Psychology, Department of


First Advisor

David J. Hansen

Date of this Version



A dissertation presented to the faculty of the Graduate College at the University of Nebraska in partial fulfillment of requirements for the degree of Doctor of Philosophy

Major: Psychology

Under the Supervision of Professor David J. Hansen

Lincoln, Nebraska, August 2023


Copyright 2023, Akemi E. Mii. Used by permission


Adverse childhood experiences (ACEs) refer to negative events during childhood or adolescence including abuse, maltreatment, and exposure to household dysfunction (Kalmakis & Chandler, 2014). ACEs are associated with negative outcomes including mental and behavioral health concerns and offending (Fox et al., 2015). The risk of negative outcomes associated with ACEs increases when an individual experiences polyvictimization (experiencing multiple types of adverse events; Felitti et al., 1998; Finkelhor et al., 2011). A majority of adolescents served by residential treatment programs (RTPs) have experienced polyvictimization (Briggs et al., 2013). Research examining juvenile offending and youth delinquency has focused on boys. Thus, research is warranted to understand adolescent girls in residential treatment to improve treatment, prevent recidivism, and prevent first encounters with juvenile justice systems. This study addressed some of these gaps by characterizing ACEs and mental and behavioral health concerns among adolescent girls within an RTP utilizing a person-centered approach.

Data were coded from archived psychological assessment records for girls who entered an RTP between 2017 and 2021 (N = 256). Psychological assessments consisted of results from a clinical interview, youth self-reported measures, and collateral information.

Girls reported experiencing an average of 5.08 ACEs (SD = 2.47). Among the sample, 13.7% reported clinical levels of posttraumatic stress, 17.8% reported clinical levels of alcohol use, and 51.4% reported clinical levels of other substance use.

Four distinct classes were identified through the latent class analysis (i.e., low adversity, household dysfunction, abuse and non-support, and polyvictimization). The polyvictimization and abuse and non-support classes reported higher levels of trauma symptoms compared to the low adversity class. Youth in the polyvictimization and household dysfunction classes reported higher scores of substance use compared to the low adversity class. Youth in the household dysfunction class displayed higher delinquent behaviors compared to the low adversity class.

These findings provide a deeper understanding of adolescent girls’ experiences of ACEs and mental and behavioral concerns when entering residential treatment. These efforts may help to inform prevention and intervention efforts that reduce burden to children, families, and the systems that serve these youth. Additional clinical and policy implications of these findings are discussed.

Advisor: David J. Hansen