The Moderating Role of School Engagement on the Relationship between Childhood Adversity and Latent Profiles of Mental and Behavioral Health Among Child Welfare-Involved Adolescents

Background: Child welfare-involved youth are at increased risk for mental and behavioral health problems. Research suggests that school engagement is an important protective factor for youth, though there is limited knowledge in examining if school engagement moderates the relationship between adversity and mental and behavioral health needs. There is a need to better understand the role of school engagement on mental and behavioral health problems for youth involved in the child welfare system. The purpose of the current study is to examine whether school engagement buffers the relationship between adversity exposure and latent profiles of mental and behavioral health problems.

Methods: This study used the National Survey on Child and Adolescent Well-Being II collected between 2008 and 2009, which included a nationally representative sample of youth involved in the U.S. child welfare system. We restricted our sample to adolescents ages 11-17 years (n = 1,054, M_age = 13.62 years, SD = 1.86). We conducted latent profile analysis using Mplus to identify the underlying patterns of mental and behavioral health problems (substance use, delinquency, internalizing and externalizing problems, post-traumatic stress symptoms); we used logistic regression to examine whether school engagement (i.e., behavioral, emotional, cognitive/behavioral school engagement) buffered the effect of childhood adversity on subgroup membership, adjusting for covariates.

Results: We identified two latent profiles: “clinical level substance use and borderline externalizing problems” (13.6%) and “non-clinically significant problems” (86.4%). We found that emotional (OR = .82, p = .036) and behavioral (OR = .89, p = .012) school engagement were uniquely associated with subgroup membership above and beyond the effects of childhood adversity, the other forms of school engagement, and covariates. Specifically, higher levels of emotional and behavioral school engagement were associated with lower odds of being in the Clinical Level Substance Use and Borderline Externalizing Symptoms subgroup compared to the Non-Clinically Significant subgroup. Childhood adversity was not significantly associated with subgroup membership, adjusting for school engagement and covariates. We did not find evidence that the association between childhood adversity and subgroup membership varied as a function of any of the three forms of school engagement.

Implications and Conclusions: Our results indicate that the majority of youth were classified into the “non-clinically significant” subgroup. It is important to continue to identify protective and promotive factors that promote resilience and buffer the effects of adversity on mental and behavioral health outcomes for child welfare-involved youth. For example, our results suggest that although school engagement did not buffer the effects of adversity, higher levels of emotional and behavioral school engagement may promote positive mental and behavioral health in this population. Such findings highlight the importance of prevention efforts aimed at increasing school engagement among child welfare-involved youth to reduce their risk of mental and behavioral health problems.