Trajectories of Mental Health in Children Adopted From Foster Care

A wealth of research has established that adopted youth are at greater risk for impaired mental health than their non-adopted peers, given the host of early life stressors that many experience. However, the specific trajectories of risk and resilience into adulthood remain unclear. The present study examines longitudinal trajectories of mental health in 49 adolescents and young adults adopted from foster care, using data collected at six time points in childhood to predict later youth outcomes from parent-report and child-report surveys. The study investigated the contribution of two major pre-adoptive risk factors, abuse/neglect and age of adoptive placement, to childhood trajectories of behavior problems, measured by the Child Behavior Checklist (CBCL). It also utilized these risk factors and behavioral trajectories to predict current outcomes of mental health, such as psychopathological symptoms, psychiatric diagnoses, and substance abuse. Pre-adoptive abuse/neglect predicted current levels of psychopathological symptoms and diagnosis of depression, while older age of placement predicted greater alcohol use. Children adopted after age 4 initially had marginally higher CBCL externalizing scores than children adopted after age 4, but their scores leveled off over time, while earlier-adopted children’s scores remained the same. Greater average levels of externalizing problems in childhood predicted ADHD diagnosis and running away from home. Lastly, youth with lowest internalizing and externalizing scores in childhood reported currently using marijuana occasionally, while higher internalizing and externalizing scores predicted both abstinence and frequent use of marijuana. These results indicate that pre-adoptive risk factors and childhood behavior problems are salient predictors of some, but not all, indicators of mental health in adolescence and young adulthood. Findings on marijuana use support past literature revealing that adolescents who experiment occasionally with marijuana are better adjusted, beginning in childhood, than their abstaining or heavy-using peers (Shedler & Block, 1990). These findings indicate that even in a sample with majority (95%) prenatal substance exposure, some experimentation with marijuana is normative

Predictive Associations Between Prenatal and Postnatal Risk Factors and Developmental and Temperamental Outcomes Among Infants in Foster Care

Infants detained for maltreatment present with a number of prenatal and perinatal risk factors, including prenatal exposure to substances, prematurity, low birth weight, birth complications, and prolonged hospital stay. These factors pose significant risk for a broad range of infant outcomes critically linked to later functioning, including cognitive, language, motor, socio-emotional, and temperamental development (Del Giudice, 2012; Singer et al., 2008). However, many infants exposed to prenatal risk also develop normatively, highlighting the need to better understand how the postnatal environment influences individual differences in response to prenatal risk. Importantly, prior to adoptive placement, infants placed in foster care often face unique stressors, including multiple foster placements and trial stays with birth families. Exposure to these pre-placement postnatal factors vary substantially across individuals, and they likely have unique and cumulative effects on developmental outcomes (Fisher et al., 2005; Waterman et al., 2013). Emerging evidence from normative samples suggests that prenatal and postnatal factors may interact to influence developmental outcomes, potentially through prenatal programming of infant responses to postnatal environments (Pluess & Belsky, 2011). These theoretical models have yet to be tested among infants in foster care, despite a need to better understand which prenatal and postnatal risk factors influence outcomes for these high-risk children. Thus, the present study aims to disentangle prenatal and postnatal risk factors to examine their unique and interactive associations with differentiated developmental outcomes (cognitive, language, motor, socioemotional) and early temperament among high-risk infants transitioning from foster care to adoption. Participants include 68 infants aged 0-28 months (race-ethnicity: 26% Hispanic, 14% African-American, 11% Caucasian, 1% Asian/Pacific Islander, 26% Mixed, 22% Unknown) referred for developmental assessment within two months of placement in adoptive homes. Prenatal/perinatal risk factors (prematurity, substance exposure, birth weight, birth complications, hospital stay) and postnatal risk factors (birth parent stay, age detained, number of placements, age at adoption) were coded from previous medical, DCFS, and court records. Infants were assessed using the Bayley Scales of Infant Development (BSID-III) to evaluate cognitive, motor (fine and gross), language (receptive and expressive), and socioemotional development. In addition, the primary adoptive parent completed the Infant/Toddler Temperament Questionnaire to measure temperament domains (e.g., sensitivity, reactivity, regularity). Preliminary correlations revealed that cognitive and motor development were most robustly associated with prenatal risk (i.e., prematurity, birth weight) and perinatal risk factors (i.e., birth complications, duration of hospital stay), whereas infant temperament domains were additionally linked to postnatal risk factors (i.e., birth parent placement, age detained, age of adoption, number of placements). Furthermore, differential associations between individual risk factors and outcomes were observed, suggesting there are likely unique risk factors predictive of different infant outcomes. Next, stepwise regressions will be employed to examine the independent, cumulative, and interactive associations between prenatal and postnatal risk factors on each developmental and temperamental outcome. Results will provide insight into the individual and cumulative effects of prenatal and preplacement postnatal risk factors for infants transitioning from foster care to adoption. Implications for key prevention and intervention targets among high-risk infants will be discussed

Emotions of L2 Learners in Different Contexts and Modes

Considering the role of emotions in L2 use/learning and in different contexts and modes (online, hybrid, in-person), the present study aims to analyze and discuss the role of different emotions that emerged in those three contexts and modes. With that aim, we draw on two different sets of data produced as part of larger studies to discuss the role of emotions in online, in-person and hybrid settings in Brazil, Spain, the UK and the USA. Overall, results point to the need to address native-speakerism in L2 education as well as unpleasant feelings related to online learning and/or to abrupt transitions in learning modes

Parent adjustment over time in gay, lesbian, and heterosexual parent families adopting from foster care.

Although increasing numbers of gay and lesbian individuals and couples are adopting children, gay men and lesbian women continue to face increased scrutiny and legal obstacles from the child welfare system. To date, little research has compared the experiences of gay or lesbian and heterosexual adoptive parents over time, limiting conceptual understandings of the similarities they share and the unique challenges that gay and lesbian adoptive parents may face. This study compared the adoption satisfaction, depressive symptoms, parenting stress, and social support at 2, 12, and 24 months postplacement of 82 parents (60 heterosexual, 15 gay, 7 lesbian) adopting children from foster care in Los Angeles County. Few differences were found between heterosexual and gay or lesbian parents at any of the assessments or in their patterns of change over time. On average, parents in both household types reported significant increases in adoption satisfaction and maintained low, nonclinical levels of depressive symptoms and parenting stress over time. Across all family types, greater parenting stress was associated with more depressive symptoms and lower adoption satisfaction. Results indicated many similarities between gay or lesbian and heterosexual adoptive parents, and highlight a need for services to support adoptive parents throughout the transition to parenthood to promote their well-being. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

Parent adjustment over time in gay, lesbian, and heterosexual parent families adopting from foster care.

Although increasing numbers of gay and lesbian individuals and couples are adopting children, gay men and lesbian women continue to face increased scrutiny and legal obstacles from the child welfare system. To date, little research has compared the experiences of gay or lesbian and heterosexual adoptive parents over time, limiting conceptual understandings of the similarities they share and the unique challenges that gay and lesbian adoptive parents may face. This study compared the adoption satisfaction, depressive symptoms, parenting stress, and social support at 2, 12, and 24 months postplacement of 82 parents (60 heterosexual, 15 gay, 7 lesbian) adopting children from foster care in Los Angeles County. Few differences were found between heterosexual and gay or lesbian parents at any of the assessments or in their patterns of change over time. On average, parents in both household types reported significant increases in adoption satisfaction and maintained low, nonclinical levels of depressive symptoms and parenting stress over time. Across all family types, greater parenting stress was associated with more depressive symptoms and lower adoption satisfaction. Results indicated many similarities between gay or lesbian and heterosexual adoptive parents, and highlight a need for services to support adoptive parents throughout the transition to parenthood to promote their well-being. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

Specifying active components of educational interventions to promote adherence to treatment in glaucoma patients: application of a taxonomy of behavior change techniques

Purpose: In response to recent calls for clearer specification of behavior change interventions, the purpose of this study was to apply a system of taxonomy for behavior change techniques (BCTs) to two educational interventions to improve adherence to glaucoma eye drops. Clarification of constituent BCTs will promote easy and reliable application of the interventions in clinical settings and research. Methods: A published taxonomy of BCTs was used to code two interventions (group and individual) to increase adherence to eye drops. Intervention materials were coded by assigning a BCT label to each text unit. We noted the frequency with which each BCT occurred, compared the interventions in terms of the BCTs that were delivered, and identified whether the taxonomy was sufficient to describe the intervention components. Results: The individual intervention consisted of 94 text units. Fifty-seven were identified as targeting behavior change and coded using 18 BCTs, many coded more than once. In the group intervention, 165 units of text were identified, and 125 were coded using 22 BCTs. The most frequently coded BCT was “provide information about behavior–health link” in the group intervention and “prompt barrier identification” in the individual intervention. The interventions included similar BCTs. All text units targeting behavior change were codable into BCTs. Conclusion: The similarity of the two interventions may have implications for the cost-effectiveness of the interventions. The taxonomy was found sufficient to describe both interventions. This level of specification can be used to ensure that precisely the same intervention that has been pilot tested is reproducible in the clinical setting and in any further research

Leveraging Leadership in Child Welfare Systems: Large-scale Trauma- and Resilience-informed Training Initiative.

Strengthening the infrastructure of public health systems around trauma-informed principles is crucial to addressing the needs of traumatized children in the child welfare system. In fact, many local and state initiatives have focused on large-scale evaluation studies to determine the value of training direct service staff on trauma foundations. Less yet is known about the benefits of training leaders on trauma foundations, which is crucial given their unique influence on implementation decisions. The current study evaluates a trauma training delivered to leadership-level stakeholders through a large-scale training initiative for the Los Angeles County Department of Children and Family Services. Findings indicated that leaders improved in trauma knowledge from baseline to post-training and reported changes in their professional wellbeing and leadership approach after the reflective training component. The leadership trauma program may have positive downstream implications for direct service staff, organizational culture, and child and family outcomes

Sensory processing challenges as a novel link between early caregiving experiences and mental health.

Early caregiving adversity (ECA) is associated with elevated psychological symptomatology. While neurobehavioral ECA research has focused on socioemotional and cognitive development, ECA may also increase risk for low-level sensory processing challenges. However, no prior work has compared how diverse ECA exposures differentially relate to sensory processing, or, critically, how this might influence psychological outcomes. We examined sensory processing challenges in 183 8-17-year-old youth with and without histories of institutional (orphanage) or foster caregiving, with a particular focus on sensory over-responsivity (SOR), a pattern of intensified responses to sensory stimuli that may negatively impact mental health. We further tested whether sensory processing challenges are linked to elevated internalizing and externalizing symptoms common in ECA-exposed youth. Relative to nonadopted comparison youth, both groups of ECA-exposed youth had elevated sensory processing challenges, including SOR, and also had heightened internalizing and externalizing symptoms. Additionally, we found significant indirect effects of ECA on internalizing and externalizing symptoms through both general sensory processing challenges and SOR, covarying for age and sex assigned at birth. These findings suggest multiple forms of ECA confer risk for sensory processing challenges that may contribute to mental health outcomes, and motivate continuing examination of these symptoms, with possible long-term implications for screening and treatment following ECA