Longitudinal Relations among Adolescent Risk Behavior, Family Cohesion, Violence Exposure, and Mental Health in a Nation
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Longitudinal Relations among Adolescent Risk Behavior, Family Cohesion, Violence Exposure, and Mental Health in a National Sample Nada M. Goodrum 1 Dean G. Kilpatrick 1
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Daniel W. Smith 1 & Rochelle F. Hanson 1 & Angela D. Moreland 1 & Benjamin E. Saunders 1 &
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Violence is a public health concern linked with mental health problems among adolescents, and risk behavior increases the likelihood of violence exposure. Family cohesion may attenuate the negative effects of risk behavior. The purpose of this study was to examine family cohesion as a moderator in the relation between risk behavior (substance use and delinquency) and violence exposure, and to explore longitudinal associations among cohesion, violence exposure, and subsequent mental health outcomes (PTSD and depression). Data were drawn from the National Survey of Adolescents-Replication, a nationally representative sample of 3604 adolescents, with data collected via structured phone interviews at three waves spanning a two-year period. Hypotheses were tested using longitudinal structural equation modeling. Findings revealed that high family cohesion attenuated the relation between risk behavior and subsequent violence exposure. Wave 2 violence exposure was associated with more Wave 3 mental health problems, but high family cohesion was related to fewer subsequent symptoms. Follow-up analyses revealed that family cohesion moderated the relation between risk behavior and experiencing, but not witnessing, violence. Several demographic associations were observed. Although risk behavior increases exposure to violence, and in turn, mental health problems, family cohesion may serve as a protective factor, attenuating the link between risk behavior and subsequent negative consequences. This effect emerged even when accounting for demographic and socioeconomic covariates. Interventions with adolescents should target family relationships as a protective factor to reduce risk of violence exposure and mental health problems, particularly for adolescents who are engaging in high-risk behaviors. Keywords Trauma . Family cohesion . PTSD . Depression . Risk behavior . Substance use
Violence exposure remains a major public health concern among adolescents. It is estimated that 50–70% of adolescents have experienced violence in their lifetime (Finkelhor et al. 2013; Kilpatrick et al. 2000). Adolescents who are victimized – particularly those who experience multiple victimizations – are at greater risk of experiencing mental health difficulties, including depression and posttraumatic stress disorder (PTSD; Finkelhor et al. 2007a; Kilpatrick et al. 2003). Consistent with the lifestyle and routine activities theory (Riley, 1987), engaging in risk behaviors, such as delinquency and substance use,
* Nada M. Goodrum [email protected]; https://orcid.org/0000-0002-3962-6209 1
National Crime Victims Research and Treatment Center, Medical University of South Carolina, 67 President Street, 2nd Fl. S., M
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