Trauma, Family Factors and the Mental Health of Homeless Adolescents (original) (raw)
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Personal and family distress in homeless adolescents
Community Mental Health Journal, 1993
Previous research has indicated that homeless children exhibit high rates of behavioral and emotional problems and come from families characterised by conflict and rejection. Further, some evidence exists to show that family variables may relate to adolescent distress differently for homeless males and females. In this study, 117 homeless adolescents were compared to a sample of non-homeless youths on the self reported incidence of personal and family problems. The homeless children reported the highest incidence of all behavioral and emotional problems, parental marital discord, overprotection, and the lowest levels of parental care and acceptance. Sex effects were not evident in reported levels of personal or family problems. However, substantially more variance in the adolescents level of behavioral and emotional disturbance was predictable from family measures for females than males. Overall, the results point to the importance of incorporating family distress models in the understanding and remediation of adolescent homelessness.
Child Abuse & Neglect, 2000
Objective: This study examined the differential effects of various forms of abuse, as well as their combined effects. The study also sought to separate the factors uniquely associated with abuse from those associated with the more general problems present in an abusive family environment. Methodology: Data were collected from 329 homeless adolescents. Preliminary analyses indicated some degree of matching for family background variables. Any differences in demographic or family characteristics were controlled for statistically. Results: Chi-square analyses revealed significant differences across groups for rates of assault, rape, depression/dysthymia, and attempted suicide. Multivariate analyses (MANOVAs) indicated significant differences in severity of internalizing problems and cognitive problems. Without exception, the group with histories of both physical and sexual abuse exhibited the most severe symptomatology and was at greatest risk for revictimization. Multiple regression analyses suggested that abuse histories were predictive of internalizing problems while family characteristics were more predictive of externalizing problems.
Factors Associated With Substance Use Disorders Among Traumatized Homeless Youth
Journal of Social Work Practice in the Addictions, 2015
This study aimed to identify homeless youths' lifestyle and trauma-related risk factors as well as protective factors associated with alcohol use disorder or no disorder and drug use disorder or no disorder. Youth receiving homeless services in Denver (n = 201), Austin (n = 200), and Los Angeles (n = 200; N = 601) completed quantitative interviews assessing demographic information, alcohol and drug use, homeless lifestyle risk factors, trauma-related risk factors, and protective factors. Findings showed differences in trauma-related risk factors between alcohol and drug use disorders, but not homeless lifestyle risks. Protective factors predicted substance use disorders beyond risk factors. Understanding trauma-related risk and protective factors associated with substance use disorders could improve interventions.
Journal of Social Distress and the Homeless, 2004
There are two factors that limit our knowledge of the risk factors associated with homeless ness among runaway adolescents, namely (1) the samples used are often composed of youth homeless service users and/or youths living on the streets (visible homelessness), whereas most adolescents in fact use "private" resources (hidden homelessness), and (2) failure to use an adequate control group to identifY risk factors associated specifically with homeless ness. Our study compares the characteristics of two groups of youths under the supervision of the youth protection system, according to the presence or absence of periods of homelessness. The results throw light on the factors underlying the shift from "at risk" to "homeless", showing that youths with experience of homelessness are more likely to have been placed in substitute home environments, have experienced significant relationship difficulties with one of their parents (deterioration of the parent/youth relationship and parental abuse) and to have been diagnosed with behavioral disorders. The findings suggest that the decision to place young people under supervision is based more on the dynamic between risk factors rather than on the existence of behavioral problems.
Journal of Adolescent Health, 2009
Almost everything known about risk factors for homelessness is based on cross-sectional studies of non-random samples. Furthermore, most studies have focused on a small number of risk factors and have not evaluated their relative importance. Our aim was to examine which factors, in a population-based sample of adolescents, independently predict homelessness in young adults. Methods: Participants (n ¼ 10,433) in the US National Longitudinal Study of Adolescent Health (Add Health) were initially selected through systematic random sampling of US high schools. Interviews were conducted at home in 1994-1995 when the participants were 11-18 years of age and again in 2001 when participants were 18-28 years of age. We examined the relationships between a range of risk factors reported in adolescence (mood-related problems, substance involvement, delinquency, personality, quality of family relations, neighborhood quality, school adjustment, religious affiliation, perpetration of violence, and experiences of victimization) and experiences of homelessness reported in young adulthood, using regression analysis. Results: Each risk factor predicted homelessness. However, only family relationship quality (odds ratio [OR] ¼ .79, 95% confidence interval [CI] ¼ .69-.90), school adjustment problems (OR ¼ 1.57, 95% CI ¼ 1.35-1.82), and experiences of victimization (OR ¼ 1.27, 95% CI ¼ 1.11-1.45) were found to independently predict homelessness. Conclusions: Among a range of well-established risk factors, a troubled family background, school adjustment problems and experiences of victimization were found to be the strongest predictors of homelessness in a general population of young people. Our findings suggest possibilities for the early identification of young persons at risk for homelessness through schools, agencies offering familybased support, and clinical services.
Prevention Science, 2020
Behavioral family interventions are an effective way to intervene to prevent negative developmental outcomes for adolescents. Participation in family interventions encompasses behavioral and cognitive/attitudinal dimensions, among others, indicated by retention and engagement, respectively. Two dimensions of participation, retention and engagement, in a family intervention were examined in a sample of newly homeless adolescents and their parents or guardians. Correlates of participation included parents with more income and less perceived family conflict and adolescents with higher endorsement of depression, anxiety, somatization, obsessive-compulsive, phobic, and psychotic symptoms on the Brief Symptom Inventory (BSI). Stronger therapeutic alliance was correlated with being more distressed (i.e., lower income, more hostility), being a female adolescent participant, and having greater comfort discussing sex with parents. Furthermore, parents and adolescents with greater distress and thus greater need were more apt to finish the intervention. The finding that families who were experiencing more distress had higher alliance scores suggests that there is an additional need for development of interventions for families in crisis. Both participant and provider perceptions are also important in development of a strong therapeutic alliance. This study's findings have implications for further exploration of the development of cultural humility and improving mental health literacy among facilitators of behavioral interventions. Keywords Homeless adolescents. Youth high-risk behaviors. Family conflict. Family interventions. Intervention engagement There is a large unmet need for family interventions for homeless adolescents. Family interventions with homeless adolescents are, however, a relatively unexplored area (Pergamit et al. 2016) even though their family relationships are often characterized by conflict, inappropriate problem-solving and poor communication (Tyler and Schmitz 2013). While research demonstrates that newly homeless adolescents will return home (Milburn et al. 2007), those who have more troubled relationships with their parents have a more difficult time remaining at home (Milburn et al. 2009). Getting homeless adolescents and their families to participate in family interventions, crucial for intervention effectiveness, is a known challenge (Spoth and Redmond 2000), especially for at-risk adolescents (e.g., Rotheram-Borus et al. 2002) that often have low completion rates (Milburn and Lightfoot 2016). This may be due to barriers to participating in terms of access, relevance, and time commitment (Coatsworth et al. 2018). One strategy often used for increasing access for these challenged families is to provide family interventions during key life transitions for adolescents when families naturally partake in their children's activities (e.g., graduation) and, thus, might be receptive to participating in an intervention that could help with the transition (Coatsworth et al. 2006). For homeless adolescents, a key life transition time may be when they first leave home, are newly homeless, and may want to reconnect via a family intervention. The success of this strategy, however, has been limited for homeless adolescents (Coatsworth et al. 2006).
Child Development, 2000
This study examines factors that contribute to depressive symptoms and to co-occurring depression, substance abuse, and conduct problems among 602 runaway and homeless adolescents. The respondents were interviewed in shelters, drop-in centers, and directly on the streets in four Midwestern states (Missouri, Iowa, Nebraska, and Kansas). Results indicate that although family-of-origin factors contribute to depressive symptoms and comorbidity among runaway and homeless adolescents, experiences and behaviors when the adolescents are on their own also have powerful effects. The authors discuss the findings from a life-course perspective focusing on mechanisms through which street experiences accentuate or amplify already high levels of psychological distress and behavioral problems among this population of young people.
Parent-adolescent violence and later behavioral health problems among homeless and housed youth
American Journal of Orthopsychiatry, 2009
Parent-adolescent violence (i.e., violence between parents and adolescents) is an important pathway to homelessness and predicts poor behavioral health outcomes among youth. However, few studies have examined links between parent violence and outcomes among youth who are homeless. Existing research has also tended to ignore adolescent violence toward parents, despite evidence that mutual violence is common. The current study examines prospective links of parent-adolescent violence to outcomes among youth who were homeless and demographically matched youth, through two complementary substudies: (a) an exploratory factor analysis (EFA) of items measuring parent and adolescent violence combined in the same analysis; and (b) an examination of predictive relationships between the factors identified in the EFA and behavioral health problems, including mental health and alcohol abuse problems. Predictive relationships were examined in the overall sample and by gender, ethnic, and housing status subgroups. Results of the EFA suggested that parent-adolescent violence includes intraindividual (i.e., separate parent and adolescent) physical components and a shared psychological component. Each of these components contributed uniquely to predicting later youth behavioral health. Implications for research and practice with youth who are homeless are discussed.
Child and Youth Care Forum, 2005
Mental health symptoms, victimization experiences, and rates of substance use among homeless youth were assessed using typical clinical intake questions and standard questionnaires. Youth were also asked what they regarded as their primary problems. Results indicated that issues likely to concern health professionals, such as past victimization, high rates of substance use, and psychological symptoms, are often not regarded as problems by homeless youth. Also, based on responses to a coping interview, homeless youth indicated that they rarely sought help from mental health professionals, and tended to cope with problems in a variety of other ways. Despite obstacles to the provision of services, many youth indicated a willingness to talk to a counselor about self-identified problems and there were some points of convergence between self-and other-identified problems.