Methods: Researchers conducted case file reviews for 360 girls participating in a juvenile specialty court between 2012 and 2016. The specialty court is designed for youth at-risk or with confirmed histories of CSE in juvenile justice system and is located in a large, southwest region of the United States. Data were longitudinal, capturing events prior to, during, and at termination of court involvement. Predictor variables were gathered at court entry and included adverse childhood experiences (i.e., mother abused substances, mother had a criminal record, mother was incarcerated), child welfare involvement, and trafficker type (i.e., acquaintance, friend, family, intimate partner, stranger, or pimp). The outcome was presence of mental health diagnosis (1 = yes; 0 = no). Descriptive analysis and logistic regressions were used to describe the girls trafficking experiences and examine the relationship between adverse childhood experiences, child welfare involvement, trafficker type, and mental health challenges. The analytic plan mainly focused on investigating whether trafficker type predicted mental health outcomes, adjusting for other forms of childhood adversity.
Results: The majority of girls identified as Black (70%) or Latina (23%) and the mean age was 16 years old. Most girls had at least one mental health condition ever (77%), with depression (61%) being the most common diagnosis. Comorbidity—or the presence of two or more mental health diagnoses—was present among 55% of girls with mental health conditions. Trafficker type was available for more than half of the girls (56%). About one-fourth of girls had more than one trafficker (23%) and had a prior interpersonal relationship at least one of their traffickers (27%). Mothers were the primary caretaker for most girls at court entry (54%). Findings from the logistic regressions indicated that having a prior interpersonal relationship with their trafficker b = 1.01, p < .05, OR = 2.76 (95% CI: 1.02, 7.48) and a child welfare case b = -1.32, p < .01, OR = 27 (95% CI: .12, .61) explained mental health outcomes above and beyond mother 's history of substance abuse or incarceration.
Conclusions and Implications: These findings highlight a continuum of childhood adversity endured by justice-involved girls experiencing exploitation. Findings suggest an important opportunity for multidisciplinary collaboration among mental health, child welfare, and juvenile justice practitioners and the need for standardized mental health assessments. To improve aftercare strategies, CSE-impacted girls would benefit from service provision that accounts for trauma and abuse related to both childhood adversity and trafficking.