Systematic Review of the Relationship Between Community Violence and PTSD in Young Adults

Purpose:  Young adults in the United States are exposed to crime, including homicide, assault, and robbery, at alarming rates and are victims of crime significantly more often than youth in other developed countries (U.N. Office on Drugs and Crime, 2011). Yet, young adults have rarely been the focus of research on community violence, and we know little about how these experiences impact young adult mental health. The purpose of this study is to systematically review studies on the relationship between community violence and PTSD in young adults.

Methods:  A search of the literature was conducted using the following inclusion criteria: 1) Mean age of participants between 18 and 30, 2) published since 2000 in a peer-review journal, and 3) included a trauma and community violence measure. Studies conducted outside the United States were excluded. A search with the electronic databases PsycINFO, MEDLINE, and Social Work Abstracts was completed, using keywords “community violence”, “urban violence”, “neighborhood violence”, “trauma”, and “PTSD”, yielding 517 articles. 460 articles were excluded following title review. Abstracts of 57 articles were reviewed, and 43 were excluded primarily due to duplication and not meeting age inclusion criteria. A review of the 14 articles that met inclusion criteria comprises the results of this study.

Results:  Few studies (N = 14) met the inclusion criteria, indicating that minimal research has been done on this topic. The majority of articles reviewed used a homogenous sample focused on Hispanic men injured by community violence (N=8) or a primarily Caucasian college sample (N=3), leaving out important populations including other races/ethnicities, females, and individuals who have seen or heard about community violence. Most studies were a-theoretical, and there was minimal overlap in measures, making it difficult to compare results across studies. All of the studies used non-probability sampling, employing primarily convenience and snowball samples. The studies reviewed indicate that community violence exposure is high, even in low-risk samples, and there is an association between community violence exposure and PTSD in young adults. Results were mixed regarding whether males are exposed to community violence more often than females. Factors associated with severity of PTSD include other mental illnesses, peritraumatic dissociation, self-blame, and low social support.  Moderators of the relationship between community violence and PTSD include social support and coping. PTSD due to community violence was found to impact young adult functioning in a number of domains including physical health, parenting, and employment.

Implications: The state of knowledge on the relationship between community violence and PTSD among young adults remains underdeveloped. Future studies should employ more rigorous sampling techniques and recruit more heterogeneous samples in terms of gender, race/ethnicity, and types of community violence exposure.  Further research on the mediating and moderating variables of the relationship between community violence and PTSD is also warranted, along with further exploration of how community violence exposure is impacting important trajectory-setting functional outcomes for young adults.  Understanding the dynamic between these variables may lead to more targeted intervention programs for young adults living in neighborhoods with high rates of violence.