Adolescence is marked by milestones: going through puberty, getting a driver’s license, graduating from high school, casting a vote.
Now there’s one more unfortunate milestone to add to the list: experiencing trauma.
Epidemic numbers of U.S. adolescents have experienced some kind of trauma by the time they are 17, according to a recent study by Kate McLaughlin, PhD, an assistant professor in the Department of Psychology at the University of Washington and an alumna of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program (2008-2010).
More than three in five adolescents (62 percent) have been exposed to at least one traumatic event, such as experiencing interpersonal violence, an accident, a man-made or natural disaster—or witnessing the death or serious injury of a loved one or someone in their social network. For most youth, the traumatic events occurred during adolescence as opposed to childhood.
Trauma, in other words, is yet another rite of passage into adulthood—and one that carries significant mental and physical health risks for exposed youth. Exposure to trauma early in life is especially dangerous because it can have lasting effects on brain development and long-term implications for physical and mental health, McLaughlin said.
“Ultimately, this study is a poignant reminder that millions of adolescents in this country are growing up under the long shadow cast by exposure to traumatic stressors,” Julian Ford, PhD, a professor of psychiatry in the School of Medicine at the University of Connecticut, wrote in an editorial that accompanies the study, which was published in the Journal of the American Academy of Child & Adolescent Psychology.
For the study, McLaughlin and her co-authors analyzed data from a national survey of youth between the ages of 13 and 17.
One notable finding: Adolescents who do not live with both biological parents were more likely to experience a traumatic event. That pattern may reflect less adult supervision in the home or greater risk of maltreatment or other traumas due to the closer presence of nonrelated adults. Despite the greater likelihood of exposure to trauma, these youth were not more likely to develop mental health problems than other peers who were also exposed to trauma, the study found.
Adolescents with pre-existing behavior disorders—which are associated with impulsive, risky behaviors and involvement with deviant peer groups—are also more likely to experience trauma, perhaps because they are more likely to spend time in violent environments. In addition, youth with behavior disorders are at greater risk of maltreatment by caregivers.
Potential for Severe Consequences
One severe consequence of trauma exposure is post-traumatic stress disorder (PTSD), a condition in which a person experiences intense, and often debilitating, feelings of fear and helplessness in the aftermath of a traumatic event. It is associated with significant role impairment or difficulty in important areas of life such as school, work, or social relationships—and other mental and physical health disorders.
About one in 20 adolescents (5 percent) have PTSD, almost the same rate as adults (6 to 7 percent of the population), the study found. Limitations in the study’s methodology, however, may have led to an under-estimation of youth with PTSD, McLaughlin noted.
PTSD is more common in girls (7 percent) than in boys (2 percent), who tend to be more vulnerable to other kinds of problems such as aggression and substance use disorders.
Adolescents who experienced some form of interpersonal violence—such as kidnapping, physical or sexual abuse, assault, or weapon-related crimes—were at greatest risk of PTSD, the study found, and rape victims were the most likely to develop it. Predictors of PTSD included female gender, prior exposure to trauma, and pre-existing fear and distress disorders.
The good news is that interventions can prevent exposure to trauma and the development of PTSD and other mental and physical health problems, McLaughlin said.
To prevent traumatic experiences from occurring, programs that strengthen families and provide greater access to high-quality child care and after-school programming are needed, she said. Additional strategies are needed to prevent the onset of PTSD and other health problems in the aftermath of a traumatic event. These include stress management skills such as deep breathing, mindfulness, and yoga, which are relatively inexpensive and can be used on a wide scale, and more intensive interventions, such as school- and community-based programs targeting youths with the highest levels of trauma exposure, and mentoring.
Interventions to prevent PTSD should be targeted at youth who are victims of interpersonal violence and who have pre-existing fear and distress disorders, she said. Interventions to prevent chronic PTSD should also attempt to prevent additional trauma.
More resources are needed to further strategies to reduce exposure to trauma and to mitigate its harmful effects, McLaughlin said. “This really is a call to action to the public health community. We need to think about childhood exposure to traumatic events as a serious problem that warrants greater attention.”