Association between longitudinal patterns of child maltreatment experiences and adolescent substance use.

BACKGROUND: Although there is a well-established link between child maltreatment and adolescent substance use, it remains unclear if and how longitudinal patterns of maltreatment experiences are associated with substance use in adolescence. OBJECTIVE: The purpose of the study was to examine how distinct patterns of longitudinal maltreatment experiences are associated with adolescent substance use. PARTICIPANTS AND SETTING: The participants were 899 adolescents from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). METHODS: We conducted repeated measures latent class analysis (RMLCA) to identify patterns of physical abuse, sexual abuse, and neglect from birth to age 17 and their relations to tobacco, alcohol, and marijuana use at age 18. RESULTS: RMLCA identified three physical abuse classes (Stable low physical abuse; School age peak physical abuse; Physical abuse primarily in infancy/toddlerhood), two sexual abuse classes (Stable no/low sexual abuse; School age peak sexual abuse), and three neglect classes (High neglect in childhood; Neglect primarily in infancy/toddlerhood; Neglect primarily at school age). Adolescents in the school age peak physical abuse class showed greater alcohol, cigarette, and marijuana use, compared to other physical abuse classes. Similarly, adolescents in the school age peak sexual abuse class showed greater substance use than those in the stable no/low sexual abuse class. Lastly, adolescents in the neglect primarily in infancy/toddlerhood class showed significantly less substance use than those in the other two neglect classes. CONCLUSIONS: Findings highlight the importance of early intervention and ongoing maltreatment prevention.

Polyvictimization, polystrengths, and their contribution to subjective well-being and posttraumatic growth.

OBJECTIVE: The negative biopsychosocial outcomes associated with exposure to victimization are well-known, however, limited research has examined the protective factors that can enhance well-being and growth following polyvictimization from in-person and digital sources. This study examines the contribution of adversities and a range of psychological and social strengths on perceptions of subjective well-being and posttraumatic growth (PTG). METHOD: A sample of 478 individuals aged 12-75 (57.5% female; Mage = 36.44) from a largely rural Appalachian region of the United States completed a survey on victimization experiences, other adversities, psychosocial strengths, subjective well-being, and PTG. RESULTS: Approximately 93.3% of individuals reported at least one digital or in-person victimization, with 82.8% reporting two or more forms of victimization. Hierarchical logistic regression analyses indicated that strengths explained more than three times the variance in subjective well-being and PTG compared to adversities, with both models explaining about half of the variance in these outcomes (49% and 50%, respectively). Psychological endurance, sense of purpose, teacher support, and polystrengths were significantly associated with better well-being and/or PTG. CONCLUSION: Some strengths hold more promise than others for promoting well-being and PTG following polyvictimization. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Exploring strengths, psychological functioning and youth victimization among American Indians and Alaska Natives in four southern states.

BACKGROUND: Identifying factors that support healthy psychological functioning after experiencing violence or other adversities in youth can lead to better prevention and intervention efforts. This is particularly important among communities with disproportionately high rates of adversity resulting from legacies of social and political injustices, such as American Indian and Alaska Native populations. METHODS: Data were pooled from four studies in the southern U.S. to examine a subsample of American Indian/Alaska Native participants (N = 147; mean age 28.54 years, SD = 16.3). Using the resilience portfolio model, we investigate the impact of three categories of psychosocial strengths (regulatory, meaning making, and interpersonal) on psychological functioning (subjective well-being and trauma symptoms), controlling for youth victimization, lifetime adversities, age, and gender. RESULTS: In examining subjective well-being, the full model accounted for 52 % of the variance, with strengths explaining more variance than adversities (45 % vs 6 %). For trauma symptoms, the full model accounted for 28 % of the variance, with strengths and adversities accounting nearly equally for the variance (14 % and 13 %). DISCUSSION: Psychological endurance and sense of purpose showed the most promise for bolstering subjective well-being while poly-strengths (having a diversity of multiple strengths) was most predictive of fewer trauma symptoms. Building psychosocial strengths offers promising strategies for prevention and intervention in Native nations and communities.

Can resilience change over time? Patterns and transitions in resilience among young children involved with the child welfare system.

This study examined transitions in resilience profiles and the role of caregiver risk and protective factors in resilience transition probabilities over 18 months among children involved with the child welfare system, using latent profile analysis and latent transition analysis. The sample included 486 children (48% female, baseline Mage = 3.49). There were three resilience profiles at Time 1 (19.9% low emotional behavioral, 26.1% low cognitive, 54.0% multidomain) and two profiles at Time 2 (18.9% low emotional behavioral, 81.1% multidomain). Caregiver mental health problems were negatively associated with membership in the multidomain resilience group at Time 1. Higher levels of cognitive stimulation were associated with initial and continued membership in the multidomain resilience group. Implications for resilient child development are discussed.

Victimization and abuse among children with disabilities: Age adjusted rates in a US national sample.

BACKGROUND: Research has indicated that children with disabilities are at higher risk for victimization although the literature on this topic is limited. OBJECTIVE: We examined rates of assault, sexual victimization, peer-sibling victimization, property crime, maltreatment, and poly-victimization among youth in the United States with and without disabilities. We examined these rates for three age groups (children ages 0-4 years, ages 5-11 years, and ages 12-17 years). PARTICIPANTS AND SETTING: We use data from the National Survey of Children's Exposure to Violence (NatSCEV), waves I (2008), II (2011), and III (2014). These are cross-sectional nationally representative samples of children and youth ages one month to 17 years (N = 12,634). RESULTS: Considering children of all ages together, children in all disability categories, except for physical disability, were at higher risk for poly-victimization. Victimization exposure overall is higher among older children (except for assault among very young children with developmental or learning disabilities), though the disparity between children with and without disabilities generally narrows as children get older. Age of the child impacted the relationships between disability and victimization. Very young children with physical disabilities were at heightened risk for most types of victimization while children with internalizing disabilities were at heightened risk for assault, property crime, and maltreatment in middle childhood and adolescence. Children with externalizing disabilities were at heightened risk for most types of victimization across all ages while developmental disabilities appeared to be risk factor for very young children and a potentially protective factor at later ages though these varied by type of victimization. CONCLUSION: Victimization risk varied by victimization and disability types. This study demonstrates the importance of controlling for demographic characteristics, especially age of the child in estimating the prevalence of victimization among children with disabilities and establishes the importance of type-specific analyses by victimization type, disability type, and age of the child.

A Qualitative Exploration of Institutional Betrayals in Rural Communities: An Emerging Typology.

To explore individuals' personal narratives of perceived betrayals and injustices committed by institutions, their representatives, or other authority figures and discern in what spheres of life they commonly manifest. 157 adults from largely rural, low-income communities in southern Appalachia participated in semi-structured qualitative interviews that asked them to describe key points in their life experiences, including high points, low points, and turning points. These were reviewed for episodes of institutional betrayals. Interview transcripts were analyzed using a grounded thematic analysis. Participants mentioned numerous instances of betrayals that occurred from interactions with institutions or their representatives. These were grouped into four categories: professional betrayals involving mistreatment from an employer, health care provider, or other authority figure; professional-organizational betrayals where a professional perpetrator was able to get support from a problematic organizational culture; corporate malfeasance involving misdeeds by business entities; and systemic injustices involving the sociopolitical architecture of society. The findings identified a range of institutional betrayal experiences that were unnecessary, unwanted, intentional, and harmful. They could be distinguished by the type of perpetrators and often led to notable harms, including unwanted system involvement and unemployment. Although participants seldom explicitly mentioned the rural setting in their descriptions of institutional betrayal, it is likely that limited options for health care providers, schools, and other institutions exacerbated some harms. Institutional betrayals need to be considered in people's trauma dosage, their cumulative lifetime burden of trauma.

Health-Related Quality of Life among American Indian and Alaska Native People: Exploring Associations with Adversities and Psychosocial Strengths.

Identifying psychosocial strengths that support physical health can lead to better pathways to prevention and intervention. Relying on the resilience portfolio model as a conceptual framework, this study explores strengths in three domains (regulation, meaning making, and interpersonal) to identify promising protective factors to support physical health-related quality of life (P-HRQOL), controlling for prior exposure to adversity, age, and gender. This study uses data from four resilience portfolio model studies collected in the southern United States, combined to increase the number of people who identified as American Indian/Alaska Native. The sample included 147 people (M age = 28.5 years; SD = 16.26), of which 57 percent are female. The surveys collected data on adversities (polyvictimization, other adversities, county poverty), psychosocial strengths (psychological endurance, sense of purpose, religious meaning making, compassion, and community support), and P-HRQOL. The full model accounted for 24 percent of the variance in P-HRQOL, with strengths explaining more than twice as much variance as adversities (13 percent versus 6 percent). A sense of purpose showed the most promise for supporting P-HRQOL. Regarding implications, authors recommend exploring a wider range of protective factors that might improve resilience in Native communities. Several evidence-based pathways to meaning making, such as narrative and mindfulness, may improve health outcomes for Native people.

Early childhood maltreatment and profiles of resilience among child welfare-involved children.

Given the high burden of child maltreatment, there is an urgent need to know more about resilient functioning among those who have experienced maltreatment. The aims of the study were to: 1) identify distinct profiles of resilience across cognitive, emotional, behavioral, and social domains in young children involved in the child welfare system; and 2) examine maltreatment characteristics and family protective factors in relation to the identified resilience profiles. A secondary analysis was conducted using data from the National Survey of Child and Adolescent Well-Being (NSCAW-II). Latent profile analysis was performed on a sample of 827 children aged 3-5 years (46% girls, Mean age = 3.96). Three distinct resilience profiles were identified: 1) low cognitive resilience (24%); 2) low emotional and behavioral resilience (20%); and 3) multidomain resilience (56%). Caregiver cognitive stimulation, no out-of-home placement, higher caregiver education level, older child age, and being a girl were associated with the multidomain resilience profile. The findings provide empirical support for the multifaceted nature of resilience and suggest that practitioners need to help children achieve optimal and balanced development by assessing, identifying, and targeting those domains in which children struggle to obtain competence.

Resilience After Trauma in Kosovo and Southeastern Europe: A Scoping Review.

Most people who experience trauma want to thrive and often find paths to well-being and healthy functioning. This scoping review explores the existing evidence on adversity and resilience in southeastern European countries, focusing on Kosovo. There is a lack of research on trauma and resilience in cultures outside the US and Western Europe. The paper provides a brief cultural and historical overview of this region and the collectivist cultures found there. We draw from a range of interdisciplinary literatures to identify key strengths that have the potential to improve health outcomes for trauma victims in this region. Overall, 42 papers from PsycInfo and PubMed were identified, using keywords such as "resilience" or "health" and "Kosovo," "Balkans," and "Southeastern Europe." Findings from this scoping review show that different cultural values, norms, and societal ecologies impact resilience within these societies. Some strengths, such as social support and sense of purpose, echoed similar research in the US and Western Europe. There was also evidence that factors such as dignity, family solidarity, social activism, and nationwide meaning-making are strengths associated with resilience for these collectivist societies of southeastern Europe. We also consider the implications of the results for other post-conflict societies. Finally, findings from this review call for culturally sensitive strength-based perspectives in promoting health and well-being after the high dosages of trauma common in this region.

"That Was the Happiest Time of My Life": Understanding Childhood Eco-Connections in Appalachian Communities.

The goal of this study was to explore facets of childhood eco-connections, using retrospective qualitative data from adults. One hundred and forty-five adults from predominantly rural and small-town communities in southern Appalachia (71.7% female), average age 36.23 years (SD = 12.08) participated in semi-structured qualitative interviews on key life experiences and the places they grew up. Mentions about place-related childhood memories or interactions were grouped into four themes based on exploratory thematic content analysis: nature nostalgia (positive reminiscences about nature experiences); nature immersion (extensive contact with the natural world during childhood); formative experiences with nature (nature interactions that taught a skill or life lesson); and rhythms of nature (appreciation of seasonal or cyclical patterns). Childhood eco-connections are multifaceted and often emerge from early impactful or intense experiences. Pro-environmentalism messages to youth may benefit from more references to childhood eco-connections.

The Long-Term Effects of Early Childhood Resilience Profiles on School Outcomes among Children in the Child Welfare System.

This study aimed to examine the association between early childhood resilience profiles and later school outcomes (academic achievement and school involvement) among children in the U.S. child welfare system. This study compared 827 children aged 3-5 years in three latent profile groups (poor emotional and behavioral resilience, low cognitive resilience, and multi-domain resilience) to their baseline profiles using data from the National Survey of Child and Adolescent Well-Being (NSCAW-II). At the three-year follow-up, children with low emotional and behavioral resilience profiles and children with the multi-domain resilience profile had significantly higher basic reading skills, reading comprehension, and math reasoning compared to children with low scores on the cognitive resilience profile. Furthermore, children with the multi-domain resilience profile had significantly higher levels of emotional school engagement than did those with the low emotional and behavioral resilience profile and considerably higher levels of behavioral school engagement compared to those with the low cognitive resilience profile. The findings highlight the persistent effects of early resilience into the later childhood years. Moreover, our results suggest the need for early identification of and intervention for children with low cognitive or emotional/behavioral resilience during the preschool years to promote academic success and school engagement during the school-age years.

A dual-factor model of posttraumatic responses: Which is better, high posttraumatic growth or low symptoms?

OBJECTIVE: Experiencing traumatic events may invoke posttraumatic symptoms (PTS) or growth (PTG). Using a dual-factor approach inspired by the dual-factor model of mental health, we explore the intersections of posttraumatic symptoms and growth with 21 strengths and indicators of psychological, physical, and spiritual well-being. METHOD: A survey completed by 1,966 participants who had experienced at least one prior victimization (average age 29.8 [SD = 1.64]; 63.6% female) assessed strengths, outcomes, and victimization. Participants were classified into four posttraumatic groups: Resilient (low symptoms, high growth, 23.9%), Prevailed (high symptoms, high growth, 26.1% of sample), Detached (low symptoms, low growth, 20.3%), and Distressed (high symptoms, low growth, 29.8%). RESULTS: Analyses of covariance (ANCOVAs) controlling for age, gender, and victimization found that posttraumatic group classification was associated with each regulatory, meaning-making, and interpersonal strength, and every well-being measure. The Distressed group scored the lowest and the Resilient group scored the highest on almost all measures. Notably, the Prevailed group scored above the Detached group on most measures, except for health-related quality of life and optimism, suggesting that high growth may be more beneficial than low symptoms when coping with trauma. CONCLUSIONS: Findings suggest that coping after trauma is more complex than merely doing well or doing poorly in response to trauma. Promoting posttraumatic growth may help even highly symptomatic people achieve well-being after trauma. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Profiles of Resilience among Children Exposed to Non-Maltreatment Adverse Childhood Experiences.

Considering the high prevalence and negative consequences of non-maltreatment adverse childhood experiences (NM-ACEs), it is critical to understand their impacts on the resilient functioning of young children. This study sought to examine heterogeneity in resilience among first-grade children who were exposed to NM-ACEs during kindergarten and explore demographic and adversity characteristics that distinguish between resilience profiles. Latent profile analysis (LPA) was conducted on 4929 children drawn from the Early Childhood Longitudinal Study-Kindergarten (ECLS-K). The results of the LPA revealed four distinct resilience profiles: (1) low cognitive and executive functioning (4%); (2) low social and behavioral functioning (14%); (3) low average functioning (31%); and (4) multi-domain resilience (51%). Female children and those in families characterized by older maternal age, higher parental education level, household income above 200% federal poverty level, not receiving welfare benefits, and races other than Black were more likely to be in the multi-domain resilience profile. The findings highlight heterogeneity in resilience among children exposed to NM-ACEs and point to the need for a comprehensive, multi-domain assessment of child functioning to support optimal resilience development in this population.

Next Steps in Untangling the Web of Violence: A Research Agenda.

In this commentary, we outline four key trends in violence and trauma research and describe needed research to advance our ability to understand, prevent, and respond these problems. The trends are the move toward evidence-based policy, the recognition of the importance of trauma dosage, the shift to strengths-based approaches, and increased attention to race, gender, and other personality and community characteristics regarding health disparities and culturally appropriate interventions. For each trend, we have identified needed research areas, taking care to identify low-resource and high-resource studies that can help us reduce the burden of trauma.

Recognizing the cumulative burden of childhood adversities transforms science and practice for trauma and resilience.

The Adverse Childhood Experiences (ACEs) studies transformed our understanding of the true burden of trauma. Notable elements of Felitti and colleagues' findings include the influence of adversity on many physical as well as psychological problems and the persistence of impacts decades after the traumas occurred. In this article, we make the case that the most revolutionary finding was the discovery of a strong dose-response effect, with marked increases in risk observed for individuals who reported four or more adversities. Over the past two decades, our understanding of the cumulative burden of trauma has expanded further, with recognition that experiences outside the family, including peer victimization, community violence, and racism, also contribute to trauma dose. Recent research has provided evidence for the pervasiveness of trauma, which we now realize affects most people, even by the end of adolescence. Extensive scientific evidence has documented that more than 40 biopsychosocial outcomes, including leading causes of adult morbidity and mortality, are associated with adverse childhood experiences, measured by dose. We summarize the state of science and explain how ACEs built a movement for uncovering mechanisms responsible for these relationships. Perhaps unexpectedly, the pervasiveness of trauma also expands our understanding of resilience, which is likewise more common than previously recognized. Emerging research on positive childhood experiences and poly-strengths suggests that individual, family, and community strengths may also contribute to outcomes in a dose-response relationship. We close with an agenda for research, intervention, and policy to reduce the societal burden of adversity and promote resilience. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A Meta-Analytic Review of Interventions That Promote Meaning in Life.

OBJECTIVE: Increasing meaning in life (MiL) among people experiencing disease or adversity may improve coping and resilience. The purpose of this review is to characterize the effects of MiL interventions. DATA SOURCE: A systematic search of PubMed, PsycInfo, and Google Scholar was conducted encompassing the following parameters: meaning in life, purpose in life, or sense of purpose with randomized controlled trials. STUDY INCLUSION & EXCLUSION CRITERIA: Randomized controlled trials (RCTs) of interventions with at least one outcome that measured improvement in MiL and were published in English between January 2000 and January 2020. DATA EXTRACTION & SYNTHESIS: 33 randomized controlled trials (k = 35) were identified. Data were coded by authors and a research assistant for intervention type, control group type, and risk of bias. The random effects model of Review Manager 5.3 was used to produce SMD and evaluate heterogeneity. RESULTS: The effect size for studies with a passive control group was SMD = 0.85 (95% CI 0.54 to 1.17) and for studies with an active control group was SMD = .032 (95% CI 0.09 to 0.55). Mindfulness programs produced the largest effect size (1.57) compared to passive controls, while narrative programs produced the largest effect relative to active controls (0.61). There was considerable heterogeneity in most estimates. CONCLUSION: Several interventions increase MiL, including some that are relatively brief and do not require licensed professionals.

Understanding the Impact of Seeing Gun Violence and Hearing Gunshots in Public Places: Findings From the Youth Firearm Risk and Safety Study.

There is a current public health emphasis on finding strategies for reducing the risks associated with children's gun violence exposure. This article examines the impact of seeing and hearing gun violence on youth of different ages and living in urban and nonurban areas. Participants were 630 youth, aged 2 to 17. Youth, ages 10 to 17, completed a self-report survey, and caregivers of young children, ages 2 to 9, completed the survey as a proxy for that child. Participants resided in Boston, MA; Philadelphia, PA; and rural areas of eastern TN. Participants were recruited through a variety of techniques including pediatric clinics, housing authorities, youth-serving agencies, festivals, word of mouth, and local e-mail lists for classified advertisements. Data were collected between October 2017 and April 2018 and analyzed in 2019. In total, 41% of youth in this study reported ever seeing or hearing gun violence; 32% had such an experience in the past year. Among exposed youth, 50% took protective action to keep themselves safe, and 58% reported being very or extremely afraid, sad, or upset as a result of the indirect gun violence. More youth living in urban compared with nonurban areas took some protective action. Females and younger children had increased odds of experiencing high fear as a result of the violence. Current gun violence prevention has typically targeted adolescents; however, current findings suggest the need to focus on younger children as well, including the distress resulting from indirect exposure to gun violence.

Analyzing Spanish Adolescents Through the Lens of the Resilience Portfolio Model.

Some negative experiences during adolescence can jeopardize psychological adaptation throughout life. Therefore, promoting adolescent resilience is an important goal to prevent symptoms of psychopathology. The Resilience Portfolio Model puts forward a framework to understand how different strengths (classified into three dimensions: regulatory, interpersonal, and meaning-making) can help people adapt and even thrive. Through this lens, the current study examines post-traumatic growth after victimization and other adversities. Participants were 407 Spanish adolescents aged from 14 to 18 (79.6% indicated some exposure to adversity). After testing their psychometric adequacy, different measures of strengths, well-being, victimization, and adversity were included in a survey for analyzing their association with post-traumatic growth. Density (more intensity of strengths), diversity (more variety of strengths), and all strength dimensions discriminated between those who scored high or low in post-traumatic growth. While endurance, meaning-making density, and diversity of strengths predicted higher post-traumatic growth, a higher emotional regulation related to lower post-traumatic growth. The model offers a guide for analyzing and promoting resilience in adolescent populations, and a series of short tools for evaluating a broad set of strengths.

Identifying Women's Strengths for Promoting Resilience After Experiencing Intimate Partner Violence.

Guided by the Resilience Portfolio Model, this study examined strengths associated with well-being and post-traumatic growth (PTG) among women who had experienced intimate partner violence (IPV). Participants were 109 Spanish women who were receiving specialized psychological services for IPV. They completed a survey on multiple indicators of strengths, subjective well-being, and PTG. The results indicated that PTG was positively correlated with well-being and all strengths. Univariate analysis comparing levels of PTG showed significant differences in all factors, except emotional regulation and optimism. Post hoc analyses revealed two patterns, with some strengths distinguishing across all levels of PTG, and others only discriminating the most resilient women (as indicated by PTG) from the rest. Multivariate analyses accounted for 42% of the variance in posttraumatic growth and 52% in well-being. The results suggest ways to promote well-being and resilience among victimized women.

The Association of Different Cyber-Victimization Types With Current Psychological and Health Status in Southern Appalachian Communities.

Research on cyber-victimization has primarily focused on cyberbullying conducted in urban and suburban (metropolitan) settings. We explore a range of cyber-victimizations, including financially motivated offenses and cyberbullying, and their associations with current psychological and health status in a nonmetropolitan sample from southern Appalachia. The forms of cyber-victimization were drawn from focus groups and interviews, and then self-report data on 14 types of cyber-victimization were collected from 478 individuals (57.1% female; age M = 36.44, SD = 16.61). Approximately 3 out of 4 participants (74.7%) reported experiencing at least one cyber-victimization. Cyber-victimization made many participants feel "very upset" (average 55.7%). Many forms of cyber-victimization were associated with elevated trauma symptoms, and lower subjective well-being and health-related quality of life. Cyber-victimization is common in this southern Appalachian community, with financially motivated incidents leading to higher prevalence rates than found in many other studies. In these data, numerous specific types of victimization, including cyber-theft, fraud, and legal-but-intrusive privacy invasions, were associated with worse psychological and physical health. More research is needed on technology-mediated victimization and these types of victimization should be more routinely included in violence assessments.