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Little is known about the prevalence of post-traumatic stress disorder (PTSD) in adult alumni of foster care and its demographic and contextual correlates. This is one or the first studies to report on racial/ethnic and gender differences and the influence of foster care experiences (i.e., revictimization during foster care, placement change rate, and placement in kinship care) on past year PTSD. Findings revealed significant gender disparities and a moderating influence of kinship care on the relationship between gender and PTSD, as well as increased risk associated with a history of emotional and sexual abuse. Recommendations are made for clinical and systemic intervention.
Events and environments experienced in childhood can have effects on development, behavior, health, mental health, and other functional outcomes into adulthood (Koenen & Widom, 2009; van der Kolk, Roth, Pelcovitz, Sunday, & Spinazzola, 2005). This is certainly the case for people who experience child abuse and neglect. Posttraumatic stress disorder (PTSD) is a major diagnosis associated with early child maltreatment. Criteria for diagnosis include experiencing or witnessing events where one's life or the lives of others are threatened or there is a real or perceived risk of serious injury accompanied by intense feelings of fear, helplessness, or horror (American Psychiatric Association [APA], 2000). Additionally, the traumatized person must have event-related symptoms (for at least one month) of (1) reexperiencing or reliving the trauma through thoughts, dreams, feelings, or other psychological distress; (2) persistent avoidance of or emotional numbing related to reminders of the trauma; and (3) increased arousal (e.g., difficulty sleeping or concentrating, irritability or angry outbursts, hyper-vigilance, or exaggerated startle response; APA, 2002).
Rates of 12-month (past year/current) PTSD in studies with foster care alumni (adults who spent time in foster care as children) range from 11.7% in the Midwest Evaluation of the Adult Functioning of Former Foster Youth (Midwest Study) of alumni at age 21 (Courtney, Dworsky, Cusick, Havlicek, Perez, & Keller, 2007) to 25.2% in Casey Family Programs' Northwest Foster Care Alumni Study (Northwest study) of alumni between ages 20 and 33 (Pecora, Kessler, Williams, O'Brien, Downs, English, White, Hiripi, White, Wiggins, & Holmes, 2005). Both studies used the Composite International Diagnostic Interview (CIDI). Still, very few studies have examined how various contextual factors related to foster care (e.g.,...