Adverse childhood experiences, parenting, and socioeconomic status: Associations with internalizing and externalizing symptoms in adolescence.

BACKGROUND: Adverse childhood experiences (ACEs), low socioeconomic status (SES), and harsh parenting practices each represent well-established risk factors for mental health problems. However, research supporting these links has often focused on only one of these predictors and psychopathology, and interactions among these variables in association with symptoms are not well understood. OBJECTIVE: The current study utilized a cross-sectional, multi-informant, and multi-method design to investigate the associations of ACEs, SES, parenting, and concurrent internalizing and externalizing problems in adolescents. PARTICIPANTS AND SETTING: Data are from a volunteer sample of 97 adolescents and their caregivers recruited from 2018 to 2021 in a southern U.S. metropolitan area to sample a range of exposure to ACEs. METHODS: Multiple linear regression models were used to assess associations among adolescents' ACEs exposure, SES, observed parenting practices, and symptoms of internalizing and externalizing psychopathology. RESULTS: Lower SES was associated with higher levels of internalizing and externalizing symptoms, while higher ACEs exposure and observed parenting were related to externalizing but not internalizing symptoms. Associations of adolescents' exposure to physical abuse and perceived financial insecurity with externalizing symptoms were moderated by warm and supportive parenting behaviors. Conversely, harsh parenting was linked to increased levels of externalizing symptoms, particularly in the context of low income. CONCLUSIONS: Findings suggest that the presence of multiple risk factors may incur greater vulnerability to externalizing problems, while warm and supportive parenting practices may provide a buffer against externalizing problems for adolescents exposed to physical abuse. Links between ACEs, SES, parenting, and youth adjustment should continue to be explored, highlighting parenting as a potentially important and malleable intervention target.

Predictors of placement disruptions in foster care.

BACKGROUND: Many children who are removed from a dangerous or neglectful home and placed in state custody subsequently experience additional disruptions while in custody, which can compound the effects of ongoing stress and instability. As such, placement stability has been identified as a critical objective and a key indicator of success for children residing in substitutive care. OBJECTIVE: To examine the utility of child protective services data in identifying predictors of placement disruption. PARTICIPANTS AND SETTING: The current study examined data from youth in Tennessee state custody who had been assessed using the Child and Adolescent Needs and Strengths (CANS) assessment within 30-days of their first, out-of-home placement. The sample included 8,853 youth ages 5-19 years old (M = 13.1; SD = 4.0; 44.8 % female). METHODS: Demographics, placement information, and the CANS assessment were collected by the Tennessee Department of Children's Services for all child welfare episodes for children as part of the system's usual standard of care. Bivariate correlation and linear regression models were conducted. RESULTS: Multiple risk indices from the CANS appeared to significantly increase risk of placement disruption, including child internalizing and externalizing symptoms, school difficulties, youth affect dysregulation, and child age. CONCLUSIONS: The current findings suggest that data collected as part of standard practice by child welfare workers such as the CANS is both feasible and has utility for identifying sources of risk for placement disruptions and to inform possible targets of intervention to enhance placement stability.

Installing trauma-informed care through the Tennessee Child Protective Services Academy.

The Child Protective Services (CPS) Academy was designed to equip members of the child-welfare workforce with knowledge that would assist them with addressing trauma in the lives of children and families. In its design, the CPS Academy applied principles of trauma-informed care, integrating evidence-based research, and a variety of clinical strategies into a comprehensive training program. Over a 2-year period, 277 frontline workers completed training through the CPS Academy. Data were collected as part of a quality-improvement effort to gauge participant satisfaction with the training platform. Participants reported that all components of the training were beneficial and relevant to their work in child welfare. Participants also demonstrated statistically significant improvement in trauma knowledge after participation in the CPS Academy (z = -4.73, p < .001), regardless of their level of education or years of experience in child welfare, F(3, 196) = 1.85, p = .14, ηp² = .03, 95% CI [0.00, 0.07]. Therefore, the content and structure of the CPS Academy can be implemented within large organizational systems to train child-welfare and CPS workforces efficiently and effectively. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Evidence-based interventions for adolescents with disruptive behaviors in school-based settings.

Disruptive behaviors in the school setting can threaten the maintenance of optimal learning environments in schools. Challenging behaviors, such as defiance, hostility, and aggression, often define disruptive classroom behaviors. This article presents a clinical review of existing literature on interventions for adolescent disruptive behavior problems in school-based settings and in outpatient mental health settings and makes recommendations around working with adolescents with disruptive behaviors in school-based settings. Many types of interventions are effective; effective implementation is key to good results.