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Symposia

Primary Care / Integrated Care

Integrated Care and Trauma: Considerations for Screening and Treating Trauma and Related Symptoms in Primary Care Settings

2 - (SYM 106) Examining Trauma Exposure and Related Symptoms in Integrated Behavioral Health Care Utilizers: Implications for Screening in Primary Care Settings

Saturday, November 16, 2024
4:30 PM – 6:00 PM EST
Location: Franklin 1, Level 4, Downtown Marriott
Abstract Body



Background: Integrated behavioral health is a promising solution to address gaps in mental health treatment and represents a unique opportunity to identify those at risk for developing PTSD and trauma-related consequences (Kazdin, 2017; Reiter et al., 2018). Our primary goal was to characterize and compare integrated behavioral health patients who did and did not endorse trauma.

 



Methods: Adult primary care patients (N = 288) referred for integrated behavioral health services completed a screener at their first visit. The screener included A Collaborative Outcome Research Framework (ACORN; Brown et al., 2015), a 14-item measure of psychiatric difficulties. ACORN items are rated from 0 (never) to 4 (very often) and scores are averaged to create a global psychiatric distress severity score. The screener also included items assessing trauma exposure and related symptoms adapted from the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5; Prins et al., 2015). Descriptive and bivariate analyses were conducted to characterize the sample and compare group differences. Missing data were excluded.

 



Results: Participants (mean age = 28.6; range = 18-86; SD = 12) were mostly White (67%), non-Latinx (73%), and female (72%). About 58% endorsed trauma exposure. Of these, 56% endorsed interpersonal trauma and 45% reported multiple traumatic events. While trauma exposure did not significantly vary across categories of race or gender, Latinx patients were significantly less likely to endorse trauma, χ2 (1, N = 286) = 7.12, p = .007. Analysis also revealed a significant association between age and trauma exposure, t(286) = 2.65, p = .008. Average age for the trauma exposed group was 30.2 years (SD = 12) versus 26.5 years (SD = 11) for those without trauma. Average ACORN scores of trauma exposed patients and patients without trauma were compared. Results indicated trauma exposure was significantly associated with increased psychiatric distress severity, t(286) = 4.63, p = .0001.  

 



Conclusion: Findings support efforts to identify trauma and address related psychiatric distress in integrated behavioral health care settings. Given the high prevalence of trauma exposure, the associated psychiatric distress, and non-significant variance across categories of race and gender, screening efforts should be broad and inclusive of all patients.