Paper
Thursday, July 12, 2007
The Effects of Cumulative Trauma on Emotional and Physical Health, and Risky Behavior in Adolescents: PTSD Symptomatology and Parental Emotional Support as Mediators
Linda A. Lewandowski, PhD, RN, College of Nursing, Wayne State University/Children's Hospital of Michigan, Detroit, MI, USA, Lisa Chiodo, PhD, SCHOOBE Project, Wayne State University School of Medicine, Detroit, MI, USA, Barbara Peterson, College of Nursing, Wayne State University, Detroit, MI, USA, and Ibrahim Kira, PhD, Community Health and Research Center, Arab American Center for Economic and Social Services, Dearborn, MI, USA.
| Learning Objective #1: discuss the relationships between cumulative trauma exposure, physical and emotional discomfort(health)and adolescent risk-taking behavior. |
| Learning Objective #2: describe the important role of parental emotional support and PTSD symptomatology in mediating these relationships. |
The effects of cumulative trauma (CT) on physical and emotional health and risk-taking behaviors is important in teens. Social support may be a buffer, but little is known about specific types of support. The purpose was to assess the combined contribution of CT and other factors that may adversely impact health risk behavior in two urban teen cohorts. The study sample (N = 371) included adolescents, ages 12-16, from two high trauma–exposure cohorts: African American and Iraqi refugees. Instruments administered: the Child Health and Illness Profile – Adolescent Edition (CHIP-AE), the Clinician-Administered PTSD Scale, the Cumulative Trauma Scale (CTS- cumulative count of trauma events-CT), and the Child and Adolescent Social Support Scale. The health risk behaviors (CHIP-AE) examined were the emotional (ED) and physical discomfort (PD) scales and the risk-taking behavior (RTB) scale. Univariate ANOVA examined the relation between factors that may adversely impact health risk behavior. ED, PD, RTB, PTSD total score, parent emotional support, gender, ethnicity, and a high vs. low trauma count score were entered into the GLM. Gender, ethnicity and interaction terms were also examined. Although CT was significantly correlated with ED, PD, and risk-taking, PTSD and parental emotional support accounted for most of the variance. ED and PD were significantly related only to the PTSD total score and parental emotional support. For the risk-taking scale, although PTSD score was uniquely related, parent emotional support was not. Boys with high levels of trauma engaged in more risky behavior including substance abuse. The relation between CT, ED, PD, and risky behavior is fully mediated by parental emotional support and PTSD symptoms. Traumatized teens who have high PTSD symptoms and low parental emotional support are most at risk for negative health and risky behaviors. Nursing interventions should promote parental emotional support of teens who are victims of trauma.