Background, experience of abuse, and mental health among adolescents in out-of-home care: a cross-sectional study of a Swedish high school national sample

Figures & data

Table 1. Sociodemographic factors for adolescents in out-of-home care, and peers not in out-of-home care.

	Without out-of-home care		In out-of-home care		Total				p-value
	n = 5792–5798		n = 41		n = 5833 – 5839
	N	%	n	%	n	%	χ^2	df	Two-sided
Total nr. of participants	5798	99.3	41	.7	5839	100
Gender							18.4	2	<.001
Boy	2583	44.6	17	41.5	2600	44.5
Girl	3162	54.6	21	51.2	3183	54.5
‘Division doesn´t fit me’	51	.9	3	7.3	54	.9
Study program							1.9	1	.163
Theoretical	4111	70.9	25	61.0	4136	70.8
Practical	1687	29.1	16	39.0	1703	29.2
Immigrant (born abroad)	513	8.9	9	22.0	522	8.9	8.6	1	.009*
Father immigrant	1270	21.9	17	41.5	1287	22.1	9.0	1	.003
Mother immigrant	1267	21.9	16	39.0	1283	22.0	7.0	1	.008
Living situation^a
With both parents or alternating	4157	71.8
With one parent	1249	21.6
Alone, with siblings or partner	386	6.7

* Fishers exact test.

^a Merged from 7 to 4 alternatives, combining ‘one parent’/’one parent with new partner’, ‘both parents’/‘alternating’ and ‘alone’/’with siblings or partner’.

Table 2. Sexual orientation, sexual health and use of narcotic drugs among adolescents in out-of-home care, and peers not in out-of-home care.

	Without out-of-home care		In out-of-home care		Total				p-value
	n = 3765–5798		n = 24–41		n = 3789–5839
	n	%	n	%	n	%	χ^2	df	Two-sided
Sexual orientation^a					5839	100	18.3	3	<.001
Heterosexual	5056	87.2	28	68.3	5084	87.1
Homosexual	83	1.4	0	0	83	1.4
Bisexual	267	4.6	4	9.8	271	4.6
Other or uncertain	392	6.8	9	22.0	401	6.9
Used contraceptives last time	2582	67.8	16	61.5	2598	67.8	.47	1	.493
Has had an abortion	240	4.1	3	7.3	243	4.2	1.0	1	.242*
Treated for chlamydia infection	235	4.1	4	9.8	239	4.1	3.4	1	.085*
Has used narcotic drugs^b	647	11.2	4	9.8	651	11.1	.1	1	1.000*
Mean age sexual debut	15.5	SD =1.6	15.0	SD =3.0			t = 1.55		.121

* Fishers exact test.

^a Merged from six to four by combining ‘queer’, ‘uncertain’ and ‘none of these’ to ‘other or uncertain’.

^b Seven options, reflecting different types of drugs dichotomized to Yes or No for any type.

Table 3. Abuse experience and disclosure for adolescents in out-of-home care, and peers not in out-of-home care.

	Without out-of-home care		In out-of-home care		Total
	n = 5298–5752		n = 35–41		n = 5333–5790		Odds ratio
	n	%	n	%	n	%	95% CI	df	p-value
Psychological abuse by adult before age 18	3318	57.7	27	71.1	3345	57.8	1.8 (0.89–3.6)	1	.101
Physical abuse by adult before age 18	1789	31.2	19	50.0	1808	31.3	2.2 (1.2–4.2)	1	.015
Sexual abuse
Any sexual abuse	1106	20.9	11	31.4	1117	20.9	1.7 (0.85–3.6)	1	.131
Penetrative abuse	344	6.1	9	22.0	353	6.2	4.3 (2.1–9.2)	1	<.001
Any sexual abuse more than once^a	604	55.6	8	88.9	612	55.9	6.4 (0.80–51.2)	1	.081
Ways to enable sexual abuse^b
Deceiving	164	15.5	1	10.0	165	15.4	0.61 (0.08–4.8)	1	.638
Use of position	311	29.2	7	63.6	318	29.6	4.2 (1.2–14.6)	1	.022
Persuasion	246	23.1	7	63.6	253	23.5	5.8 (1.7–20.1)	1	.005
Threat of rejection	54	3.4	0	0	54	3.4	–	–	–
Holding on	216	13.4	3	17.6	219	13.5	1.4 (.39–4.9)	1	.612
Beating or hurting	22	1.4	0	0	22	1.4	–	–	–
Gave alcohol, narcotics or pills	50	4.7	0	0	50	4.7	–	–	–
Other	437	40.8	1	10.0	438	40.5	0.16 (0.02–1.3)	1	.084
Have disclosed sexual abuse to anyone^c	715	66.4	3	33.3	718	66.1	0.25 (0.06–1.0)	1	.053
Reported to social services	48	4.5	0	0	48	4.4	–	–	–
Reported to police	99	9.2	1	11.1	100	9.2	1.2 (0.15–9.9)	1	.845

^a Dichotomized from three to two alternatives by merging ‘2-5 times’ and ‘more than 5 times’ to ‘more than once’. n = 1086 reference group (20 missing) and nine index group (two missing).

^b Multiple answers possible.

^c 1077 reference group (29 missing) and nine index (two missing).

Table 4. Self-reported mental health for adolescents in out-of-home care, and peers not in out-of-home care.

	Without out-of-home care		In out-of-home care		Total
	n = 5544–5733		n = 35–38		n = 5579–5771
	n	%	n	%	n	%	Odds ratio	df	p-value
Sought help for mental problems
Depression or anxiety	1067	19.0	18	50.0	1085	19.2	4.3 (2.2–8.2)	1	<.001
Eating disorders	317	5.7	7	20.0	324	5.8	4.1 (1.8–9.5)	1	.001
Inattention problems (ADHD)	398	7.1	11	31.4	409	7.3	5.6 (2.9–12.3)	1	<.001
Autism spectrum disorder	107	1.9	2	5.7	109	2.0	3.1 (0.73–13.0)	1	.126
Suicide attempt	223	4.0	7	19.4	230	4.1	5.8 (2.5–13.3)	1	<.001
Alcohol or substance abuse	122	2.2	4	11.4	126	2.3	5.7 (2.0–16.5)	1	.001
Any of above mental problems	1447	25.7	21	58.3	1468	25.9	4.0 (2.1–7.9)	1	<.001
Non-Suicidal Self Injury	1021	17.8	14	36.8	1035	17.9	2.7 (1.4–5.2)	1	.003

Table 5. Trauma symptom measured through Trauma Symptoms Checklist for Children and Rosenberg total scale for adolescents in out-of-home care, and peers not in out-of-home care.

	Without out-of-home care		In out-of-home care		t-test independent groups
	n = 5624–5757		n = 34–38
	Mean	SD	Mean	SD	p-value
TSCC subscales
Anxiety	4.69	4.0	5.79	5.0	.110
Depression	5.15	4.5	7.68	6.0	.001
Anger	4.15	4.1	4.82	3.6	.339
Post-traumatic Stress	6.22	5.1	8.03	6.6	.039
Dissociation	6.01	4.9	7.21	5.4	.156
Sexual concerns	2.25	2.5	2.26	2.4	.975
Rosenberg total scale	21.08	6.6	16.68	7.6	<.001