Trauma Experiences, Maltreatment-Related Impairments, and Resilience Among Child Welfare Youth in Residential Care

Abstract

The aim of this paper was to provide a description of the trauma experiences, trauma-related sequels, and resilience features of a sample of Canadian youth in residential care facilities, as well as to explore the impact of gender and of the number of different traumas experienced on trauma-related sequels and resilience features. A convenience sample of 53 youth aged 14 to 17 recruited from six child protection residential care units agreed to voluntarily participate in the study. They were administered the Childhood Trauma Questionnaire, the Trauma Symptom Checklist for Children, and the Child and Youth Resilience Measure. Results revealed high rates of abusive and neglectful experiences in the lives of these youth. Most have experienced multiple forms of trauma. Girls were more likely to report sexual abuse and to display clinical levels of sexual concerns, as well as posttraumatic stress and dissociation symptoms. Multiple forms of trauma were related to higher clinical levels of depression, anger, posttraumatic stress, and dissociation, as well as to lower individual, relational, and community resilience features.

This is a preview of subscription content, log in to check access.

References

  1. Ackerman, P., Newton, J., McPherson, W., Jones, J., & Dykman, R. (1998). Prevalence of posttraumatic stress disorder and other psychiatric diagnoses in three groups of abused children (sexual, physical, or both). Child Abuse & Neglect, 22, 759–774.

    Article  CAS  Google Scholar 

  2. Barth, R. P. (1994). Long-term in-home services. In D. J. Besharov (Ed.), When drug addicts have children (pp. 175–194). Washington: Child Welfare League of America.

    Google Scholar 

  3. Bernstein, D. P., & Fink, L. (1998). Childhood trauma questionnaire: A retrospective self-report manual. San Antonio: Psychological Corporation.

    Google Scholar 

  4. Bernstein, D. P., Fink, L., Handelsman, L., Foote, J., Lovejoy, M., Wenzel, et al. (1994). Initial reliability and validity of a new retrospective measure of child abuse and neglect. The American Journal of Psychiatry, 151, 1132–1136.

    PubMed  CAS  Google Scholar 

  5. Bernstein, D. P., Ahluvalia, T., Pogge, D., & Handelsman, L. (2003). Validity of the childhood trauma questionnaire in an adolescent psychiatric population. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 340–348.

    Article  Google Scholar 

  6. Brady, L. K., & Caraway, J. S. (2002). Home away from home: factors associated with current functioning in children living in a residential treatment setting. Child Abuse & Neglect, 26, 1149–1163.

    Article  Google Scholar 

  7. Briere, J. (1996). Trauma symptom checklist for children: Professional manual. Lutz: Psychological Assessment Resources.

    Google Scholar 

  8. Briere, J., & Lanktree, C.B. (1995). The trauma symptom checklist for children (TSCC): Preliminary psychometric characteristics. Unpublished manuscript, Department of Psychiatry, University of Southern California School of Medicine.

  9. Burns, B., Phillips, S., Wagner, H., Barth, R., Kolko, D., Campbell, et al. (2004). Mental health needs and access to mental health services by youths involved with child welfare: A national survey. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 960–970.

    PubMed  Article  Google Scholar 

  10. Cahill, L., Kaminer, R., & Johnson, P. (1999). Developmental, cognitive, and behavioural sequelae of child abuse. Child and Clinics of North America, 8, 827–843.

    CAS  Google Scholar 

  11. Chernoff, R., Combs-Orme, T., Risley-Curtis, C., & Heiser, A. (1994). Assessing the health status of children entering foster care. Pediatrics, 93, 594–601.

    PubMed  CAS  Google Scholar 

  12. Clausen, J. M., Landsverik, J., Ganger, W., Chadwick, D., & Litrownik, A. (1998). Mental health problems of children in foster care. Journal of Child and Family Studies, 7, 283–296.

    Article  Google Scholar 

  13. Cohen, J. A., Deblinger, E., Mannarino, A. P., & Steer, R. A. (2004). A multi-site, randomized controlled trial for sexually abused children with PTSD symptoms. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 393–402.

    PubMed  Article  Google Scholar 

  14. Connor, D. F., Doerfler, L. A., Toscano, P. F., Volungis, A. M., & Steingard, R. (2004). Characteristics of children and adolescents admitted to a residential treatment center. Journal of Child and Family Studies, 13, 497–510.

    Article  Google Scholar 

  15. Cook, A., Spinazzola, J., Ford, J., Lanktree, C., Blaustein, M., Cloitre, M., et al. (2005). Complex trauma in children and adolescents. Psychiatric Annals, 35, 390–398.

    Google Scholar 

  16. Copeland, W., Keeler, G., Angold, A., & Costello, E. (2007). Traumatic events and posttraumatic stress in childhood. Archives of General Psychiatry, 64, 577–584.

    PubMed  Article  Google Scholar 

  17. Curtis, P., & McCullough, C. (1993). The impact of alcohol and other drugs on the child welfare system. Child Welfare, 72, 533–542.

    PubMed  CAS  Google Scholar 

  18. Daigneault, I., Dion, J., Hébert, M., & Collin-Vezina, D. (2010). Adolescent resilience, mindfulness and self-esteem following sexual abuse trauma. Paper presented at the International Society for Traumatic Stress Study 26th annual meeting: Translation, Collaboration and Mutual Learning.

  19. Dimigen, G., Del Priore, C., Butler, S., Evans, S., Ferguson, L., & Swan, M. (1999). Psychiatric disorder among children at time of entering local authority care: Questionnaire survey. British Medical Journal, 319, 675–675.

    PubMed  CAS  Google Scholar 

  20. Drapeau, S., St. Jacques, M., Lepine, R., Begin, G., & Martine, B. (2007). Processes that contribute to resilience among youth in foster care. Journal of Adolescence, 30, 977–999.

    PubMed  Article  Google Scholar 

  21. Dubner, A. E., & Motta, R. W. (1999). Sexually and physically abused foster care children and posttraumatic stress disorder. American Psychological Association, 7, 367–373.

    Google Scholar 

  22. Elliott, D.M., McNeil, D., Cox, J., & Bauman, D. (1995, July). Multivariate impacts of sexual molestation, physical abuse, and neglect in a forensic sample. Paper presented at the 4th International Family Violence Research Conference, Durham, NH.

  23. Everson, M., Smith, J., Hussey, J., English, D., Litrownik, A., Dubowitz, H., et al. (2008). Concordance between adolescent reports of childhood abuse and child protective services determinations in an at-risk sample of young adolescents. Child Maltreatment, 13, 14–26.

    PubMed  Article  Google Scholar 

  24. Garland, A., Landsverk, J., & Lau, A. (2003). Racial/ethnic disparities in mental health service users among children in foster care. Child and Youth Services Review, 25, 491–507.

    Article  Google Scholar 

  25. Gregoire, K. A., & Schultz, D. J. (2001). Substance-abusing child welfare parents: treatment and child placement outcomes. Child Welfare, 80, 433–452.

    PubMed  CAS  Google Scholar 

  26. Griffin, G., Martinovich, Z., Gawron, T., & Lyons, J. (2009). Strengths moderate the impact of trauma on risk behaviors in child welfare. Residential Treatment for Children & Youth, 26, 105–118.

    Article  Google Scholar 

  27. Gurwitch, R. H., Pfefferbaum, B., Montgomery, J. M., Klomp, R. W., & Reissman, D. B. (2007). Building community resilience for children and families. Oklahoma City: Terrorism and Disaster Center at the University of Oklahoma Health Sciences Center.

    Google Scholar 

  28. Halfon, N., Mendonca, A., & Berkowitz, G. (1995). Health status of children in foster care: the experience of the center for the vulnerable child. Archives of Pediatrics & Adolescent Medicine, 149, 386–392.

    CAS  Google Scholar 

  29. Harman, J. S., Childs, G. E., & Kelleher, K. J. (2000). Mental health care utilization and expenditures by children in foster care. Archives of Pediatrics & Adolescent Medicine, 154, 1114–1117.

    CAS  Google Scholar 

  30. James, S., Leslie, L. K., Hurlburt, M. S., Slymen, D. J., Landsverk, J., Davis, I., et al. (2006). Children in out-of-home care: Entry into intensive or restrictive mental health and residential care placements. Journal of Emotional and Behavioral Disorders, 14, 196–208.

    Article  Google Scholar 

  31. Kearney, C., Wechsler, A., Kaur, H., & Lemos-Miller, A. (2010). Posttraumatic stress disorder in maltreated youth: A review of contemporary research and thought. Clinical Child and Family Psychology Review, 13, 46–76.

    PubMed  Article  Google Scholar 

  32. Keller, T., Wetherbee, K., Le Prohn, N., Payne, V., Sim, K., & Lamont, E. (2001). Competences and problem behaviors of children in family foster care: Variations by kinship placement status and race. Children and Youth Services Review, 23, 915–940.

    Article  Google Scholar 

  33. Kerker, B., & Dore, M. (2006). Mental health needs and treatment of foster youth: barriers and opportunities. The American Journal of Orthopsychiatry, 76, 138–147.

    PubMed  Article  Google Scholar 

  34. Kinniburgh, K., Blaustein, M., Spinazzola, J., & van der Kolk, B. (2005). Attachment, self-regulation, and competency: a comprehensive intervention framework for children with complex trauma. Psychiatric Annals, 35, 424–430.

    Google Scholar 

  35. Kolko, D., Hurlburt, M., Zhang, J., Barth, R., Leslie, L., & Burns, B. (2010). Posttraumatic stress symptoms in children and adolescents referred for child welfare investigation: a national sample of in-home and out-of-home care. Child Maltreatment, 15, 48–53.

    PubMed  Article  Google Scholar 

  36. Konenkamp, K., & Ehrle, J. (2002). The well-being of children involved with the child welfare system: A national overview. Washington: Urban Institute.

    Google Scholar 

  37. Landsverk, J. A., Burns, B. J., Stambaugh, L. F., & Rolls Reutz, J. A. (2009). Psychosocial interventions for children and adolescents in foster care: review of research literature. Child Welfare, 88, 49–69.

    PubMed  Google Scholar 

  38. Lehman, P. (1997). The development of posttraumatic stress disorder (PTSD) and a sample of child witnesses to mother assault. Journal of Family Violence, 12, 241–257.

    Article  Google Scholar 

  39. Leona, S., Ragsdale, B., Miller, S., & Spacarelli, S. (2008). Trauma resilience among youth in substitute care demonstrating sexual behavior problems. Child Abuse & Neglect, 32, 67–81.

    Article  Google Scholar 

  40. Leslie, L., Hurlburt, M., Landsverk, J., Barth, J., & Slymen, D. (2004). Outpatient mental health services for children in foster care: a national perspective. Child Abuse & Neglect, 28, 697–712.

    Article  Google Scholar 

  41. McCann, J., James, A., Wilson, S., & Dunn, G. (1996). Prevalence of psychiatric disorders in young people in the care system. British Medical Journal, 313, 1529–1530.

    PubMed  CAS  Google Scholar 

  42. McCloskey, L., & Walker, M. (2000). Posttraumatic stress in children exposed to family violence and single-event trauma. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 108–115.

    PubMed  Article  CAS  Google Scholar 

  43. McGee, R., Wolfe, D., Yuen, S., Wilson, S., & Carnochan, J. (1995). The measurement of maltreatment: a comparison of approaches. Child Abuse & Neglect, 19, 233–249.

    Article  CAS  Google Scholar 

  44. McMillen, J., Zima, B., Scott, L., Auslander, W., Munson, M., Ollie, M., et al. (2005). Prevalence of psychiatric disorders among older youths in the foster care system. Journal of the American Academy of Child and Adolescent Psychiatry, 44, 88–95.

    PubMed  Article  Google Scholar 

  45. Murphy, J., Jellinek, M., Quinn, D., Smith, G., Poitrast, F., & Goshko, M. (1991). Substance abuse and serious child mistreatment: prevalence, risk, and outcome in a court sample. Child Abuse & Neglect, 15, 197–211.

    Article  CAS  Google Scholar 

  46. Paivio, S. C. (2001). Stability of retrospective self-reports of child abuse and neglect before and after therapy of child abuse issues. Child Abuse & Neglect, 25, 1053–1068.

    Article  CAS  Google Scholar 

  47. Pilowsky, D. (1995). Psychopathology among children placed in family foster care. Psychiatric Services, 46, 906–910.

    PubMed  CAS  Google Scholar 

  48. Polnay, L., Glaser, A., & Rao, V. (1996). Better health for children in resident care. Archives of Disease in Childhood, 75, 263–265.

    PubMed  Article  CAS  Google Scholar 

  49. Price, J., & Landsverk, J. (1998). Social information-processing patterns as predictors of social adaptation and behavior problems among maltreated children in foster care. Child Abuse & Neglect, 22(9), 845–858.

    Article  CAS  Google Scholar 

  50. Putnam, F. W. (2003). Ten-year research update review: child sexual abuse. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 269–278.

    PubMed  Article  Google Scholar 

  51. Quinn, K., & Epstein, M. H. (1998). Characteristics of children, youth, and families served by local interagency systems of care. In M. H. Epstein, K. Kutash, & A. Duchnowski (Eds.), Outcomes for children and youth with emotional and behavioural disorders and their families (pp. 81–114). Austin: Pro-Ed.

    Google Scholar 

  52. Racusin, R., Maerlender, A., Sengupta, A., Isquith, P., & Straus, M. (2005). Community psychiatric practice: psychosocial treatment of children in foster care: a review. Community Mental Health Journal, 41, 199–221.

    PubMed  Article  Google Scholar 

  53. Romanelli, L., Hoagwood, K., Kaplan, S., Kemp, S., Hartman, R., Trupin, C., et al. (2009). Best practices for mental health in child welfare: parent support and youth empowerment guidelines. Child Welfare, 88, 189–218.

    PubMed  Google Scholar 

  54. Sadowski, C. M., & Friedrich, W. N. (2000). Psychometric properties of the Trauma Symptom Checklist for Children (TSCC) with psychiatrically hospitalized adolescents. Child Maltreatment, 5, 364–372.

    PubMed  Article  CAS  Google Scholar 

  55. Saunders, B.E., Berliner, L., & Hanson, R.F. (Eds.). (2004). Child physical and sexual abuse: Guidelines for treatment (Revised Report: April 26, 2004). Charleston, SC: National Crime Victims Research and Treatment Center. (http://www.musc.edu/ncvc).

  56. Scher, C. D., Stein, M. D., Asmundson, G. J. G., McCreary, D. R., & Forde, D. R. (2001). The Childhood Trauma Questionnaire in a community sample: Psychometric properties and normative data. Journal of Traumatic Stress, 14, 843–857.

    PubMed  Article  CAS  Google Scholar 

  57. Silver, S. E., Duchnowski, A., Kutash, K., Friedman, R. M., Eisen, M., Prange, M., et al. (1992). A comparison of children with serious emotional disturbances served in residential and school settings. Journal of Child and Family Studies, 1, 43–59.

    Article  Google Scholar 

  58. Simms, M. D., Dubowitz, H., & Szilagyi, M. A. (2000). Health care needs of children in the foster care. Pediatrics, 106, 909–918.

    PubMed  CAS  Google Scholar 

  59. Singer, M. I., Anglin, T. M., Song, L. Y., & Lunghofer, L. (1995). Adolescents’ exposure to violence and associated symptoms of psychological trauma. Journal of the American Medical Association, 273, 477–482.

    PubMed  Article  CAS  Google Scholar 

  60. Smith, D. W., Swenson, C. C., Hanson, R. F., & Saunders, B. E. (1994). The relationship of abuse and disclosure characteristics to Trauma Symptom Checklist for Children scores: A (preliminary) construct validity analysis. Boston: Poster session presented at the second annual colloquium of the American Professional Society on the Abuse of Children.

    Google Scholar 

  61. Spencer, C. S., Shelton, D., & Frank, R. G. (1997). The market for residential and day schools for children with serious emotional disturbance. Journal of Mental Health Administration, 24, 72–81.

    PubMed  CAS  Google Scholar 

  62. Tarren-Sweeney, M. (2008). The mental health of children in out-of-home care. Current Opinion in Psychiatry, 21, 345–349.

    PubMed  Article  Google Scholar 

  63. Taylor, N., & Siegfried, C. (2005). Helping children in the child welfare system heal from trauma: A systems integration approach. Retrieved October 2, 2009, from http://www.nctsnet.org/nctsn_assets/pdfs/promising_practices/A_Systems_Integration_Approach.pdf

  64. Trocmé, N., Fallon, B., MacLaurin, B., Sinha, V., Black, T., Fast, E., et al. (2010). Executive summary in Canadian incidence study of reported child abuse and neglect – 2008: Major findings. Ottawa: Public Health Agency of Canada.

    Google Scholar 

  65. Ungar, M., Liebenberg, L., Boothroyd, R., Kwong, W. M., Lee, T. Y., Leblanc, J., et al. (2008). The study of youth resilience across cultures: lessons from a pilot study of measurement development. Research in Human Development, 5, 166–180.

    Article  Google Scholar 

  66. Walker, J. (2007). Unresolved loss and trauma in parents and the implications in terms of child protection. Journal of Social Work Practice, 21, 77–87.

    Article  Google Scholar 

  67. Whitaker, D., Archer, L., & Hicks, L. (1998). Working in children’s homes: Challenges and complexities. New York, NY: John Wiley & Sons.

    Google Scholar 

  68. Wright, K. D., Asmundson, G. J. G., McCreary, D. R., Scher, C., Hami, S., & Stein, M. (2001). Factorial validity of the Childhood Trauma Questionnaire in men and women. Depression and Anxiety, 13, 179–183.

    PubMed  Article  CAS  Google Scholar 

  69. Xiaoming, L., Xiaoyi, F., Bonita, S., Guoxiang, Z., Xiuyun, L., Junfeng, Z., et al. (2009). Psychometric evaluation of the Trauma Symptoms Checklist for Children (TSCC) amongst those affected by HIV/AIDS in China. AIDS Care, 21, 261–270.

    Article  Google Scholar 

  70. Zahradnik, M., Stewart, S. H., O’Connor, R. M., Stevens, D., Ungar, M., & Wekerle, C. (2010). Resilience moderates the relationship between exposure to violence and posttraumatic reexperiencing in Mi’kmaq youth. International Journal of Mental Health and Addiction, 8, 408–420.

    Article  Google Scholar 

  71. Zima, B., Bussing, R., Freeman, S., Yang, X., Belin, T., & Forness, S. (2000). Behavior problems, academic skill delays and school failure among school-aged children in foster care: Their relationship to placement characteristics. Journal of Child and Family Studies, 9, 87–103.

    Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Delphine Collin-Vézina.

Additional information

Work on this project was supported by grants from the Canadian Foundation of Innovation and from the Centre for Research on Children and Families to Dr. Delphine Collin-Vézina (principal investigator). The authors wish to express their sincere gratitude to the youth who agreed to participate in this study and to share some of the struggles they have faced in their lives, as well as the staff members who committed additional time and energy to contribute to the success of this research project.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Collin-Vézina, D., Coleman, K., Milne, L. et al. Trauma Experiences, Maltreatment-Related Impairments, and Resilience Among Child Welfare Youth in Residential Care. Int J Ment Health Addiction 9, 577–589 (2011). https://doi.org/10.1007/s11469-011-9323-8

Download citation

Keywords

  • Trauma
  • Youth
  • Child welfare
  • Symptoms
  • Resilience