Abstract: Adverse Childhood Experiences Among Youth Aging out of Foster Care: A Latent Class Analysis (Society for Social Work and Research 21st Annual Conference - Ensure Healthy Development for all Youth)

Schedule:

Thursday, January 12, 2017: 3:15 PM

Preservation Hall Studio 7 (New Orleans Marriott)

* noted as presenting author

Rebecca Rebbe, MSW, EdM, Doctoral Student, University of Washington, Seattle, WA

Paula S. Nurius, PhD, Professor, University of Washington, Seattle, WA

Kym R. Ahrens, MD, MPH, Assistant Professor, University of Washington, Seattle, WA

Mark E. Courtney, PhD, Professor, University of Chicago, Chicago, IL

Background and Purpose:

More than 20,000 children age out, or emancipate, from foster care in the United States each year, carrying with them elevated risk of deleterious outcomes transitioning into early adulthood. Adverse childhood experiences (ACEs) research demonstrates that early life exposures to stressors are linked in a dose-response manner with mental and physical health outcomes in both adolescent and adult age periods (Anda et al. 2006; McLaughlin et al. 2010). This study tests for subgroups among youth aging out of foster care by investigating the structure of ACEs as well as the predictive implications of these ACEs profile differences for early adulthood outcomes.

Methods:

These data derive from the Midwest Evaluation of the Adult Functioning of Former Foster Youth (Midwest Study), the largest longitudinal study of youth aging out of foster care, consisting of 732 youth from three Midwestern states (Courtney et al. 2011). A latent class analysis (LCA) was conducted using fifteen indicators of childhood adversity, testing for evidence of distinct subgroups on the basis of differing patterns of ACEs among foster youth. Chi square tests of independence and Tukey’s post hoc test were then used to test the relationship between the classes relative to young adult outcomes.

Results:

The LCA multiple fit statistics indicate that a three-class model best fit the data. These identified classes labeled are distinguished by 1) Complex Adversity (29.32%, mean number of ACEs: 7.92), 2) Environmental Adversity (12.19%; mean number of ACEs: 5.71), and 3) Lower Adversity (58.49%; mean number of ACEs: 2.85). Environmental Adversity youth experienced more community-based adversities such as witnessing another being killed or seriously injured, surviving a life-threating accident, and living through a natural disaster or fire. Differences in young adult outcomes were found amongst the classes for economic precariousness, psychosocial functioning, and risk contexts. Complex Adversity youth reported significantly greater homelessness, depressive symptoms, and alcohol dependence than Lower Adversity youth, and drug dependence, PTSD, and mental health treatment than both other classes. Both Complex Adversity and Environmental Adversity youth reported greater risk contexts (prostitution, criminal conviction), and the Environmental Adversity youth reported higher levels of arrests and gang membership. The results indicate that not only does the accumulation of adversity matter, but so does the composition of the adversity.

Conclusions & Implications:

This is the first study, to our knowledge, to evaluate differential patterns of ACEs in youth aging out of foster care. Results suggest that these youth vary significantly in terms of both level and patterns of stress/adversity exposures, and that these variations are predictive of subsequent economic, psychosocial, and risk context outcomes. We will elaborate implications relative to comprehensive screening for cumulative and patterned maltreatment, household, and environmental ACEs as well as targeted services based on these exposures to improve outcomes for this vulnerable population.