Girls with foster care involvement may be particularly vulnerable to the negative effects of maltreatment experiences, as indicated by poorer functioning with peers when compared to biologically-reared children and boys in foster care (Leve et al., 2007). These girls have often experienced high rates of sexual abuse and maltreatment, have had numerous caregiver transitions, and show risky decision-making behavior as evidenced by their engagement in drug use, their association with older antisocial males, their pregnancy rates, and their engagement in health-risking sexual behaviors, the costs of which are great (Kerr et al., 2008;Leve &Chamberlain, 2005a;2005b;Pawlby et al., 1997;Underwood, 1998). It is particularly important to understand decision making in this population due to their increased risk for early pregnancy and the transmission of risk to a second generation. However, little is known about the decision-making processes associated with risky decision making in adolescent girls with foster care involvement. This proposal aims to bridge this gap in knowledge. The current proposal aims to conduct hypothesis-driven exploratory research to further the understanding of how decision making might be associated with health-risking sexual behaviors and drug use for these girls. Capitalizing on a unique opportunity to study an existing sample of girls with foster care involvement, the sample consists of 100 girls who participated in a randomized intervention trial prior to entering middle school that was aimed at preventing the onset of drug use, criminality, and health-risking sexual behaviors (R01 MH054257;December 1, 2003- November 30, 2008). In the proposed study, we intend to address four research questions. First, we will examine several key aspects of decision-making processes in girls with foster care involvement. Specifically, we predict that the sample will show high levels of risky decision making for both risks to achieve gains and ones to avoid losses, coupled with a diminished sensitivity to changes in risk/reward contingencies that would signal avoiding (or approaching) a risky option (i.e., adaptive decision making). Second, we will investigate the prediction of risky decision making during adolescence from the girls'early experiences. Third, we will examine associations between risky decision making and health-risking sexual behaviors, drug use, and delinquency. Finally, we will conduct a post-hoc examination of the effects of the previously conducted structured preventive intervention on competent decision-making skills. The proposed work will provide necessary groundwork for subsequent projects aimed at understanding the neural substrates of adaptive decision making in adolescent populations with foster care experiences, and projects aimed at prospectively examining the malleability of decision-making processes in such populations to ultimately reduce risk for drug use and health-risking sexual behavior.

Public Health Relevance

The current project has direct relevance to identifying specific vulnerability factors that may be associated with risky decision making. Further, the proposed project has the potential to provide a deeper conceptualization of the mechanisms that drive real-life health-risking behaviors. This work has the potential to yield important insights that may help researchers develop interventions aimed at promoting better decision making in children in high-risk populations, ultimately reducing drug use and associated problems.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Exploratory/Developmental Grants (R21)
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Study Section
Psychosocial Development, Risk and Prevention Study Section (PDRP)
Program Officer
Lloyd, Jacqueline
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Decision Research
United States
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Clark, Miriam; Buchanan, Rohanna; Kovensky, Rachel et al. (2018) Partner influences on young women's risky drug and sexual behavior. Reprod Health 15:156
Clark, Miriam; Buchanan, Rohanna; Leve, Leslie D (2018) Young Women's Perspectives of Their Adolescent Treatment Programs: A Qualitative Study. Int J Environ Res Public Health 15:
Weller, Joshua A; Leve, Leslie D; Kim, Hyoun K et al. (2015) Plasticity of risky decision making among maltreated adolescents: Evidence from a randomized controlled trial. Dev Psychopathol 27:535-51
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