Maltreatment and Mental Health in Older Foster Youth

描述（由申请人提供）：18岁从儿童福利系统中解放出来的青少年必须在没有持续支持保证的情况下突然谈判过渡到独立的成年期。年龄较大的寄养青年的心理健康问题的性质和严重程度具有重要意义，因为患有精神疾病的青少年在成年后更有可能出现负面结果。由于虐待、忽视、遗弃或父母无行为能力的历史，以及与精神病理学发展相关的多种其他家庭和环境条件，在国家监护下的青少年有患精神疾病的风险。本研究涉及对一个大型数据集的二次分析，该数据集来自中西部三个州儿童福利机构的所有17岁或以上的青少年，并且已经在寄养中生活了至少一年。通过结构化诊断访谈（CIDI）评估心理健康，并获得关于他们遭受虐待的经历、儿童福利系统的历史、服务的利用、关系网络和社会支持以及心理社会和适应功能的信息。提出了几点分析。首先，将检查精神健康障碍的性质、患病率和合并症，并根据个人和系统层面的因素（例如，寄养地点的类型）进行变化。其次，潜在类别分析将确定特定的虐待和忽视模式，这些虐待概况将被调查，以确定与特定精神健康障碍的具体对应关系。第三，将调查社会支持和成功的寄养干预是否会缓和虐待与心理健康之间的联系。最后，将分类与回归树分析（CART）应用于个体、虐待和儿童福利因素，以建立一个预测模型，以识别可能出现心理健康问题的青少年。了解与被寄养青年的心理健康问题有关的因素和过程，对于提供有针对性的预防干预措施和治疗服务，帮助他们顺利过渡到独立是必要的。此外，研究这一人群提供了独特的机会来研究创伤和社会心理因素如何与青春期后期的心理健康联系起来。

DESCRIPTION (provided by applicant): Adolescents emancipated from the child welfare system at 18 years of age must negotiate the transition to independent adulthood suddenly and without guarantees of continuing support. The nature and severity of mental health problems among older foster youth has important implications because negative outcomes in adulthood are more likely for adolescents with psychiatric disorders. Adolescents in state custody are at risk for psychiatric disorders due to histories of abuse, neglect, abandonment, or parental incapacity and exposure to multiple other familial and environmental conditions associated with the development of psychopathology, This study involves secondary analysis of a large dataset derived by sampling all youth from three Midwestern state child welfare agencies who were 17 years or older and had been in foster care for at least one year. Mental health was assessed with a structured diagnostic interview (CIDI), and information was obtained on their experience of maltreatment, history in the child welfare system, utilization of services, relationship networks and social support, and psychosocial and adaptive functioning. Several analyses are proposed. First, the nature, prevalence, and comorbidity of mental health disorders will be examined, along with variations according to individual and system-level factors (e.g., type of foster placements). Second, latent class analysis will identify particular patterns of abuse and neglect experienced, and these maltreatment profiles will be investigated for specific correspondences with particular mental health disorders. Third, the possibility that links between maltreatment and mental health are moderated by social support and successful foster care intervention will be investigated. Finally, classification and regression tree analysis (CART) will be used on individual, maltreatment, and child welfare factors to develop a predictive model to identify youth likely to exhibit mental health problems. Knowledge of factors and processes associated with mental health problems among foster youth is necessary for providing targeted preventive interventions and treatment services to help them cope with the transition to independence. Furthermore, studying this population presents unique opportunities to examine how trauma and psychosocial factors are linked to mental health in late adolescence.