Investigating the Relationship between Trauma Symptoms and Placement Instability

Shelby L. Clark, Ashley N. Palmer, Becci A. Akin, Stacy Dunkerley, Jody Brook

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Background: Placement stability while in foster care has important implications for children's permanency and well-being. Though a majority of youth have adequate placement stability while in foster care, a substantial minority experience multiple moves during their time in care. Research on correlates of placement instability has demonstrated a relationship between externalizing behaviors and placement instability. Likewise, evidence suggests higher levels of trauma are associated with increased externalizing behaviors. However, few studies have examined the relationship between trauma symptoms and placement instability. Objective: The purpose of this study was to investigate whether children with clinically significant trauma symptoms had higher odds of placement instability. Participants and setting: Administrative data collected as a part of a summative evaluation for a federally-funded trauma III grant project were used. The sample included 1,668 children ages 5 and older who entered foster care during a 30-month period in a Midwestern state and completed a self-reported trauma screen within 120 days of entering care. Methods: Hierarchical logistic regression was conducted to examine the contributions of trauma symptoms scores to placement instability, above and beyond demographic characteristics and case characteristics. Results: Results from the final analytic model, which controlled for demographic and case characteristics, showed that children with clinically significant trauma symptoms (i.e., scores ≥19) had 46% higher odds of experiencing placement instability (OR = 1.46, 95% CIs [1.16, 1.82], p =.001). Findings support the need to screen for and treat trauma symptomology among youth in foster care.

Original languageEnglish
Article number104660
JournalChild Abuse and Neglect
StatePublished - Oct 2020

Bibliographical note

Publisher Copyright:
© 2020 Elsevier Ltd


  • Placement stability
  • foster care
  • placement instability
  • trauma assessment
  • trauma symptoms

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental and Educational Psychology
  • Psychiatry and Mental health


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