Trauma Issues with Specific Populations: Adolescents & Transition Age Youth OVERVIEW Michael Dennis, Ph.D. and Megan Catlin, M.S. Chestnut Health Systems,

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

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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


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


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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


10

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


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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


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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


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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


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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


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Past 90 day HIV Risk Behaviors by Severity of Victimization


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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


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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)


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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?

Documents

Trauma Issues with Specific Populations: Adolescents & Transition Age Youth OVERVIEW Michael Dennis, Ph.D. and Megan Catlin, M.S. Chestnut Health Systems,