Identification of Trauma Classes and Their Relation to Multiple Mental Health Disorders Among Justice-Involved Youth

Background and Purpose: Among justice-involved youth, having multiple traumatic exposures is associated with multiple psychological problems. Treatment for multiple disorders is more challenging than treatment for single disorders, therefore understanding distinct groupings of trauma exposure and their relation to multiple co-occurring disorders can assist practitioners in identifying and providing services to youth at greatest risk for psychiatric problems. This research aims to advance work on trauma exposure among justice-involved youth by examining how different groupings of trauma exposure influence multiple psychiatric diagnoses. The current study addresses two research questions: 1. Can justice-involved youth be grouped into latent classes based on their trauma exposures? 2. What is the association between these latent classes and the number of psychiatric diagnoses a youth experiences?

Methods: This study included 426 youths, who were admitted to custody in the New Jersey Juvenile Justice System between July 2015 and April 2019. The current study includes youth between 12 to 17 years. Indicators of trauma exposure came from youths’ self-report on the Life Events Checklist, which includes 17 items that assess individuals’ exposure to interpersonal and non-interpersonal trauma during their lifetime. Family violence, parental incarceration, parental drug/alcohol use, and parental mental health issue were also included as additional indicators of interpersonal trauma exposure. The outcome variable is the number of psychiatric diagnoses that youth were assessed as having as part of a standardized intake process. Latent class analysis was conducted to explore potential latent classes that represented distinct patterns of trauma exposure in youths. This study further examined the association between latent classes and youths’ number of psychiatric diagnoses, after controlling several covariates, including age, sex, race/ethnicity, homelessness, and gang affiliation.

Results: Latent class analysis identified four classes that represented different trauma exposure experiences of youths. Class 1, the high exposure or polyvictimization class, was characterized by a high probability of being exposed to multiple traumas across the various indicators. Class 2, a mixed exposure class, was characterized by a high probability of parental-related dysfunction (i.e., parental incarceration and drug/alcohol use). Class 3, a second mixed exposure class marked by environmental violence, was characterized by an extremely high probability of being exposed to physical assault and accidental trauma. Class 4, a lower exposure class, was the class that relatively had the lowest probability of experiencing any of the traumas. Further analysis found that youths in Class 1 had 0.75 more psychiatric diagnoses than youths in Class 4 (p < .05).

Conclusions and Implications: The findings suggest several distinct latent classes of youths’ trauma exposure experiences. Some youths had a relatively low probability of experiencing trauma exposure, while others might have higher probabilities of experiencing one or multiple types of trauma exposure. Moreover, youths who had higher probabilities of experiencing multiple types of trauma exposure had more psychiatric diagnoses compared to those who had a lower probability of trauma exposure. Sharing these results with the local juvenile justice agency is supporting their efforts to better understand and respond to youth who have experienced various forms of trauma.