Navigating mental health complexity in residential care: Validation of the assessment checklist for adolescents – Short form

Abstract

Background: Adolescents in residential care who have been exposed to early interpersonal adversities may exhibit a range of mental health difficulties that are not well captured by traditional assessment measures. The Assessment Checklist for Adolescents – Short Form (ACA-SF) was developed for assessing maltreatment-related symptoms observed in young people in out-of-home care. Purpose: The aim of this study was to analyse the psychometric properties of the ACA-SF in a sample of adolescents in residential care. Study sample: The sample was composed of 160 adolescents (49.4% boys, 48.8% girls, and 1.9% non-binary gender), aged 11–18, from 24 residential facilities in Spain. Results: The results of the factor analyses largely overlapped with the original six-factor version, with items measuring Non-Reciprocal Behaviour, Social Instability, Emotional Dysregulation/Distorted Social Cognition, Dissociation/Trauma Symptoms, Food Maintenance, and Sexual Behaviour. Our analyses, however, also revealed a seventh factor: Pseudomature Behaviours. The ACA-SF showed good internal consistency, convergent validity, and concurrent validity, as demonstrated by its associations with adverse interpersonal experiences, internalizing and externalizing problems, and psychosocial correlates. Two path analysis models analysing the relationship between interpersonal experiences and mental health supported the distinctiveness of maltreatment-related symptoms. Conclusions: These findings constitute the first attempt to replicate the factor structure of the ACA-SF in adolescents in residential care. Furthermore, they support the use of this instrument as a reliable and valid standardized measure for the assessment of maltreatment-related symptoms in youth.