Prevalence Rates of Acute Stress Disorder Symptomatology and Association to Juvenile Crime Involvement

摘要

Little is known about the relationship between acute stress disorder and criminal behavior among youth. This study examined data from the National Comorbidity Survey-Adolescent Supplement (NCS-A). Participants in this survey, which took place between February 2001 and January 2003, consisted of 10,148 youth between the ages of 13 and 18 years. Because the NCS-A was conducted prior to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), symptoms of posttraumatic stress disorder from the fourth edition of the DSM were mapped to DSM-5 criteria for ASD. Due to changes in the DSM-5 criteria for ASD, youth in this study were described as having “ASD symptomatology.” Youth with ASD symptomatology were significantly more likely to report involvement in crimes than youth without any lifetime diagnosis, regardless of whether the crimes resulted in arrest. The data presented here provide a more accurate picture of the relationship between ASD and crime. These data suggest that it may be useful to develop prevention and intervention strategies that provide education and support to at-risk youth who develop ASD symptoms. The quality of life for untreated youth decreases significantly, and untreated youth are likely at risk for criminal involvement, suicide, and other comorbid psychiatric disorders. In 1994, acute stress disorder (ASD) was first included in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) to facilitate identification of individuals at risk of developing posttraumatic stress disorder (PTSD).sup 1 , – , 4 /sup According to the criteria established in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5),sup 5 /sup ASD may occur in people who experience, witness, or are involved in a situation in which actual or threatened death, serious injury, or actual or threatened physical or sexual violation are possible. Symptoms include, but are not limited to, a sense of detachment or numbing, recurrent memories of the event, avoidance of thoughts of the event, and aggressive behavior.sup 5 /sup Research also has shown that ASD symptoms are largely predictive of PTSDsup 6 /sup and suggests that by preventing or treating the symptoms of ASD, the chances of developing PTSD can be decreased. Given the high incidence of trauma and ASD in youth, it is important to note the negative effects associated with both. By the age of 16 years, a majority of individuals will have experienced at least one trauma.sup 7 /sup Youth with ASD symptoms exhibit signs of greater emotional problems, demonstrate higher subjective threat appraisal at the time of their trauma exposure, and report more cognitive misappraisals than trauma-exposed youth without ASD symptoms.sup 8 , – , 10 /sup Research also suggests that youth with multiple acute stress symptoms experience increased levels of co-occurring symptoms of depression and anxiety after experiencing a traumatic event.sup 11 /sup In the context of ASD, emotional numbing and future stress symptoms can be predicted by physiological provocation directly following a traumatic experience.sup 12 /sup The literature emphasizes the significant psychological and emotional impact that ASD symptoms can have on youth and highlights the severe problematic nature of the disorder. Furthermore, studies have found that trauma exposure and related symptoms vary based on several demographic factors. There is evidence that females are at a higher risk for developing posttraumatic stress symptoms when compared with males,sup 8 , 13 /sup and that PTSD occurs more commonly in older adolescents.sup 8 /sup Prior research also suggests that college-aged African-American students experience a higher risk of exposure to more severe types of trauma, higher rates of PTSD,sup 14 /sup and increased interpersonal violencesup 15 /sup when compared with European-American college-aged students. Geographic factors may also be important, and one study demonstrated that living in an urban environment greatly increases the risk of trauma exposure and mental health needs in children due to increased instances of community violence, crime, gang activity, drug use, and poverty.sup 16 , – , 18 /sup These risk factors should be taken into consideration when determining who is most vulnerable to developing trauma-related disorders. The negative impact that trauma has on adolescent development and decision-making is also well documented.sup 19 /sup Several studies have found a link between youth trauma exposure and subsequent violence and crime involvement.sup 20 , – , 23 /sup Specifically, studies have revealed that youth in detention have substantial rates of trauma.sup 24 , 25 /sup Research