Profiles of Childhood Adversity and Associated Psychopathology in Youth Entering Residential Care

Clinical Impact Statement This study found five patterns of childhood adversity in youth entering a residential program. Because these were associated with different clinical outcomes, residential care programs should consider assessing a youth's pattern of childhood adversity during routine admission procedures to inform the youth's treatment. Objective: We explore patterns of childhood adversity (CA) in youth entering residential care. We also examine possible sex differences as well as the association between these patterns and key indicators of clinical functioning, including emotional problems, conduct problems, hyperactivity/inattention, prosocial behavior, peer problems, and trauma symptoms. Method: Data were obtained from archival records of 2,066 youth (M-age = 15.57, SD = 1.57) entering a family style residential program for the first time. The sample composition was: 65% boys, 45.8% White, 26.0% Black or African American, 12.5% Hispanic or Latino, 10.5% Multiracial, and 5.1% Other race. Inclusive latent class analysis was used to identify profiles of CA. Profile membership was used to examine sex differences and predict clinical functioning. Results: Five CA profiles were found: (1) Low Exposure, (2) Familial Dysfunction, (3) Neglect/Emotional Abuse, (4) High Exposure without Sexual Abuse, and (5) High Exposure with Sexual Abuse. Girls were more likely than boys to be in Neglect/Emotional Abuse and High Exposure with Sexual Abuse profiles. Each CA profile was associated with distinct clinical outcomes. Conclusions: This study highlights the importance of considering CA patterns when working with youth entering residential care. CA screening and classification during residential care admissions could better inform interventions for youth and their families and potentially improve the effectiveness of mental health services received. Future research should continue to study the connections between CA profiles and clinical outcomes.

Automated summary

This study examines patterns of childhood adversity in youth entering residential care and explores possible sex differences and their association with clinical functioning indicators. Five patterns of childhood adversity were identified, and each pattern had distinct clinical outcomes. Girls were more likely to experience neglect/emotional abuse or high exposure with sexual abuse. The findings highlight the importance of considering childhood adversity patterns in residential care and suggest that screening and classification could improve interventions for youth and their families.