Abuse and Mental Health Outcomes Among Detained African American Adolescent Females: The Mediating Role of Attachment Open Access

Abstract

Introduction: Rates of child maltreatment among adolescents in the United States juvenile justice system are substantially higher than rates among the general population. This population of detained girls also frequently experience mental health outcome such as depression and substance use. The number of girls in the juvenile justice system is increasing with girls accounting for approximately 30% of juvenile arrests. The subpopulation of detained African American adolescent girls are at increased risk of adverse health outcomes, making them an important target population.

Objective: The purpose of this study is to assess the role of attachment in this relationship between abuse and the health outcomes of depressive symptoms and substance use among a sample of detained African American adolescent girls.

Methods: This cross-sectional study included 188 African American girls age 13-17 in a short- term juvenile detention facility in Atlanta, Georgia. This study used baseline data collected in 2011 to evaluate the association between exposure to abuse and psychological variables.

Results: Significant associations were found between experiencing abuse and depressive symptoms (B= 4.80 p<.001 R²=.091) and abuse and substance use (B=4.04 p=.001 R²=.055). Significant associations were also found between abuse and attachment (B=-1.04 p=.006 R²=.041), and attachment and depressive symptoms (B=-.848 p<.001 R²=.072). These variables were included in the mediation model, which showed that attachment partially mediated the relationship between abuse and depressive symptoms (B= 3.92 p<.001).

Conclusions: This study is one of the first known to examine the relationship between experiencing abuse, mental health outcomes, and attachment within the specific population. These findings can help inform future interventions aimed at preventing the development of mental health problems by enhancing attachment among this population. Future studies should utilize a more compressive variable for abuse and incorporate additional covariates into the model.

Table of Contents

Chapter I: Background And Significance. 1

Theory. 2

Public Health Relevance. 5

Purpose and Study Aims. 7

Chapter II: Literature Review. 9

Youth In The Juvenile Justice System. 9

Adverse Health Among Youth In The Juvenile Justice System. 10

Child Maltreatment, Health and Delinquency. 12

Attachment. 15

Current Study. 16

Chapter III: Methods. 18

Participants. 18

Study Procedures. 18

Measures. 19

Data Analysis. 21

Chapter IV: Results. 23

Demographics. 23

Predictor Variable. 24

Hypothesized Mediator. 26

Outcome Variables. 26

Mediation Analyses. 26

Chapter V: Discussion. 30

Limitations. 33

Implications and Future Directions. 35

Conclusions. 37

References. 38

About this Master's Thesis

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School	Rollins School of Public Health
Department	Behavioral Sciences and Health Education
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Mental Health
Keyword	African American Females Detained Youth Depression Adolescent Health Substance Use Attachment
Committee Chair / Thesis Advisor	Sales, Jessica, Emory University
Committee Members	Diclemente, Ralph Joseph, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs CDC

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