Pathways from assaultive violence to post-traumatic stress, depression, and generalized anxiety symptoms through stressful life events

Longitudinal mediation models

Sarah Lowe, S. Joshi, S. Galea, A. E. Aiello, M. Uddin, K. C. Koenen, M. Cerdá

Research output: Contribution to journalArticleResearchpeer-review

1 Citation (Scopus)

Abstract

Background Assaultive violence events are associated with increased risk for adverse psychiatric outcomes, including post-traumatic stress (PTS), depression, and generalized anxiety. Prior research has indicated that economic, legal, and social stressors that could follow assaultive events may explain the increased risk for adverse psychiatric outcomes, yet longitudinal studies have not adequately examined this pathway. In the current study, we aimed to address this limitation. Methods Participants (N = 1360) were part of a longitudinal population-based study of adults living in Detroit. At three waves, participants indicated their exposure to assaultive violence and economic, legal, and social stressors, and completed inventories of PTS, depression, and generalized anxiety. Longitudinal mediation models were used to test the hypothesized pathway from assaultive violence to each psychiatric outcome. Results The hypothesized models evidenced good fit with the data and, in each, the paths from Wave 1 (W1) assaultive violence to W2 stressors, and from W2 stressors to W3 symptoms were significant (range of Standardized Estimates: 0.09-0.15, all p < 0.01). Additionally, the indirect paths from W1 assaultive violence to W3 symptoms were significant (range of Standardized Estimates: 0.01-0.02, all p < 0.05). Conclusions The findings illustrate that the economic, legal, and social stressors that could follow assaultive violence increase risk for a range of psychiatric symptoms. Although future research is needed, the results suggest that investment in interventions that prevent and mitigate assaultive violence survivors' exposure to such stressors may be an effective way to prevent mental illness in the aftermath of violent assaults.

Original languageEnglish
Pages (from-to)2556-2566
Number of pages11
JournalPsychological Medicine
Volume47
Issue number14
DOIs
StatePublished - 1 Oct 2017

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Violence
Anxiety
Psychiatry
Depression
Economics
Longitudinal Studies
Survivors
Equipment and Supplies
Research
Population
Exposure to Violence

Keywords

  • Assaultive violence
  • depression
  • generalized anxiety
  • post-traumatic stress
  • stressful life events

Cite this

Lowe, Sarah ; Joshi, S. ; Galea, S. ; Aiello, A. E. ; Uddin, M. ; Koenen, K. C. ; Cerdá, M. / Pathways from assaultive violence to post-traumatic stress, depression, and generalized anxiety symptoms through stressful life events : Longitudinal mediation models. In: Psychological Medicine. 2017 ; Vol. 47, No. 14. pp. 2556-2566.
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Pathways from assaultive violence to post-traumatic stress, depression, and generalized anxiety symptoms through stressful life events : Longitudinal mediation models. / Lowe, Sarah; Joshi, S.; Galea, S.; Aiello, A. E.; Uddin, M.; Koenen, K. C.; Cerdá, M.

In: Psychological Medicine, Vol. 47, No. 14, 01.10.2017, p. 2556-2566.

Research output: Contribution to journalArticleResearchpeer-review

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T2 - Longitudinal mediation models

AU - Lowe, Sarah

AU - Joshi, S.

AU - Galea, S.

AU - Aiello, A. E.

AU - Uddin, M.

AU - Koenen, K. C.

AU - Cerdá, M.

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N2 - Background Assaultive violence events are associated with increased risk for adverse psychiatric outcomes, including post-traumatic stress (PTS), depression, and generalized anxiety. Prior research has indicated that economic, legal, and social stressors that could follow assaultive events may explain the increased risk for adverse psychiatric outcomes, yet longitudinal studies have not adequately examined this pathway. In the current study, we aimed to address this limitation. Methods Participants (N = 1360) were part of a longitudinal population-based study of adults living in Detroit. At three waves, participants indicated their exposure to assaultive violence and economic, legal, and social stressors, and completed inventories of PTS, depression, and generalized anxiety. Longitudinal mediation models were used to test the hypothesized pathway from assaultive violence to each psychiatric outcome. Results The hypothesized models evidenced good fit with the data and, in each, the paths from Wave 1 (W1) assaultive violence to W2 stressors, and from W2 stressors to W3 symptoms were significant (range of Standardized Estimates: 0.09-0.15, all p < 0.01). Additionally, the indirect paths from W1 assaultive violence to W3 symptoms were significant (range of Standardized Estimates: 0.01-0.02, all p < 0.05). Conclusions The findings illustrate that the economic, legal, and social stressors that could follow assaultive violence increase risk for a range of psychiatric symptoms. Although future research is needed, the results suggest that investment in interventions that prevent and mitigate assaultive violence survivors' exposure to such stressors may be an effective way to prevent mental illness in the aftermath of violent assaults.

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