Violence, Nonviolent Adversity, and Mental Health: Cumulative Stress Effects in the Transition to Young Adulthood

Background: Although violence exposure is one of the most injurious factors to developmental mental health, guides to preventing and ameliorating its effects has been limited by insufficient assessment of 1) violence (of multiple exposure forms, multiple timepoints, both perpetration and victimization histories) and of 2) co-occurrence with nonviolent adverse exposures. This paper advances etiological and practice knowledge through longitudinal investigation of both violence and nonviolent exposures as stressors in relation to multiple indicators of mental health. This theory-guided project integrates models of cumulative stress and developmental victimology (Nurius et al., 2008), samples a population indicated for risk of high exposure, and provides findings that enable testing of trends and subgroups.

Methods: This sample (n=851) was initially surveyed in high school (on the basis of drop out risk; age M=16) and subsequently as young adults (n= 739; age M=20.6). Currently underway is a recontact survey, of which the initial completed interviews are used here for preliminary analysis (age M=27). At baseline 45% were female, 60% were racial minority, and SES was generally low to moderate. Well-established measures (Thompson et al., 2000) have captured factors theorized to pose significant risk to healthy development—focal here being stress exposure (violent and nonviolent events) and mental health (anxiety, depression, PTSD, anger). Violence exposure was assessed (17 items) for multiple forms of witnessed events and direct experiences spanning childhood, adolescence, and young adulthood (Finkelhor et al, 2005).

Results: Preliminary results indicate (1) substantial levels of violence (85% with at least one victimization and perpetration form; 50% reporting multiple victimization forms and 40% multiple perpetration form at each timepoint) (2) significant associations among victimization, perpetration, and nonviolent events (average r=0.43 for cumulative exposures). The utility of a cumulative stress and victimology framework in predicting young adult (time 3) mental health (anxiety, PTSD, depression, and unmanaged anger) was tested through multivariate regressions. Significant predictions of young adult mental health are emerging for anxiety, PTSD, and anger; the average R2s reflecting approximately 27% of explained variance. Planned analyses when the full sample is obtained and merged with prior collected data (which will be completed well before the SSWR conference) will extend these initial findings—(1) modeling developmental trajectories of these stress and mental health relationships from adolescence into and across early adulthood and (2) disaggregating the unique contribution of differing violence exposure clusters in accounting for mental health.

Conclusions: These findings are providing important insights as to the unique and combined effects of cumulative stress (violent and nonviolent exposures; combinations of violence exposures) on the mental health pathways of at-risk youth transitioning to young adulthood. Addition of a new timepoint onto an extant longitudinal dataset allows rare investigation of developmental trends, distinguishing subgroup profiles of impairment and resilience. We will discuss implications for preventive interventions and tailoring interventions, informed by initial subgroup risk profiling.