Childhood trauma is prevalent and associated with co-occurring depression, anxiety, mania and psychosis in young people attending Australian youth mental health services

Abstract

Objectives: Childhood trauma is common and associated with mental ill health. While high rates of trauma are observed across individual disorder groups, there is evidence that trauma is associated with an admixture of affective, anxiety, and psychotic symptoms in adults. Given that both early onset of mental disorder and trauma exposure herald poor outcomes, it is important to examine trauma prevalence rates in youth mental health services and to determine whether this trauma-related clustering is present in help-seeking young people. Methods: We used data from the Transitions Study, a longitudinal investigation of young people attending one of four headspace youth mental health services in Melbourne and Sydney, Australia between January 2011 and August 2012. Participants were 775 young people aged 12 to 25 (65.9% female; mean age = 18.3, SD = 3.2). Childhood trauma was assessed using the Childhood Trauma Questionnaire (CTQ). Multinomial regression was used to assess whether reported childhood trauma was more strongly associated with the co-occurrence of depression, anxiety, mania, and psychosis symptoms than with any one in isolation. Results: Approximately 84% of participants reported some form of abuse (emotional: 68%; physical: 32%; sexual: 22%) or neglect (emotional: 65%; physical: 46%) during childhood or adolescence. Exposure to multiple trauma types was common. Childhood trauma was significantly associated with each symptom domain (depression, mania, anxiety and psychosis). Childhood trauma was more strongly associated with the co-occurrence of these symptoms than with any one of these domains in isolation, such that trauma-exposed young people were more likely to experience increased symptom clustering than their non-exposed counterparts. Conclusions: Childhood trauma is pervasive in youth mental health services and associated with a heterogeneous symptom profile that cuts across traditional diagnostic boundaries.

Trauma-informed mental health and/or substance use prevention programs for young people: protocol for a mixed-methods systematic review

“…These criteria are based on findings from recent trauma-informed methodological studies 33,42,43 as well as seminal technical handbooks regarding trauma-informed approaches. 31,32,44 The present review limits the scope of mental ill-health prevention programs to symptoms and feelings of depression and anxiety. These symptoms and associated disorders represent the largest burden of mental ill-health among young people.…”

“…30 Trauma-informed prevention realises, recognises, and responds to trauma, its signs, symptoms, and impacts, actively resisting re-traumatisation. 31,32 In doing so, trauma-informed approaches cultivate resilience and empower individuals to mitigate the impact of their adverse experiences. 32 For example, the trauma-informed electronic cigarette prevention program, 'Rise Above', aims to provide youth with social and emotional skills in conjunction with substance use knowledge and resistance skills.…”

“…31,32 In doing so, trauma-informed approaches cultivate resilience and empower individuals to mitigate the impact of their adverse experiences. 32 For example, the trauma-informed electronic cigarette prevention program, 'Rise Above', aims to provide youth with social and emotional skills in conjunction with substance use knowledge and resistance skills. 33 Unlike traditional public health prevention, experts recommend that trauma-informed prevention programs provide psychoeducation regarding trauma and its impacts and relevant skill-building to develop healthy strategies to cope and enhance social and emotional competencies .…”