28 Journal of Child & Adolescent Trauma, 2:28–45, 2009 Copyright © Taylor & Francis Group, LLC ISSN: 1936-1521 print / 1936-153X online DOI: 10.1080/19361520802675884 WCAT 1936-1521 1936-153X Journal of Child & Adolescent Trauma, Vol. 2, No. 1, Jan 2009: pp. 0–0 Journal of Child & Adolescent Trauma Predictors of Clinically Significant Sexual Concerns in a Child Welfare Population Predictors of Sexual Concerns in Children A. M. Lyons et al. AMY M. LYONS, SCOTT C. LEON, CHRISTOPHER ZADDACH, ERICA J. LUBOYESKI, AND MARYSE RICHARDS Loyola University Chicago This study employed a risk and resilience paradigm to examine the correlates of youth with and without clinically significant sexual concerns (Trauma Symptom Checklist for Children) in a child welfare sample. Participants were 158 youth in substitute care with sexual behavior problems, as well as their caregivers. A multivariate classifica- tion tree analysis yielded an overall classification rate of 88%. Youth with clinically significant sexual concerns were more likely to have been sexually abused, have a substantial number of prior placements, and be residing in residential placements. For youth without a sexual abuse history, being female and witnessing community violence was associated with sexual concerns. This study demonstrated that a range of vari- ables interact in complex ways to predict sexual concerns symptoms. Keywords child welfare, sexual concerns, trauma, risk, protective factors Sexual concerns include symptoms of both sexual preoccupation and distress (Briere, 1996). Sexual preoccupation involves increased precocious sexual thoughts and fantasies (Briere, 1996; Noll, Horowitz, Bonanno, Trickett, & Putnam, 2003), while sexual distress refers to anxiety related to unwanted sexual feelings and fears about being sexually exploited (Briere, 1996). Children who experience sexual distress often present as fearful of others, untrusting, anxious, and easily upset by sexual thoughts (Briere, 1996; Briere & Elliot, 1994). Overall, the negative affect, disturbing thoughts, mistrust, and impaired social rela- tions associated with sexual concerns represent a distressing symptom picture, and can have an ongoing negative impact on youths’ development (Briere, 1996). Consequently, under- standing the factors associated with the presence or absence of sexual concerns, particularly among highly vulnerable youth, could have critical implications for therapeutic intervention. The current study employed a risk and resilience paradigm (Luthar, Cicchetti, & Becker, 2000) to shed light on the risk factors that co-occur with clinically significant sex- ual concerns as well as the variables associated with relatively lower rates of sexual con- cerns symptoms. A classification tree statistical strategy known as Optimal Data Analysis (ODA) was used to optimally classify a sample of 158 youth in the child welfare system in Cook County, Illinois who either did or did not report experiencing clinically significant sexual concerns. This strategy allows researchers to begin to understand how variables interact in nuanced ways to predict complex psychological phenomena such as sexual preoccupation and distress. Submitted August 14, 2008; revised December 5, 2008; accepted December 7, 2008. Address correspondence to Amy M. Lyons, Loyola University Chicago, Department of Psychol- ogy, 6525 N. Sheridan Road, Damen Hall, Room 624, Chicago, IL 60626. E-mail: alyons1@luc.edu