National Clinician Scholars Program, University of California Los Angeles.
School of Medicine, Duke University.
Psychol Trauma. 2018 Nov;10(6):652-661. doi: 10.1037/tra0000340. Epub 2017 Nov 27.
The purpose of this study is to describe typologies of service utilization among trauma-exposed, treatment-seeking adolescents and to examine associations between trauma history, trauma-related symptoms, demographics, and service utilization.
Latent class analysis was used to derive a service utilization typologies based on 10 service variables using a sample of 3,081 trauma-exposed adolescents ages 12 to 16 from the National Child Traumatic Stress Network Core Dataset. Services used 30 days prior to the initial assessment from 5 sectors were examined (health care, mental health, school, social services, and juvenile justice).
A 5-class model was selected based on statistical fit indices and substantive evaluation of classes: (a) High intensity/multisystem, 9.5%; (b) Justice-involved, 7.2%; (c) Low intensity/multisystem, 19.9%; (d) Social service and mental health, 19.9%; and (e) Low service usage/reference, 43.5%. The classes could be differentiated based on cumulative trauma, maltreatment history, PTSD, externalizing and internalizing symptoms, and age, gender, race/ethnicity and place of residence.
This study provides new evidence about patterns of service utilization by trauma exposed, treatment seeking adolescents. Most of these adolescents appear to be involved with at least 2 service systems prior to seeking trauma treatment. Higher cumulative exposure to multiple types of trauma was associated with greater service utilization intensity and complexity, but trauma symptomatology was not. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
本研究旨在描述创伤暴露、寻求治疗的青少年的服务利用类型,并探讨创伤史、与创伤相关的症状、人口统计学特征与服务利用之间的关系。
采用潜在类别分析,根据来自国家儿童创伤应激网络核心数据集的 3081 名 12 至 16 岁创伤暴露青少年的 10 项服务变量,得出服务利用类型。研究考察了在初始评估前 30 天内来自 5 个领域(医疗保健、心理健康、学校、社会服务和少年司法)的服务使用情况。
基于统计拟合指数和对类别的实质性评估,选择了 5 类模型:(a)高强度/多系统,占 9.5%;(b)涉及司法,占 7.2%;(c)低强度/多系统,占 19.9%;(d)社会服务和心理健康,占 19.9%;(e)低服务使用率/参考,占 43.5%。这些类别的划分可以基于累积创伤、虐待史、创伤后应激障碍、外化和内化症状以及年龄、性别、种族/民族和居住地来区分。
本研究为创伤暴露、寻求治疗的青少年的服务利用模式提供了新的证据。大多数寻求创伤治疗的青少年之前似乎至少涉及 2 个服务系统。较高的累积暴露于多种类型的创伤与更高的服务利用强度和复杂性相关,但与创伤症状无关。(美国心理协会,2018 年)