Health Provider Checklist for Adolescent and Young Adult Males

Trauma

Key Points

  • Traumatic events include sexual abuse, physical abuse, domestic violence, community and school violence, medical trauma, motor vehicle accidents, acts of terrorism, war experiences, natural and human-made disasters, suicides, and other traumatic.
  • Exposure to violence is significantly more common in males, urban youth, ethnic minorities, and lower income youth. Across studies of urban, low-income youth, ∼25% have witnessed murder.
  • Many of the reactions displayed by children and adolescents who have been exposed to traumatic events are similar or identical to behaviors that mental health professionals see on a daily basis in their practice.
  • Health professionals must be sensitive to this array of issues and provide (or refer for) help in a culturally responsive manner.

Overview

A traumatic event is one that threatens injury, death, or the physical integrity of self or others and also causes horror, terror, or helplessness at the time it occurs. Traumatic events include sexual abuse, physical abuse, domestic violence, community and school violence, medical trauma, motor vehicle accidents, acts of terrorism, war experiences, natural and human-made disasters, suicides, and other traumatic losses. 1

Witness to violence has negative health effects, including post-traumatic stress disorder, depression and anxiety, distress, aggression, and externalizing behaviors.2 In a national survey, approximately half of all 13- to 17-year-olds witnessed violence in the previous year, with nearly 10% witnessing family assault, 42% witnessing an assault in their community, 1.3% witnessing murder, 10% witnessing a shooting, and 2% witnessing war.3 Exposure is significantly more common in males, urban youth, ethnic minorities, and lower income youth. Across studies of urban, low-income youth, ∼25% have witnessed murder.4 (as cited in 5)

The United States is a highly diverse society comprising many different racial and ethnic groups. There is no doubt that because of poverty and discrimination, racial and ethnic minority youth and families are more likely to be subjected to traumatic events, and immigrant youth and families may be particularly at risk. Cultural context and background, as well as membership in a minority group, will affect how individuals perceive a traumatic event and its impact and how the community can assist in recovery….Health professionals must be sensitive to this array of issues and provide (or refer for) help in a culturally responsive manner.6 Most evidence-based, trauma-focused treatments include opportunities for the child to review the trauma in a safe, secure environment under the guidance of a specially trained mental health professional.7

Many of the reactions displayed by children and adolescents who have been exposed to traumatic events are similar or identical to behaviors that mental health professionals see on a daily basis in their practice.

These include:

  • the development of new fears
  • separation anxiety (particularly in young children)
  • sleep disturbance, nightmares
  • sadness
  • loss of interest in normal activities
  • reduced concentration
  • decline in schoolwork
  • anger
  • somatic complaints
  • irritability8

1 2008 Presidential Task Force on Posttraumatic Stress Disorder and Trauma in Children and Adolescents. Children and Trauma. American Psychological Association. 2008.

2 Buka SL, Stichick TL, Birdthistle I, Earls FJ. Youth exposure to violence: prevalence, risks, and consequences. Am J Orthopsychiatry. 2001;71(3):298–310

3 Finkelhor D, Turner H, Ormrod R, Hamby SL. Violence, abuse, and crime exposure in a national sample of children and youth. Pediatrics. 2009;124(5):1411–1423 (2013 Update)

4 Buka SL, Stichick TL, Birdthistle I, Earls FJ. Youth exposure to violence: prevalence, risks, and consequences. Am J Orthopsy- chiatry. 2001;71(3):298–310

5 Bell, David L., Breland, David J. and Ott, Mary. Adolescent and Young Adult Male Health: A Review. Pediatrics; originally published online August 12, 2013; DOI: 10.1542/peds.2012-3414

6 2008 Presidential Task Force on Posttraumatic Stress Disorder and Trauma in Children and Adolescents. Children and Trauma. American Psychological Association. 2008.

7 Ibid