(PS4-D85) Does the Type of Adverse Experience Affect Mental Health Outcomes in Child Welfare-involved Youth?

Background: As of 2019, there were over 400,000 children involved in the U.S welfare system, with nearly a quarter million youth entering foster care every year (Child Welfare Information Gateway, 2021). These youth are more likely to experience traumatic events, adverse childhood experiences (ACEs), and mental health symptoms compared to youth in the general population. The current study attempts to fill a gap in the literature highlighted by the Surgeon General’s recent advisory regarding the youth mental health crisis, which noted child welfare-involved youth as a special population and emphasized how youth exposure to ACEs can result in many harmful and long-lasting physical and mental health conditions (U.S. Department of Health and Human Services, 2021). Therefore, the present study sought to (a) identify clusters of child welfare involved youth based on their type and level of exposure to ACEs and (b) determine if and how these different ACE-exposed groups differ in mental health outcomes.

Method: Child welfare-involved youth (N=129, 59% female) ages 8-16 and their guardians were enrolled as part of a larger court-lead program. Youth and caregivers completed a battery of measures including demographics, the ACEs questionnaire, and several mental health scales from the Behavioral Assessment System for Children, Third Edition and the Trauma Symptom Checklist for Children.

Results: A K-means cluster analyses was conducted using the ACEs scores in order to identify clusters of youth along two dimensions of ACEs (i.e., household dysfunction and child abuse/neglect). Ultimately, a 3-cluster solution was identified: a low-ACEs cluster (n = 62), a cluster scoring high in household dysfunction (HD; n = 37), and a cluster scoring high in child abuse/neglect (A&N; n = 30). Results of ANOVA tests revealed that youth with a low number of ACEs tend to differ from youth who endorsed a high number of HD ACEs and those who endorsed a high number of A&N ACEs, while the HD and A&N groups did not differ from each other. More specifically, the low ACEs group reported significantly lower mental health symptoms on almost every scale examined with the exception of parent-reported externalizing and internalizing symptoms, where there were no differences between any of the groups. There was only one instance in which the A&N group significantly differed from the HD group, which was on parent-reported adaptive skills scale with the A&N group having significantly worse adaptive skills.


Conclusion: Our results indicated child welfare-involved youth who encounter HD and A&N adverse experiences face similarly high rates of mental health symptomology. This highlights the importance of screening for ACEs beyond abuse and neglect, given the similar rates of mental health concerns despite trauma type. Further, because of this, equal consideration needs to be given when connecting these youth to services to help alleviate the psychological effects of the given adverse events. Future studies should focus on connecting these youth to appropriate services given their unique backgrounds and needs.