Saturday, 15 January 2005 - 4:00 PM

This presentation is part of: Suicide in Young Adults

Sexual, Substance Abusing, and Suicidal Behavior of Maltreated Youth: Changes Over 18 Months

This paper examines sexual, substance abusing, and suicidal behaviors of adolescents in the child welfare system and predictors in the transition to and from these three types of risky behaviors over 18 months. Though not all youth who are maltreated engage in risky behaviors, a larger proportion of maltreated than non-maltreated youth engage in risky sexual behavior (Noll, Trickett, & Putman, 2003), are substance abusers (Ireland, Smith, & Thornberry, 2002), and exhibit suicidal behaviors (Brown, Cohen, Johnson, & Smailes, 1999).

Data are from the National Survey of Child and Adolescent Well-Being (NSCAW), the first national probability survey of children assessed following a child maltreatment report. The initial sample frame included all children aged 11 to 15 years at baseline who were reported and investigated as victims of maltreatment (n=1179). Cases with missing data, either due to subject attrition or missing data on any of the variables analyzed, were excluded from all analyses resulting in a final unweighted sample size of 675. (Bias due to missing data was examined. Chi-square and t-test statistics found only one significant difference. Youth with incomplete data were more likely to have been in out-of-home care at baseline than youth with complete data.)

All analyses were conducted with calculated sample weights in SAS using SUDAANŽ to adjust standard errors, account for clustering and stratification in the sampling design, and allow for inferences about risky behaviors in the population of youth investigated as victims of child maltreatment in the U.S. Descriptive analyses and repeated measures regression using generalized estimating equations (GEE) addressed change over time. Separate models were analyzed for males and females for the three types of risky behavior. To maintain adequate sample size, a multi-stage approach was used by running separate models for child-, peer-, and family-level factors before running final models that included only significant variables from each of these blocks along with control variables.

The average age of the final sample was 12.7 years and 58% were female. Racial/ethnic breakdown was 27% African American, 52% White, 15% Hispanic, and 6% Other. The breakdown for most serious type of maltreatment was 33% physical abuse, 14% sexual abuse, 11% neglect-failure to provide, 32% neglect-failure to supervise, and 10% Other maltreatment type. At baseline, 84% of youth remained in the home and 16% were living in out-of-home care.

Maltreated children reported more risky behaviors than youth in the general population over 18 months. Approximately 20% of youth are reporting high levels of risky sexual behavior, 10% are reporting high levels of substance abuse, and 5% of youth are reported high levels of suicidal behavior. Risky behaviors over 18 months vary by child welfare services setting and various child-, peer-, and family-level factors. Indicators of change in risky behavior also vary by gender. Findings can inform policy and practice decisions related to the sexual, substance abusing, and suicidal behaviors of adolescents in the child welfare system and prevention and intervention efforts with specific subpopulations such as girls and youth living in out-of-home care.

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