Potentially traumatic events (PTEs) are experiences that involve an exposure to actual death, threatened death, sexual violence, or serious injury that may lead to the development of Post-Traumatic Stress Disorder (PTSD; American Psychiatric Association, 2022). A study using a national survey of over 6000 U.S. adolescents found approximately 61 % of youth ages 13 to 17 reported experiencing a PTE (McLaughlin et al., 2013). Following a PTE, studies have shown about 85 % of youth tend to recover and do not develop PTSD (Alisic et al., 2014). However, prior research has shown girls tend to have higher rates of PTSD, and girls who have experienced interpersonal trauma have the highest incidence when compared to girls and boys who have not experienced interpersonal trauma (Alisic et al., 2014; McLaughlin et al., 2013). Research has shown women tend to experience more interpersonal trauma, specifically sexual assault, which has been associated with more severe PTSD symptoms (Tolin and Foa, 2008). The extant literature points to the impact of interpersonal trauma but has been limited in examining contextual factors that may play a part in PTSD symptoms.

Individuals with preexisting depression are more likely to develop PTSD after experiencing a potentially traumatic event and their symptoms tend to be more chronic compared to those without preexisting depression (Breslau and Kessler, 2014). Another study found that youth with PTSD also have a higher risk of suicidal thoughts and behaviors (Eskander et al., 2020). The current study uses a clinical sample of youth who screened positive for depression and/or suicidal thoughts and behaviors, given the high risk for the development of PTSD within this subgroup.

Bronfenbrenner's ecological systems theory details how different systems within a person's environment can impact psychological functioning (Crawford, 2020). Yet, little research has examined the role of health-related social needs (HRSNs) on the development of PTSD in youth. HRSNs are adverse social and economic conditions that can include housing instability, food insecurity, lack of transportation, and lack of utilities (Billioux et al., 2017). Unmet HRSNs are recognized for negatively impacting healthcare utilization and exacerbating health problems (Garg et al., 2022). Research has shown that low socioeconomic status (SES) is linked to a higher likelihood of experiencing traumatic and stressful life events in young people (Hatch and Dohrenwend, 2007; Perkonigg et al., 2000). While HRSNs could impact PTSD risk independent of trauma experience, this evidence suggests HRSNs may be a risk factor for trauma exposure and could therefore impact the relationship between trauma exposure and PTSD risk.

Prior research has suggested a relationship between HRSNs and mental health outcomes. For instance, Kuhn and colleagues (2020) found that increased externalizing and internalizing symptoms in youth were associated with greater unmet HRSNs, which, in turn, were linked to decreased mental health care utilization. Similarly, Garg and colleagues (2022) found that psychiatric disorders were more prevalent among adults seeking assistance with transportation, food, healthcare, and personal safety HRSNs compared to those who were not seeking assistance for HRSNs, with transportation needs showing the strongest association. Despite these findings, the relationship between HRSNs, trauma exposure, and subsequent mental health symptoms, such as PTSD remains underexamined for youth.

This report aimed to: (1) examine the types of traumatic experiences reported at baseline by a clinical sample of youth, (2) to characterize the relationship between trauma exposure and subsequent PTSD symptoms, and (3) explore the relationship between PTSD symptoms and reported HRSNs. Based on prior studies, we expected that greater HRSNs would act as a risk factor for PTSD in individuals with trauma exposure (Hatch and Dohrenwend, 2007; Perkonigg et al., 2000).