Associations between Cumulative Violence Exposure in Childhood and Internalizing and Externalizing Behaviors in Adolescence: Potential Gender Differences

Background and Purpose: It is well studied that violence exposure in childhood may result in detrimental mental health outcomes in adolescence such as internalizing (e.g., depression and anxiety) and externalizing behaviors (e.g., aggression and rule-breaking behaviors). However, relatively few research examined the impact of cumulative violence exposure (i.e., exposure to multiple types of violence) although recent research suggest that cumulative violence exposure may be a better predictor of mental health outcomes than individual types of violence. Moreover, while the general strain theory posits that violence-exposed girls tend to show internalizing behaviors and violence-exposed boys tend to show externalizing behaviors, previous research reported conflicted findings on the gender difference, warranting further examination. Lastly, a large body of the previous studies relied on samples consisting predominantly White youth, although youth of color are at greater risk of being exposed to multiple types of violence.

Methods: Data from the Wave 5 and 6 of the Fragile Families and Child Wellbeing Study were used. The sample consisted of 946 adolescents (age 9 at Wave 5 and age 15 at Wave 6), mostly youth of color (73.2%). Path analysis was conducted to test if the baseline model of the association between cumulative violence exposure at age 9 (i.e., a composite score created by summing the dichotomized scores of child abuse, exposure to intimate partner violence, bullying victimization, and exposure to community violence) and internalizing and externalizing behaviors at age 15 yields an adequate model fit. Then, a cross-group invariance testing was conducted in which the fit of the constrained model (i.e., all structural paths are constrained to be equal between girls and boys) was compared with the unconstrained models (i.e., the constraints on each structural path is released) to examine gender differences in the path structure.

Results: The baseline model showed an adequate fit for the overall sample (including both girls and boys), χ²(6, 946) = 36.12, p < .001; GFI = .99; CFI = .97; RMSEA = .07 [.051, .096]; SRMR = .04. The structural pathways between cumulative violence exposure and internalizing and externalizing behaviors were all significant, controlling for previous level of internalizing and externalizing behaviors, race and socioeconomic status. In the subsequent cross-group invariance testing, the constrained model showed an adequate fit; however, releasing the constraints on the any of the structural paths did not yield significant improvements in model fit, indicating that the model is invariant between girls and boys.

Conclusions and Implications: Findings suggest the need for an extra attention on mental health care for children exposed to multiple types of violence. Regarding the invariance between gender, it is possible that cumulative violence exposure is a highly impactful strain such that its effects on mental health may not differ across gender. Also, considering that the sample consisted of predominantly youth of color, it may be possible that race-related factors (e.g., minority stress) overshadow the effects of gender.