From court to the community: improving access to evidence-based treatment for underserved youth involved in the juvenile legal system at-risk for suicide.

BACKGROUND: Juvenile legal involved youth (JLIY) experience disproportionately high rates of suicidal and self-injurious thoughts and behaviors (SSITB). Many JLIY lack access to evidence-based treatment specifically designed to treat SSITB, thereby increasing the overall risk of suicide. The overwhelming majority of JLIY are not placed in secure facilities and almost all incarcerated youth are eventually released to the community. Consequently, SSITB are a major concern of JLIY residing in the community and it is critical that this population has access to evidence-based treatment for SSITB. Unfortunately, most community mental health providers who treat JLIY have not been trained in evidence-based interventions that are specifically designed to SSITB, which often leads to youth experiencing prolonged periods of SSITB. Training community mental health providers who serve JLIY in the detection and treatment of SSITB shows promise for decreasing the overall suicide risk for JLIY. METHODS: The current proposal aims to reduce SSITB among JLIY, and thus reduce mental health disparities in this vulnerable and underserved youth population, by increasing access to evidence-based treatment strategies specifically designed to treat SSITB behaviors. We will implement an agency-wide training among at least 9 distinct community mental health agencies that serve JLIY referred to treatment by a statewide court system in the Northeast. Agencies will be trained in an adapted version of the COping, Problem Solving, Enhancing life, Safety, and Parenting (COPES+) intervention. Training will be implemented via a cluster-randomized stepped wedge trial that proceeds through multiple phases. DISCUSSION: This research engages multiple systems (i.e., juvenile legal and mental health systems) serving JLIY and has the potential to directly inform treatment practices in juvenile legal and mental health systems. The current protocol has significant public health implications as the primary goals are to reduce SSITB among adolescents involved in the juvenile legal system. By implementing a training protocol with community-based providers to help them learn an evidence-based intervention, this proposal aims to reduce mental health disparities in a marginalized and underserved population. TRIAL REGISTRATION: osf.io/sq9zt.

Youth Dually-Involved in the Child Welfare and Juvenile Justice Systems: Varying Definitions and Their Associations with Trauma Exposure, Posttraumatic Stress, & Offending.

Recently, scholars have placed increasing effort on better understanding the unique needs of youth involved in both the child welfare and juvenile justice systems. This study drew from the Developmental Cascade of Multisystem Involvement Framework to examine group differences in trauma exposure, posttraumatic stress symptoms, and offending among youth solely involved in the juvenile justice system and youth with varying degrees of dual-system involvement, including crossover youth (i.e., youth with a history of maltreatment and offending regardless of system involvement), dual-contact youth (i.e., youth who had a history of a substantiated CW maltreatment petition prior to their involvement in the current study), and dually-involved youth (i.e., youth under the care and custody of the state's child welfare system at the time of study participation). Four-hundred adolescents (25% girls, Mage = 15.97) who were recruited from a detention center and completed self-report measures assessing trauma exposure, posttraumatic stress, and offending. Juvenile justice and child welfare records also were collected. Results indicated that, compared to youth solely involved in the juvenile justice system, crossover youth reported significantly more exposure to traumatic events, more severe posttraumatic stress symptoms, and more self-reported offending. In contrast, results indicated few differences between dual-contact youth and youth solely involved in the juvenile justice system; these groups only differed in age and in recidivism charges. There also were few differences between dually-involved youth and youth solely involved in the juvenile justice system; these groups only differed in age and exposure to non-Criterion A traumatic events. The current results suggest that categorizing youth as crossover youth based on their own self-reported history of child maltreatment exposure resulted in more observed differences between dual-system youth and youth solely involved in juvenile justice. The present results have valuable implications for how we operationalize youth's system involvement and highlight the importance of examining child maltreatment as a point of prevention and intervention efforts for these youth.

The Effect of Sexual Concerns on Placement Changes and School Transfers for Youth in the Child Welfare System.

Youths in the child welfare system experience high rates of placement changes and school transfers; therefore, prior research focused on variables that may be linked with such disruptions. Indeed, researchers have established that mental health symptoms (e.g., PTSD symptoms) are linked with placement disruptions. However, an important aspect of mental health for youth in the child welfare system has largely been ignored: sexual concerns (e.g., distress, preoccupation). Thus, the present study evaluated whether higher levels of sexual preoccupation and distress among a sample of child welfare-involved youths (N = 124) in a northeastern state predicted placement changes and school transfers above and beyond variables previously linked with these disruptions. Our hypotheses were partially supported such that higher levels of sexual distress were linked with increased odds of experiencing a placement change (OE = 2.60; p <.01). Counter to our hypotheses, higher levels of sexual preoccupation were linked with lower odds of experiencing both placement changes (OE = -2.98; p <.01) and school transfers (OR = 0.18; p < .05). Furthermore, sexual preoccupation and sexual distress were not linked with increased rates of placement changes. The current findings have implications for the assessment of sexual concerns and the prevention of placement changes among youth in the child welfare system.

Associations Among Trauma Exposure, Posttraumatic Dissociation, Reckless/Self-Destructive Behavior, and Adolescent Offending.

Previous research has established that trauma exposure and subsequent posttraumatic stress symptoms confer risk for adolescent offending and involvement in the juvenile justice system. However, recent research and theory have called attention to the contributions of specific posttraumatic reactions, including posttraumatic dissociation (PD) and reckless or self-destructive behavior (RSDB), to offending behavior among adolescents. Therefore, this study investigated direct and indirect associations among trauma exposure, PD, RSDB, and offending in a sample of justice-involved adolescents. Participants were 301 adolescents (Mage = 16.03, SD = 1.24; 21% girls) recruited from a detention center in the Mountain West. The sample was racially and ethnic diverse, with 63% identifying as a racial or ethnic minority. Youth completed self-report measures of trauma exposure, PD, RSDB, and offending. As hypothesized, results of multiple mediation analysis demonstrated a significant indirect effect linking trauma exposure and offending through PD and RSDB. Results testing an alternative multiple mediation model were non-significant. These findings suggest that PD and RSDB may serve as key links accounting for the association between trauma exposure and offending behavior and reinforce the value of incorporating trauma-informed practices within juvenile justice systems.

CommWalker: correctly evaluating modules in molecular networks in light of annotation bias.

Motivation: Detecting novel functional modules in molecular networks is an important step in biological research. In the absence of gold standard functional modules, functional annotations are often used to verify whether detected modules/communities have biological meaning. However, as we show, the uneven distribution of functional annotations means that such evaluation methods favor communities of well-studied proteins. Results: We propose a novel framework for the evaluation of communities as functional modules. Our proposed framework, CommWalker, takes communities as inputs and evaluates them in their local network environment by performing short random walks. We test CommWalker's ability to overcome annotation bias using input communities from four community detection methods on two protein interaction networks. We find that modules accepted by CommWalker are similarly co-expressed as those accepted by current methods. Crucially, CommWalker performs well not only in well-annotated regions, but also in regions otherwise obscured by poor annotation. CommWalker community prioritization both faithfully captures well-validated communities and identifies functional modules that may correspond to more novel biology. Availability and implementation: The CommWalker algorithm is freely available at opig.stats.ox.ac.uk/resources or as a docker image on the Docker Hub at hub.docker.com/r/lueckenmd/commwalker/. Contact: deane@stats.ox.ac.uk. Supplementary information: Supplementary data are available at Bioinformatics online.

Investigating the Association Between Posttraumatic Risky Behavior and Offending in Adolescents Involved in the Juvenile Justice System.

Risky behavior is common among traumatized youth and is associated with juvenile offending. This study examined predictors of posttraumatic risky behavior, the unique contribution of posttraumatic risky behavior in predicting offending, and tested whether a distinct class of youth was characterized by high levels of posttraumatic risky behavior. Participants were 400 adolescents (25% girls) between the ages of 12 and 19 years old (M = 15.97, SD = 1.25) who were involved in the Utah juvenile justice system. Approximately 54% of the sample identified as an ethnic minority. Youth completed self-report measures of trauma exposure, posttraumatic risky behavior, posttraumatic stress symptom severity, and offending. Formal legal records of offending were also collected. The results indicated that female sex was significantly related to posttraumatic risky behavior, though age was not significantly associated with posttraumatic risky behavior. Age and ethnicity were associated with both self-reported and formal offending, and male sex was associated with formal offending. Posttraumatic risky behavior was not related to formal offending, but was related to self-reported offending in some of the tested models. Latent class analysis identified 92 youth characterized by high levels of posttraumatic risky behavior; these youth also evidenced the highest rates of trauma exposure, posttraumatic stress symptom severity, and self-reported offending. There were no ethnic, age, or sex differences between youth in the high and low posttraumatic risky behavior groups. These results add to the extant literature documenting the associations among exposure to trauma, posttraumatic stress, and juvenile offending.

The roles of trauma exposure, rejection sensitivity, and callous-unemotional traits in the aggressive behavior of justice-involved youth: A moderated mediation model.

Research has demonstrated an association between childhood trauma exposure and adolescent aggression. This association may be explained by rejection sensitivity, defined as anger, or anxiety in the anticipation of rejection, which can be a consequence of trauma exposure. Callous-unemotional (CU) traits also are associated with trauma exposure and aggressive behavior; however, research has not yet investigated the interactive roles that rejection sensitivity and CU traits play in the relation between trauma exposure and aggression. Therefore, this study sought to investigate the role of rejection sensitivity in the association between trauma exposure and aggression, and whether this indirect effect was moderated by CU traits. Participants included 380 detained youth (98 girls, 282 boys) who completed self-report measures of trauma exposure, angry, and anxious rejection sensitivity, CU traits, and aggression. Results of moderated mediation demonstrated that the relation between trauma exposure and aggression exhibited an indirect effect through angry rejection sensitivity, but only at moderate or high levels of CU traits. This pattern was not found for anxious rejection sensitivity. Results suggest that interventions aimed to decrease aggressive behavior in traumatized adolescents may benefit from considering how youth respond to rejection, as well as whether youth endorse CU traits, as this may help to limit further involvement in the juvenile justice system after release.

Testing gender-differentiated models of the mechanisms linking polyvictimization and youth offending: Numbing and callousness versus dissociation and borderline traits.

The increasing prevalence of girls in the juvenile justice system suggests the importance of examining whether models of adolescent offending are differentiated by gender. Polyvictimization has emerged as a robust predictor of youth justice involvement, especially for girls, and research exploring mechanisms underlying the link between polyvictimization and offending suggests further gender differences in that callous-unemotional (CU) traits have been implicated in samples of boys whereas borderline personality (BP) traits have been implicated amongst girls. However, a limitation of these studies is that most have included all-male or all-female samples, thus not allowing for comparisons across gender. Further, few studies have used a trauma-informed lens to investigate posttraumatic symptoms, particularly dissociation and emotional numbing, that might account for these associations. To address this gap, this study investigated associations among polyvictimization, dissociation, numbing, CU, BP, and offending in a sample of 782 youth (579 boys and 203 girls) recruited from a detention center. As hypothesized, for both genders, polyvictimization was related to BP through the indirect effect of dissociation and to CU through the indirect effect of emotional numbing. Further, for both genders, path models indicated indirect effects on the association between polyvictimization and offending through dissociation and BP. These results suggest the value of using a trauma-informed approach to understanding youth justice involvement and continuing to fine-tune models of gender differences in traumatized girls' and boys' offending.

PTSD and dissociation symptoms as mediators of the relationship between polyvictimization and psychosocial and behavioral problems among justice-involved adolescents.

Polyvictimization (PV) has been shown to be associated with psychosocial and behavioral impairment in community and high risk populations, including youth involved in juvenile justice. However, the mechanisms accounting for these adverse outcomes have not been empirically delineated. Symptoms of posttraumatic stress disorder (PTSD) and dissociation are documented sequelae of PV and are associated with a wide range of behavioral/emotional problems. This study used a cross-sectional research design and bootstrapped multiple mediation analyses with self-report measures completed by a large sample of justice-involved youth (N = 809, ages 12-19 years old, 27% female, 46.5% youth of color) to test the hypothesis that PTSD and dissociation symptoms mediate the relationship between PV and problems with anger, depression/anxiety, alcohol/drug use, and somatic complaints after controlling for the effects of exposure to violence and adversities related to juvenile justice involvement. As hypothesized, PTSD symptoms mediated the relationship of PV with all outcomes except alcohol/drug use problems (which had an unmediated direct association with PV). Partially supporting study hypotheses, dissociation symptoms mediated the relationship between PV and internalizing problems (i.e., depression anxiety; suicide ideation). Implications are discussed for prospective research demarcating the mechanisms linking PV and adverse outcomes in juvenile justice and other high risk populations.

Direct interaction of human serum proteins with AAV virions to enhance AAV transduction: immediate impact on clinical applications.

Recent hemophilia B clinical trials using adeno-associated virus (AAV) gene delivery have demonstrated much lower coagulation factor IX (FIX) production in patients compared with the high levels observed in animal models and AAV capsid-specific cytotoxic T lymphocyte response elicited at high doses of AAV vectors. These results emphasize the necessity to explore effective approaches for enhancement of AAV transduction. Initially, we found that incubation of all AAV vectors with human serum enhanced AAV transduction. Complementary analytical experiments demonstrated that human serum albumin (HSA) directly interacted with the AAV capsid and augmented AAV transduction. The enhanced transduction was observed with clinical grade HSA. Mechanistic studies suggest that HSA increases AAV binding to target cells, and that the interaction of HSA with AAV does not interfere with the AAV infection pathway. Importantly, HSA incubation during vector dialysis also increased transduction. Finally, HSA enhancement of AAV transduction in a model of hemophilia B displayed greater than a fivefold increase in vector-derived circulating FIX, which improved the bleeding phenotype correction. In conclusion, incubation of HSA with AAV vectors supports a universal augmentation of AAV transduction and, more importantly, this approach can be immediately transitioned to the clinic for the treatment of hemophilia and other diseases.

Numbing of Positive, Negative, and General Emotions: Associations With Trauma Exposure, Posttraumatic Stress, and Depressive Symptoms Among Justice-Involved Youth.

Increasing attention has been drawn to the symptom of emotional numbing in the phenomenology of posttraumatic stress disorder (PTSD), particularly regarding its implications for maladaptive outcomes in adolescence such as delinquent behavior. One change in the definition of emotional numbing according to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013) was the limitation to the numbing of positive emotions. Previous research with youth, however, has implicated general numbing or numbing of negative emotions in PTSD, whereas numbing of positive emotions may overlap with other disorders, particularly depression. Consequently, the goal of this study was to investigate whether numbing of positive emotions was associated with PTSD symptoms above and beyond numbing of negative emotions, general emotional numbing, or depressive symptoms among at-risk adolescents. In a sample of 221 detained youth (mean age = 15.98 years, SD = 1.25; 50.7% ethnic minority), results of hierarchical multiple regressions indicated that only general emotional numbing and numbing of anger accounted for significant variance in PTSD symptoms (total R(2) = .37). In contrast, numbing of sadness and positive emotions were statistical correlates of depressive symptoms (total R(2) = .24). Further tests using Hayes' Process macro showed that general numbing, 95% CI [.02, .45], and numbing of anger, 95% CI [.01, .42], demonstrated indirect effects on the association between trauma exposure and PTSD symptoms.

Prediction of adeno-associated virus neutralizing antibody activity for clinical application.

Patients with neutralizing antibodies (Nabs) against adeno-associated virus (AAV) are usually excluded from the treatment with AAV vectors. To develop a standard assay for detecting Nab inhibition activity, we systematically studied current AAV Nab assays in vitro and in vivo. Several factors were found that influence the Nab titers based on the in vitro assay, including sera volume, AAV dose per cell, cell number and choice of transgenes. When the Nab titer assay was performed in vivo via intramuscular (IM) or systemic administration, a fourfold increase in sensitivity for measurement of Nab titers was observed compared with an identical in vitro test. To better mimic the clinical setting, after passively transferring human Nabs into mice, blood was collected before systemic injection of AAV vector and used for Nab titer analysis in vitro or via IM injection. The results showed that AAV delivered via IM injection had a similar inhibition pattern to systemic administration. These studies indicate critical parameters necessary for optimizing Nab sensitivity and that an in vivo Nab assay is more sensitive than an in vitro assay for inclusion/exclusion criteria. The variables identified by this study may explain some of the compounding clinical data seen to date with respect to efficiency of AAV transduction in various phase I clinical trials.

The roles of emotion dysregulation and dissociation in the association between sexual abuse and self-injury among juvenile justice-involved youth.

To date, scholars have established associations among nonsuicidal self-injury and sexual abuse, posttraumatic stress symptoms, and dissociation. However, leading theoretical models of the mechanisms underlying the association between trauma and negative outcomes suggest a more parsimonious explanation in that deficits in emotion regulation may underlie these various risk factors for self-injury. This study examined whether sexual abuse was differentially associated with nonsuicidal self-injury over and above other forms of traumatic experiences and whether the association between sexual abuse and self-injury was statistically mediated by emotion dysregulation and dissociation. Participants included 525 youth (392 boys, 133 girls) recruited from the U.S. juvenile justice system who completed measures of self-reported trauma exposure, posttraumatic stress symptoms, dissociation, and emotion dysregulation. Results of a hierarchical regression demonstrated that sexual abuse predicted posttraumatic stress symptoms and self-injury over and above other forms of traumatic experiences. Results of bootstrapped mediation analyses indicated that emotion dysregulation and dissociation in combination were implicated in self-injury among youth. The results suggest that youth in the juvenile justice system who experience sexual abuse may be at risk for higher rates of posttraumatic stress symptoms and that self-injury may be particularly salient for youth who experience sexual abuse. Furthermore, the results shed light on the role that dissociation and emotion dysregulation play in the relation between sexual abuse and self-injury, suggesting that a larger framework of self-regulation may have both empirical and clinical utility in helping to understand the underlying processes at play in these associations.

Mutations in PTPN11, encoding the protein tyrosine phosphatase SHP-2, cause Noonan syndrome.

Noonan syndrome (MIM 163950) is an autosomal dominant disorder characterized by dysmorphic facial features, proportionate short stature and heart disease (most commonly pulmonic stenosis and hypertrophic cardiomyopathy). Webbed neck, chest deformity, cryptorchidism, mental retardation and bleeding diatheses also are frequently associated with this disease. This syndrome is relatively common, with an estimated incidence of 1 in 1,000-2,500 live births. It has been mapped to a 5-cM region (NS1) [corrected] on chromosome 12q24.1, and genetic heterogeneity has also been documented. Here we show that missense mutations in PTPN11 (MIM 176876)-a gene encoding the nonreceptor protein tyrosine phosphatase SHP-2, which contains two Src homology 2 (SH2) domains-cause Noonan syndrome and account for more than 50% of the cases that we examined. All PTPN11 missense mutations cluster in interacting portions of the amino N-SH2 domain and the phosphotyrosine phosphatase domains, which are involved in switching the protein between its inactive and active conformations. An energetics-based structural analysis of two N-SH2 mutants indicates that in these mutants there may be a significant shift of the equilibrium favoring the active conformation. This implies that they are gain-of-function changes and that the pathogenesis of Noonan syndrome arises from excessive SHP-2 activity.

Piloting an Evidence-Based Assessment Protocol for Incarcerated Adolescents.

Although evidence-based assessment is considered an essential component of evidence-based practice, few adolescents have access to evidence-based assessment. Despite experiencing high rates of mental health disorders, incarcerated justice-involved adolescents are rarely able to access evidence-based psychiatric care. In this article, we discuss the components of an evidence-based assessment protocol designed and piloted with incarcerated adolescents involved in Rhode Island's juvenile justice system. In particular, we describe the components of our evidence-based protocol, ways in which evidence-based assessment may need to be modified when working with this population, and discuss policy and clinical implications relevant to increasing access to evidence-based assessment among incarcerated adolescents.

Spring and latch dynamics can act as control pathways in ultrafast systems.

Ultrafast movements propelled by springs and released by latches are thought limited to energetic adjustments prior to movement, and seemingly cannot adjust once movement begins. Even so, across the tree of life, ultrafast organisms navigate dynamic environments and generate a range of movements, suggesting unrecognized capabilities for control. We develop a framework of control pathways leveraging the non-linear dynamics of spring-propelled, latch-released systems. We analytically model spring dynamics and develop reduced-parameter models of latch dynamics to quantify how they can be tuned internally or through changing external environments. Using Lagrangian mechanics, we test feedforward and feedback control implementation via spring and latch dynamics. We establish through empirically-informed modeling that ultrafast movement can be controllably varied during latch release and spring propulsion. A deeper understanding of the interconnection between multiple control pathways, and the tunability of each control pathway, in ultrafast biomechanical systems presented here has the potential to expand the capabilities of synthetic ultra-fast systems and provides a new framework to understand the behaviors of fast organisms subject to perturbations and environmental non-idealities.

Advancing Our Understanding of the Risk Factors Associated with Crossover Youth in the Child Welfare and Juvenile Justice Systems: A Trauma-Informed Research Agenda.

Previous research has provided robust evidence demonstrating that a notable proportion of youth become involved in both the child welfare (CW) system and the juvenile justice (JJ) system, a population often referred to as crossover youth. Prior work has identified a number of risk factors associated with crossing over between these systems. However, there are limitations to the extant literature, key among which is a lack of systematic attention to the influence of trauma exposure and posttraumatic sequelae on the crossover trajectory. In contrast, viewing this research through a trauma-informed lens promises to enhance our ability to integrate findings across studies and to derive theoretically derived hypotheses about underlying mechanisms which will better inform future research and the development of effective prevention and intervention efforts. Accordingly, the purpose of this article is to present a trauma-informed research agenda that would strengthen future research in the field. After providing a brief critique of the existing studies that has documented known risk factors associated with the crossover population, we outline ways in which future research could apply relevant theoretical trauma-informed approaches, including developmental traumatology, to further advance our knowledge of risk factors and mechanisms associated with the crossover trajectory. We conclude by discussing policy and system-wide implications related to the proposed research agenda.

A Pilot Study of a Tablet-Based Emotion Regulation Intervention for Early Adolescents.

OBJECTIVE: This study examined the feasibility, acceptability, and preliminary outcomes of internet-based Talking About Risk and Adolescent Choices (iTRAC), a tablet intervention designed to promote emotion regulation (ER) skills among middle schoolers as a strategy for reducing risk behaviors. METHODS: Adolescents (12-14 years) were recruited from 3 urban US schools for advisory groups (n = 15), acceptability testing (n = 11), and pilot testing (n = 85). Youth advisory boards and expert panels tailored content, resulting in an animated intervention of instructional videos, games, and activities designed to teach ER strategies to young adolescents. Eighty-five adolescents were randomized to the 4-module digital iTRAC intervention or a wait-list control group. Adolescents and 1 parent completed baseline and 3-month follow-up questionnaires examining ER attitudes and behaviors; adolescents also completed behavioral tasks related to distress tolerance. RESULTS: Among those randomized to iTRAC, 88% completed all modules. Moderate effect sizes ( d ≥ 0.36) were found from baseline to follow-up on adolescents' beliefs in the controllability of emotions, awareness of emotions, self-efficacy for managing emotions, perceived access to ER strategies, and use of ER strategies. Parent measures of adolescent regulation showed mixed results. CONCLUSION: A digital intervention to enhance ER skills for youth in early adolescence was feasible and demonstrated promising indicators of impact on emotional competence. Increasing adolescents' awareness of and access to ER strategies could reduce decisions driven by transient emotions, which in turn may reduce engagement in risk behaviors and resultant negative health outcomes. This brief tablet-based intervention has the potential to be self-administered and used to increase emotional competency.

Intimate Partner Violence in Adolescence: Associations With Perpetration Trauma, Rumination, and Posttraumatic Stress.

Engagement in intimate partner violence (IPV) is related to a host of negative outcomes for youth, including posttraumatic stress symptoms (PTSS). Moreover, research indicates that the perpetration of violence may constitute a traumatic experience, termed perpetration trauma (PT), which, in turn, is related to elevated levels of PTSS. Little research to date, however, has illuminated the underlying processes that may link IPV perpetration, PT, and PTSS. One potential contributor to this association is rumination on negative emotions. In particular, for youth who report PT and rumination, engaging in IPV may be associated with elevations in PTSS. To investigate this hypothesis, data were gathered from a sample of 235 justice-involved youth (184 boys, 51 girls) who completed self-report measures of IPV perpetration and victimization, PT, sadness and anger rumination, and PTSS. Results of moderated mediational analyses indicated that IPV perpetration was related to PTSS through sadness rumination, and that these effects were stronger when youth endorsed PT. In turn, IPV perpetration was related to PTSS through anger rumination only when youth did not endorse PT. In addition, tests of alternative models indicated that these results were specific to IPV perpetration, given that IPV victimization was not related to PTSS through anger or sadness rumination when youth endorsed PT. These results suggest that the combination of rumination on sadness and endorsement of PT may put youth who perpetrate IPV at the greatest risk of PTSS. Therefore, interventions seeking to interrupt the cycle of IPV perpetration may benefit from targeting perpetrators' sadness rumination, PT, and PTSS.

A Bayesian Structural Equation Modeling Factor Analysis of the UCLA Posttraumatic Stress Disorder Reaction Index for DSM-5 in a Polyvictimized Sample of Adolescents.

The revised criteria for posttraumatic stress disorder (PTSD) in the fifth edition of the Diagnostic and Statistical Manual necessitated the development of new screening tools for youth, one of the most widely used of which is the UCLA Posttraumatic Stress Disorder Reaction Index for DSM-5 (RI-5). Thus far, the few studies that have investigated the RI-5's factor structure have supported a four-factor model. However, to date this research has been limited to youth with histories of exposure to single-event traumatic stressors, a significant limitation as evidence suggests many trauma-exposed youth report exposure to multiple types of traumatic stressors, or polyvictimization. It is imperative to determine the generalizability of previous factor models to specific populations which they are purported to represent. We investigated whether the RI-5's four-factor model replicated in a sample of 455 polyvictimized justice-involved adolescents. Initial confirmatory factor analysis demonstrated that the four-factor model did not converge. Therefore, we utilized Bayesian Structural Equations Modeling (BSEM) to determine why the previously proposed factor structure did not converge. The BSEM model suggested that the global factor structure was acceptable and did not require addition or subtraction of any factor or cross-factor loadings. However, small and moderate residual covariances resulted in model misspecification, suggesting there may be additional associations not captured by the current DSM-5 model for polyvictimized youth. Future work should continue examining the RI-5's factor structure in order to better understand whether the current results are unique and how measurements assessing DSM-5 PTSD symptom criteria perform in diverse trauma-exposed youth populations.