Service usage typologies in a clinical sample of trauma-exposed adolescents: A latent class analysis

Psychol Trauma. 2018 Nov;10(6):652-661. doi: 10.1037/tra0000340. Epub 2017 Nov 27.


Objective: The purpose of this study is to describe typologies of service utilization among trauma-exposed, treatment-seeking adolescents and to examine associations between trauma history, trauma-related symptoms, demographics, and service utilization.

Method: Latent class analysis was used to derive a service utilization typologies based on 10 service variables using a sample of 3,081 trauma-exposed adolescents ages 12 to 16 from the National Child Traumatic Stress Network Core Dataset. Services used 30 days prior to the initial assessment from 5 sectors were examined (health care, mental health, school, social services, and juvenile justice).

Results: A 5-class model was selected based on statistical fit indices and substantive evaluation of classes: (a) High intensity/multisystem, 9.5%; (b) Justice-involved, 7.2%; (c) Low intensity/multisystem, 19.9%; (d) Social service and mental health, 19.9%; and (e) Low service usage/reference, 43.5%. The classes could be differentiated based on cumulative trauma, maltreatment history, PTSD, externalizing and internalizing symptoms, and age, gender, race/ethnicity and place of residence.

Conclusions: This study provides new evidence about patterns of service utilization by trauma exposed, treatment seeking adolescents. Most of these adolescents appear to be involved with at least 2 service systems prior to seeking trauma treatment. Higher cumulative exposure to multiple types of trauma was associated with greater service utilization intensity and complexity, but trauma symptomatology was not. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

MeSH terms

  • Adolescent
  • Child Abuse / therapy
  • Female
  • Humans
  • Latent Class Analysis
  • Male
  • Patient Acceptance of Health Care*
  • Stress Disorders, Post-Traumatic / therapy
  • Stress, Psychological / therapy*