DOI
https://doi.org/10.25772/Z34T-BA95
Author ORCID Identifier
https://orcid.org/0000-0002-7973-3295
Defense Date
2023
Document Type
Dissertation
Degree Name
Doctor of Philosophy
Department
Social Work
First Advisor
Sunny H. Shin, PhD
Second Advisor
Shelby E. McDonald, PhD
Third Advisor
Gary Cuddeback, PhD
Fourth Advisor
Albert Farrell, PhD
Fifth Advisor
Hollee McGinnis, PhD
Abstract
Youth involved in the U.S. child welfare system are at increased risk for exposure to childhood adversity, including child maltreatment, household dysfunction (e.g., parental separation/divorce, substance use, mental illness), community violence, and poverty. In turn, they are also at increased risk for psychological maladjustment, such as internalizing and externalizing symptoms. Prior research has shown that minoritized racial/ethnic youth are disproportionately involved in the child welfare system, and it has been argued that this over-representation is due to higher rates of maltreatment and poverty as well as systemic racism. Despite evidence that minoritized racial/ethnic youth may be at increased risk for exposure to childhood adversity and may have less access to protective factors that promote positive developmental outcomes, there is limited research that has focused on whether there are racial/ethnic differences in the association between childhood adversity and psychological adjustment among child welfare-involved youth. Further, research on longitudinal psychological adjustment outcomes following exposure to childhood adversity has focused on adult outcomes. Few studies have focused on the effects of childhood adversity during childhood and adolescence and have compared different conceptualizations of childhood adversity among child welfare-involved youth. In the current three-paper dissertation, theoretical foundations in developmental psychopathology and models of childhood adversity (i.e., individual risk, cumulative risk, dimensional models) were used to guide comparisons of conceptualizations of childhood adversity and examination of factors that influence the relationship between childhood adversity and psychological adjustment.
The first paper involved systematically reviewing, synthesizing, and evaluating the literature regarding racial/ethnic differences in the association between exposure to childhood adversity and psychological adjustment among child welfare-involved youth. Papers two and three involved secondary analyses of nationally representative, longitudinal data collected across three time points between March 2008 and December 2012. Participants (N = 1,011) included adolescents between the ages of 11-17 years at baseline who had received a child welfare investigation for alleged maltreatment. In paper two, conditional latent growth curve models (LGCMs) were used to establish latent trajectories of psychological adjustment symptoms (i.e., internalizing, externalizing, and post-traumatic stress) over time and to compare conceptualizations of childhood adversity based on their ability to predict the latent growth factors (i.e., intercept, slope). Paper three built on the latent trajectories established in paper two and used moderation analyses to examine supportive relationships with caregivers and peers as potential protective factors that buffer the effects of childhood adversity on psychological adjustment. In both papers two and three, multiple group modeling was used to examine whether there were differences in the associations between childhood adversity and psychological adjustment across racial/ethnic groups.
In the systematic review, I identified 13 studies that meaningfully assessed racial/ethnic differences in the association between childhood adversity and psychological adjustment using either moderation or multiple group analysis. Findings across these studies varied. Some studies found significant racial/ethnic differences, but other studies found no differences. Inconsistencies in findings may be due to differences in study samples and methodologies. In paper two, the LGCM findings showed that on average internalizing, externalizing, and post-traumatic stress symptoms decreased over time among child welfare-involved adolescents; however, there was significant variation in both the overall level and linear rate of change in symptoms. There were no significant differences between the individual and cumulative risk models, and so the more parsimonious cumulative score of childhood adversity was used in subsequent analyses. Comparing between the cumulative score and the dimensional model of adversity and psychopathology (DMAP) approach, the dimensional approach examining threat and deprivation as separate dimensions of adversity demonstrated utility in identifying unique associations. The cumulative score was associated with the intercept factor of internalizing and post-traumatic stress symptoms. Examining dimensions of adversity indicated that deprivation, but not threat, was associated with the intercept factor of post-traumatic stress symptoms. In paper three, the moderation analysis found that supportive relationships with peers moderated the association between the cumulative score and the intercept factor of externalizing symptoms and between deprivation and the intercept factor of externalizing symptoms. Supportive relationships with caregivers were not a significant moderator in any of the models. Finally, no racial/ethnic differences in the associations between childhood adversity and psychological adjustment were found in either paper two or paper three.
This dissertation expands previous research and advances knowledge regarding associations between childhood adversity and psychological adjustment over time within the context of child welfare-involved adolescents. Specifically, this dissertation compared three different approaches to assessing childhood adversity (i.e., individual risk, cumulative risk, DMAP) and examined longitudinal trajectories of psychological adjustment in this population. The findings indicate that the dimensional approach identified distinct associations between childhood adversity and psychological adjustment that the cumulative risk approach masked. Further, supportive relationships with peers, specifically high levels of support, buffered the effects of childhood adversity on externalizing symptoms. The results also highlight the inconsistent results regarding racial/ethnic differences in the association between adversity and psychological adjustment. Future research should explore developmental mechanisms through which unique dimensions of adversity impact psychopathology and continue to identify risk and protective factors, including factors associated with race/ethnicity (e.g., minority stressors), that may influence those processes. Gaining a better understanding of how childhood adversity impacts long-term psychological adjustment for youth involved in the child welfare system can inform interventions and identify ways in which the child welfare system can better prevent adversity and intervene to support youth and their families to promote positive psychological adjustment outcomes.
Rights
© The Author
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
5-7-2023