Original article
Age-Varying Links Between Violence Exposure and Behavioral, Mental, and Physical Health

https://doi.org/10.1016/j.jadohealth.2016.03.038Get rights and content

Abstract

Purpose

To examine age-varying prevalence rates and health implications of weapon-related violence exposure (WRVE) from adolescence to young adulthood (ages 14–30) using time-varying effect modeling.

Methods

Data were from the Add Health study, a longitudinal study of adolescents in the United States (N = 5,103) followed into young adulthood across four assessment waves from age 14–30.

Results

WRVE rates varied with age, peaking during mid-to-late adolescence (ages 16–18). Rates were higher for males (vs. females) and African-American youth (vs. white) across nearly all ages. Rates were higher for Hispanic youth (vs. white) during adolescence. WRVE was positively associated with frequent heavy episodic drinking and negatively associated with self-reported general health; these associations were significant during adolescence and early adulthood (ages 15–24). WRVE was positively associated with depressive symptoms. This association remained stable over age and was stronger for females from ages 16–21. The association between violence exposure and decreased general physical health was stronger for white versus African-American youth from ages 15–17, with no significant association observed for African-American youth at any age.

Conclusions

Despite its severity, WRVE is prevalent among U.S. youth during adolescence and young adulthood, particularly among males and African-Americans during mid-to-late adolescence. The associations between WRVE and health were stronger during adolescence and differed by sex and race/ethnicity. This information may assist in the timing and targeting of intervention efforts aimed at interrupting the effects of violence exposure on youth behavioral, mental, and physical health.

Section snippets

Procedures and participants

Data are from the public-use sample of the National Longitudinal Study of Adolescent to Adult Health (Add Health; [21]) a sample of adolescents recruited in grades seven through 12 in the United States (N = 6,504). The sample comprised 80 high schools and feeder middle schools stratified with respect to region, urbanicity, school type and size, and ethnicity. Participants completed surveys in 1994–1995 (Wave I), 1995–1996 (Wave II), 2001–2002 (Wave III), and 2007–2008 (Wave IV). Because TVEM

Results

Figure 1 shows the age-varying WRVE count (Panel A) and prevalences of each WRVE type (Panels B, C, and D) by sex. The bolded curves represent the age-varying WRVE levels; the dashed lines represent 95% confidence intervals. Males were exposed to significantly more violence at all ages. Each exposure type was more prevalent in males than females at nearly all ages. Peak rates of witnessing violence (males: 14.58%, age 17.1; females: 9.57%, age 15.6), threat of violence (males: 19.62%, age 17.6;

Discussion

We used TVEM to understand the age-varying prevalence and health implications of past-year WRVE in a large longitudinal study of youth from ages 14–30. Examining these questions in a longitudinal study provides confidence that our results more closely reflect developmental patterns compared with studies examining age differences in a repeat cross-sectional design. WRVE rates were highest during mid-to-late adolescence (ages 16–18) for all exposure types. Consistent with national statistics [3],

Acknowledgments

Special acknowledgment is due Ronald R. Rindfuss and Barbara Entwisle for assistance in the original design. Information on how to obtain the Add Health data files is available on the Add Health website (http://www.cpc.unc.edu/addhealth). The authors would like to thank Amanda Applegate for her comments on a previous draft of this article. Portions of this work were presented at the 2015 Society for Prevention Research annual meeting in Washington, D.C.

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    Conflicts of Interest: The authors have no conflicts of interest or financial disclosures to report.

    Disclaimer: The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse or the National Institutes of Health.

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