Adolescent trauma, psychopathology and mental health service use

Abstract

Research has shown that, by the time an individual reaches adolescence, they are likely to have experienced at least one traumatic event, and, when compared to trauma in adulthood, exposure is at its peak during the adolescent years. Further research has examined negative sequelae associated with traumatic experiences, and has found psychological outcomes such as depression, behaviour disorders, and PTSD to be highly prevalent amongst traumatised adolescents. It has also been consistently found that, amongst those adolescents with poor psychological responses to trauma, incidences of multiple trauma experiences are prevalent, with some experiencing as many as four or five traumatic events in one year alone.

This current thesis aimed to further explore the nature of trauma in adolescence by examining the trauma histories of an American general population sample of adolescents (N = 10,123), the National Comorbidity Survey – Adolescent Supplement (NCS-A). It did this by applying an advanced statistical technique, latent class analysis (LCA), to the trauma data. Utilising LCA makes the adolescents the focus of the study and not the traumatic events. It does this by identifying latent classes useful in explaining homogenous groups of individuals who display similar patterns of trauma exposure. Four classes were identified in chapter 3. A low risk class, where experiences of any trauma events are minimal, was first identified as the baseline group. Three trauma classes were then identified; high risk, sexual assault risk, and non-sexual assault risk. This thesis then aimed to determine sociodemographic profiles of those adolescents belonging to each of the trauma groups by applying multinomial logistic regression in chapter 4. Adolescent risk factors such as being female, coming from a home where neither biological parent was present, and where a history of parental psychopathology was evident, were all identified as being indicative of trauma group membership. Confirmatory factor analysis (CFA) was then utilised in chapter 5 in order to identify an appropriate model of adolescent psychopathology. Internalising factors of distress and fear, and externalising factors of social norm violation behaviours and oppositional behaviours were found to best explain the mental health symptoms of this group of American adolescents. The resulting CFA dimensions were then applied to previously identified trauma classes in order to determine associations with psychopathology in chapter 6, with significant relationships evident as a result of the regression analyses. In addition, chapter 7 of this thesis examines adolescent mental health service use and submits service categories to further regression analysis in order to determine associations with trauma and psychopathology, with significant associations found for services used by adolescents within the school environment and within the juvenile justice system.

This thesis provides a fuller profile of the adolescents who are exposed to multipletypes of trauma, the nature of such events, the associated psychopathology andmental health service use. Such a profile will aid in the effective intervention forthose adolescents who are psychologically damaged by trauma events, and may evenhelp in the prevention of further trauma by identifying those most at risk.

Date of Award	Dec 2015
Original language	English
Sponsors	Department for Employment and Learning
Supervisor	Gary Adamson (Supervisor), Mark Shevlin (Supervisor) & Orla McBride (Supervisor)