The Links Between Sexual Abuse Severity, Running Away, and Parental Connectedness Among Youth at a Hospital-Based Child Advocacy Center

Purpose: Runaway adolescents often have strained relationships with their parents. Given parental support is an important protective resource for traumatized young people, understanding differences in support within parent–adolescent relationships could aid in designing more effective interventions. We hypothesized (1) runaway adolescents seen at a Child Advocacy Center (CAC) would have poorer parental relationships than adolescents without a history of running away and (2) severity of diagnosed sexual violence would be associated with lower parental connectedness. Methods: Data were from 2,042 adolescents aged 10–19 years and their parents evaluated for any reason at our hospital-based CAC from 2008 to 2017. Parent–adolescent relationship scales were completed by adolescents and at least one parent/guardian (usually mothers). Sexual abuse was stratified at four levels, higher levels indicating increasingly severe forms of abuse. T-tests and analyses of variance to tested relationships between supportive and controlling parental behaviors by runaway status, and, among runaways, by the severity of sexual abuse. Results: Runaway adolescents comprised 58.3% of adolescents seen at the CAC; runaways reported lower parental support and higher parental controlling than patients without a history of running away. Those with the most severe forms of sexual abuse (including sexual exploitation and gang rape) reported the least supportive and most controlling relationships with parents, as did their parents. Conclusions: Findings support our clinical observations that polyvictimization of adolescents who have spent significant time as runaways may further strain parent–adolescent relationships. Future clinical research should focus on developing interventions to promote parental connectedness after a runaway episode.