Background

Many adolescents in group care have experienced higher rates of traumatic event exposure, behavior problems, and severe trauma sequelae compared to those outside of group care. Yet, little research has examined from a person-centered perspective their diverse trauma profiles and corresponding service needs.

Objective

This exploratory study aimed to examine the heterogeneity of trauma-related profiles among youth in group care to highlight potential distinct service needs among subgroups.

Method

Data from the Maltreatment and Adolescent Pathways Study identified 96 randomly selected youth (14–17 years) in Canadian group care settings who completed a battery of self-report measures. Cluster analysis was employed to reveal common patterns of maltreatment and trauma symptoms among subgroups, further described and validated by externalizing behaviors (substance use, risky sexual behavior), internalizing symptoms (global mental health, anger), and personal/parental demographic factors.

Results

Four distinct clusters emerged: (1) no/low maltreatment, low trauma; (2) moderate physical and emotional abuse, moderate trauma; (3) moderate-severe maltreatment, low trauma; and (4) severe maltreatment, high trauma. Clusters 1, 2, and 4 reflected ‘dose-response’ relationships between maltreatment and trauma symptoms; Cluster 3 was characterized as ‘resilient’. Females were highly over-represented in Cluster 4, echoing previous research.

Conclusions

Findings align with previous research confirming high incidence of maltreatment, internalizing, and externalizing problems among youth in group care, but extends to emphasize the importance of providing trauma-informed services tailored to their variable, complex presentations. Limitations and suggestions for group care settings to provide this wide range of services at program and individual levels are discussed.

中文翻译：

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团体护理环境中青年的不同创伤概况：聚类分析

背景

与团体护理以外的青少年相比，许多接受团体护理的青少年经历了更高的创伤事件暴露率、行为问题和严重的创伤后遗症。然而，很少有研究从以人为本的角度审视他们不同的创伤概况和相应的服务需求。

客观的

这项探索性研究旨在检查团体护理中青年的创伤相关概况的异质性，以突出亚组之间潜在的不同服务需求。

方法

虐待和青少年途径研究的数据确定了 96 名在加拿大团体护理机构中随机选择的青少年（14-17 岁），他们完成了一系列自我报告措施。聚类分析用于揭示亚组中虐待和创伤症状的常见模式，并通过外化行为（物质使用、危险性行为）、内化症状（整体心理健康、愤怒）和个人/父母人口因素进一步描述和验证。

结果

出现了四个不同的集群：（1）没有/低虐待，低创伤；(2)中度身心虐待、中度创伤；（3）中重度虐待，低创伤；(4)虐待严重，创伤大。集群 1、2 和 4 反映了虐待和创伤症状之间的“剂量反应”关系；集群 3 的特点是“有弹性”。女性在第 4 组中的比例过高，与之前的研究相呼应。

结论

调查结果与先前的研究一致，证实了青少年在团体护理中的虐待、内化和外化问题的高发率，但延伸到强调提供针对其多变、复杂的表现的创伤知情服务的重要性。讨论了在计划和个人层面提供这种广泛服务的团体护理设置的限制和建议。