Attention, Externalizing, and Internalizing Problems of Youth Exposed to Parental Incarceration.
Samantha J Boch, Barbara J Warren, Jodi L Ford
PMID 30958077WHAT IT FOUND
Parental incarceration was linked to higher caregiver-reported behavior problems, but after other adverse childhood experiences were included, many links weakened or disappeared.
Assess total adversity and economic hardship, not incarceration alone.
Key findings
01Exposed youth had higher caregiver-reported total, attention, externalizing, and internalizing behavior scores than unexposed youth.
02After other factors were added, several links were no longer present: total and externalizing problems after adverse childhood experiences were added, and internalizing problems after socioeconomic factors were added.
03Exposed youth had an average of 15 additional adverse childhood experiences, compared with 4 for unexposed youth.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study looked at one time point and cannot show that parental incarceration caused behavior problems. The parent studies were not designed to study parental incarceration, so details such as sentence length, offense type, distance to prison, and probation were not examined. Only 67 adolescents were exposed to parental incarceration, which was too few to examine timing of exposure or differences by sex. Pubertal stage was missing for 138 adolescents, so the analysis had to fill in those data. Caregivers reported both exposure and behavior problems, which can share the same reporter bias. The attention result is unclear because the paper gives contradictory statements about whether it remained after adverse childhood experiences were added. Adverse childhood experiences often occur around the same time as parental incarceration, so their effects cannot be cleanly separated.
The easy way to misread this
Do not conclude that parental incarceration itself causes attention, externalizing, internalizing, or total behavior problems. The study is observational, exposed youth also had many more adverse childhood experiences and economic hardship, and many adjusted links disappeared.