Trajectories of Depressive Symptoms, Associations with Substance Use, and Gender Differences Among Criminal Justice-Involved Young Adults to Midlife: A Multilevel Growth Curve Model

Background and Purpose: Justice-involved individuals, particularly women, experience disproportionately high rates of mental health challenges, including depression and co-occurring substance use disorders (CODs). Despite the known burden of these issues, limited research has examined longitudinal trajectories of depressive symptoms among adults with early criminal justice involvement, particularly through a gendered lens. Grounded in Gendered General Strain Theory (GGST), this study aims to: (1) assess depressive symptom trajectories from young adulthood to midlife among justice-involved individuals, (2) evaluate associations between depressive symptoms and substance use, and (3) examine gender differences in these trajectories. The study hypothesizes linear growth in depressive symptoms, positive associations with substance use, and significant gender disparities.

Methods: Data were drawn from Waves III-V of the National Longitudinal Study of Adolescent to Adult Health (Add Health), focusing on individuals (N=884) who reported arrest or police custody by young adulthood. Depressive symptoms were assessed using a modified three-item CES-D scale. Substance use was measured for alcohol, cannabis, cocaine, and other drugs. Covariates included sociodemographic characteristics, clinical diagnoses, and situational strain measures (e.g., victimization and financial hardship). Multilevel growth curve modeling (MGCM) was employed to evaluate depressive symptom trajectories, accounting for repeated measures nested within individuals, with interactions tested for gender and time.

Results: Depressive symptoms increased linearly from ages 18–26 (Wave III) to ages 33–43 (Wave V). Women exhibited significantly higher depressive symptoms at baseline compared to men, although their symptoms slightly decreased over time; in contrast, men’s symptoms increased, resulting in persistent gender disparities. Past-30-day cannabis use and prior financial hardship were associated with higher depressive symptoms at baseline, while moderate alcohol use (1–2 times per week) was linked to lower symptoms. African American participants reported significantly higher depressive symptoms compared to non-Hispanic Whites. While victimization and childhood abuse were not significantly associated with depressive symptoms, a prior diagnosis of depression and financial strain remained significant predictors at baseline. No substance use-by-time interaction effects were observed.

Conclusions and Implications: This study highlights persistent and gendered disparities in depressive symptom trajectories among individuals with early justice involvement. Findings underscore the heightened vulnerability of justice-involved women, supporting the need for gender-responsive mental health and substance use interventions. Financial strain emerged as a critical factor associated with depressive symptoms, suggesting the importance of addressing socioeconomic barriers in treatment and reentry programming. Future research should further explore how dynamic changes in substance use and contextual stressors influence mental health over time and develop tailored interventions that reflect the lived experiences of justice-involved populations, particularly women.