Internalizing Symptoms Among Youth in Foster Care: Prevalence and Associations with Exposure to Maltreatment

Abstract

Among youth in foster care (N = 303, aged 11–17 years), we investigated prevalence of internalizing symptoms; associations between symptom level and maltreatment types and numbers; and the interaction between gender and maltreatment, on internalizing symptoms. Youth completed Spence Children Anxiety Scale, Short Mood Feelings Questionnaire, and Child and Adolescent Trauma Screen. Compared to community samples, symptom levels above clinical cut-off was more frequent, with social- and generalized anxiety (ES = 0.78–0.88) being most prevalent among youth in foster care. Girls reported more internalizing symptoms (ES = 0.59–0.93). Sexual abuse and neglect were associated with a broader range of internalizing symptoms (ES = 0.35–0.64). Increased incidence of maltreatment was associated with increased levels of symptoms (ES = 0.21–0.22). Associations between maltreatment and symptom level were stronger for girls. This study stresses the importance of broad screening of maltreatment and internalizing symptoms to meet the needs of youth in foster care.

Internalizing Symptom Profiles Among Youth in Foster Care: A Comparison Study

“…According to Dozois et al ( 24 ), the psychopathology of parents seems to be a risk factor affecting a broad range of internalizing problems. This is related to our previous findings where different maltreatment types were associated with a broad range of internalizing symptoms ( 29 ). These findings may partly explain why, in the present study, we do not identify profiles with large differences in shape and that youth in foster care did not have a higher risk of belonging to a specific symptom profile compared to their peers in the clinical and population-based samples.…”

“…Our finding that youth in foster care are more likely to belong in the high symptom profile compared to the general population youth sample strengthens the argument that internalized symptoms in youth entering foster care should be assessed. While elevated levels of internalizing symptoms may reflect a history of maltreatment and relational problems among youth in foster care ( 29 ), these may also reflect how demanding the transition into a new home may be for these youth. As they must establish new relationships away from their primary carers ( 51 , 52 ), these challenges may trigger or maintain symptoms of anxiety or depression in youth in foster care.…”

“…Regarding internalizing symptoms, a thorough assessment of girls in foster care is needed. A previous study reported sex differences in maltreatment exposures such as physical/emotional abuse, neglect, and sexual abuse among youth in foster care, with girls being more exposed ( 29 ). Furthermore, in this same study, girls in foster care were found to have higher anxiety symptoms when subjected to all three maltreatment types and higher depression symptoms when exposed to neglect compared to boys.…”

“…Furthermore, in this same study, girls in foster care were found to have higher anxiety symptoms when subjected to all three maltreatment types and higher depression symptoms when exposed to neglect compared to boys. This may indicate a greater vulnerability to internalizing symptoms among girls in foster care compared to boys ( 29 ).…”

“…Exposure to sexual abuse was the only maltreatment type associated with an increase in the level of all anxiety symptom subtypes, whereas neglect yielded increased symptom levels for all anxiety subtypes, except separation anxiety and fear of physical injury (i.e., simple phobia). Physical/emotional abuse increased the symptom level for social anxiety and OCD ( 29 ). These findings indicate the relevance of investigating subtypes of anxiety, as this may be affected by the specific maltreatment experiences of the youth and manifest itself in the shape of the symptom profile for foster youth.…”