Examining Contextual Factors and Resilience in Adolescents who Faced Adversity as Children

91 Pages·2017·0.64 MB·English

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Veronica Zapotoczny, The University of Western Ontario
Supervisor: Kim Shuey, The University of Western Ontario
A thesis submitted in partial fulfillment of the requirements for the Master of Arts degree in
Sociology
© Veronica Zapotoczny 2014
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«EXAMINING CONTEXTUAL FACTORS AND RESILIENCE IN ADOLESCENTS
WHO FACED ADVERSITY AS CHILDREN»
(Thesis Format: Monograph)

by

«Veronica Zapotoczny»

Graduate Program in «Sociology»

A thesis submitted in partial fulfillment of
the requirements for the degree of
« Master of Arts in Sociology – Program and Policy Evaluation »

The School of Graduate and Postdoctoral Studies
The University of Western Ontario
London, Ontario, Canada

© «Veronica Zapotoczny » « 2014 »
ii

Abstract
The subject of mental health has increasingly become a topic of discussion as
individuals advocate for recognition of this health issue. Early childhood adversity is
often associated with mental health problems amongst adolescents, however, many do
not succumb to these experiences and instead have resilient health outcomes. This study
utilized data from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) to
analyze the relationship between early adversity and adolescent mental health, how social
context may mediate this association, and finally, what factors are associated with mental
health resilience. It was found that many at risk children had positive health outcomes at
age 14, and contextual factors such as history of witnessed violence, social support, and
neighborhood safety mediated this association. Furthermore, neighborhood safety was
found to be positively associated with mental health resilience. Such findings suggest that
current policies need to address contextual factors when seeking to prevent mental health
problems amongst adolescents.

Keywords: early childhood adversity, social context, resilience, life course, cumulative
dis/advantage, internalizing and externalizing behaviors, mental health
iii

Acknowledgements
I could not have completed this project without the help of many friends, colleagues, and
superiors here at the University of Western Ontario. Thank you to all for your advice
when I was faced with many decisions, your assistance when challenges arose, and
support when it was greatly needed. This work is really the result of many helping hands.
In particular, a great thank you to my supervisor for providing me with an opportunity to
research a topic that was interesting to me on a personal level, but also for being
extremely patient with me during the whole process. The knowledge and experiences I
gained here will be cherished and used as stepping stones for future endeavors.
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Table of Contents

Abstract ............................................................................................................................... ii
Acknowledgements ............................................................................................................ iii
Table of Contents ............................................................................................................... iv
List of Tables ..................................................................................................................... vi
List of Appendices ............................................................................................................ vii
Chapter 1 ..............................................................................................................................1
1 « Introduction » .............................................................................................................1
1.1 « Introduction » .....................................................................................................1
Chapter 2 ..............................................................................................................................3
2 « Literature » .................................................................................................................3
2.1 « Life Course » ......................................................................................................3
2.2 « Stress Process » ..................................................................................................9
2.3 « Cumulative Dis/Advantage » ...........................................................................13
2.4 « Resilience » ......................................................................................................14
2.5 « Research Questions » .......................................................................................18
2.6 « Justification and Rationale » ............................................................................18
Chapter 3 ............................................................................................................................20
3 « Methods ».................................................................................................................20
3.1 « LONGSCAN Dataset » ....................................................................................20
3.2 « Measures » ........................................................................................................25
3.3 « Outcome Measures » ........................................................................................29
3.4 « Contextual Variables » .....................................................................................31
Chapter 4 ............................................................................................................................34
v

4 « Results » ...................................................................................................................34
4.1 « Descriptive Analyses » .....................................................................................34
4.2 « Multivariate Results ».......................................................................................38
Chapter 5 ............................................................................................................................53
5 « Discussion » .............................................................................................................56
5.1 « Discussion »......................................................................................................56
5.2 « Limitations and Future Directions » .................................................................64
5.3 « Public Policy » ..................................................................................................66
5.4 « Conclusion » .....................................................................................................69
Works Cited .......................................................................................................................72
Appendix A ........................................................................................................................80
Curriculum Vitae ...............................................................................................................83
vi

List of Tables

Table 1. ………………………………………………………………………………….23
Table 2…………………………………………………………………………………...28
Table 3…………………………………………………………………………………...30
Table 4…………………………………………………………………………………...30
Table 5…………………………………………………………………………………...36
Table 6…………………………………………………………………………………...42
Table 7…………………………………………………………………………………...46
Table 8…………………………………………………………………………………...50
Table 9…………………………………………………………………………………...54
vii

List of Appendices
Appendix A…...…………………………………………………………………………76
1

Chapter 1
1 Introduction
1.1 Introduction
Previous research shows that early stressful experiences, often experienced
amongst those faced with different types of adversity, contribute to adverse mental health
outcomes and that these outcomes are visible as early as adolescence (Wickrama et al.
2010). Many theoretical frameworks have guided research examining the relationship
between early adversity and later mental health outcomes. The life course perspective
emphasizes that individuals are affected by both the time period and their more
immediate structural contexts, but are also actively involved in making decisions about
their life (Elder 1998). Although many factors can be attributed to immediate health
outcomes, stress exposure has been shown to be a significant factor in affecting long-term
health across the life course (Pearlin et al. 1981; Pearlin 1989). Acute, chronic, and
ambient stressors have various impacts on the health of individuals and the accumulation
of such stressors has been shown to have long-term consequences for health. However,
the harmful effects of such stress have also been shown to manifest as early as
adolescence (McFarlane 2010). The accumulation of stress exposure over the life course
leads to health inequalities, and cumulative dis/advantage theories argue that it is not
simply the quantity of stress over the life course that can be detrimental to health, but
rather it is the accumulation and compounding nature of stressors that influence health
trajectories across the life course (Singh-Manoux et al. 2005).
Although the accumulation of stress and adversity is associated with health
inequalities over the life course, many adolescents who experience adversity early in life
follow pathways of positive health and development (Antonovsky 1979). Resilience in
health outcomes despite adversity has not be rigorously examined as a sociological
concept, and thus research in this area is limited (Schafer, Shippee, and Ferraro 2009).
Psychological research has identified individual-level factors, such as personality traits
and coping mechanisms to be associated with pathways of resilience, however, meso-
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level factors such as social context have been under researched for their role in promoting
resilient outcomes amongst disadvantaged populations.
In order to address gaps in the literature, this thesis addresses three main research
questions. First, what is the relationship between childhood adversity and adolescent
mental health outcomes? Second, to what extent are positive social environments
protective against the harmful effect of early adversity on mental health, and do these
contexts have the same effect depending on one’s social location? Finally, what factors
are associated with mental health resilience amongst those who faced adversity as
children and are these effects the same depending on location in the social structure?
Answers to these questions will help us understand not only the effect of different
types of adversity, but also whether or not meso-level factors have an impact on
mediating the relationship between risk/demographic characteristics and later
developmental outcomes. In addition, this research will also further current sociological
understanding of resilience and explore predictors of resilience that are not normally
examined in the sociological context.
This thesis follows a monograph format, and is organized as follows. Chapter 2
situates the current project within the existing literature on the life course perspective, the
stress process model, cumulative dis/advantage theory, as well as current resilience
literature. Chapter 3 outlines the methods used to examine the proposed research
questions and what hypotheses have been suggested. Chapter 4 contains detailed results
of the analyses conducted. Chapter 5 provides a discussion that bridges theory and results
to explain the relationships found. Chapter 5 also includes a discussion of policy
implications of this research, including an analysis of “Ontario’s Comprehensive Health
and Addictions Strategy” as an example of current policy addressing the mental health
needs of individuals within the province of Ontario. Finally, future directions for
research and policy are proposed.