Unrecognized Posttraumatic Stress Disorder as a Treatment Barrier for a Gang-Involved Juvenile Offender

This study examines the case of GH, an 18-year-old Latino male participating in an employment-based delinquency intervention for gang-affiliated youth. Although postintervention measures revealed that GH showed gains on key outcomes (i.e., delinquency, employment), he experienced sporadic treatment setbacks (e.g., work absenteeism, fighting) that disrupted his progress. A comprehensive psychological assessment suggested that his aggressive, illegal behavior and difficulty maintaining employment could have been influenced by previously undiagnosed posttraumatic stress disorder (PTSD). Excerpts from counseling sessions illustrated how reactive aggression, hypervigilance, sleep disruptions, and emotional numbing could have interfered with treatment gains and ultimately contributed to GH's re-arrest. Implications for early, accurate identification of PTSD in delinquency interventions for gang youth are discussed.