Prevalence and timing of diagnosable mental health, alcohol, and substance use problems among older adolescents in the child welfare system

Abstract

This study reports the prevalence of PTSD, major depression, alcohol abuse/dependence and substance abuse/dependence diagnoses assessed with a structured clinical interview protocol in a population-based, multi-state, age cohort of older adolescents about to exit child welfare systems. PTSD was the most common diagnosis and was observed at rates above those seen in the general population. Rates of specific diagnoses varied according to gender, race, type of child welfare placement, and state of residence. In general, African American youth and those in kinship family foster care were less likely to have mental health and substance use problems. Analysis of the timing of onset relative to entry into care revealed that Caucasian youth were more likely to have diagnoses prior to entry into state custody, and race differentials were less pronounced for diagnosis after placement in foster care. Observed state-to-state differences suggest that age of entry into care and the likelihood of pre-existing mental health and substance use conditions could be attributable to child welfare policies regarding screening and placement.Older adolescents emancipating from the child welfare system often face the transition to independent adulthood abruptly and without guarantees of continuing support (Collins, 2001;Geenen & Powers, 2007;McCoy, McMillen, & Spitznagel, 2008;Stein, 2006). The transition from adolescence to adulthood typically provides new freedoms and opportunities, but it also poses many challenges that can test coping skills, exacerbate pre-existing difficulties, and derail developmental trajectories (Maughan & Champion, 1990;Schulenberg, Sameroff, & Cicchetti, 2004). In general, adolescents who enter this developmental period with psychiatric disorders or heavy substance use are more likely than others to experience negative outcomes in adulthood (Davis & Vander Stoep, 1997;Schulenberg & Maggs, 2002;Vander Stoep et al., 2000). Mental health and substance use problems are among the many factors that can jeopardize the prospects of youth exiting the foster care system (Anctil, McCubbin, O'Brien, Pecora, & Anderson-Harumi, 2007). Because they commonly are exposed to multiple adverse familial and environmental conditions associated with the development of psychopathology, youth leaving state custody are likely to have elevated risk for various forms Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author ManuscriptChild Youth Serv Rev. Author manuscript; available in PMC 2011 April 1. Published in final edited form as:Child Youth Serv Rev. (Pecora, White...

Drug use in adolescents with mild intellectual disability in different living arrangements

“…These findings are in line with previous research indicating the low rate of drug use among individuals with ID who lived with their families (Rimmer et al, 1995;Taylor et al, 2004). Similar differences were found between typically developing adolescents living with their parents and those in state care in the studies from the Serbia (Backović, Marinković, Grujičić-Š ipetić, & Maksimović, 2006), US (Aarons et al, 2008;Keller, Salazar, & Courtney, 2010;Pilowsky & Wu, 2006;Thompson & Auslander, 2007), UK (McCann, James, Wilson, & Dunn, 1996) and Germany (Schmid, 2008).…”

The Relationship Between Post-Traumatic Stress Symptoms and Substance Use Among Adolescents Involved with Child Welfare: Implications for Emerging Adulthood

“…This is surprising given that PTSD has been identified as the highest occurring diagnosis among adolescents involved with child welfare (Keller et al 2010). In those studies that have explored the link between PTSS and substance use among adolescents involved with child welfare, the findings indicate that PTSS increase the risk for substance use and substance use disorders.…”

Reshaping Child Welfare’s Response to Trauma

“…Participants had at least 1 year in care before turning 17 (Keller, Salazar, & Courtney, 2010). Of the 732 youth in foster care at ages 17-18, the lifetime rate of PTSD was 15.1% (Keller et al, 2010).…”