Posttraumatic Stress Symptoms in Children and Adolescents Referred for Child Welfare Investigation: A National Sample of In-Home and Out-of-Home Care
Abstract
This study examines the prevalence and correlates of heightened posttraumatic stress (PTS) symptoms in a nationally representative sample of 1,848 children and adolescents (ages 8-14) who were referred to child welfare for investigation of abuse or neglect based on the National Survey of Child and Adolescent Well-Being. The severity of current PTS symptoms was assessed using the PTS subscale of the Trauma Symptom Checklist for Children, a standardized child-report scale evaluating common symptoms associated with trauma. The overall prevalence of clinically significant PTS symptoms was 11.7% (overall mean T score = 49.5). The prevalence was higher for cases that were placed in out-of-home care (19.2%) than those maintained at home (10.7%). Multivariate hierarchical regression identified four contributors to heightened PTS symptoms: younger child age, abuse by a nonbiological parent, violence in the home, and child depression. The authors discuss the modest but still lower than expected prevalence of self-reported, clinically significant PTS symptoms and the variables associated with greater risk for heightened PTS symptoms found among cases referred to child welfare services.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In a national sample of 8- to 14-year-old children referred for child welfare investigation, rates of posttraumatic symptoms did not differ among children who had experienced physical abuse (10%), sexual abuse (13%), and neglect (13%).
“In a national sample of in-home and out-of-home care, 8-to 14-year-old children referred for child welfare investigation were not different in the rates of posttraumatic symptoms among children who had experienced physical abuse (10%), sexual abuse (13%), and neglect (13%) (Kolko et al, 2010).”
From Deviations from the expectable environment in early childhood and emerging psychopathology (2015) · cites this paper as Kolko et al, 2010
Several studies have documented that neglect is associated with developing PTSD or posttraumatic symptomatology.
“Nevertheless, several studies have documented that neglect is associated with developing PTSD or posttraumatic symptomatology.”
From Deviations from the expectable environment in early childhood and emerging psychopathology (2015) · cites this paper as Kolko et al, 2010
Cites
Diagnostic and Statistical Manual of Mental Disorders
American Psychiatric Association (2013) · doi:10.1176/appi.books.9780890425596 · Cited by 116,369 · see citing works
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,841 · see citing works
Posttraumatic Stress Disorder in the National Comorbidity Survey
Kessler, R. C. (1995) · Archives of General Psychiatry · doi:10.1001/archpsyc.1995.03950240066012 · Cited by 10,379 · see citing works
Bonanno, G. A. (2004) · American Psychologist · doi:10.1037/0003-066x.59.1.20 · Cited by 6,851 · see citing works
Traumatic Events and Posttraumatic Stress Disorder in an Urban Population of Young Adults
Breslau, N. (1991) · Archives of General Psychiatry · doi:10.1001/archpsyc.1991.01810270028003 · Cited by 2,544 · see citing works
Kilpatrick, D. G., Ruggiero, K. J., Acierno, R., Saunders, B. E., Resnick, H. S., & Best, C. L. (2003) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.71.4.692 · Cited by 1,590 · see citing works
Traumatic Events and Posttraumatic Stress in Childhood
Copeland, W., Keeler, G. P., Angold, A. C., & Costello, E. J. (2007) · Archives of General Psychiatry · doi:10.1001/archpsyc.64.5.577 · Cited by 1,547 · see citing works
BURNS, B. J., PHILLIPS, S. D., WAGNER, H. R., BARTH, R. P., KOLKO, D. J., CAMPBELL, Y., & LANDSVERK, J. (2004) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/01.chi.0000127590.95585.65 · Cited by 1,153 · see citing works
Self-citationThe Prevalence and Consequences of Exposure to Violence among African-American Youth
Fitzpatrick, K. M., & Boldizar, J. P. (1993) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199303000-00026 · Cited by 709 · see citing works
Age of onset of child maltreatment predicts long-term mental health outcomes
Kaplow, J. B., & Widom, C. S. (2007) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.116.1.176 · Cited by 639 · see citing works
Evidence-Based Psychosocial Treatments for Children and Adolescents Exposed to Traumatic Events
Silverman, W., Ortiz, C. D., Viswesvaran, C., Burns, B., Kolko, D., Putnam, F., & Amaya-Jackson, L. (2008) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374410701818293 · Cited by 576 · see citing works
Self-citationManly, J. T., Cicchetti, D., & Barnett, D. (1994) · Development and Psychopathology · doi:10.1017/s0954579400005915 · Cited by 470 · see citing works
Ackerman, P. T., Newton, J. E. O., McPherson, W. B., Jones, J. G., & Dykman, R. A. (1998) · Child Abuse & Neglect · doi:10.1016/s0145-2134(98)00062-3 · Cited by 409 · see citing works
Posttraumatic stress disorder in children: The influence of developmental factors
Salmon, K., & Bryant, R. A. (2002) · Clinical Psychology Review · doi:10.1016/s0272-7358(01)00086-1 · Cited by 407 · see citing works
Trauma in children and adolescents: risk and treatment of psychiatric sequelae.
Pine, D., & Cohen, J. (2002) · Biological Psychiatry · doi:10.1016/s0006-3223(01)01352-x · Cited by 385 · see citing works
No Safe Haven II: The Effects of Violence Exposure on Urban Youth
Schwab‐Stone, M., Chen, C., Greenberger, E., SILVER, D., Lichtman, J. H., & Voyce, C. K. (1999) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199904000-00007 · Cited by 369 · see citing works
Enhancing early attachments : theory, research, intervention, and policy
Berlin, L. J., Ziv, Y., Amaya-Jackson, L. M., & Greenberg, M. T. (2005) · Cited by 355 · see citing works
Boney‐McCoy, S., & David Finkelhor, B. (1996) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.64.6.1406 · Cited by 325 · see citing works
Posttraumatic Stress in Children Exposed to Family Violence and Single-Event Trauma
McCloskey, L. A., & WALKER, M. (2000) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200001000-00023 · Cited by 242 · see citing works
Boney‐McCoy, S., & Finkelhor, D. (1996) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.64.6.1406 · Cited by 235 · see citing works
Defining maltreatment chronicity: Are there differences in child outcomes?
English, D. J., Graham, J. C., Litrownik, A. J., Everson, M., & Bangdiwala, S. I. (2005) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2004.08.009 · Cited by 212 · see citing works
Shahinfar, A., Fox, N. A., & Leavitt, L. A. (2000) · American Journal of Orthopsychiatry · doi:10.1037/h0087690 · Cited by 179 · see citing works
Psychosocial interventions for maltreated and violence-exposed children
Cohen, J., Mannarino, A., Murray, L., & Igelman, R. (2006) · Journal of Social Issues · doi:10.1111/j.1540-4560.2006.00485.x · Cited by 174 · see citing works
NSCAW Research Group (2002) · Children and Youth Services Review · doi:10.1016/s0190-7409(02)00199-8 · Cited by 165 · see citing works
Sexually and physically abused foster care children and posttraumatic stress disorder.
Dubner, A. E., & Motta, R. W. (1999) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.67.3.367 · Cited by 162 · see citing works
Outcome of therapy for sexually abused children: A repeated measures study
Lanktree, C. B., & Briere, J. (1995) · Child Abuse & Neglect · doi:10.1016/0145-2134(95)00075-j · Cited by 145 · see citing works
Lanktree, C. B., Gilbert, A. M., Briere, J., Taylor, N., Chen, K., Maida, C. A., & Saltzman, W. R. (2008) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2007.10.003 · Cited by 139 · see citing works
Relationship Between Entry Into Child Welfare and Mental Health Service Use
Leslie, L. K., Hurlburt, M. S., James, S., Landsverk, J. A., Slymen, D. J., & Zhang, J. (2005) · Psychiatric Services · doi:10.1176/appi.ps.56.8.981 · Cited by 134 · see citing works
Self-citationLehmann, P. (1997) · Journal of Family Violence · doi:10.1023/a:1022842920066 · Cited by 126 · see citing works
Hanson, R. F., Brown, S., Fricker-Elhai, A. E., Kilpatrick, D. G., Saunders, B. E., & Resnick, H. S. (2005) · Child Maltreatment · doi:10.1177/1077559505279295 · Cited by 125 · see citing works
Knutson, J. F., DeGarmo, D. S., Koeppl, G. K., & Reid, J. B. (2005) · Child Maltreatment · doi:10.1177/1077559504273684 · Cited by 123 · see citing works
Sexually and physically abused foster care children and posttraumatic stress disorder.
Dubner, A. E., & Motta, R. W. (1999) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.67.3.367 · Cited by 116 · see citing works
Violence Exposure Among School-Age Children in Foster Care: Relationship to Distress Symptoms
Stein, B. D., Zima, B. T., Elliott, M. N., et al. (2001) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200105000-00019 · Cited by 113 · see citing works
Sadowski, C. M., & Friedrich, W. N. (2000) · Child Maltreatment · doi:10.1177/1077559500005004008 · Cited by 108 · see citing works
Posttraumatic Stress Symptoms in Parentally Bereaved Children and Adolescents
Stoppelbein, L., & Greening, L. (2000) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200009000-00010 · Cited by 106 · see citing works
Nilsson, D. K., Wadsby, M., & Svedin, C. G. (2008) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2007.09.009 · Cited by 93 · see citing works
Saigh, P. A., Yasik, A. E., Oberfield, R. A., Halamandaris, P. V., & McHugh, M. T. (2002) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.111.3.462 · Cited by 85 · see citing works
SCHOOL SURVEY OF EXPOSURE TO VIOLENCE AND POSTTRAUMATIC STRESS SYMPTOMS IN ADOLESCENTS
Seedat, S., van Nood, E., Vythilingum, B., Stein, D. J., & Kamlner, D. (2000) · Southern African Journal of Child and Adolescent Mental Health · doi:10.1080/16826108.2000.9632366 · Cited by 77 · see citing works
Childhood post-traumatic stress disorder: an overview.
Bellis, M. D., & Dillen, T. V. (2005) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2005.05.006 · Cited by 73 · see citing works
Davidson‐Arad, B., Englechin-Segal, D., & Wozner, Y. (2003) · Child Abuse & Neglect · doi:10.1016/s0145-2134(03)00113-3 · Cited by 72 · see citing works
The Potential for Child Neglect: The Case of Adolescent Mothers and Their Children
Lounds, J. J., Borkowski, J. G., & Whitman, T. L. (2006) · Child Maltreatment · doi:10.1177/1077559506289864 · Cited by 72 · see citing works
Crouch, J. L., Smith, D. W., Ezzell, C. E., & Saunders, B. E. (1999) · Child Maltreatment · doi:10.1177/1077559599004003006 · Cited by 61 · see citing works
Kolko, D., Selelyo, J., & Brown, E. (1999) · International Journal of Child Abuse & Neglect · doi:10.1016/s0145-2134(99)00022-8 · Cited by 61 · see citing works
Self-citationChildren's Self-Report of Exposure to Violence and Its Relation to Emotional Distress
Raviv, A., Raviv, A., Shimoni, H. N., Fox, N. A., & Leavitt, L. A. (1999) · Journal of Applied Developmental Psychology · doi:10.1016/s0193-3973(99)00020-9 · Cited by 42 · see citing works
Effects of Perpetrator and Victim Gender on Negative Outcomes of Family Violence
Howells, N. L., & Rosenbaum, A. (2008) · Journal of Family Violence · doi:10.1007/s10896-007-9144-5 · Cited by 37 · see citing works
Developmental Correlates of Psychological Reactance
Dowd, E. T., Pepper, H. F., & Seibel, C. A. (2001) · Journal of Cognitive Psychotherapy · doi:10.1891/0889-8391.15.3.239 · Cited by 28 · see citing works
Fricker-Elhai, A. E., & Smith, D. W. (2002) · Journal of Child Sexual Abuse · doi:10.1300/j070v10n04_04 · Cited by 28 · see citing works
The relationship between childhood support and later emergence of PTSD
Lauterbach, D., Koch, E. I., & Porter, K. A. (2007) · Journal of Traumatic Stress · doi:10.1002/jts.20249 · Cited by 25 · see citing works
Pharmacotherapy and Health Care Costs Among Patients With Schizophrenia and Newly Diagnosed Diabetes
LESLIE, D. L., & Rosenheck, R. A. (2005) · Psychiatric Services · doi:10.1176/appi.ps.56.7.803 · Cited by 19 · see citing works
Cohen, J. A., & Kolko, D. J. (2008) · American Academy of Pediatrics eBooks · doi:10.1542/9781581106411-6-section_4_chapter17 · Cited by 4 · see citing works
Self-citationFeldman, M. (2008) · PubMed · Cited by 3 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Deviations from the expectable environment in early childhood and emerging psychopathology
Humphreys, K. L., & Zeanah, C. H. (2015) · Neuropsychopharmacology · doi:10.1038/npp.2014.165 · Cited by 231 · see citing works
Factors Related to Posttraumatic Stress Disorder in Adolescence
Nooner, K. B., Linares, L. O., Batinjane, J., Kramer, R. A., Silva, R., & Cloitre, M. (2012) · Trauma, Violence, & Abuse · doi:10.1177/1524838012447698 · Cited by 192 · see citing works
The grip of trauma: How trauma disrupts the academic aspirations of foster youth
Morton, B. M. (2018) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2017.04.021 · Cited by 103 · see citing works
Investigating the Relationship between Trauma Symptoms and Placement Instability
Clark, S. L., Palmer, A. N., Akin, B. A., Dunkerley, S., & Brook, J. (2020) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2020.104660 · Cited by 63 · see citing works
Mazzone, A., Nocentini, A., & Menesini, E. (2018) · Aggression and Violent Behavior · doi:10.1016/j.avb.2017.12.004 · Cited by 62 · see citing works
McGuire, A., Huffhines, L., & Jackson, Y. (2021) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2021.105026 · Cited by 18 · see citing works
Fulginiti, A., He, A. S., & Negriff, S. (2018) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2018.10.010 · Cited by 17 · see citing works
- Authors
- Kolko, D. J., Hurlburt, M. S., Zhang, J., Barth, R. P., Leslie, L. K., & Burns, B. J.
- Affiliations
- University of Pittsburgh (US)
- Rady Children's Hospital-San Diego (US)
- Child and Adolescent Services Research Center
- University of Maryland, Baltimore (US)
- Tufts Medical Center (US)
- Duke University (US)
- Venue
- Child Maltreatment
- Publisher
- SAGE Publications
- Published
- 2009-06-29
- Volume
- 15
- Issue
- 1
- Pages
- 48-63
- ISSN
- 1077-5595 (ISSN-L)
- 1552-6119
- OpenAlex
- W2076185423
- Cited by
- 172
- References
- 51
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 5 · 2023: 8 · 2022: 8 · 2021: 9 · 2020: 15 · 2019: 14 · 2018: 12 · 2017: 19 · 2016: 17 · 2015: 16 · 2014: 11 · 2013: 12 · 2012: 8
- FWCI
- 5.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Child Maltreatment (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (MH 59672, R01MH059672)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Safety Research › Child Welfare and Adoption
- Keywords
- posttraumatic stress symptoms, child abuse, child neglect, child welfare investigations, out-of-home care, childhood depression, domestic violence, child age, National Survey of Child and Adolescent Well-Being, Trauma Symptom Checklist for Children
- MeSH terms
- Adolescent, Age Factors, Child, Child Abuse, Child Welfare, Child, Institutionalized, Depression, Female, Foster Home Care, Humans, Male, Risk Factors, Stress Disorders, Post-Traumatic, Prevalence, Multivariate Analysis, Domestic Violence
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review