This study sought to address a gap in the literature regarding the relationship between exposure to violence and adolescent substance use. In particular, extant research has lacked studies that compare the relative effects of direct and indirect exposure on substance use, have not employed longitudinal data, and have failed to examine potential gender differences in these relationships. Based on the data from a large, longitudinal study, this investigation found that both direct and indirect exposure to violence increased subsequent substance use, and this relationship was significant for males and females. Although this is the overall pattern of results, three specific findings were also evidenced.
First, the significant relationship between exposure to violence in the community and substance use among adolescents is consistent with most prior research in this area (Fagan, 2003
; Farrell & Sullivan, 2004
; Kaufman, 2009
; Kilpatrick et al., 2000
; Kilpatrick et al., 2003
; Kliewer & Murrelle, 2007
; Kliewer et al., 2006
; Schwab-Stone et al., 1995
; Taylor & Kliewer, 2006
; Zinzow et al., 2009
). These findings are also consistent with the general postulations of GST, whereby persons who experience direct or indirect (i.e., vicarious) strains are at high risk for developing strong, negative emotions, which must be managed via either prosocial or antisocial (i.e., criminal) responses, such as substance use (Agnew, 2002
). The findings, however, show somewhat less support for this relationship compared to prior studies, given that the effect of exposure to violence did not always retain its significance in the full models, which controlled for prior substance use and a range of other risk factors. The inclusion of these variables and the use of longitudinal data is a more rigorous test of the impact of violence exposure on substance use compared to many other past studies (which have often relied on cross-sectional data and a more limited number of control variables) and may explain the somewhat weaker impact of exposure to violence evidenced in this study. These results also suggest that other experiences, notably peer influences, may be more salient predictors of substance use than exposure to violence (see also Kilpatrick et al., 2000
Second, in this study, analyses directly compared the magnitude of the effects of direct and indirect exposure to violence on substance use, whereas past studies have typically assessed only one or the other forms of victimization, or have included both types in a summary measure of exposure to violence. The results presented here suggest that indirect exposure may be a more important predictor of substance use compared to direct exposure, although this difference may be more relevant for females. This finding is unexpected given that GST hypothesizes that personal and direct experiences with strains should have the strongest relationship to criminality or delinquency (Agnew, 2006
). Nevertheless, the theory also notes that indirect and vicarious strains are important and can engender negative emotions and criminal coping mechanisms, particularly when youth witness violence occurring to those close to them (e.g., friends or family members; Agnew, 2002
With one exception (marijuana use), the effects of both types of violence were nonsignificant in the full models predicting substance use among male respondents. However, for females, the effect of indirect exposure retained its significance across each outcome, and direct exposure did so for binge drinking. Furthermore, when indirect and direct exposure were included in the same analyses (), only indirect exposure predicted the frequency of marijuana use for males, and both forms of exposure failed to predict the other outcomes for males. In addition, indirect exposure was a significant predictor of substance use for females, but direct exposure was not. These differing results underscore the importance of assessing the degree to which different types of exposure to violence are likely to result in different types of outcomes.
Third, our findings highlight the importance of examining gender differences in the exposure to violence–substance use relationship, which has rarely been done in past studies. Overall, the results did not indicate many significant gender differences in the impact of direct and indirect exposure to violence on substance use. Although a few differences emerged when examining results separately for males and females, the equality of coefficient tests indicated only one significant gender difference in the magnitude of effects: The effect of direct exposure to violence on binge drinking was stronger for females compared to males (although only in the model including only demographic characteristics). These findings are similar to the few other empirical studies that have tested for, but have not found, significant gender differences in the relationship between exposure to violence and substance use (Kaufman, 2009
; Kilpatrick et al., 2000
; Sullivan et al., 2004
; Thompson et al., 2008
). In addition, many previous tests of GST have reported that other strains have similar effects for males and females on various delinquent behaviors (Agnew & Brezina, 1997
; Hoffman & Su, 1997
; Mazerolle, 1998
Although GST has suggested that the relationship between exposure to violence and delinquency may vary by gender (Agnew, 1992
; Broidy & Agnew, 1997
), we did not find strong evidence of this in our study. GST has posited that males are more likely to respond to strains with outward forms of anger, such as violence and aggression (Broidy & Agnew, 1997
), and females are more likely to internalize their reactions to strains, such as experiencing depression or using substances to cope with the pains of being exposed to violence (Kaufman, 2009
). As Agnew (2002)
has suggested, in this study, males were more likely to experience strains in the form of exposure to violence, but males and females were equally likely to engage in substance use as a coping mechanism. These findings are consistent with the more general tenets of the theory, which was formulated as a “general” theory of crime intended to explain delinquency and criminality for all persons regardless of sex or other demographic differences. It should be noted, however, that substance use has received limited attention in theoretical discussion and empirical tests of GST. Therefore, the degree to which exposure to violence leads to substance use via strain processes—and gender differences in these processes—is not as robustly understood compared to other outcomes (e.g., crime, aggression).
Our findings were also not completely congruent with feminist theories of crime, which suggest that victimization and exposure to violence are significant risk factors for female criminality and possibly more important in leading to illegal behaviors among females versus males (Belknap & Holsinger, 2006
; Chesney-Lind, 1997
; Fagan, 2001
). In contrast to this perspective, our findings indicate that exposure to violence had a similar impact on female and male substance use. It is important to note, however, that feminist theories emphasize sexual assault as a particularly salient predictor of female criminality, and our measures of exposure did not include sexual assault. In addition, feminist theories have not discussed in detail the gender differences in the effects of victimization experienced outside the home (which are more commonly experienced by males), as we do in this study, and it may be that this form of violence engenders more similar responses from males and females, at least in terms of substance use. The analyses did show that exposure to violence, in the form of direct victimization, was a stronger predictor of binge drinking for females than males, which is more consistent with the predictions of feminist theories. Heavy drinking is far less common among adolescents and may be indicative of more serious negative responses to traumatic experiences, particularly the desire to self-medicate and/or escape from the emotions engendered by victimization. In this case, then, our findings may partially
support feminist theories’ expectations as well as certain tenants from GST (i.e., that females are more likely to cope with internalizing or “escape” behaviors).
This study thus adds to mounting evidence that exposure to violence can lead to increased substance use among adolescents and should be a call to action to ensure that victims receive assistance to help them cope with the traumas they have experienced. Counseling and other supportive services should target youth who have disclosed episodes of direct and indirect exposure to violence either via school personnel (i.e., counselors or nurses), given the high rates of exposure to violence among school-aged youth, or community-based agencies serving youth (e.g., Boys & Girls Clubs, YMCAs) who may not regularly attend school.
More universal and preventive interventions should also be delivered to provide all youth with services and to reach them before
victimization or exposure to violence occurs and/or leads to substance use. Effective school-based prevention programs—such as Promoting Alternative Thinking Strategies (PATHS; Greenberg, Kusche, & Mihalic, 1999
) and Life Skills Training (Botvin, Griffin, & Nichols, 2006
)—can be used to enhance behavioral and emotional competence among elementary and middle school–aged children by providing them with skills to cope with stress and anxiety and to recognize and respond appropriately to negative emotions. It is also important for communities to adopt strategies that will reduce youth perpetration of violence, which should, in turn, decrease the likelihood that adolescents will be victimized and/or witness victimization. Fortunately, models of school- and community-based programs that have been shown to reduce the perpetration and/or victimization of youth are available (Hahn et al., 2007
; Hawkins, Catalano, Kosterman, Abbott, & Hill, 1999
; Hawkins et al., 2011
; Sussman, Dent, & Stacy, 2002
). Regardless of the specific strategies employed by practitioners and community members, our findings show that services should be delivered to all youth, regardless of age or gender, because exposure to violence appears to be widespread and equally influential in increasing the likelihood of substance use.
Although this study has addressed an important gap in the literature linking exposure to violence and negative social behaviors and has relevance for policy and practice, it has some limitations. First, the generalizability of this study is limited. Data were only collected in one city—Chicago—at one period—the 1990s. Second, the PHDCN was designed to explore the development of adolescents nested within neighborhoods. We were only interested in comparing gender differences in the individual-level, longitudinal impact of exposure to violence on substance use. Although this study controlled for potential neighborhood influences, additional research is needed to examine the degree to which neighborhood characteristics may be related to the relationship between exposure to violence and substance use. Third, this study only used dichotomous measures to assess indirect or direct exposure to violence. We did not examine how the amount or frequency of victimization impacted substance use, and it is possible that the effects of exposure would have been stronger if operationalized as a scale reflecting the number of violent experiences the youth was exposed to. Only a few studies have examined these types of relationships (operationalizing victimization and exposure to violence as a scale; see Sullivan et al., 2004
; Thompson et al., 2008
), although this research has not assessed gender differences. Thus, more research is necessary in this area. In general, although this study adds to the limited literature exploring the relationship between exposure to violence and adolescent substance use, more research is clearly needed to untangle the relationships between direct and indirect violence exposure, subsequent substance use, and gender.