Future Directions in Child Maltreatment Research.

Child maltreatment (or child abuse and neglect) is a common area of interest in clinical child psychology. Research has examined the causes and consequences as well as the myriad risk factors and interventions that are effective in supporting child maltreatment victims and families. Child maltreatment is unique, however, from the study of disorders and even other kinds of adversity in that the scientific interest is shared across many disciplines including but not limited to, social welfare, medicine, law, and biology. As a result, the current state of the field although robust, is limited by a lack of shared definitions, common approaches to research and inclusion of widely differing sample types making the results often nonreproducible and of limited generalizability. The goal of the current paper is to provide clinical child and adolescent psychologists a guide to the complexity of child maltreatment research and to suggest possible solutions to navigate the challenges associated with research on child maltreatment. The manuscript provides suggestions that researchers could follow to ensure that mistakes from the past are not repeated and so that clinical psychology can contribute to the field with the most robust research for this significantly important public health issue.

Maneuvering through Life with Positivity: Estimating the Effects of Foster Youth's Appraisal on Coping Styles.

Youth in foster care tend to experience a disproportional number of adverse life experiences and demonstrate high rates of emotional and behavioral difficulties. According to the transactional model of stress and coping, how youth appraise their experiences influences the type of coping strategies they use in response to adversity, and these relations are key components to understanding later adjustment. However, few studies have examined potential effects of appraisal on coping for youth in foster care. Furthermore, it is not well understood if or how such interaction may vary across age. To address this gap, this study examined potential age moderation of contemporaneous primary, threat-based appraisal effects on coping in a large sample of 490 youth in foster care (48% female, ages 8 to 18) using a series of statistical models which were capable of detecting very general forms of effect moderation. Results indicated that primary appraisal positively predicted direct and prosocial coping, and negatively predicted asocial coping. The linear effects of appraisal on coping did not vary based on age of the youth. The findings suggest that primary appraisals of life events for youth in foster care does have a unique influence on certain coping styles, suggesting perhaps new directions for research on youth exposed to multiple adversities. To promote wider use of the non-parametric time-varying effect model in R, the analysis syntax is also included in the appendix.

Academic Functioning of Youth in Foster Care: The Influence of Unique Sources of Social Support.

Youth in foster care often experience more difficulty in school compared to their non-foster care peers. Difficulties exist across domains of academic functioning, including both performance (e.g., low grades) and behavioral health (e.g., high externalizing concerns) in school. One factor that has shown to be associated with positive academic functioning in the general population but remains to be comprehensively examined among youth in foster care is social support. This includes examining specific sources of support for youth in foster care and taking into consideration the context of the frequent placement disruptions many children in foster care experience. This study sought to determine which sources of social support are associated with academic functioning for youth in foster care by examining child-report of social support from parents, teachers, friends, and classmates in relation to school grades and teacher-reported behavioral health outcomes. Information on each source of social support was obtained from the self-report of 257 youth in foster care, and information on placement characteristics were obtained from child welfare casefiles. Teachers provided information on youth's behavioral health in school, and academic grades were obtained from school records. Results suggested that youth reported teacher social support, as compared to parent, friend, or classmate social support, was most influential for both performance and behavioral health in school. Findings highlight the need for additional research on the important role of teachers for promoting academic success amongst youth in foster care, as well as the importance of placement changes in relation to academic functioning.

Child Maltreatment, Trauma, and Physical Health Outcomes: The Role of Abuse Type and Placement Moves on Health Conditions and Service Use for Youth in Foster Care.

OBJECTIVE: The purpose of the study was to investigate the relations between abuse types, non-maltreatment-related trauma, and health service utilization in a sample of youth in foster care with and without chronic medical conditions. METHOD: A total of 213 youth, aged 8-21 years, provided self-report of general trauma and abuse exposure. Medicaid claims for each child were collected from official state databases. RESULTS: Exposure to sexual abuse, neglect, or general trauma but not exposure to physical abuse or psychological abuse increased the rates of medical visits, while only general trauma increased medical hospitalizations. CONCLUSIONS: Trauma types are not equally predictive of health care utilization for youth with chronic health conditions.

Case file coding of child maltreatment: Methods, challenges, and innovations in a longitudinal project of youth in foster care.

State social service agency case files are a common mechanism for obtaining information about a child's maltreatment history, yet these documents are often challenging for researchers to access, and then to process in a manner consistent with the requirements of social science research designs. Specifically, accessing and navigating case files is an extensive undertaking, and a task that many researchers have had to maneuver with little guidance. Even after the files are in hand and the research questions and relevant variables have been clarified, case file information about a child's maltreatment exposure can be idiosyncratic, vague, inconsistent, and incomplete, making coding such information into useful variables for statistical analyses difficult. The Modified Maltreatment Classification System (MMCS) is a popular tool used to guide the process, and though comprehensive, this coding system cannot cover all idiosyncrasies found in case files. It is not clear from the literature how researchers implement this system while accounting for issues outside of the purview of the MMCS or that arise during MMCS use. Finally, a large yet reliable file coding team is essential to the process, however, the literature lacks training guidelines and methods for establishing reliability between coders. In an effort to move the field toward a common approach, the purpose of the present discussion is to detail the process used by one large-scale study of child maltreatment, the Studying Pathways to Adjustment and Resilience in Kids (SPARK) project, a longitudinal study of resilience in youth in foster care. The article addresses each phase of case file coding, from accessing case files, to identifying how to measure constructs of interest, to dealing with exceptions to the coding system, to coding variables reliably, to training large teams of coders and monitoring for fidelity. Implications for a comprehensive and efficient approach to case file coding are discussed.

Longitudinal Assessment of Self-Harm Statements of Youth in Foster Care: Rates, Reporters, and Related Factors.

Self-harm in youth is a risk factor related to mental health and future morbidity, yet, relatively little is known about the rates and course of self-harm in youth residing in foster care. This study examined self-harm talk in foster youth based on caregiver and child report for 135 children between the ages of 8- and 11-years old. Longitudinal data on course of self-harm talk from both youth and caregivers also are provided. Caregivers identified that 24% of youth participants had disclosed a desire to die or to hurt themselves. Youth self-report revealed that 21% of children indicated a desire for self-harm, and rates of self-harm from both reporters decreased over time. While overall rates were similar across reporters, findings show discrepancies between youth self-report and caregiver report within individuals. Also, caregivers for youth in residential facilities were more likely to report youth self-harm talk than caregivers from foster home settings.

Trying to Fit a Square Peg in a Round Hole? Testing the Robustness of Maltreatment Measurement Models for Youth.

Research on maltreatment exposure often demonstrates mixed findings and a potential explanation for this may be the measurement of maltreatment. One approach for addressing measurement concerns, which also accounts for maltreatment's multidimensional nature, is the use of a measurement or latent model. However, there is minimal evidence on the generalizability of this approach across populations of youth. This study examined measurement invariance of a one-factor maltreatment model across two samples of youth exposed to maltreatment using case file data from the SPARK and LONGSCAN datasets (N = 1286). Results showed that only partial metric invariance could be established for the one-factor model between SPARK and LONGSCAN subsamples, and neglect and emotional abuse indicators tended to show low factor loadings. Findings highlight the need to consider how potential differences in documentation and maltreatment rates influence model performance and the need for research on which maltreatment characteristics may best capture youths' experiences.

Let it go, let it go: Stop measuring child maltreatment as a binary yes/no.

Numerous methods are used in the measurement of child maltreatment (CM) exposure. As a science, it is necessary that the field of CM research evaluate its measurement approaches periodically to ensure that the common approaches are the best approaches. A prominent method for measuring CM in research as a predictor variable is to conceptualize CM as a two-level, yes/no binary variable (e.g., 0 = No CM exposure, 1 = CM exposure). While there is no consensus on what method is the best approach for measuring CM, empirical evidence suggests that the binary measurement approach to CM has significant limitations. The current paper sought to progress the field of CM and trauma research forward by reviewing several lines of research demonstrating why the use of a binary yes/no CM measurement approach is problematic. As evidence for why a binary measurement of CM should be halted, this paper reviews research on: why the characteristics or details of CM exposure matter, risk of CM "contamination," and CM's relation with environmental or systemic factors. The ethical and clinical implications of a CM binary measurement approach are also discussed. Several recommendations for the field are provided on how researchers can improve the measurement of CM and ensure accurate and replicable studies are being published.

Youth Reported Perpetrators of Victimization Within a Foster Care Sample.

Maltreatment type, severity, and chronicity are predictors of poor youth outcomes, yet youth reported perpetrators of abuse have gone largely unstudied. Little is known about variation in perpetration across youth characteristics (e.g., age, gender, placement type) and abuse features. This study aims to describe youth reported perpetrators of victimization within a foster care sample. 503 youth in foster care (ages 8-21 years) reported on experiences of physical, sexual, and psychological abuse. Follow up questions assessed abuse frequency and perpetrators. Mann-Whitney U Tests were used to compare central tendency differences in number of perpetrators reported across youth characteristics and victimization features. Biological caregivers were commonly endorsed perpetrators of physical and psychological abuse, though youth also reported high levels of peer victimization. For sexual abuse, non-related adults were commonly reported perpetrators, however, youth reported higher levels of victimization from peers. Older youth and youth residing in residential care reported higher numbers of perpetrators; girls reported more perpetrators of psychological and sexual abuse as compared to boys. Abuse severity, chronicity, and number of perpetrators were positively associated, and number of perpetrators differed across abuse severity levels. Perpetrator count and type may be important features of victimization experiences, particularly for youth in foster care.

Caregiver Report of Children's Exposure to Adverse Life Events: Concordance Between Questionnaire and Interview Approaches.

Assessment practices for measuring adverse life events (ALEs) are often characterized by considerable variability, which is associated with inconsistency and reproducibility issues when conducting research on children with ALE exposure. One aspect of assessment variability for caregiver report of children's ALE history that has received minimal attention is assessment format. To address this issue, the current study evaluated concordance between two main ALE assessment formats: interviews and questionnaires. This involved examining overall endorsement of ALEs and concordance among multiple characteristics of ALE exposure, including type, polyvictimization, frequency, severity, and age of onset. Fifty-eight caregivers (Mage = 33.72; 60% Black; 55% below the federal poverty line) of preschool and school-age children were administered an ALE assessment in both a questionnaire and interview format across two sessions. The sum scores and concordance rates between format responses were compared based on ALE type, polyvictimization, frequency, severity, and age of onset of exposure. Results indicated that most total or sum scores were similar between formats, with the exception of ALE severity scores. However, there was most often low-to-moderate concordance across the 50 types of ALEs examined in the current study, suggesting that a different constellation of events comprised each sum or total score. This was also the case across all characteristics of the ALEs and most notably for the severity of ALE. Based on these findings, the format of assessment may be associated with inconsistent reporting of children's ALE exposure across multiple characteristics of ALE. Researchers may need to utilize multiple types of ALE assessments when relying on caregiver report of a child's ALEs.

The longitudinal association of adverse events and working memory among preschoolers: A random-intercept cross-lag analysis.

OBJECTIVE: Past research examining the relation between adversity and working memory (WM) has found mixed results and has been limited by methodological issues (e.g., cross-sectional studies, limited measurement of adversity). The present study examined how adverse life events may impact WM among preschoolers who live in financially underresourced families and communities longitudinally over the course of 1 year. METHOD: The sample included 325 children (aged 3-5 at baseline), recruited because of their increased risk of exposure to high levels of adversity, and their primary caregivers. Children completed WM tasks and caregivers reported on their child's exposure to adverse events in the past 6 months across three time points, each time point occurring 6 months apart. Associations between adverse life events and WM over time were explored using a random-intercept cross-lagged panel model. RESULTS: No relations between preschoolers' adverse event exposure and WM (B = 0.05-0.75, p = .056-.764) were found across the three time points. CONCLUSION: Results indicated that at the individual level, when controlling for stable covariates, frequency of adverse life event exposure and WM abilities were unrelated to subsequent frequency of adverse event exposure and WM abilities. Findings suggest that WM may continue to develop typically, in the preschool years, despite exposure to adverse life events. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Adversity effects on nonword repetition skills: A proxy measure of language and reading ability.

BACKGROUND: Children exposed to adversity are at increased risk for underachievement in reading; however, how early that risk appears and the mechanisms underlying that risk are unclear. OBJECTIVE: Identify whether individual variation in nonword repetition-a clinical indicator of language and reading ability-can be captured in early childhood (three- to five-years-old) and how various features of adversity exposure (e.g., dosage, severity) are associated with performance. PARTICIPANTS AND SETTING: Community-based sample of children between the ages of three- and five-years-old who were exposed to significant adversity (n = 92) and living in a major Midwestern metropolitan area. METHODS: Participants completed a nonword repetition task, and their parent completed a comprehensive adversity questionnaire to report on the child's cumulative lifetime adversity exposure. RESULTS: Over a third of the participants (34.78 %) did not meet age expectations on the nonword repetition task; however, nonword repetition performance did not significantly associate with the features of the adverse experience (i.e., dosage, severity, frequency, chronicity). CONCLUSIONS: Risk for underachievement in reading appears early in the preschool years for children exposed to adversity; however, the underlying mechanisms remain unclear since the features of the children's adverse experiences did not associate with their performance. Implications for prevention and early identification within the learning context are discussed.

Adversity's Impact on Adults' Self-Report and Physiological Difficulties with Emotion Regulation: Appraisal as a Moderating Mechanism.

Globally, there is a high prevalence of adversity exposure, and there is evidence indicating a linear association between adversity exposure, particularly childhood adversity, and adults' psychological distress. To better understand this association, researchers have examined the role of emotion regulation abilities, which are thought to impact and underlie one's psychological well-being. The present study examined the association between childhood versus adulthood adversity exposure and self-reported difficulties with emotion regulation and physiological indicators of emotion regulation (e.g., resting respiratory sinus arrythmia [RSA], RSA reactivity, and RSA recovery). Further, the study assessed appraisal styles (i.e., patterns of subjective interpretations) across adverse life events as a possible moderator to help explain why some, but not all, exposed to adversity may display emotion regulation difficulties. Participants were 161 adults participating in a larger federally funded project. Results found no direct association between childhood or adulthood adversity exposure and self-reported or physiological indicators of difficulties with emotion regulation. However, adulthood adversity exposure was associated with stronger trauma appraisal styles, and stronger trauma appraisal styles were associated with greater self-reported difficulties with emotion regulation and greater RSA reactivity. Results also showed interactions between greater childhood adversity and stronger trauma appraisal styles for lower resting RSA and greater RSA recovery. The present study demonstrates that emotion regulation is complex, dynamic, and has multiple dimensions and that childhood adversity may impact internal regulatory processes, but only in conjunction with trauma appraisal styles, which are associated with adulthood adversity.

A social network analysis of perpetrators of child maltreatment reported by youth in foster care.

OBJECTIVE: Prior research on child maltreatment has focused on distinct features of maltreatment (type, severity, chronicity) important for youth outcomes, yet perpetrators of child maltreatment reported by youth have gone largely unstudied. The present study examines connections between perpetrators, the total number and type of perpetrators reported, and the frequency at which each type of perpetrator was reported across 24 relationship types to provide a foundation for future research seeking to provide comprehensive measurement of perpetrator profiles. METHODS: Data from 503 youth in foster care (8-21 years old) were collected through the Studying Pathways to Adjustment and Resilience in Kids (SPARK) Project. Youth reported on their history of physical, sexual, and psychological maltreatment. Social Network Analysis (SNA) was used to visualize links between perpetrators within maltreatment type and paired samples t-tests were used to compare differences between network edge weights. RESULTS: Full sample SNA results were highly interconnected and variable across maltreatment types. Biological parents and peers were the most common perpetrators of physical and psychological abuse with peers and non-family adults being most common for sexual abuse. Family and community member groupings were most distinct in the physical and psychological abuse networks whereas in the sexual abuse network, ties between perpetrators were more equidistant. CONCLUSIONS: Differences exist in perpetrator profiles across maltreatment types, adding a layer of complexity to how maltreatment experiences are captured, and variability in profiles might provide insight to differing youth outcomes. Understanding individual youth perpetrator profiles could be used to inform foster care placements and reduce the risk of revictimization.

Adding fuel to the fire? Examining exposure to potentially stressful or traumatic events before and during the COVID-19 pandemic in low-income, Black families.

OBJECTIVE: The COVID-19 pandemic has upended the lives of many individuals. While emerging evidence has begun to document health (e.g., infection) and financial (e.g., job loss) consequences, less is known about the day-to-day experiences of some of the country's most vulnerable populations. The current study sought to address this gap in understanding by examining exposure to potentially stressful or traumatic experiences (PSTEs) and their relation to mental health among predominately low-income, African American/Black individuals. METHOD: Adult caregivers (N = 110) from an ongoing longitudinal research project occurring prior the pandemic completed surveys about their exposure to COVID-19-specific PSTEs during the initial months of the pandemic. Information on participants was combined with pre-COVID-19 PSTE exposure and examined in relation to current mental health functioning (e.g., depression). RESULTS: Findings indicated that participants experienced several different types of COVID-19-specific PSTEs across multiple domains, including home, work, social life, and health and well-being. Results from model testing indicated that COVID-19-specific PSTEs were only associated with worry about COVID-19-specifically. Adulthood PSTEs prior to COVID-19 were also associated with current anxiety symptoms. CONCLUSIONS: Among low-income, African American/Black individuals with a history of exposure to PSTEs, additional PSTEs experienced during the COVID-19 pandemic may not contribute significantly to general mental health functioning above and beyond pre-COVID-19 PSTE exposures. Taken together, research on PSTE exposure from the pandemic should make attempts to account for lifetime PSTE exposure to most accurately evaluate current mental health concerns, especially among marginalized populations. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Methodological inconsistencies confound understanding of language measurement in the child maltreatment population: A systematic review.

BACKGROUND: While researchers have found a link between childhood maltreatment and language difficulties, the underlying mechanisms remain unclear and replication across the literature is inconsistent. OBJECTIVE: To conduct a systematic review examining the methodological inconsistencies related to studies' samples construction, maltreatment measurement, and language outcomes using a language acquisition theory-based approach. METHODS: Using the PRISMA framework, a literature search was conducted across five databases to identify studies that have investigated the effects of maltreatment on the language dimensions of vocabulary and grammar. Data were extracted for participant and maltreatment characteristics. RESULTS: Fifty articles were reviewed. The results revealed: 1) maltreated children performed consistently below peers on grammar but not vocabulary assessments, 2) disproportionate use of vocabulary assessments, 3) considerable variability on participant characteristics and limited multidimensional measurement of maltreatment exposure, and 4) only nine studies analyzed the relationship between a maltreatment dimension (e.g., type, severity) and language. CONCLUSIONS: Based on the results of this review, we propose three calls to action: 1) more language acquisition research in the child maltreatment field, 2) specificity when constructing samples with maltreated children, and 3) comprehensive and multidimensional maltreatment measurement. Implications for education were examined.

Measurement Models of Child Maltreatment and Associations With Suicidal Ideation Endorsement by Youth in Foster Care: A Multiverse Analytic Approach.

Youth suicidal ideation is a prevalent experience, particularly among youth exposed to maltreatment, with a variety of indicators such as youth statements of ideation. To better understand suicidal ideation, and the associations with youth mental health outcomes, a fruitful path may be through the study of the dimensions (e.g., severity, frequency) of maltreatment exposure. While there exists extensive work on methods to best operationalize casefile records of maltreatment, such work has not been undertaken for youth self-reports, which are an important indicator of youth functioning following exposure. To address the lack of clarity of how to best operationalize youth self-reports of maltreatment, a multiverse analytic approach was taken to operationalize severity and frequency in a sample of 471 8- to 17-year-old children in foster care. We examined differences across measurement models and the models' associations with caregiver reports of youth suicidal ideation statements. Results indicate that the operationalizations used to define maltreatment resulted in differing measurement models that further differed in their associations with reports of youth suicidal ideation. This study highlights the importance of how researchers operationalize their data and the role dimensions of maltreatment have in further elucidating differential outcomes for youth exposed to maltreatment.

Perceived social support: Measurement differences in youth residing in the community versus youth residing in foster care.

BACKGROUND: Social support is commonly examined as a protective factor for children with a history of child maltreatment, and it has been measured by self-report via the Social Support Scale for Children (SSSC). Although the SSSC has established adequate reliability and validity in community and clinical samples, its psychometric properties have yet to be assessed in a sample of foster care youth. OBJECTIVE: This study provided a psychometric comparison of the SSSC in youth residing in foster care with youth residing in the community. PARTICIPANTS AND SETTING: Participants were two, comparable samples of 214 youth participants residing in foster care and 163 youth participants from the community between the ages of 8-12 years. METHODS: Community participants were recruited from local middle schools, and an age-matched comparison sample from a larger study on youth in foster care was utilized for comparison. Youth self-reported across measures and provided demographic information. Confirmatory factor analysis was utilized to determine measurement model fit to the data, and invariance testing was conducted to compare measurement models across the samples. RESULTS: Differences between samples in the factor structure and item distribution of the SSSC emerged. Specifically, the community sample provided adequate fit to the original four-factor model (friend, classmate, teacher, parent) of the SSSC, whereas the foster sample required a three-factor model (combined friend and classmate constructs). The newly defined three-factor model provided significant associations with youth behavioral and emotional outcomes. CONCLUSIONS: Youth in foster care may perceive social support across sources differently from youth residing in the community.

Individual and Social Risk and Protective Factors as Predictors of Trajectories of Post-traumatic Stress Symptoms in Adolescents.

The present study elucidates heterogeneity in post-traumatic stress symptoms (PTSS) across adolescence in a sample of youth who have experienced myriad types and combinations of potentially traumatic events (PTEs), including substantiated physical abuse, sexual abuse, neglect and/or at least one other self-reported PTE. A machine learning technique was used to assess a multivariate set of variables (e.g., PTEs, individual risk and protective factors, social risk and protective factors, and racial and ethnic minority status) as predictors of PTSS trajectory group membership. The sample included 498 maltreated (n = 275) and comparison (n = 223) 14-19-year-old female adolescents (M = 15.27, SD = 1.06 at Time 1) assessed annually until age 19. 45.7% of participants were White, 45.3% Black, 0.4% Native American, 0.8% Hispanic, and 7.7% other. Growth mixture modeling identified three distinct trajectories of PTSS: (1) recovery (56%); (2) moderate, chronic (25%); and (3) high, chronic (19%). An elastic net model was used to test predictors of membership in the recovery versus the high, chronic PTSS trajectory groups. Results demonstrated that the recovery trajectory was characterized by the absence of sexual abuse, physical abuse, and other traumas, higher self-esteem, less affective dysregulation, less risky peers, lower levels of parent depression, and being of racial/ethnic minority status. Findings help to characterize individual variation in trajectories of PTSS following PTEs by underscoring the unique trauma responses of racial and ethnic minority youth and offering possible targets of interventions to promote recovery from PTSS.

Strategies for Longitudinal Research with Youth in Foster Care: A Demonstration of Methods, Barriers, and Innovations.

Longitudinal research on youth in foster care is important, but often challenging to accomplish. To assist the field, a thorough description of the development of the SPARK (Studying Pathways to Adjustment and Resilience in Kids) project, a longitudinal research project on the mechanisms of resilience for foster youth and their caregivers, is presented. Authors explain the difficult task for researchers in accessing youth in foster care and suggest strategies for success. Recruitment approaches for foster youth and their families are also provided along with examples of effective techniques. Data collection concerns are discussed, and the authors provide recommendations for researchers to consider when asking youth sensitive questions. Finally, data collection on academic information from teachers and how the SPARK project works with the academic community to gain information on school functioning for youth in the project is described. Suggestions for methodology utilized in future research along with examples of innovative adjustments to typical research procedures are provided as guidance for how research on maltreated youth can be conducted.