Despite historical concerns about the validity of the construct of borderline personality disorder (BPD) in adolescence, there is now general consensus that BPD in adolescence constitutes a valid and reliable diagnosis. Yet the development and refinement of measures to assess borderline traits in adolescents is in its infancy. Moreover, brief and easy-to-administer measures of borderline traits for use in large-scale studies do not exist. The aim of the current study was to evaluate the Borderline Personality Features Scale for Children (BPFSC; Crick, Murray-Close, & Woods, 2005) and develop a short version of the BPFSC through the use of item response theory (IRT) methods. BPFSC data from a community sample of 964 adolescents (mean age ϭ 15.1 years, SD ϭ .79; 55.9% female) were used to examine the factor structure of the BPFSC. The hypothesized 4-factor structure was not supported. The unidimensional IRT analysis showed instances of local dependence among item pairs and item responses that were not strongly related to the underlying construct. As a consequence, items were eliminated, creating a unidimensional 11-item brief BPFSC (the BPFSC-11). Next, evidence of construct validity of scores based on the shortened version was evaluated using a different sample of 371 inpatient adolescents. We demonstrated similar indices of construct validity as observed for the BPFSC total score with the BPFSC-11 scores and found evidence for good criterion validity. Use of the BPFSC-11 in clinical settings will reduce the burden on respondents without loss of information.

The study provides the first empirical evidence of well-established theoretical approaches to the development of BPD.

Human trafficking is a significant and growing public health concern. Subgroups of adolescents and young adults are particularly vulnerable to human trafficking, especially youth who are unstably housed or homeless. While youth experiencing trafficking come into contact with the healthcare system, they are often not identified during routine assessment due to lack of specific inquiry and low disclosure. Therefore, we utilized a mixed-methods study design to assess the differences in the identification of human trafficking among youth experiencing homelessness (n = 129) between a standard psychosocial assessment tool and a human trafficking specific assessment tool. Findings indicate that the tool developed to specifically assess for human trafficking was more likely to identify youth experiencing sexual and labor exploitation, as well as the risk factors for human trafficking. Secondly, youth reported that mistrust of the system, fear of involving the police if reported, not wanting to interact with the mental healthcare system, and stigma are barriers to disclosing human trafficking. In conclusion, healthcare providers caring for youth experiencing homelessness should adopt improved screening tools for human trafficking to reduce the risk of missed opportunities for prevention and treatment among this high-risk population of youth.

Experiencing sexual trauma has been linked to internalizing and externalizing psychopathologies. Insecure attachment has been shown to moderate the relation between sexual trauma and trauma symptoms among adults. However, few studies have explored relations among sexual trauma, attachment insecurity, and trauma symptoms in adolescence, and none have used developmentally appropriate measures. The present study sought to examine attachment security as a potential moderator of the relation between having a history of sexual trauma (HST) and trauma symptoms among adolescents at an inpatient psychiatric facility. Attachment to caregivers was measured by the Child Attachment Interview (CAI) and trauma symptoms by the Trauma Symptoms Checklist for Children (TSCC). HST was assessed with responses to two separate interviews that asked about traumatic experiences: the Computerized Diagnostic Interview Schedule for Children (C-DISC) and the CAI. Moderation analyses were conducted using univariate General Linear Modeling (GLM). Of the 229 study participants, 50 (21.8%) had a HST. The relation between HST and trauma symptoms was significantly moderated by insecure attachment with both mother, F(1, 228) = 4.818, p = .029, and father, F(1, 228) = 6.370, p = .012. Specifically, insecurely attached adolescents with a HST exhibited trauma symptoms at levels significantly greater than securely attached adolescents with a HST and adolescents with no HST. Results are consistent with previous research that suggests secure attachment may protect against the development of trauma symptoms among those who have experienced a sexual trauma.

This is the first study to describe the relation between attachment security, emotion regulation, and symptom change in a sample of adolescents completing inpatient treatment in a naturalistic setting. We examined whether attachment security predicted symptom change, and whether emotion regulation capacities mediated this relation. A sample of n = 194 inpatient adolescents was assessed (65.5 % female, Mage = 15.45 years, SD = 1.44) at admission and discharge and analyses were conducted in accordance with the aforementioned objectives including testing of moderation and mediation models. We found that securely attached adolescents experienced greater reduction in internalizing symptoms from admission to discharge, even when controlling for length of stay. Nonacceptance of emotional responses mediated the relation between maternal attachment security and internalizing symptom change. These findings did not hold for externalizing symptoms, nor when paternal attachment was explored. Attachment plays an important role in symptom change for internalizing problems, with nonacceptance of emotional responses partially mediating this link. Possible explanations for the absence of moderation for paternal attachment and externalizing problems are discussed, as are explanations for the mediating effect of emotion regulation.