Severity of Victimization and Co-Occurring Mental Health Disorders Among Substance Using Adolescents

Abstract

Background Co-occurring mental health disorders are widespread among substance using adolescents. Severity of victimization may be an important factor in explaining co-occurrence of mental health problems among adolescents with substance misuse problems. Purpose The purpose of this study was to evaluate whether severe victimization experiences were shared risk factors for internalizing only, externalizing only, and co-occurring internalizing and externalizing disorders among victimized substance-using adolescents. Method Data for this cross-sectional study were obtained from a multisite research project. Adolescents, ages 11–18, participated in a comprehensive screening program for substance abuse at 106 Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Substance Abuse Treatment (CSAT)-funded grantee sites throughout the United States. Results Longer duration/frequent victimization, more than one type of victimization, and recent victimization were related to co-occurring internalizing and externalizing disorders. Victimization by a trusted person, however, was only related to internalizing disorders. Conclusion The findings show that some indicators of severe victimization experiences are shared risk factors for internalizing, for externalizing, and for co-occurring internalizing and externalizing problems, thus providing support for the common factors model of co-morbidity. These findings suggest that practitioners in substance abuse treatment must thoroughly assess for severe victimization experiences among adolescents presenting with co-occurring mental health issues. Treatment planning and interventions may focus on helping adolescents cope effectively with their victimization experiences and addressing their MH needs.

Experiences of victimization among adolescents with Substance Abuse Disorders in Sweden

“…This link has also been confirmed by several previous studies (2,3,5,7,13,22,27,28). These experiences may cause adolescents to begin to use alcohol or drugs as a way of coping with painful memories and the psychological consequences of the events in which they have been involved (2,6,17,21,23,29). In this type of cross-sectional study, however, it is difficult to determine what the "chicken" is and what the "egg" is.…”

“…In addition, a history of sexual abuse is more predictive of alcohol and drug abuse among girls than among boys (17,25). However, some studies have shown that a history of childhood sexual abuse is strongly related to high alcohol consumption among boys (21,29).…”

“…The degree of victimization is often related to the degree of psychiatric disorder (2,28). Serious substance abuse problems among adolescents are seen as these individuals' way of coping with the stress and painful emotions that arise from traumatic events (2,6,17,21,23,29). Alongside victimization, elevated substance abuse can probably also be explained by other factors, such as peer pressure and changed individual attitudes toward drugs (23,26).…”

Mental health problems among young people in substance abuse treatment in Sweden

“…Experiences of traumatic events, violence and physical abuse, which are more common among the girls in the study, can be one explanation for their higher level of mental health problems. It is also probable that some girls begin to use drugs or alcohol to alleviate or manage such painful experiences and the stress that they cause [57][58][59][60]. The girls in the study generally show somewhat earlier onset of drug use and more frequent use.…”

Perceptions of Recidivism Among Incarcerated Youth: The Relationship Between Exposure to Childhood Trauma, Mental Health Status, and the Protective Effect of Mental Health Services in Juvenile Justice Settings

“…Research has widely acknowledged the effects of early physical, sexual, and emotional abuse on various mental health conditions including anxiety, depression, suicidal ideation, post-traumatic stress disorder (PTSD), and anger (Bolger & Patterson, 2001;Green et al, 2010;Hazen, Connelly, Roesch, Hough, & Landsverk, 2009;Higgins & McCabe, 2003;Martin, Bergen, Richardson, Roeger, & Allison, 2004;Runyon & Kenny, 2002). There is even a documented association between longer duration and frequency of traumatic events and co-occurring mental health disorders (Sabri, 2011). Given the disproportionately high rates of mental health problems among youth involved in the juvenile justice system, there are concerns that external or internal manifestations of mental health symptoms within facilities can lengthen stays leading to suicide attempts, and even pose greater danger to others (U. S. House of Representatives Committee on Government Reform, 2004Reform, , 2005.…”