In this study, Becker-Haimes and colleagues (2021) investigated whether trauma exposure might bias clinicians’ assessments of other non-traumatic symptoms (referred to as trauma-related diagnostic overshadowing bias). Mental health clinicians (n = 266; 82% female; age and ethnic information was not provided) were presented with clinical vignettes which depicted adolescents and pre-adolescents (of Hispanic or Black ethnic background) who were experiencing symptoms consistent with either a ‘target’ diagnosis of obsessive-compulsive disorder (OCD) or oppositional defiant disorder (ODD). The same clinical presentations were described in either the presence or absence of potentially traumatic events (physical or sexual abuse). Clinicians rated the likelihood that patients met the target diagnostic criteria and what treatment they would offer. Independent of the clinician’s trauma-informed care level of training, they rated the main target diagnosis as less likely in the presence of traumatic events. Evidence-based treatment modalities for the target diagnosis were also rated as less appropriate. The under-diagnosing of OCD or ODD was amplified by the presence of sexual vs physical abuse. In sum, this experimental study suggests that clinicians may be less likely to recognise symptoms as diagnostically relevant when young people report exposure to traumatic events.
Becker-Haimes, E. M., Wislocki, K., DiDonato, S., Beidas, R. S., & Jensen-Doss, A. (2021). Youth trauma histories are associated with under-diagnosis and under-treatment of co-occurring youth psychiatric symptoms. Journal of Clinical Child & Adolescent Psychology, 1-12. doi.org/10.1080/15374416.2021.1923020