Gender and Racial/Ethnic Differences In Psychosocial Functioning Among Adolescents Entering out-of-Home Care: A Multigroup Latent Profile Analysis

Background/Purpose: Youth involved with the U.S. child welfare system experience disproportionate rates of exposure to childhood adversity and are at increased risk for maladaptive psychosocial functioning. Early identification of youth at risk for psychosocial problems is important to provide trauma-informed services, stabilize out-of-home placements, and promote positive permanency outcomes. The current study identified distinct subgroups of youth based on psychosocial functioning upon entry into out-of-home care and examined whether the subgroups were similar across gender and race/ethnicity.

Method: We used data from 6,345 adolescents (12-17 years, M = 14.88, SD = 1.61) who entered out-of-home care between 2016-2022 in one U.S. state and received psychosocial functioning screening. Sum scores for each of the screening assessments (adverse life events, PTSD symptoms, emotional problems, conduct problems, hyperactivity problems, peer problems, prosocial behavior, and substance use) were computed. Higher scores indicated worse functioning for all except for prosocial behavior. Clinical cut-off scores were used to interpret scores. We conducted latent profile analyses in Mplus version 8.10 to identify underlying subgroups of youth based on patterns of scores on the 8 assessments. We then conducted multigroup similarity analysis to test whether the subgroups were similar across binary gender and racial/ethnic groups.

Results: Within the full sample of youth, we identified four subgroups of psychosocial functioning: Low adverse life events and average psychosocial functioning (Class 1, 24%), Slightly raised conduct problems and low prosocial behaviors (Class 2, 29%), Slightly raised emotional and peer problems, moderate PTSD problems, and average prosocial behaviors (Class 3, 28%), and Slightly raised emotional problems, moderate PTSD symptoms, high or very high conduct, hyperactivity, peer, and substance use problems and very low prosocial behaviors (Class 4, 19%). In the multigroup similarity analysis, we found support for configural similarity (i.e., the same number of subgroups) across males and females (4 profiles identified) and across racial/ethnic groups (5 profiles identified). We did not find support for structural similarity (i.e., mean scores were not similar) across gender or racial/ethnic groups. Males tended to have subgroups characterized by higher levels of conduct, hyperactivity, substance use, and prosocial behavior problems, whereas females tended to have subgroups characterized by higher levels of emotional problems and average prosocial behaviors. White youth tended to have subgroups characterized by higher levels of emotional, conduct, hyperactivity, and peer problems, and prosocial behaviors ranging from average to very low. Racial/ethnic minority youth tended to have subgroups characterized by higher levels of substance use problems and either average or very low prosocial behaviors.

Conclusions/Implications: Our findings indicate that youth psychosocial functioning at time of entry into out-of-home care can help to identify youth in need of services. It is notable that 24% of youth in the full sample had no psychosocial problems. The variation in psychosocial functioning across subgroups indicates the diverse needs of youth entering out-of-home care. Differences in scores across gender and racial/ethnic groups emphasize the importance of tailoring services to youth’s needs. Further research should explore potential protective factors these groups may have access to that promote psychosocial wellbeing.