Child and Family Translational Research Center, Boys Town, NE, USA.
Am J Community Psychol. 2019 Dec;64(3-4):321-332. doi: 10.1002/ajcp.12364. Epub 2019 Aug 1.
Trauma-informed care is recommended to improve the quality of group home services for youth. Youth exposure to trauma and associated symptoms are important factors involved in making the clinical impression that determines treatment services. This study considered three dimensions of trauma (exposure, symptoms, and clinical impression) to determine associations with behavioral incidents of youth in trauma-informed group homes and how trauma was related to changes in psychopathology from intake to discharge. Archival records of youth (N = 1,096), age 9-18 (M = 15.7 years) who received services from January 2013 to December 2017, and departed the program were used. Statistical procedures included hierarchical linear modeling and analysis of covariance. Results indicated trauma symptoms predicted emotional problems and self-injurious behavior. Youth in high- and low-trauma groups both showed decreases in behavioral incidents and psychopathology, but clinical impression of trauma moderated the change in emotional problems from intake to discharge. Youth deemed by clinicians to have lower trauma (based on history of maltreatment and expression of trauma symptoms) had greater decrease in emotional problems from admission to discharge. Limitations and implications for further research on implementation and effectiveness of trauma-informed models are discussed.
创伤知情关怀被推荐用于提高青年群体之家服务的质量。青年接触创伤及相关症状是确定治疗服务的临床印象的重要因素。本研究考虑了创伤的三个维度（暴露、症状和临床印象），以确定它们与创伤知情群体之家中青年的行为事件之间的关联，以及创伤与从入院到出院期间精神病理学变化的关系。本研究使用了 2013 年 1 月至 2017 年 12 月期间接受服务并离开该项目的 9-18 岁（M=15.7 岁）青年（N=1,096）的档案记录。统计程序包括分层线性建模和协方差分析。结果表明，创伤症状预测了情绪问题和自伤行为。处于高创伤和低创伤组的青年都表现出行为事件和精神病理学的减少，但创伤的临床印象调节了从入院到出院期间情绪问题的变化。临床医生认为创伤程度较低（基于虐待史和创伤症状的表达）的青年，从入院到出院期间情绪问题的减少程度更大。讨论了对创伤知情模式的实施和有效性进行进一步研究的限制和意义。
