Resilience in the face of adversity: classes of positive adaptation in trauma-exposed children and adolescents in residential care

BMC Psychology - Tập 11 - Trang 1-13 - 2023
Katharina Sölva1, Alexander Haselgruber1, Brigitte Lueger-Schuster1
1Unit of Psychotraumatology, Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria

Tóm tắt

Children and adolescents in residential care often face multiple traumatic experiences. However, some individuals show resilient adaptation. To depict this heterogeneity, the person-centered examination of different classes of adaptation is a powerful tool. Up to date, resilience was insufficiently addressed in this population. Data from 141 children and adolescents in residential care institutions in Austria regarding trauma history, psychopathology, behavioral adjustment, and protective factors were assessed with standardized self-report questionnaires. Distinct classes of adaptation after traumatic experiences were examined with Latent Class Analysis. Class differences regarding traumatic experiences and protective factors were analyzed with χ2 testing. Three classes were identified [resilience (66.18%), mixed psychopathology (13.97%, mixed), high psychopathology (19.85%, high)]. Only males were classified into the resilient class and only females into the high class. The high class differed significantly from the resilient class regarding cumulative trauma history and protective factors. The mixed class did not differ from the resilient class regarding trauma history, however, they differed significantly regarding protective factors. The resilient class was associated with protective factors. Strong gender differences show the relevance of a differentiated evaluation of gender-specific protective factors and resilience indicators. Fostering protective factors may be a suitable approach for tailored intervention measures.

Tài liệu tham khảo

Masten AS, Barnes AJ. Resilience in children: developmental perspectives. Children. 2018. https://doi.org/10.3390/children5070098. Masten AS. Ordinary magic: resilience processes in development. Am Psychol. 2001;56(3):227–38. https://doi.org/10.1037//0003-066X.56.3.227. Masten AS. Resilience in developing systems: progress and promise as the fourth wave rises. Dev Psychopathol. 2007;19(3):921–30. https://doi.org/10.1017/S0954579407000442. Masten AS. Resilience in children threatened by extreme adversity: frameworks for research, practice, and translational synergy. Dev Psychopathol. 2011;23(2):493–506. https://doi.org/10.1017/S0954579411000198. Chmitorz A, et al. Intervention studies to foster resilience: a systematic review and proposal for a resilience framework in future intervention studies. Clin Psychol Rev. 2018;59:78–100. https://doi.org/10.1016/j.cpr.2017.11.002. Luthar SS, Cicchetti D, Becker B. The construct of resilience: a critical evaluation and guidelines for future work. Child Dev. 2000;71(3):543–62. Hyland P, Shevlin M, Fyvie C, Karatzias T. Posttraumatic stress disorder and complex posttraumatic stress disorder in DSM-5 and ICD-11: clinical and behavioral correlates. J Trauma Stress. 2018;31(2):174–80. https://doi.org/10.1002/jts.22272. Gilbert R, Widom CS, Browne K, Fergusson D, Webb E, Janson S. Burden and consequences of child maltreatment in high-income countries. The Lancet. 2009;373(9657):68–81. https://doi.org/10.1016/S0140-6736(08)61706-7. Cheng J, Liang Y, Fu L, Liu Z. The relationship between PTSD and depressive symptoms among children after a natural disaster: a 2-year longitudinal study. Psychiatry Res. 2020;292:113296. https://doi.org/10.1016/j.psychres.2020.113296. Forresi B, et al. Post-traumatic stress disorder, emotional and behavioral difficulties in children and adolescents 2 years after the 2012 earthquake in Italy: an epidemiological cross-sectional study. Eur Child Adolesc Psychiatry. 2020;29(2):227–38. https://doi.org/10.1007/s00787-019-01370-0. Dai W, Liu A, Kaminga AC, Deng J, Lai Z, Wen SW. Prevalence of posttraumatic stress disorder among children and adolescents following road traffic accidents: a meta-analysis. Revue Canadienne De Psychiatrie. 2018;63(12):798–808. https://doi.org/10.1177/0706743718792194. Cerel J, Fristad MA, Verducci J, Weller RA, Weller EB. Childhood bereavement: psychopathology in the 2 years postparental death. J Am Acad Child Adolesc Psychiatry. 2006;45(6):681–90. https://doi.org/10.1097/01.chi.0000215327.58799.05. Hillis SD, Mercy JA, Saul JR. The enduring impact of violence against children. Psychol Health Med. 2017;22(4):393–405. https://doi.org/10.1080/13548506.2016.1153679. Beaglehole B, Mulder RT, Frampton CM, Boden JM, Newton-Howes G, Bell CJ. Psychological distress and psychiatric disorder after natural disasters: systematic review and meta-analysis. Br J Psychiatry. 2018;213(6):716–22. https://doi.org/10.1192/bjp.2018.210. Carr A, Duff H, Craddock F. A systematic review of reviews of the outcome of noninstitutional child maltreatment. Trauma Violence Abuse. 2020;21(4):828–43. https://doi.org/10.1177/1524838018801334. Fowler PJ, Tompsett CJ, Braciszewski JM, Jacques-Tiura AJ, Baltes BB. Community violence: a meta-analysis on the effect of exposure and mental health outcomes of children and adolescents. Dev Psychopathol. 2009;21(1):227–59. https://doi.org/10.1017/S0954579409000145. Cloitre M, Stolbach BC, Herman JL, van der Kolk BA, Pynoos RS, Wang J, Petkova E. A developmental approach to complex PTSD: Childhood and adult cumulative trauma as predictors of symptom complexity. J Trauma Stress. 2009;22(5):399–408. https://doi.org/10.1002/jts.20444. Hodges M, Godbout N, Briere J, Lanktree C, Gilbert A, Kletzka NT. Cumulative trauma and symptom complexity in children: a path analysis. Child Abuse Negl. 2013;37(11):891–8. https://doi.org/10.1016/j.chiabu.2013.04.001. Rutter M. Resilience, competence, and coping. Child Abuse Negl. 2007;31(3):205–9. https://doi.org/10.1016/j.chiabu.2007.02.00. Haselgruber A, Sölva K, Lueger-Schuster B. Symptom structure of ICD-11 Complex Posttraumatic Stress Disorder (CPTSD) in trauma-exposed foster children: examining the International Trauma Questionnaire: child and Adolescent Version (ITQ-CA). Eur J Psychotraumatol. 2020;11(1):1818974. https://doi.org/10.1080/20008198.2020.1818974. Rafiq S, Campodonico C, Varese F. The relationship between childhood adversities and dissociation in severe mental illness: a meta-analytic review. Acta Psychiatr Scand. 2018;138(6):509–25. https://doi.org/10.1111/acps.12969. Hébert M, Langevin R, Oussaïd E. Cumulative childhood trauma, emotion regulation, dissociation, and behavior problems in school-aged sexual abuse victims. J Affect Disord. 2018;225:306–12. https://doi.org/10.1016/j.jad.2017.08.044. Cicchetti D, Toth SL. Child maltreatment. Annu Rev Clin Psychol. 2005;1:409–38. https://doi.org/10.1146/annurev.clinpsy.1.102803.144029. Allwood MA, Bell-Dolan D, ArshadHusain S. Children’s trauma and adjustment reactions to violent and nonviolent war experiences. Am Acad Child Adolescents Psychiatry. 2002;41(4):450–7. https://doi.org/10.1097/00004583-200204000-00018. Wamser-Nanney R, Chesher RE. Trauma characteristics and sleep impairment among trauma-exposed children. Child Abuse Negl. 2018;76:469–79. https://doi.org/10.1016/j.chiabu.2017.11.020. Sattler KMP, Font SA. Resilience in young children involved with child protective services. Child Abuse Negl. 2018;75:104–14. https://doi.org/10.1016/j.chiabu.2017.05.004. Zolkoski SM, Bullock LM. Resilience in children and youth: a review. Child Youth Serv Rev. 2012;34(12):2295–303. https://doi.org/10.1016/j.childyouth.2012.08.00. Collins LM, Lanza ST. Latent class and latent transition analysis: With applications in the social, behavioral, and health sciences. Wiley Series in Probability and Statistics. Hoboken: Wiley; 2010. Gallitto E, Lyons J, Weegar K, Romano E. Trauma-symptom profiles of adolescents in child welfare. Child Abuse Negl. 2017;68:25–35. https://doi.org/10.1016/j.chiabu.2017.03.011. Laursen BP, Hoff E. Person-centered and variable-centered approaches to longitudinal data. Merrill-Palmer Q. 2006;52(3):377–89. https://doi.org/10.1353/mpq.2006.0029. Luthar SS, Crossman EJ, Small PJ, editors. Resilience and adversity. New York: Wiley; 2015. Yule K, Houston J, Grych J. Resilience in children exposed to violence: a meta-analysis of protective factors across ecological contexts. Clin Child Fam Psychol Rev. 2019;22(3):406–31. https://doi.org/10.1007/s10567-019-00293-1. Fergus S, Zimmerman MA. Adolescent resilience: a framework for understanding healthy development in the face of risk. Annu Rev Public Health. 2005;26:399–419. https://doi.org/10.1146/annurev.publhealth.26.021304.144357. Luszczynska A, Benight CC, Cieslak R. Self-efficacy and health-related outcomes of collective trauma. Eur Psychol. 2009;14(1):51–62. https://doi.org/10.1027/1016-9040.14.1.51. Simmen-Janevska K, Brandstätter V, Maercker A. The overlooked relationship between motivational abilities and posttraumatic stress: a review. Eur J Psychotraumatol. 2012. https://doi.org/10.3402/ejpt.v3i0.18560. Hamill SK. Resilience and self-efficacy: the importance of efficacy beliefs and coping mechanisms in resilient adolescents. Colgate Univ J Sci. 2003;35:115–46. Drapeau S, Saint-Jacques M-C, Lépine R, Bégin G, Bernard M. Processes that contribute to resilience among youth in foster care. J Adolesc. 2007;30(6):977–99. https://doi.org/10.1016/j.adolescence.2007.01.005. Sagone E, de Caroli ME, Falanga R, Indiana ML. Resilience and perceived self-efficacy in life skills from early to late adolescence. Int J Adolesc Youth. 2020;25(1):882–90. https://doi.org/10.1080/02673843.2020.1771599. Sölva K, Haselgruber A, Lueger-Schuster B. The relationship between cumulative traumatic experiences and ICD-11 post-traumatic symptoms in children and adolescents in foster care: the mediating effect of sense of coherence. Child Abuse Neglect. 2020;101:104388. https://doi.org/10.1016/j.chiabu.2020.104388. Braun-Lewensohn O, Sagy S, Roth G. Brief report: Adolescents under missile attacks: sense of coherence as a mediator between exposure and stress-related reactions. J Adolesc. 2011;34(1):195–7. https://doi.org/10.1016/j.adolescence.2010.01.006. Mc Gee SL, Höltge J, Maercker A, Thoma MV. Sense of coherence and stress-related resilience: investigating the mediating and moderating mechanisms in the development of resilience following stress or adversity. Front Psych. 2018;9:378. https://doi.org/10.3389/fpsyt.2018.00378. Afifi TO, McMillan HL. Resilience following child maltreatment: a review of protective factors. Can J Psychiat. 2011;56(5):266–72. Lou Y, Taylor EP, Di Folco S. Resilience and resilience factors in children in residential care: a systematic review. Child Youth Serv Rev. 2018;89:83–92. https://doi.org/10.1016/j.childyouth.2018.04.010. Jain S, Buka SL, Subramanian SV, Molnar BE. Protective factors for youth exposed to violence. Youth Violence Juvenile Justice. 2012;10(1):107–29. https://doi.org/10.1177/1541204011424735. Perkins DF, Jones KR. Risk behaviors and resiliency within physically abused adolescents. Child Abuse Negl. 2004;28(5):547–63. https://doi.org/10.1016/j.chiabu.2003.12.001. Edmond T, Auslander W, Elze D, Bowland S. Signs of resilience in sexually abused adolescent girls in the foster care system. J Child Sex Abus. 2006;15(1):1–28. https://doi.org/10.1300/J070v15n01_01. Turner MG, Hartman JL, Exum ML, Cullen FT. Examining the cumulative effects of protective factors: resiliency among a national sample of high-risk youths. J Offender Rehabil. 2007;46(1):81–111. https://doi.org/10.1080/10509670802071535. Bronsard G, Alessandrini M, Fond G, Loundou A, Auquier P, Tordjman S, Boyer L. The prevalence of mental disorders among children and adolescents in the child welfare system: a systematic review and meta-analysis. Medicine. 2016;95(7):1–17. https://doi.org/10.1097/MD.0000000000002622. Daining C, DePanfilis D. Resilience of youth in transition from out-of-home care to adulthood. Child Youth Serv Rev. 2007;29(9):1158–78. https://doi.org/10.1016/j.childyouth.2007.04.006. Yates TM, Grey IK. Adapting to aging out: profiles of risk and resilience among emancipated foster youth. Dev Psychopathol. 2012;24(2):475–92. https://doi.org/10.1017/S0954579412000107. Muthen B. Latent Variable Analysis: Growth mixture modeling and related techniques for longitudinal data. In: Kaplan D, editor. Handbook of quantitative methodology for the social sciences. Newbury Park: Sage; 2004. p. 345–68. Roesch SC, Villodas M, Villodas F. Latent class/profile analysis in maltreatment research: a commentary on Nooner et al., Pears et al., and looking beyond. Child Abuse Neglect. 2010;34(3):155–60. https://doi.org/10.1016/j.chiabu.2010.01.003. Keller TE, Cusick GR, Courtney ME. Approaching the transition to adulthood: distinctive profiles of adolescents aging out of the child welfare system. Soc Serv Rev. 2007. https://doi.org/10.1086/519536. Miller EA, Paschall KW, Azar ST. Latent classes of older foster youth: prospective associations with outcomes and exits from the foster care system during the transition to adulthood. Child Youth Serv Rev. 2017;79:495–505. Au TM, Dickstein BD, Comer JS, Salters-Pedneault K, Litz BT. Co-occurring posttraumatic stress and depression symptoms after sexual assault: a latent profile analysis. J Affect Disord. 2013;149(1–3):209–16. https://doi.org/10.1016/j.jad.2013.01.026. Anthony EK, Robbins DE. A latent class analysis of resilient development among early adolescents living in public housing. Child Youth Serv Rev. 2013;35(1):82–90. https://doi.org/10.1016/j.childyouth.2012.10.012. Haahr-Pedersen I, et al. Females have more complex patterns of childhood adversity: implications for mental, social, and emotional outcomes in adulthood. Eur J Psychotraumatol. 2020;11(1):1708618. DuMont KA, Widom CS, Czaja SJ. Predictors of resilience in abused and neglected children grown-up: the role of individual and neighborhood characteristics. Child Abuse Negl. 2007;31(3):255–74. https://doi.org/10.1016/j.chiabu.2005.11.015. Sun J, Stewart D. Age and gender effects on resilience in children and adolescents. Int J Ment Health Promot. 2007;9(4):16–25. https://doi.org/10.1080/14623730.2007.9721845. Collin-Vézina D, Coleman K, Milne L, Sell J, Daigneault I. Trauma experiences, maltreatment-related impairments, and resilience among child welfare youth in residential care. Int J Ment Heal Addict. 2011;9(5):577–89. https://doi.org/10.1007/s11469-011-9323-8. Gander T, et al. Predictive factors for changes in quality of life among children and adolescents in youth welfare institutions. Soc Psychiatry Psychiatr Epidemiol. 2019;54(12):1575–86. https://doi.org/10.1007/s00127-019-01724-8. Vibhakar V, Allen LR, Gee B, Meiser-Stedman R. A systematic review and meta-analysis on the prevalence of depression in children and adolescents after exposure to trauma. J Affect Disord. 2019;255:77–89. https://doi.org/10.1016/j.jad.2019.05.005. Bernstein DP, et al. Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse Negl. 2003;27(2):169–90. https://doi.org/10.1016/S0145-2134(02)00541-0. Gerdner A, Allgulander C. Psychometric properties of the Swedish version of the Childhood Trauma Questionnaire-Short Form (CTQ-SF). Nord J Psychiatry. 2009;63(2):160–70. https://doi.org/10.1080/08039480802514366. Karos K, Niederstrasser N, Abidi L, Bernstein DP, Bader K. Factor structure, reliability, and known groups validity of the German version of the Childhood Trauma Questionnaire (Short-form) in Swiss patients and nonpatients. J Child Sex Abus. 2014;23(4):418–30. https://doi.org/10.1080/10538712.2014.896840. Sachser C, et al. International development and psychometric properties of the Child and Adolescent Trauma Screen (CATS). J Affect Disord. 2017;210:189–95. https://doi.org/10.1016/j.jad.2016.12.040. Cloitre M, Bisson JI, Brewin CR, Hyland P, Karatzias T, Lueger-Schuster B, Shevlin M. International Trauma Questionnaire - Child and Adolescent Version (ITQ-CA) [Measurement instrument]. 2018. World Health Organization (2018). International classification of diseases (11th ed.). World Health Organization. Retrieved from https://ICD.who.int/browse11/l-m/en. Döpfner M, Plück J, Kinnen C. Deutsche Schulalter-Formen der Child Behavior Checklist von Thomas M. Achenbach. Göttingen: Hogrefe; 2014. Armstrong J, Bernstein CE, Putnam FW. Skala für Dissoziative Erfahrungen von Jugendlichen - Kurzform (A-DES 8): Kindertraumainstitut; 2006. Lohaus A, Nussbeck FW, Petermann F. Fragebogen zu Ressourcen im Kindes- und Jugendalter (FRKJ 8–16). Göttingen: Hogrefe; 2017. Schafer JL, Graham JW. Missing data: our view of the state of the art. Psychol Methods. 2002;7(2):147–77. https://doi.org/10.1037//1082-989X.7.2.147. Muthén LK, Muthén BO. Mplus: Statistical Analysis with Latent Variables: User’s Guide (Version 8) (Los Angeles, CA: Authors, 2017). Hipp JR, Bauer DJ. Local solutions in the estimation of growth mixture models. Psychol Methods. 2006;11(1):36–53. https://doi.org/10.1037/1082-989X.11.1.36. Akaike H. A new look at the statistical model identification. IEEE Trans Autom Control. 1974;19(6):716–23. https://doi.org/10.1109/TAC.1974.1100705. Schwarz G. Estimating the dimension of a model. Ann Stat. 1978;6(2):461–4. https://doi.org/10.1214/aos/1176344136. Sclove SL. Application of model-selection criteria to some problems in multivariate analysis. Psychometrika. 1987;52(3):333–43. Nylund-Gibson K, Ten Choi AY. frequently asked questions about latent class analysis. Transl Issues Psychol Sci. 2018;4(4):440–61. https://doi.org/10.1037/tps0000176. Vermunt JK. Latent class modeling with covariates: two improved three-step approaches. Polit Anal. 2010;18(4):450–69. https://doi.org/10.1093/pan/mpq025. Shpiegel S. Resilience among older adolescents in foster care: the impact of risk and protective factors. Int J Ment Heal Addict. 2016;14(1):6–22. https://doi.org/10.1007/s11469-015-9573-y. Hartman JL, Turner MG, Daigle LE, Exum ML, Cullen FT. Exploring the gender differences in protective factors: implications for understanding resiliency. Int J Offender Ther Comp Criminol. 2009;53(3):249–77. https://doi.org/10.1177/0306624X08326910. Haavik L, Joa I, Hatloy K, Stain HJ, Langeveld J. Help seeking for mental health problems in an adolescent population: the effect of gender. J Ment Health (Abingdon, England). 2019;28(5):467–74. https://doi.org/10.1080/09638237.2017.1340630. Grych J, Hamby S, Banyard V. The resilience portfolio model: understanding healthy adaptation in victims of violence. Psychol Violence. 2015;5(4):343–54. https://doi.org/10.1037/a003967. Bronfenbrenner U. Toward an experimental ecology of human development. Am Psychol. 1977;32(7):513–31. https://doi.org/10.1037/0003-066X.32.7.513. Hobfoll SE. Conservation of resources: a new attempt at conceptualizing stress. Am Psychol. 1989;44(3):513–24. https://doi.org/10.1037/0003-066X.44.3.513. In-Albon T, Meyer AH, Metzke CW, Steinhausen H-C. A cross-lag panel analysis of low self-esteem as a predictor of adolescent internalizing symptoms in a prospective longitudinal study. Child Psychiatry Hum Dev. 2017;48(3):411–22. https://doi.org/10.1007/s10578-016-0668-x. Pace U, Zappulla C, Di Maggio R. The mediating role of perceived peer support in the relation between quality of attachment and internalizing problems in adolescence: a longitudinal perspective. Attach Hum Dev. 2016;18(5):508–24. https://doi.org/10.1080/14616734.2016.1198919. King DW, Taft C, King LA, Hammond C, Stone ER. Directionality of the association between social support and posttraumatic stress disorder: a longitudinal investigation. J Appl Soc Psychol. 2006;36(12):2980–92. https://doi.org/10.1111/J.0021-9029.2006.00138.X. Dubow EF, Huesmann LR, Boxer P, Landau S, Dvir S, Shikaki K, Ginges J. Exposure to political conflict and violence and posttraumatic stress in Middle East youth: protective factors. J Clin Child Adolesc Psychol. 2012;41(4):402–16. https://doi.org/10.1080/15374416.2012.684274. MacDonald K, et al. Minimization of childhood maltreatment is common and consequential: results from a large, multinational sample using the childhood trauma questionnaire. PLoS ONE. 2016;11(1):e0146058. https://doi.org/10.1371/journal.pone.0146058. Abajobir AA, Kisely S, Williams G, Strathearn L, Clavarino A, Najman JM. Gender differences in delinquency at 21 years following childhood maltreatment: a birth cohort study. Pers Individ Differ. 2017;106:95–103. https://doi.org/10.1016/j.paid.2016.10.020. Häuser W, Schmutzer G, Brähler E, Glaesmer H. Maltreatment in childhood and adolescence: results from a survey of a representative sample of the German population. Deutsches Ärzteblatt Int. 2011;108:287–94. https://doi.org/10.3238/arztebl.2011.0287.