Purpose: To describe the transition patterns into and out of post-traumatic stress (PTS) for youth and identify social supports preceding these transitions.
Methods: We used inhomogeneous, continuous-time, 1Markov Chain models to model transitions in and out of PTS using data from Waves 1, 3, 4, and 5 of the National Survey of Child and Adolescent Wellbeing (NSCAW I)-a longitudinal study of children who first had contact with the child welfare system between 1999 and 2000. Our analytic sample contained 915 individuals aged 11-17 years. We analyzed data in 2020.
Results: Youth with stronger peer relationships were less likely to transition into PTS (HR: 0.82; 95% CI [0.70-0.96]), and these individuals were also more likely to transition out of PTS (HR: 1.21; 95% CI [1.04, 1.42]). Youth with adult support were less likely to transition into PTS at any given time interval (HR: 0.37; 95% CI [0.17-0.78]), but adult support was not associated with the transition out of PTS.
Conclusions: Strengthening peer relationships may help at-risk children both avoid PTS altogether and recover from PTS after its onset. Promoting adult support, however, may only be most effective when attempting to prevent PTS-onset.
Keywords: child welfare; longitudinal; post-traumatic stress; social support.