Externalizing behaviors following trauma exposure.
Dodd, Kassing, Alvis, Hill, & Kaplow (2022) published “Prevalence and Correlates of Externalizing Behaviors Among Youth Seeking Treatment Following Trauma Exposure” in Psychological Trauma: Theory, Research, Practice, and Policy. They observe that exposure to trauma often is accompanied by externalizing problems. Their study involved 260 youth referred to a trauma and grief specialty clinic. Ranging from 7-19 and slightly more than half female, the participants and caregivers provided data during a pretreatment assessment. They identified four groups:
Those with both posttraumatic stress symptoms (PTSS) and externalizing behaviors (EXTs)(18%)
Those with externalizing behaviors only (EXTs) (36%)
Those with only posttraumatic stress symptoms (PTSS) (13%)
Those with subclinical symptoms (34%)
Here’s the rest of the abstract:
The comorbid PTSS and EXTs group had the highest scores on all other child and caregiver symptom measures. Compared to the subclinical group, youth in the PTSS-only group had increased depressive symptoms and suicidal ideation, whereas youth in the EXTs-only group had elevated levels of caregiver strain. Conclusion: Co-occurring PTSS and EXTs is a common presentation among trauma-exposed youth referred to treatment. These youth are also likely to suffer from other problems of clinical concern, including suicidal ideation, and their problems are associated with caregiver distress. More research is needed to examine unique risk and resiliency factors related to the development of youth EXTs in response to trauma exposure.
It’s important to note that this group of participants had had experiences that led to their referral to a clinic. What we don’t know is how common comorbidity of posttraumatic stress and externalizing behaviors are. Certainly, externalizing behaviors can be “a cry for help” by traumatized youth, a symptom that sometimes elicits traumatic experiences, or both. Since externalizing behaviors accompany increased caregiver strain, it’s important that professionals treating youth with externalizing behaviors also collect data about possible trauma since the comorbidity relates to greater distress in children and their caregivers.