Risk and Resilience Factors for Psycho-Behavioral Symptom Trajectories Among Child Welfare-Involved Youth

Background: Youth in the child welfare system have an increased risk of experiencing adverse psycho-behavioral outcomes. However, the role of maltreatment types in shaping the developmental trajectories of internalizing, externalizing, and posttraumatic stress (PTS) symptoms remains unknown. Additionally, the role of protective factors in these trajectories is unclear. Understanding the shape or pattern of the developmental trajectories of these psycho-behavioral symptoms and associated risk and resilience factors has crucial implications for child welfare practice as it guides the design and implementation of effective intervention programs. This study contributes to the current literature by 1) investigating the development trajectories of psycho-behavioral symptoms (i.e., internalizing, externalizing, and PTS) of child welfare-involved adolescents; and 2) examining the effects of the type of maltreatment and promotive factors (e.g., child prosocial skills, caregiver-child relationships, satisfaction with peers, neighborhood safety) on the development of psycho-behavioral symptoms over time.

Methods: Using three waves of data from the National Survey of Child and Adolescent Well-Being (NCSAW-II), latent growth curve modeling (LGCM) was conducted. A total of 357 adolescents aged 11 to 13 at baseline were followed over a three-year period. Internalizing and externalizing symptoms were measured using the Youth Self Report (YSR) at three time points (T1: baseline, T2: 18-month follow-up, and T3: 36-month follow-up). PTS symptoms were assessed using the Trauma Symptoms Checklist for Children (TSCC) PTS scale T1-T3. Child maltreatment was measured at T1 using Child Protective Services records. Child prosocial skills, caregiver-child relationships, satisfaction in peer relationships were all assessed at T1 using the Social Skills Rating System (SSRS), 12-item relatedness scale, and the Loneliness and Social Dissatisfaction Questionnaire, respectively. Caregiver perception of neighborhood safety was also measured at T1 using the Abridged Community Environment Scale. Control variables included child’s sex and race/ethnicity.

Results: The LGCM model yielded good model fit (CFI = .986; RMSEA = .027 [90% CI: .00–.04]; SRMR = .03). Findings indicated that adolescents’ internalizing symptoms decreased over time, whereas externalizing symptoms remained stable over time. PTS symptoms decreased over time in girls, but not boys. Physical abuse predicted higher levels of externalizing behaviors and sexual abuse predicted a slower decrease in PTS symptoms. Greater child prosocial skills and higher quality of caregiver-child relationship were associated with lower initial levels of externalizing symptoms. Additionally, a higher quality caregiver-child relationship and greater satisfaction with peer relationships were associated with lower initial levels of internalizing and PTS symptoms.

Conclusion:  Our findings suggest that the relationship between child maltreatment and trajectories of internalizing, externalizing, and PTS symptoms is complex. When planning treatment, practitioners and clinicians should be mindful that the type of child maltreatment may influence different expressions of psycho-behavioral symptoms. Findings further suggest that intervention strategies should consider interpersonal and social skills to effectively prevent the development of psycho-behavioral symptoms in child welfare-involved youth. Specifically, intervention programs aiming to improve child prosocial skills, parent-child relationships, and peer relationships may be effective in promoting the well-being among high-risk youth.