Citation

Palines PA, Rabbitt AL, Pan AY, Nugent ML, Ehrman WG. Child Abuse Negl. 2019; ePub(ePub): ePub.

Affiliation

Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, 53213, USA.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.chiabu.2019.104196

PMID

31575432

Abstract

BACKGROUND: Individuals at high-risk for trafficking are often subject to preexisting complex trauma that only intensifies during the trafficking experience. This greatly increases their risk of mental illness, although the actual prevalence of mental health disorders in children who are sex trafficked remains unclear.

OBJECTIVE: To examine the prevalence of mental health diagnoses among a sample of youth identified as being sex trafficked, and to discuss these rates in relation to other high-risk groups reported in the literature. PARTICIPANTS AND SETTING: 143 female and male child trafficking victims in Wisconsin.

METHODS: We retrospectively reviewed individual medical records, identifying mental health diagnoses and behaviors. The results were compared to summarized prevalence data for mental health disorders in sex trafficked, runaway children, juvenile offenders, and foster care children identified via a scoping review.

RESULTS: We observed significantly higher rates of ADHD (52.4%, p < 0.0001), bipolar disorder (26.6%, p < 0.0001), and PTSD (19.6%, p < 0.05 to p < 0.0001) in our sample of trafficked youth compared to all high-risk groups, as well as for depression (45.5%), anxiety (19.6%), conduct disorder (19.6%), ODD (25.9%), and psychosis (14.0%) relative to multiple groups individually.

CONCLUSIONS: The complex trauma suffered by child survivors of sex trafficking can impart numerous effects with overlapping symptomatology of many mental health disorders. Survivors' adaptive responses to complex trauma may lead to improper diagnosis and treatment of mental health disorders at the expense of prompt access to trauma-focused therapies. Alternative diagnoses and treatments of this complex dysfunction are discussed.

Copyright © 2019. Published by Elsevier Ltd.

Language: en

Keywords

Anxiety; Attention deficit hyperactivity disorder; Bipolar disorder; Child prostitution; Child sex trafficking; Commercial sexual exploitation of children; Complex trauma; Disorders of Extreme Stress Not Otherwise Specified; Human trafficking; Mental health; Post-traumatic stress disorder; Psychosis