TY - JOUR PY - 2021// TI - Youth trauma histories are associated with under-diagnosis and under-treatment of co-occurring youth psychiatric symptoms JO - Journal of clinical child and adolescent psychology A1 - Becker-Haimes, Emily M. A1 - Wislocki, Katherine A1 - DiDonato, Stephen A1 - Beidas, Rinad S. A1 - Jensen-Doss, Amanda SP - ePub EP - ePub VL - ePub IS - ePub N2 - 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.

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.

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.

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.

Language: en

LA - en SN - 1537-4416 UR - http://dx.doi.org/10.1080/15374416.2021.1923020 ID - ref1 ER -