Severity of Victimization and Co-Occurring Mental Health Disorders Among Substance Using Adolescents

Co-occurring mental health disorders are widespread among substance using adolescents. Severity of victimization may be an
important factor in explaining co-occurrence of mental health problems among adolescents with substance misuse problems.

The purpose of this study was to evaluate whether severe victimization experiences were shared risk factors for internalizing
only, externalizing only, and co-occurring internalizing and externalizing disorders among victimized substance-using adolescents.

Data for this cross-sectional study were obtained from a multisite research project. Adolescents, ages 11–18, participated
in a comprehensive screening program for substance abuse at 106 Substance Abuse and Mental Health Services Administration
(SAMHSA) Center for Substance Abuse Treatment (CSAT)-funded grantee sites throughout the United States.

Longer duration/frequent victimization, more than one type of victimization, and recent victimization were related to co-occurring
internalizing and externalizing disorders. Victimization by a trusted person, however, was only related to internalizing disorders.

The findings show that some indicators of severe victimization experiences are shared risk factors for internalizing, for
externalizing, and for co-occurring internalizing and externalizing problems, thus providing support for the common factors
model of co-morbidity. These findings suggest that practitioners in substance abuse treatment must thoroughly assess for severe
victimization experiences among adolescents presenting with co-occurring mental health issues. Treatment planning and interventions
may focus on helping adolescents cope effectively with their victimization experiences and addressing their MH needs.