Testing Relationships Between Exposure to Violence and Substance Use: Comparing Cognitive and Mental Health Mediation and Integrating Propensity Score Matching

Abstract

Exposure to violence has been identified as a robust risk factor for substance use. While criminological theories have also been demonstrated to be relevant for predicting this behaviour, there is limited research that compares the role that exposure to violence plays in this regard across multiple theories. There have also been issues in not accounting for pre-existing levels of mediators in specifying mechanisms underpinning these relationships. This study examines the mediating roles of cognitive and mental health variables from the dual systems model and general strain theory for explaining the exposure to violence–substance use relationship. The first four waves of the Pathways to Desistance data were analysed. Generalized structural equation modelling (GSEM) was used to test for direct and indirect effects. Propensity score matching was used to address concerns that pre-existing levels of cognitive and mental health variables may be driving mediation effects. Results indicated that exposure to violence at wave 2 was associated with increased heavy-episodic drinking and marijuana use at wave 4. Sensation-seeking at wave 3 significantly mediated both of these relationships. No other significant mediation effects were observed. Results indicate that message-framing interventions may be useful for reducing drives towards substance use behaviours stemming from violence exposure.