Trauma and PTSD among adolescents with severe emotional disorders involved in multiple service systems

This study examined the prevalence and correlates of posttraumatic stress disorder (PTSD) among adolescents with severe emotional disorders who were involved in multiple service systems.

Sixty-nine adolescents, ages 11-17, and their primary caregivers participated in a system-of-care project in three regions of New Hampshire and were interviewed to determine adolescent trauma exposure, prevalence of PTSD, treatment history, family background, behavioral and emotional problems, functioning, caregiver strain, and strengths and resilience.

The rate of current PTSD was 28%, which was underdiagnosed in adolescents' medical records. PTSD was related to gender (42% for girls and 19% for boys; p=.03), history of sexual abuse (61% among youths with sexual abuse and 15% among youths without), chart diagnosis of depression (47% among youths with depression diagnoses and 16% among youths without), and treatment with multiple psychotropic medications (53% among youths prescribed two or more medications and 26% among those prescribed no medication or one medication). Adolescents with PTSD also were more likely to have run away, engaged in self-injurious and delinquent behavior, reported higher anxiety and depression, and functioned worse at school and home than those without PTSD.

PTSD is a common but underdiagnosed disorder among adolescents with severe emotional and behavioral disorders who are involved in multiple service systems. Routine screening for trauma exposure and PTSD should be conducted with all adolescents receiving mental health services so that treatment can be provided to those with PTSD.