Skandsen Annika, Nilsen Sondre Aasen, Hysing Mari, Teicher Martin H, Sand Liv, Bøe Tormod
Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway.
Stavanger University Hospital, Stavanger, Norway.
Child Psychiatry Hum Dev. 2024 Feb 8. doi: 10.1007/s10578-024-01671-9.
Adolescents who experience potentially traumatic experiences (PTEs) have an increased risk of psychopathology. PTEs often co-occur and may form interrelated patterns of exposure. This study investigated underlying classes of PTE exposure among Norwegian adolescent participants in the youth@hordaland study, and whether such classes were associated with contact with child and adolescent mental health services (CAMHS) and psychiatric diagnoses. The data stem from the population-based youth@hordaland study conducted in 2012 which was linked to the Norwegian Patient Registry (NPR, n = 8845). Exposure to PTEs was assessed by adolescent self-report whereas psychiatric disorders (Axis 1) were derived from the NPR. Latent Class Analysis was used to identify distinct classes of PTE exposure-patterns in the data. Logistic regression analyses were performed to investigate associations between classes of PTEs and contact with CAMHS and psychiatric diagnoses. Three classes of PTE exposure were identified based on model fit indices and theoretical considerations. Compared with participants in the low trauma class (88% of participants), those in the Situational-(6%) and Interpersonal trauma class (6%) had higher odds-ratios (ORs) for contact with CAMHS (OR = 2.27 (95% CI [1.78, 2.87])) and (OR = 3.26 (95% CI [2.61, 4.04])) respectively, and for being diagnosed with a psychiatric disorder in CAMHS (ORs ranged from 2.19 - 10.4) after adjusting for sex and parental education. There were more participants diagnosed with ADHD within the Interpersonal trauma class compared to the Situational trauma class when adjusting for sex and parental education (OR = 2.22 (95% CI [1.17, 4.40])). Three relatively homogeneous PTE classes, consisting of distinct patterns of trauma exposure were associated with a higher odds of contact with CAMHS and of being diagnosed with a psychiatric disorder in CAMHS. The study highlights the co-occurrence of PTEs and their impact across the diagnostic spectrum.
经历潜在创伤性事件（PTEs）的青少年出现精神病理学问题的风险增加。PTEs常常同时发生，并可能形成相互关联的暴露模式。本研究调查了参与“青年@霍达兰”研究的挪威青少年参与者中PTE暴露的潜在类别，以及这些类别是否与儿童和青少年心理健康服务（CAMHS）接触及精神科诊断相关。数据来源于2012年开展的基于人群的“青年@霍达兰”研究，该研究与挪威患者登记处（NPR，n = 8845）相关联。PTEs暴露通过青少年自我报告进行评估，而精神障碍（轴I）则来自NPR。潜在类别分析用于识别数据中不同的PTE暴露模式类别。进行逻辑回归分析以研究PTEs类别与CAMHS接触及精神科诊断之间的关联。基于模型拟合指数和理论考量，识别出三类PTE暴露。与低创伤类别（88%的参与者）的参与者相比，处于情境性创伤类别（6%）和人际创伤类别（6%）的参与者与CAMHS接触的比值比（ORs）更高（OR = 2.27（95% CI [1.78, 2.87]））和（OR = 3.26（95% CI [2.61, 4.04]）），在调整性别和父母教育程度后，在CAMHS中被诊断为精神障碍的比值比（ORs范围为2.19 - 10.4）。在调整性别和父母教育程度后，人际创伤类别中被诊断为注意力缺陷多动障碍（ADHD）的参与者比情境性创伤类别更多（OR = 2.22（95% CI [1.17, 4.40]））。三类相对同质的PTE类别，由不同的创伤暴露模式组成，与与CAMHS接触及在CAMHS中被诊断为精神障碍的较高几率相关。该研究强调了PTEs的同时发生及其在整个诊断范围内的影响。
