Usual Care for Maltreatment- Related Pediatric Posttraumatic Stress Disorder in Germany
Abstract
Abstract. Child maltreatment represents a major risk factor for the development of emotional and behavioral problems, especially posttraumatic stress disorder (PTSD). While effective trauma-focused treatments are available, little is known about the usual mental healthcare for abused youths in Germany. The present study compared the utilization of mental healthcare in abused youths who had developed a PTSD (N = 95) with a group presenting other mental disorders (N = 146). Semistructured interviews were used to assess maltreatment histories, current mental health, and healthcare utilization. In addition, potential child factors associated with access to mental healthcare (age and level of functioning) were examined. Results showed that 65 % of both diagnostic groups currently fail to use any mental healthcare service. Of the participants with PTSD, 43 (45 %) had never received any mental healthcare intervention. Investigations on potential barriers are necessary to close the huge gap between clinical services and evidence-based, trauma-focused interventions.
Zusammenfassung. Kindesmisshandlung, -missbrauch und -vernachlässigung stellen Risikofaktoren für die Entwicklung emotionaler Probleme und Verhaltensauffälligkeiten dar, insbesondere für die Entwicklung einer Posttraumatischen Belastungsstörung (PTBS). Während wirksame traumafokussierte Therapien verfügbar sind, ist bisher wenig über die übliche psychiatrisch/psychotherapeutische Versorgung misshandelter Kinder und Jugendlicher in Deutschland bekannt. Die vorliegende Untersuchung vergleicht daher die Inanspruchnahme psychiatrischer und psychotherapeutischer Hilfen durch misshandelte Kinder und Jugendliche, welche eine PTBS entwickelt haben (N = 95), mit einer Gruppe, welche andere psychische Störungen aufweist (N = 146). Mittels semistrukturierter klinischer Interviews wurden die Misshandlungsanamnese, die aktuelle psychische Gesundheit sowie die in Anspruch genommenen Hilfen erhoben. Des Weiteren wurden Faktoren untersucht, welche möglicherweise mit dem Zugang zu therapeutischer Versorgung assoziiert sind (aktuelles Alter und psychosoziales Funktionsniveau). Die Ergebnisse zeigen, dass innerhalb beider Untersuchungsgruppen 65 % der Kinder und Jugendlichen aktuell keine psychiatrischen und psychotherapeutischen Hilfen in Anspruch nehmen. Dreiundvierzig Studienteilnehmer mit einer PTBS (45 %) hatten vor Studienteilnahme noch nie eine Therapie erhalten. Daher ist die Untersuchung von Barrieren notwendig, welche die Dissemination evidenzbasierter Therapien für misshandelte Kinder und Jugendliche möglicherweise erschweren.
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