Exposure to Violence and Post-Traumatic Stress: Do Community, Family, and Peers Matter?

Background and Purpose: Prior research finds a consistent link between exposure to violence and traumatic stress symptomology. Children exposed to violence are at much greater risk of post-traumatic stress symptoms as well as clinical diagnosis of post-traumatic stress disorder.  Family, peer, and neighborhood risk factors are all hypothesized to influence exposure to violence. However, the relationship between these factors and their effect on post-traumatic stress is uncertain. The following research questions guided the study: To what extent is the relationship between neighborhood risk factors, parental behaviors, and exposure to delinquent peers and post-traumatic stress mediated by being a victim of or witnessing community violence? 

Methods: Data were collected from a sample of 320 African American youth living in public housing at community centers and community rooms within each research setting. Survey measures included the Survey of Exposure to Community Violence – Self Report, the Ambient Hazards subscale of the Subjective Neighborhood Scale, the Exposure to Deviant Peers subscale from the National Youth Survey, and the Parental Attitude Measure. Post-traumatic stress was assessed using the Impact of Event Scale. To examine direct and indirect effects of neighborhood risk, parenting behaviors, exposure to delinquent peers, and being a victim of or witnessing community violence on post-traumatic stress, we use a two-step SEM procedure with the WLSMV estimator in Mplus. Chi-square values that are not statistically significant, RMSEA <0.05, CFI and TLI >0.95, and WRMR <0.90 were examined to determine goodness of fit. Indirect effects and significance were also calculated for each mediating relationship of interest.

Results: After testing and determining the best-fitting measurement models, the final, trimmed structural models for both being a victim of and witnessing community violence indicated good fits to the data, χ²(1209)=1465.137, RMSEA=0.031(0.024, 0.036), CFI=0.982, TLI=0.981, WRMR=1.08 for being a victim of community violence, and χ²(1526)=1903.871, RMSEA=0.033(0.028, 0.038), CFI=0.974, TLI=0.973, WRMR=1.16 for witnessing community violence. Both models indicated that only witnessing or being a victim of community violence had a direct effect on post-traumatic stress. Neighborhood risk, parenting behaviors, and exposure to delinquent peers were all fully mediated through either witnessing or being a victim of community violence. Exposure to delinquent peers positively mediated the effects of neighborhood risk and parenting behaviors on witnessing or being a victim of community violence. Parenting behavior positively mediated the association between neighborhood risk and exposure to delinquent peers.

Conclusions and Implications: This study demonstrates the powerful role of violence exposure on post-traumatic stress. While there are certainly indirect effects of neighborhood risk, parenting behaviors, and exposure to delinquent peers on post-traumatic stress, each of these paths operate through their relationship with violence exposure. This comprehensive empirical model suggests that while multiple co-occurring environmental factors provide appropriate points of intervention given their relationship with community violence exposure, these factors only have an effect on post-traumatic stress insofar as they impact youth exposure to community violence.