The Value of a Safe, Connected Social Climate for Adolescent Girls in Residential Care

Adverse childhood experiences and residential care environment: The mediating role of trauma-related symptoms and psychological maladjustment in adolescents

BACKGROUND

Research has consistently found poorer outcomes in adolescents who have been exposed to early interpersonal adversities, especially those in out-of-home placements. The presence of mental health problems also contributes to the perception of a more negative group climate and peer interactions through cascading effects.

OBJECTIVE

To analyze the sequential relationships between exposure to adverse childhood experiences (ACEs), trauma-related symptoms, psychological maladjustment, and the perception of group climate and peer interactions. In addition, the study analyzes the mediating role of trauma-related symptoms and psychological maladjustment.

PARTICIPANTS AND SETTING

The sample comprised 161 adolescents in out-of-home care (46.6 % males, 49.7 % females, 3.7 % non-binary), aged 12-18 (M = 15.22, SD = 1.59) from 24 residential facilities in Spain.

METHODS

This study is part of the VRINEP project. Group care workers reported about ACEs and trauma-related symptoms through online questionnaires, whereas adolescents self-reported about psychological maladjustment, group climate, and peer interactions.

RESULTS

Differential associations between ACEs with trauma-related symptoms and internalizing problems were found. The relationship between certain ACEs and externalizing problems was fully mediated by trauma-related symptoms. Likewise, psychological maladjustment was related to a more negative perception of the group climate and peer interactions. Although trauma-related symptoms were not directly associated with the perception of the residential environment, they were indirectly associated with peer relational aggression through externalizing problems.

CONCLUSIONS

Mental health has a significant impact on the perception of the group climate and peer interactions among adolescents in residential care who have been exposed to ACEs.

Self-stigmatization of high-school students seeking professional psychological help: the chain-mediating effect of perceived social support and optimism

Background

Research has shown that stigmatization of professional psychological help-seeking is an important factor influencing attitudes toward seeking professional psychological help (ATSPPH). However, how perceived social support (PSS) and optimism have a mediating role is not clear.

Objective

Examine the associations between ATSPPH, self-stigmatization of seeking help, PSS, and optimism in a cohort of Chinese high-school students (HSSs).

Methods

An offline survey was conducted in three high schools in Chongqing (China) from 20 February to 20 May 2023. Participants were HSSs recruited through their teachers. A total of 2,159 HSSs completed a survey on demographic information as well as the Self-Stigmatization of Seeking Help (SSOSH) score, ATSPPH, Perceived Social Support Scale (PASS), and Life Orientation Test (LOT). Mediation analyses were conducted using the "Process" macro in SPSS 26.0 to estimate the direct and indirect effects of self-stigmatization of seeking psychological help on ATSPPH.

Results

Self-stigmatization of seeking psychological help was significantly and negatively related to ATSPPH among HSSs. Self-stigmatization of psychological help-seeking influenced ATSPPH through three pathways: (a) separate mediating effect of PSS (effect = -0.029); (b) separate mediating effect of optimism (effect = -0.069); (c) chain-mediating effect of PSS and optimism (effect = -0.017). These data suggested that self-stigmatization of psychological help-seeking could influence ATSPPH directly and indirectly through PSS and optimism.

Conclusion

PSS and optimism mediated the relationship between self-stigmatization of seeking help and ATSPPH. Improving the ability of HSSs to perceive social support and cultivating optimism could help improve the self-stigmatization of help-seeking and promote a positive attitude toward professional help-seeking.

Adolescents' attachment, quality of relationships with residential caregivers, and emotion regulation

INTRODUCTION

Adolescents in residential care are more likely to report insecure and especially disorganized attachments, which lead to difficulties in emotion regulation and compromise the quality of their interpersonal relationships. In residential care, it is expected that sensitive and responsive caregivers are able to help adolescents regulate their feelings of distress, enabling them to experience a sense of emotional security. The present study sought to analyze the effects of the quality of attachment on emotion regulation and to test the moderating effect of quality of relationship (from adolescents' and caregivers' perspectives) on this association.

METHODS

The sample involved 306 adolescents, 12-18 years of age, living in residential care and 70 caregivers.

RESULTS

The findings underscored the importance of the quality of the relationship with residential caregivers on adolescents' emotion regulation competencies over time. The results also showed that the quality of relationship (emotional closeness) as perceived by the caregivers moderated the association between adolescents' attachment avoidance levels and their emotion regulation strategies.

CONCLUSIONS

The results are discussed according to attachment theory, and underscore the role the relationship with caregivers plays in the affective reorganization of adolescents living in residential care.

Youth in Residential Care: A Cross-Sectional Mediation Analysis of Youth’s Perceptions of Their Social Images, Self-Representations, and Adjustment Outcomes

Individuals’ perceptions of their social images [i.e., meta-representations (MR)] and perceived stereotyping threat create involuntary stress responses that may affect important outcomes, such as self-esteem, academic achievement, and mental health. This study aimed to (1) analyze the indirect associations between residential care youth’s MR and their psychological adjustment (i.e., externalizing and internalizing problems) through their self-representations (SR) and (2) test the moderating role of youth’s age and residential unit size in those associations. A sample of 926 youth aged between 12 and 25years old filled out self-report questionnaires regarding their representations about how people in general perceive them (i.e., MR) and their SR. Residential care professionals filled in the socio-demographic questionnaires and the Child Behavior Checklist. Data were analyzed through multiple mediation models and moderated mediation models. Results showed that (1) youth’s behavioral MR were indirectly associated with higher internalizing and externalizing behavior through higher levels of behavioral SR and (2) youth’s emotional MR were associated with higher internalizing problems through higher emotional SR, but also with lower internalizing problems through lower levels of behavioral SR. These results emphasize the importance of stimulating positive SR, by showing that they can be a protective factor for youth in residential care.

The views of children in residential care on the COVID-19 lockdown: Implications for and their well-being and psychosocial intervention

BACKGROUND

Recent international research has warned of the impact of the COVID-19 lockdown on vulnerable children. However, little is known regarding the in-care population.

OBJECTIVE

To find out how children in residential care perceived the influence of the COVID-19 lockdown in their everyday life, relationships and subjective well-being.

PARTICIPANTS AND SETTING

856 children from 10 to 17 years old (M_age = 15.5, males = 71.2%, females = 28.8%) living in residential centres in Catalonia.

METHODS

Cross-sectional study. Children responded to an on-line questionnaire administered between June and July 2020. Bivariate analysis and multiple linear regression were used comparing the answers by sex.

RESULTS

Better relationships with caregivers (β = 9.156, [4.089-14.22], r² = 0.244, p < .01) and having a person of trust (ß = 4.588, [2.041-7.134], r² = 0.244, p < .01) were found to be relevant for children's subjective well-being. For girls, improving their grades (β = 14.86, [8.560-21.15], r² = 0.234, p < .01) were relevant while boys' subjective well-being was significantly affected by an increase in use of social networks (β = 8.917, [2.733-15.10], r² = 0.234, p < .01).

CONCLUSIONS

A gender perspective is needed to help girls in situations of vulnerability. We should continue to listen to children's opinions, giving them the opportunity to participate in improving the children's home and its immediate environment and ensuring they have access to stable adult role models.

Improvement of group climate in a residential setting for juveniles with mild intellectual disability through training of staff in Non-Violent Resistance

BACKGROUND

An open group climate is essential in successful residential care for juveniles with mild intellectual disability (MID). This study examined whether non-violent resistance, adapted for MID (NVR-MID), stimulates an open group climate in time.

METHOD

NVR-MID was implemented in three residential settings in The Netherlands, in a quasi-experimental stepped wedge design. In total, 124 clients with MID (M_age  = 16.39 [SD = 4.95], 49.9% male) participated. Group climate was assessed seven times with the Group Climate Inventory for Children or the Group Climate Inventory-Revisited (GCI-R), during a total of 20 months.

RESULTS

Open group climate scores increased in all three institutions; effect size was medium. Clients with lower IQs experienced group climate as more positive compared to clients with higher IQs. Effects were similar for both groups.

CONCLUSIONS

As NVR-MID appeared to contribute to a positive experienced group climate, it might be advisable to implement NVR-MID on larger scale.

Perceived social support and quality of life among adolescents in residential youth care: a cross-sectional study

BACKGROUND

Residential youth care (RYC) institutions aim to provide care and stability for vulnerable adolescents with several previous and present challenges, such as disrupted attachments, wide-ranging adverse childhood experiences, mental health problems, and poor quality of life (QoL). To the best of our knowledge, the present study is the first to provide knowledge of the associations between perceived social support and QoL and to explore the potential moderating effect of perceived social support on QoL for adolescents who have experienced maltreatment and polyvictimization.

METHODS

All RYC institutions with adolescents between the ages 12-23 in Norway were asked to participate in the study. A total of 86 institutions housing 601 adolescents accepted the invitation, from which 400 adolescents volunteered to participate. The Child and Adolescent Psychiatric Interview was used to gather information on maltreatment histories and degree of victimization; the Kinder Lebensqualität Fragebogen was used to measure QoL through several domains (overall QoL, physical well-being, emotional well-being, and self-esteem); and the Social Support Questionnaire was used to measure perceived social support. Linear regression and independent samples t-test were used to study the associations between perceived social support and QoL as well as the potential moderating effect of perceived social support in the association between maltreatment history and QoL.

RESULTS

Perceived social support was positively associated with QoL for both girls and boys, with domain-specific findings. A higher number of different types of support persons was associated with overall QoL, emotional well-being, and self-esteem for boys, but only with self-esteem for girls. Individual social support from RYC staff and friends was associated with higher QoL for girls. However, perceived social support did not moderate the association between maltreatment history and reduced QoL for either sex.

CONCLUSIONS

This study emphasizes the importance of maintaining social support networks for adolescents living in RYC, the crucial contribution of RYC staff in facilitating social support, and the potential value of social skills training for these vulnerable adolescents. Furthermore, a wider range of initiatives beyond social support must be carried out to increase QoL among adolescents with major maltreatment and polyvictimization experiences.

Nightmares and flashbacks: The impact of commercial sexual exploitation of children among female adolescents placed in residential care

BACKGROUND

Important unresolved questions remain concerning the specific vulnerabilities and intervention needs of female adolescents who experience commercial sexual exploitation of children (CSEC), when compared to other highly vulnerable female adolescents.

OBJECTIVE

This study aimed to assess differences in the level of post-traumatic symptoms reported by those who experienced CSEC during adolescence and those who did not.

PARTICIPANTS AND SETTING

The study used longitudinal data collected from 125 French-speaking female adolescents who were placed in residential centers between the ages 12 and 17 years.

METHOD

Post-traumatic symptoms were assessed at Time 1 and Time 6, while CSEC involvement was assessed at Times 1-5. One-way ANOVAs were performed to inspect differences in the level of post-traumatic symptoms at Time 6 between the participants who reported CSEC during adolescence (n = 70; 56.0%) and those with no history of CSEC (n = 55; 44.0%). Hierarchical regressions examined the effects of CESC while controlling for age, immigration status, child sexual abuse, and post-traumatic symptoms reported at Time 1.

RESULTS

CSEC during adolescence predicted higher levels of general post-traumatic symptoms, anxious arousal, intrusive experiences, defensive avoidance, and dissociation.

CONCLUSIONS

CSEC experiences intensify the existing vulnerabilities to traumatic sequelae that characterize female adolescents who are placed in residential care.

Refining the COPES to Measure Social Climate in Therapeutic Residential Youth Care

BACKGROUND

Previous studies have shown that social climate in therapeutic residential youth care (TRC) is important to the welfare of residents, staff, and assessing treatment outcomes. The most influential theory on social climate in residential settings is the theory of Moos. The measurement of the concepts and aspects of this theory using the Community Oriented Programs Environment Scale (COPES) has repeatedly been criticized regarding usability, validity, and reliability, especially for TRC.

OBJECTIVE

To improve the usability and psychometric quality of the COPES by shortening and refining the original subscale structure for usage in TRC.

METHODS

Four-hundred adolescents living in Norwegian TRC participated. We supplemented confirmatory factor analysis (CFA) with item response theory (IRT) to evaluate model fit, investigate factor loadings, and shorten scales to improve their psychometric qualities and usability in describing social climate in TRC.

RESULTS

The original subscales were not acceptable as evaluated by the criteria for CFA and IRT. By removing psychometrically weak items, the instrument was shortened to 40 items within the original ten subscales. This short version showed acceptable psychometric qualities based on both CFA and IRT criteria and the instrument retained its content validity. Finally, the original three higher-order dimensions was not supported.

CONCLUSIONS

Compared to the original instrument, the refined 40-item version of the COPES represents a more usable instrument for measuring social climate in TRC. Future studies are needed to confirm the multifaceted refined short version in comparable samples of youth and staff to further investigate predictive value and construct validity.