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  • 19 publications addressed this question 1-19
  • Four different study populations had multiple publications recording different features as follows:
    • Goldstein 2011 & Wekerle 2009 2,17
    • James 2009, Traube 2012 & Tyler 2008 4,13,14
    • McGee 1995, McGee 1997 & McGee 2001 6,7,8
    • McMillen 2005 & Vaughn 2007 9,15
  • These 19 articles all met our inclusion criteria and all of the included studies were ranked A1 for confirmation of neglect / emotional maltreatment
  • Only six studies included normal controls 1,3,12,16,17,19


  • Study designs: 
    • 1 case-control 19
    • 2 case-series 16,18
    • 4 prospective cohort / longitudinal 3,12-14
    • 12 cross-sectional 1,2,4-11,15,17


  • Age: This review included children aged 11-20 but the majority of studies addressed children with a mean age between 14.5 and 16.9 years



Influence of ethnicity and socio-economic group

All six comparative studies matched or controlled for ethnicity 1,3,12,16,17,19, and five out of the six matched or controlled for socio-economic status 1,3,12,17,19


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  1. Aarons GA, Monn AR, Hazen AL, Connelly CD, Leslie LK, Landsverk JA, Hough RL, Brown SA. Substance involvement among youths in child welfare: the role of common and unique risk factors. The American Journal of Orthopsychiatry. 2008;78(3):340-349 [Pubmed]

  2. Goldstein AL, Wekerle C, Tonmyr L, Thornton T, Waechter R, Pereira J, Chung R. The relationship between post-traumatic stress symptoms and substance use among adolescents involved with child welfare: implications for emerging adulthood. International Journal of Mental Health and Addiction. 2011;9(5):507-524 [Abstract available from Springer Link]

  3. Hibbard RA, Spence C, Tzeng OC, Zollinger T, Orr DP. Child abuse and mental health among adolescents in dependent care. The Journal of Adolescent Health. 1992;13(2):121-127 [Pubmed]

  4. James S, Montgomery SB, Leslie LK, Zhang J. Sexual risk behaviors among youth in the child welfare system. Children and Youth Services Review. 2009;31(9):990-1000 [Pubmed]

  5. Kools S, Paul SM, Norbeck JS, Robbins NR. Dimensions of health in young people in foster care. International Journal of Adolescent Medicine and Health. 2009;21(2):221-233 [Pubmed]

  6. McGee RA, Wolfe DA, Olson J. Multiple maltreatment, attribution of blame, and adjustment among adolescents. Development and Psychopathology. 2001;13(4):827-846 [Pubmed]

  7. McGee RA, Wolfe DA, Wilson SK. Multiple maltreatment experiences and adolescent behavior problems: adolescents' perspectives. Development and Psychopathology. 1997;9(1):131-149 [Pubmed]

  8. McGee RA, Wolfe DA, Yuen SA, Wilson SK, Carnochan J. The measurement of maltreatment: a comparison of approaches. Child Abuse & Neglect. 1995;19(2):233-249 [Pubmed]

  9. McMillen JC, Zima BT, Scott LD, Jr, Auslander WF, Munson MR, Ollie MT, Spitznagel EL. Prevalence of psychiatric disorders among older youths in the foster care system. Journal of the American Academy of Child and Adolescent Psychiatry. 2005;44(1):88-95 [Pubmed]

  10. Thompson R, Proctor LJ, English DJ, Dubowitz H, Narasimhan S, Everson MD. Suicidal ideation in adolescence: examining the role of recent adverse experiences. Journal of Adolescence. 2012;35(1):175-186 [Pubmed]

  11. Thompson RG Jr, Auslander WF. Risk factors for alcohol and marijuana use among adolescents in foster care. Journal of Substance Abuse Treatment. 2007;32(1):61-69 [Pubmed]

  12. Thornberry TP, Ireland TO, Smith CA. The importance of timing: the varying impact of childhood and adolescent maltreatment on multiple problem outcomes. Development and Psychopathology. 2001;13(4):957-979 [Pubmed]

  13. Traube DE, James S, Zhang J, Landsverk J. A national study of risk and protective factors for substance use among youth in the child welfare system. Addictive Behaviors. 2012;37(5):641-650 [Pubmed]

  14. Tyler KA, Johnson KA, Brownridge DA. A longitudinal study of the effects of child maltreatment on later outcomes among high-risk adolescents. Journal of Youth and Adolescence. 2008;37(5):506-521 [Abstract available from Springer Link]

  15. Vaughn MG, Ollie MT, McMillen JC, Scott L Jr, Munson MR. Substance use and abuse among older youth in foster care. Addictive Behaviors. 2007;32(9):1929-1935 [Pubmed]

  16. Wechsler-Zimring A, Kearney CA. Posttraumatic stress and related symptoms among neglected and physically and sexually maltreated adolescents. Journal of Traumatic Stress. 2011;24(5):601-604 [Pubmed]

  17. Wekerle C, Leung E, Wall AM, MacMillan H, Boyle M, Trocme N, Waechter R. The contribution of childhood emotional abuse to teen dating violence among child protective services-involved youth. Child Abuse & Neglect. 2009;33(1):45-58 [Pubmed]

  18. Wekerle C, Wolfe DA, Hawkins DL, Pittman AL, Glickman A, Lovald BE. Childhood maltreatment, posttraumatic stress symptomatology, and adolescent dating violence: considering the value of adolescent perceptions of abuse and a trauma mediational model. Development and Psychopathology. 2001;13(4):847-871 [Pubmed]

  19. Williamson JM, Borduin CM, Howe BA. The ecology of adolescent maltreatment: a multilevel examination of adolescent physical abuse, sexual abuse, and neglect. Journal of Consulting and Clinical Psychology. 1991;59(3):449-457 [Pubmed]



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