Community Mental Health Journal, Vol. 29, No. 5, October 1993

Personal and Family Distress in Homeless Adolescents

Mark R. Dadds, Ph.D. David Braddock, B.Sa

Simone Cuers, B.A. Amanda Elliott, B.A.

Adrian Kelly, M. Clir~ Psych.

ABSTRACT: Previous research has indicated that homeless children exhibit high rates of behavioral and emotional problems and come from families characterised by conflict and rejection. Further, some evidence exists to show that family variables may relate to adolescent distress differently for homeless males and females. In this study, 117 homeless adolescents were compared to a sample of non-homeless youths on the self reported incidence of personal and family problems. The homeless children reported the highest incidence of all behavioral and emotional problems, parental marital discord, overprotection, and the lowest levels of parental care and acceptance. Sex effects were not evident in reported levels of personal or family problems. However, substantially more variance in the adolescents level of behavioral and emotional disturbance was predictable from family measures for females than males. Overall, the results point to the importance of incorporating family distress models in the understanding and remediation of adolescent homelessness.

The last several decades have seen a move to view childhood home- lessness less as a product of adolescent psychopathology (e.g., Riemer, 1940) and more as a complex phenomenon that involves a range of intrapersonal, familial and societal factors (Adams & Adams, 1987; Goodman, Saxe & Harvey, 1991; Rafferty & Shinn, 1991). Clear evi- dence is available to show that homeless adolescents are at higher than

Mark R. Dadds, David Braddock, Simone Cuers, Amanda Elliott, and Adrian Kelly are affiliated with the Department of Psychology, The University of Queensland.

Address correspondence to Mark R. Dadds, Department of Psychology, The University of Queens- land, Queensland 4072, Australia.

Part of this research was supported from a grant to the first author from the Queensland Government Department of Family Services, 1990.

413 �9 1993 Human Sciences Press, Inc.

414 Community Mental Health Journal

usual risk for psychological problems, particularly depression, low self esteem and impulsivity (Adams & Adams, 1987; Edelbrock, 1980; Fox, Barnett, Davies & Bird, 1990; Leventhal, 1964; Wolk & Brandon, 1977). A recent study also found a high incidence of psychotic symptoms in homeless youths (Mundy, Robertson, Robertson & Greenblatt, 1990). However, studies are not available that indicate whether these prob- lems are antecedents or consequences of being homeless.

There is also clear evidence that the families of homeless youths tend to be characterised by parent-child conflict, discipline problems, physi- cal and sexual abuse, lack of affection and caring, and substance abuse (Adams & Adams, 1987; Janus, McCormak, Burgess & Harman, 1987; Solarz, 1988). Little research has, however, examined the relationship between psychological problems in homeless youth and their family environment. Even fewer studies have examined the possible role of gender and other sociodemographic variables in mediating this rela- tionship. Wolk and Brandon (1977) found that sex differences may be important in that girls may leave home to avoid punitive and over- protective environments whereas boys may leave due to poor parental supervision and control in conjunction with their own immaturity and impulsivity. Given the findings by Wolk and Brandon (1977) it seems likely that any observed relationship between family and adolescent distress may be different for males and females.

The aim of this study was to 1) examine levels of self reported psycho- logical problems in a large sample of homeless adolescents, 2) examine levels of family stress (marital problems, overprotection, acceptance) reported by homeless youths, and 3) examine how much prediction of psychological problems in the adolescents could be afforded by family distress, separately for males and females. It was hypothesized that homeless youths would report more behavioral and emotional prob- lems, more parental marital discord and overprotectiveness and less parental care and acceptance than comparison youths. It was further hypothesized that homeless females would report the highest levels of parental overprotectiveness and that family distress would predict psy- chological problems most powerfully in homeless females.

METHOD

Part ic ipants were 117 homeless adolescents (51 female, 68 males) and 124 comparison adolescents (73 female, 51 male). All par t ic ipants were between the ages of 13 and 18 years (homeless males: M = 16.0, SD = 1.1, females: M = 15.6, SD = 1.4; comparison

Mark R. Dadds, Ph.D., et al. 415

males: M = 15.0, SD = 0.9, females: M = 14.9, SD = 0.8). An adolescent was considered homeless if he or she reported not having lived with caregivers for the past week or more, and currently had no permanent residence that provided sleeping facilities apart from shelters for homeless people. Comparison children were recruited from secondary schools in the Australian city of Brisbane (population of approx. 1 million). Full class samples were included as, although students were offered the choice of participation, none withdrew from the study.

Homeless youths were located through several homeless youth shelters (68%) and directly from the streets (32%) in the metropolitan area of Brisbane over a 4 month period in 1989. Brisbane is a city of approximately 1 million people on the east coast of Australia. Youths were approached and asked to participate in the survey; approx- imately 50% agreed. Any youths who reported having used drugs that day, or appeared to be under the influence of drugs, was excluded. This applied to a small percentage of youths who were obviously drunk and freely admitted to their state of intoxication. The majority of refusals to participate came in the form of youths saying they were simply not interested.

Initial interview questions focussed on determination and descriptions of their home- lessness and, while these measures were not thought reliable enough to incorporate into our formal research design, we present them here to allow comparisons to other homeless samples. All youths cited family problems as the primary reason for their homelessness. On average, they had been away from home for 10.7 months (SD = 14.5), had first experienced homelessness at 12.3 years of age (SD = 3.3) and had left home 6.8 times (SD = 11.1). Fifty eight percent reported they had run away from home compared with 42% who reported they had been thrown out. A measure of socioeconomic status based on mothers' and fathers' employment (1-7 scale, 1 = high SES; Daniel, 1983) revealed no differences between the homeless (M = 4.61, SD = 1.10) and comparison samples (M = 4.67, SD = 1.06). One way analysis of variance tests revealed no differences between groups on any of the other demographic measures, including years of education (homeless: M = 9.37, SD = 1.01; comparison: M = 9.73, SD = 0.73), numbers of siblings (homeless: M = 2.7, SD = 1.8; comparison: M = 2.3, SD = 1.5), and age (see above).

Measures

A four-part questionnaire booklet contained the following measures: a biographical sheet, the Children's Perception Questionnaire (CPQ), the Achenbach Youth Self- Report Form (YSR), and the Parental Bonding Instrument (PBI). The CPQ (Emery & O'Leary, 1982) consisted of 16 questions; ten relating to perceived marital discord and six to felt acceptance. The 22 distractor items used in the original CPQ were not used in this study and no attempt was made to disguise the nature of the questionnaire. Subjects were required to answer each question on a three point scale; r true", "a little true", or "true". Responses were scored on a scale of 0 to 1 with "not true" scoring 0, ~a little true" scoring 0.5 and ~'true" scoring 1. The range for perceived marital discord was 0-10, with 0 indicating no marital discord and 10 very high discord. The range for felt acceptance was 0-6, where 0 would be a rating of non-acceptance and 6 a rating of high parental acceptance. Emery and O'Leary (1982) reported high internal consistency for the CPQ scales as well as strong validity for the children's ratings of marital discord.

The next measure used was the Achenbach & Edelbrock (1983) Youth Self-Report Profile for adolescents. This measure included 112 one sentence questions which were scored from 0 = "not true", 1 = ~'sometimes true", or 2 = "often true". In scoring profiles the questions were grouped into the following 7 subscales; depressed, unpopular,

416 Community Mental Health Journal

somatic complaints, self-destructive/identity problems (for males only), thought disor- der, delinquent and aggressive. Two more global scales of internalizing and externaliz- ing consist of a selection of items from the other scales that relate most to either undercontrolled, acting out behaviour (externalizing) or overcontrolled, inhibited be- haviour (internalizing). Subjects' raw scores on each scale were transformed into stan- dard T scores with a range of 55-100, where a score of over 70 was within the clinical range. Achenbach and Edelbrock (1983) have reported good psychometric properties of the YSR. In particular, it has a test-retest reliability of 0.69 over 6 months, and correlates significantly with both parent and clinician ratings using the Child Behav- iour Checklist, the parallel form of YSR for use by the youth's caregivers.

The Parental Bonding Instrument (PBI) (Parker, Tupling & Brown, 1979; Parker, 1989) asks subjects to score their parents as they remembered them during their first 16 years. The PBI consists of 25 items with two dimensions underlying parental attitudes and behaviours; 12 items relate to a care and nurturance dimension and 13 items relate to an overprotection dimension. Subjects have a choice of four responses to each item of %ery true", "a little true", "a little untrue" or "not true at all". Reliability and validity of the PBI have been reported as quite acceptable, and a number of studies have documented the suitability of using the PBI with adolescent samples (Cubis, Lewin & Dawes, 1989; Parker, 1989).

Adolescents from non-intact or reconstituted families were instructed to fill out the CPQ and the PBI with reference to the parental figures who had assumed the most responsibility in raising them.

Procedure

Homeless youths were approached at the various youth shelters or directly on the streets. Those who agreed to participate were escorted to the nearest quiet room (shelter) or public seating (streets) and provided with the questionnaire booklet. The research assistant remained with the participant for the duration of the completion of the booklet, and was free to help the youth if he or she could not comprehend procedure or any of the language used in the questionnaires. Comparison youths were tested in groups in the school setting using the same booklets.

RESULTS

P r e l i m i n a r y ana ly se s r evea led no di f ferences in demograph ics , YSR scores or f a m i l y d is t ress levels b e t w e e n homeless y o u t h located in she l t e r s ve rsus on the s t reets . This suppor t s previous r e sea rch (Mundy e t al, 1990) and thus , we combined homeless y o u t h s in to one sample for f u r t h e r ana lys i s . Table 1 shows the pe rcen tage of y o u t h s in each group who scored in the cl inical r a n g e on each subscale of t he Y o u t h Self Repor t F o r m a n d the m e a n s a n d SDs on the s ame measu re s . Consis- t e n t l y t he homeless y o u t h s r epor ted the h i g h e s t inc idence of psychologi- cal p roblems compared w i t h t he compar i son you ths . A m a n o v a was used to compare m a l e s a n d f emales f rom the homeless w i t h compar i son y o u t h s on the 7 YSR subscales . No in t e r ac t i on emerged , b u t m a i n

Mark R. Dadds, Ph.D., et al. 417

TABLE 1 Means, SDs and Percentage of Subjects Scoring

in the Clinical Range on the Youth Self Report Form

Homeless Comparison

Female Male Female Male

Depression M 64.8 67.2 60.1 58.7 SD (8.8) (9.5) (7.0) (5.7) % 27.4 27.9 6.8 7.8

Unpopular M 60.7 64.0 57.8 58.3 SD (7.1) (8.3) (5.2) (6.8) % 9.8 29.4 4.1 5.9

Somatic M 64.0 64.3 61.1 59.0 Complaints SD (10.5) (9.9) (9.5) (7.4)

% 17.6 25.0 13.6 3.9 Self M - 67.4 - 60.4 Destruct ive SD (9.2) (6.6)

% - 3O.9 - 7.8 Thought M 70.5 68.2 63.7 60.9 Disorder % (12.3) (10.3) (9.1) (6.5)

SD 47.1 39.7 19.2 9.8

Del inquent M 72.1 70.5 58.5 57.8 SD (11.6) (10.3) (4.8) (7.2) % 43.1 42.6 2.7 11.6

Aggressive M 67.2 65.3 57.7 58.8 SD (11.4) (10.2) (4.3) (6.0) % 39.2 27.9 1.3 7.8

In te rna l iz ing M 62.7 63.6 55.7 54.8 SD (12.7) (8.6) (12.7) (9.6) % 31.4 22.0 10.9 5.8

Externa l iz ing M 67.7 66.94 52.05 56.4 SD (12.8) (10.5) (9.7) (9.3) % 43.1 35.3 1.3 7.8

effects were evident for both sex, F(6,231) = 3.49, p < 0.01, and group, F(6,231) = 20.2, p < 0.001. Follow-up univariate analyses revealed that females were less unpopular than males, and reported more thought disor- der. The group effect was evident on every YSR subscale; homeless youths reported more problems than comparison youths on every subscale.

418 Community Mental Health Journa l

The homeless youths reported more CPQ marital problems (homeless: M = 5.42, SD = 2.17; comparison: M = 2.32, SD = 1.94), and PBI parental overprotectiveness (homeless: M = 21.20, SD = 9.16; compari- son: M = 11.90, SD = 7.70), and the least CPQ parental acceptance (homeless: M = 2.04, SD = 1.78, comparison: M = 4.09, SD = 1.75) and PBI care (homeless: M = 15.55, SD = 8.55; comparison: M = 26.63, SD = 8.10), compared to the comparison youths. Manova comparing home- less with comparison youths revealed no interaction or main effect for sex, but a strong overall group effect, F(4,213) = 33.7, p < 0.001. Follow up univariate analyses showed that the homeless youths scored signifi- cantly more negatively than the comparison youths on each of the four family measures.

Finally, we attempted to predict overall internalizing and externaliz- ing scores on the YSR from the family measures. Analyses were con- ducted on the homeless and comparisons samples. Table 2 shows the results of these analyses, including correlation and beta weights for the individual predictors and the overall regression results. Externalizing problems could be predicted from family measures for both homeless females (26% of variance) and comparison females (33% of variance). Externalizing problems in both samples of males were unrelated to their reports of family problems. Examination of the beta weights in table 2 shows that for the comparison females, felt acceptance, marital discord and care all contributed in the prediction of externalizing prob- lems. For the homeless females, all prediction of externalizing problems came from the measure of overprotectiveness.

Internalizing problems were also significantly related to family prob- lems for both homeless (12% of variance) and comparison females (25% of variance). Inspection of the beta weights in table 2 shows that overprotectiveness contributed the largest individual predictions for both groups of females. For comparison females, felt acceptance by parents also added unique variance to the prediction. For males, family problems were related to internalizing problems for the comparison group only. Inspection of the beta weights reveals that the only signifi- cant predictor was overprotection.

DISCUSSION

The aim of this study was to examine self reported psychopathology and its relationship to family variables in homeless adolescents. Clearly, the homeless sample who participated in this study were experiencing behavioural and emotional problems at a level far in excess of the

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420 Community Mental Health Journal

comparison sample we selected. The range of problems was also exten- sive, with approximately 20-40% of homeless youths scoring in the clinical range on each subscale of the Youth Self Report Form. Further, the homeless youths reported high levels of marital discord and paren- tal overprotection, and low levels of parental care and acceptance com- pared to the non-homeless sample. These results support previous re- search showing that juvenile homelessness is a complex phenomenon incorporating an interaction of child and family factors, and is associ- ated with inflated levels of behavioural and emotional problems in the adolescent.

Our data provides only partial support for sex differences in the correlates of adolescent homelessness. Overall, profiles for males and females on the Youth Self Report Form were quite similar and there were no sex effects on the levels of reported marital discord, overprotec- tiveness, care and acceptance in the families of the homeless adoles- cents. Thus, in terms of overall levels of family distress we were unable to support previous speculations tha t homelessness in females is associ- ated with higher levels of parental overprotectiveness than for males (Wolk & Brandon, 1977).

However, reported levels of family problems were clearly predictive of behavioural and emotional problems in both homeless and comparison females, but not in males. Reports of parental overprotectiveness were also related to externalizing behaviour problems for homeless girls. For males, externalizing problems were not associated with family prob- lems and internalizing problems showed only a weak association for the comparison sample. Thus, it is possible that while females are not exposed to higher levels of overprotection than males, they are more distressed by the levels they experience. These results provide partial support for sex differences in the role of family variables in the psycho- logical adjustment of homeless youths (Wolk & Brandon, 1977).

Our results have shown that homeless youth as a group report they experience a wide range of behavioural and emotional problems, high levels of marital discord and overprotectiveness in their parents and low levels of care and acceptance. The design of the current study does not allow us to tease out the causal sequences involved in family distress and adolescent problems in this homeless sample. While it is likely that lack of care and nurturance and an excess of overprotective- ness tend to produce distress in adolescents, the reverse is probably also important to consider. That is, the more disturbed youths might elicit more rejection and overprotectiveness from their parents. Longitudinal designs will be required to examine the developmental sequencing of these phenomena.

Mark R. Dadds, Ph.D., et al. 421

Overprotectiveness emerged as the most robust predictor of distress in our adolescent samples, particularly the females. There are a num- ber of explanations of this. It may be that high levels of distress in adolescents tends to influence them to report, in retrospect, that they received more disturbed parenting. However, research reviewed by Parker (1989) indicates that reports on the PBI are not significantly affected by depression or social desirability in the reporters, and so this explanation seems unlikely. It is quite conceivable that increasing autonomy and behaviour problems in adolescents (e.g., rejection of parent's values, association with unacceptable peers) would elicit high levels of overprotectiveness in their parents. Conversely, high levels of overprotectiveness could foster increased rejection of the parents by the adolescent. A coercive cycle may develop in which growing autonomy and rejection of parental values by the adolescent is associated with escalating overprotectiveness, and perhaps diminishing care and nur- turance, from parents. For some adolescents, this cycle may reach a crisis point culminating in their leaving home or being rejected from the home, and experiencing high levels of psychological distress and disturbance.

Further research is needed to replicate and build on the above results using longitudinal designs and independent ratings of adolescent and family problems rather than self report alone. It may also be useful to explore parental perceptions of family process and children's adjust- ment, in families of children who have left or been rejected from the family home. In the meantime, these results point to the importance of targeting family-adolescent relationships in the design of preventative programs and other community responses to adolescent homelessness.

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