How Trauma May Magnify Risk of Involuntary and False Confessions Among Adolescents

Empirical research on police interrogation has identified both personal and situational factors that increase criminal suspects’ vulnerability to involuntary, unreliable, or false confessions. Although trauma exposure is a widely documented phenomenon known to affect adolescents’ perceptions, judgments, and behaviors in a wide array of contexts (especially stressful contexts), trauma history remains largely unexamined by interrogation researchers and virtually ignored by the courts when analyzing a confession. This article argues that trauma may operate as an additional personal risk factor for involuntary and false confessions among adolescents by generating both additive and interactive effects beyond youths’ general, developmentally-driven vulnerabilities in police interrogations. First, we briefly review adolescent trauma symptomatology, emphasizing the heterogeneity of adolescents’ responses to trauma. Next, using Leo and Drizin’s (2010) “Three Errors” framework of police-induced false confessions, we systematically apply clinical findings to each of the three police errors—misclassification, coercion, and contamination—to outline the psychological mechanisms through which adolescents with trauma histories may be at increased risk for making involuntary or unreliable statements to police. Finally, we offer considerations for interrogation research, clinical forensic practice, police practices, and courtroom procedures that could deepen our understanding of trauma’s role in the interrogation room, improve the integrity of investigative and adjudicatory processes, and ultimately promote justice for adolescent suspects with trauma exposure.

Mortality in adolescent trauma: a comparison of children’s, mixed and adult major trauma centres

ObjectiveWe aimed to compare adolescent mortality rates between different types of major trauma centre (MTC or level 1; adult, children’s and mixed).MethodsData were obtained from TARN (Trauma Audit Research Network) from English sites over a 6-year period (2012–2018), with adolescence defined as 10–24.99 years. Results are presented using descriptive statistics. Patient characteristics were compared using the Kruskal-Wallis test with Dunn’s post-hoc analysis for pairwise comparison and χ2 test for categorical variables.Results21 033 cases met inclusion criteria. Trauma-related 30-day crude mortality rates by MTC type were 2.5% (children’s), 4.4% (mixed) and 4.9% (adult). Logistic regression accounting for injury severity, mechanism of injury, physiological parameters and ‘hospital ID’, resulted in adjusted odds of mortality of 2.41 (95% CI 1.31 to 4.43; p=0.005) and 1.85 (95% CI 1.03 to 3.35; p=0.041) in adult and mixed MTCs, respectively when compared with children’s MTCs. In three subgroup analyses the same trend was noted. In adolescents aged 14–17.99 years old, those managed in a children’s MTC had the lowest mortality rate at 2.5%, compared with 4.9% in adult MTCs and 4.4% in mixed MTCs (no statistical difference between children’s and mixed). In cases of major trauma (Injury Severity Score >15) the adjusted odds of mortality were also greater in the mixed and adult MTC groups when compared with the children’s MTC. Median length of stay (LoS) and intensive care unit LoS were comparable for all MTC types. Patients managed in children’s MTCs were less likely to have a CT scan (46.2% vs 62.8% mixed vs 64% adult).ConclusionsChildren’s MTC have lower crude and adjusted 30-day mortality rates for adolescent trauma. Further research is required in this field to identify the factors that may have influenced these findings.

Translation and Adaptation of the Spanish Version of the Child and Adolescent Trauma Screening CATS-C following ITC Guidelines for Translating and Adapting Test

The aim of this report is to present each of the stages taken to adapt the Child and Adolescent Trauma Screening (CATS-C) to Spanish.Each stage has been carried out rigorously, following the ITC Guidelines for Translating and Adapting Tests (Second Edition, 2017) published by the ITC (International Test Commission). This guide sets out a series of procedures and standards of good practice to be followed in order to comply with both legal and ethical principles and the standards of good practice established in relation to the use of tests in research.The Spanish adaptation of the CATS-C has been carried out by different members of the Believe Project. The Believe Project is part of the Pnínsula Research Group, which is located in The Mind, Brain and Behavior Research Center at the University of Granada (Spain). This project centers on psychological and neuropsychological impairments acquired by female victims and survivors of intimate partner violence. A high percentage of women suffering intimate partner violence develop PTSD.In turn, we will carry out a similar project with the children who are victims and survivors of IPV with adapted test for this population. We will include the CATS-C questionnaire to measure posttraumatic stress disorder (PTSD), as we have done previously with the adults version for female survivors of IPV. We consider that a high percentage of women suffering intimate partner violence develop PTSD and their children can develop PTSD as direct or indirect victims too. For this reason, our research group is interested in translating a specific measure for PTSD for children and adolescents following DSM-5 criteria.

Internalizing Symptoms Among Youth in Foster Care: Prevalence and Associations with Exposure to Maltreatment

Among youth in foster care (N = 303, aged 11–17 years), we investigated prevalence of internalizing symptoms; associations between symptom level and maltreatment types and numbers; and the interaction between gender and maltreatment, on internalizing symptoms. Youth completed Spence Children Anxiety Scale, Short Mood Feelings Questionnaire, and Child and Adolescent Trauma Screen. Compared to community samples, symptom levels above clinical cut-off was more frequent, with social- and generalized anxiety (ES = 0.78–0.88) being most prevalent among youth in foster care. Girls reported more internalizing symptoms (ES = 0.59–0.93). Sexual abuse and neglect were associated with a broader range of internalizing symptoms (ES = 0.35–0.64). Increased incidence of maltreatment was associated with increased levels of symptoms (ES = 0.21–0.22). Associations between maltreatment and symptom level were stronger for girls. This study stresses the importance of broad screening of maltreatment and internalizing symptoms to meet the needs of youth in foster care.