Living under threat: adolescents’ continuous traumatic stress reactions in relation to violence exposure

<b>Background:</b> Adolescents exposed to violence are at a higher risk for mental health problems than their peers. Exposure to ongoing violence can potentially lead to Continuous Traumatic Stress (CTS). CTS reactions have never been studied in relation to violence exposure in adolescent samples.<b>Objective:</b> We aimed to validate the Lithuanian version of the Continuous Traumatic Stress Response (CTSR) scale in the adolescent sample, to explore the adolescents' CTS reactions using the person-oriented approach, and to study the relationship between different types of violence and CTS reactions.<b>Method:</b> In total, 321 adolescents (<i>M</i>(<i>SD</i>)_age = 14.19 (1.26)) from Lithuania were included in the current study, of which 181 (56.4%) were female, 135 (42.1%) were male, and 54.5% (<i>n </i>= 175) were continuously exposed to violence over their lifetime. Confirmatory factor analysis (CFA) with measurement invariance across genders and age groups was used to test the structural validity of the CTSR scale. A latent class-analysis approach was used to explore the patterns of CTS reactions.<b>Results:</b> The results showed good structural, convergent, and differential validity of the CTSR scale. Exhaustion/Detachment, Rage/Betrayal, and Fear/Helplessness were more profound in continuous violence exposure versus non-exposure groups, with even higher CTS reactions when recently exposed to violence. Three groups of adolescents with <i>low</i>, <i>moderate</i>, and <i>high</i> CTS reactions were distinguished with the suggested cut-off sum score of CTSR ≥18 for severe CTS reactions. The intensity of exposure to neglect, psychological abuse, physical abuse, and sexual abuse positively predicted Continuous traumatic stress (CTS) response group membership.<b>Conclusions:</b> These results stress the need for psychological support when exposed to continuous interpersonal violence in adolescence.