Background: Although major advances have increased understanding adolescent mental health, little is known concerning trauma symptoms among a particularly high-risk group of youth – runaway/homeless adolescents. Nearly two million youth run away or are forced out of their homes each year; many experience multiple mental health problems due to family disorganization, parental rejection, and abuse. These youth often suffer from exposure to chronic family problems and confront numerous traumatic events that my produce symptoms of post traumatic stress disorder (PTSD) or traumatic distress. To develop knowledge relevant for human service researchers and practitioners, this study examined family and youth predictors of traumatic distress.

Methods: Data from quantitative surveys and agency data were collected on 350 youth 12-18 years of age admitted to two runaway/homeless youth shelters in New York and Texas. Youth's traumatic distress and other psychological symptoms were measured using the Trauma Symptom Checklist (TSCC - Briere, 1996); family environment and functioning were evaluated using the Family Functioning Scale (Tavitian, et al., 1987). Youth averaged 15 years of age, were predominately female (56%), Caucasian (42%) or African American (38%), had run away approximately five times (SD+12), and had been away from home for more than 5 days (SD+17).

Results: Chi-square and ttests indicated few significant differences between youth from New York and Texas: New York youth were older and a greater proportion African American. The youth participant's traumatic distress scores (mean 68, SD +10) were identified as clinically significant (scores above 65 are considered in this range [Briere, 1996]) and 98% of youth were higher than the standardized average of 50 (SD+10). Bivariate correlations demonstrated runaway youth's higher levels of traumatic distress were significantly related to being male, Caucasian, using drugs, reporting poor health, poorer academic performance, and higher levels of depression, anxiety, dissociation symptoms, and anger. Family variables (parental drug use, sexual/physical abuse, poor family functioning and communication) were also significantly related to higher traumatic distress. Multiple regression analyses indicated that higher scores on depression, anxiety, and dissociation, mother's drug use, worry about family relationships, and poor family communication predicted greater levels of traumatic distress (F=20.10, p<.001) and accounted for 69% of the variance in the participant's traumatic distress.

Conclusions/practice Implications: Findings suggest that runaway/homeless youth have substantially higher rates of traumatic distress than standardized averages developed for use with the TSCC. As considerable research has linked measures of depressive symptom to family stresses, these findings suggest that traumatic distress is associated with a range of psychological symptoms. For youth who have experienced this distress before running away, the experiences associated with running away likely exacerbates these symptoms. As social workers are the major service providers for these youth, understanding the risk runaway youth face in terms of their mental health, especially those related to traumatic distress, should alert providers to target interventions addressing these problem areas. Social workers are in a prime position to improve integration of services that utilize effective mental health interventions and provide appropriate assessment and referral for these high-risk youth.