A Network Analysis of the Relationship Between Mental and Physical Health in Unsheltered Homeless Persons in Los Angeles County.

Homelessness is a public health crisis both nationally, in the United States, and internationally. Nevertheless, due to the hidden vulnerabilities of persons who are without shelter, little is known about their experiences during periods of homelessness. The present research adopts a network approach that conceptualizes how the major risk factors of homelessness interact, namely substance abuse problems, poor mental health, disability, and exposure to physical or sexual violence by an intimate partner. Our analysis draws on a large demographic survey of over 5,000 unsheltered homeless persons conducted in 2017 by the Los Angeles Homeless Services Authority. We estimated a network structure for 12 survey items tapping individual risk using the graphical least absolute shrinkage and selection operator algorithm. We then examined network centrality metrics and implemented a community detection algorithm to detect communities in the network. Our results indicated that mental illness and intimate partner violence (IPV) are central measures that connect all other mental and physical health variables together and that post-traumatic stress disorder and IPV are both highly affected by changes in any part of the network and, in turn, affect changes in other parts of the network. A community detection analysis derived four communities characterized by disability, sexual victimization and health, substance use, and mental health issues. Finally, a directed acyclic graph revealed that drug abuse and physical disability were key drivers of the overall system. We conclude with a discussion of the major implications of our findings and suggest how our results might inform programs aimed at homelessness prevention and intervention.

Diverse Long-Term Effects of Childhood Exposure to Intimate Partner Violence: Development of Externalizing Behaviors in Males and Females.

Using data from all three waves of the Project on Human Development in Chicago Neighborhoods (PHDCN) longitudinal cohort study, this article examined the long-term effects of intimate partner violence (IPV) exposure during childhood and early adolescence on subsequent externalizing behaviors (i.e., delinquency, violence, and drug offenses). A propensity score matching (PSM) was employed to match a group of individuals reporting childhood/adolescence IPV exposure to those not exposed to IPV on key variables. Longitudinal latent class analyses (LLCA) were then utilized to estimate the longitudinal developmental trajectories of externalizing behaviors separately for the IPV- and non-IPV-exposed males and females and compared with each other. PSM revealed that there were small but significant differences in mean levels of externalizing behaviors between IPV-exposed and non-IPV-exposed youth at Waves 2 and 3. Furthermore, LLCA indicated that there were three distinct developmental trajectories of externalizing behaviors among the IPV-exposed males but four distinct developmental trajectories of externalizing behaviors among the IPV-exposed females, non-IPV-exposed males, and non-IPV-exposed females. Overall, the IPV-exposed males had the largest number of life-course-persistent offenders as well as adolescents who started their offending at a very early age but rapidly declined by the end of the study period. However, the non-IPV-exposed males', albeit smaller, life-course-persistent group displayed by far the highest levels of externalizing behaviors of the entire sample. Females in the present study were largely similar to each other in the development of externalizing behaviors, regardless of IPV exposure. Policy implications are discussed.

Violence Trajectories Associated With Dating Violence Victimization and Perpetration: An Examination of Gendered Pathways.

The present study investigated the relationship between intimate partner violence (IPV) during adolescence and early adulthood and general involvement in violence using publicly available data from the National Longitudinal Study of Adolescent Health (Add Health). Longitudinal Latent Class Analysis (LLCA) was utilized to investigate the patterns of violence among victims and perpetrators of IPV. The longitudinal developmental trajectories of violence involvement were then separately compared and contrasted between males and females experiencing IPV victimization and/or perpetration as well as males and females not experiencing IPV victimization and/or perpetration. While majority of youth scored low on involvement in violence as evidenced by assignment into an "abstainer" category, multiple diverse longitudinal trajectories of violence involvement were identified based on gender and exposure to IPV.