Trauma Issues with Specific Populations: Adolescents & Transition Age Youth OVERVIEW Michael Dennis,...
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Transcript of Trauma Issues with Specific Populations: Adolescents & Transition Age Youth OVERVIEW Michael Dennis,...
Trauma Issues with Specific Populations: Adolescents & Transition Age Youth
OVERVIEW Michael Dennis, Ph.D. and Megan Catlin, M.S.
Chestnut Health Systems, Normal, IL
Presentation at Substance Abuse and Mental Health Services Administration’s Pre- Conference Training Session, Trauma-Informed Care: An Essential Element of Recovery Training. Hollywood, FL, June 18, 2011
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Acknowledgement and Contact Information
• Analysis performed with support from SAMHSA contrac t no. 270-07-0191 using data from SAMHSA/CSAT GAIN Data set from 182 grantees (17534, 16386, 16400, 16414, 16904, 16915, 16928, 16939, 16961, 16984, 16992, 17046, 17070, 17071, 17334, 17433, 17434, 17446, 17475, 17476, 17484, 17486, 17490, 17517, 17523, 17534, 17535, 17547, 17589, 17604, 17605, 17638, 17646, 17648, 17673, 17702, 17719, 17724, 17728, 17742, 17744, 17751, 17755, 17761, 17763, 17765, 17769, 17775, 17779, 17786, 17788, 17812, 17817, 17821, 17825, 17830, 17831, 17847, 17864, 18406, 18587, 18671, 18723, 18735, 18849, 19313, 19323, 19942, 20084, 20085, 20086, 20100, 20117, 20200, 20300, 20400, 20759, 20781, 20798, 20806, 20827, 20828, 20847, 20848, 20849, 20852, 20865, 20870, 20910, 20921, 20941, 21551, 21580, 21585, 21597, 21624, 21632, 21682, 21688, 21705, 21714, 21774, 21788, 21815, 21874, 21883, 21890, 21892, 21948, 30100, 30200, 30300, 30400, 30500, 30600, 30700, 31000, 31100, 31200, 110000, 130000, 140000, 150000, 160000, 190000, 200000, 210000, 220000, 230000, 240000, 250000, 260000, 270000, 280000, 290000, 300000, 310000, 320000, 330000, 340000, 350000, 360000, 370000, 380000, 390000, 400000, 410000, 420000, 430000, 440000, 450000, 460000, 470000, 480000, 500000, 510000, 520000, 540000, 570000, 580000, 590000, 600000, 610000, 620000, 630000, 640000, 655372, 655373, 655374, 660000, 670000, 680000,, 690000, 700000, 820000, 830000, 840000, 850000, 860000, 870000, 880000, 910000, 920000)
• Opinions are those of the author and not official positions of the government
• Available from www.chestnut.org/li/posters • Please direct comments to Michael Dennis, Chestnut Health Systems, 448
Wylie Drive, Normal, IL 61761, 309-451-7801, [email protected] .
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Goals
1. To examine the prevalence and demographic correlates of victimization
2. To demonstrate how clinical conditions vary by the severity of victimization
3. To describe the breakout session
4
CSAT GAIN Data on Adolescents & Young Adults
Sample: The 2010 CSAT data set included data on 24,091 clients who were due for at least one follow-up from 182 local evaluations, recruited between 1997-2010 and up to 4 follow-up interviews completed and available in the last quarterly data set of 2010.
Levels of Care: Outpatient, Intensive Outpatient, Short-term & Moderate/Long term Residential, Corrections-Based Treatment and Post-Treatment Continuing Care
Instrument: Global Appraisal of Individual Needs (GAIN) (see www.chestnut.org/li/gain)
Follow-up: 85% with one or more follow-ups at 3, 6, 9 & 12 months post intake.
Funding: CSAT contract 270-07-0191 and 182 individual grants (see Detailed Acknowledgement)
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2010 CSAT Data Set Subset to <25 Years of Age
Source: CSAT 2010 SA Dataset Subset to Adolescents and Young Adults (n=24,091)
18-25 Years Old
12.3%, (n=2,971)
12-15 Years Old
15.8%, (n=3,813)
15-17 Years Old
71.8%, (n=17,307)
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Demographic Characteristics
*Any Hispanic ethnicity separate from race group
18%
40%
15%
2%
20%
16%
NA
26%
32%
16%
27%
16%
27%
37%
50%
11%
70%
25%
27%
54%
31%
89%
33%
31%
0% 10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Single Parent Custody
Employed
In School
Hispanic*
Mixed/Other
Caucasian
African American
Female
Under 15
15-17
18-25
CSAT data is diverse with
large numbers of females minorities
Source: CSAT 2010 SA Dataset Subset to Adolescents and Young Adults (n=24,091)
As age goes up, School goes
down and Employment
goes up
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40%34%
29%7%
58%31%
31%25%
19%
11%6%10%8%8%
1%
45% 19% 36%
0%
10
%
20
%
30
%
40
%
50
%
60
%
70
%
80
%
90
%
10
0%
Ever attacked w/ gun, knife, other weapon
Ever hurt by striking/beating
Abused emotionally
Ever forced sex acts against your will/anyone
Age of 1st abuse < 18
Any with more than one person involved
Any several times or for long time
Was person family member/trusted one
Were you afraid for your life/injury
People you told not believe you/help you
Result in oral, vaginal, anal sex
Currently worried someone attack
Currently worried someone beat/hurt
Currently worried someone abuse emotionally
Currently worried someone force sex acts
Severity of Victimization
General Victimization Scale
Source: CSAT 2010 SA Dataset Subset to Adolescents and Young Adults (n=24,091)64% Any Victimization
Categorized as: Low (0)
Moderate (1-3)High (4-15)
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Severity of Victimization by Age
39% 45%53%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Under 15(OR=1.0)
15-17 (OR=1.3)
18-25 (OR=1.8)
Low
Moderate
High
Source: CSAT 2010 SA Dataset Subset to Adolescents and Young Adults (n=24,091)
9
9
Severity of Victimization by Gender
42%54%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Male(OR=1.0)
Female(OR=1.6)
Low
Moderate
High
Source: CSAT 2010 SA Dataset Subset to Adolescents and Young Adults (n=24,091)
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10
Severity of Victimization by Race
34%45% 45% 51% 54%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
AfricanAmerican(OR=1.0)
Hispanic(OR=1.6)
White(OR=1.6)
Other(OR=2.1)
Mixed(OR=2.3)
Low
Moderate
High
Source: CSAT 2010 SA Dataset Subset to Adolescents and Young Adults (n=24,091)
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Severity of Victimization by Level of Care
41% 46%56% 62%
71%
0%10%20%30%40%50%60%70%80%90%
100%
Outpatient(OR=1.0)
IntensiveOutpatient(OR=1.3)
ContinuingCare OPCC
(OR=1.8)
Long TermResid.
(OR=2.4)
ShortTermResid.
(OR=3.6)
Low
Moderate
High
Source: CSAT 2010 SA Dataset Subset to Adolescents and Young Adults (n=24,091)
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12
Multiple Clinical Problems are the NORM!
21%
41%
62%
80%
31%
34%
13%
24%
11%
33%
35%
48%
0% 10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Alcohol
Cannabis
Other drug disorder
Depression
Anxiety
Trauma
ADHD
Conduct Disorder
Suicide
Homeless/Runaway
Victimization
Violence/ illegal activity
Source: CSAT 2010 SA Dataset Subset to Adolescents and Young Adults (n=24,091)
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Substance Disorders by Severity of Victimization
33%
17% 29
%
20%
35%
20%
38%
32%37
%
25%
44%
40%
0%
20%
40%
60%
80%
100%
Cannabis(OR=1.2)
Alcohol(OR=1.6)
Tobacco(OR=1.9)
Other Drug(OR=2.7)
Low Moderate High
Source: CSAT 2010 SA Dataset Subset to Adolescents and Young Adults (n=24,091)
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Psychiatric Disorders by Severity of Victimization
28%
25%
15%
4% 7%
47%
37%
27%
8%
16%
63%
55%
52%
23%
42%
0%
20%
40%
60%
80%
100%
ConductDisorder(OR=2.2)
AttentionDeficit/
Hyperactivity(OR=2.5)
MajorDepressive
Disorder(OR=3.9)
GeneralAnxietyDisorder(OR=5.6)
TraumaticStress
Disorder(OR=6.8)
Low Moderate High
Source: CSAT 2010 SA Dataset Subset to Adolescents and Young Adults (n=24,091)
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Past 90 day HIV Risk Behaviors by Severity of Victimization
Source: CSAT 2010 SA Dataset Subset to Adolescents and Young Adults (n=24,091)
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Other Behavioral Health Issues by Severity of Victimization
21%
15%
4% 7%
26%
21%
6%
13%
40%
41%
19% 34
%
0%
20%
40%
60%
80%
100%
Violence/Illegal Activity
(OR=2.5)
Victimization(OR=4.1)
Suicidal Thoughts(OR=5.4)
Homeless/Runaway(OR=7.3)
Low Moderate High
Source: CSAT 2010 SA Dataset Subset to Adolescents and Young Adults (n=24,091)
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17
46%
72%
15%0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Low(OR=1.0)
Moderate(OR=4.8)
High(OR=14.6)
None
One
Two
Three
Four
Five to Twelve
The number of Major Clinical Problemsis highly related to Victimization
Significantly more likely to
have 5+ problems (OR=14.6)
Source: CSAT 2010 SA Dataset Subset to Adolescents and Young Adults (n=24,091)
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Goals of Afternoon Breakout
1. To compare the effectiveness of several evidenced based approaches adolescent treatment in terms of changes victimization, trauma, emotional problems, substance use, abuse & dependence, hiv risk behaviors and crime
2. To review some of the promising trauma-informed or integrated treatments for co-occurring trauma and substance abuse?