Differences in the diagnosis and treatment decisions for children in care compared to their peers: An experimental study on post-traumatic stress disorder.

Objectives: Despite evidence of high rates of diagnosable mental health difficulties in children in care, there remains ongoing debate around the appropriateness of traditional diagnoses and treatments. The aim of this study was to quantitatively explore whether mental health diagnosis and treatment...

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Published in:British Journal of Clinical Psychology Vol. 61; no. 4; pp. 1075 - 1089
Main Authors: McGuire, Rosie, Halligan, Sarah L., Meiser-Stedman, Richard, Durbin, Lucy, Hiller, Rachel M.
Format: research tables/charts Journal Article
Published: Wiley-Blackwell Nov2022
Online Access:View this record in EBSCOhost
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      dt: Nov2022
      vid: 61
      iid: 4
      pid: 480
      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/bjc.12379
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        atl: Differences in the diagnosis and treatment decisions for children in care compared to their peers: An experimental study on post-traumatic stress disorder.
      aug:
        au:
          McGuire, Rosie
          Halligan, Sarah L.
          Meiser-Stedman, Richard
          Durbin, Lucy
          Hiller, Rachel M.
        affil: Department of Psychology, University of Bath, Bath, UK.
      sug:
        subj:
          Foster Home Care
          Stress Disorders, Post-Traumatic Diagnosis
          Stress Disorders, Post-Traumatic Therapy
          Decision Making, Clinical
          Healthcare Disparities
          Human
          Funding Source
          Experimental Studies
          Comparative Studies
          Quantitative Studies
          United Kingdom
          Surveys
          Child
          Child: 6-12 years
      ab: Objectives: Despite evidence of high rates of diagnosable mental health difficulties in children in care, there remains ongoing debate around the appropriateness of traditional diagnoses and treatments. The aim of this study was to quantitatively explore whether mental health diagnosis and treatment decision-making differed when a young person was identified as being in care, specifically focused on posttraumatic stress disorder (PTSD). PTSD is a trauma-specific mental health disorder with rates substantially higher in children in care versus their peers. Methods: Participants were 270 UK mental health professionals who completed an online survey. Participants were randomized to receive one of two vignettes, which were identical in their description of a teenage boy experiencing PTSD symptoms, except in one he was in foster care and in the other he lived with his mother. Participants were asked to select a primary diagnosis, treatment approach, and potential secondary diagnosis. Results: Professionals were twice as likely to choose a primary diagnosis of PTSD and a National Institute for Clinical Excellence (NICE)-recommended PTSD treatment when randomized to the mother vignette versus the foster carer vignette. Selecting PTSD as the primary diagnosis made clinicians three times more likely to select a NICErecommended treatment for PTSD. Developmental trauma was the most common ‘diagnosis’ for both groups, although this led to different treatment decisions. Conclusions: In the context of PTSD, we found children in care face diagnosis and treatment decision-making biases. Practice implications are discussed.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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