Reporting of Child Maltreatment During the COVID-19 Pandemic in a Southern State in the United States.

OBJECTIVES: COVID-19-related stay-at-home orders (SAHOs) created an immediate physical barrier between children and professionals such as pediatricians and teachers, who are often first to identify and report signs of child maltreatment. Our objective was to determine how the SAHO in a southern state was associated with reports of child maltreatment and whether this association was modified by sociodemographic characteristics. METHODS: We linked data on reports of child maltreatment from a southern state in the United States from October 1, 2018, through September 30, 2020, to data from the US Census Bureau to obtain data on county-level socioeconomic characteristics. We fit a segmented regression model to evaluate changes in reports before and after the SAHO, March 20, 2020. We evaluated potential disparities by child age, case and allegation severity, and socioeconomic characteristics. RESULTS: Of 374 885 hotline calls, 276 878 (73.9%) were made before the SAHO and 98 007 (26.1%) after it. Although an immediate decrease in reports of child maltreatment occurred on the day of the SAHO, the rates of reporting within socioeconomic groups started increasing thereafter. While we found no significant change in the overall rate of change in hotline calls after versus before the SAHO (0.23; 95% CI, -0.11 to 0.58), stratified analyses indicate that the rates at which reporting increased varied by education level, health insurance coverage, median annual household income, and unemployment. CONCLUSIONS: Evaluating these trends is important for policy makers and practitioners to understand how policies enforced during the pandemic influence child maltreatment reporting and how these policies may affect reporting differently across socioeconomic groups.

Physiology and emotions: Within individual associations during caregiver-adolescent conflict.

Concordance between physiological and emotional responses is central to models of emotion and has been shown to correspond to effective responses and well-being in adults. A deeper understanding of physiological-emotional concordance during ecologically relevant scenarios is essential to then determine if these associations predict mental health problems or can serve as a helpful biomarker of risk or resilience in adults and youth. The present study assessed the minute-to-minute associations between sympathetic (i.e., skin conductance level [SCL]) and parasympathetic (i.e., respiratory sinus arrhythmia [RSA]) nervous system activity and self-reported emotions, assessed via video-mediated recall procedures, during a parent-adolescent conflict discussion task. Associations between emotion ratings and physiological activity were assessed in adolescents (N = 97; ages 10-15) and their adult caregivers (N = 97). Utilizing a multilevel modeling approach, findings demonstrated a significant positive association between SCL and emotion ratings for youth, suggesting that increased engagement and alertness contributed to more positive emotion. RSA was unrelated to emotion ratings. The presence of significant variability in associations indicated the presence of potential moderators. This could include clinically relevant processes (e.g., emotion regulation, relationship quality, and mental health). Future research should continue to build on findings to determine if, when, and for whom, physiological-emotional concordance occurs, and whether the degree of concordance predicts risk for mental and physical health problems.

Mean-level correspondence and moment-to-moment synchrony in adolescent and parent affect: Exploring associations with adolescent age and internalizing and externalizing symptoms.

Interactions with parents are integral in shaping the development of children's emotional processes. Important aspects of these interactions are overall (mean level) affective experience and affective synchrony (linkages between parent and child affect across time). Respectively, mean-level affect and affective synchrony reflect aspects of the content and structure of dyadic interactions. Most research on parent-child affect during dyadic interactions has focused on infancy and early childhood; adolescence, however, is a key period for both normative emotional development and the emergence of emotional disorders. We examined affect in early to mid-adolescents (N = 55, Mage = 12.27) and their parents using a video-mediated recall task of 10-min conflict-topic discussions. Using multilevel modeling, we found evidence of significant level-2 effects (mean affect) and level-1 effects (affective synchrony) for parents and their adolescents. Level-2 and level-1 associations were differentially moderated by adolescent age and adolescent internalizing and externalizing symptoms. More specifically, parent-adolescent synchrony was stronger when adolescents were older and had more internalizing problems. Further, more positive adolescent mean affect was associated with more positive parent affect (and vice versa), but only for dyads with low adolescent externalizing problems. Results underscore the importance of additional research examining parent-child affect in adolescence.

Adverse childhood experiences, parenting, and socioeconomic status: Associations with internalizing and externalizing symptoms in adolescence.

BACKGROUND: Adverse childhood experiences (ACEs), low socioeconomic status (SES), and harsh parenting practices each represent well-established risk factors for mental health problems. However, research supporting these links has often focused on only one of these predictors and psychopathology, and interactions among these variables in association with symptoms are not well understood. OBJECTIVE: The current study utilized a cross-sectional, multi-informant, and multi-method design to investigate the associations of ACEs, SES, parenting, and concurrent internalizing and externalizing problems in adolescents. PARTICIPANTS AND SETTING: Data are from a volunteer sample of 97 adolescents and their caregivers recruited from 2018 to 2021 in a southern U.S. metropolitan area to sample a range of exposure to ACEs. METHODS: Multiple linear regression models were used to assess associations among adolescents' ACEs exposure, SES, observed parenting practices, and symptoms of internalizing and externalizing psychopathology. RESULTS: Lower SES was associated with higher levels of internalizing and externalizing symptoms, while higher ACEs exposure and observed parenting were related to externalizing but not internalizing symptoms. Associations of adolescents' exposure to physical abuse and perceived financial insecurity with externalizing symptoms were moderated by warm and supportive parenting behaviors. Conversely, harsh parenting was linked to increased levels of externalizing symptoms, particularly in the context of low income. CONCLUSIONS: Findings suggest that the presence of multiple risk factors may incur greater vulnerability to externalizing problems, while warm and supportive parenting practices may provide a buffer against externalizing problems for adolescents exposed to physical abuse. Links between ACEs, SES, parenting, and youth adjustment should continue to be explored, highlighting parenting as a potentially important and malleable intervention target.

Comparison of three models of adverse childhood experiences: Associations with child and adolescent internalizing and externalizing symptoms.

Exposure to adverse childhood experiences (ACEs) is prevalent and confers risk for psychopathology later in life. Approaches to understanding the impact of ACEs on development include the independent risk approach, the Dimensional Model of Adversity and Psychopathology (DMAP) distinguishing between threat and deprivation events, and the cumulative risk approach. The present research provides an empirical confirmation of DMAP and a comparison of these three approaches in predicting internalizing and externalizing symptoms in youth. In Study 1, mental health professionals (N = 57) rated ACEs as threat or deprivation events. These ratings were used to create composites to represent the DMAP approach in Study 2. With cross-sectional and longitudinal data from children and adolescents in state custody (N = 23,850), hierarchical linear regression analyses examined independent risk, DMAP, and cumulative risk models in predicting internalizing symptoms, disinhibited externalizing symptoms, and antagonistic externalizing symptoms. All three approaches produced significant models and revealed associations between exposure to ACEs and symptoms. Individual risk accounted for significantly more variance in symptoms than cumulative risk and DMAP. Cumulative risk masked differential associations between ACEs and psychological symptoms found in the individual risk and DMAP approaches. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Predictors of placement disruptions in foster care.

BACKGROUND: Many children who are removed from a dangerous or neglectful home and placed in state custody subsequently experience additional disruptions while in custody, which can compound the effects of ongoing stress and instability. As such, placement stability has been identified as a critical objective and a key indicator of success for children residing in substitutive care. OBJECTIVE: To examine the utility of child protective services data in identifying predictors of placement disruption. PARTICIPANTS AND SETTING: The current study examined data from youth in Tennessee state custody who had been assessed using the Child and Adolescent Needs and Strengths (CANS) assessment within 30-days of their first, out-of-home placement. The sample included 8,853 youth ages 5-19 years old (M = 13.1; SD = 4.0; 44.8 % female). METHODS: Demographics, placement information, and the CANS assessment were collected by the Tennessee Department of Children's Services for all child welfare episodes for children as part of the system's usual standard of care. Bivariate correlation and linear regression models were conducted. RESULTS: Multiple risk indices from the CANS appeared to significantly increase risk of placement disruption, including child internalizing and externalizing symptoms, school difficulties, youth affect dysregulation, and child age. CONCLUSIONS: The current findings suggest that data collected as part of standard practice by child welfare workers such as the CANS is both feasible and has utility for identifying sources of risk for placement disruptions and to inform possible targets of intervention to enhance placement stability.

Installing trauma-informed care through the Tennessee Child Protective Services Academy.

The Child Protective Services (CPS) Academy was designed to equip members of the child-welfare workforce with knowledge that would assist them with addressing trauma in the lives of children and families. In its design, the CPS Academy applied principles of trauma-informed care, integrating evidence-based research, and a variety of clinical strategies into a comprehensive training program. Over a 2-year period, 277 frontline workers completed training through the CPS Academy. Data were collected as part of a quality-improvement effort to gauge participant satisfaction with the training platform. Participants reported that all components of the training were beneficial and relevant to their work in child welfare. Participants also demonstrated statistically significant improvement in trauma knowledge after participation in the CPS Academy (z = -4.73, p < .001), regardless of their level of education or years of experience in child welfare, F(3, 196) = 1.85, p = .14, ηp² = .03, 95% CI [0.00, 0.07]. Therefore, the content and structure of the CPS Academy can be implemented within large organizational systems to train child-welfare and CPS workforces efficiently and effectively. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Evidence-based interventions for adolescents with disruptive behaviors in school-based settings.

Disruptive behaviors in the school setting can threaten the maintenance of optimal learning environments in schools. Challenging behaviors, such as defiance, hostility, and aggression, often define disruptive classroom behaviors. This article presents a clinical review of existing literature on interventions for adolescent disruptive behavior problems in school-based settings and in outpatient mental health settings and makes recommendations around working with adolescents with disruptive behaviors in school-based settings. Many types of interventions are effective; effective implementation is key to good results.