Poster #61 - Youth Self- Reported PTSD Symptoms Predict Parent-Rated low Social Responsiveness/Emotional Dysregulation Among Foster Youth

• In Event: 1-005 - Poster Session 01
  In Poster Session: PS 01 Section - Developmental Psychopathology

Integrative Statement

The fifth edition of the Diagnostic and Statistical Manual (DSM-5, APA, 2013) categorize Disinhibited Social Engagement Disorder (DSED) and Reactive Attachment Disorder (RAD) as two distinct trauma and stressor-related disorders. Further, criteria for RAD now comprise two cluster of symptoms: A) absence of attachment behaviors, and B) low social responsiveness/emotional dysregulation. The RAD and DSED Assessment (RADA) interview (Minnis, 2017) is a revised version of the CAPA-RAD interview (Minnis et al., 2009) and is compliant with the new DSM-5 criteria. A recent study using the RADA interview indicated that RAD is devisable into two factors, one of which capture attachment-related difficulties (RAD1), while the other comprise more general trauma-related symptoms (RAD2, Lehmann et al., accepted).

In this study, we aim to assess the convergent-discriminant validity of the RADA interview by examining the possible differential predictive value of youth self-reported posttraumatic stress disorder (PTSD) symptoms on the three established RADA factors, namely DSED, RAD1 and RAD2 respectively, as reported by foster parents. Our hypothesis is that self-reported PTSD symptoms are more strongly associated to parent-reported low social responsiveness/emotional dysregulation (RAD2), than attachment-related difficulties (RAD1) or DSED respectively.

The RADA interview online version, measuring RAD (11 items) and DSED (9 items), was completed by the foster parents. The Child and Adolescent Trauma Screen (CATS, Sachser et al. 2017) is based on the DSM-5 criteria for PTSD. Items cover intrusions, avoidance, negative alterations in cognition and mood, and hyper-arousal. CATS was completed by the foster youth.

Structural Equation modeling (SEM) analysis, which took the categorical nature into account (DWLS estimator), was conducted using Lavaan package in R (Rossel, 2012). The sample used in this SEM analysis was youth living in foster families (N = 398, 53.7% boys) aged 11-17 years (Mage = 15.0, SD = 2.0) and their foster parents, recruited from Child protective services. The SEM model hypothesized one PTSD factor comprising all 15 items in the CATS. This factor was regressed on three factors from the RADA, comprising Lack of attachment behaviors (RAD1, 2 items); Emotional dysregulation (RAD 2, 9 items), and disinhibited behavior (DSED, 9 items).

Preliminary results showed satisfactory fit of the model with our data (X2 = 41129.628, df = 735, p < 0.001, CFI = 0.99, TLI = 0.99, RMSEA 0.04, 90 % Confidence Interval [CI] [0.04, 0.04]) As hypothesized, youth reported PTSD symptoms showed the strongest association with RAD 2; emotional dysregulation symptoms (β 0.23, p = 0.007), followed by DSED (β 0.19, p = 0.033). RAD1; absence of attachment behaviors was not associated with youth reported PTSD symptoms (β 0.06, p = 0.49). These preliminary findings support our suggestion that RAD as defined in DSM-5 may consist of two related but separate constructs, where symptoms compliant with criterion B is associated with PTSD symptoms.

Authors

• Stine Lehmann, Norwegian Research Centre, Bergen
  Presenting Author

• Kyrre Breivik, Regional Centre for Child and Youth Mental Health and Child Welfare -West, Uni Research Health, Bergen
  Non-Presenting Author

• Sebastien Monette, UQAM
  Non-Presenting Author

• Helen Minnis, University of Glasgow
  Non-Presenting Author