Objectives
Existing research suggests that current and former foster youth represent an under-studied group that is presumed to be at increased risk for comorbid substance abuse and mental illness. Recent reviews by Braciszewaski and Stout, 2012, and Havlicek et al., 2013, highlight the significant gaps in our knowledge and understanding concerning both the risk and protective factors impacting foster youth. We sought to expand the literature by undertaking a secondary analysis of a large national cohort.
Methods
This case control study utilized data collected as part of the National Longitudinal Study of Adolescent Health (Add Health), the largest, and most comprehensive survey of adolescents ever undertaken in the United States. We utilized questions from Wave III to identify individuals who self-reported having spent time in foster care then matched them to similar individuals without a reported history of time spent in foster care. Non-foster care history individuals were matched with foster care history individuals 4:1 utilizing parental income during adolescence as a proxy for socio-economic status, Hispanic ethnicity, gender, race, and birth year. All analyses and algorithmic matchings were run on SPSS v24. Chi-square tests were used for categorical variables and t-tests for continuous variables.
Results
In this study foster youth only differed from their matched controls in two of the tested analyses. 1) Foster youth were less likely to have ever smoked an entire cigarette; and 2) were more likely than matched controls to have taken prescription drugs recreationally. The two groups did not differ in their self-reported prevalence of mental illness, use of cannabis, use of alcohol, or history of having met criteria for DSM-IV cannabis or alcohol dependence.
Conclusions
These findings run contrary to what would be expected given the available literature on childhood trauma and subsequent substance use. Potential explanations include weaknesses inherent in using cohort data, such as loss to follow up and participation bias, as well as potential recall bias as many of the substance use questions asked individuals to recall use that had occurred over ten years previously. Further research will be needed to elucidate the import of the findings.