Relationships Between Psychosocial Risks and Stress in Homeless Children

Homeless children are typically exposed to the worst environmental conditions associated with poverty. Despite recent attention to psychosocial risks associated with homelessness, limited attention has been paid to stress-related symptoms in homeless children. Better understanding of homeless children’s experience of stress could point the way toward improvement of services for them. The purpose of the present exploratory study was to assess associations between child psychosocial riskfactors and emotional and behavioral symptoms of stress in homeless children, Twenty-two homeless nlothers of 29 children between the ages of 2 and 10 were surveyed about known psychosocial risks for homeless children and completed the Pediatric Emotional Distress Scale (PEDS), a 17-item measure of stress-related symptoms in children. Findings suggest that the stress-related symptoms of these children are related to the cumulative effects of environmental risk factors. The PEDS appears to be a sensitive measure of stress in children, and its brevity provides an advantage in assessments in high-stress situations. More developmental work with low-SES samples, however, is recommended.     

Homeless Children and Stress: An Empirical Study

Families with children constitute the fastest-growing segment of the homeless population. Past literature has indicated that children who are homeless experience more stress than children who are not homeless. This study measured the level of psychosocial stress experienced by homeless children by utilizing two direct and two indirect measurement tools. The sample included 52 children from family-shelter facilities in Central Florida. T-test results indicated a statistically significant difference between the sample's scores and that of the normative group. Prompt intervention at both the individual and environmental level is recommended.     

Life Experiences and Vulnerabilities of Homeless Women: A Comparison of Women Unaccompanied Versus Accompanied by Minor Children, and Correlates with Children's Emotional Distress

The histories and service needs of 2 groups of homeless women, those unaccompanied by minor children (n = 46) and those accompanied by minor children (n = 22), were compared, on the basis of their responses to a biennial survey of homeless people in a midsize city in the southeast United States. Mothers of children aged 2–10 also completed a measure of stress symptoms for their children (n = 20). Irrespective of family status group, problems such as substance abuse, history of mental illness, health problems, chronicity of homelessness, and crime victimization tended to cluster together. The findings also suggest that declining and/or inadequate levels of public benefits, Temporary Assistance to Needy Families, and Medicaid-funded health care in particular, have adversely affected the 2 groups, particularly families with children. The young children in this sample experienced elevated levels of stress, and significant associations were found between children's stress levels and certain risk factors of their mothers. Implications for service delivery are discussed.     

Factors Associated With Substance Use Disorders Among Traumatized Homeless Youth

This study aimed to identify homeless youths’ lifestyle and trauma-related risk factors as well as protective factors associated with alcohol use disorder or no disorder and drug use disorder or no disorder. Youth receiving homeless services in Denver (n = 201), Austin (n = 200), and Los Angeles (n = 200; N = 601) completed quantitative interviews assessing demographic information, alcohol and drug use, homeless lifestyle risk factors, trauma-related risk factors, and protective factors. Findings showed differences in trauma-related risk factors between alcohol and drug use disorders, but not homeless lifestyle risks. Protective factors predicted substance use disorders beyond risk factors. Understanding trauma-related risk and protective factors associated with substance use disorders could improve interventions.     

Mothers' perception of their relationship with their children during displacement: A six month follow-up

The data presented in this work were gathered within the framework of the psychosocial assistance programme for families with children in one of the oldest displacement shelters in Croatia. Over a period of 6 months, the mothers (N = 58) assessed the psychosocial adjustment difficulties of their children and how displacement affected their relationship with their children (N = 109). The study revealed that as time passed in displacement, mothers talked significantly less with their children and were generally more nervous. The most common difficulties manifested by children were appetite disorders, night fears, sleeping disturbances in general, increased sweating, fear of separation from their mother, despondency and general fearfulness. Over time the reported incidence of stress-related reactions in children significantly decreased. However, after a year spent in displacement, 12% of the children still manifested five or more stress symptoms. Children with a higher incidence of disorders had mothers whose adaptation to displacement was poorer and whose relationship with their children was less favourable. Their families were more often separated. Particularly apparent was the importance of providing psychological assistance for mothers and children who are unable to cope with the stress of displacement.     

Children in Foster Care and the Development of Favorable Outcomes

Young foster children have invariably faced a variety of risks that are strongly linked to long-term deficits in functioning across multiple developmental domains. Despite these risks, however, some children demonstrate more favorable outcomes and exhibit adaptation and the development of assets. In the present study, the relationship of early childhood factors (e.g., maltreatment history, placement history, parenting practices, environmental stress, developmental status, and attachment behavior) to the development of favorable outcomes in middle childhood was examined in a sample of foster children who had been in foster care in preschool (N = 35). Favorable outcomes were defined as demonstrations of emotion regulation and school adjustment during middle childhood. Developmental status (particularly attention and executive functioning) and a lack of environmental stress during early childhood foster care experiences had a significant positive relationship with the development of emotion regulation and school adjustment in middle childhood.     

The Association Between Infants’ Attention Control and Social Inhibition is Moderated by Genetic and Environmental Risk for Anxiety

Infant social inhibition is associated with increased risk for anxiety later in life. Although both genetic and environmental factors are associated with anxiety, little empirical work has addressed how developing regulatory abilities work with genetic and environmental risk to exacerbate or mitigate problem behaviors. The current study was aimed at addressing this gap in research by investigating an early emerging regulatory behavior, attention control, in association with genetic and environmental risk for anxiety. Participants included 9‐month‐old adopted infants, their birth mothers, and adoptive parents (N = 361). Lifetime diagnosis of birth mother social phobia was obtained using structured interviews. Adoptive parents completed self‐report measures of anxiety symptoms. Infant social inhibition and attention control were coded during a stranger interaction and a barrier task, respectively. Neither adoptive nor birth parent anxiety was directly associated with social inhibition. The association of attention control with social inhibition in infants was moderated by birth and adoptive parent anxiety symptoms. When infants of birth mothers with social phobia were raised by adoptive parents with high self‐reported anxiety symptoms, greater attention control was associated with greater social inhibition. However, when raised by adoptive parents with low self‐reported anxiety, greater attention control was associated with less social inhibition.     

A population-based inquiry of homeless episode characteristics and early educational well-being

Child homelessness and educational well-being is an area of national research that requires more precise investigation to address mixed findings. The aim of this study was to extend the investigation of the relations between homelessness and educational well-being by determining if timing and frequency of homeless episodes are differentially associated with children's academic and classroom engagement outcomes. This investigation used a comprehensive research model to study the effects of these homeless episode characteristics within a large urban student cohort. Additionally, this study accounted for co-occurring early risk factors. Findings indicated that having a first homeless episode in early childhood was associated with non-proficiency in mathematics and academic engagement problems. Also more frequent homeless episodes were related to truancy in third grade. These results stress the importance of early intervention for homeless children and underscore the need to further understand the variation in young children's homeless experiences.     

Depressive Symptoms and Their Association With Adverse Environmental Factors and Substance Use in Runaway and Homeless Youths

We used diathesis‐stress and stress‐sensitization models to determine whether family maltreatment, street‐related traumatic events, stressful life events, and substance use were associated with depressive symptoms in runaway and homeless youths (RHY) in Los Angeles. Greater severity of depressive symptoms was significantly related to family maltreatment, being exposed to more traumatic stressors during homelessness, and current substance use compared to no substance use. Family maltreatment was also found to moderate the relationship between traumatic stressors and depressive symptoms. Importantly, cumulative exposure to the investigated risk factors at varying levels was associated with more severe depressive symptoms. Using a trauma‐informed approach to screen for RHY at risk of depression may pave the way for secondary prevention of major depression in RHY.     

A Theory of Mental Health and Optimal Service Delivery for Homeless Children

Homeless children are a vulnerable group with high risk for developing mental health disorders. The pathways to disorders among homeless children have not been fully elucidated, with significant logistical and measurement issues challenging accurate and thorough assessment of need. The environments of homeless children are uniquely chaotic, marked by frequent moves, family structure changes, household and neighborhood disorder, parenting distress, and lack of continuous services. Despite high rates of service use, mental health outcomes remain poor. This paper reviews the literature on homeless children’s mental health, as well as prior theoretical explorations. Finally, the paper proposes a theoretical model that explains elevated rates of mental health problems among homeless children as consequences of harmful stress reactions triggered by chronic household instability along with repeated service disruptions. This model draws upon existing conceptual frameworks of child development, family poverty, health services utilization, and the biology of stress to clarify the role of environmental chaos in the development of child emotional and behavioral problems. Potential strategies to mitigate the risk for mental health disorders among homeless children and future research directions are discussed.     

Gender differences in health risks and physical symptoms among the homeless

Gender differences in health risks and symptoms are compared for a survey sample of 100 homeless persons and for the general population. Homeless men appear at greater risk of exhibiting symptoms. Nonetheless, homeless women report more symptoms, a result consistent with general population trends. Predisposing illnesses were the most accurate predictors of the number of reported symptoms, but gender explained a significant amount of variation in reported symptoms after other health risks were controlled. The findings inform the debate on the relative importance of biological factors, acquired risks, illness perception and behavior, and reporting bias in explaining why women report more symptoms in survey research. It appears likely that female reporting bias and gender differences in illness perception are underestimated in general population surveys because even under extreme conditions, men are less likely than women to report symptoms.     

African American Family and Parenting Strategies in Impoverished Neighborhoods

This article considers how qualitative insights can inform quantitatively-derived neighborhood effects theories. Neighborhood effects theories argue that inner-city areas lack social and economic resources that promote the social mobility prospects of African American children. Consequently, children who grow up in impoverished neighborhoods are at risk for dropping out of school, bearing children prematurely, and engaging in delinquent activities. Qualitative studies, however, identify family and parenting strategies that buffer children from the risks associated with inner-city residence. When these practices are used, children are more likely to complete high school, forego premature childbearing, and participate in prosocial activities. Insights from qualitative studies expand on neighborhood effects theories by identifying variations in child social mobility prospects and the processes by which conventional outcomes are achieved. More specifically, qualitative studies focus attention on important factors that permit children to succeed, despite social and economic obstacles.     

Lesbian, gay, and bisexual homeless youth: an eight-city public health perspective

This article reports on results of a one-day public health survey conducted in six states by homeless youth providers to measure and compare risk factors between lesbian, gay, and bisexual (LGB) homeless youth and non-LGB homeless youth. This article intends to inform the child welfare field on existing gaps in services and areas where more training and technical support is necessary in providing services to homeless LGB youth. The findings point to substantial differences within the homeless youth sample and demonstrate that in addition to the public health risks young people face merely by being homeless, the risks are exacerbated for those who self-identify as lesbian, gay, or bisexual. The article informs child welfare providers and policymakers about the substantial vulnerability of LGB youth beyond that of non-LGB homeless youth and the need to fund programming, training, technical assistance and further research to specifically respond to the complex needs of this population.     

Early psychosocial risk factors and postnatal parental reflective functioning

Psychosocial factors have been found to relate to parental reflective functioning (PRF), a parent's ability to mentalize about themselves and their child. Relations between maternal psychosocial risk factors and PRF were investigated in a community sample. A sample of mothers (n = 146) was assessed for risk factors when infants were 6 months, infant temperament was assessed using an observational measure, and PRF was assessed with the Parent Development Interview-Revised (PDI). PRF was measured again with the Parental Reflective Functioning Questionnaire (PRFQ) when children were 4 years (n = 105) and 5 years (n = 92), with an additional sample of mothers (n = 48) tested at these two timepoints. Results showed that in infancy, total maternal psychosocial risk related to lower PDI-PRF; regression analyses highlighted low socioeconomic status, unplanned pregnancy, and low maternal anxiety as independent predictors of lower PDI-PRF. PDI-PRF scores at 6 months did not relate to PRFQ scores, but PRFQ subscales showed stability over time from age 4–5. Results are discussed with regard to the impact of maternal psychosocial risk and infant temperament on PRF and the stability and concordance of PRF measures.     

Psychosocial Well‐Being and the Relationship Between Divorce and Children's Academic Achievement

As an unprecedented number of children live in families experiencing divorce, researchers have developed increasingly complex explanations for the consequences associated with marital dissolution. Current accounts focus on changes to family finances, destabilized parenting practices, elevated parental conflict, and deterioration of the parent–child relationship, to explain the impact of divorce. A less studied explanation draws attention to children's diminished psychosocial well‐being following divorce. Using data from the Early Childhood Longitudinal Study—Kindergarten cohort (ECLS‐K) (N = 10,061), I examined the role of psychosocial well‐being in the relationship between divorce and children's outcomes. The results suggest that divorce is associated with diminished psychosocial well‐being in children, and that this decrease helps explain the connection between divorce and lower academic achievement.     

Characteristics of Homeless Alcohol and Drug Abusers Identified Through an Assertive Outreach Program

Differences between substance abusers and non-abusers, and among abusers of alcohol, drugs, or both substances, were investigated for 1166 persons identified as homeless or at risk of homelessness by an assertive outreach program in a moderate size city. The 603 self-reported substance abusers included disproportionate numbers of male, Black, unmam'ed, and currently homeless persons with a history or symptoms of mental illness, who expressed a primary need for assistance dealing with the social seIVice system. Type of abuse was associated with demographic charaeten'stics, length of homelessness, mental illness status, and primary expressed needs. An accurate picture of subgroup differences can aid design and delivery of services for the homeless.     

Psychological Symptoms of Sexually Victimized Children and Adolescents Compared With Other Maltreatment Subtypes

The differential effects of sexual victimization and other forms of maltreatment on psychological functioning are not well understood. A sample of sexually victimized children and adolescents (N = 70; 6.3–17.9 years) and a group of youth with a history of nonsexual maltreatment (N = 108; 6.7–16.9 years) were compared using measures of mental health and psychosocial functioning. Assessments included standardized clinical interviews on individual maltreatment history and current psychopathology as well as questionnaires on behavioral and emotional symptoms, including posttraumatic stress symptoms. The results from this study suggest that the risk of experiencing any current mental disorders was independent of type of maltreatment. The risk of meeting the criteria for a current diagnosis of major depression, however, is greater among youth with a history of maltreatment that includes sexual victimization. The significant impact of sexual victimization on posttraumatic stress symptoms was found to be nonsignificant after controlling for age and gender effects. The results indicate that the outcomes of child maltreatment depend on type of maltreatment, but age and gender must be taken into account.     

HIV/AIDS and homelessness

This article describes the results of research on the demographic, housing, psychosocial characteristics, and service needs of a sample of homeless people with HIV disease. Results show that respondents are similar in demographic and housing characteristics to the general homeless population. On average, respondents report high levels of stress and depression, moderate satisfaction with perceived social support availability, moderate beliefs in their ability to influence health related outcomes, moderate levels of self-efficacy, and low levels of physical and psychosocial disability. A range of services was identified as both helpful and useful in supporting a stable living arrangement. Implications for social policy, service provision, and research are discussed.     

Results of a Heart Disease Risk-Factor Screening Among Traditional College Students

Abstract

Biological, behavioral, and psychosocial contributions to the gender gap in coronary heart disease (CHD) are discussed. Although CHD is the Number 1 cause of death for both sexes in the industrialized world, CHD mortality rates between these countries are larger than those between men and women, suggesting that biological factors are not the sole influences on the gender gap in CHD. Traditional coronary risk factors cannot explain the rapid increase in CHD mortality among middle-aged men in many of the newly independent states of eastern Europe. However, eastern European men score higher on stress-related psychosocial coronary risk factors (eg, social isolation, vital exhaustion) than men living in the West. Comparisons between the sexes also reveal gender differences in psychosocial and behavioral coronary risk factors, including excessive alcohol consumption and smoking, favoring women. Overall, it appears that men's coping with stressful events may be less adaptive physiologically, behaviorally, and emotionally, contributing to their increased risk for CHD.