This revised R01 study proposal utilizes a rigorous and innovative series of statistical techniques to analyze data from The National Longitudinal Study of Adolescent Health (Add Heath), a multi-wave prospective and nationally-representative study of more than 20,000 subjects followed from childhood to adulthood, to address critical gaps cutting across the mental health, addiction, infectious disease, and criminal justice fields. Physical, sexual, and/or emotional trauma in childhood may cause psychopathology, HIV-related drug and sex risk, and criminal justice involvement. Research has identified associations between childhood trauma and psychopathology outcomes, HIV risk behaviors, and criminal justice system involvement. However, the complex interplay among these variables over the life course is not well defined. In addition, research on factors that promote resiliency in the face of trauma is limited. Though social support buffers the effects of stressful life events, there is limited understanding of the degree to which children who have experienced trauma may be protected from adverse mental and physical health outcomes in adulthood if they receive support from parents, schools, and/or mentors during their adolescence and young adulthood. We propose to measure the degree to which physical, sexual, and emotional traumas during childhood are associated with hypothesized causal pathways leading to elevated levels of psychopathology, HIV risk behavior, and arrest and incarceration. We also seek to test the degree to which variations in social support protect against the deleterious effects of trauma on HIV risk behavior and criminal justice outcomes. The proposed analyses are designed to provide an empirical basis for development of novel trauma-informed interventions that will address the psychopathology, substance use, and sexual risk behaviors that drive both HIV and criminal justice involvement.
In the US, there are over 7 million adults in the criminal justice system including over 2 million in jail or prison, and rates of mental illness and HIV risk are disproportionately high in this group. Well over half of these individuals have experienced emotional, physical, and/or sexual abuse in childhood, and these childhood traumas may drive their elevated rates of mental illness and risk of contracting HIV, as well as their involvement in the criminal justice system itself. The proposed analyses will address critical public health priorities by providing data needed to plan interventions to address mental and physical health disparities and reduce involvement in the criminal justice system.