Gender-Specific Factors Associated with Trauma and PTSD among Street Youth: The Importance of Youth Transience

Background: Homeless youth experience disproportionate rates of trauma and Posttraumatic Stress Disorder (PTSD). They often engage in deviant survival strategies, such as panhandling, selling sexual favors, and dealing drugs, increasing their risk for victimization. Transience may require the use of dangerous survival strategies and thus increase trauma. This study examines transience and other homeless cultural factors as correlates of trauma in three U.S. cities. Methods: A cross-sectional study of 146 homeless youth from Los Angeles (n=50), Denver (n=50) and St. Louis (n=46) were recruited from service organizations using comparable methods. Participants were 18-24 years old and had spent at least 2 weeks away from home in the prior month. Semi-structured interviews assessed youth transience level and standardized measures determined level of depression, mania, trauma, PTSD, and addiction. Multinomial logistic regression analysis examined factors associated with experiencing a traumatic event and meeting PTSD criteria. Post hoc analyses examined gender-specific risk factors. Results: Approximately 57% of youth had experienced a traumatic event, while 24% met criteria for PTSD. Having an alcohol addiction was associated with greater risk for traumatic events. Youth who reported manic symptoms, alcohol addiction, and greater transience were more likely to meet PTSD criteria. Factors differed slightly by gender with transience being more influential among females. Discussion: Highly mobile homeless youth appear to live dangerous lifestyles, and their transience may prevent consistent treatment, resulting in PTSD symptoms. Use of virtual/internet-based interventions for treating highly mobile homeless youth may provide the continuity of care needed amid their transient episodes.