Conduct Problems As a Pathway From Childhood Adversity to Community Violence Exposure: The Protective Roles of Caregiver Knowledge and Involvement

Exposure to community violence (ECV) poses a prevalent threat to the health and development of adolescents. Research indicates those who have more Adverse Childhood Experiences (ACEs) are at higher risk for ECV, which further exacerbates risk of negative mental and physical health impacts. Additionally, those with more ACEs are more likely to exhibit conduct problems, which has also been linked to risk for ECV. Despite the prevalence and impact of ECV, there is limited longitudinal research on the risk factors that precede this exposure as well as family-level factors that may prevent it. The current study examined conduct problems as a potential mediator between ACEs and future indirect (i.e. witnessing) ECV in adolescents. Additionally, this study included caregiver factors, such as caregiver knowledge about their adolescent, caregiver involvement, and caregiver-adolescent relationship quality as potential protective moderators. Participants included (N = 1137) caregiver-adolescent dyads identified as at-risk for child maltreatment prior to child's age four for inclusion in the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). Conduct problems at age 14 mediated the relationship between ACEs from ages 0-12 and indirect ECV at age 16 (standardized indirect effect = .03, p = .005). Caregiver knowledge moderated the indirect relationship (b = -.40, p = .030), and caregiver involvement moderated the direct relationship between ACEs and indirect ECV (b = -.03, p = .033). Findings expand our knowledge about the longitudinal pathways that increase risk of violence exposure over the course of adolescent development, as well as the protective benefits caregivers can offer to disrupt these pathways and reduce risk of future traumatization. Implications are discussed for interventions that aim to address and prevent trauma and adverse outcomes among youth exposed to child maltreatment, household dysfunction, and community violence.

Everyday Conflict in Families at Risk for Violence Exposure: Examining Unique, Bidirectional Associations with Children's Anxious- and Withdrawn-Depressed Symptoms

Exposure to family conflict during childhood increases risk for the development of anxiety and mood problems, though the potential for bidirectionality in this association remains unknown. It is also unclear whether nonviolent family conflict is related to children's anxious- and withdrawn-depressive symptoms within high-risk family contexts, independent of more severe events such as children's exposure to violent victimization. Participants included 1,281 children and their caregivers identified as being at high risk for family violence, interviewed prospectively at ages 6, 8, and 10 about family conflict, children's anxious- and withdrawn-depressive behaviors, and children's victimization experiences. After controlling for cumulative victimization prior to and between each time point, significant cross-lagged, bidirectional associations were identified between family conflict and children's anxious- and withdrawn-depressive symptoms across ages 6 and 8, but not across ages 8 and 10. Invariance testing revealed no differences in model fit between boys and girls and minimal differences depending on whether families were reported for maltreatment prior to recruitment. Findings are partially supportive of a conceptualization of the family-child relationship that is reciprocal, while highlighting the role of daily negative familial interactions, over and above experiences of victimization, in predicting anxious- and withdrawn-depressed symptoms in early and middle childhood.

Bidirectional associations between family conflict and child behavior problems in families at risk for maltreatment

BACKGROUND

Children's exposure to family conflict is associated with the development of behavior problems. However, it remains unclear whether this association (1) functions bidirectionally and (2) exists independent of more severe forms of violent victimization.

OBJECTIVE

The present study aimed to examine bidirectional and transactional associations between family conflict and children's behavioral problems, controlling for time-varying violent victimization experiences. Invariance testing examined whether these models differed by gender and by maltreatment status prior to initial recruitment.

PARTICIPANTS AND SETTING

Participants were caregiver-child dyads identified prospectively as being at risk for maltreatment and family violence exposure prior to age four (N = 1281; 51.4 % female; 74.6 % persons of color).

METHODS

Caregivers were interviewed prospectively about family conflict, children's aggressive and delinquent behavior, and children's victimization experiences at child ages 6, 8, and 10.

RESULTS

After controlling for prior victimization, significant cross-lagged bidirectional associations were identified between family conflict and child behavior problems. Indirect effects from age 6 to age 10 externalizing problems through age 8 family conflict were not supported. Several bidirectional paths were stronger among boys than girls. Results revealed little evidence for moderation by prerecruitment maltreatment status.

CONCLUSIONS

Findings support a conceptualization of the family-child relationship that is reciprocal in nature and highlight the importance of non-violent, everyday negative family processes. Interventions aiming to improve child behavior problems by targeting severely dysfunctional family processes should also address non-violent, lower-level patterns of negative family interactions, such as everyday instances of blame, criticism, nonacceptance, and favoritism.

Trajectories of adolescent psychopathology among youth who were maltreated and placed in out-of-home care

BACKGROUND

Although researchers have found an increased risk for psychopathology among maltreated adolescents placed in out-of-home care, different trajectories of psychopathology by out-of-home placements have not been previously studied.

OBJECTIVE

The current study is built on previous investigation of youth in different long-term out-of-home placements and examined the trajectories of adolescent psychopathology by out-of-home placement classes.

PARTICIPANTS AND SETTING

We leveraged data from the Southwestern site of the Longitudinal Studies of Child Abuse and Neglect. Participants included caregiver-youth dyads (N = 273), who had substantiated reports of child maltreatment (CM) prior to children's age four and were placed in out-of-home care.

METHODS

Five out-of-home placement classes from ages 4 to 12 (i.e., stable adopted, stable reunified, stable kinship care, stable non-kin foster care, and unstable placement) were identified from previous study and participants were interviewed at youth ages 12, 14, and 16 to assess adolescent psychopathology. Latent Growth Curve Analysis was used to examine trajectories of psychopathology by placement classes.

RESULTS

Adolescents in unstable placement and stable adopted classes had higher intercepts and more positive or less negative slopes for psychopathology compared to those in stable kinship care and stable reunified classes.

CONCLUSIONS

Adolescents in unstable placement and stable adopted classes were at similarly elevated risk for psychopathology, whereas adolescents in stable kinship care and stable reunified classes were at lower risk for psychopathology. We discuss the clinical implication to preventing and intervening risks for psychopathology among maltreated youth in unstable and adopted placements.

Neglect, Abuse, and Adaptive Functioning: Food Security and Housing Stability as Protective Factors for Adolescents

This study addresses gaps in knowledge of protective factors that support adaptive functioning among maltreated adolescents. The sample included 1003 high-risk youths participating in the Longitudinal Studies of Child Abuse and Neglect (53% female, 56% Black, and 82% living in poverty). Adolescent neglect (Exposure to Risky Situations, Lack of Monitoring, Inattention to Basic Needs, Permitting Misbehavior, Lack of Support) and physical, sexual, and emotional abuse were self-reported at age 16. Age 18 adaptive functioning measures included healthcare receipt (medical, dental, and mental health), self-rated global health, high school graduation or enrollment, prosocial activities, peer relationships (Companionship, Conflict, Satisfaction, and Intimacy), and independent living skills. Previous childhood maltreatment, demographics, and earlier prosocial activities and peer relationships were controls. Structural equation modeling showed that adolescent neglect and abuse were associated with lower adaptive functioning. Multigroup models showed protective effects for food security on the relationships between sexual abuse and self-rated health and between Inadequate Monitoring and Companionship. Housing stability buffered relationships between Inadequate Support and high school graduation or enrollment and between Permitting Misbehavior and independent living skills. Findings imply the need for adolescent-focused prevention, including the promotion of food security and housing stability to support adaptive functioning in maltreated adolescents. However, notable mixed findings show the need for additional research.

Development and validation of a postnatal risk score that identifies children with prenatal alcohol exposure

BACKGROUND

This study aimed to develop an efficient and easily calculable risk score that can be used to identify an individual's risk of having been exposed to alcohol prenatally.

METHODS

Data for this study were collected as part of the Collaborative Initiative on Fetal Alcohol Spectrum Disorders, Phases 2 and 3. Two cohorts (ages 5 to 17 years) completed a comprehensive neurobehavioral battery and a standard dysmorphology exam: a development cohort (DC; n = 325) and a comparative cohort (CC; n = 523). Both cohorts included two groups: those with histories of heavy prenatal alcohol exposure (AE-DC, n = 121; AE-CC, n = 177) and a control group that included subjects with minimal or no prenatal alcohol exposure (CON-DC, n = 204; CON-CC, n = 346). Behavioral assessments and physical exam data were combined using regression techniques to derive a risk score indicating the likelihood of prenatal alcohol exposure. Subjects were then divided into two subgroups: (1) low risk and (2) high risk. Chi-square (χ² ) determined classification accuracy and ROC curves were produced to assess the predictive accuracy. Correlations between risk scores and intelligence quotient and executive function scores were calculated.

RESULTS

Subjects were accurately classified in the DC (χ²  = 78.61, p < 0.001) and CC (χ²  = 86.63, p < 0.001). The classification model also performed well in the DC (ROC = 0.835 [SE = 0.024, p < 0.001]) and CC (ROC = 0.786 [SE = 0.021, p < 0.001]). In the AE-CC and CON-CC, there were modest but significant associations between the risk score and executive function (AE-CC: r = -0.20, p = 0.034; CON-CC: r = -0.28, p < 0.001) and intelligence quotient (AE-CC: r = -0.20, p = 0.034; CON-CC: r = -0.28, p < 0.001).

CONCLUSION(S)

The risk score significantly distinguished alcohol-exposed from control subjects and correlated with important cognitive outcomes. It has significant clinical potential and could be easily deployed in clinical settings.

A Systematic Review of the Validity, Reliability, and Clinical Utility of Developmental Trauma Disorder (DTD) Symptom Criteria

Exposure to complex trauma is a prevalent and costly public health concern. Though not yet included in the formal diagnostic systems, developmental trauma disorder (DTD) was proposed to capture the consistent and predictable emotional, behavioral, and neurobiological sequelae observed in children exposed to complex trauma. This systematic review synthesizes and evaluates the existing empirical evidence for DTD as a reliable, valid, distinctive, and clinically useful construct. We identified 21 articles reporting on 17 non-overlapping samples that evaluated DTD symptom criteria using objective, empirical methods (e.g., factor analysis, associations with other diagnostic constructs, associations with trauma exposure type, clinician ratings of utility). Studies were largely supportive of the DTD construct and its clinical utility; however, it will be crucial for this work to be replicated in larger samples, by independent research groups, and with more rigorous methodological and analytic approaches before definitive conclusions can be drawn. Findings from this review, while preliminary, provide a promising empirical foundation for DTD and bring the field closer to improving diagnostic parsimony for children and adolescents affected by complex trauma.

Differences in late adolescent psychopathology among youth with histories of co-occurring abuse and neglect experiences

BACKGROUND

Knowledge about the impacts of child abuse and neglect (CAN) experiences on late adolescent psychopathology has been limited by a failure to consider the frequent co-occurrence of CAN types and potential unique impacts of specific combinations.

OBJECTIVE

Using person-centered analyses, we aimed to identify unobserved groups of youth with similar patterns of lifetime CAN experiences before age 16 and differences in psychopathology symptom counts between groups two years later.

PARTICIPANTS AND SETTING

Participants were 919 adolescent-caregiver dyads (56% female; 56% Black, 7% Latina/o, 13% mixed/other).

METHODS

Prospective, multi-informant data, including child protective services records and caregiver and youth reports were collected, and youth completed a diagnostic interview at age 18.

RESULTS

Latent Class Analyses classified adolescents into four distinct groups based on patterns of physical neglect, supervisory neglect, and physical, sexual, and psychological abuse: "Low-Risk" (37%), "Neglect" (19%), "Abuse" (11%), and "Multi-type CAN" (33%). The Multi-type CAN class had significantly more major depressive, generalized anxiety, and nicotine use symptoms than the Low-Risk class, and more post-traumatic stress, antisocial personality, and illicit substance use symptoms, than Low-Risk and Neglect classes. The Abuse class had significantly more generalized anxiety and attention deficit/hyperactivity symptoms than the Low-Risk class, and more major depressive, antisocial personality, and illicit substance use symptoms, than Low-Risk and Neglect classes. The Neglect class did not have elevated psychopathology symptoms.

CONCLUSION

Findings highlight important differences in the associations between lifetime CAN experience patterns and psychopathology. Researchers should explore mechanisms underlying psychopathology that are impacted by different CAN experience patterns.

Psychometric Analysis of the Dating Anxiety Scale for Adolescents in Samples of Polish and U.S. Young Adults: Examining the Factor Structure, Measurement Invariance, Item Functioning, and Convergent Validity

This study explored whether the Dating Anxiety Scale for Adolescents (DAS-A), which was originally developed in the United States to assess dating anxiety in adolescents, is appropriate for use in samples of young adults from Poland and the United States. The factor structure, measurement invariance across country, gender and relationship status, degree of precision across latent levels of the DAS and the functioning of individual items, and convergent validity were examined in a sample of 309 Polish and 405 U.S. young adults. The confirmatory factor analysis (CFA) supported the original three-factor measurement model of the DAS. Invariance tests revealed factor loadings and item thresholds that differed across subgroups, supporting partial metric and partial scalar invariance. The MIRT analysis showed that all items adequately discriminated participants with low and high anxiety. Dating anxiety latent factor correlations with mental health and interpersonal competence were significant in the expected negative directions. The results call for careful interpretation of research involving the DAS in cultural, gender, and relationship status groups, particularly when the primary goal is to compare mean levels of dating anxiety. Further development of the scale is recommended before it can be used across country, gender, and relationship status groups.

Feasibility and promise of community providers implementing home-based parent-child interaction therapy for families investigated for child abuse: A pilot randomized controlled trial

BACKGROUND

Despite evidence supporting Parent-Child Interaction Therapy's (PCIT) effectiveness for maltreatment prevention, its integration in child welfare services (CWS) has been challenging.

OBJECTIVE

Using a pilot randomized controlled trial design, we evaluated the (1) feasibility of training therapists from CWS providers to implement home-based PCIT (2) feasibility of retaining parent-child dyads at-risk for child abuse in voluntary PCIT services, and (3) promise of PCIT for improving parenting skills.

PARTICIPANTS AND SETTING

Between 2015-2017, 23 therapists from CWS providers and 55 caregiver-child dyads who were determined to be at moderate-to-high risk for physical and/or emotional abuse, remained in the same home, and were referred for voluntary parenting services following a child protective investigation participated.

METHODS

We trained 14 therapists in home-based PCIT and randomly assigned participating dyads to receive PCIT or services as usual (SAU). Dyads completed baseline and post-treatment assessments, including self-reported and observed parenting skills.

RESULTS

All therapists successfully completed the PCIT training; none completed full certification requirements. Of all randomized dyads, 51 % completed at least one treatment session, and the mean number of treatment sessions was 10.83. Caregivers assigned to PCIT used more self-reported (d = .72) and observed (d = .59) positive parenting skills post-treatment than caregivers assigned to SAU. Negative, inconsistent, and punitive parenting strategies and parenting stress did not significantly differ between caregivers assigned to PCIT and SAU.

CONCLUSIONS

Despite several challenges to feasibly implementing PCIT in community-based child welfare settings, even a small dose of PCIT improved positive parenting skills among at-risk parent-child dyads.

Reward-related neural correlates of early life stress in school-aged children

OBJECTIVES

Early life stress likely contributes to dysfunction in neural reward processing systems. However, studies to date have focused almost exclusively on adolescents and adults, measured early life stress retrospectively, and have often failed to control for concurrent levels of stress. The current study examined the contribution of prospectively measured cumulative life stress in preschool-age children on reward-related neural activation and connectivity in school-age children.

METHODS

Children (N = 46) and caregivers reported children's exposure to early life stress between birth and preschool age (mean = 4.8 years, SD = 0.80). At follow-up (mean age = 7.52 years, SD = .78), participants performed a child-friendly monetary incentive delay task during functional magnetic resonance imaging.

RESULTS

Children with higher levels of cumulative early life stress, controlling for concurrent stressful life events, exhibited aberrant patterns of neural activation and connectivity in reward- and emotion-related regions (e.g., prefrontal cortex, temporal pole, culmen), depending on the presence of a potential reward and whether or not the target was hit or missed.

CONCLUSIONS

Findings suggest that stress exposure during early childhood may impact neural reward processing systems earlier in development than has previously been demonstrated. Understanding how early life stress relates to alterations in reward processing could guide earlier, more mechanistic interventions.

Intergenerational Transmission of Abusive Parenting: Role of Prospective Maternal Distress and Family Violence

Parents who were abused as children are at increased risk for perpetuating maladaptive parenting practices, yet the mechanisms underlying this relationship remain unclear. This study prospectively examined maternal distress (a latent variable consisting of depressive symptoms and daily stress) and family violence as potential mediators in the intergenerational transmission of abusive (i.e., psychologically aggressive and physically assaultive) parenting. Participants included (N = 768) mother-child dyads identified as being at-risk for family violence and maltreatment prior to children's age four. More maternal childhood abuse was associated with more distress and increased risk for family violence exposure in adulthood. However, only maternal distress mediated the association between mothers' history of abuse and their use of abusive parenting strategies. This study provides critical information about ecological mechanisms underlying the intergenerational transmission of abusive parenting and suggests the importance of targeting depression and stress management among mothers with abuse histories to curtail the cycle of violence.

Risk for substance use among adolescents at-risk for childhood victimization: The moderating role of ADHD

BACKGROUND

Youth who are victimized by violence are at heightened risk for substance use (SU) during adolescence, a period characterized by elevated impulsivity and risk-taking behavior. This risk may be magnified by attention-deficit/hyperactivity disorder (ADHD).

OBJECTIVE

To examine risk/protective factors for adolescent SU among adolescents at-risk for victimization and whether ADHD moderates these associations.

PARTICIPANTS AND SETTING

Participants were 1058 caregiver-adolescent dyads in the U.S. who participated in the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN).

METHOD

Binary logistic regression analyses were conducted for each SU type. First-order effects of all variables were tested first and for each SU outcome, followed by tests of two-way interactions between ADHD group and each predictor, after controlling for first-order effects.

RESULTS

More externalizing behavior (odds ratio [OR] = 1.38; 95 % confidence interval [CI]:1.12, 1.71) and less parental knowledge (OR = .75; 95 %CI: .60, .95) were associated with greater risk for subsequent tobacco use. Less positive peer affiliation was associated with greater risk for subsequent illicit SU (OR = .59; 95 %CI: .36, .96). More deviant peer affiliation were associated with greater risk for all forms of SU. ADHD moderated the association between deviant peer affiliation and marijuana use [b = .9, p < .05, 95 %CI: .03, 1.77), such that deviant peer affiliation was a significantly stronger predictor of marijuana use among adolescents with ADHD than those without.

CONCLUSIONS

Findings suggest risk and protective factors for SU are largely consistent for adolescents at-risk for victimization with and without ADHD, but at-risk adolescents with ADHD may be more susceptible to deviant peer influences.

Racial/ethnic group differences in parenting attitudes among at-risk emerging adults: The roles of adversity, relationship quality, and caregiver involvement and attitudes

BACKGROUND

Healthy parenting attitudes are foundational for positive parenting and child well-being. However, few studies explore their formation and mediators explaining racial/ethnic group differences.

OBJECTIVE

The present study prospectively examines potential mediators for racial/ethnic group differences in parenting attitudes in a diverse sample of emerging adults (EA).

PARTICIPANTS & SETTING

Participants are EA and their caregivers (N = 891) who participated in the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN).

METHODS

Adverse childhood experiences (ACEs), parenting attitudes, and caregiver-child relationship quality and involvement were assessed. Mediators of racial/ethnic group differences were tested using Structural Equation Modeling with bias-corrected confidence intervals based on 1000 bootstrapped samples.

RESULTS

Black EA had less appropriate developmental expectations and perceptions of family roles, empathy toward children, and rejection of physical punishment, compared to White EA. Latinx EA also had less empathy toward children compared to White EA. Caregivers' parenting attitudes mediated group differences, beyond ACEs and relationship quality and involvement. Significant mediation effects include: appropriate developmental expectations, R² = 0.08, p < .05; rejection of physical punishment, R² = 0.06, p < .05; appropriate family roles, R² = 0.16, p < .05; and empathy toward children, R² = 0.15, p < .05, for Black relative to White EA, as well as, empathy toward children, R² = 0.12, p < .05, for Latinx relative to White EA.

CONCLUSION

Findings highlight the mediating role of intergenerational transmission of parenting attitudes for explaining racial-ethnic differences and supporting positive parenting practices in diverse communities.

Examining the Factor Structure and Measurement Invariance of the Trauma Symptom Checklist for Children in a Diverse Sample of Trauma-Exposed Adolescents

The Trauma Symptom Checklist for Children (TSCC) is a widely used youth assessment of broad, transdiagnostic symptomatology following trauma. However, its factor structure has not been thoroughly tested in diverse samples. Youth (N = 738) exposed to interpersonal violence, including physical and sexual abuse, completed the TSCC. Confirmatory factor analysis was used to test one-, six-, and eight-factor models of the TSCC clinical scales, based on previous literature and the TSCC manual. We examined measurement invariance across boys and girls and Black and non-Black participants, as well as convergent and discriminant validity. An eight-factor structure, consisting of posttraumatic stress, anxiety, depression, anger, overt dissociation, fantasy dissociation, sexual preoccupation, and sexual distress, demonstrated the best fit, with two items removed. Invariance tests supported configural and metric (but not scalar) invariance. This research highlights the need for further testing before differences between gender and racial groups can be accurately compared.

Overcoming racial battle fatigue: The associations between racial microaggressions, coping, and mental health among Chicana/o and Latina/o college students

OBJECTIVES

The current study tested a conditional process model to determine if (a) different problem-focused coping styles mediated the association between racial microaggressions and mental health, and (b) ethnic identity exploration and commitment moderated these associations.

METHOD

Participants were 681 Chicana/o and Latina/o undergraduates matriculating at a public research university in the southwestern United States; 71.7% (n = 488) identified as female and the average age of participants was 20.1 years. Data collected using an online survey were analyzed using structural equation modeling with bootstrapped confidence intervals.

RESULTS

Experiencing more racial microaggressions was associated with students' use of more problem-focused coping styles, as well as poorer mental health. All coping styles partially mediated the association between microaggressions and mental health. However, only reflective coping was associated with more positive mental health; reactive and suppressive coping were associated with poorer mental health. These associations were not moderated by ethnic identity.

CONCLUSIONS

Consistent with the racial battle fatigue framework, experiencing racial microaggressions in college may contribute to diminished mental well-being for Chicana/o and Latina/o students. Using reflective rather than suppressive or reactive coping styles could facilitate psychological well-being following racial microaggressions among Chicana/o and Latina/o college students. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Black and proud: The role of ethnic-racial identity in the development of future expectations among at-risk adolescents

OBJECTIVES

Research examining factors that foster future expectations has been limited, especially among at-risk ethnic minority adolescents. The present study prospectively examined the protective role of ethnic-racial identity (ERI) in the association between adverse childhood experiences (ACEs) and future family, educational, and occupational expectations among at-risk Black and White adolescents.

METHODS

Data were collected from 558 adolescents (73% Black, 27% White) who were at-risk for family violence and participated in the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). Information about ACEs was collected prospectively (CPS records and caregiver reports) between birth and age 12. Adolescents reported their ERI, feelings of affirmation and belonging, to their ethnic-racial groups at age 12 and their future expectations at age 14.

RESULTS

Structural equation models revealed that in general, ACEs were associated with more negative educational expectations, b = -.04, p < .001, and stronger ERI was associated with decreased expectations for occupational difficulties, b = -.36, p < .001. Tests of moderation revealed that for Black, but not White adolescents, stronger ERI was significantly associated with more positive educational expectations, b = .36, p < .001, and that the negative association between ACEs and educational and occupational expectations was mitigated by stronger ERI, b = .15, p < .001.

CONCLUSIONS

Findings underscore the importance of cultivating strong ERI among at-risk Black adolescents as a positive coping strategy to increase their educational and occupational expectations. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Prospective Risk and Protective Factors for Juvenile Arrest Among Youth At Risk for Maltreatment

This study aimed to prospectively identify ecological risk factors for juvenile arrest in a sample of youth at risk for maltreatment. Chi-Squared Automatic Interaction Detector analysis was performed with data from 592 youth from the Longitudinal Studies of Child Abuse and Neglect to identify the optimal combination of age 14 predictors of past-year arrest at age 16. Results extended previous research, which has identified being male, having more conduct disorder symptoms, suspension from school, perceived school importance, witnessing family violence, and having a jailed family member as key risk and protective factors for arrest by identifying important interactions among these risk factors. These interactions differentiate youth at the greatest risk of arrest, which, in this sample, were males with greater than two symptoms of conduct disorder who witnessed family violence. These findings suggest that longitudinal and multi-informant data could inform the refinement of actuarial risk assessments for juvenile arrest.

The role of co-occurring intimate partner violence, alcohol use, drug use, and depressive symptoms on disciplinary practices of mothers involved with child welfare

BACKGROUND

Evidence suggests intimate partner violence (IPV), substance use, and depression adversely affect the disciplinary practices of caregivers involved with child welfare; however, it remains uncertain whether the combined effects of these conditions are syndemic.

OBJECTIVE

The purpose of this study was to examine the (1) associations between IPV, problematic drug use, problematic alcohol use, and depressive symptoms and self-reported disciplinary practices among a sample of mothers with child welfare contact; and (2) effect of co-occurrence of these conditions on child disciplinary practices.

PARTICIPANTS AND SETTING

We used data from the second cohort of the National Survey of Child and Adolescent Well-Being (NSCAW II). The analysis focused on 965 biological mothers with children who were subjects of child abuse/neglect investigations between February 2008 and April 2009 in the United States.

METHOD

We conducted multiple linear regression analyses.

RESULTS

Our findings showed that IPV (B = .28; 95% CI = [.04, .53]) and depressive symptoms (B = .27; 95% CI = [.03, .52]) were independently associated with psychologically aggressive disciplinary practices. Also, IPV was independently associated with physically aggressive disciplinary practices (B = .64; 95% CI = [.18, 1.11]); and IPV (B = .21; 95% CI = [.06, .35]) and depressive symptoms (B = .22; 95% CI = [.07, .37]) were independently associated with neglectful parenting strategies. A significant effect was found for the interaction between problematic drug use and depressive symptoms with physically aggressive practices as the outcome. As the number of conditions caregivers had increased, so did their propensity for self-reporting each of the disciplinary practices (p <  .05).

CONCLUSIONS

The findings highlight the need for using a more holistic/multidisciplinary approach to child maltreatment prevention research, policy, and intervention.

Direct and Indirect Pathways From Adverse Childhood Experiences to High School Dropout Among High-Risk Adolescents

Adverse childhood experiences (ACEs) are associated with an increased risk for school dropout. This study examined pathways from childhood adversity to school dropout through academic, behavioral, emotional, and social pathways. Data were collected prospectively from 728 adolescents and their caregivers who participated in the Longitudinal Studies of Child Abuse and Neglect and from child protective services records. Path analyses revealed a direct association between ACEs and dropout, as well as indirect effects through poor reading achievement and elevated externalizing problems. ACEs were associated with elevated internalizing problems, which were negatively associated with dropout. However, ACEs were not associated with peer influences. Implications of the identified mechanisms in the ACEs and school dropout association for future preventive interventions are discussed.

Depression and Chronic Health Conditions Among Latinos: The Role of Social Networks

The purpose of this study was to examine the "buffering hypothesis" of social network characteristics in the association between chronic conditions and depression among Latinos. Cross-sectional self-report data from the San Diego Prevention Research Center's community survey of Latinos were used (n = 393). Separate multiple logistic regression models tested the role of chronic conditions and social network characteristics in the likelihood of moderate-to-severe depressive symptoms. Having a greater proportion of the network comprised of friends increased the likelihood of depression among those with high cholesterol. Having a greater proportion of women in the social network was directly related to the increased likelihood of depression, regardless of the presence of chronic health conditions. Findings suggest that network characteristics may play a role in the link between chronic conditions and depression among Latinos. Future research should explore strategies targeting the social networks of Latinos to improve health outcomes.

Post-traumatic stress as a pathway to psychopathology among adolescents at high-risk for victimization

OBJECTIVE

Victimization by violence elevates adolescents' risk for developing internalizing and externalizing psychopathology. Recent findings suggest that disruptions in developmental processes associated with post-traumatic stress (PTS) reactions may partially account for the relationship between victimization and the subsequent development of psychopathology during adolescence. The present study tested the temporal sequencing of these associations using multi-informant measurements in a large, diverse sample of adolescents at high-risk for victimization.

METHOD

Data were collected from a multi-site consortium of prospective studies, the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). Information about 833 youth's victimization experiences (i.e., direct, indirect, familial, and non-familial violence), PTS, and affective, anxiety, attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) symptoms were gathered from youth and their caregivers during biannual face-to-face interviews when youth were between the ages of 4 and 14 years, and continuously from official child protective services records.

RESULTS

Structural equation modeling revealed that cumulative victimization contributed to elevations in youth and caregiver reported late childhood and early adolescent psychopathology. While PTS mediated the association between victimization and youth reported ADHD, ODD, CD, major depressive, and generalized anxiety symptoms during adolescence, it only mediated the association between victimization and caregiver reported affective symptoms.

CONCLUSIONS

PTS reactions following childhood victimization partially accounted for escalations in psychopathology during the transition to adolescence. These findings underscore the importance of integrating trauma-informed assessment and intervention approaches with at-risk adolescents. Researchers should determine whether trauma-focused interventions sufficiently ameliorate other psychopathology among victimized adolescents or if additional interventions components are necessary.

Unstable child welfare permanent placements and early adolescent physical and mental health: The roles of adverse childhood experiences and post-traumatic stress

Although researchers have found that child welfare placement disruptions are associated with elevated youth physical and mental health problems, the mechanisms that explain this association have not been previously studied. The present study built on a previous investigation of the physical and behavioral consequences of long-term permanent placement patterns among youth who participated in the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). The current investigation (n=251) aimed to (a) report the early adolescent living situations of youth with different long-term placement patterns, and (b) to delineate the roles of adverse childhood experiences (ACEs) and post-traumatic stress (PTS) reactions in the association between unstable long-term placement patterns and physical and mental health problems during the transition to adolescence. Information about youth's living situations, ACEs, and physical and mental health was gathered prospectively from child protective services records and biannual caregiver and youth interviews when youth were 4-14 years old. The majority of youth remained with the same caregiver during early adolescence, but youth with chronically unstable permanent placement patterns continued to experience instability. Path analyses revealed that ACEs mediated the association between unstable placement patterns and elevated mental, but not physical, health problems during late childhood. Additionally, late childhood PTS mediated the association between unstable placement patterns and subsequent escalations in physical and mental health problems during the transition to adolescence. Findings highlight the importance of long-term permanency planning for youth who enter the child welfare system and emphasize the importance of trauma-focused assessment and intervention for these youth.

Long-Term Placement Trajectories of Children Who Were Maltreated and Entered the Child Welfare System at an Early Age: Consequences for Physical and Behavioral Well-Being

OBJECTIVE

This study aimed to identify children's long-term placement trajectories following early child welfare involvement and the association of these trajectories with subsequent physical and behavioral well-being.

METHOD

Participants were 330 children who entered out-of-home care following a substantiated report of child abuse or neglect during infancy/early childhood and their caregivers. Participants were interviewed at child ages 4 and 12 years to assess children's physical and behavioral well-being and every 2 years in between to determine child placements.

RESULTS

Latent Class Analyses identified four stable placement trajectories (i.e., adopted [32%], kinship care [15%], stable reunified [27%], and stable foster care [9%]), and two unstable trajectories (i.e., disrupted reunified [12%] and unstable foster care [5%]). Logistic regressions revealed that children in the unstable trajectories had significantly poorer physical and behavioral well-being than children in stable trajectories.

CONCLUSIONS AND RELEVANCE

Maltreated children placed in out-of-home care are at risk for long-term placement instability and poorer physical and behavioral well-being.

Developmental transitions in presentations of externalizing problems among boys and girls at risk for child maltreatment

The present study examined the impact of children's maltreatment experiences on the emergence of externalizing problem presentations among children during different developmental periods. The sample included 788 youth and their caregivers who participated in a multisite, prospective study of youth at-risk for maltreatment. Externalizing problems were assessed at ages 4, 8, and 12, and symptoms and diagnoses of attention-deficit/hyperactivity disorder, oppositional defiant disorder, and conduct disorder were assessed at age 14, during interviews with youth and caregivers. Information about maltreatment allegations was coded from official records. Latent transition analysis identified three groups of youth with similar presentations of externalizing problems ("well adjusted," "hyperactive/oppositional," and "aggressive/rule-breaking") and transitions between groups from ages 4, 8, and 12. A "defiant/deceitful" group also emerged at age 12. Girls were generally more likely to present as well adjusted than boys. Children with recent physical abuse allegations had an increased risk for aggressive/rule-breaking presentations during the preschool and preadolescent years, while children with sexual abuse or neglect allegations had lower probabilities of having well-adjusted presentations during middle childhood. These findings indicate that persistently severe aggressive conduct problems, which are related to the most concerning outcomes, can be identified early, particularly among neglected and physically and sexually abused children.

Parenting Mediates Symptoms and Impairment in Children With ADHD-Inattentive Type

The current study investigates potential pathways between inattentive symptom severity, positive and negative parenting practices, and functional impairment (i.e., academic, social, and home impairment) in a sample of children diagnosed with attention-deficit/hyperactivity disorder, Predominantly Inattentive Type (ADHD-I). Participants included 199 children and their parents and teachers enrolled in a randomized clinical trial investigating the efficacy of an integrated psychosocial intervention for children with ADHD-I. Boys constituted slightly more than half the sample; children averaged 8.6 years of age (range = 7-11) and were from varied ethnic/racial backgrounds. As part of the initial screening and assessment procedures, parents and teachers completed questionnaires assessing child behavior and parent/family functioning. Results supported both main effects of symptoms and parenting on impairment, as well as a mediational path between symptoms and impairment via parenting, as observed by parents in the home setting. Specifically, higher severity of inattention was associated with higher rates of homework, social, and home impairment. Negative parenting contributed to homework and home impairment, and positive and negative parenting contributed to social impairment, incrementally above and beyond the impact of inattention symptom severity alone. Negative parenting partially mediated the relationship between inattentive symptom severity and impairment, such that higher rates of inattention were associated with higher rates of negative parenting, which in turn was associated with higher rates of homework, social, and home impairment. Results provide support for underlying mechanisms for associations between symptoms and impairment in children with ADHD-I and identify potential intervention targets to improve impairment experienced by these children.

Additive effects of parent adherence on social and behavioral outcomes of a collaborative school-home behavioral intervention for ADHD

The present study evaluated the impact of the Collaborative Life Skills Program (CLS), a novel school-home psychosocial intervention, on social and behavioral impairments among children with attention and behavior problems. Fifty-seven ethnically/racially diverse children (70 % boys) with attention and/or behavior problems in the second through fifth grades participated in a pilot study. Ten school-based mental health professionals were trained and then implemented the intervention at their respective schools. Children significantly improved from pre- to post-treatment on parent, teacher, and report card ratings of children's social and behavioral functioning. Treatment improvements were consistent for children with and without co-occurring disruptive behavior problems. The impact of the intervention was enhanced when parents used the intervention strategies more regularly, according to both clinicians' and parents' reports. Findings support the emphasis of CLS on coordinating intervention strategies across contexts to facilitate the generalization of treatment-related improvements in social and behavioral functioning.

Changes in Youth's Experiences of Child Maltreatment Across Developmental Periods in the LONGSCAN consortium

OBJECTIVE

The present study applied person-centered data analytic techniques to identify groups of youth with allegations for combinations of maltreatment types during preschool, early and late childhood.

METHOD

Latent Class Analyses were conducted using officially reported child maltreatment data for five types of maltreatment (i.e., failure-to-provide and lack-of-supervision neglect, and physical, sexual and emotional abuse) from 788 youth in a large prospective study during preschool, early, and late childhood.

RESULTS

Three similar classes were identified during preschool and early childhood, characterized by no maltreatment allegations, allegations for neglect and emotional maltreatment, and allegations for all maltreatment types. During late childhood, four classes were identified characterized by no maltreatment allegations, mixed patterns of maltreatment allegations, physical and emotional abuse allegations, and allegations for all maltreatment types. Youth in maltreated classes were more likely to be re-victimized during subsequent developmental periods, often by similar maltreatment combinations. Youth in maltreated classes characterized by physically violent maltreatment types had higher Externalizing and Total behavior problems at each age.

CONCLUSIONS

These findings confirm the vulnerability of maltreated youth to re-victimization, particularly by similar combinations of maltreatment. They also indicate that youth's susceptibilities to specific forms of maltreatment may vary across developmental periods.

Prevention of serious conduct problems in youth with attention deficit/hyperactivity disorder

The purpose of this review is to discuss issues in the prevention of serious conduct problems among children and adolescents with attention deficit/hyperactivity disorder (ADHD). The authors began by reviewing research on the common genetic and environmental etiological factors, developmental trajectories, characteristics and impairments associated with ADHD and comorbid oppositional defiant and conduct disorders. Next, the authors presented empirically based models for intervention with children and adolescents with ADHD that are at risk of developing serious conduct problems and detailed the evidence supporting these models. Researchers have demonstrated the utility of medication and psychosocial intervention approaches to treat youth with these problems, but current evidence appears to support the superiority of multimodal treatments that include both approaches. Future directions for researchers are discussed.

Psychometric properties of a youth self-report measure of neglectful behavior by parents

OBJECTIVE

This study aimed to empirically assess psychometric properties of a multi-dimensional youth self-report measure of neglectful behavior by parents.

METHOD

Data were gathered from 593 12-year-old youth participating in the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) consortium; 272 also had data at age 14. Youth responded to a 25-item measure of their experiences of neglect. Expert raters classified items into 4 factors, followed by confirmatory factor analyses. We evaluated cross group measurement equivalence by gender and longitudinal measurement equivalence from age 12 to age 14. Validity was assessed by the relationships between factor scores and (1) neglect reports to child protective services (CPS), (2) quality of parent-child interactions, and (3) parental monitoring.

RESULTS

A 3-factor model (Physical Needs, Emotional Support, and Parental Monitoring) of neglect was obtained, with equivalence across gender and longitudinally (age 12-14). The pattern of correlations between the factor scores, CPS reports, and measures of the parent-child relationship offered modest to moderate support for convergent validity.

CONCLUSIONS

The findings suggest a promising and relatively brief youth self-report measure of neglect to help advance research in this area.

Factors Related to the Likelihood of Hiring a Health Advocate

This study was designed to explore factors related to the likelihood of hiring a health advocate. Independent variables were selected from the health service use model to capture predisposing, enabling, and illness-level factors. Participants were 889 adults (M age = 50.9 years, SD = 17.9 years, 52% female) recruited from a large cultural park in San Diego, California during the spring and summer of 2008. Participants read a description of a health advocate and completed a brief set of questions on age, gender, confidence in health care, effort maintaining health, self-rated health, and the likelihood of hiring a health advocate. Hierarchical regression analysis revealed that participants age 40-64 , non-Caucasians , participants who exerted more effort maintaining their health , and participants 65 and older who were less satisfied with their social support reported greater likelihood of hiring a health advocate. Findings were similar to those of studies that applied the health service use model to predict use of other health services, such as medical visits. These findings suggest factors that health care organizations offering health advocacy services could consider when targeting potential clients.