The Relation of Exposure to Traumatic Events and Longitudinal Mental Health Outcomes for Children Enrolled in Systems of Care: Results from a National System of Care Evaluation

Abstract

This study examined the relation between children's history of exposure to potentially traumatic events (PTEs) and clinical and functional mental health trajectories over a 18-month period among a national sample of youth referred for services in children's behavioral health systems of care (SOCs). Using data from the national evaluation of the Comprehensive Community Mental Health Services program for communities funded from 1997 to 2000, the study sample included 9556 children and their families. Latent growth modeling was used to assess the effect of history of exposure to PTEs on trajectories in a number of behavioral health outcomes during the 3-year period following referral to services, controlling for child demographic characteristics (gender, race, and age). Results revealed that, on average, children in SOCs exhibited significant improvements over time on all four outcome measures. Children with a history of exposure to PTEs had higher rates of internalizing and externalizing problem behaviors and functional impairments and fewer behavioral and emotional strengths at baseline, but experienced improvements in these outcomes at the same rates as children without exposure to a traumatic event. Finally, child race, gender, and age also were associated with differences in behavioral health trajectories among service recipients. Implications for SOCs, including approaches to make them more trauma-informed, are discussed.

Effects of individual risk and state housing factors on adverse outcomes in a national sample of youth transitioning out of foster care

“…In the child welfare system, the majority of young people in care have experienced complex trauma, or exposure to at least two types of traumatic events such as child maltreatment and removal from home (Beyerlein & Bloch, 2014;Greeson et al, 2011;Ko et al, 2008). Complex trauma has been associated with increased risk of mental health problems and externalizing behaviors, including substance abuse (Thornberry, Ireland, & Smith, 2001), depression, and delinquency and problem behaviors (Burns et al, 2004;Thornberry et al, 2001;Thornberry, Henry, Ireland, & Smith, 2010;Whitson & Connell, 2016). Complex trauma and victimization experiences may increase the propensity for engaging in antisocial behaviors, and potentially leading to juvenile or criminal justice involvement (Ryan & Testa, 2005;Snyder et al, 2016).…”

A 3-year retrospective study of 866 children and adolescent outpatients followed in the Nice Pediatric Psychotrauma Center created after the 2016 mass terror attack

“…Early-onset chronic stress does not heal naturally, and its effects appear to exacerbate over time ( 74 ). Therefore, intervening early is crucial to minimize and reduce long-term negative effects ( 75 ). Early intervention aims to avoid PTSD chronicity.…”

A 3-year retrospective study of 866 children and adolescent outpatients followed in the Nice Pediatric Psychotrauma Center created after the 2016 mass terror attack

“…Early-onset chronic stress does not heal naturally, and its effects appear to exacerbate over time [26]. Therefore, intervening early is crucial to minimize and reduce longterm negative effects [27]. The aim of early intervention is to avoid PTSD chronicity.…”