Exploring conduct difficulties amongst middle-aged children living in care

Abstract

Background

The present study aimed to explore the attachment and internal representations among looked after children who experience conduct difficulties (CDi). CDi were explored alongside levels of emotional symptoms (ES), as were how young people responded to stories in a narrative-based measure.

Methods

Children living in care at Five Rivers Child Care aged four to 11 were eligible for the study. In part one, quantitative analyses were conducted on 82 participants, drawing upon the relationship between the children’s Story Stem Assessment Profile completions and the carers' Strengths and Difficulties Questionnaire (SDQ) completions. In part two, qualitative analyses focused on a subsample (n = 27) of those who scored high for CDi and within normal parameters for ES, as captured through the emotional difficulties subscale, on the SDQ.

Results

Quantitative analysis showed no significant findings between levels of CDi and attachment representations of the self and others. In part two, negative representations of parental figures were more commonly portrayed, and there was less coherence in stories that were emotionally arousing.

Conclusion

This study emphasises the importance of understanding the complexity of CDi. These findings provide preliminary insights for professionals working with looked after children and contribute to developing future regulations, policies and interventions. Consideration of the prevalence of both ES and externalising presentations when exploring CDi remains essential to deepen our understanding of what can be such a unique aetiology.

Plain language summary

This study looked at behaviour problems in children aged four to 11 who were living in foster care. The researchers wanted to understand how these children thought about themselves, other people and the world around them – and whether these thoughts are connected to their behaviour.

Eighty-two carers filled out the Strengths and Difficulties Questionnaire (SDQ), which is used to measure children’s emotional and behavioural challenges. Children completed the Story Stem Assessment Profile (SSAP) to explore their attachment and other internal representations. Following this quantitative enquiry, in the second part, a subsample of 27 children who scored highly for conduct disorder and within normal parameters for internalising difficulties on the SDQ were selected for a more in-depth qualitative enquiry.

The first part of the study didn’t find a clear link between the level of behaviour difficulties and how children viewed themselves or others. However, in the second part, many of the children showed negative views of adults in their stories, especially when the story involved strong emotions. These stories were also often less organised and harder to follow.

This research highlights how complex behaviour problems in children can be, especially for those in care. It also shows how important it is to understand each child’s emotional background and relationships, so professionals can better support them and develop more effective approaches to care and intervention.