Maltreated Youth Research Articles

The association between out-of-home placement and offending behavior among maltreated youth: A systematic review

Although children who have been maltreated receive either in-home or out-of-home services in the United States every year, the role of these services in offending behavior remains unclear. Additionally, although maltreated children placed in out-of-home care have different placement experiences (e.g., different types of placements, different numbers of placements), research that summarizes the findings of previous studies and investigates patterns of offending behavior by different placement characteristics is sparse. The present systematic review addressed this gap in existing knowledge by examining the current literature on the association between out-of-home placement and offending behavior among youth with Child Protection Services maltreatment reports. The first research question was: Do maltreated youth placed in out-of-home care demonstrate higher rates of offending behavior as compared to those who received in-home service? The second research question was: For maltreated youth placed in out-of-home care, does offending behavior differ by placement characteristics (i.e., type of placement, number of placements, age at first placement, and neighborhood associated with placement)? Five electronic databases, PsycINFO, PubMed, Criminal Justice Abstracts, Social Work Abstracts, and Social Sciences Citation Index, were searched and a total of 15 articles were included in the current review. The first research question was addressed by eleven studies that compared offending behavior for maltreated youth placed in out-of-home care with those who received in-home care. These studies revealed mixed findings: many studies showed higher rates of offending behavior for maltreated youth placed in foster care compared to those who remained at home, but some studies found no difference between the two groups. The second research question was addressed by ten studies that explored the impact of different placement characteristics on offending behavior of maltreated youth placed in out-of-home care. These studies showed consistent findings; studies showed that more restricted types of care, a higher number of placements, those placed at a later age, and placement with greater ethnic heterogeneity in the neighborhood are each associated with higher rates of offending behavior. Our results suggest that efforts need to be made to place maltreated youth in less restricted care and to reduce the number of placements.

Growth patterns of future orientation among maltreated youth: A prospective examination of the emergence of resilience.

During adolescence, a positive outlook toward the future (i.e., future orientation) can protect youth from the risks conferred by childhood adversity. Research to date, however, has largely considered future orientation as a static attribute. Developmental systems perspectives suggest that future orientation, when considered across time, will exhibit dynamic trajectories with levels changing in response to the varying balance of risks and resources in youths' environments. Investigating the developmental course and consequences of future orientation is particularly germane to maltreated youth who may benefit from programs that target this protective mechanism. The present study tested hypotheses regarding the developmental course of future orientation, including the association of distinct future orientation trajectories with time-varying risk factors and resources, and the association of continuity and change in future orientation trajectories with young adult psychosocial functioning. Hypotheses were investigated with longitudinal (T1 Mage = 12.22, T2 Mage = 13.52, T3 Mage = 14.79, T4 Mage = 18.54), multireporter data from a nationally representative sample of maltreated youth (N = 1,461). Growth mixture modeling (GMM) identified three classes of growth trajectories in future orientation: high-persistent, low start/increasing, and high start/decreasing. Time-variant and -invariant risk factors and resources differentiated youths' future orientation trajectories. Youth in the high-persistent and low start/increasing trajectories were more likely to attain young adulthood developmental milestones-including independent living skills, social capital, employment, and higher weekly income. This study documents how an important component of resilient adaptation emerges and promotes positive outcomes among highly vulnerable youth. (PsycINFO Database Record

A Multilevel Meta-analysis on Academic Achievement Among Maltreated Youth.

Maltreatment can influence normative development and negatively impact emotional, behavioral, and social functioning in youth. As a result, it is not surprising that maltreated youth, as compared to non-maltreated youth, tend to underperform academically. Research on the academic performance of maltreated youth has increased over the last decade and several review papers have been published in this area. While the conclusions of these review articles have been that maltreated youth are at greater risk for academic deficits as compared to their non-maltreated peers, there are several conflicting findings within the literature that make it difficult to determine if or to what extent maltreated youth may demonstrate academic difficulty. Using a multilevel, structural equation model meta-analysis technique, the current study sought to provide a quantitative synthesis of the literature by examining the mean difference between maltreated and non-maltreated youth on measures of academic performance. Moreover, the current study also examined group differences between academic subject and maltreatment type. A total of 72 effect sizes were extracted from 32 studies that met inclusion criteria. Results demonstrated an overall negative, medium effect size, such that maltreated youth tended to perform slightly greater than half a standard deviation below non-maltreated youth on measures of academic performance. Moderation analyses suggest deficits may be greater on measures of general academic performance, as compared to language arts measures. No differences were observed for maltreatment type. These findings highlight the need for increased focus on academic difficulties among maltreated youth.

Alcohol Use and Depressive Symptoms Among a Nationally Representative Sample of Youth Investigated for Maltreatment

The relationships between depressive symptoms and alcohol use among maltreated youth have been well documented. However, the direction of these associations remains unclear. Two prevalent but contrasting perspectives on these associations-the self-medication and impaired-functioning hypotheses-have each received extensive support. The present study aims to test these hypotheses and to reconcile these theoretical and empirical inconsistencies by advancing a third integrative conceptualization, the bidirectional hypothesis, which considers developmental timing in the transactional associations between maltreated youth's depressive symptoms and alcohol use over time. Data were drawn from the National Survey of Child and Adolescent Well-Being II, a longitudinal, nationally representative sample of youth involved with Child Protective Services because they have been maltreated. The current study included data from 657 youth followed over three equidistant time points for 3 years. Youth were aged 11-14 years at the first time point, with 52.7% female and 51.4% White. Autoregressive analyses within a structural equation modeling framework supported the impaired-functioning hypothesis during early adolescence and the self-medication hypothesis during mid- to late adolescence. The data were consistent with the bidirectional hypothesis in which depressive symptoms and alcohol use differentially predicted each other depending on the stage of adolescence. The bidirectional associations between alcohol use and depressive symptoms are influenced by developmental timing. Researchers should consider age when tailoring prevention programs that target maltreated youth. Depressive symptoms should be screened early and frequently to prevent adolescent substance use.

Brain structural covariance network centrality in maltreated youth with PTSD and in maltreated youth resilient to PTSD.

Child maltreatment is a major cause of pediatric posttraumatic stress disorder (PTSD). Previous studies have not investigated potential differences in network architecture in maltreated youth with PTSD and those resilient to PTSD. High-resolution magnetic resonance imaging brain scans at 3 T were completed in maltreated youth with PTSD (n = 31), without PTSD (n = 32), and nonmaltreated controls (n = 57). Structural covariance network architecture was derived from between-subject intraregional correlations in measures of cortical thickness in 148 cortical regions (nodes). Interregional positive partial correlations controlling for demographic variables were assessed, and those correlations that exceeded specified thresholds constituted connections in cortical brain networks. Four measures of network centrality characterized topology, and the importance of cortical regions (nodes) within the network architecture were calculated for each group. Permutation testing and principle component analysis method were employed to calculate between-group differences. Principle component analysis is a methodological improvement to methods used in previous brain structural covariance network studies. Differences in centrality were observed between groups. Larger centrality was found in maltreated youth with PTSD in the right posterior cingulate cortex; smaller centrality was detected in the right inferior frontal cortex compared to youth resilient to PTSD and controls, demonstrating network characteristics unique to pediatric maltreatment-related PTSD. Larger centrality was detected in right frontal pole in maltreated youth resilient to PTSD compared to youth with PTSD and controls, demonstrating structural covariance network differences in youth resilience to PTSD following maltreatment. Smaller centrality was found in the left posterior cingulate cortex and in the right inferior frontal cortex in maltreated youth compared to controls, demonstrating attributes of structural covariance network topology that is unique to experiencing maltreatment. This work is the first to identify cortical thickness-based structural covariance network differences between maltreated youth with and without PTSD. We demonstrated network differences in both networks unique to maltreated youth with PTSD and those resilient to PTSD. The networks identified are important for the successful attainment of age-appropriate social cognition, attention, emotional processing, and inhibitory control. Our findings in maltreated youth with PTSD versus those without PTSD suggest vulnerability mechanisms for developing PTSD.

The educational attainment of maltreated youth involved with the child welfare system: Exploring the intersection of race and gender

Gaps in academic achievement between minority and White students are well documented in the literature. Research demonstrates that systemic inequities related to race are often the source of the achievement gap. Some reports, however, suggest that the achievement gap is not only due to racial differences, but rather the intersection of race and gender. While these reports use an intersectional approach to examine differences in educational attainment within the general population, this approach has not been tested among maltreated youth involved with the child welfare system. Using an intersectional framework, this study investigated whether race and gender alone or the intersection of race and gender predicted the educational attainment of 429 maltreated youth involved with the U.S. child welfare system. Secondary data analysis was conducted using two waves of data from the National Survey of Child and Adolescent Well-Being (NSCAW-I). After holding household poverty, maltreatment type and severity, and caregiver education constant, race and gender alone did not predict the likelihood of youth completing their education. However, when analyzing educational attainment based on the intersection of race and gender, Black males were significantly less likely to complete their education than White males, White females, and Hispanic females. These results highlight the prevalence of educational gaps for Black males who are victims of maltreatment and illustrates the importance of using an intersectional lens in maltreatment research and practice to identify such vulnerabilities.

Are emotions controllable? Maltreated and non-maltreated youth’s implicit beliefs about emotion and aggressive tendencies

Although child maltreatment places youth at substantial risk for difficulties with emotion regulation and aggression, not all maltreated youth show these adverse effects, raising important questions about characteristics that discriminate those who do versus do not evidence long-term negative outcomes. The present investigation examined whether implicit beliefs about emotion moderated the association between maltreatment and aggression. Maltreated (n = 59) and community-matched (n = 66) youth were asked regarding their beliefs about emotion and aggressive behaviors. Beliefs about emotion were more strongly associated with aggression among maltreated youth, particularly physically abused youth. Maltreated youth who believed they had poor ability to control emotion reported significantly higher levels of aggression than comparison youth. However, maltreated youth who believed they had high ability to control emotion did not differ significantly in aggression from that of comparison youth. Findings offer unique insight into a factor that may increase or buffer maltreated youth’s risk for aggression and thus highlight potential directions for interventions to reduce aggressive tendencies.

Trajectories of resting frontal brain activity and psychopathology in female adolescents exposed to child maltreatment.

Resting frontal electroencephalogram (EEG) alpha asymmetry patterns reflecting different affective and motivational tendencies have been proposed as a putative mechanism underlying resilience among maltreated youth. This 2-year prospective study examined whether developmental stability of resting frontal alpha asymmetry moderated the relation between child maltreatment severity and psychopathology in female adolescents (n = 43; ages 12-16) recruited from child protection agencies. Results identified two trajectories of resting frontal asymmetry: 60.5% displayed stable right and 39.5% displayed stable left frontal alpha asymmetry. Although individuals with these alpha asymmetry profiles experienced comparable childhood trauma severity, adolescents with stable left alpha asymmetry and lower levels of trauma were less likely to present symptoms or an episode of posttraumatic stress disorder (PTSD) and depression over 2 years than those with stable right alpha asymmetry and lower levels of trauma. These findings suggest that developmental patterns of resting left frontal brain activity may buffer against psychopathology in maltreated female youth.

The cortisol awakening response and anterior cingulate cortex function in maltreated depressed versus non-maltreated depressed youth

Symptomatology of depression among children who have (vs. have not) experienced maltreatment is greater in severity, more resistant to conventional treatment, and associated with elevated risk for suicide. Recent evidence implicates perturbations in stress regulatory systems and heightened negative self-appraisals as factors that increase the severity of psychopathology experienced by depressed maltreated (vs. non-maltreated) youth. Likely explanatory mechanisms for these differences are disturbances in the function of the hypothalamic-pituitary axis (HPA) and persistent negative self-referential biases supported by prefrontal cortex function including the dorsal anterior cingulate cortex (dACC). The cortisol awakening response (CAR) and dACC activity during a self-appraisal task were assessed in maltreated and non-maltreated depressed youth. Hierarchical linear models were employed to model the CAR. Maltreatment group, dACC activity during positive and negative self-appraisals as well as other key predictors, were included in the models. Post hoc analyses explored explanations for significant differences. Results indicated that maltreated depressed youth exhibited a higher CAR compared to non-maltreated youth. At low levels of dACC activity during processing of negative self-descriptors maltreated and non-maltreated depressed youth’s CAR did not differ. However, at elevated levels of dACC activity during processing of negative self-descriptors maltreated depressed youth exhibited significantly higher CAR compared to non-maltreated depressed youth.

Commentary: The importance of exploring dose-dependent, subtype-specific, and age-related effects of maltreatment on the HPA axis and the mediating link to psychopathology. A response to Fisher (2017).

We greatly appreciate Dr. Fisher's commentary that provides an excellent backdrop and well-considered perspective on our findings. We agree that our results mesh well with previous work documenting hypocortisolism among youth who experienced early adversity, especially neglect. Moreover, as also perceptively noted by Dr. Fisher, our cross-sectional data provide support for the notion that hypocortisolism is not simply a transient phenomenon, but, rather, a persistent pattern characterizing maltreated youth. Specifically, the consistency of the between group effect (from age 9.69 onwards) on a multimonth index of cumulative cortisol and the dose-dependent gradient of cortisol secretion within the maltreated group, which was related to the number of subtypes and the length of exposure to maltreatment, lend weight to this view.

School connectedness and high school graduation among maltreated youth

Maltreated youth have higher rates of school dropout than their non-maltreated peers. School connectedness is a modifiable predictor of school success. We hypothesized maltreated youth’s school connectedness (supportive relationships with adults at school and participation in school clubs) would be positively associated with high school graduation. We included youth with at least one Child Protective Services (CPS) report by age twelve from Longitudinal Studies of Child Abuse and Neglect, a prospective cohort study. Participation in extracurricular activities and adult relationships reported at age 16, high school graduation/General Education Development (GED) status reported at age 18, and demographics were provided by youth and caregivers. Maltreatment data were coded from CPS records. The outcome was graduation/receipt of GED. Multivariable logistic regressions examined the association between school connectedness and graduation/receipt of GED, controlling for confounders. In our sample of 318 maltreated youth, 73.3% graduated. School club was the only activity with a statistically significant association with graduation in bivariate analysis. Having supportive relationships with an adult at school was not significantly associated with graduation, though only 10.7% of youth reported this relationship. Maltreated youth who participated in school clubs had 2.54 times the odds of graduating, adjusted for study site, gender, poverty status, caregiver high school graduation status, and age at first CPS report (95% CI: [1.02, 6.33]). Few maltreated youth reported relationships with adults at school, and additional efforts may be needed to support these vulnerable youth. School club participation may represent an opportunity to modify maltreated youth’s risk for school dropout.

Posttraumatic symptoms among maltreated youth using classification and regression tree analysis

Individual psychological factors have been shown to exacerbate risk for posttraumatic stress disorder (PTSD) symptoms in youth following maltreatment, but the novel contribution of the present study includes a focus on interactive relationships between these factors on specific PTSD symptom clusters. This study identified maltreated youth at highest risk for re-experiencing, avoidance, and hyperarousal symptom clusters via cognitive, affective, and demographic variables. Participants (n=400) included ethnically diverse maltreated youth. Classification and regression tree (CART) analysis, a form of binary recursive partitioning (BRP), identified subgroups of maltreated youth at highest risk for three core PTSD symptom clusters. Posttraumatic cognitions, anhedonia, negative mood, processing speed, and ethnicity best predicted re-experiencing symptoms. Depersonalization/derealization, verbal comprehension, sexual maltreatment, and age best predicted avoidance symptoms. Negative cognitions about self, IQ, dissociation, working memory, and posttraumatic cognitions best predicted hyperarousal symptoms. Core PTSD symptom clusters may thus be associated with unique collections of risk factors for maltreated youth. Clinical protocols for this population could be recalibrated to be more sensitive to specific profiles that more accurately identify highest risk maltreated youth and better inform evidence-based treatment practices.

Reduced hair cortisol after maltreatment mediates externalizing symptoms in middle childhood and adolescence.

The enduring impact of childhood maltreatment on biological systems and ensuing psychopathology remains incompletely understood. Long-term effects of stress may be reflected in cumulative cortisol secretion over several months, which is now quantifiable via hair cortisol concentrations (HCC). We conducted a first comprehensive investigation utilizing the potential of hair cortisol analysis in a large sample of maltreated and nonmaltreated children and adolescents. Participants included 537 children and adolescents (3-16years; 272 females) with maltreatment (n=245) or without maltreatment histories (n=292). Maltreated subjects were recruited from child protection services (CPS; n=95), youth psychiatric services (n=56), and the community (n=94). Maltreatment was coded using the Maltreatment Classification System drawing on caregiver interviews and complemented with CPS records. Caregivers and teachers reported on child mental health. HCC were assessed in the first 3cm hair segment. Analyses uniformly supported that maltreatment coincides with a gradual and dose-dependent reduction in HCC from 9 to 10years onwards relative to nonmaltreated controls. This pattern emerged consistently from both group comparisons between maltreated and nonmaltreated subjects (27.6% HCC reduction in maltreated 9-16-year-olds) and dimensional analyses within maltreated subjects, with lower HCC related to greater maltreatment chronicity and number of subtypes. Moreover, both group comparisons and dimensional analyses within maltreated youth revealed that relative HCC reduction mediates the effect of maltreatment on externalizing symptoms. From middle childhood onwards, maltreatment coincides with a relative reduction in cortisol secretion, which, in turn, may predispose to externalizing symptoms.

"Neurobehavioral markers of resilience to depression amongst adolescents exposed to child abuse": Correction to Dennison et al. (2016).

Reports an error in "Neurobehavioral markers of resilience to depression amongst adolescents exposed to child abuse" by Meg J. Dennison, Margaret A. Sheridan, Daniel S. Busso, Jessica L. Jenness, Matthew Peverill, Maya L. Rosen and Katie A. McLaughlin (Journal of Abnormal Psychology, 2016[Nov], Vol 125[8], 1201-1212). In the article there was an error in the title. The word "Adolescents" was singular. The online version of this article has been corrected. (The following abstract of the original article appeared in record 2016-52992-014.) Childhood maltreatment is strongly associated with depression, which is characterized by reduced reactivity to reward. Identifying factors that mitigate risk for depression in maltreated children is important for understanding etiological links between maltreatment and depression as well as improving early intervention and prevention. We examine whether high reward reactivity at behavioral and neurobiological levels is a marker of resilience to depressive symptomology in adolescence following childhood maltreatment. A sample of 59 adolescents (21 with a history of maltreatment; Mean Age = 16.95 years, SD = 1.44) completed an fMRI task involving passive viewing of emotional stimuli. BOLD signal changes to positive relative to neutral images were extracted in basal ganglia regions of interest. Participants also completed a behavioral reward-processing task outside the scanner. Depression symptoms were assessed at the time of the MRI and again 2 years later. Greater reward reactivity across behavioral and neurobiological measures moderated the association of maltreatment with baseline depression. Specifically, faster reaction time (RT) to cues paired with monetary reward relative to those unpaired with reward and greater BOLD signal in the left pallidum was associated with lower depression symptoms in maltreated youth. Longitudinally, greater BOLD signal in the left putamen moderated change in depression scores over time, such that higher levels of reward response were associated with lower increases in depression over time among maltreated youths. Reactivity to monetary reward and positive social images, at both behavioral and neurobiological levels, is a potential marker of resilience to depression among adolescents exposed to maltreatment. These findings add to a growing body of work highlighting individual differences in reactivity to reward as a core neurodevelopmental mechanism in the etiology of depression. (PsycINFO Database Record

The child protection and juvenile justice nexus in Australia: A longitudinal examination of the relationship between maltreatment and offending

There is convincing evidence that many young people who are in the justice system have had contact with child protection services and that victims of childhood maltreatment are at increased risk of subsequent youth justice involvement. In Australia, however, there have been few longitudinal studies that have examined these associations and relatively less is known in this area. This study examines the overlap between the child protection and youth justice involvement in South Australia, and determines how substantiated maltreatment and variations in these experiences (e.g., the type, timing and recurrence of maltreatment) relate to criminal convictions as a youth. The results show that although the majority of child-protection involved youth do not become convicted offenders, the odds of subsequent convictions are significantly greater both for those with notifications and substantiated maltreatment and for those who had been placed in out-of-home care. Multivariate analyses revealed that the strongest predictors for receiving a conviction among maltreated youth were: male gender, Aboriginal and Torres Strait Islander ethnicity, experiences of physical abuse and emotional abuse, a greater number of substantiations (recurrence), experiencing maltreatment that commenced in childhood and continued into adolescence, and placement in out-of-home care. The mechanisms through which maltreatment might be linked with behavior are then considered, along with directions for future research in this area.

Neurobehavioral markers of resilience to depression amongst adolescents exposed to child abuse.

Childhood maltreatment is strongly associated with depression, which is characterized by reduced reactivity to reward. Identifying factors that mitigate risk for depression in maltreated children is important for understanding etiological links between maltreatment and depression as well as improving early intervention and prevention. We examine whether high reward reactivity at behavioral and neurobiological levels is a marker of resilience to depressive symptomology in adolescence following childhood maltreatment. A sample of 59 adolescents (21 with a history of maltreatment; Mean Age = 16.95 years, SD = 1.44) completed an fMRI task involving passive viewing of emotional stimuli. BOLD signal changes to positive relative to neutral images were extracted in basal ganglia regions of interest. Participants also completed a behavioral reward-processing task outside the scanner. Depression symptoms were assessed at the time of the MRI and again 2 years later. Greater reward reactivity across behavioral and neurobiological measures moderated the association of maltreatment with baseline depression. Specifically, faster reaction time (RT) to cues paired with monetary reward relative to those unpaired with reward and greater BOLD signal in the left pallidum was associated with lower depression symptoms in maltreated youth. Longitudinally, greater BOLD signal in the left putamen moderated change in depression scores over time, such that higher levels of reward response were associated with lower increases in depression over time among maltreated youths. Reactivity to monetary reward and positive social images, at both behavioral and neurobiological levels, is a potential marker of resilience to depression among adolescents exposed to maltreatment. These findings add to a growing body of work highlighting individual differences in reactivity to reward as a core neurodevelopmental mechanism in the etiology of depression. (PsycINFO Database Record

Resilience Variables and Posttraumatic Symptoms Among Maltreated Youth

ABSTRACTChild maltreatment is associated with an array of social, behavioral, neurobiological, and developmental problems that can last for many years. A key outcome of child maltreatment includes posttraumatic stress symptoms such as reexperiencing, avoidance, and hyperarousal. Considerable research has focused on risk factors for posttraumatic symptoms in maltreated youth, but less so on possible protective factors such as resilience. This study examined several resilience variables (sense of mastery, sense of relatedness, emotional reactivity) in an ethnically diverse sample of maltreated adolescents with posttraumatic symptoms. Key aspects of resilience that predicted posttraumatic stress disorder (PTSD) symptoms included sense of mastery (for fewer symptoms) and emotional reactivity (for more symptoms). In particular, optimism, self-efficacy, and adaptability were inversely related to PTSD symptoms. In addition, emotional reactivity moderated a relationship between resilience resource scores and PTSD symptoms. The findings appeared to apply most to sexually maltreated youth. The results preliminarily demonstrate the importance of considering resilience-based variables during clinical processes for maltreated youth.

Who Are the Men Caring for Maltreated Youth? Male Primary Caregivers in the Child Welfare System.

The goal of this study is to better understand the characteristics of men who act as primary caregivers of maltreated children. We examined differences between male primary caregivers (fathers) for youth involved in the child welfare system and female primary caregivers (mothers). We conducted secondary data analyses of the National Survey of Child and Adolescent Well-Being-II baseline data. Overall, primary caregiving fathers and mothers were more similar than different, though a few differences were revealed. Compared to mothers, fathers tended to be older and were more likely to be employed, with a higher household income and older children. Fathers and mothers did not differ in terms of depression or parenting behavior, but there was evidence that mothers have more problems with drug use compared to fathers. Compared to fathers, mothers reported higher levels of internalizing and externalizing problems in their children. Children with male primary caregivers were more likely to have experienced physical abuse but less likely to have experienced emotional abuse or witnessed domestic violence than children with female primary caregivers. These findings may help to inform researchers, practitioners, and policy makers on how to address the needs of male caregivers and their children.

Maltreated and comparison adolescents' recollections of lifetime residences: Relationship to delinquency and marijuana use.

Both childhood maltreatment and frequent childhood residence changes are associated with poor behavioral outcomes including drug use and delinquency. It is not clear whether a higher number of residences results in poorer outcomes for maltreated adolescents compared to adolescents living in the same community but without child welfare-documented maltreatment. Our study of child welfare-affiliated maltreated youth (n=216) and comparison youth (n=128) from the same community (age M = 18.21, SD = 1.42) examined: 1. whether child/caregiver characteristics and maltreatment status were associated with lifetime number of residences and 2. whether child/caregiver characteristics, residences, and maltreatment status were associated with delinquency and marijuana use. The outcomes of this study, number of residences, delinquency, and marijuana use, were all skewed, and consequently negative binomial regressions were used. Maltreatment status, ever living with a non-parent caregiver, and being older are associated with more residence changes during childhood. More residences and male sex are associated with person offense delinquency and marijuana use. In lower income neighborhoods, such as where the adolescents in this study lived, residence changes are not unusual, but in this study maltreated youth moved more often than youth from the same community. It is important to help caregivers who live in disadvantaged neighborhoods, especially families with child welfare involvement, understand the behavioral consequences of residence changes and provide support for stable long-term housing.

A Critical Look At Trauma-Informed Care Among Agencies and Systems Serving Maltreated Youth and Their Families.

The past two decades have witnessed an increase in programs targeting children and youth impacted by traumatic events, with a heightened focus on ensuring that all such programs and relevant service systems are trauma informed. While such efforts are laudable, trauma-informed care (TIC) is defined in a number of ways, limiting evaluation of these initiatives, specifically as they relate to the potential for improved outcomes or reduced costs often used to advocate for TIC. Widespread interest in TIC, despite an apparent dearth of empirical research, served as the impetus for this special section. Our goal was to identify the most rigorous empirical studies available. These six papers were selected based on their inclusion of a definition of TIC, focus on at least one component of TIC in a child-serving system, and availability of empirical data demonstrating the effectiveness of their efforts. In addition to introducing these papers, we share preliminary data from a brief, anonymous survey of child-serving professionals across various systems and roles to obtain feedback about definitional and conceptual issues related to TIC. While this special section provides a representation of available empirical work, significant gaps between research and practice of TIC remain, with important implications for future work.