Family Risk Exposure Profiles During Early Childhood: Developmental Processes and Adolescent Well-Being.

Although prior work indicates that exposure to multiple family risk factors negatively impacts adjustment in childhood and adolescence, few studies have examined whether children in high-risk families transition in and out of adversity during early childhood and whether patterns of change matter for adjustment in adolescence. Using data from a sample of 216 caregiver-child dyads participating in a study of prenatal cocaine exposure (116 exposed and 100 non-exposed; 50.9% girls), we used latent transition analysis to identify distinct profiles of early exposure to caregiver substance use (SU) and SU-related familial risk (caregiver psychological distress, exposure to violence, harshness, and low sensitivity) and the association between these profiles and adolescent well-being (i.e., hope, happiness, and life satisfaction). Assessments occurred when children were 13, 24, 36, and 48 months and during kindergarten ( = 66.16, = 4.47) and early adolescence ( = 13.26, = 0.88). Caregivers self-identified as 72.09% Black, 15.81% White, 10.23% Hispanic/Latinx, 1.40% other, and 0.47% American Indian. Four profiles of varying levels of exposure to caregiver SU and SU-related risks were identified from infancy to kindergarten: , , , and . Most children stayed in the same profile (64.2%), while the rest transitioned between profiles. Children exposed to caregiver SU and family adversity had lower positive outcomes in adolescence. Stable membership in the profile had significant maladaptive consequences on adolescent well-being. Implications for research and the design of tailored interventions to promote well-being among at-risk youth are discussed.