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Out-of-home placement, sleep problems, and later mental health and crime: A prospective investigation

NCJ Number
American Journal of Orthopsychiatry Volume: 92 Issue: 3 Dated: 2022 Pages: 257-267
Date Published
11 pages

The authors of this report present a longitudinal study of maltreated children and out-of-home placement experiences in childhood, and its relation to sleep problems, anxiety, and depression later in life; they discuss their research methodology and outcomes, and highlight the need for greater attention and efforts to facilitate sleep in placement settings to ensure that maltreated children have adequate sleep conditions so that subsequent mental health problems may be reduced.


Previous research suggests that out-of-home placement experiences increase the risk for mental health problems and criminal involvement. However, few studies have examined the mechanisms whereby out-of-home placement increases the risk for these outcomes. The present study examines whether sleep problems explain in part, the relationship between childhood placement experiences and depression and anxiety and criminal arrests in adulthood. Data are from a prospective longitudinal study of 531 children with documented cases of childhood maltreatment who were followed into adulthood. Cases are from 1967 to 1971, from a metropolitan county in the Midwest. Sleep problems were assessed in young adulthood. Depression and anxiety symptoms and arrest records were assessed in middle adulthood. Structural equation modeling was used to test hypotheses. Both types of out-of-home placement experiences (for maltreatment only and for maltreatment and delinquency) predicted more sleep problems in adulthood across all models. Sleep problems in young adulthood predicted higher levels of anxiety and depression in middle adulthood, but not criminal arrests. Sleep problems mediated the relationship between placement only and internalizing symptoms and results differed for male, female, White, and Black individuals examined separately. Using court-substantiated cases of childhood abuse and neglect, this study demonstrates the long-term negative consequences of out-of-home placement experiences for sleep problems and anxiety and depression in adulthood. More attention is needed to ensure adequate sleep for maltreated children. Publisher Abstract Provided

Date Published: January 1, 2022