Adverse Childhood Experiences and Psychological Distress in Juvenile Offenders: The Protective Influence of Resilience and Youth Assets
Kristen Clements-Nolle, Rachel Waddington
Journal of Adolescent Health, Published in issue: January 2019; p49–55
Original Articles
Abstract
Purpose
To examine whether internal resiliency and external assets directly protect juvenile offenders exposed to adverse childhood experiences (ACEs) from psychological distress and moderate the relationship between ACE exposure and psychological distress.
Methods
A total of 429 male and female adolescents involved with juvenile justice systems in a Western state completed an audio computer-assisted self-interview. Validated measures assessed ACEs, psychological distress, internal resiliency, and external youth assets. Hierarchical linear regression was used to assess the direct and moderating protective effects of internal resilience, family communication, school connectedness, peer role models, and nonparental role models on psychological distress. All models controlled for age, sex, race/ethnicity, free/reduced lunch qualification, current custody, supervision status, detention, and site.
Results
The mean ACE score among participants was 3.7 (standard deviation = 2.2) and 52.8% reported four or more ACEs. Participants with 4–5 ACEs (β = .37, p < .001) and 6–8 ACEs (β = .49, p < .001) were at increased risk for psychological distress. High internal resilience (β = −.20, p < .001), family communication (β = −.19, p < .001), school connectedness (β = −.14, p < .01), and peer role models (β = −.09, p < .05) were associated with a reduction in psychological distress in the presence of high ACE exposure. In the interaction models, having a high number of ACEs remained strongly associated with increased psychological distress. However, internal resilience (β = −.24, p < .01) and school connectedness (β = −.18, p < .05) significantly moderated (reduced) the relationship between high ACE exposure and psychological distress.
Conclusions
Our findings suggest that programs and policies that promote internal resilience and protective factors across multiple levels of influence may protect juvenile offenders exposed to childhood trauma from psychological distress.
Category: Young Persons
Barriers and enablers to adolescent self-consent for vaccination: A mixed-methods evidence synthesis
Barriers and enablers to adolescent self-consent for vaccination: A mixed-methods evidence synthesis
Harriet Fisher, Sarah Harding, Matthew Hickman, John Macleod, Suzanne Audrey
Qualitative Health Research, Volume 29 Issue 2, January 2019; Pages 417-429
Review article Open access
Abstract
Introduction
The recent global expansion of routine adolescent vaccination programmes has the potential to protect young people against infectious diseases and improve their health. Although the legal framework in many countries permits young people to consent for vaccinations if competent, lack of written parental consent can still prevent uptake. We aimed to review systematically the associated barriers and enablers to implementation of adolescent self-consent procedures.
Methods
A comprehensive search strategy of ten databases from inception to June 2018 was undertaken to identify relevant qualitative and quantitative studies. Titles, abstracts and full texts were assessed for eligibility, and the methodological quality of eligible primary studies evaluated. Thematic synthesis methods were used to interpret and combine qualitative data, and to identify overarching themes as well as similarities and differences within themes. Quantitative data were summarised and, because the data were sufficiently similar in focus, were integrated within the qualitative framework.
Results
Twenty-five publications related to 23 studies were included. Three themes were identified which related to the policy framework, protection, and self-determination. Despite supportive national policy frameworks, implementation of adolescent self-consent procedures can be prevented by local policies, professionals’ misunderstandings of the legal framework and the context in which the vaccination programme is delivered. Motivation to protect young people’s health increased acceptability of adolescent self-consent, but implementation might be prevented to protect the reputation of professionals or relationships with parents. Further, maintaining the role of parents as decision-makers for their child’s healthcare was frequently prioritised over enabling young people’s autonomy to consent.
Conclusions
Barriers to the implementation of adolescent self-consent procedures have implications for young people’s health and uptake of vaccination programmes. There is a need to clarify the policy framework and challenge the primacy of parental consent.
International Human Rights of Children
International Human Rights of Children
Editors: Ursula Kilkelly, Ton Liefaard
Springer, Singapore, 2019
Chapter – Children’s Right to Health, J Tobin; pp 277-298
Abstract
The aim of this chapter is to, first, examine the meaning of the right to health for children and, second, explore the practical ways in which this right might be relevant to addressing children’s health needs. It is argued that despite the considerable ambiguity associated with the right to health, there is now a well-developed body of academic commentary and jurisprudence from the human rights treaty monitoring bodies which provides a persuasive understanding of the key feature of a child’s right to health. This right will be shown to be of relevance to advocacy efforts, the development of policies and programs, service delivery, and research to address children’s health needs.
Center for Informed Consent Integrity 