Youths who are detained are at great risk for both childhood maltreatment and psychiatric disorders. Depending on the sample and measure, 3% to 53% of delinquent youths have been sexually abused (1
)and 27% to 75% have been physically abused (1
). Recent studies also find that over two-thirds of detained youths have a psychiatric disorder (9
Studies of community, homeless, and clinical samples document an association between maltreatment and psychiatric disorders (11
). Despite their high risk for maltreatment and
psychiatric disorders, few studies have examined the association between them in detained youths. Instead, most studies have focused on childhood maltreatment and its association with drug use (5
). We found only 3 studies of childhood maltreatment and psychiatric disorders in detained youths (4
). All 3 reported an association between maltreatment and disorder. Yet, these studies focused on only 1 or 2 disorders and had methodological limitations.
Dixon et al examined post-traumatic stress disorder (PTSD) and childhood sexual abuse among female juvenile detainees in Australia (23
). However, their sample was small (n=100) and of limited generalizability to youths detained in the United States. They also relied on only 1 screen question to assess sexual abuse. Using 1 screen question may result in under-reporting; a more reliable and robust approach is to ask a series of specific questions about types of sexual abuse (24
Two studies of detainees conducted in the United States (4
)had large samples (> 500) but also used only 1 screen question to assess maltreatment. Gover and MacKenzie examined the association between childhood maltreatment and depression and anxiety; however, they combined all types of maltreatment for analyses (7
). Gover focused only on the relationship between childhood sexual abuse and depression (4
To our knowledge, no large-scale study of detained youths has examined the relationship between childhood maltreatment and a range of psychiatric disorders. This omission is critical because findings from studies of community, homeless, and clinical samples (11
)may not generalize to detained youths who are disproportionately poor, male, and racial/ethnic minorities. Furthermore, the detention center is a potential point of triage for child protection services and
psychiatric treatment. Data on the association between child maltreatment and psychiatric disorders will help guide effective protective and therapeutic interventions.
This is the third article to examine childhood maltreatment among participants in the Northwestern Juvenile Project, a longitudinal study of health needs and outcomes of detained youths. The first article documented the low concordance rates between self-report and official records of physical abuse; only 17% of those who reported physical abuse had a court record of maltreatment (25
). The second article examined forced sexual victimization as part of a larger study of PTSD and trauma; however, it did not examine physical abuse (26
In this article, we present prevalence data on physical and sexual abuse, assessed by self-report and official records. We then examine the relationship between types of maltreatment and 4 types of psychiatric disorders: anxiety, affective, disruptive behavior, and substance use. We hypothesize that all types of maltreatment will be associated with psychiatric disorders, that youth with a history of severe maltreatment will have the highest prevalence rates of disorders, and that patterns of associations between maltreatment and disorder will differ for males and females.