Early Complex Sexual and Non-Sexual Trauma on PTSD and Self-Injurious Behaviors among Homeless Youth

Objective:  This study investigates the relative impact of different early (prior to becoming homeless) and later (since becoming homeless) trauma experiences and early complex trauma on PTSD symptoms and self-injurious behaviors among a sample of homeless youth (N=389).  Method:  Youth (aged 13 to 25) who had been homeless or precariously housed in the past year completed a survey about housing history, sexual behaviors, experiences of violence, mental health, substance use/abuse, and service utilization.  Based on survey responses, an early compound sexual trauma was conceptualized to reflect different levels of trauma exposure that ranges from no reported trauma, to single trauma, to multiple non-sexual traumas, and multiple traumas including sexual trauma.  Results:  Multivariate analyses revealed that sexual abuse and adverse home environment predicted PTSD cut-off scores. Only adverse home environment was a significant predictor of self-injury among the early traumas reported.  Results using the early compound sexual trauma variable revealed a linear trend in the risk for mental health problems, with multivariate findings confirming significant differences between lower-order trauma exposure and multiple-trauma exposure that included sexual abuse.  Conclusions:  Findings illustrate the importance for greater nuanced conceptualization of early trauma, particularly trauma experiences that have been compounded by sexaul trauma.  This knowledge can impact the design and implementation of culturally-competent mental health care and services for ethnically-diverse homeless youth.