Behavior In Young Adults Research Articles

Youth self-report of emotional maltreatment: Concordance with official reports and relation to outcomes

Emotional maltreatment (EMT) is an underreported, common, and pernicious type of maltreatment with long-lasting negative consequences. This paper examines concordance between youth self-report of EMT and official reports using data from 770 participants in the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). In addition, the paper examines the relation between the experience of EMT in childhood (as measured both through self-report at ages 12 and 16, and in official reports throughout childhood) and trauma symptoms and risk behaviors in young adulthood (measured at age 18). The correlation between self-reported experiences of EMT and official reports was very low, ranging from 0.05 to 0.12 across the four EMT subtypes (psychological safety and security; acceptance and self-esteem; autonomy; and restriction). Controlling for race, gender, and official reports of other types of maltreatment, both youth self-report and official reports of the psychological safety and security subtype of EMT predicted trauma symptoms, including anger, anxiety, depression, intrusive experiences, defensive avoidance, and dissociation. Improved detection of EMT and more effective and targeted interventions are needed, both to decrease rates of EMT from caregivers and to assuage its harmful effects on children and youth.

Relationships between problematic alcohol consumption and delinquent behaviour from adolescence to young adulthood.

Heavy episodic drinking (HED) has been associated with increased risk for short- and long-term injury and harms, such as violence and delinquent behaviour; however, the temporal relationship between the two remains unclear, particularly on transition to young adulthood. This study investigates transactional pathways between HED and delinquent behaviour from adolescence to emerging adulthood. Data were drawn from the Australian Temperament Project; a population-based longitudinal study that has followed the health and development of participants (and parents) across 30 years from birth in 1982. The analytic sample was 1650 participants and included five measurement waves spanning adolescence (3 waves: 13-18 years) and young adulthood (2 waves; 19-24 years). There was strong continuity across waves of both HED and delinquency, as well as across-time associations between them. Delinquent behaviour in adolescence was associated with up to twofold increases in the odds of HED at each subsequent adolescent wave. HED in the late teens was associated with over fourfold increases in the odds of persistent (two waves) HED in young adulthood. HED in the late teens was associated with increases in the odds of delinquent behaviour in young adulthood (over twofold for male and one and a half-fold for female participants). While delinquent behaviour predicts both future HED and future delinquent behaviour in adolescence, once young people reach the legal drinking age of 18 years, HED becomes a predictor of current and future delinquent behaviour and future HED, suggesting that increased access to alcohol increases the likelihood of young people engaging in delinquent behaviour. [Miller PG, Butler E, Richardson B, Staiger PK, Youssef GJ, Macdonald JA, Sanson A, Edwards B, Olsson CA. Relationships between problematic alcohol consumption and delinquent behaviour from adolescence to young adulthood. Drug Alcohol Rev 2016;35:317-325].

Rationale, design and methods for the 22 year follow-up of the Western Australian Pregnancy Cohort (Raine) Study.

BackgroundYoung adulthood is a critical life period for health and health behaviours. Related measurements collected before and after birth, and during childhood and adolescence can provide a life-course analysis of important factors that contribute to health and behaviour in young adulthood. The Western Australian Pregnancy Cohort (Raine) Study has collected a large number of such measurements during the fetal, perinatal, infancy, childhood and adolescence periods and plans to relate them to common health issues and behaviours in young adults, including spinal pain, asthma, sleep disorders, physical activity and sedentary behaviour and, work absenteeism and presenteeism. The aim of this paper is to describe the rationale, design and methods of the 22 year follow-up of the Raine Study cohort.Methods/DesignThe Raine Study is a prospective cohort study. Participants still active in the cohort (n = 2,086) were contacted around the time of their 22nd birthday and invited to participate in the 22 year follow-up. Each was asked to complete a questionnaire, attend a research facility for physical assessment and an overnight sleep study, wear activity monitors for a week, and to maintain a sleep and activity diary over this week. The questionnaire was broad and included questions related to sociodemographics, medical history, quality of life, psychological factors, lifestyle factors, spinal pain, respiratory, sleep, activity and work factors. Physical assessments included anthropometry, blood pressure, back muscle endurance, tissue sensitivity, lung function, airway reactivity, allergic status, 3D facial photographs, cognitive function, and overnight polysomnography.DiscussionDescribing the prevalence of these health issues and behaviours in young adulthood will enable better recognition of the issues and planning of health care resources. Providing a detailed description of the phenotype of these issues will provide valuable information to help educate health professionals of the needs of young adults. Understanding the life-course risk factors of health issues and behaviours in young adulthood will have important health planning implications, supporting the development of targeted interventions to improve current health status and reduce the onset and development of further ill-health across adulthood.

Healthy lifestyle factors and metabolic syndrome among college students

The relationship between five healthy lifestyle factors (HLF) and metabolic syndrome (MetS) was examined in 18‐24 year old college adults as a part of the College Health and Nutrition Assessment Survey (CHANAS), an on‐going, cross‐sectional survey at the University of New Hampshire. Participants (n=4,468; 74.1% female) were recruited from a mixed‐majors introductory nutrition class between 2005‐12. The five HLF characterized included never smoked (93%), healthy BMI (72%), regular physical activity (70%), low risk alcohol behavior (48%), and a healthy diet score (44%). The mean number of HLF was 3.3±1.1. MetS criteria include abdominal obesity, low HDL, high triglycerides, elevated blood pressure, and high blood glucose; 21% of participants had at least 2 criteria of MetS. The prevalence of MetS (3 or more risk factors) was significantly different between participants with 0‐1, 2, 3, 4 and 5 HLF (14%, 9%, 5%, 3%, 1%; p<0.001). These findings suggest that healthy behaviors in young adulthood is associated with improved metabolic health and lower disease risk.

Early emerging nicotine dependence symptoms in adolescence predict daily smoking in young adulthood

PurposeThe present study evaluated the predictive validity of individual early emerging nicotine dependence symptoms in adolescence on smoking behavior in young adulthood. MethodsA total of 492 adolescents who, at baseline, had not smoked more than 100 cigarettes in their lifetime and 123 adolescents who smoked more than 100 cigarettes lifetime, and who participated in the 6-year follow-up assessment were included in the present analyses. Predictive validity of 10 nicotine dependence items administered at baseline was evaluated at the 6 year follow-up when the sample had entered young adulthood (mean age=21.6). ResultsAmong adolescents who had smoked fewer than 100 cigarettes, experiencing higher levels of overall nicotine dependence as well as individual symptoms at baseline longitudinally predicted an increase in risk for daily smoking in young adulthood, after controlling for baseline smoking and other tobacco use. For adolescents who had smoked more than 100 cigarettes at baseline, level of nicotine dependence and individual symptom endorsement did not predict smoking behavior in young adulthood. ConclusionsThese findings add to accumulating evidence that early emerging dependence symptoms reported at low levels of smoking exposure signal a greater propensity for continued smoking behavior. Screening for these early emerging symptoms among novice adolescent smokers represents an important and unused tool in tobacco control efforts aimed at preventing the development of chronic smoking patterns.

The relationship among childhood risk and protective factors, racial microaggression and ethnic identity, and academic self-efficacy and antisocial behavior in young adulthood

We examined how childhood and adolescent risk and protective factors and perceptions of racial microaggression and ethnic identity during young adulthood contributed to academic self-efficacy, substance abuse, and criminal intentions of 409 undergraduate students enrolled in a public urban university. Participants (mean age — 24) completed a web-based survey subsequent to a stratified, random sampling procedure. Findings from structural equation models revealed that risk factors reflecting problem behavior during childhood were associated with higher levels of substance use and criminal intentions during adulthood. The early protective factor of school engagement was positively related to academic self-efficacy and negatively related to criminal intentions in young adults. Racial microaggression was inversely related, while ethnic identity was positively associated, with academic self-efficacy among young adults after controlling for the influence of child and adolescent risk and protective factors. Implications for advancing interventions that address the influence of child and adolescent risk and protective factors, racial microaggression, and ethnic identity on academic and behavioral outcomes for young adults are noted.

Eating disorder symptoms do not just disappear: the implications of adolescent eating-disordered behaviour for body weight and mental health in young adulthood.

This study reports the outcomes of childhood and adolescent eating-disordered behaviour on the development of body mass index (BMI) and psychological functioning in young adulthood in a population-based sample in Germany (the BELLA study). Information at baseline and follow-up was obtained through a telephone interview and mailed self-report questionnaires. At both measurement points, BMI, eating disorder symptoms (SCOFF questionnaire), and symptoms of depression and anxiety were assessed in the same cohort of 771 participants (n=420 females, n=351 males). The age range at baseline was 11-17years, and the age range at follow-up was 17-23years. High scores for eating-disordered behaviour in childhood or adolescence significantly predicted eating-disordered behaviour in young adulthood (multiplicative effect estimate: 1.31; 95% CI: 1.2-1.42, p<0.0001), although there was a decline in prevalence (from 19.3 to 13.8%, p=0.002) and severity (mean decrease in SCOFF 0.07, 95% CI: -0.01-0.14, p=0.06). After accounting for potentially confounding variables at baseline (SES, probands' BMI, parental BMI, depressive symptoms), participants with more eating disorder symptoms at baseline had a higher risk of developing overweight (odds ratio (OR): 1.58; 95% CI: 1.19-2.09, p=0.001), obesity (OR=1.67; 95% CI: 1.03-2.66, p=0.03), and depressive symptoms at follow-up (additive effect estimate: 0.45; 95%CI: 0.19-0.7, p=0.0006). Early symptoms of depression showed a significant relationship with extreme underweight in young adulthood (OR=1.13; 95%CI: 1.01-1.25, p=0.02). The high stability of eating disorder symptoms and the significant association with overweight and worse mental health in adulthood underscore the need for early detection and intervention during childhood and adolescence. Youth with depression should be monitored for the development of restrictive eating disorders.

Do changes in social and economic factors lead to changes in drinking behavior in young adults? Findings from three waves of a population based panel study.

BackgroundSocial and economic measures in early childhood or adolescence appear to be associated with drinking behavior in young adulthood. Yet, there has been little investigation to what extent drinking behavior of young adults changes within young adulthood when they experience changes in social and economic measures in this significant period of their life.MethodsThe impact of changes in living arrangement, education/employment, income, and deprivation on changes in average weekly alcohol units of consumption and frequency of hazardous drinking sessions per month in young adults was investigated. In total, 1,260 respondents of the New Zealand longitudinal Survey of Family, Income and Employment (SoFIE) aged 18-24 years at baseline were included.ResultsYoung adults who moved from a family household into a single household experienced an increase of 2.32 (95% CI 1.02 to 3.63) standard drinks per week, whereas those young adults who became parents experienced a reduction in both average weekly units of alcohol (β = -3.84, 95% CI -5.44 to -2.23) and in the frequency of hazardous drinking sessions per month (β = -1.17, 95% CI -1.76 to -0.57). A one unit increase in individual deprivation in young adulthood was associated with a 0.48 (95% CI 0.10 to 0.86) unit increase in average alcohol consumption and a modest increase in the frequency of hazardous drinking sessions (β = 0.25, 95% CI 0.11 to 0.39).ConclusionsThis analysis suggests that changes in living arrangement and individual deprivation are associated with changes in young adult’s drinking behaviors. Alcohol harm-minimization interventions therefore need to take into account the social and economic context of young people’s lives to be effective.

Gender influence on schizophrenia-relevant abnormalities in a cuprizone demyelination model.

The aim of this study was to determine whether early demyelination can impact behavior in young adulthood. For this purpose, albino Wistar rats of either sex were exposed to cuprizone (CPZ) in two different intoxication protocols: one group was intoxicated before weaning (CPZ-BW), from postnatal day 7 (P7) to P21, through maternal milk, whereas the other group was intoxicated after weaning (CPZ-AW), from P21 to P35. After treatment, rats were returned to a normal diet until P90 when behavioral studies were performed. Both treatments produced marked demyelination in the corpus callosum and retraction of cortical myelin fibers. The subsequent normal diet allowed for effective remyelination at P90. Interestingly, CPZ-AW correlated with significant behavioral and neurochemical changes in a gender-dependent manner. CPZ-AW treatment altered both the number of social activities and the latency to the first social interaction in males, while also highly compromising recognition-related activities. In addition, only P90 males treated AW showed a hyperdopaminergic striatum, confirmed by an increase in tyrosine hydroxylase expression and in dopamine levels. Our results suggest that the timing of demyelination significantly influences the development of altered behavior, particularly in adult males.

Children's proneness to shame and guilt predict risky and illegal behaviors in young adulthood.

Do shame and guilt help people avoid doing wrong? Although some research suggests that guilt-proneness is a protective factor while shame-proneness puts individuals at risk, most research is either cross-sectional or short-term. In this longitudinal study, 380 5th graders (ages 10-12) completed measures of proneness to shame and guilt. We re-interviewed 68% of participants after they turned 18years old (range 18-21). Guilt-proneness assessed in childhood predicted fewer sexual partners, less use of illegal drugs and alcohol, and less involvement with the criminal justice system. Shame-proneness, in contrast, was a risk factor for later deviant behavior. Shame-prone children were more likely to have unprotected sex and use illegal drugs in young adulthood. These results held when controlling for childhood SES and teachers' ratings of aggression. Children's moral emotional styles appear to be well established by at least middle childhood, with distinct downstream implications for risky behavior in early adulthood.

PARTNERSHIP TRANSITIONS AND ANTISOCIAL BEHAVIOR IN YOUNG ADULTHOOD: A WITHIN-PERSON, MULTI-COHORT ANALYSIS.

This study examines the effects of young adult transitions into marriage and cohabitation on criminal offending and substance use, and whether those effects changed since the 1970s as marriage rates declined and cohabitation rates rose dramatically. It also examines whether any beneficial effects of cohabitation depend on marriage intentions. Using multi-cohort national panel data from Monitoring the Future (N = 15,875), the authors estimated fixed effects models relating within-person changes in marriage and cohabitation to changes in criminal offending and substance use. Marriage predicts lower levels of criminal offending and substance use, but the effects of cohabitation are limited to substance use outcomes and to engaged cohabiters. There are no cohort differences in the associations of marriage and cohabitation with criminal offending, and no consistent cohort differences in their associations with substance use. There is little evidence of differences in effects by gender or parenthood. Young adults are increasingly likely to enter romantic partnership statuses that do not appear as effective in reducing antisocial behavior. Although cohabitation itself does not reduce antisocial behavior, engagement might. Future research should examine the mechanisms behind these effects, and why non-marital partnerships reduce substance use and not crime.

Risk Behaviors and Negative Health Outcomes for Adolescents with Late Bedtimes

Late bedtimes in adolescence may be a serious risk factor for later poor health and functional outcomes. The current study sought to extend existing cross sectional data by examining whether late bedtimes in adolescence predicts poor outcomes in young adulthood. Data from wave 2 (1996) and wave 3 (2001-2002) of the nationally representative sample of US youth (National Longitudinal Study of Adolescent Health) was used to examine the longitudinal relationship between late bedtime, and several risk behaviors and negative health outcomes following 3,843 adolescents into young adulthood. At wave 2 the mean age was 16 with 52.1% female. At wave 3 the mean age was 21.8. In cross sectional analyses, late bedtime was associated with 1.5 to over 3 times greater odds of involvement in risk behaviors and negative health outcomes, including emotional distress, suicidality, criminal and violent activity, and use of cigarettes, alcohol and illicit drugs. In longitudinal analyses, late bedtime assessed at wave 2 predicted a number of serious health outcomes at wave 3, with late bedtime in adolescence associated with around 1.5 greater odds of involvement in health jeopardizing behaviors such as criminal activity, alcohol abuse, cigarette use, illicit drug use and emotional distress in young adulthood. There was also a dose effect, such that the later the bedtime in adolescence, the greater the risk of involvement in risk behaviors in young adulthood. This research suggests that late bedtime in adolescence predicts multiple serious risk behaviors and health outcomes in young adulthood.

General and substance-specific predictors of young adult nicotine dependence, alcohol use disorder, and problem behavior: Replication in two samples

BackgroundThis paper presents two replications of a heuristic model for measuring environment in studies of gene–environment interplay in the etiology of young adult problem behaviors. MethodsData were drawn from two longitudinal, U.S. studies of the etiology of substance use and related behaviors: the Raising Healthy Children study (RHC; N=1040, 47% female) and the Minnesota Twin Family Study (MTFS; N=1512, 50% female). RHC included a Pacific Northwest, school-based, community sample. MTFS included twins identified from state birth records in Minnesota. Both studies included commensurate measures of general family environment and family substance-specific environments in adolescence (RHC ages 10–18; MTFS age 18), as well as young adult nicotine dependence, alcohol and illicit drug use disorders, HIV sexual risk behavior, and antisocial behavior (RHC ages 24, 25; MTFS age 25). ResultsResults from the two samples were highly consistent and largely supported the heuristic model proposed by Bailey et al. (2011). Adolescent general family environment, family smoking environment, and family drinking environment predicted shared variance in problem behaviors in young adulthood. Family smoking environment predicted unique variance in young adult nicotine dependence. Family drinking environment did not appear to predict unique variance in young adult alcohol use disorder. ConclusionsOrganizing environmental predictors and outcomes into general and substance-specific measures provides a useful way forward in modeling complex environments and phenotypes. Results suggest that programs aimed at preventing young adult problem behaviors should target general family environment and family smoking and drinking environments in adolescence.

Determinants of Sustained Binge Drinking in Young Adults

Binge drinking occurs frequently among young adults, posing risks to health and safety. Little is known, however, about which drinkers continue to binge later into adulthood. We sought to identify predictors of sustained binge drinking behaviors in young adulthood. Participants from the Nicotine Dependence in Teens (NDIT) cohort (n = 609, 53% female) completed self-report questionnaires in 20 survey cycles (SCs) during secondary school between 1999 and 2005, and in 2 postsecondary school SCs in 2007 to 2008 (SC 21; Mage = 20 years) and 2011 to 2012 (SC 22; Mage = 24 years). Participants reporting past-year binge drinking in both SCs 21 and 22 were categorized as sustainers (n = 517). Using multivariable logistic regression, we investigated 25 potential predictors of sustained binge drinking, binge-drinking frequency, and change in frequency over time among sustainers. Compared with stoppers, sustainers (85% of participants) were more likely to be younger, male, and to have no college/university education. Sustainers began drinking alcohol and binge drinking earlier, drank at least monthly during more secondary school grades, binged more frequently at age 20, and scored higher on impulsivity and novelty seeking in adolescence. Among sustainers, frequent binge drinkers were more likely to be male, to be nonstudents, to score higher on novelty seeking, and to have reported more depressive symptoms in adolescence. Sustainers who decelerated their binge frequency between SCs 21 and 22 were more likely to be female, to have achieved a higher level of education, and to report more depressive symptoms in SC 21. The determinants of sustained binge drinking are similar to predictors of binge drinking reported in the literature. Early identification of, and intervention with, youth who are impulsive, inclined toward novelty seeking, and who report higher levels of early sub clinical depressive symptoms might forestall their involvement in risky alcohol use.

Sexual Risk Behavior in Young Adulthood: Broadening the Scope Beyond Early Sexual Initiation

A robust link between early sexual initiation and sexual risk-taking behavior is reported in previous studies. The relationship may not be causal, however, as the effect of common risk factors is often not considered. The current study examined whether early initiation was a key predictor of risky sexual behavior in the 20s and 30s, over and above co-occurring individual and environmental factors. Data were drawn from the Seattle Social Development Project, a longitudinal panel of 808 youth. Early predictors (ages 10 to 15) and sexual risk taking (ages 21 to 24 and 30 to 33) were assessed prospectively. Early sexual initiation (before age 15) was entered into a series of probit regressions that also included family, neighborhood, peer, and individual risk factors. Although a positive bivariate relation between early sexual initiation and sexual risk taking was observed at both ages, the link did not persist when co-occurring risk factors were included. Behavioral disinhibition and antisocial peer influences emerged as the strongest predictors of sexual risk over and above early sexual initiation. These results suggest that early sexual initiation must be considered in the context of common antecedents; public health policy aimed at delaying sexual intercourse alone is unlikely to substantially reduce sexual risk behavior in young adulthood.

Psychometric properties of the Mother and Father Compulsive Caregiving Scales: a brief measure of current young adult caregiving behaviors toward parents

This study assessed the psychometric properties of the Mother and Father Compulsive Caregiving Scales (MFCC). Exploratory (N = 1283, 71.5% Caucasian) and confirmatory (N = 2203, 76.6% Caucasian) factor analyses revealed two-factor structures for each parent: burden and autonomy. Correlational analyses with retrospective self-reports of parent–child relationship quality, family risk indicators, and psychological symptoms demonstrated similar convergent validity for both mother and father burden factors while, interestingly, the findings for mother and father autonomous factors showed different patterns. Results support that the MFCC is a short and convenient measure that would be clinically useful for the assessment of controlling/caregiving behaviors in young adulthood.

Validation and Gender-Based Comparison of the Eating Behavior Scale for Japanese Young Adults

Young adulthood is a time when eating behaviors can become disturbed. In general, women want to lose weight, and men want to gain weight in the form of muscle. A convenient tool to assess characteristics of eating behavior in young adulthood is needed in order to promote a healthy diet. The first aim of this study was to develop an eating behavior scale for Japanese young adults (EBS). The secondary aim was to compare eating behaviors between men and women. The EBS was modified from a questionnaire directed at high school students by Tayama and colleagues (Tayama, Watanabe, Nishimura, Murakami, & Fukudo, 2008). The participants of this study were 794 Japanese young adults (404 men and 390 women) enrolled at three universities and two vocational schools in Japan. They were recruited in the classroom and were asked to submit the completed EBS questionnaire if they agreed to participate. We assessed the validity of the EBS and compared factors between men and women. Three subscales were extracted from the EBS: “Extrinsic eating” (e.g., eating when others eat or when feeling irritated), “Eating quickly” (e.g., eating quickly or not chewing food well), and “Strong taste” (e.g., liking strong-tasting or greasy food). Overall EBS score and “Extrinsic eating” were higher, and “Strong taste” was lower, in women than that in men. The findings indicate that the EBS is suitable as a simple tool to assess properties of eating behavior of healthy Japanese young adults.

Predictors of intentions to participate in politics and actual political behaviors in young adulthood

Drawing on data from a three-wave longitudinal study, the present research examined predictors of young adults’ intentions to participate in politics and their actual political activities while referring to the broader assumptions of the theory of planned behavior. The analyses were based on a sample of university students from the federal state of Thuringia, Germany. The results showed that attitudes toward political behaviors and internal political efficacy beliefs explained changes in students’ intentions to participate in politics. However, the perceived meaning that political participation has for important others had no additional effect. Furthermore, students’ intentions to participate in politics and their internal political efficacy beliefs predicted changes in their actual behaviors. Together, the findings supported the theory of planned behaviors as a useful framework helping to predict young adults’ intentions and actual involvement in political activities.

The Use of Multiple Versus Single Assessment Time Points to Improve Screening Accuracy in Identifying Children at Risk for Later Serious Antisocial Behavior

Guided by Kraemer et al.'s (Psychological Methods, 3:257-271, 1999) framework for measuring the potency of risk factors, we sought to improve on the classification accuracy reported in Petras et al. (Journal of the American Academy of Child and Adolescent Psychiatry 43:88-96, 2004a) and Petras et al. (Journal of the American Academy of Child and Adolescent Psychiatry 44:790-797, 2005) by using multiple as opposed to single point in time assessments of early aggressive and disruptive behavior in the classification of youth who would likely benefit from targeted preventive interventions. Different from Petras et al. (2004a, 2005), the outcome used in this study included serious antisocial behavior in young adulthood as well as in adolescence. Among males, the use of multiple time points did not yield greater classification accuracy than the highest single time points, that is, third and fifth grades. For females, although fifth grade represented the best single time point in terms of classification accuracy, no significant association was found between earlier time points and the later outcome, rendering a test of the multiple time points hypothesis moot. The findings presented in this study have strong implications for the design of targeted intervention for violence prevention, indicating that the screening quality based on aggression ratings during the elementary years is rather modest, particularly for females.

Turbulent times: Effects of turbulence and violence exposure in adolescence on high school completion, health risk behavior, and mental health in young adulthood

Turbulent social environments are associated with health and developmental risk, yet mechanisms have been understudied. Guided by a life course framework and stress theory, this study examined the association between turbulent life transitions (including frequent residential mobility, school transitions, family structure disruptions, and homelessness) and exposure to violence during adolescence and high school completion, mental health, and health risk behaviors in young adulthood. Participants (n = 4834) from the U.S. National Longitudinal Survey of Youth, 1997 cohort were followed prospectively from age 12–14 years for 10 years. We used structural equation models to investigate pathways between turbulence and cumulative exposure to violence (CEV), and high school completion, mental health, and health risk behaviors, while accounting for early life socio-demographics, family processes, and individual characteristics. Results indicated that turbulence index was associated with cumulative exposure to violence in adolescence. Both turbulence index and cumulative exposure to violence were positively associated with higher health risk behavior, poorer mental health, and inversely associated with high school completion. These findings highlight the importance of considering the cumulative impact of turbulent and adverse social environments when developing interventions to optimize health and developmental trajectory for adolescents transitioning into adulthood.