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Childhood Adversity and Associated Psychosocial Function in Adolescents with Complex Trauma

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Abstract

Background

Childhood adversity is linked to a number of adult health and psychosocial outcomes; however, it is not clear how to best assess and model childhood adversity reported by adolescents with known maltreatment exposure.

Objective

This study sought to identify an empirically-supported measurement model of childhood adversity for adolescents in child protective custody and associations among childhood adversity and adolescent outcomes.

Methods

Self-report survey data assessed childhood adversity and adolescent outcomes, including psychological wellbeing, quality of life, and substance use, in 151 adolescents ages 16–22 in protective custody with a documented maltreatment history.

Results

Findings suggest that, among youth with complex trauma histories, it is important to distinguish among risk related to unexpected tragedy (e.g., natural disaster, parental divorce), family instability (e.g., parental substance abuse or mental health concerns), and family violence (e.g., physical or sexual abuse). Family violence was associated with poorer psychological wellbeing and quality of life, while family instability was associated with cigarette and marijuana use.

Conclusion

Among adolescents with complex trauma histories, childhood adversity assessments reflect multiple domains of adversity, each of which are differentially related to adolescent risks. Properly assessing childhood adversity in adolescents with complex trauma histories may help target interventions for specific risks (e.g., substance use) based on which types of childhood adversity youth have been exposed to.

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Acknowledgements

We thank Kris Flinchum at Hamilton County Job and Family Services for her contribution to this project, and Katie Nause, Vikash Patel, and Antonio Allen for their assistance with data collection as staff members in our lab. We also thank Imani Crosby, Libby Ireson, Sara Post, Shyla Moore, and Swathi Prasad for their contributions as student volunteers. Finally, we thank the foster youth and their caseworkers for participation and facilitating the completion of this study.

Funding

This project was supported in part by the National Center for Advancing Translational Sciences of the National Institutes of Health, under Award Number 5UL1TR001425-02, the CareSource Foundation, the Cincinnati Children’s Hospital Medical Center Research Foundation, and the National Institute of Drug Abuse, under Award Number 1 K01 DA041620-01A1.

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Authors and Affiliations

  1. Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH, 45267, USA

    Sarah J. Beal, Constance A. Mara & Mary V. Greiner

  2. Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, MLC 7039, Cincinnati, OH, 45229-3026, USA

    Sarah J. Beal & Constance A. Mara

  3. Appalachian State University, 287 Rivers Street, Boone, NC, 28608, USA

    Twila Wingrove

  4. Loyola University Chicago, 1032 W Sheridan Rd, Chicago, IL, 60660, USA

    Nathan Lutz

  5. Pennsylvania State University, 209 HHD, University Park, PA, 16802, USA

    Jennie G. Noll

  6. Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA

    Mary V. Greiner

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  1. Sarah J. Beal
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Dr. Beal takes full responsibility for the integrity of the data and data analysis for this study.

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Correspondence to Sarah J. Beal.

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All the authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in this study, which involved human participants, were in accordance with the ethical standards of Cincinnati Children’s Hospital Medical Center (CCHMC) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The institutional review board at CCHMC approved this study.

Informed Consent

For youth under 18 years of age, informed consent to participate in this study was obtained from the legal custodian (Child Protective Services) and all youth provided informed assent to participate. All youth 18 years of age and older provided informed consent to participate in this study.

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Beal, S.J., Wingrove, T., Mara, C.A. et al. Childhood Adversity and Associated Psychosocial Function in Adolescents with Complex Trauma. Child Youth Care Forum 48, 305–322 (2019). https://doi.org/10.1007/s10566-018-9479-5

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