1.  Stressors associated with chronic poverty contribute to “social morbidities” including adolescent substance use, HIV, teen pregnancy, and delinquent behaviors (Harper, 1999)  In turn, these morbidities are associated with delinquency (i.e., gang membership) and participation in violent behaviors  As youth social stressors increase, risk factors accumulate, and the probability of gang affiliation increases (McDaniel, 2012)  Gangs offer tangible and perceived benefits including a sense of belonging, status, power, identity, financial support, and protection  Gang membership  additional exposure to violence & maladaptive coping mechanisms (Harper, 1999; Opland, 1995) such as engaging in drug and alcohol use and sexual risk behaviors (Harper, 1999; Walker-Barnes, 2004). Objective: Explore the role of adverse childhood events in the lives of adolescent gang members  Stressors associated with chronic poverty contribute to “social morbidities” including adolescent substance use, HIV, teen pregnancy, and delinquent behaviors (Harper, 1999)  In turn, these morbidities are associated with delinquency (i.e., gang membership) and participation in violent behaviors  As youth social stressors increase, risk factors accumulate, and the probability of gang affiliation increases (McDaniel, 2012)  Gangs offer tangible and perceived benefits including a sense of belonging, status, power, identity, financial support, and protection  Gang membership  additional exposure to violence & maladaptive coping mechanisms (Harper, 1999; Opland, 1995) such as engaging in drug and alcohol use and sexual risk behaviors (Harper, 1999; Walker-Barnes, 2004). Objective: Explore the role of adverse childhood events in the lives of adolescent gang members  58 in-depth semistructured interviews with 14-19 year old gang members of six area gangs  Two larger ‘corporate’ gangs; four local community or neighborhood gangs  Participants were recruited through direct sampling methods with outreach from research staff or via referral of contacts by study participants  Received waiver of parental consent for minors  Incentives: $30 per interview; $10 for referral of additional eligible gang member (maximum of 2 referrals)  Interview topics: history of gang involvement (including when and why they joined the gang, initiation practices, and current gang activities), current drug and alcohol use, sexual practices and relationships, and family history  Interviews were audio recorded, transcribed verbatim, and coded and analyzed for key themes and patterns using MAXQDA qualitative analysis software  Codebook created collaboratively & codes were refined throughout  Interviews were analyzed using a constant comparative method  58 in-depth semistructured interviews with 14-19 year old gang members of six area gangs  Two larger ‘corporate’ gangs; four local community or neighborhood gangs  Participants were recruited through direct sampling methods with outreach from research staff or via referral of contacts by study participants  Received waiver of parental consent for minors  Incentives: $30 per interview; $10 for referral of additional eligible gang member (maximum of 2 referrals)  Interview topics: history of gang involvement (including when and why they joined the gang, initiation practices, and current gang activities), current drug and alcohol use, sexual practices and relationships, and family history  Interviews were audio recorded, transcribed verbatim, and coded and analyzed for key themes and patterns using MAXQDA qualitative analysis software  Codebook created collaboratively & codes were refined throughout  Interviews were analyzed using a constant comparative method  The motivation for joining gangs is a response to adverse childhood events including abuse, abandonment, parental substance use, and significant financial hardship  Gang members are rarely perceived as victims or in need of mental health services and treatment & are often treated without regard to adverse childhood events, trauma, or mental health  There are a lack appropriate mental health services and trauma informed care for gang members; services and treatment should target children experiencing multiple life stressors to potentially decrease gang involvement  The motivation for joining gangs is a response to adverse childhood events including abuse, abandonment, parental substance use, and significant financial hardship  Gang members are rarely perceived as victims or in need of mental health services and treatment & are often treated without regard to adverse childhood events, trauma, or mental health  There are a lack appropriate mental health services and trauma informed care for gang members; services and treatment should target children experiencing multiple life stressors to potentially decrease gang involvement Early childhood trauma among adolescent gang members Katherine Quinn, MA 1, Meridith Mueller, MPH, and Julia Dickson-Gomez, PhD 2 1 Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI; 2 Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, WI METHODS & ANALYSIS BACKGROUND This research was funded by the National Institute on Drug Abuse (R01DA027299). For more information please contact: Julia Dickson-Gomez, PhD: jdickson@mcw.edu, 414-955-7700jdickson@mcw.edu Methods Analysis RESULTS CONCLUSION Adverse childhood events Adolescents cited numerous adverse/ traumatic events in childhood including: parental substance use significant financial hardship parental absence neighborhood violence domestic violence child abuse and neglect 19 year-old African American female: “My mom’s in jail. She’s been in and out of jail for drugs and gang affiliation. When I was little she was in prison for 12 years, she got out, went back in, got out again, now she’s back. And my dad, he’s a truck driver. He goes over the road but when he comes home he gets all into the drugs and everything. I never see him ‘cause he always chasing the drugs. I’m kind of used to it. I’ve been basically without them since I was little... would cook dinner for three other kids. I don’t mind.... I felt I was their mom. I took care of everything. Took them to school, and then, there was even a time when we were home alone and four men busted in our doors with guns, and my mom wasn’t there to help us. She was out buying her drugs and messin’ around with other guys.” 17 year-old African American male: “It was domestic violence. Like, it was my dad. He was on drugs real bad, he was on dope. And my mom. But they always wanted the best for me, but I never would get the best for me ‘cause I was too worried about gangbanging. Gangbanging took over my life. Took complete control of me... Who don’t want protection in a world of violence?” Motivators for joining gangs Adverse experiences cited as reasons for joining the gang to gain: sense of family/belonging money protection 19 year-old Hispanic male “They provide man. My clique provides. Like I said, my mom, my little brothers are still in school – supplies got to be bought, groceries gotta be paid for, and I can’t do that on my own with no job, you know what I’m saying- my record, my background. My hustle gotta be hard; it’s gotta be strong. That’s the difference; I have to be here to provide for my family. You understand me? My family wouldn’t make it without the help from the clique and the things I do.” 18 year-old African American male Interviewer: Did that [death of mom and dad] influence you going into the gang? 18 year-old male: Yeah, ‘cause it leads to depression and you know, when you’re in depression you bound to do a lot of things that you usually wouldn’t do. You know, like when I first got out, thought about how my father was a drinker, and I started it.... The gang was family to me. I was 12 years old and my father was a drinker all the time and he never had time for us. I go out into the streets and seeing how they was, I want to be with them. See some love that the family couldn’t. Interviewer: Did you ever feel that you needed to join to be protected? 18 year-old male: Me, just love. Wanted to be loved and have a family. Revictimization Yet, gang membership is often associated with revictimization/ additional stress & trauma (i.e., exposure to violence, sexual risk behaviors, significant drug and alcohol use, and family and economic hardship) 19 year-old African American male “My brother tried to follow me around and I was into the running around with the gang – and selling drugs and stuff. So, my brother was always following me around he was like, accidently shot by one of his friends.” As a result of his brother’s death, this participant noted his gang involvement increased and he now carries a gun regularly to protect his family because: “I don’t want nobody to do nothing to [mom] because of things I’m doing in the street... Because my mom and me fell out for a minute because she thought it was my fault that my brother passed.” Adolescents frequently cited the prominence of substance use within the gang and the subsequent sexual risk behaviors and expectations. 19 year-old African American female “I used a lot of alcohol and drugs when I was younger. I had a couple of threesomes with dudes and girls... The next day, it was a blur. I mean, I get kinda disgusted, but then I go on with my day. It was like normal to me.... If I was sober would I have did it? I know I wouldn’t of did it. But drinking, I didn’t care.”