Victimization and Posttraumatic Stress Disorder Among Runaway and Homeless Adolescents

This article presents lifetime and 12-month prevalence rates and comorbidity for posttraumatic stress disorder (PTSD) among a sample of 428 homeless and runaway adolescents. Data are from baseline interviews of a longitudinal diagnostic study of 428 (187 males; 241 females) homeless and runaway adolescents aged 16–19 years (mean age = 17.4 years, SD = 1.05). The data were collected by full-time street interviewers on the streets and in shelters in eight Midwestern cities of various populations. About one-third (35.5%) of the runaways met lifetime criteria for PTSD and 16.1% met 12-month criteria for the disorder. More than 90% of the adolescents who met criteria for PTSD met criteria for at least one of the other four diagnoses. Multivariate analyses indicated that correlates of PTSD were age of adolescent, being female, having experienced serious physical abuse and/or sexual abuse from an adult caretaker, and having been assaulted or injured by weapon when on the street. The multiplicative interaction between sexual abuse by caretaker and sexual assault when the adolescents were on their own was statistically significant, indicating that rape victims were highly likely to meet criteria for PTSD regardless of early sexual abuse. At very high levels of early sexual abuse, the probability of meeting criteria for PTSD converges with that for sexual assault victims.

[1]  S. Morton,et al.  Enumerating Homeless People , 1996 .

[2]  H. Wittchen,et al.  Composite International Diagnostic Interview. CIDI Interviewerheft (deutsche Bearbeitung) , 1991 .

[3]  R. Kessler.  Building on the ECA: The National Comorbidity Survey and the Children's ECA. , 1994 .

[4]  P. M. Sullivan,et al.  The prevalence of disabilities and maltreatment among runaway children. , 2000, Child abuse & neglect.

[5]  G. Canino,et al.  Test-retest reliability of the Diagnostic Interview Schedule for Children (DISC 2.1). Parent, child, and combined algorithms. , 1995, Archives of general psychiatry.

[6]  H. Wittchen.  Reliability and validity studies of the WHO--Composite International Diagnostic Interview (CIDI): a critical review. , 1994, Journal of psychiatric research.

[7]  M Davies,et al.  The Diagnostic Interview Schedule for Children-Revised Version (DISC-R): I. Preparation, field testing, interrater reliability, and acceptability. , 1993, Journal of the American Academy of Child and Adolescent Psychiatry.

[8]  J. Ginzler,et al.  The Characteristics and Mental Health of Homeless Adolescents , 2000 .

[9]  L. Whitbeck,et al.  Abusive family backgrounds and later victimization among runaway and homeless adolescents , 1997 .

[10]  M. Greenblatt,et al.  The prevalence of psychotic symptoms in homeless adolescents. , 1990, Journal of the American Academy of Child and Adolescent Psychiatry.

[11]  L. Whitbeck,et al.  Mental disorder and comorbidity among runaway and homeless adolescents. , 2004, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[12]  Shaffer,et al.  Test-Retest Reliability of the Diagnostic Interview Schedule for Children (DISC 2.1) , 2022 .

[13]  Dc Washington.  Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. , 1994 .

[14]  R. Kessler.  The National Comorbidity Survey of the United States , 1994 .

[15]  L. Whitbeck,et al.  A Risk-Amplification Model of Victimization and Depressive Symptoms Among Runaway and Homeless Adolescents , 1999, American journal of community psychology.

[16]  L. Whitbeck,et al.  Mental disorder, subsistence strategies, and victimization among gay, lesbian, and bisexual homeless and runaway adolescents , 2004, Journal of sex research.

[17]  A. Burgess,et al.  Histories of sexual abuse in adolescent male runaways. , 1987, Adolescence.

[18]  R. Kessler,et al.  Posttraumatic stress disorder in the National Comorbidity Survey. , 1995, Archives of general psychiatry.

[19]  N. Margetson,et al.  Psychosocial background and behavioral and emotional disorders of homeless and runaway youth. , 1992, Hospital & community psychiatry.

[20]  J. Ginzler,et al.  Challenges faced by homeless sexual minorities: comparison of gay, lesbian, bisexual, and transgender homeless adolescents with their heterosexual counterparts. , 2002, American journal of public health.

[21]  N. Breslau,et al.  Traumatic events and posttraumatic stress disorder in an urban population of young adults. , 1991, Archives of general psychiatry.

[22]  B. McCarthy,et al.  Mean Streets: Youth Crime and Homelessness , 1998 .

[23]  J. Buckner,et al.  Mental disorders and service utilization among youths from homeless and low-income housed families. , 1997, Journal of the American Academy of Child and Adolescent Psychiatry.

[24]  Lee Ann,et al.  Nowhere to Grow: Homeless and Runaway Adolescents and Their Families , 2001 .

[25]  S. Wolfe,et al.  Homeless and matched housed adolescents: a comparative study of psychopathology. , 1998, Journal of clinical child psychology.

[26]  H. Resnick,et al.  Violence and risk of PTSD, major depression, substance abuse/dependence, and comorbidity: results from the National Survey of Adolescents. , 2003, Journal of consulting and clinical psychology.

[27]  Kimberly D. Ryan,et al.  Personal Victimization in a High-Risk Environment: Homeless and Runaway Adolescents , 1999 .

[28]  L. Whitbeck,et al.  The Impact of Childhood Sexual Abuse on Later Sexual Victimization among Runaway Youth. , 2001 .

[29]  M. Nimmo,et al.  Youth on the street: abuse and neglect in the eighties. , 1987, Child abuse & neglect.

[30]  S. Cochran,et al.  Prevalence of mental disorders, psychological distress, and mental health services use among lesbian, gay, and bisexual adults in the United States. , 2003, Journal of consulting and clinical psychology.

[31]  H. Resnick,et al.  Prevalence of civilian trauma and posttraumatic stress disorder in a representative national sample of women. , 1993, Journal of consulting and clinical psychology.

[32]  J. Unger,et al.  Homeless youth and their exposure to and involvement in violence while living on the streets. , 1997, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[33]  R. Kessler,et al.  Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. , 1994, Archives of general psychiatry.