Service Use Typologies Among Trauma-Exposed Children: The Roles of PTSD and Dissociation

PTSD;Dissociation;Trauma;Adolescent;Nursing;Health Sciences;Nursing

Choi, KristenMunro-Kramer, Michelle Lynne ;

University of Michigan

关键词: PTSD;    Dissociation;    Trauma;    Adolescent;    Nursing;    Health Sciences;    Nursing;   

Others  :  https://deepblue.lib.umich.edu/bitstream/handle/2027.42/138540/krchoi_1.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: The Illinois Digital Environment for Access to Learning and Scholarship

【 摘 要 】

Childhood maltreatment is an important public health problem because it can impair child development and result in chronic physical and mental health disorders and increased social risk. The purpose of this study is to describe the prevalence of posttraumatic stress disorder (PTSD), dissociation, and the dissociative subtype of PTSD (PTSD-D) among adolescents with exposure to trauma, to describe typologies of service usage by trauma-exposed adolescents, and to examine the co-occurrence of PTSD and dissociation. This study used baseline data from the National Child Traumatic Stress Network (NCTSN) Core Data Set (CDS) collected from 2004 to 2010. The sample included 3,081 trauma-exposed adolescents ages 12 to 16 who were seeking clinical services at an NCTSN site. Psychopathology variables were PTSD, dissociation, and behavioral symptoms, measured with the UCLA PTSD Reaction Index, the Trauma Symptom Checklist for Children, and the Child Behavior Checklist. Latent class analysis was used to derive a model of service use typologies and PTSD/dissociation groups. This study illuminated the complex relationships between trauma, dissociation, posttraumatic stress, and service utilization in an adolescent population. The PTSD-D group, characterized by depersonalization and derealization, did not substantially differ from the PTSD-only group on trauma history or mental health measures. In a latent class model that accounted for a broader range of dissociation symptoms, distinct PTSD/dissociation groups emerged, including a dissociative subtype group, and PTSD-only group, and a unique dissociation group characterized by dissociative amnesia and detached arousal. There were five distinct service usage typologies with varying levels of pattern complexity and intensity of level of care. Trauma itself, rather than PTSD or dissociation, was associated with service usage complexity. This study suggests that there is a need to broadly assess dissociation symptoms among adolescents in clinical settings and provide trauma-informed care in service sectors where they might be seeking treatment.