Physical health, mental health, and behaviour problems among early adolescents in foster care
Article first published online: 13 FEB 2012
© 2012 Blackwell Publishing Ltd
Child: Care, Health and Development
Volume 39, Issue 2, pages 220–227, March 2013
How to Cite
Woods, S. B., Farineau, H. M. and McWey, L. M. (2013), Physical health, mental health, and behaviour problems among early adolescents in foster care. Child: Care, Health and Development, 39: 220–227. doi: 10.1111/j.1365-2214.2011.01357.x
- Issue published online: 25 JAN 2013
- Article first published online: 13 FEB 2012
- Accepted for publication 9 October 2011
- foster care;
- mental health;
- physical health
Background Adolescents with chronic illness in the general population are at increased risk of mental health and behaviour problems. Depression is also associated with delinquency. Adolescents in foster care are more at risk for chronic illness and mental health issues. We investigated whether adolescents in long-term foster care with chronic illness have associated higher rates of internalizing and externalizing problems and delinquency. We also investigated if depression mediates the relationship between physical health and externalizing behaviours.
Methods Data are from the National Survey of Child and Adolescent Well-Being; adolescents age 11 and older residing in long-term foster care (n= 188). Children whose caregivers reported on the occurrence of a chronic illness were compared using anova on internalizing and externalizing subscale scores and total scores of the Youth Self Report (YSR) and Child Behavior Checklist (CBCL), and modified Self-Report of Delinquency (MSRD) scores of delinquency and total number of delinquent acts. Bootstrapping analyses were used to test our hypothesis that depressive symptoms (Children's Depression Inventory) function as a mediator.
Results Adolescents with a chronic illness reported greater internalizing (YSR: F= 7.069, P= 0.009; CBCL: F= 4.660, P= 0.032) and externalizing (YSR: F= 5.878, P= 0.016; CBCL: F= 3.546, P= 0.061) problems, a greater number of delinquent acts (6.66, F= 5.049, P= 0.026) and heightened overall delinquency (F= 5.049, P= 0.026). Depression significantly mediated the effects of overall health on delinquency (95% CI, 0.03–1.76).
Conclusions It is important to consider the complex interrelationships between physical health, mental health, and behaviour for adolescents in foster care. These findings support the need for comprehensive services for these youths, including specialized assessments and collaboration between protective services and healthcare systems.