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

McGuire, Rosie, Halligan, Sarah L., Meiser-Stedman, Richard ORCID: https://orcid.org/0000-0002-0262-623X, Durbin, Lucy and Hiller, Rachel M. (2022) Differences in the diagnosis and treatment decisions for children in care compared to their peers: An experimental study on post-traumatic stress disorder. British Journal of Clinical Psychology, 61 (4). pp. 1075-1088. ISSN 0144-6657

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Abstract

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 post-traumatic 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 NICE-recommended 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.

Item Type:	Article
Additional Information:	Funding: This work is funded by the ESRC as part of the first author's PhD studentship award.
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Groups > Mental Health Faculty of Medicine and Health Sciences > Research Centres > Lifespan Health
Depositing User:	LivePure Connector
Date Deposited:	24 Jun 2022 14:30
Last Modified:	19 Oct 2023 03:20
URI:	https://ueaeprints.uea.ac.uk/id/eprint/85779
DOI:	10.1111/bjc.12379

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