Psychosocial screening and monitoring for children in foster care: Psychometric properties of the Brief Assessment Checklist in a Dutch population study

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.

Psychosocial well-being of Flemish foster children residing in their foster homes during the COVID-19 lockdown

The measures implemented to contain the COVID-19 pandemic profoundly affected the lives of children and families all around the world, probably affecting children's psychosocial well-being. The negative consequences of lockdowns are presumed to hit even harder on vulnerable groups such as foster children who already struggle with their psychosocial well-being in normal circumstances and who face specific challenges during lockdowns such as: additional help that is no longer available or only offered digitally and physical contact with birth parents that is forbidden. Nevertheless, some scholars point to the positive side of lockdowns (e.g.: relief due to closure of schools). This study aims to asses the psychosocial well-being of Flemish foster children residing in their foster homes during the COVID-19 lockdown and the factors that are associated with the change in their psychosocial well-being. 888 foster parents reported on the psychosocial well-being of just as many foster children through the Brief Assessment Checklist for Children and Adolescents. The COVID-19 lockdown was not associated with a decreased psychosocial well-being of Flemish foster children residing in their foster homes during the lockdown. Foster parents reported a slight improvement in their relationship with their foster child during the lockdown which points to a positive consequence of the lockdown. In addition, this improvement was positively associated with an increased psychosocial well-being during adverse circumstances and should therefore be enhanced. The type and amount of contact with birth parents is significantly associated with foster children's changed psychosocial well-being during the lockdown. Foster parents who reported an increase in alternative contact (e.g., (video)calls and messages) between their foster child and his/her birth parent(s) during the lockdown, also reported an increase in their foster child's psychosocial well-being during that period.

Predictive validity for the clinical diagnosis of a new parent questionnaire, the CABI, compared with CBCL

BACKGROUND

The questionnaires completed by the parents give a first general information on the behavioral problems of the child-adolescent, as a useful orientation to the clinical evaluation. The Child and Adolescent Behavior Inventory (CABI) is a 75-item parent questionnaire, which explores a large number of problem areas. The study of its predictive validity for the clinical diagnosis, in comparison with the Diagnostic and Statistical Manual of Mental Disorders (DSM)-oriented scales of the Child Behavior Checklist (CBCL), can assess whether its use may be advantageous.

MATERIAL AND METHODS

Parents/caregivers of 462 children and adolescents responded to both CABI and CBCL as a preliminary routine investigation. The results were compared with those of diagnoses obtained after the completion of the usual clinical procedure.

RESULTS

Accuracy values (probability of correct classification) resulted high for both instruments and significantly better for CABI anxiety and attention-deficit hyperactivity disorder (ADHD) scales, and for CBCL oppositional defiant disorder (ODD) and conduct disorder (CD) scales; no significant difference was found for depression scales. All the areas under the curve (AUC) of the receiver operating characteristic analysis reached excellent values, suggesting a very good predictive ability of the five scales of the two instruments. The comparison of AUC showed the CABI's anxiety and ADHD scales to give significantly higher values than those of CBCL, indicating that these two scales have a better predictive ability.

CONCLUSION

The study indicates a very good comparative (vs CBCL) and predictive validity of the CABI, suggesting an advantage in the use of this shorter questionnaire, available for free use both for clinical practice and supposedly for screening and epidemiological evaluations.

The Mental Health of Adolescents Residing in Court-Ordered Foster Care: Findings from a Population Survey

The mental health of a representative sample of 230 adolescents residing in foster care in New South Wales, Australia, was estimated in a state-wide epidemiological survey from carer-report responses on the Child Behavior Checklist (CBCL) and the Assessment Checklist for Adolescents (ACA). Rates of CBCL total problems, externalizing and internalizing scores above the borderline range cut-points were 49, 44 and 29% respectively, representing a relative risk of 3.8, 3.7 and 2.7 respectively in comparison to Australian children at large. These rates are 10-14% lower than that previously estimated for pre-adolescent Australian children in foster care. Whereas older age is associated with poorer mental health among pre-adolescent children in foster care, the present study findings suggest that this effect does not extend into adolescence. Around half of adolescents residing in foster care have mental health difficulties requiring referral to treatment services, including attachment- and trauma-related difficulties that are uncommon among clinic-referred children at large.