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Adverse Childhood Experiences, Quality of Life and the Mediating Roles of Self-Efficacy and Self-Directedness in Youth Residential Care Leavers

Milou Leiting (), Katharina Beck, David Bürgin, Jörg M. Fegert, Nils Jenkel, Cyril Boonmann, Klaus Schmeck, Alexander Grob and Marc Schmid
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Milou Leiting: University of Basel
Katharina Beck: University of Basel
David Bürgin: University of Basel
Jörg M. Fegert: University Hospital Ulm
Nils Jenkel: University of Basel
Cyril Boonmann: University of Basel
Klaus Schmeck: University of Basel
Alexander Grob: University of Basel
Marc Schmid: University of Basel

Applied Research in Quality of Life, 2024, vol. 19, issue 6, No 22, 3479-3499

Abstract: Abstract Purpose Young people in youth residential care report high rates of adverse childhood experiences (ACEs), e.g., abuse and neglect in their families. Various studies show ACEs to impair social participation and mental health, whereas less is known about how ACEs are associated with quality of life (QoL). The aim of the current study is to (1) evaluate the association between ACEs and psychological, physical, social, and environmental QoL in young adult care leavers, and (2) to examine how self-efficacy and self-directedness mediate this association. Methods 179 formerly out-of-home placed young adults (Mage = 26.5, 33.4% women, response rate = 30.3%) were queried at baseline with the Junior Temperament and Character Inventory Revised (JTCI 12-18-R) and at a 10-year follow-up with the Maltreatment and Abuse Chronology of Exposure (MACE) scale, the General Self-Efficacy Scale (GSE) and the World Health Organization Quality-of-Life Questionnaire (WHOQoL-BREF). Results Prevalence rates for ACEs were high, with 87.2% of participants experiencing at least one type of ACE. Cumulative ACEs were associated with lower QoL in all four domains. Self-efficacy (β = -0.111, [-0.187, -0.044]) and self-directedness (β = -0.052, [-0.123, -0.004]) partially mediated the association between severity of ACEs and overall QoL. Conclusions ACEs increase the risk for a lower QoL of young adult care leavers. Results underline the importance of prevention and early intervention efforts for troubled young people and their families, as well as the importance of pedagogical work during residential care. Additional to research on functional outcomes, studies investigating well-being and quality of life in this at-risk populations are needed.

Keywords: Quality of life; Youth residential care; Child welfare; Adverse childhood experiences; Self-directedness; Self-efficacy (search for similar items in EconPapers)
Date: 2024
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DOI: 10.1007/s11482-024-10392-z

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