Protective factors for externalising behaviour problems in children and adolescents living in out-of-home care: A systematic review

Abstract

Children and adolescents in out-of-home care (OOHC) often display disproportionate levels of externalising behaviour problems compared to the general population, which are further linked with detrimental outcomes. Yet, despite similar levels of vulnerability, not all children and adolescents in OOHC develop these behaviours. To inform effective prevention and intervention strategies, it is important to understand individual, familial, and environmental factors that are associated with reduced risk for externalising behaviour problems for children and adolescents living in OOHC. This systematic review aimed to identify and synthesise knowledge on protective factors for externalising behaviour problems in children and adolescents between 0 and 19 years old residing in OOHC. A systematic search was conducted in PubMed, PsycINFO, Embase, CINAHL, and the Proquest Social Abstracts and Social Services databases, with 28 included studies (n=6814). Findings were synthesised in accordance with the Ecological Systems Framework (Bronfenbrenner, 1979; 1994; 2005). Results indicated that protective factors associated with fewer externalising behaviour problems in the microsystem included a better self-concept, active or engaged coping styles, more community interactions, higher school engagement, better school stability, and better quality relationships with biological parents, siblings, caregivers, and peers. In the young person’s exosystem, fewer children in the home and higher neighbourhood income were associated with fewer externalising behaviour problems. No studies in this review investigated protective interactions in the mesosystem, and further research is needed to understand how these could be associated with behaviour problems. Given the short and long-term consequences associated with externalising behaviours, professionals working with children and young people in OOHC should focus on identifying protective factors that can be targeted in prevention and intervention efforts. This review indicated that prevention and intervention efforts can be aimed at individual, relational, and contextual factors.