An Investigation of Complex Attachment- and Trauma-Related Symptomatology Among Children in Foster and Kinship Care

The paper reports an investigation into the nature, patterns and complexity of mental health symptomatology reported for a large (N = 347) population sample of children in foster and kinship care. Cluster analyses were performed on caregiver-reported Child Behavior Checklist (CBCL) and Assessment Checklist for Children (ACC) scores. The derived profile types are characterized more by symptom complexity than specificity, and are delineated more by elevation than shape. The analyses indicate that social and interpersonal relationship difficulties are hallmark features of clinical presentations of children in care; that anxiety is more often observed as a component of felt insecurity than as generalized or trauma-specific anxiety; and that attention-deficit hyperactivity is rarely manifested in isolation from other difficulties. Whereas 35 % of children had clinical difficulties that could plausibly be construed as discrete mental disorders or comorbidity, another 20 % displayed complex attachment- and trauma-related symptomatology that is not adequately conceptualized within DSM or ICD classifications.