Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Doctor of Philosophy

Program

Education

Supervisor

Stewart, Shannon

Abstract

Children with mental health problems have a significantly worse quality of life (QoL) compared to typically developing children or those with chronic medical conditions (Sawyer et al., 2002). Unfortunately, the literature examining specific factors associated with QoL in this vulnerable population is quite scarce. Studies have begun to investigate the relationships between traumatic events, strengths, and QoL (Cohrdes & Mauz, 2020; Lamoureux-Lamarche & Vasiliadis, 2017; Weber et al., 2016). However, research has yet to examine the impact of both interpersonal (e.g., child maltreatment) and non-interpersonal (e.g., natural disasters) types of trauma on QoL in children and youth with mental health issues. Moreover, to the best of our knowledge, no study has explored the potential role strengths may play in buffering against the negative impact trauma often has on QoL, within this particular population. Finally, the majority of research has been conducted on overall QoL, with very little attention being paid to QoL at the subdomain level. Therefore, this dissertation aimed to close some of these gaps in the current literature.

The first study examined how traumatic life events are associated with QoL. Results showed a strong association between interpersonal trauma and lower QoL, as well as a dose-response relationship between number of interpersonal traumatic events and QoL; specifically, individuals who experienced a greater number of traumatic events reported lower QoL. Furthermore, there was a weak association between experiencing non-interpersonal trauma and QoL. Supplemental analyses revealed additional significant associations between interpersonal trauma and certain subdomains of QoL. The second study examined how strengths are associated with QoL, and explored whether strengths influence the relationship between trauma and QoL. Results showed that among the various internal and relational strengths included in the study, having a consistent positive outlook was the strongest predictor of overall QoL. Supplemental analyses revealed additional significant associations between particular strengths and subdomains of QoL. Furthermore, strengths reduced the impact of interpersonal traumatic events on QoL, at the overall and domain-specific level. Potential explanations for these associations are discussed, and clinical implications as well as future directions are suggested.

Summary for Lay Audience

Children with mental health struggles have worse quality of life (QoL) compared to children without these issues, as well as those with physical health problems. Unfortunately, there is very little research examining factors that are related to QoL in this specific population. In general, studies have shown that experiencing a traumatic event, such as abuse or a natural disaster, is linked to lower QoL. Furthermore, an individual’s strengths, such as support from family and friends or higher self-esteem, is linked to higher QoL, even if they have experienced trauma in the past. However, research has not looked into these relationships between trauma, strengths, and QoL in children and youth with mental health issues, specifically. Therefore, this dissertation aimed to address some of these gaps.

The first study found that children and youth who had experienced interpersonal trauma reported worse QoL; additionally, as the number of types of trauma increased, their QoL decreased. In contrast, we did not find a link between experiencing non-interpersonal trauma and QoL. The second study found that while various strengths were related to higher QoL, the most influential one was having a consistent positive outlook; here, a young person who generally has a consistent positive outlook is able to focus on their strengths, work realistically toward achievable goals, and has an appreciation of opportunities in life and relationships with others. Furthermore, we also found that strengths could lessen the negative impact of trauma on QoL. These findings underscore the need to obtain a better understanding of the factors that are linked to QoL in children and youth with mental health issues, as this can help inform policy development and treatment planning.

Available for download on Sunday, September 20, 2026

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