Profiles of Psychosocial Adversity and Their Associations with Risky Health Behaviors and Mental Health Outcomes in Young Adults

Introduction: Extensive research has shown that psychosocial adversity is associated with poor mental health outcomes and engagement in risky health behaviors, such as substance abuse and risky sex. The current study focuses on 3 forms of psychosocial adversity: interpersonal trauma, discrimination, and neighborhood disadvantage. These factors have primarily been studied separately; however, research suggests they may have a profound cumulative influence on health functioning. Such experiences may lead to alterations in assumptions about the world, as well as increased likelihood of engaging in risky health behaviors, possibly reflecting strategies to cope with stress, or to fulfill goals such as emotion regulation or interpersonal connection.

Method: The sample consisted of 1125 students (mean age = 20.0, SD = 3.3; 74.5% female; 27.3% African American, 18.7% Asian, 54.0% White) at a large university. Participants completed an online survey on lifetime trauma exposure, perceived discrimination, childhood neighborhood, and current substance use, risky sexual behavior, and mental health symptoms. A latent profile analysis was conducted 1) to identify subgroups of participants based on experiences of psychosocial adversity; and 2) to determine how patterns of adversity are differentially associated with risky health behaviors, world assumptions (e.g., trustworthiness of others, safety), and mental health.

Results: Analyses revealed 5 classes, with patterns reflecting variation in exposure to forms of adversity. Trauma and discrimination showed similar patterns within each class, but diverged from neighborhood in 2 classes. Gender differences were not observed, but African Americans were overrepresented in classes characterized by neighborhood disadvantage. There were class differences for all outcomes, indicating that class membership reflects distinctions in mental health, assumptions about the world, and risky behaviors. These distinctions were more pronounced (i.e., greater number of between class differences) for anxiety, depression, and alcohol than for world assumptions, marijuana, and risky sex. Classes characterized by higher trauma exposure were at the highest risk for poor health outcomes.

Conclusions: Findings suggest that although all forms of adversity examined in the current study are associated with risky behaviors, they do not consistently co-occur. Furthermore, although all combinations of heightened exposure to adversity were related to increased risk, classes with high trauma and discrimination were linked to the most detrimental outcomes. These results facilitate greater contextualization of different forms of psychosocial adversity, and differential associations with world assumptions, risky behaviors, and mental health more broadly.