title: Assessing stress-related treatment needs among girls at risk for poor functional outcomes: The impact of cumulative adversity, criterion traumas, and non-criterion events.
abstract: Despite growing recognition that cumulative adversity (total stressor exposure, including complex trauma), increases the risk for psychopathology and impacts development, assessment strategies lag behind: Adversity-related mental health needs (symptoms, functional impairment, maladaptive coping) are typically assessed in response to only one qualifying Criterion-A traumatic event. This is especially problematic for youth at-risk for health and academic disparities who experience cumulative adversity, including non-qualifying events (separation from caregivers) which may produce more impairing symptomatology. Data from 118 delinquent girls demonstrate: (1) an average of 14 adverse Criterion-A and non-Criterion event exposures; (2) serious maladaptive coping strategies (self-injury) directly in response to cumulative adversity; (3) more cumulative adversity-related than worst-event related symptomatology and functional impairment; and (4) comparable symptomatology, but greater functional impairment, in response to non-Criterion events. These data support the evaluation of mental health needs in response to cumulative adversity for optimal identification and tailoring of services in high-risk populations to reduce disparities.
authors.affiliation: University of California, San Diego, Psychiatry Department, 8950 Villa la Jolla Dr, Suite A109, La Jolla, CA 92037, USA; San Diego State University, Sociology Department, 5500 Campanile Dr, San Diego, CA 92182, USA. Electronic address: alansing@ucsd.edu.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Lansing
authors.affiliation: University of California, San Diego, Psychiatry Department, 8950 Villa la Jolla Dr, Suite A109, La Jolla, CA 92037, USA; San Diego State University, Sociology Department, 5500 Campanile Dr, San Diego, CA 92182, USA.
authors.forename: Wendy Y
authors.initials: WY
authors.lastname: Plante
authors.affiliation: San Diego State University, Sociology Department, 5500 Campanile Dr, San Diego, CA 92182, USA.
authors.forename: Audrey N
authors.initials: AN
authors.lastname: Beck
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D003071:Cognition; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007407:Interviews as Topic; D008016:Life Change Events; D008297:Male; D008603:Mental Health; D011599:Psychopathology; D036301:Qualitative Research; D012307:Risk Factors; D016728:Self-Injurious Behavior; D014947:Wounds and Injuries / Q000453:epidemiology / Q000523:psychology*
keywords: Adverse childhood experiences; Cumulative adversity; Delinquent girls; Functional impairment; High-risk youth; Loss