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Trauma exposure and PTSD among older adolescents in foster care

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

Youth in foster care represent a highly traumatized population. However, trauma research on this population has focused primarily on maltreatment rather than the full spectrum of trauma experiences identified within the DSM-IV. The current study aims to fill this gap by reporting the prevalence of exposure to specific types of traumatic events for a large sample of youth with foster care experience. The study also reports the likelihood of lifetime PTSD diagnoses associated with each specific type of trauma.

Method

Data are from a longitudinal panel study of 732 adolescents aged 17 and 18 who were in foster care. Lifetime trauma exposure and PTSD diagnosis were assessed using the Composite International Diagnostic Interview. Statistical comparisons were made using logistic regressions.

Results

The majority of respondents had experienced at least one trauma in their lifetime. While overall trauma prevalence did not differ by gender, males were more likely to experience interpersonal violence and environmental trauma, while females were more likely to experience sexual trauma. Caucasian participants reported higher rates of trauma exposure than African-American participants did. The types of trauma associated with the highest probability of a lifetime PTSD diagnosis were rape, being tortured or a victim of terrorists, and molestation.

Conclusions

Youth in foster care are a highly traumatized population and meet diagnostic criteria for PTSD at higher rates than general youth populations. The ongoing impact of trauma may be particularly problematic for these young people given their abrupt transition to independence.

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References

  1. Badeau S, Gesiriech S (2004) A child’s journey through the child welfare system. The Pew Commission on Children in Foster Care, Washington

    Google Scholar 

  2. Pecora PJ, White CR, Jackson LJ, Wiggins T (2009) Mental health of current and former recipients of foster care: A review of recent studies in the USA. Child Fam Soc Work 14(2):132–146

    Article  Google Scholar 

  3. Keller TE, Salazar AM, Courtney ME (2010) Prevalence and timing of diagnosable mental health, alcohol, and substance use problems among older adolescents in the child welfare system. Child Youth Serv Rev 32(4):626–634

    Article  PubMed  Google Scholar 

  4. McMillen JC, Zima BT, Scott LD Jr, Auslander WF, Munson MR, Ollie MT et al (2005) Prevalence of psychiatric disorders among older youths in the foster care system. J Am Acad Child Adolesc Psychiatry 44:88–95

    Article  PubMed  Google Scholar 

  5. Giaconia RM, Reinherz HZ, Silverman AB, Pakiz B, Frost AK, Cohen E (1995) Traumas and posttraumatic stress disorder in a community population of older adolescents. J Am Acad Child Adolesc Psychiatry 34(10):1369–1380

    Article  PubMed  CAS  Google Scholar 

  6. Merikangas KR, He J, Burstein M, Swanson S, Avenevoli SA, Cui L et al (2010) Lifetime prevalence of mental disorders in U.S. adolescents: results from the national comorbidity survey replication—adolescent supplement (NCS-A). J Acad Child Adolesc Psychiatry 49(10):980–989

    Article  Google Scholar 

  7. Breslau N, Wilcox HC, Storr CL, Lucia VC, Anthony JC (2004) Trauma exposure and posttraumatic stress disorder: a study of youths in urban America. J Urban Health: Bull of the New York Acad Med 81(4):530–544

    Article  Google Scholar 

  8. Copeland WE, Keeler G, Angold A, Costello EJ (2007) Traumatic events and posttraumatic stress in childhood. Arch Gen Psychiatry 64:577–584

    Article  PubMed  Google Scholar 

  9. Roberts AL, Gilman SE, Breslau J, Breslau N, Koenen KC (2011) Race/ethnic differences in exposure to traumatic events, development of post-traumatic stress disorder, and treatment-seeking for post-traumatic stress disorder in the United States. Psychol Med 41:71–83

    Article  PubMed  CAS  Google Scholar 

  10. Tolin DF, Foa EB (2006) Sex differences in trauma and posttraumatic stress disorder: a quantitative review of 25 years of research. Psychol Bull 132(6):959–992

    Article  PubMed  Google Scholar 

  11. Krupnick JL, Green BL, Stockton P, Goodman L, Corcoran C, Petty R (2004) Mental health effects of adolescent trauma exposure in a female college sample: exploring differential outcomes based on experiences of unique trauma types and dimensions. Psychiatry 67:264–279

    PubMed  Google Scholar 

  12. Mueser KT, Taub J (2008) Trauma and PTSD among adolescents with severe emotional disorders involved in multiple service systems. Psychiatric Serv 59(6):627–634

    Article  Google Scholar 

  13. Pecora PJ, Williams J, Kessler RC, Downs AC, O’Brien K, Hiripi E et al (2003) Assessing the effects of foster care: early results from the casey national alumni study. Casey Family Programs, Seattle

    Google Scholar 

  14. Dubner AE, Motta RW (1999) Sexually and physically abused foster care children and posttraumatic stress disorder. J Consult Clin Psychol 67:367–373

    Article  PubMed  CAS  Google Scholar 

  15. Courtney ME, Dworsky A (2006) Early outcomes for young adults transitioning from out-of-home care in the USA. Child Fam Soc Work 11(3):209–219

    Article  Google Scholar 

  16. Henry GT (1990) Practical sampling, vol 21. Sage Publications, Newbury Park

    Google Scholar 

  17. World Health Organization (1997) Composite International Diagnostic Interview (CIDI Core): version 2.1. World Health Organization, Geneva

    Google Scholar 

  18. Lau AS, McCabe KM, Yeh M, Garland AF, Hough RL, Landsverk J (2003) Race/ethnicity and rates of self-reported maltreatment among high-risk youth in public sectors of care. Child Maltreat 8(3):183–194

    Article  PubMed  Google Scholar 

  19. Colman, I., Garad, Y., Zeng, Y., Naicker, K., Weeks, M., Patten, S. B. et al (2012). Stress and development of depression and heavy drinking in adulthood: Moderating effects of childhood trauma. Soc Psychiatry Psychiatr Epidemiol. doi: 10.1007/s00127-012-0531-8

  20. Pine DS, Cohen JA (2001) Trauma in children and adolescents: risk and treatment of psychiatric sequelae. Biol Psychiatry 51(7):519–531

    Article  Google Scholar 

  21. Courtney ME (2009) The difficult transition to adulthood for foster youth in the US: implications for the state as corporate parent. Soc Policy Rep 23(1):3–19

    Google Scholar 

  22. Samuels GM, Pryce JM (2008) “What doesn’t kill you makes you stronger”: survivalist self-reliance as resilience and risk among young adults aging out of foster care. Child Youth Serv Rev 30:1198–1210

    Article  Google Scholar 

  23. Schoeni R, Ross K (2004) Family support during the transition to adulthood. MacArthur Foundation Research Network on Transitions to Adulthood and Public Policy, Philadelphia

    Google Scholar 

  24. McMillen JC, Raghavan R (2009) Pediatric to adult mental health service use of young people leaving the foster care system. J Adolesc Health 44:7–13

    Article  PubMed  Google Scholar 

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Acknowledgments

This study is based on a collaborative research effort with cooperation and funding from the Illinois Department of Children and Family Services, the Wisconsin Department of Health and Family Services, and the Iowa Department of Human Services. Preparation of this manuscript was supported by a grant from the National Institute of Mental Health (R03 MH070525).

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Authors and Affiliations

  1. Social Development Research Group, University of Washington, 9725 Third Ave NE, Suite #401, 98115, Seattle, WA, USA

    Amy M. Salazar

  2. School of Social Work, Portland State University, 1600 SW 4th Avenue, Suite 900, 97201, Portland, OR, USA

    Thomas E. Keller

  3. Regional Research Institute for Human Services, Portland State University, 1600 SW 4th Avenue, Suite 900, 97201, Portland, OR, USA

    L. Kris Gowen

  4. School of Social Service Administration, University of Chicago, 969 E 60th St, 60637, Chicago, IL, USA

    Mark E. Courtney

Authors
  1. Amy M. Salazar
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  2. Thomas E. Keller
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  3. L. Kris Gowen
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  4. Mark E. Courtney
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Corresponding author

Correspondence to Amy M. Salazar.

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Salazar, A.M., Keller, T.E., Gowen, L.K. et al. Trauma exposure and PTSD among older adolescents in foster care. Soc Psychiatry Psychiatr Epidemiol 48, 545–551 (2013). https://doi.org/10.1007/s00127-012-0563-0

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  • DOI: https://doi.org/10.1007/s00127-012-0563-0

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