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McGuire R, Meiser-Stedman R, Smith P, Schmidt D, Bjornstad G, Bosworth R, Clarke T, Coombes J, Geijer Simpson E, Hudson K, Oliveira P, Macleod J, McGovern R, Stallard P, Wood K, Hiller RM. Access to best-evidenced mental health support for care-experienced young people: Learnings from the implementation of cognitive therapy for PTSD. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2024. [PMID: 39012021 DOI: 10.1111/bjc.12471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 04/15/2024] [Indexed: 07/17/2024]
Abstract
OBJECTIVES Rates of PTSD are up to 12 times higher in care-experienced young people (CEYP) compared to their peers. Trauma-focused CBTs (tf-CBT) are the best-evidenced treatment for youth with PTSD, yet, in practice, CEYP often struggle to access this treatment. We worked alongside services to understand barriers and facilitators of the implementation of cognitive therapy for PTSD (a type of tf-CBT) to CEYP. DESIGN This was an active, open implementation trial. METHODS We recruited 28 mental health teams across England, including general CAMHS, targeted CAMHS for CEYP and social care-based teams. From these teams, participants were 243 mental health professionals, from a wide variety of professional backgrounds. Following recruitment/intervention training, teams participated in rolling three monthly focus groups and individual interviews, to understand what helped and hindered implementation. Data were analysed using a framework analysis conducted using CFIR 2.0. RESULTS Almost half of the teams were able to implement, but only approximately one quarter with CEYP, specifically. Universal barriers that were discussed by almost all teams particularly highlighted service structures and poor resourcing as major barriers to delivery to CEYP, as well as the complexities of the young person and their network. Unique factors that differentiated teams who did and did not implement included commissioning practices, the culture of the team, leadership engagement and style, and the development of supervision structures. CONCLUSIONS Findings offer key considerations for mental health teams, service leads, commissioners and policy-makers to enhance delivery of best-evidenced mental health treatments like CT-PTSD, for CEYP.
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Affiliation(s)
- Rosie McGuire
- Division of Psychology & Language Sciences, UCL, London, UK
| | - Richard Meiser-Stedman
- Department of Clinical Psychology and Psychological Therapies, University of East Anglia, Norwich, UK
| | - Patrick Smith
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Davin Schmidt
- Division of Psychology & Language Sciences, UCL, London, UK
| | | | | | | | - Joe Coombes
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Emma Geijer Simpson
- Population Health Sciences Institute, University of Newcastle, Newcastle, UK
| | - Kristian Hudson
- Improvement Academy, NIHR ARC Yorkshire & Humber, Bradford Teaching Hospitals NHS Trust, Bradford, UK
| | - Paula Oliveira
- Anna Freud National Centre for Children & Families, London, UK
| | - John Macleod
- NIHR School for Primary Care, University of Bristol, Bristol, UK
| | - Ruth McGovern
- Population Health Sciences Institute, University of Newcastle, Newcastle, UK
| | | | - Katie Wood
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Rachel M Hiller
- Division of Psychology & Language Sciences, UCL, London, UK
- Anna Freud National Centre for Children & Families, London, UK
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Olenik Shemesh D, Heiman T, Wright MF. Problematic Use of the Internet and Well-Being among Youth from a Global Perspective: A Mediated-Moderated Model of Socio-Emotional Factors. J Genet Psychol 2024; 185:91-113. [PMID: 37933515 DOI: 10.1080/00221325.2023.2277319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 10/26/2023] [Indexed: 11/08/2023]
Abstract
Problematic Use of the Internet (PUI) is characterized as the inability to control one's internet use or as an excessive use of the internet that may result in social, psychological, and emotional difficulties (Fernandes et al., 2019). It is regarded nowadays as an increasingly worrisome public heath issue, especially among youth. This study explored the contexts in which youth PUI occurs and its associations with socio-emotional functioning that may lead to a decrease in one's sense of well-being. We conducted this exploration among 783 middle school students from the US (425 students; 54.27%) and Israel (358 students; 45.73%). The overall age of both samples ranged between 12 and 16 (M = 13.94, SD = 1.59). In the Israeli sample, 49.1% of the students were girls and 50.9% were boys, whereas in the US sample, 48.8% were girls and 51.2% were boys. The study examined the role of depressive mood, loneliness, resilience, self-control, and school engagement in mediating the relationship between PUI and well-being, and how country of origin might moderate these relationships. Results indicate PUI was related to lower well-being only for the US sample. Yet, for both samples, higher loneliness was related to lower well-being, and higher school engagement was related to higher well-being. A moderated mediation analysis revealed the socio-emotional variables were all mediators in these associations, but differently for each country sample. The study results are discussed according to key factors required for developing intervention programs for coping with youth PUI behaviors.
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Affiliation(s)
| | - Tali Heiman
- Psychology and Education, The Open University of Israael, Raanana, Israel
| | - Michelle F Wright
- Child Study Center Department of Psychology, Pennsylvania State University, University Park, PA, USA
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Kim K, Moss C, Park JJ, Wekerle C. Child Maltreatment and the Child Welfare System as Environmental Factors in the International Classification of Functioning. FRONTIERS IN REHABILITATION SCIENCES 2022; 2:710629. [PMID: 36188868 PMCID: PMC9397842 DOI: 10.3389/fresc.2021.710629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 12/13/2021] [Indexed: 11/13/2022]
Abstract
The WHO defines child maltreatment as any form of neglect, exploitation, and physical, emotional, or sexual abuse, committed against children under the age of 18. Youth involved in the child welfare system report more maltreatment experiences and environmental turbulence (e.g., number of moves, caseworkers), placing them at greater risk for poorer physical and mental health. The International Classification of Functioning, Disability, and Health (ICF) provides a framework to describe health conditions and severity of disabilities for an individual and/or group in the context of environmental factors. The Maltreatment and Adolescent Pathways (MAP) study is a longitudinal study, assessing self-reports on variables (e.g., child maltreatment history, trauma symptoms, dating violence, and substance use) of youth in an urban child protection service system. This study focuses on 11 of the 24 MAP publications that pertain to health and functioning, which can be considered applicable to the ICF framework, following established linking rules. The purpose of this study is to analyze these MAP sub-studies, with maltreatment and involvement in the child welfare system as environmental factors that impact the functioning of child welfare-involved youth. Findings indicate significant relationships across environmental factors (i.e., child maltreatment histories, child welfare system involvement), health conditions (i.e., trauma symptomatology, psychological distress, intellectual disabilities), and functioning problems (i.e., substance use, adolescent dating violence, sexual risk-taking, coping motives, sleep problems). The interrelated nature of these factors in the MAP sub-studies suggests the value of the ICF model to a holistic health view of use to practitioners supporting system-involved youth, clarifying unattended environmental factors in guiding service provision for foster care and/or maltreated youth.
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Affiliation(s)
- Katherine Kim
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Corinne Moss
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
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Cole J, Sprang G, Silman M. Interpersonal Trauma Exposure, Trauma Symptoms, and Severity of Substance Use Disorder among Youth Entering Outpatient Substance Abuse Treatment. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2019; 12:341-349. [PMID: 32318204 PMCID: PMC7163824 DOI: 10.1007/s40653-018-0239-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A substantial body of literature has found associations between interpersonal victimization, trauma symptoms, and substance use disorders (SUD) among adolescents. Secondary data analysis was conducted on structured interview data collected by treatment providers as 172 adolescents (ages 12-19) entered outpatient substance abuse treatment. Results indicate high prevalence rates of interpersonal trauma exposure: 71.5% self-reported trauma exposure, specifically direct physical abuse or assault, sexual abuse or assault, and/or witnessing intimate partner violence of a parent. Severity of SUD, as measured by number of DSM-5 criteria endorsed, was not only associated with the number of types of criterion A events for Posttraumatic Stress Disorder but also more self-reported internalizing problems. There was no significant relationship between the severity of SUD and the severity of trauma symptoms at treatment intake, gender, or attention problems. Ongoing assessment of possible trauma symptoms is recommended throughout substance abuse treatment with youth who have reported trauma exposure, as well as continued screening of trauma exposure.
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Affiliation(s)
- Jennifer Cole
- Center on Drug and Alcohol Research, Department of Behavioral Science, University of Kentucky, 333 Waller Avenue, Suite 480, Lexington, KY 40504 USA
| | - Ginny Sprang
- Department of Psychiatry, Center on Trauma and Children, University of Kentucky, Lexington, KY USA
| | - Miriam Silman
- Center on Trauma and Children, University of Kentucky, Lexington, KY USA
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5
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Sideli L, Di Forti M, Ferraro L, Montana S, Tripoli G, Quattrone D, Colizzi M, La Barbera D, La Cascia C. The Relationship Between Dissociative Experiences and Cannabis Use: a Systematic Review. CURRENT ADDICTION REPORTS 2019. [DOI: 10.1007/s40429-019-0235-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Washburn M, Carr LC, Dettlaff AJ. The moderating effects of ethnicity on key predictors of trauma in child welfare involved adolescents. J Adolesc 2018; 67:179-187. [PMID: 30008300 DOI: 10.1016/j.adolescence.2018.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 06/10/2018] [Accepted: 06/18/2018] [Indexed: 10/28/2022]
Abstract
Key predictors of trauma were examined using a multi-group analysis of a nationally representative sample of 716 child welfare involved youth ages 11-17. Results indicate that co-occurring clinical depression was associated with trauma across all racial/ethnic groups. Results also support that youth's ethnicity moderates the relationship between gender, history of sexual abuse and sexual orientation and the development of trauma. Contrary to prior research, trauma was not significantly associated with substance abuse or having experienced out of home placement for all ethnic groups. Implications for policy, practice with child welfare involved adolescents and future research in this area are discussed.
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Affiliation(s)
- Micki Washburn
- Center for Child and Family Innovation Research & Center for Drug and Social Policy Research, University of Houston Graduate College of Social Work, 3511 Cullen Blvd Room 315 Social Work Building, Houston, TX 77204, USA.
| | - L Christian Carr
- Center for Child and Family Innovation Research, University of Houston Graduate College of Social Work, 3511 Cullen Blvd Room 345 A Social Work Building, Houston, TX 77204, USA.
| | - Alan J Dettlaff
- University of Houston Graduate College of Social Work, 3511 Cullen Blvd Room 212 Social Work Building, Houston, TX 77204, USA.
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7
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Yoon S, Kobulsky JM, Yoon D, Kim W. Developmental Pathways from Child Maltreatment to Adolescent Substance Use: The Roles of Posttraumatic Stress Symptoms and Mother-Child Relationships. CHILDREN AND YOUTH SERVICES REVIEW 2017; 82:271-279. [PMID: 29503490 PMCID: PMC5831507 DOI: 10.1016/j.childyouth.2017.09.035] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
While many studies have identified a significant relation between child maltreatment and adolescent substance use, the developmental pathways linking this relation remain sparsely explored. The current study examines posttraumatic stress (PTS) symptoms, mother-child relationships, and internalizing and externalizing problems as potential longitudinal pathways through which child maltreatment influences adolescent substance use. Structural equation modeling was conducted on 883 adolescents drawn from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). The pathways of PTS symptoms linked physical and sexual abuse to substance use, and the pathways of mother-child relationships linked emotional abuse and neglect to substance use. None of the four types of maltreatment affected substance use via internalizing or externalizing problems. The findings suggest that intervention efforts aimed at addressing posttraumatic stress symptoms and improving mother-child relationship quality may be beneficial in reducing substance use among adolescents with child maltreatment histories.
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Affiliation(s)
- Susan Yoon
- College of Social Work, The Ohio State University, USA
| | | | - Dalhee Yoon
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, USA
| | - Wonhee Kim
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, USA
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Naughton AM, Cowley LE, Tempest V, Maguire SA, Mann MK, Kemp AM. Ask Me! self-reported features of adolescents experiencing neglect or emotional maltreatment: a rapid systematic review. Child Care Health Dev 2017; 43:348-360. [PMID: 28238208 DOI: 10.1111/cch.12440] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 11/24/2016] [Accepted: 11/27/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Neglect is often overlooked in adolescence, due in part to assumptions about autonomy and misinterpretation of behaviors being part of normal adolescent development. Emotional maltreatment (abuse or neglect) has a damaging effect throughout the lifespan, but is rarely recognized amongst adolescents. Our review aims to identify features that adolescents experiencing neglect and/ or emotional maltreatment report. METHOD A rapid review methodology searched 8 databases (1990-2014), supplemented by hand searching journals, and references, identifying 2,568 abstracts. Two independent reviews were undertaken of 279 articles, by trained reviewers, using standardised critical appraisal. Eligible studies: primary studies of children aged 13-17 years, with substantiated neglect and/ or emotional maltreatment, containing self-reported features. RESULTS 19 publications from 13 studies were included, demonstrating associations between both neglect and emotional maltreatment with internalising features (9 studies) including depression, post traumatic symptomatology and anxiety; emotional maltreatment was associated with suicidal ideation, while neglect was not (1 study); neglect was associated with alcohol related problems (3 studies), substance misuse (2 studies), delinquency for boys (1 study), teenage pregnancy (1 study), and general victimization for girls (1 study), while emotionally maltreated girls reported more externalising symptoms (1 study). Dating violence victimization was associated with neglect and emotional maltreatment (2 studies), while emotional abuse of boys, but not neglect, was associated with dating violence perpetration (1 study), and neither neglect nor emotional maltreatment had an association with low self-esteem (2 studies). Neither neglect nor emotional maltreatment had an effect on school performance (1 study), but neglected boys showed greater school engagement than neglected girls (1 study). CONCLUSIONS If asked, neglected or emotionally maltreated adolescents describe significant difficulties with their mental health, social relationships, and alcohol or substance misuse. Practitioners working with youths who exhibit these features should recognize the detrimental impact of maltreatment at this developmental stage, and identify whether maltreatment is a contributory factor that should be addressed.
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Affiliation(s)
- A M Naughton
- Designated Doctor Safeguarding Children, National Safeguarding Team, Public Health Wales NHS Trust, UK
| | - L E Cowley
- College of Biomedical and Life Sciences, School of Medicine, Cardiff University, Cardiff, UK
| | - V Tempest
- College of Biomedical and Life Sciences, School of Medicine, Cardiff University, Cardiff, UK
| | - S A Maguire
- College of Biomedical and Life Sciences, School of Medicine, Cardiff University, Cardiff, UK
| | - M K Mann
- Support Unit for Research Evidence, Cardiff University, Cardiff, UK
| | - A M Kemp
- College of Biomedical and Life Sciences, School of Medicine, Cardiff University, Cardiff, UK
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9
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Wekerle C, Goldstein AL, Tanaka M, Tonmyr L. Childhood sexual abuse, sexual motives, and adolescent sexual risk-taking among males and females receiving child welfare services. CHILD ABUSE & NEGLECT 2017; 66:101-111. [PMID: 28139252 DOI: 10.1016/j.chiabu.2017.01.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 12/19/2016] [Accepted: 01/16/2017] [Indexed: 05/14/2023]
Abstract
Childhood sexual abuse (CSA) is associated with multiple negative outcomes, including increased risky sexual behavior. To date, the majority of research on the relationship between CSA and risky sex in adolescence has been limited, with a lack of focus on males and youth receiving child welfare services. Participants in the current study were 297 youth (mean age=15.98; SD=1.01, 57.6% female) from the child welfare system who reported being sexually active at the time of the survey. CSA was associated with severity of other types of maltreatment for both genders, and exposure to intimate partner violence for females only. In general, males engaged in more sexual risk behaviors than females. Males with CSA had stronger motives to have sex for: (1) coping, (2) peer approval and (3) partner approval, as compared to non-CSA males; as well as (4) greater motives for partner and peer approval compared to females with CSA. Males with no CSA had stronger sexual motives for enhancement (e.g., feeling pleasure) compared to females with no CSA. Mediation analyses revealed a significant indirect effect for coping motives for males: CSA was associated with increased motives to use sex for coping which was associated with increased sexual risk-taking. These findings provide important information regarding the relationship between CSA and sexual risk-taking for child welfare sample and highlight coping with negative affect as a potential mechanism that underlies the CSA-risky sex relationship. It also encourages further consideration of motives for risk and resilience behaviors among youth.
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Affiliation(s)
- Christine Wekerle
- Department of Pediatrics, McMaster University, 1280 Main Street. W., Hamilton, ON L8N 3Z5 Canada.
| | - Abby L Goldstein
- Department of Applied Psychology and Human Development, University of Toronto, Canada.
| | - Masako Tanaka
- Department of Psychiatry and Behavioural Neurosciences, Offord Centre for Child Studies, McMaster University, Canada.
| | - Lil Tonmyr
- Public Health Agency of Canada, ON, Canada.
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10
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Mergler M, Driessen M, Lüdecke C, Ohlmeier M, Chodzinski C, Weirich S, Schläfke D, Wedekind D, Havemann-Reinecke U, Renner W, Schäfer I. Relationships between a Dissociative Subtype of PTSD and Clinical Characteristics in Patients with Substance Use Disorders. J Psychoactive Drugs 2017; 49:225-232. [DOI: 10.1080/02791072.2017.1296209] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Michaela Mergler
- Psychologist, Alpen-Adria-Universitat Klagenfurt, Clinical Psychology, Klagenfurt, Austria
| | - Martin Driessen
- Professor, Clinic of Psychiatry and Psychotherapy Bethel, Bielefeld, Germany
| | - Christel Lüdecke
- Clinician, Klinikum Region Hannover Psychiatrie Wunstorf, Wunstorf, Germany
| | | | - Claudia Chodzinski
- Social Worker, Medizinische Hochschule Hannover Klinik fur Psychiatrie Sozialpsychiatrie und Psychotherapie, Hannover, Germany
| | - Steffen Weirich
- Clinician, Universitatsmedizin Rostock Klinik und Poliklinik fur Psychiatrie und Psychotherapie, Rostock, Germany
| | - Detlef Schläfke
- Professor, Department of Forensic Psychiatry, University of Rostock, Rostock, Germany
| | - Dirk Wedekind
- Professor, Universitatsklinikum Göttingen, Göttingen, Germany
| | | | - Walter Renner
- Professor, Pan European University Bratislava, Bratislava, Slovakia
| | - Ingo Schäfer
- Clinician, Universitatsklinikum Hamburg Eppendorf Klinik und Poliklinik fur Psychiatrie und Psychotherapie, Hamburg, Germany
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Erickson SJ, Krapf EM, Gerstle M. Adolescent cancer survivors’ posttraumatic stress symptoms: Concordance between self-report and maternal-proxy report. J Health Psychol 2016; 22:1789-1798. [DOI: 10.1177/1359105316636949] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Subsyndromal posttraumatic stress among pediatric cancer survivors has been associated with negative physical and mental health outcomes. However, adolescent self-report and mother-proxy report of adolescents’ posttraumatic stress symptoms evidenced varying concordance depending on methodology. There was moderate concordance, particularly among younger respondents, when total posttraumatic stress symptoms were viewed continuously and low-moderate concordance when viewed categorically; moderate-strong concordance for only one posttraumatic stress disorder symptom cluster; low-moderate agreement for high-frequency items; and no concordance for identifying caseness. Although a significant subset of pediatric cancer survivors experience posttraumatic stress, mothers and adolescents demonstrate limited symptom, categorical, and caseness agreement, potentially impacting adolescents’ healthcare service utilization.
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12
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Cecil CAM, McCrory EJ, Viding E, Holden GW, Barker ED. Initial Validation of a Brief Pictorial Measure of Caregiver Aggression: The Family Aggression Screening Tool. Assessment 2015; 23:307-20. [PMID: 26085494 DOI: 10.1177/1073191115587552] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In the present study, we report on the development and initial psychometric properties of the Family Aggression Screening Tool (FAST). The FAST is a brief, self-report tool that makes use of pictorial representations to assess experiences of caregiver aggression, including direct victimization and exposure to intimate partner violence. It is freely available on request and takes under 5 minutes to complete. Psychometric properties of the FAST were investigated in a sample of 168 high-risk youth aged 16 to 24 years. For validation purposes, maltreatment history was assessed using the Childhood Trauma Questionnaire; levels of current psychiatric symptoms were also assessed. Internal consistency of the FAST was good. Convergent validity was supported by strong and discriminative associations with corresponding Childhood Trauma Questionnaire subscales. The FAST also correlated significantly with multi-informant reports of psychiatric symptomatology. Initial findings provide support for the reliability and validity of the FAST as a brief, pictorial screening tool of caregiver aggression.
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Punzi EH, Tidefors I. “It Wasn't the Proper Me” — Narratives about Alcoholism and View of Oneself: The Impact of Disavowed Shortcomings and Dissociation. ALCOHOLISM TREATMENT QUARTERLY 2014. [DOI: 10.1080/07347324.2014.949110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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14
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Faulkner B, Goldstein AL, Wekerle C. Pathways from childhood maltreatment to emerging adulthood: investigating trauma-mediated substance use and dating violence outcomes among child protective services-involved youth. CHILD MALTREATMENT 2014; 19:219-232. [PMID: 25287053 DOI: 10.1177/1077559514551944] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Longitudinal survey data were used to examine the relationship between two types of childhood maltreatment, abuse/neglect and exposure to intimate partner violence (IPV), and two outcomes, substance use and dating violence, within the past year. Participants were youth (N = 158, aged 16-19 at Time 3) involved with child protective services (CPS). A parallel multiple mediator model was used to test the hypothesis that trauma symptoms would mediate the relationship between both types of maltreatment and dating violence, marijuana, and alcohol use outcomes. Although both types of maltreatment were not directly associated with dating violence and substance use outcomes, the indirect effects of anxiety, anger, and dissociation on the relationship between maltreatment and substance use/dating violence were significant. Direct effects of both types of maltreatment on past year use of dating violence + alcohol use and dating violence + marijuana use were not significant, but results demonstrated a significant indirect effect for anger on the relationship between exposure to IPV and past year dating violence + marijuana use. No other indirect effects were significant. Findings highlight the negative effects of exposure to IPV and have implications for the development of prevention programming for youth transitioning out of CPS.
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15
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Goldstein AL, Faulkner B, Wekerle C. The relationship among internal resilience, smoking, alcohol use, and depression symptoms in emerging adults transitioning out of child welfare. CHILD ABUSE & NEGLECT 2013; 37:22-32. [PMID: 23260123 DOI: 10.1016/j.chiabu.2012.08.007] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Revised: 07/31/2012] [Accepted: 08/02/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVE It is well established that child maltreatment reflects a context of risk for multiple negative outcomes. Identifying factors that protect against negative outcomes is important for the development of strengths-based approaches that emphasize resilience, particularly for youth transitioning out of the child welfare system. The current study examined the relationship between an internal resilience measure, the Connor-Davidson Resilience Scale (CD-RISC; Connor & Davidson, 2003), and several external measures of resilience and behavioral outcomes (tobacco use and dependence, alcohol use and problems, and depression symptoms). In addition, two models of resilience were examined in the context of child maltreatment: a compensatory model and a risk-protection model. METHODS Ninety-three emerging adults (ages 18-25) who were making the transition out of child welfare completed self-report measures of child maltreatment, internal resilience (CD-RISC), external resilience (academic achievement, religious and community involvement, monitoring by caregivers, and presence of an adult mentor), alcohol and tobacco use, and depression symptoms. RESULTS Internal resilience was significantly associated with involvement in religion and community, and monitoring by caregivers. In addition, internal resilience was negatively associated with past year smoking and nicotine dependence, and with symptoms of depression. Hierarchical regression analyses were conducted to examine the direct and interaction effects of resilience on depression symptoms in the context of child maltreatment. When internal resilience was added to the model, it made a significant contribution to depression scores over and above child maltreatment (physical, sexual, and emotional abuse; emotional neglect). In addition, there was a significant Sexual Abuse×Resilience interaction, wherein high resilience was associated with a reduction in depression scores at higher levels of sexual abuse. CONCLUSIONS These findings support internal resilience as both a compensatory and protective factor for depression symptoms in the context of sexual abuse among emerging adults transitioning out of child welfare. Prevention and early intervention within child welfare should include strengthening internal resilience, with continued monitoring of competencies through the transition from adolescence to emerging adulthood.
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Affiliation(s)
- Abby L Goldstein
- Department of Applied Psychology & Human Development, OISE, University of Toronto, Canada
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16
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Tanaka M, Wekerle C, Schmuck ML, Paglia-Boak A. The linkages among childhood maltreatment, adolescent mental health, and self-compassion in child welfare adolescents. CHILD ABUSE & NEGLECT 2011; 35:887-98. [PMID: 22018519 DOI: 10.1016/j.chiabu.2011.07.003] [Citation(s) in RCA: 120] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2011] [Revised: 07/20/2011] [Accepted: 07/21/2011] [Indexed: 05/20/2023]
Abstract
OBJECTIVES Childhood maltreatment is a robust risk factor for poor physical and mental health. Child welfare youths represent a high-risk group, given the greater likelihood of severe or multiple types of maltreatment. This study examined the relationship between childhood maltreatment and self-compassion - a concept of positive acceptance of self. While not applied previously to a child welfare sample, self-compassion may be of value in understanding impairment among maltreatment victims. This may be most pertinent in adolescence and young adulthood, when self-identity is a focal developmental process. METHODS The present sample was drawn from the Maltreatment and Adolescent Pathways (MAP) Longitudinal Study, which followed randomly selected adolescents receiving child protection services across two years within an urban catchment area. Child maltreatment was assessed at baseline using the Childhood Trauma Questionnaire (Bernstein et al., 1994, 2003). Mental health, substance and alcohol use problems, suicide attempt, and self-compassion were assessed at the two-year follow-up point. There were 117 youths, aged 16-20 years (45.3% males) who completed the self-compassion scale (Neff, 2003). Bivariate correlations were computed between adolescent self-compassion and each form of self-reported maltreatment (physical abuse, sexual abuse, emotional abuse, emotional neglect, and physical neglect). Finally, hierarchical, stepwise regression was used to examine unique contributions of child maltreatment subtypes in predicting adolescent self-compassion, as well as maltreatment-related impairment. RESULTS Higher childhood emotional abuse, emotional neglect, and physical abuse were associated with lower self-compassion. Controlling for age and gender, emotional abuse was significantly associated with reduced self-compassion, even when the effects of emotional neglect and physical abuse were taken into account. Youths with low self-compassion were more likely to have psychological distress, problem alcohol use, and report a serious suicide attempt, as compared with those with high self-compassion. A number of maltreatment-related areas of impairment, identified by screening instruments, were significantly associated with lower self-compassion. CONCLUSION Self-compassion may be a fruitful aspect of research to pursue in an effort to better understand the impact of childhood emotional abuse on adolescent functioning, particularly considering the under-researched group of those receiving child protective services.
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Affiliation(s)
- Masako Tanaka
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Patterson Building, Chedoke Hospital, Hamilton, Ontario, Canada
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