Abstract
Traumatic experiences during childhood are common and often lead to chronic mental health conditions such as posttraumatic stress disorder (PTSD). The primary aim of this study was to determine whether a well‐validated screening tool for PTSD administered in frontline services effectively identifies diagnosable PTSD in young people with a history of maltreatment. In total, 141 young people in community care settings were screened using three screening instruments (Child Revised Impact of Events Scale‐8; Generalised Anxiety Disorder‐2; Patient Health Questionnaire‐2). Participants described a range of adverse life events: 110 of the 141 participants reported at least one adverse life experience (mean number for the total sample was 2.8), with 44.2 per cent (n = 46) experiencing at least one form of interpersonal trauma; and 102 participants (72.3 per cent) screened positively for probable PTSD and subsequent mental health assessments confirmed this condition in 64.7 per cent of these participants. Further, 36.9 per cent (n = 52) and 46.8 per cent (n = 66) met the threshold for probable depression and anxiety, respectively. Three items were associated with positive PTSD screens: a history of being on the child protection register, previous mental health contact and interpersonal index trauma. Interpersonal traumas were also associated with higher risks of offending. It seems feasible to use screening measures effectively within frontline social care services if staff are provided with appropriate training and support to identify young people with PTSD who may benefit from evidence‐based mental health therapies.Key Practitioner Messages There is strong evidence of the link between childhood adversities and poor mental health, including PTSD. This study found that a short instrument can be embedded within social care services to screen children and young people for PTSD. It is important that frontline staff have the necessary training and tools to understand the effects of trauma and screen children's mental health in order to facilitate access to effective therapies at an early stage.
Highlights
Over the past 25 years, the impact of maltreatment on children's mental health has been investigated extensively (e.g. Cecil et al, 2017; Hanlon et al, 2020)
There are some differences between the two international mental health classification manuals - DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition; American Psychiatric Association, 2013) and ICD-11 (International Classification of Diseases 11th Revision; World Health Organization (WHO), 2019) - in the diagnostic criteria for posttraumatic stress disorder (PTSD)
A sample of 27 positive and negative results were assessed and approximately half (55.6%; n = 10) of those who screened positively for PTSD were subsequently agreed by formal mental health assessments and almost a quarter (22.2%; n = 2) who did not meet PTSD threshold on the screens were subsequently assessed positively for PTSD by mental health assessments (Table 4)
Summary
Over the past 25 years, the impact of maltreatment on children's mental health has been investigated extensively (e.g. Cecil et al, 2017; Hanlon et al, 2020). Exposure to one or more potentially traumatic events in childhood is a common experience, with nearly 60 per cent of children reporting at least one, including physical, emotional and sexual abuse, and physical and emotional neglect (Runyon et al, 2019) Exposure to such potential traumas is associated with an increased risk of mental health problems such as posttraumatic stress disorder (PTSD), anxiety, depression, suicidal ideation and substance abuse across the life course (Hanlon et al, 2020; Leenarts et al, 2013). There are some differences between the two international mental health classification manuals - DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition; American Psychiatric Association, 2013) and ICD-11 (International Classification of Diseases 11th Revision; World Health Organization (WHO), 2019) - in the diagnostic criteria for PTSD Both manuals agree that three core symptom clusters (re-experiencing, avoidance and hyperarousal) differentiate PTSD from other disorders. It is argued that CPTSD is more relevant to individuals exposed to very severe, repeated or prolonged trauma (Karatzias et al, 2017)
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