Journal of Child & Adolescent Trauma

, Volume 12, Issue 4, pp 447–456 | Cite as

The Association between Caregiver Substance Abuse and Mental Health Problems and Outcomes for Trauma-Exposed Youth

  • Briana Woods-JaegerEmail author
  • Ernestine C. Briggs
  • Rebecca L. Vivrette
  • Robert C. Lee
  • Liza Suarez
  • Harolyn M. E. Belcher


Trauma-exposed youth with impaired caregivers (i.e., due to substance use and/or mental health problems) may be at particular risk for negative outcomes. This study utilized data from the National Child Traumatic Stress Network Core Data Set to examine the impact of caregiver impairment on youth outcomes. Trauma-exposed youth with an impaired caregiver due to either: substance use (n = 498), mental health problems (n = 231), or both substance use and mental health problems (n = 305) were compared to youth without a reported impaired caregiver (n = 2282) to determine if impaired caregiver status is independently associated with increased likelihood of negative behavioral and mental health outcomes and service utilization after accounting for demographics and exposure to traumatic events. Youth with impaired caregivers compared to those without were more likely to display PTSD, emotional and behavioral problems, suicidality, self-injury, and substance abuse and had higher rates of service utilization (p < 0.05). Differential patterns were observed based on the type of caregiver impairment. Findings support the importance of family-centered assessment and intervention approaches for youth affected by trauma.


Adolescent Caregiver impairment Mental health Risk behavior Trauma 



This manuscript was developed (in part) under grant numbers 2U79SM054284 from the Center for Mental Health Services (CMHS), Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS). The views, policies, and opinions expressed are those of the authors and do not necessarily reflect those of SAMHSA or HHS. We would like to acknowledge the 56 sites within the NCTSN that have contributed data to the Core Data Set as well as the children and families that have contributed to our growing understanding of child traumatic stress.

Compliance with Ethical Standards

Conflict of Interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical Standards and Informed Consent

All procedures were approved by the Duke University Health System Internal Review Board (IRB), as well as the IRB of all participating NCTSN centers.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Briana Woods-Jaeger
    • 1
    Email author
  • Ernestine C. Briggs
    • 2
  • Rebecca L. Vivrette
    • 3
  • Robert C. Lee
    • 2
  • Liza Suarez
    • 4
  • Harolyn M. E. Belcher
    • 5
    • 6
  1. 1.Department of Behavioral Sciences and Health EducationEmory University Rollins School of Public HealthAtlantaUSA
  2. 2.Department of Psychiatry and Behavioral Sciences, Duke University School of MedicineUCLA-Duke University National Center for Child Traumatic StressDurhamUSA
  3. 3.Department of PsychiatryUniversity of Maryland School of MedicineBaltimoreUSA
  4. 4.University of Illinois at ChicagoUrban Youth Trauma CenterChicagoUSA
  5. 5.Center for Diversity in Public Health Leadership Training, Kennedy Krieger InstituteBaltimoreUSA
  6. 6.Department of PediatricsJohns Hopkins University School of MedicineBaltimoreUSA

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