Rates of HIV infection among homeless youth range from about 3–25% across U.S. studies (Medlow, Klineberg, & Steinbeck, 2014), and pregnancy is also more common among homeless than stably housed youth (Begun, 2015; Tucker et al, 2012c).…”

Drug use patterns and predictors among homeless youth: Results of an ecological momentary assessment

“…To cope with stress, they may turn to drug and alcohol use to cope with the harsh conditions of the streets and escape from significant life stressors (17,18). Other studies support the positive relations between various street related stressors and drug use among homeless youth (19,20). For example, Tyler and colleagues found that homeless youth who had experienced victimization or trade sex since becoming homeless were more likely to use drugs (19).…”

DSM-5 and ICD-11 as competing models of PTSD in preadolescent children exposed to a natural disaster: assessing validity and co-occurring symptomatology

“…Other types of trauma (e.g. maltreatment, medical injuries) also commonly affect children and contribute to the development of PTSD (Bender, Brown, Thompson, Ferguson, & Langenderfer, 2015; Kassam-Adams, Marsac, & Cirilli, 2010). In many cases, a PTSD diagnosis has been used to identify youth in need of mental health services (Jaycox et al, 2010) or document treatment outcome (Barron, Abdallah, & Smith, 2013).…”