ARTICLES
Mechanisms Linking Violence Exposure to Health Risk Behavior in Adolescence: Motivation to Cope and Sensation Seeking

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ABSTRACT

Objective

This study examined two potential mechanisms linking violence exposure and health risk behavior among adolescents in psychiatric care: sensation seeking and coping with stress through escape behavior.

Method

Male (59%) and female adolescents (N = 251), ages 12 to 19 years, from diverse ethnic backgrounds (61% African American, 19% white, 12% Latino, 8% biracial or other ethnicity) completed a computer-administered survey assessing study variables from 1999-2004. Overall clinic consent rate was 41%. Age and gender were included in all analyses.

Results

Consistent with the literature on nonpsychiatric samples, violence exposure was associated with both increased substance use and sexual risk taking. Violence exposure was not associated with motivation to engage in risk behavior as a means of escape, although motivation to cope through escape was associated with a greater likelihood of substance use. Sensation seeking was related to substance use and sexual risk taking among all adolescents and with violence exposure primarily within male adolescents.

Conclusions

Clinical interventions should promote adaptive coping strategies that emphasize maintaining healthy behavior, effective problem solving skills, and stress management techniques.

Section snippets

Overview of Procedures

The data from the present study are part of a larger longitudinal study to understand human immunodeficiency virus risk behavior among youth in psychiatric care. Adolescents and caregivers were recruited from four outpatient clinics in Chicago between 1999 and 2004. At three sites, a clinic staff member telephoned eligible families and requested permission to release their names and contact information to research staff. At the fourth site, data were collected as part of the clinic's routine

Preliminary Analyses

Age was significantly associated with all study variables (all p values <.01). Older adolescents were more likely to report a greater number of violent events (r = 0.18), ever using a greater number of substances (r = 0.61), and engaging in more risky sex (r = 0.60). Older adolescents were also more likely to engage in risk behaviors as a means of escaping from stress (r = 0.24) and to endorse items consistent with a sensation-seeking personality (r = 0.18). The correlation between sensation

DISCUSSION

This study tested whether violence exposure was related to health risk behaviors among adolescents receiving psychiatric care. We examined two alternative models to explain associations: a stress-coping model, in which the desire to escape from stress mediates an association between violence exposure and risk behavior, and a problem behavior syndrome model, in which violence exposure and risk behavior co-occur because they represent different means of sensation seeking. Consistent with previous

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    This research was supported by R01 MH58545, T32 MH019391 , the Warren Wright Adolescent Center at Northwestern Memorial Hospital, Northwestern Memorial Hospital's Intramural Grants Program, and the University of Pittsburgh Provost's Office .

    The authors gratefully acknowledge the Healthy Youths Program staff and the families who participated. They also thank the administrators and staff at Northwestern Memorial Hospital, Children's Memorial Hospital, the Cook County Bureau of Health, and the Institute for Juvenile Research.

    Disclosure: The authors have no financial relationships to disclose.

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