Potentially traumatising events and post-traumatic stress symptoms of adolescents in out-of-home care

Kurzfassung/Abstract

Background: Children and adolescents in out-of-home care are particularly vulnerable to potentially traumatising events (PTEs) and trauma-related mental health disorders. In Germany, there is limited evidence on trauma exposure and posttraumatic stress symptoms (PTSS) among youth in child welfare facilities. Better understanding their psychopathology could support the development of tailored trauma-focused interventions.
Objective: This study investigates PTEs and PTSS (DSM-5 criteria) in adolescents living in residential care. It also examines risk factors for PTSS and compares self-reports with proxy-reports from institutional staff.
Method: A total of N = 126 adolescents (mean age = 14.98 years, SD = 1.62, range = 11-19) from 17 residential care facilities in southern Germany and their institutional caregivers completed questionnaires assessing demographics, PTEs, and PTSS.
Results: Participants reported an average of M = 4.51 PTEs (SD = 3.08, range = 0-12). High rates of online victimisation were found, with 19.8% reporting cyberbullying and 22.2% reporting being coerced online into sexual acts - the latter showing a strong correlation with PTSS (r = 0.33). Adolescents scored an average of M = 21.24 (SD = 11.01, range = 2-50) on the CATS-2, with scores above the clinical cut-off (≥21) indicating high symptom burden. Significant predictors of PTSS included the number of PTEs (β = .55, p < .001), female gender (β = .27, p < .01), and interpersonal trauma (β = .55, p < .001). Correlations between self- and staff-reports were low (r = .06-.19), with staff reporting fewer symptoms.
Conclusion: The findings underline the high vulnerability of youth in care to trauma and stress-related symptoms and support the need for trauma-sensitive care. The prominence of online victimisation highlights the need for routine clinical screening. Low agreement between self- and caregiver reports reinforces the importance of directly assessing adolescents' experiences.