Associations Between Adversity and Psychological Distress and Physiological Stress Among Youth Experiencing Homelessness: The Buffering Role of Social Network Processes

Project Summary/Abstract Youth experiencing homelessness (YEH) face increased levels of adversity and higher rates of trauma, suicide, and mortality compared to their housed peers. Adversity is associated with negative long-term psychological and physiological outcomes including impaired mental health and dysregulated stress systems. However,

protective factors in this population are not well understood. Social network processes are a potentially modifiable factor that may mitigate negative outcomes associated with adversity and may serve as an avenue for future intervention. The overarching research goal of this study is to examine different risk profiles of YEH

and their association with psychological distress and physiological stress, and social network processes as potential protective pathways. The aims will be addressed using a cross-sectional secondary analysis of the baseline data from the randomized controlled trial, Housing, opportunities, motivation and engagement

(HOME) for homeless youth at-risk for opioid use disorder (#UG3/UH3DA050174, National Institute on Drug Abuse). The specific aims of the proposed study are to (1) Examine the relationships between adversity profiles and psychological distress (depressive symptoms, suicidal ideation, suicide attempt) and physiological

stress (hair cortisol concentration [HCC]) (2) Examine the relationships between social network processes (family/friend perceived satisfaction of support received, family/friend prosocial behavior) and psychological distress and physiological stress and (3) Explore the extent to which social network processes moderate the

relationship between adversity and psychological distress and physiological stress. The baseline data from the HOME study (N=240) contains information on youth demographics, adversity (childhood physical, sexual, and emotional abuse, neglect, and street victimization), physiological stress (HCC as a measure of cumulative

stress), and psychological distress (depressive symptoms, suicidal ideation, and suicide attempt). Latent profile analysis will be conducted to identify risk profiles of YEH who show differing adversity patterns and regression analyses will be conducted to address the aims above. This proposal is responsive to the National Institute of

Nursing Research’s research priority of health prevention and promotion through the lens of social determinants of health and health equity. This pre-doctoral training plan has the following goals: (1) Develop statistical proficiency. (2) Advance understanding of stress physiology, social network processes, and their

relationship to each other across childhood, adolescence and young/emerging adulthood. (3) Cultivate skills related to conducting mental health promotion research with historically marginalized populations. (4) Advance skills for conducting independent research as nurse faculty at a research-intensive academic

institution. The proposed research and training plan will provide the applicant a foundation to a career in nursing science as an early-stage investigator aimed at addressing health inequities and protective factors within historically marginalized populations.