Posttraumatic stress disorder symptoms and dissociation as serial mediators of the relationship between cumulative victimization and adjustment problems among poly-victimized at-risk youth

Abstract

Introduction: Poly-victimization (PV) has a greater adverse impact on adolescents' lives than any single victimization type, even when repeatedly experienced. Adolescents who experience PV tend to present with an array of adjustment problems, and research has begun to identify mechanisms linking PV to adjustment problems. Both posttraumatic stress disorder (PTSD) and dissociation are linked to PV and adjustment problems; however, it is unclear how these variables play a role in the pathways from PV to adjustment problems. This study assessed PTSD and dissociation as serial mediators in the PV-adjustment problems link. Method: Two hundred eighteen Portuguese youth identified as poly-victims (56% girls) and aged between 12 and 17 years old (M = 15.63; SD = 1.26) were recruited from three at-risk contexts' cohorts. Participants completed self-report measures of trauma exposure, posttraumatic symptoms, dissociative symptoms, and emotional and social adjustment problems. Results: The study results suggest that, among poly-victim adolescents, PTSD and dissociation may be mediators of the relationship between the cumulative extent of victimization and adjustment problems. Conclusion: The current study's findings highlight the importance of careful assessment of both PTSD and dissociative symptoms and indicate that targeted interventions are essential when working with poly-victimized youth with the highest scores of cumulative victimization.Clinical Impact Statement Clinicians working with youth from at-risk contexts should not simply focus on their observed behavior problems without assessing trauma history and trauma-related psychopathology. In order to identify the full burden of traumatic experiences on at-risk youth, it is important to assess an array of traumatic experiences, posttraumatic stress disorder, and dissociation symptoms that contribute to these youth's adjustment problems. Identifying posttraumatic stress disorder and dissociative symptomatology earlier would allow clinicians to address these symptoms