A Path Analysis Investigating the Relationships between Family Violence, Addictive Behaviors, and Trauma among Adolescents in China

Family violence is a public health concern in China. Exposure to family violence, including witnessing intimate partner violence (IPV) between parents and/or experiencing child abuse, has numerous deleterious effects on adolescent’s mental and behavioral health. This study examined specific mental and behavioral health outcomes of family violence exposure including trauma symptoms and addictive behaviors using a nationally representative sample of adolescents in China. Cross-sectional, self-report data were collected from 16,254 adolescents (M = 15.89 years of age, 47.69% female) using a self-administered survey. More than two-thirds of the sample reported having been exposed to child abuse or IPV at home. Adolescents who were exposed to child abuse and/or IPV were significantly more likely to misuse substances, engage in gambling activities and exhibited more trauma symptoms than their non-exposed peers. A multivariate path analysis revealed that child abuse had an indirect effect on severity of trauma symptoms through problem drinking, cigarette smoking, and gambling behavior. Witnessing IPV between parents had an indirect effect on trauma symptoms through problem drinking and cigarette smoking. An alternative pathway model suggested that child abuse and witnessing IPV between parents had indirect effects on a variety of substance misuse and gambling behavior through PTSD. Findings offer a unique insight into the effects of family violence exposure on adolescents in Greater China. Family violence awareness and intervention could be a meaningful intervention strategy to address substance use and behavioral health problems among adolescents in China.