Adolescent Exposure to Violence and Adult Anxiety, Depression, and PTSD

Published date01 June 2020
Date01 June 2020
Subject MatterArticles
Adolescent Exposure to
Violence and Adult Anxiety,
Depression, and PTSD
Herbert C. Covey
, Leah McCoy Grubb
Robert J. Franzese
, and Scott Menard
The present study investigates how adolescent exposure to violence (AEV), in the form of parental
physical abuse, witnessing parental violence, and exposure to violence in the neighborhood, is
related to adult anxiety, depression, and post-traumatic stress disorder, controlling for more
general adolescent violent victimization and for self-reports and parent reports of mental health
problems in adolescence, on a national household-based probability sample of individuals who were
adolescents in the mid-1970s and who were followed through early adulthood in the early 2000s.
The results suggest that AEV is associated with mental health problems in adolescence but not,
controlling for other variables, in adulthood, but there is continuity in mental health problems
associated with AEV from adolescence to adulthood.
adolescent exposure to violence, physical abuse, witnessing parental violence, neighborhood
violence, adult mental health
There is an extensive literature (Acosta, Albus, Reynolds, Spriggs, & Weist, 2001; Buka, Stichick,
Birdthistle, & Earls, 2001; Gewirtz & Edleson, 2007; Kendall-Tackett, 2013; Lynch, 2003; Ruback
& Thompson, 2001; Widom, 2014) on the relationship of childhood and adolescent exposure to
violence (AEV) with subsequent menta l health problems, including but not limi ted to anxiety,
depression, and post-traumatic stress disorder (PTSD). A linkage from childhood and AEV and
later mental health problems is explicitly suggested by a combination of the strain theories of Merton
(1938) and Agnew (2006). According to Merton’s anomie theory, the experience of strain, in the
form of a disjunction between culturally approved goals and one’s ability or opportunity to achieve
those goals using societally approved means, may lead to a variety of negative adaptations to reduce
Adams County Department of Human Services, Commerce City, CO, USA
Georgia Southern University, Statesboro, GA, USA
Rockhurst University, Kansas City, MO, USA
Institute of Behavioral Science, University of Colorado, Boulder, CO, USA
Corresponding Author:
Scott Menard, Institute of Behavioral Science, University of Colorado, Boulder, CO 80309, USA.
Criminal Justice Review
2020, Vol. 45(2) 185-201
ª2017 Georgia State University
Article reuse guidelines:
DOI: 10.1177/0734016817721294
that strain. Those adaptations range from what Merton termed ritualism, abandoning the goals but
continuing to engage in conforming behavior, to innovation, which includes predatory criminal
behavior such as theft, to retreatism, which includes substance abuse and mental health problems.
It is this last type of adaptation with which we are concerned in the present article.
Merton’s theory focused specifically on economic strain, but Agnew proposed a general strain
theory that extends strain theory (1) by including noneconomic as well as economic strains and (2)
by including not only (a) the disjunction between goals and the means to achieve them but also (b)
removal of positively valued stimuli and (c) exposure to negative or noxious stimuli as sources of
strain. This last category, exposure to negative or noxious stimuli, would include exposure to
violence in the home or neighborhood. Thus, based on Agnew’s general strain theory as an extension
of Merton’s anomie theory, we would expect that exposure to noxious stimuli, in this case exposure
to violence, may lead to a variety of adaptations, one of which is the experience of mental health
problems. In this context, the expectation would be that the strain of exposure to violence would
most likely result in trauma-linked mental health symptoms such as anxiety, depression, and PTSD.
While strain theory forms the primary theoretical basis for the present research, there are other
theoretical perspectives that also suggest a link between AEV and adult mental health problems. A
theoretical linkage between AEV and adult anxiety, depression, and PTSD is implied in the literature
on the neurobiology of the impact of traumatic events on brain functioning. Anda et al. (2006) and
Perry (2001) concluded that the impact of traumatic events and experiences, such as exposure to
violence, on brainfunctioning leads to increasedrisk for anxiety, depression,PTSD, and other adverse
mental health outcomes, such as higher levels of anxiety (Weems et al., 2013). Adverse childhood
experiences(ACEs), such as exposure to violence,also have been found to have negativeeffects on the
development of brain function (Anda, Butchart, Felitti, & Brown, 2010; Teicher et al., 2003). In
addition, some studies have found that traumatized individuals with PTSD were more likely to have
structural abnormalities in regions of their brains (Carrion, Weems, & Reiss, 2007; Karl et al., 2006;
Weems, Klabunde, Russell, & Carrion, 2015). However, other studies have found no structural
differences among posttraumatic children in other regions of the brain (hippocampus; Woon &
Dawson, 2008). In many of these studies, age appears to be an intervening variable with younger
differing from older youth. The additive effects of multiple exposure to adverse experiences, such as
exposure to violence, are also implicated in the prevalence of long-term criminal behaviors (Baglivio
& Epps, 2015; Baglivio et al., 2014;Baglivio, Wolff, Epps, & Nelson,2015; Caspi et al., 2002). Taken
together, these studies suggest that, in addition to strain theory, research on neurobiology,heterotypic
continuity, and the relationship of exposure to violence with behavioral trajectories would lead us to
expect a positive relationship between AEV and adult mental health problems.
Past research on the relationship of AEV with later mental health problems has produced mixed
results (Menard, 2002; Ruback & Thompson, 2001) and also has indicated that different forms of
exposure to violence may be linked to different symptomatic outcomes, with anxiety and depression
more closely associated with physicalabuse and witnessing violence,and PTSD apparently associated
more with neighborhood violence andto a lesser extent (at least in the long term) with physical abuse
(Dunn, Gilman, Willett, Slopen, & Molnar,2012; Gewirtz & Edleson, 2007; Gorman-Smith & Tolan,
1998; Luster, Small, & Lower, 2002; Mrug & Windle, 2010; Scarpa, 2001; Tajima, 2004; Vrana &
Lauterbach, 1994; Widom, 2014). Past research also suggests that there are gender differences in
response, with females more likely than males to retreat and dissociate and males more likely to
become more aroused and engage in externalizing behaviors (Anda et al., 2006; Perry, 2001).
Much of this research has focused on childhood rather than adolescence (or no clear distinction is
made between childhood and adolescence; see Kitzmann, Gaylord, Holt, & Kenny, 2003; Menard,
Weiss, Franzese, & Covey, 2014), using small, cross-sectional (Gewirtz & Edleson, 2007; Kitzmann
et al., 2003; Widom, 2014) samples of clinical or otherwise unrepresentative respondents, often
involving individuals who had experienced exposure to violence with no comparison or control
186 Criminal Justice Review 45(2)

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