@article{ref1,
title="Youth trauma histories are associated with under-diagnosis and under-treatment of co-occurring youth psychiatric symptoms",
journal="Journal of clinical child and adolescent psychology",
year="2021",
author="Becker-Haimes, Emily M. and Wislocki, Katherine and DiDonato, Stephen and Beidas, Rinad S. and Jensen-Doss, Amanda",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVE: We examined whether in the presence of trauma exposure, non-traumatic stress-related symptoms are interpreted by mental health clinicians as less salient than the trauma exposure and are de-emphasized as a treatment target, consistent with a diagnostic overshadowing bias.<br><br>METHODS: Using an adapted version of a diagnostic overshadowing bias experimental paradigm, mental health clinicians (N = 266, M age = 34.4 years, 82% female) were randomly assigned to receive two of six clinical vignette variations. Vignette 1 described an adolescent with obsessive-compulsive disorder (OCD). Vignette 2 described a pre-adolescent with oppositional defiant disorder (ODD). Vignettes were identical except for whether the youth reported exposure to a potentially traumatic event (PTE; no PTE, sexual PTE, or physical PTE). Clinicians received one vignette with a PTE and one without, counterbalancing order. Clinicians rated the likelihood the youth met criteria for various diagnoses and the appropriateness of various treatments on 7-point scales.<br><br>RESULTS: Across both vignettes, clinicians rated the target diagnosis (OCD in Vignette 1, ODD in Vignette 2) as less likely for vignettes with a PTE than for the same vignettes without a PTE. Clinicians also rated evidence-based treatment modalities for target diagnoses as less appropriate in the presence of a PTE than when a PTE was present.<br><br>CONCLUSIONS: Consistent with possible bias, clinicians may under-recognize and under-treat non-traumatic stress-related mental health symptoms in youth with a co-occurring trauma history. Future work to validate this bias in real-world practice is indicated.<p /> <p>Language: en</p>",
language="en",
issn="1537-4416",
doi="10.1080/15374416.2021.1923020",
url="http://dx.doi.org/10.1080/15374416.2021.1923020"
}