Structural Equation Model of Posttraumatic Stress Among Runaway/Homeless Youth

Background and Purpose: Significant gains have been achieved in understanding adolescent mental health; however, little is known about the development of Posttraumatic stress among a particularly high-risk group—runaway/homeless adolescents. Precocious departure from familial homes is frequently due to family conflict, exposure to abuse and other traumatic events. Few studies have included family relationships in relation to Posttraumatic Stress among runaway/homeless youth, despite the fact that relationship issues are an intricate component of youths' runaway behavior and trauma symptoms. Thus, the purpose of this study is to test the hypothesis that gender and types of abuse (physical, sexual, neglect) are associated with youths' perceptions of poor family relationships, sexual concerns and depression. Each of these variables is then hypothesized to simultaneously predict the level of Posttraumatic stress among homeless/runaway youth.

Methods: Data were from quantitative surveys collected on 350 adolescents 12-18 years of age admitted to two youth shelters in New York and Texas. Youth averaged 15 years of age, were predominantly female (56%), Caucasian (42%), had run away an average of 5 times, and spent more than 5 days away from home. Youths' Posttraumatic Stress symptoms (dependent variable), sexual concerns associated with previous abuse, and depression were measured using the Trauma Symptom Checklist for Children. The Family Functioning Scale measured youths' worries related to family relationships. Sexual, physical abuse and neglect were measured through research-developed questions.

Structural equation modeling, using AMOS 16, was selected as an appropriate technique due to its capacity to test overall and interrelationship effects of abuse, gender, family relationship worries, sexual concerns and depression on Posttraumatic Stress symptoms. Maximum likelihood estimation procedure was used; estimated means and intercepts were selected in order to manage missing data. A latent variable of abuse was modeled from the observed variables of neglect, sexual, and physical abuse.

Results: After designating structural paths within the model and co-varying error terms between physical and sexual abuse variables within the latent abuse variable, the model represented an excellent fit to the data (chi-square=18.0, (df=15), p=.260; CFI=.99, RMSEA=.02). Results of the structural model revealed four significant path coefficients: Females were more likely to experience family relationship worries directly (unstandardized path coefficients=5.99, p<.000). As the level of trauma increased, scores on family relationship worries increased (30.02, p=.01), as did severity of depression scores (33.57, p=.01). As sexual concerns increased, Posttraumatic Stress symptoms also increased (1.0, p<.000).

Conclusion/Implications: Results of the structural model are promising for the field of runaway/homeless youth services as they provide insight into the antecedents of Posttraumatic Stress symptoms for these adolescents. Such information could aid practitioners to better recognize the important issues concerning trauma symptoms and focus on effective methodologies to treat these highly vulnerable adolescents. Findings may assist policymakers further understand the degree to which laws and programs should address youths' trauma experiences and factors associated with those experiences. Nevertheless, further research is needed to retest similar structural models to verify its utility in predicting pathways leading to symptoms of Posttraumatic Stress among runaway/homeless youth.