Background
Childhood onset of delinquent behaviour and severe family problems, including child maltreatment and neglect, are associated with a variety of adverse outcomes in young adulthood [
1‐
6]. These childhood problems are important risk factors for later delinquent behaviour and hamper psychological functioning [
1,
3,
4,
7‐
17]. So far, childhood risk factors of adulthood problems have been studied either within delinquent populations [
1‐
3,
9,
13,
18‐
21] or in populations of young adults who experienced maltreatment and out-of-home placements in their childhood [
3,
22]. These studies focused predominantly on the severity, age of onset and persistence of delinquent behaviour and on maltreatment and family interferences by, for example, the Child Protection Services (CPS; Dutch:
Raad voor de Kinderbescherming). However, such childhood problems are closely interrelated and the presence of multiple problems in childhood drastically increases the probability of adverse adult outcomes [
19,
23,
24]. Therefore, studies should focus on combinations of risk factors in young children [
13,
25,
26], instead of focusing on single risk factors, and assess to what extent these combinations can predict outcomes later in life. In this way, it may be possible to distinguish among youth risk profiles which may help tailor primary, secondary and tertiary prevention strategies. The present study tackled these issues by retrospectively studying combined risk factors and long-term outcomes of both childhood judicial and civil CPS interferences in multi-problem young adults.
Young adulthood is considered a distinct developmental stage comprising major psychological [
27‐
29], social [
27] and neurobiological [
30] changes that are critical for a healthy transition towards adulthood [
31‐
33]. In most cases, young adults (aged 18–27) who experienced severe psychological, family and judicial problems since childhood encounter difficulties during this transition in becoming self-sufficient adults [
32‐
35]. Previous studies have provided evidence that these vulnerable young adults are at high risk of an accumulation of several problems such as unemployment, psychological problems, early parenthood, and court involvement [
34,
36‐
38]. Furthermore, a majority of these young adults suffer from substance use disorder [
39,
40], and lack social support [
33,
34]. This group with multiple and intertwined problems has been called multi-problem young adults, and is increasingly recognized as warranting specific scientific attention in order to inform and help improve professional support [
33,
41]. An important aspect in this respect is to understand the development of the childhood problems that culminate in these multi-problem young adults.
In general, childhood problems as risk factors of later delinquent behaviour and mental health problems are widely studied. These risk factors are often distinguished on the individual and family level [
2,
9,
12,
13]. Individual risk factors as intellectual disability, disruptive behaviour, psychological problems and an early onset of substance use are related to the development of antisocial behaviour [
2,
42‐
44] later in life, and to mental health problems in adulthood as well [
45]. Other risk factors in this respect are low school achievement and truancy [
46,
47]. Important risk factors on the family level are inadequate parenting, low social economic status, maltreatment and neglect, mental health problems and substance abuse of parents [
12]. All these factors may have contributed in their own unique way to the various problems of young adults.
Many multi-problem young adults have demonstrated delinquent behaviour and severe family problems during childhood [
1,
22,
48‐
50] and, therefore, are likely to have underwent CPS interference during their youth. In The Netherlands, there are two main reasons for a child to receive a CPS investigation: to request a civil or a penal measure. It is not uncommon for children to receive multiple CPS interferences during their lives [
3]. Therefore, the characteristics of CPS interference differ among children [
21,
51‐
53]. Multi-problem young adults are likely to have experienced several judicial, school and family problems simultaneously [
19,
23,
24], for which the timing, the number and the intensity of CPS investigations may vary [
3]. CPS characteristics can be seen as static risk factors [
54] for deviant development since children who underwent CPS interference have an elevated risk of developing delinquent behaviour and mental health problems in young adulthood [
1,
3,
8,
21,
48,
55,
56]. The annual arrest rate for young adults who as children had been referred to CPS is more than four times higher than the national rate for 18- to 24-year olds [
57] and 50% of this young adult population have experienced mental health problems [
57].
Whereas all children who were exposed to severe family problems and/or who were involved in juvenile delinquency have an elevated risk of adult problem behaviour [
1,
6,
15,
50,
58‐
61], the extent to which these problems persist and evolve into young adulthood differs substantially [
7,
61,
62]. This might indicate heterogeneous profiles of the concurrent childhood problems. Several studies investigated and aimed to reduce the heterogeneity of problems within comparable populations of high-risk youths by exploring profiles [
9,
13]. A study by Haapasalo found two groups of young adult offenders with CPS interventions: an early onset multiple intervention group and a late onset group who had fewer interventions [
3]. A study by Dembo et al. [
9] in high-risk youths reported two classes based on self-report data; one with a low prevalence and the other with a high prevalence of problems in family and peer relations, psychological functioning and education [
9]. Furthermore, Geluk et al. [
13] distinguished three profiles in childhood arrestees, differing in the extent of problems in peer relations, psychological functioning and authority conflicts. So, exploring profiles proved useful in ordering these childhood problems into several homogenous classes concerning the onset, the prevalence and the extent of the problems. However, these studies did not explore specifically if and how these childhood classes may contribute to a deviant development into (young) adulthood.
Although CPS does not provide treatment, CPS interference is directly related to extensive contact with judicial, mental health and social services [
48,
63] and CPS may refer their clients to appropriate care, if necessary. However, many (young) adults with a childhood history of CPS interference still experience serious problems, even after repeated intervention [
3,
48,
49,
64,
65]. As such, it seems that the effectiveness of current secondary prevention and intervention practices during childhood is limited in this population. Therefore, retrospectively identifying classes of interrelated static risk factors of CPS interference within a relatively unstudied population of multi-problem young adults may prove useful for more effective problem recognition and screening purposes in childhood [
26,
54]. Finally, relating these childhood classes to delinquency and mental health problems in young adulthood may give useful indications for the prevention of the escalation of these problems to clinical practice [
48,
49].
The present study aims to explore whether groups of CPS characteristics in childhood can be identified within a sample of multi-problem young adults. Furthermore, the associations between class membership and both self-reported delinquency and psychological functioning in young adulthood are investigated. Based on the literature, we expect multi-problem young adults to have a significant prevalence of CPS interference. Within this group we expect to find distinct latent classes differing in the onset, number and intensity of judicial and civil interferences [
3] and in the extent of family problems [
7,
9]. Lastly, it is hypothesized that classes of CPS interference in youths relate differently to current psychological dysfunctioning and current severity of delinquent behaviour in multi-problem young adults [
1,
65,
66].
Discussion
The purpose of this study was twofold. The first aim was to retrospectively identify distinct classes in multi-problem young adults based on childhood CPS characteristics. This resulted in four latent classes: a late CPS/penal investigation group (44.9%), an early CPS/multiple investigation group (30.8%), a late CPS interference without investigation group (14.6%) and an early CPS/family investigation group (9.7%). The second aim was to explore whether these classes differed on current young adult psychological functioning and delinquent behaviour. The early CPS/family investigation group reported significantly more problematic anxiousness/depression problems than the other groups. Substance use differed significantly among groups, although post hoc tests only revealed borderline significant differences. No differences in current delinquent behaviour were reported among the classes.
In our sample of multi-problem young adults, 65.9% had one or more CPS interference(s) during their childhood versus 1% of the total population of Dutch children in 2016 [
86]. Furthermore, 29.5% in the current sample underwent maltreatment versus 3% of Dutch youth that was in danger of any type of maltreatment in 2010 [
87]. Thus, the prevalence of CPS interferences and severe family problems is, as expected, clearly higher in this population of multi-problem young adults than in the general population. One should note, however, that these percentages are not completely comparable, since the prevalence in the current study was not limited to 1 year. The high prevalence of CPS interference in multi-problem young adults matches their self-reported problems in childhood quite adequately: 83.3% reported service use in their youth and 63.2% reported family problems. As expected, multi-problem young adults also experience heterogeneous problems in their current functioning. This extends findings in other studies [
88‐
90] that argue that different forms of problem behaviour (such as mental health problems, delinquency and substance use) with an onset in childhood are interrelated and may be seen as symptoms of a general disposition toward deviant behaviour through life, by some referred to as problem behaviour syndrome (PBS) [
91]. How PBS is expressed may vary over time and across contexts. For children with PBS, the transition to adulthood typically occurs in the context of severe family problems and interference by multiple justice/care/and child welfare systems [
41,
66]. Therefore, they may experience a differential pathway into adulthood in which more tailor-made specialized care is needed to support their adopting adult responsibilities such as independent living [
41]. This way, they may be prevented from growing into multi-problem young adults. Our first findings underline the importance of gaining more insight into the childhood onset of the problem heterogeneity of multi-problem young adults in order to enhance effective tailor-made intervention.
The present study confirmed several distinct classes of risk factors for adult problem behaviour in addition to earlier studies [
3,
9,
13]. Dembo et al.
9 and Geluk et al.
13 identified two and three classes, respectively, differing in the extent of problem behaviour; Haapasalo [
3] reported two classes differing in age of onset and number of CPS interventions. A first distinction in the identified classes in the current study indeed occurred between early (below age 13) and late (from age 15) CPS involvement. The early CPS/multiple investigation group had the earliest onset of delinquent behaviour (below age 13). Several studies show that early onset delinquents are more at risk for problems in young adulthood, such as mental health problems, substance abuse, drug related and violent delinquent behaviour, than later onset delinquents [
20,
61]. Furthermore, the early CPS/multiple investigation group underwent the most CPS investigations and is, therefore, also comparable to the early onset group in the Haapasalo study [
3], in which the offenders demonstrated more problems during their youth and were in greater need of CPS interventions such as placement in foster care.
Regarding the long term outcomes of childhood CPS interference specifically, the early CPS/family investigation group reported the most anxious/depression problems and the most substance abuse in young adulthood. Maltreatment, family supervision and other severe family problems in childhood have repeatedly been shown to be robust risk factors for mental health problems in (young) adulthood [
7,
16]. For example, according to Thornberry et al. [
15], childhood maltreatment is indeed strongly related to later substance abuse and internalizing problems. Although the early CPS/family investigation was the smallest identified group (9.7%), they seem to have followed the most adverse developmental pathway into young adulthood. It is possible that CPS failed to provide appropriate interventions for this group, since the CPS involvement was not as intensive as for the early onset/multiple investigation group. Moreover, the early CPS/family group was the only group that did not engage in delinquent behaviour in childhood/adolescence. This may have caused them to stay unnoticed for a longer period of time. However, traumatic events in the child’s family environment may have already occurred long before the first CPS interference and are associated with an increased likelihood of adverse adult outcomes [
7,
16]. Besides a broader focus on the problems of the child itself, children with solely civil CPS interference may benefit from more attention to treatment of the problems of the parents. Interventions could be aimed at strengthening their parenting capabilities and resources. Adopting such a ‘two-generation approach’ has shown promising results in preventing family and childhood problems from growing worse [
92].
No significant differences among classes in current delinquent behaviour were found among groups. The late CPS/penal group was the largest group in our sample (44.9%); their first CPS investigation was at age 15 or older and the age of onset of their delinquent behaviour varied between ages 13 and 15. All multi-problem young adults showed a strong tendency for persisting in and/or developing criminal behaviour into adulthood, notwithstanding their distinct childhood histories. Moreover, since the group without CPS investigations also reported delinquent behaviour in adulthood, all forms of CPS interference (even marginal contact) should be considered risk factors for later antisocial behaviour. In addition, the late CPS/penal children proved to be a group without severe family problems, at least according to the CPS data. Steinberg [
17] noted that adolescent onset offenders often manifest less severe patterns of family pathology and mental health problems than life course persistent offenders [
61]. In our sample, both late onset CPS groups indeed reported fewer mental health problems in young adulthood than the early onset groups. A follow-up study should be conducted to explore whether these differences in problem behaviour among groups still persist into (middle) adulthood. Finally, since all groups persisted in their delinquent behaviour, children with CPS interference should be targeted as a high-risk population in need of specialized interventions aimed at reducing the criminogenic risk factors associated with recidivism.
Limitations
Like any other study, this study has some limitations. First, the CPS record investigation in the current study was not performed using a validated instrument, because an applicable instrument was not available. However, CPS investigations are standardized and in order to optimize and monitor the quality of the data, inter-rater reliability was analysed and found to be substantial. Second, registered offence data, and in particular data on the first offence, is likely to be under reported, as a minority of juvenile delinquents is actually convicted [
24]. Still, in this sample officially recorded and self-reported delinquency data are, while not exactly similar, quite comparable, both showing a high prevalence of delinquent behaviour. Third, in this study, self-report questionnaires were also used to investigate socio-demographic characteristics and psychological functioning. To achieve good reliability, a validated self-report psychological functioning questionnaire is used and anonymity and privacy of participants was emphasized before and during the assessment of questionnaires. Fourth, a majority of 87.4% of participants in this study have a non-Dutch ethnicity. In our case, non-Dutch ethnicity refers to an amalgam of cultural backgrounds, for example Surinamese, Antillean, Moroccan and Turkish. However, due to small sample sizes per ethnic subgroup, it was not possible to perform separate analyses. Fifth, generalizability of study results to an international context is not straightforward, because of different service system organizations. In Great-Britain and the United States of America, for example, child protection service and the judicial youth system are more separate systems than in The Netherlands [
93,
94]. Scandinavian countries have more comparable systems to the Dutch system, although those systems are more based on prevention. For instance, in Sweden voluntary and involuntary services are not divided as in The Netherlands [
95]. And lastly, LCA is an exploratory data-driven method and the findings per class represent probabilities on latent indicators.
Authors’ contributions
TD and AP are the principal investigators and obtained funding for the study. LD coordinate the record and register research and, together with JZ and ML, the data collection during the study. LD and FB drafted the manuscript with important contributions from CP, ML, JZ, RM, AB, TD, and AP. LD and AB together performed the data analysis. All authors read and approved the final manuscript.