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Research has shown that there are a number of risk factors that increase the odds of youth joining gangs, from individual- to family- to neighborhood-level risks. Studies have identified child abuse and other childhood traumatic experiences as influences on gang membership. Adverse childhood experiences (ACEs) provide a framework for how to measure and identify these traumatic events. This dissertation study uses longitudinal data from the Pittsburgh Youth Study (PYS) to inform the relationship between early life events and later gang membership. First, the count of total ACEs experienced by gang involved youth were compared to nongang youth. Then, latent class analysis was used to create groupings of ACEs to determine if particular classes of adverse events are associated with higher odds of gang membership during later adolescence. Using the longitudinal data structure of the PYS, additional latent classes were developed when breaking up the adversity into separate age ranges. ACE categories for the youngest cohort were able to be divided into early school entry (elementary school), early adolescence (middle school), and later adolescence (high school) due to their earlier age of first survey, and then these age-graded categories were added into the latent class model to determine if age specific adversity increased odds of gang membership. Lastly, covariates were added into the model to test if time-stable elements increased odds of belonging to one of the classes identified in the initial latent class analysis. The methods described above produced results, showing that gang involved youth have significantly more childhood adversity than nongang involved youth on average. When the latent class analysis was conducted, a three-class solution was found to be the most appropriate model, with classes with higher odds of adversity leading to greater odds of gang membership. There was no significant difference between two classes that had higher odds of adversity, though both included high rates of community violence experiences and parental separation. There were mixed findings on the impact of age specific adversity. Lastly, covariates were added into the model finding early school achievement plays a large role in predicting class membership, while familial financial strain does not. The findings from this dissertation have important implications for policy and practice around gang prevention and intervention in that they can help pinpoint constellations of risk factors. Evidence-based school intervention programs, such as The Fourth R-- an in-school intervention designed to reduce delinquency through positive relationship building with teachers, parents, and pro-social peers (Crooks et al., 2011)-- are important for reducing the odds of experiencing higher odds of adversity. Additionally, programs that work with youth who experience adversity can help reduce the hurt they perpetrate on others. / Criminal Justice

The aim of this arts-based research study was to experience, analyze, and gain insight into songs written by adolescents who have had adverse childhood experiences and who identify with Hip Hop culture. This study investigated the aesthetic components of eleven songs including their musical elements, the compositional techniques, the affective-intuitive qualities, and the interaction between the music and the lyrics. An arts-based research design, rooted in the ethos of Hip Hop, was employed to gain a holistic understanding of the songs. My artistic encounters and subsequent analyses of the songs revealed the complex inner struggles and developmental challenges for adolescents who have experienced extreme trauma. Three groupings of songs emerged: Songs that Protect Vulnerability, Songs of Abandonment, and Songs of Faith and Love. Each category reflects a different stage of developmental growth for the songwriters. Employing Fowler's (1981/1995) stages of faith development, a music-centered developmental model of therapeutic songwriting with adolescents is proposed in this study. This model consists of three therapeutic songwriting stages: Imitation, Developing Self-Reflection, and Developing Self-Love. The implications for this study include developing an arts-based method of song analysis for students and professionals, developing a music-centered therapeutic songwriting assessment, developing a perspective for music therapy practice and research rooted in the ethos of Hip Hop, and developing longitudinal arts-based research studies that track the life of songs across various stages of developmental growth. / Music Therapy

Early stressors like trauma can lead to developmental changes that have life-long negative health consequences (Merikangas et al., 2010; Anda et al., 2006). Approximately 1 in 4 youth experience substantial trauma during their developmental years (Merikangas et al., 2010; Duke, Pettingell, McMorris, and Borowsky, 2010). Such findings suggest the need for early intervention and treatment for adolescents exposed to traumatic events and adversity. Ideally, adolescents could be treated within primary care settings where parents overwhelmingly seek services for their children. Primary care settings are sought out at a 94% to 97% rate of services as compared to only a 4% to 33% rate of parents seeking out mental health services (Guevara et al., 2001). Unfortunately, no adolescent trauma-informed interventions have yet been adapted for use in primary care (Glowa, Olson, and Johnson, 2016). This study aimed to fill this critical gap between adolescent mental health issues associated with trauma and adverse childhood experiences and the lack of treatment in integrated primary care settings. The need for trauma-informed treatment for adolescents who have experienced trauma and adverse experiences is especially salient as evidence-based treatment for adolescents in this setting is limited. A modified Delphi approach was employed to address this gap in the research. Two rounds of questionnaires and focus groups were utilized with a panel of experts and youth stakeholders to gain consensus on treatment recommendations. Ultimately, expert panelists and youth stakeholders identified 59 recommendations for adolescent trauma treatment to be delivered in integrated primary care settings. / Doctor of Philosophy / Childhood trauma can have negative health, social, and educational outcomes that extend into adulthood and over one’s lifespan (Black, Woodworth, Tremblay, & Carpenter, 2012; Merikangas et al., 2010). Approximately 1 in 4 youth today experience trauma (Duke et al., 2010). Trauma can include a variety of things such as physical, sexual, or emotional abuse; being the victim of a crime; witnessing violence in the home; living through a natural disaster or experiencing an accident (Anda et al., 2006; APA, 2017). The frequency of trauma in adolescence suggests the need for early intervention and treatment. Ideally, adolescents could be treated within primary care settings where parents and adolescents frequently seek care services. Unfortunately, no adolescent trauma interventions have been created for this setting (Glowa, Olson, & Johnson, 2016). This study was designed to improve the treatment of adolescent trauma in primary care settings. For this research study a modified Delphi technique was used. Two rounds of questionnaires and focus groups were utilized with participants that consisted of a panel of experts from the field and youth aged 14-18 years old. Ultimately, the study participants made 59 recommendations for adolescent trauma treatment to be delivered in primary care settings.

Introduction: Adverse Childhood Experiences (ACEs) are known to increase risk of mental health challenges throughout development, and sleep is known to decrease risk of mental health challenges. These have not been studied in tandem in younger cohorts. We investigated whether interactions between sleep duration and sleep regularity would moderate the impact of ACE exposure on risk for the development of mental health disorders. Methods: We conducted secondary cross-sectional analyses on the 2020-2021 waves of the National Survey of Children's Health (NSCH) (n = 92,669). We used logistic and ordinal regression to replicate known main effects of ACEs (total, household, community, and single) and sleep (duration and irregularity) on mental health diagnostic status and symptom severity, and we examined the interaction of ACEs and sleep on mental health diagnostic status. To correct for multiple comparisons, all original models were performed with one half of the dataset and then replicated in the second half. Follow-up analyses by age cohort (0-5, 6-11, 12-17 years) further examined interaction effects across development. Poverty level, parental education status, child age, child sex, neighborhood safety, neighborhood support, and race/ethnicity were included as covariates, as indicated in a priori acyclic graph (DAG) modeling. Results: Known main effects for ACE and sleep on mental health diagnoses were replicated across all models. Interactions between ACE exposure and adequate sleep duration or increased sleep irregularity were not clinically significant, although some were statistically significant due to large sample size, such that adequate sleep duration was associated with marginally increased risk of mental health diagnosis (Omnibus B = 0.048, p < 0.0001) and greater bedtime irregularity was associated with marginally decreased risk of mental health diagnosis (Omnibus B = -0.030, p < 0.001). Discussion: Main effects in this analysis are consistent with previous literature on ACEs, sleep, and mental health. However, interaction effects were largely small and clinically insignificant. Dichotomous and categorical parent-report items assessing sleep health may not be sensitive to interaction effects, compared with continuous data or physiological measurements. Further, examining mental health symptoms (rather than diagnosis status) may also allow for more nuanced understanding of potential interaction effects.

<p dir="ltr">Background—Adverse Childhood Experiences (ACEs) are events that occur before age 18, such as abuse and neglect, which are potentially traumatic. ACEs can lead to profound negative impacts on physical and psychological health and social relationships. Despite this, positive social connections can mitigate these effects. However, individuals with ACEs may struggle to form healthy relationships because of mistrust, leading to continued exposure to detrimental social environments. Additionally, ACE-exposed adults often internalize stigma.</p><p dir="ltr">Methods—Utilizing data spanning from 1995 to 2014, Chapter 2 examines 629 adults from the MIDUS II: Biomarker study. Employing counterfactual modeling, the study estimates the treatment effect of ACE exposure on well-being and employs weighted multilevel mixed models to analyze life course changes. Chapter 3 uses 1,243 respondents from the MIDUS II: Biomarker study, employing latent class analysis to identify social relationship patterns and assess their mediation between ACEs and the pursuit/enjoyment of new relationships. Chapter 4 uses experimental data from 493 respondents, employing vignette experiments to gauge perceptions of warmth and competence, with gender and happiness examined as moderators, and threat, status, four stigmatizing descriptions as mediators.</p><p dir="ltr">Results—ACE exposure is associated with increased chronic conditions, lower self-rated health, diminished psychological and social well-being. However, the strength of the treatment effects differs based on the type and number of ACE exposures. Latent Class Analysis of social relationships indicates four classes: healthy, ambivalent, kin-focused, and difficult, with higher ACEs linked to a decreased probability of being in the “healthy” class. ACEs also predict reduced enjoyment of interactions with new people, mediated 41% by the current social relationship class. ACE vignettes are perceived as less warm and competent, with happiness moderating some ACE-related perceptions. Status, “mentally ill”, and “damaged” emerged as strong mediators.</p><p dir="ltr">Conclusion—While ACE exposure is related to lower well-being, the rate of decline does not differ from non-ACE-exposed individuals across time. Those in strained relationships are less likely to enjoy new social interactions, potentially perpetuating ACE-related health consequences. Addressing interpersonal trust issues in ACE-exposed adults through social interventions may mitigate these effects. Additionally, there is stigma against each of the ten ACEs, and the medicalization of ACEs contributes to stigma.</p>

Thesis (PhD)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: The impetus for this study is contextualised within social work teaching and learning and arose from the emergence of adverse childhood experiences (ACEs) of social work students. The researcher had become increasingly interested in the ways in which these ACEs impacted on students in social work classrooms and felt compelled to enquire what the responses of teaching and learning in social work should be. The rationale for the study was further established by the dearth of research in this focal area. The research goal was to gain an understanding of the experiences of third-year students and the perspectives of social work teachers with regard to the role of adverse childhood experiences during teaching and learning activities and to recommend meaningful teaching practices. There were seven research objectives that focused on obtaining theoretical perspectives from the literature and on exploring and describing the adverse childhood experiences of students within the context of teaching and learning in social work. The research objectives generated the central research question: What are the learning experiences of third-year social work students at a South African university with regard to the role of their own adverse childhood experiences? A qualitative approach and case study design was deemed the most appropriate research philosophy and method to address the study’s objectives and central research question. The case study design was used to explore how individuals (third-year social work students at the University of the Western Cape) experienced a particular phenomenon (in this case adverse childhood experiences) in relation to teaching and learning within a social work context. To provide credence to the two purposes of this research, namely exploring and describing, two methods and two sources of data were utilised: (i) a reflective assignment in a specific social work third-year module from which 20 assignments were selected using purposive sampling; and (ii) individual interviews with ten student participants (derived from the sample of assignments) and two teaching staff participants. Three overarching topics emerged from the findings, namely the adverse childhood experiences of student participants; the after-effects of adverse childhood experiences in the context of teaching and learning in social work; and suggestions by participants for social work teaching and learning in the context of adverse childhood experiences. Each topic was delineated further into themes, sub-themes, and categories. The conclusions are that there was compelling evidence showing students to have endured formidable adverse childhood experiences; that students experienced overwhelming emotional reactions and responses during teaching and learning that exposed vicarious traumatisation; and that gaps present in current teaching and learning practices in social work render these practices insufficient to meet the learning needs of students. Three core recommendations relating to teaching and learning are offered: To develop the content of professional learning in the social work curriculum regarding the professional use of self, self-awareness and virtue ethics; to reconstruct and reaffirm the signature pedagogy regarding teaching and learning approaches and methods in social work; and to align fieldwork and placement learning with student profiles while also focusing on lecturer attentiveness and responsiveness. / AFRIKAANSE OPSOMMING: Die impetus vir hierdie studie is vervat in die onderrig en leer in maatskaplike werk van maatskaplike werk studente wat afbrekende kindertydse ervarings (AKE’s) deurgemaak het. Die navorser, wie se belangstelling al hoe meer geprikkel is deur die wyse waarop hierdie AKE’s studente in maatskaplike werk in die lesingsaal beïnvloed, is genoodsaak om inligting in te win oor wat die reaksie op onderrig en leer in maatskaplike werk behoort te wees. Die rasionaal vir die studie is verder deur die gebrek aan navorsing in hierdie fokusarea versterk. Die doel van die navorsings was om begrip vir die ervarings van derdejaarstudente en die perspektiewe van maatskaplikewerkdosente te ontwikkel oor die rol van AKE’s tydens onderrig- en leeraktiwiteite, en om betekenisvolle onderrigpraktyke aan te beveel. Die fokus van die sewe navorsingsdoelwitte was die inwin van teoretiese perspektiewe, asook die eksplorering en beskrywing van studente se AKE’s binne die konteks van die onderrig en leer van maatskaplike werk. Die navorsingsdoelwitte het die sentrale navorsingsvraag gegenereer: Hoe ervaar derdejaarstudente hul eie afbrekende kindertydse ervarings in maatskaplike werk aan ’n Suid-Afrikaanse universiteit? n Kwalitatiewe benadering en gevallestudiemetode is as geskikte metodes beskou om die studie se doelwitte en sentrale navorsingsvraag te ondersoek. Die gevallestudiemetode is gebruik om na te vors hoe individue (derdejaarstudente in maatskaplike werk aan die Universiteit van Wes-Kaapland) ’n spesifieke fenomeen (in hierdie geval AKE’s) ten opsigte van onderrig en leer binne die konteks van maatskaplike werk ervaar. Om geloofwaardigheid te verleen aan die twee doelwitte van hierdie navorsing, naamlik ’n verkennings ondersoek en beskrywing, is van twee metodes en twee databronne gebruik gemaak: (i) ’n Reflektiewe taak in ’n spesifieke derdejaarmodule in maatskaplike werk waaruit 20 take met behulp van ’n doelbewuste steekproef gekies is; en (ii) individuele onderhoude met tien deelnemende studente (gekies uit die steekproef van take), en twee deelnemende dosente. Drie oorkoepelende onderwerpe het uit die bevindinge na vore gekom, naamlik die AKE’s van studentedeelnemers; die nagevolge van afbrekende kindertydse ervarings binne die konteks van die onderrig en leer van maatskaplike werk; en voorstelle van deelnemers vir onderrig en leer van maatskaplike werk binne die konteks van AKE’s. Elke onderwerp word verder in temas, subtemas en kategorieë weergegee. Die gevolgtrekking is dat oortuigende bewyse bestaan wat toon dat studente ontsaglik AKE’s deurgemaak het; dat studente oorweldigende emosionele reaksies en response ervaar tydens onderrig en leer wat tot indirekte traumatisering lei; en dat daar tekortkominge is in die huidige onderrig- en leermetodes vir maatskaplike werk wat nie genoegsaam aandag gee aan die leerbehoeftes van studente nie. Daar is drie kernaanbevelings rakende onderrig en leer: Om die omvang van professionele leer ten opsigte van die professionele gebruik van die self, selfbewustheid en deugsaamheid in die maatskaplike werk-kurrikulum te ontwikkel; om maatskaplike werk se kenmerkende pedagogie oor onderrig- en leerbenaderings en metodes te rekonstrueer en te herbevestig; en om praktiese plasing en leer tydens plasing met die profiel van ’n student te belyn, terwyl die fokus ook op die oplettendheid en reaksie van die dosent moet wees.

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Child maltreatment and household dysfunction have long been linked to delinquency, adult criminality, and sexual offending. However, the association between adverse childhood experiences (ACEs), factors related to out-of-home placement, and the onset of maladaptive behaviors has not thoroughly been explored in adolescents who have engaged in sexually abusive behavior. In the present study, we examined archival records of 120 male youths who have received treatment for sexually abusive behavior. As expected, the male adolescents in this sample have experienced higher rates of ACEs than samples of adult males in the community, adult males who committed sexual offenses, and juvenile justice–involved males as reported in the literature. Discrete-time survival analyses yielded increased risks of onset of aggression and sexually abusive behavior during early childhood and mid-to-late childhood, with significant associations between higher ACE scores and a greater number of out-of-home placements. Implications and future directions are discussed.

This study aims to evaluate the implementation of Trauma-Informed Care (TIC) trainings in Johnson City, Tennessee, and the surrounding Appalachian area. Previous TIC trainees were sent an email survey asking them if they had followed through with their plan to implement the training at their place of work or in other areas of their lives. The response rate for this study was 2%, possibly due to extraneous variables such as the Coronavirus Pandemic and the lag time between the initial training and survey follow-up. The responses that were analyzed indicated promise for the practical implementation of TIC concepts at the companies involved in the training initiative. Additional research is needed in order to further analyze TIC implementation.