TOPLINE:

Nearly 16% of adolescents in primary care reported exposure to trauma, with 7.5% showing moderate-to-high symptoms of traumatic stress. An elevated risk for exposure to trauma was noted among youth with mental health issues and also among female and Hispanic individuals.

METHODOLOGY:

• Researchers aimed to describe rates of exposure to trauma and symptoms of traumatic stress and their associations with mental health issues among youth in a large healthcare.
• They included 24,675 adolescents aged 11-19 years (average age, 14.2 years; 50% female; 77% White and non-Hispanic) at primary care clinics for well-child visits from 2022 to 2024.
• Participants completed the Pediatric Traumatic Stress Screening Tool, Patient Health Questionnaire for Adolescents, and Generalized Anxiety Disorder seven-item questionnaire to assess past and recent trauma, depression, and anxiety.
• The Columbia-Suicide Severity Rating Scale was used for further assessment of the risk for suicide if indicated by a response on the Patient Health Questionnaire.
• Demographic data and mental health codes were obtained from electronic health records; complex medical conditions were defined as those expected to last 12 months or longer and to show multiple organ systems or extensive involvement in one organ system.

TAKEAWAY:

• Trauma exposure was reported by 15.5% of adolescents, and 7.5% showed moderate or high symptoms of traumatic stress.
• Female and Hispanic youth were more likely to report exposure to trauma. Among those who reported a potentially traumatic event, higher traumatic stress symptoms were more prevalent among racial or ethnic minorities and those with higher medical and mental health complexity.
• Adolescents with a history of trauma and many symptoms of traumatic stress had a higher likelihood of reporting suicidal thoughts than those with moderate or low symptoms (49% vs 10%). They were also 10 times more likely to have a high risk for suicide (4.8% vs 0.48%).
• Female adolescents had higher risks for exposure to trauma (risk ratio [RR], 1.39; P < .001) and of experiencing high traumatic stress (RR, 1.94; P < .001) than male adolescents. Lower Child Opportunity Index scores and prior mental health diagnoses were linked to increased risks for exposure to trauma and traumatic stress. 

IN PRACTICE:

“Screening for trauma exposures and traumatic stress can be integrated alongside other mental health screening such as depression, anxiety, and suicide,” the authors wrote.

SOURCE:

The study was led by Brooks R. Keeshin, MD, of the Department of Pediatrics at the University of Utah in Salt Lake City. It was published online on October 27, 2025, in Pediatrics.

LIMITATIONS:

The retrospective design of the study limited the ability to compare findings with structured assessments, and it relied on existing clinical variables. The data on racially minority populations were lacking.

DISCLOSURES:

The study was funded by the National Child Traumatic Stress Initiative, part of the Substance Abuse and Mental Health Services Administration. This study was also supported by the University of Utah Study Design and Biostatistics Center, with funding in part from the National Center for Research Resources and National Center for Advancing Translational Sciences. The authors reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.