Exploring Agreement Between Adolescent Self-Reported PTSD Symptoms and Clinical Diagnoses on a Psychiatric Inpatient Unit. Issue 4 (2nd October 2022)

• Record Type: Journal Article
• Authors: White, C. Nicole; Ugueto, Ana M.
• Is Part Of: Evidence-based practice in child and adolescent mental health. Volume 7:Issue 4(2022)
• Page Start: 463
• Page End: 476
• Publication Date: 2022-10-02
• Subjects: Child psychiatry -- Periodicals; Child mental health -- Periodicals; Teenagers -- Mental health -- Periodicals; Child psychology -- Periodicals; Adolescent psychology -- Periodicals; 618.9289
• DOI: 10.1080/23794925.2022.2127133
• Languages: English
• ISSNs: 2379-4925

Abstract

ABSTRACT: A significant number of adolescents in the U.S. experience traumatic events, putting them at risk for developing Posttraumatic Stress Disorder (PTSD). Despite this risk, PTSD is not a commonly assigned diagnosis in psychiatric settings. The current study examined rates of psychiatrist-reported PTSD (PR-PTSD) diagnoses compared to probable PTSD diagnoses based on adolescent self-reported PTSD (SR-PTSD) symptoms on a psychiatric inpatient unit ( n = 151, age 13–17). Self-report measures included questions on exposure to trauma and The Child PTSD Symptom Scale for DSM-5 (CPSS-5). Approximately 60% of participants met criteria for a "probable PTSD diagnosis" on the CPSS-5; however, only 10 out of 151 (6.6%) and 58 out of 151 (38.4%) were given PR-PTSD at admission and at discharge, respectively. Chi-square analyses indicated adolescents with SR-PTSD were more likely to have previous psychiatric admissions, χ 2 (1, N = 149) = 3.87, p = .049. There was also a significant association between SR-PTSD and suicide risk, χ 2 (3, N = 148) = 9.93, p = .019. Both the null and low suicide risk groups contributed the most to predicting SR-PTSD based on the standardized residuals being ±1.96. Additionally, SR-PTSD and insurance status were significantly associated, χ 2 (1, N = 147) = 4.48, p = .034. All of the cells equally contributed to the significance. When comparing diagnosis given at admission to SR-PTSD, agreement was poor (κ=.070, p = .043), and there was no agreement between diagnosis given at discharge and SR-PTSD (κ=.116, p = .074). Findings from the study highlight a discrepancy in SR-PTSD and PR-PTSD in adolescent psychiatric settings.