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Over 4.2 million youth and young adults experience homelessness in the U.S. per year. Without stable housing, these youth are at risk of trauma exposure, such as adverse childhood experiences (ACE), is prevalent among young adults experiencing homelessness (YAEH). YAEH, therefore, are likely to engage in heavy drinking as a form of combating their traumatic experiences. Furthermore, YAEH may also be embedded in a peer support network where they may receive support critical to their survival during homelessness, while at the same time, facilitating opportunities and adding pressure for heavy drinking. The stress and coping theory (SCT) argues that individuals’ coping capacity may mediate the relationships between stressors and risk behavior engagement, including heavy drinking. Literature on the role coping may play in the relationships of previous trauma and peer supports with YAEH’s heavy drinking risks remains scarce. Informed by the SCT, this study aims to explore whether YAEH’s coping may serve as a mechanism through which traumatic experiences (e.g., ACE), perceived stress, and peer support may be associated with their heavy drinking risks. Specifically, we hypothesized that active and avoidant coping would each mediate the relationships between peer support, ACE, and perceived stress and heavy drinking. A better understanding of the role coping plays in YEAH’s heavy drinking risks will provide critical insights for future heavy drinking risk reduction interventions targeting this vulnerable population.
Method
This study used cross-sectional survey data collected from YAEH (N=1,348) aged between 18-24 from seven major cities in the U.S. In addition to personal attributes (e.g., demographics and substance use behaviors), this survey also incorporated an egocentric social network component to collect YAEH’s network composition, including sources of social supports. Past 30-day heavy drinking was defined as having five or more drinks within a couple of hours. Bivariate regressions were conducted to investigate associations of independent variables with coping, including active coping and avoidant coping (hypothesized intervening mechanism), and heavy drinking. Using the Lavaan package in R, a recursive path analysis model was conducted to examine our hypotheses.
Results
Heavy drinking was highly prevalent among YAEH (34.34%). In the final path model, avoidant coping had a direct positive effect on heavy drinking (β=0.423, p <0.001); ACE, perceived stress, and having more peers who provided social supports had indirect effects on YAEH’s heavy drinking through avoidant coping (β=0.202, p < .001; β=0.186, p < .001; β=0.079, p < .001; respectively).
Conclusion and Implications
This study found that avoidant coping fully mediated the relationship between peer support, ACE, and perceived stress and heavy drinking. Our finding indicates that the YAEH may be utilizing heavy drinking to “avoid” coping (e.g., self-medication) with their traumatic experiences, homeless stress, and social pressure. The preference for adopting avoidant coping strategies may stem from YAEH’s lack of active coping knowledge and skills under the context of surviving homelessness and the trauma along with it. Future heavy drinking risk reduction interventions may need to focus on addressing YAEH’s use of avoidant coping to combat trauma and stress.