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. 2022 Jun 30;16(1):69–79. doi: 10.1007/s40653-022-00464-3

Depression and Substance Use as Consequences of Exposure to Family Violence: A Moderation Mediation and Self-Medication Hypothesis Study

Timothy I Lawrence 1,✉, Ariel A Mcfield 2, Madeleine M Byrne 3, Sheree STarver 4, Tiah K Stewart 1
PMCID: PMC9908810  PMID: 36776628

Abstract

Ample evidence exists suggesting that exposure to family violence leads to substance use and this relationship is moderated by gender; however, much is still unknown of the underlying mechanism of this relationship. Thus, the current study first examined whether exposure to family violence was associated with substance use. Then consistent with the self-medication hypothesis, we tested whether depressive symptoms mediated the relations between exposure to family violence and substance use. Finally, we examined the moderating effect of gender on the relationships among exposure to family violence and depressive symptoms/substance use (N = 1,850). Results suggest that exposure to family violence positively associated with substance use. Mediation results revealed that depressive symptoms explained the relationship between exposure to family violence and substance use. Moderation results indicated that males who were exposed to family violence were more likely to endorse depressive symptoms and more likely to use substances while controlling for sibling aggression victimization. This study provides new insight into the internalizing and externalizing symptoms of exposure to family violence, specifically for male adolescents. Implications are discussed.

Keywords: Family violence, Depression, Gender, Substance use, Mediation

Introduction

Drug and alcohol use among adolescents continues to be a public health concern. Studies suggest that more than 10% of 12–17- year- old adolescents were identified as substance users. In addition, 25% reported having easy access to cocaine and other illicit substances (Nation & Heflinger, 2006; Swaim & Stanley, 2018). Studies suggest several risk factors for adolescent substance use such as chronic stress (Kilpatrick et al., 2000; Rhodes & Jason, 1990; Wills, 1986), lack of social support (Brownfield & Sorenson, 1991; Richter et al., 1991; mental illness such as PTSD (Stewart et al., 1998; Lipschitz et al., 2003), sibling aggression victimization (Tucker et al., 2015), anxiety (Neighbors et al., 1992; Ohannessian, 2014) and depression (Lewinsohn et al., 1995; Snyder & Smith, 2015). Specifically, adolescents who endorse depressive symptoms are often at a greater risk to use substances, which were consistent into adulthood (Melvin et al., 2013).

Consistent with the previous studies, exposure to family violence often leads to substance use (Downs & Harrison, 1998; Dube et al., 2006; Espelage et al., 2014; Marques et al., 2021). In addition, adolescents exposed to family violence were more likely to seek substances and consume alcohol by the age of 14 (Downs & Harrison, 1998). Despite this, the link between exposure to family violence and substance use is not consistent. One study found that exposure to family violence does not increase the likelihood for adolescents to use substances (Gilbert et al., 2009).

Considering these inconsistent results, more evidence is needed to determine whether exposure to family violence is associated with substance use among adolescents. In addition, as previously mentioned, adolescents who endorse depressive symptoms were more likely to use substances. (Avanci et al., 2012; Chan et al., 2021). It is possible that the link between exposure to family violence and substance use is explained by depressive symptoms. As adolescents experience family violence, they can endorse depressive symptoms, which could increase their likelihood of using substances for coping purposes. In addition, these relationships might be moderated by gender, such that gender differences of exposure to family violence could vary in developing depressive symptoms and substance use.

Finally, while exposure to family violence could predict adolescent substance use, prior literature suggests exposure to family violence can trigger sibling aggression victimization, which can lead to substance use (Eriksen & Jensen, 2006). Specifically, prior literature suggests as adolescents witness violence in the home, their pro-social communicative strategies decrease, subsequently leading to sibling violence (Linares, 2006; Renner, 2012; Tucker et al., 2014). The social learning literature posited that sibling aggression is reinforced through observation and imitation of perceived positive outcomes of aggressive behavior. Further, as violence occurs in the home, aggressive behaviors will become the preferred and common response among siblings (Eriksen & Jensen, 2006; Hoffman & Edwards, 2004). Therefore, to better understand the relations between exposure to family violence and substance use, we controlled for sibling aggression victimization. The first aim of the present study was to examine whether exposure to family violence associates with substance use. The second goal was to explore whether depressive symptoms mediate the relationship between exposure to family violence and substance use. The third goal was to investigate whether gender buffers the relationship between exposure to family violence, depression, and substance use while controlling for sibling aggression victimization.

Exposure to Family Violence

Adolescents are often exposed to violence within the home either through hearing violent acts or through personally witnessing acts (Cooley-Quille et al., 1995; Edleson, 1999; Schwab-Stone et al., 1999). Such violence is categorized as a public safety concern with negative mental health effects such as endorsement of PTSD symptoms (Dovran et al., 2016; Evans et al., 2008; Haj-Yahia & Bargal, 2015; McLaughlin et al., 2013), and higher ratings of anxiety and depressive symptoms (Eisman et al., 2015; Heinze et al., 2018). In addition to internalizing mental illness symptoms, adolescents exposed to family violence are likely to use substances (Herrenkohl et al., 2013; Lee, 2012).

One theory to explain the relationship between exposure to family violence and substance use is the self-medication hypothesis (SMH). This model suggests that individuals who have encountered negative experiences often use substances to ease or relieve their trauma and negative emotions associated with negative events (Garland et al., 2013; Khantzian, 1987; Robinson et al., 2011). Consistent with the SMH, studies have suggested that individuals who have experienced traumatic events often lack adaptive coping strategies, increasing their likelihood to use substances (Cardoso, 2018; Staiger et al., 2009), which could lead to endorsing depressive symptoms (Berg et al., 2017).

Depressive Symptoms

As previously mentioned, adolescents exposed to family violence often endorse depressive symptoms (Lewinsohn et al., 1995; Snyder & Smith, 2015); however, this relationship is not consistent. For instance, when controlling for anger, adolescents who were exposed to family violence were less likely to endorse depressive symptoms (Kitamura & Hasui, 2006). Some suggest that the inconsistent relationship is related to how adolescents either internalize or externalize their trauma symptoms related to their early exposure to violence (Moylan et al., 2010; O’Keefe, 1996). Further, prior literature indicated that as adolescents experience violence within their home or community, they often internalize these events leading to the endorsement of trauma symptoms, which could then lead to externalizing symptoms such as substance use (Cooley-Quille et al., 1995). Despite this, few studies have examined the underlying variable that could explain why traumatic events such as exposure to family violence are associated with substance use. One possible explanatory variable is depressive symptoms. Drawing from the idea that exposure to family violence can lead to internalizing symptoms; it is possible that as a way of coping, adolescents might result to using substances.

Gender

Prior research has shown that the impact of exposure to family violence often differs by gender (Djikanovic et al., 2013). Specifically, studies suggests that boys are often more negatively affected than girls exposed to family violence because they are less likely to adjust and endorse more distressful symptoms (Farley et al., 2021; Izaguirre & Calvete, 2018; Jaffe et al., 1986; Kerig, 1999). Some contend the reason for this is that violence and arguments are less shielded from boys than girls, which also might increase the likelihood of parents displacing their aggression on the boys (Jouriles & LeCompte, 1991; Jouriles et al., 1989). Despite this, an alternative suggestion is that girls often cope with trauma and respond to violence differently from boys. For instance, boys exposed to family violence are more likely to develop externalizing symptoms such as misbehavior and aggression (Maschi et al., 2008) In contrast, girls are more likely to develop internalizing symptoms consistent with depression (Haller & Chassin, 2012; Sternberg et al., 2006).

Despite these clear linkages, a contrary study found that gender makes no difference in externalizing and internalizing symptoms as a response to exposure to family violence (Howells & Rosenbaum, 2008). Considering these inconsistent results, it is important to better understand whether experiencing depressive symptoms and using substances as a response to exposure to family violence differ by gender. This is important because our investigation can inform clinicians and psychologists of who is at greater risk to endorse depressive symptoms and use substances as a result of exposure to family violence. Also, clinicians and psychologists can tailor interventions for internalizing and externalizing symptoms among adolescents exposed to family violence.

Self-Medication Hypothesis

The self-medication hypothesis (SMH) is an ethological explanation of the occurrence of substance use. There are two main assumptions of this model. The first assumption is that, as individuals’ encounter traumatic events, they develop mental illness symptoms, which increases the likelihood to use substances to alleviate their psychiatric symptoms Cooper, 1994; Khantzian, 1987). The second assumption is the use of substances depends on the intensity of the psychiatric symptoms. For example, prolonged depression or anxiety often leads to alcohol or marijuana use because of their calming and sedative effects. In contrast, individuals with episodic depression might use stimulants such as nicotine and cocaine because of their energizing properties (Khantzian, 2003). Despite the utility of both assumptions, this study focused on how traumatic events such as exposure to family violence can lead to the endorsement of depressive symptoms and increases the likelihood of adolescents using substances to alleviate their depressive symptoms.

Prior literature has supported SMH model among individuals with several mental illness diagnoses (Hall & Queener, 2007; Koskinen et al., 2010; Lembke, 2012; Maremmani et al., 2015). Despite empirical support, contrary studies suggest individuals who encountered negative experiences, who also endorse mental illness symptoms often do not use substances (Breslau et al., 2003; Cerda et al., 2008; North et al., 2011). There are two possible explanations for these relationships. One reason for this inconsistent result could be while individuals experience negative events, they can find alternative methods of coping (Shadur & Hussong, 2014). The second explanation could be despite encountering negative events and endorsement of mental illness symptoms, adolescents with higher social support were less likely to use substances (Muller et al., 2000; Pinto et al., 2017). Although there is inconsistent evidence of the SMH, few studies have specifically tested the relationship between exposure to family violence and substance use explained by depressive symptoms guided by the SMH model. Psychological distress from exposure to family violence can increase vulnerability for adolescents to endorse depressive symptoms, subsequently increasing their likelihood to use substances.

The Current Study

The purpose of the current study was to test whether exposure to family violence increases the likelihood of adolescents to use substances. The second goal was to examine whether the depressive symptoms mediate the relationship between exposure to family violence and substance use. The third goal was to examine whether gender moderates the relationships between exposure to family violence, depressive symptoms, and substance use while controlling for sibling aggression victimization. Consistent with prior literature, we predict that exposure to family violence would positively associate with substance use (H1). Regarding depressive symptoms explaining the relationship between exposure to family violence and substance use, due to lack of prior literature exploring these relationships, we considered these relationships as exploratory. Lastly, although prior literature, on the one hand, suggests that gender often moderates the relationship between exposure to family violence and depressive symptoms, there are contrary results of these relationships. Thus, the current study considers the buffering effects of gender on the relationships between exposure to family violence, depressive symptoms, and substance use as exploratory.

Method

Participants

Data used in this study were from Bullying, Sexual, and Dating Violence Trajectories From Early to Late Adolescence in the Midwestern United States, 2007–2013 (Espelage et al., 2016). The original purpose of this longitudinal study was to examine the degree to which individual, familial, and peer variables are associated with the risk of teen dating violence and bullying experiences in early adolescents. Middle school students were initially surveyed and followed into three high schools. Five waves of survey were collected pertaining to familial violence (parents and siblings), physical abuse within their home, bullying, self-reported delinquency, and association with delinquent friends. Because we used a cross-sectional design, we utilized the first wave (N = 1,850).

Parental Consent

Parents of all the students were sent a letter informing them of the risk and purpose of the study to obtain consent. For participation, they were asked to sign it and return it to the investigators. At the beginning of each survey, teachers and research assistants removed students whose parents declined their participation in the study. In addition, students were reminded that they should not complete the survey if their parents never returned the consent form. A 95% completion rate was achieved in the study. Afterward, students were asked to consent to fully participate in the study through an assent sheet. For the current study, the demographic makeup of students was 49.8% female, age ranges from 10 to 15 years old (M = 13.9; SD = 1.05), 43% African American, 43% White Caucasian, 14% other, 2% Asian, % Hispanic, 2% Native American, and 7% Biracial.

Measures

Exposure to Family Violence

Exposure to family violence was measured using The Family Conflict and Hostility Scale (Thornberry et al., 2003). This scale measures the degree to which individuals perceive conflict and hostility within their family. This measure is comprised of three items, with an example item such as, “how often are there physical fights in the household, like people hitting, shoving, or throwing things?” On a 5-point Likert scale ranging from 1(never) to 5(always). Items were averaged together, which created an overall score (α = 0.79). Higher scores indicate increased exposure to family violence.

Depressive Symptoms

Depression was measured using the Orpinas Modified Depression Scale (Orpinas, 1993). This measure comprised of six items, which assess depressive symptoms within the previous 30 days. An Example item is, “Do you feel hopeless about your future” measured on a 5-point Likert scale ranging from 1(never) to 5(almost always). Items were averaged together, which created an overall score (α = 0.82). Higher scores indicate more depressive symptoms.

Substance Use

Substance use was measured using the Problem Behavior Frequency Scale (Farrell et al., 2000). This scale measures an individual’s use and frequency of alcohol and drug use. This scale comprised of 8 items, with example items such as “smoke marijuana” or “drunk liquor” measured on a 5-point Likert scale ranging from 1(never) to 5(10 more times). Items were averaged together, which created an overall score (α = 0.87). Higher scores represent increased substance use.

Gender

Gender was measured by asking students their gender ranging from 1 as male and 0 as female.

Sibling Aggression Victimization

Sibling aggression victimization was measured using adopted items from the University of Illinois Bullying Scale. This scale comprised of 5 items, with an example item such as, “my sisters and brothers hit me and pushes me around” measured on a 5-point Likert scale ranging from 0(never) to 4(7 or more times). Items were averaged together, which created an overall score (α = 0.82). Higher scores indicate increased sibling victimization.

Results

Preliminary analyses were conducted to assess skewness, normality, multi-collinearity, and missing data. There was no problematic skew, and the data was normally distributed. However, there were missing data for the current sample (missing at random). Thus, a multiple imputation was used. Descriptive statistics and correlations for all variables were examined (see Table 1). Both exposure to family violence (r = 0.18) depressive symptoms (r = 0.30), and sibling aggression victimization (r = 38) were positively correlated with substance use.

Table 1.

Correlations, means, standard deviations, skew, and scale reliability

Variable 1 2 3 4
1.Family Violence -
2.Depression .30*** -
3.Sibling Aggression .38*** .23*** -
4.Substance Use .18*** .13*** .11** -
M 0.45 1.21 1.31 1.06
SD 31.87 .7783 .4247 .2613
Skew .05 .47 .17 .11
Cronbachs’s α .79 .82 .82 .87
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Family violence = exposure to family violence, Sibling aggression = sibling aggression victimization

**p <.01; *** p <.001

Then to examine mediation moderation, an Andrew Hayes PROCESS (model 58) was used. This model required three main steps. In step one, the relationship between exposure to family violence and substance use is mediated by depressive symptoms. In the second step, the relationship exposure to family violence and depressive symptoms is moderated by gender. Then in the final step, the relationship between depressive symptoms and substance use is moderated by gender while controlling for sibling aggression victimization.

In step 1, in which depressive symptoms was the outcome variable, the overall model was significant, R2 = 0.12, F(4, 1845) = 64.2261, p < 0.001. Exposure to family violence (β = 0.59, p < 0.001), sibling aggression, (β = 0.22, p < 0.001), gender (β = 0.17, p < 0.001), and interaction between gender and exposure to family violence, (β = 0.22, p = 0.02) were all positively related to depressive symptoms. In step 2, in which substance use was the outcome variable, the overall model was R2 = 0.04, F(5, 1844) = 15. 0427, p < 0.001. Exposure to family violence (β = 0.11, p < 0.001), depressive symptoms (β = 0.03, p < 0.001), and the interaction between depressive symptoms and gender (β = 0.04, p = 0.01) were all positively related to substance use. However, gender (β = -0.02, p = 0.11) and sibling aggression victimization, (β = 0.02, p = 0.09) were not statistically related to substance use. Indirect effects were used to test whether depressive symptoms explained the relationship between exposure to family violence and substance use. The relationship between exposure to family violence and substance use was mediated by depressive symptoms, IEcoefficient = 0.4822, SEboot = 0.01, 95% CIboot = [0.0147, 0.0641] (see Fig. 1).

Fig. 1.

Fig. 1

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This figure represents the mediational role of depressive symptoms and the buffering effect of gender. The dotted lines represent significant indirect path. ** p < .01, ***p < .001

Discussion

There were four main goals of the current study. The first goal was to test whether exposure to family violence was related to substance use. Then the second goal was to explore whether depressive symptoms mediated the relationship between exposure to family violence and substance use. The third goal was to explore whether gender moderated the relationship between exposure to family violence and depressive symptoms. The final goal was to examine whether gender moderated the relationship between depressive symptoms and substance use. The results for the first goal suggest that adolescents who were exposed to family violence were more likely to use substances.

This is consistent with prior literature, which suggested that violence within the home often increases the likelihood for adolescents to use substances (Downs & Harrison, 1998; Dube et al., 2006; Espelage et al., 2014). One explanation could be as adolescents witnessed violence within their home, they could have endorsed traumatic symptoms, which increased their willingness to use substances to cope. Another explanation could be witnessing violence within the home created an unsafe environment to civilly discuss concerns, which could have increased the likelihood for adolescents to use substances. Although this might be the case, contrary to prior studies (Button & Gealt, 2010; Dantchev & Wolke, 2019; Maniglio, 2015; Wu et al., 2010), we found sibling aggression victimization and gender differences were not statistically associated with substance use. One possible explanation for these results could be sibling victimization experiences led to other maladaptive coping strategies, such as excessive eating (Striegel-Moore et al., 2002; Sweetingham & Waller, 2008) that was not tested in the current study.

Pertaining to the mediation question, consistent with the SHM model, we found that depressive symptoms explained the relationship between exposure to family violence and substance use. This is consistent with prior literature that suggested early exposure to family violence often leads to internalizing symptoms, which could increase the likelihood for substance use (Ingram et al., 2020; Izaguirre & Calvete, 2018). There are two possible explanations of these relationships. One explanation could be as a result of family violence, adolescents endorsed depressive symptoms such as hopelessness and powerlessness, and use substances to alleviate their symptoms. Another reason could be exposure to family violence might have increased avoidance (Kraaij et al., 2003; Moretti & Craig, 2013) and maladaptive rumination (Skitch & Abela, 2008), subsequently leading to substance use.

Regarding gender moderating the relationship between exposure to family violence and depression, results suggest that boys exposed to family violence were more likely to develop depressive symptoms than girls. This is partially contradictory to prior literature, which suggested that boys exposed to family violence were more likely to endorse externalizing symptoms than girls (Sternberg et al., 2006). There are several possible explanations for these results. One explanation is that because boys were less shielded from family violence (Jouriles & LeCompte, 1991; Jouriles et al., 1989), doing so increased their likelihood to endorsed symptoms consistent with depression such as hopelessness and anhedonia. Another explanation could be that violence might have decreased adolescent boys’ external locus of control, which often increases negative rumination and excessive worry about stressful events (Scotts et al., 2010).

Finally, gender moderated the relationship between depressive symptoms and substance use, such that boys who endorsed depressive symptoms were more likely to use substances compared to girls. There are several possible explanations for this relationship. It is possible that, as prior literature indicated that boys are often less likely to adaptively cope with depressive symptoms (Bennett et al., 2005). In this case, maladaptive coping might have increased the likelihood for boys to use substances. Another reason could be while boys experienced depressive symptoms, they suppressed their symptoms, which increased the degree to which they would use substances. Finally, it is possible that although adolescent girls were more likely to ruminate about their depressive symptoms compared to boys (Jose & Brown, 2008), boys were more likely to actively seek maladaptive methods to cope with depressive symptoms such as substance use.

Implications

Findings have direct implications for prevention efforts. To prevent family violence, violence prevention programs should reach out to families suspected of having an occurrence of family violence and encourage engagement in treatment programs or involve law enforcement agencies. This approach has several promising results in reducing family violence (Simbandumwe et al., 2008). Another way to perhaps prevent family violence is to encourage school counselors and teachers to increase interaction with students. By doing so, teachers and counselors can better ascertain whether adolescents have experienced family violence in the home.

Regarding the gender moderating the relationship between exposure to family violence and depression, it appears that boys are at a higher risk of experiencing depressive symptoms because of exposure to family violence. To disrupt this pattern, school personnel should allocate sometime talking with male students about their home life, specifically asking questions pertaining to mental illness symptoms and potential environmental factors that may impact their functioning. While doing so, offer counseling within the school, community mental health facilities to their families, which should concentrate on treating depressive symptoms. While discussing with male students, if there were reported occurrences of family violence, reporting these incidents to child protective services could not only prevent family violence but also assist in locating mental health services within the community.

Finally, boys who endorsed depressive symptoms were more likely to use substances. Perhaps, while providing education to students, academic administrators should implement substance use reduction training to dissuade students from using substances. In addition, school clinicians should implement skillful methods of handling depressive symptoms, such as thought reframing exercises and reappraisal of emotions. Implementing core cognitive-behavioral therapy (CBT) interventions among students has shown to decrease substance use over time (Barrett et al., 2001; Latimer et al., 2003). In addition to professionals identifying risk factors associated with family violence and reporting violence, psychoeducation specifically on male emotional intelligence may also be discussed. Specifically, professionals should receive training on effectively recognizing depressive symptoms among adolescent males and reinforcing the healthy expression of emotions. Also, adolescent males may be provided safe spaces to communicate their feelings and effective coping strategies that are gender specific. Another way to reduce depression and substance use among adolescents’ males could be for mental health advocates to periodically visit schools and conduct voluntary therapy targeted to reduce depressive symptoms, which could result in turn, decrease adolescents’ likelihood of using substances. Tables 2 and 3

Table 2.

Regression coefficients and standard errors for each step in the mediation moderation analysis (N=1,850)

Depression Symptoms Substance Use
Variables b(SE) 95% CI b(SE) 95% CI
Family Violence .59(.05)*** [.48, .70] .11(.02)*** [.07, .16]
Depression - - .03(.09)** [.01, .04]
Sibling Aggression .22(.04)*** [.13, .30] .02(.01) [-.05, .06]
Gender .17(03)*** [.11, .23] -.02(.01) [-.04, .05]
Family X Gender .23(.10)* [.02, .43] - -
Depression X Gender - - .04(.01)* [.09, .08]
R2 .12*** - .04***
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*p <.05; **p <.01; ***p <.001

Table 3.

Results from a factor analysis of all latent variables

Latent Variables Factor Loadings
1 2 3 4
Factor 1: Family Violence
1. How often is there yelling, quarrelling, or arguing in your household? .804 .301 .245 .047
2. How often do family members lose their temper or blow up for no reason in your household? .781 .251 -.492 .371
3. How often are there physical fights in the household, like people hitting, shoving, throwing? .663 .380 -.219 .381
Factor 2: Depressive Symptoms
1. Were you very sad? .218 .666 .418 .037
2. Were you grouchy or irritable or in a bad mood? .031 .743 .364 .259
3. Did you worry a lot? .182 .651 .341 .308
4. Did you feel hopeless about the future? .314 .705 .305 .595
5. Did you feel like not eating or eating more than usual? .070 .617 .382 .056
6. Did you feel happy? * .489 .736 .217 .105
7. Did you feel nervous or afraid that things won’t work out the way you would like them to? .042 .590 .221 .261
8. Did you sleep a lot more or a lot less than usual? .559 .603 .364 .390
9. Did you have difficulty concentrating on your schoolwork? .414 .717 .419 .219
Factor 3: Substance Use
1. Drank beer (more than a sip or taste)? .385 .429 .757 .471
2. Drank wine or wine coolers (more than sip or taste)? .491 .311 .738 .271
3. Smoked cigarettes? .231 .290 .687 .481
4.Been drunk? .369 .302 .834 .042
5.Drank liquor (like whisky or gin)? .341 .219 .792 .189
6. Use marijuana or weed (pot, hash, reefer)? .310 .058 .719 .320
7. Use inhalants? .317 .318 .605 .471
8. Used other illegal drugs? .410 .448 .603 .469
Factor 4: Sibling Aggression Victimization
1. My sister or brother calls me names .318 .356 .281 .805
2. My sister or brother picks on me .042 .289 .157 .837
3. My sister or brother hits me and pushes me around .201 .069 .319 .670
4. I am scared that my sister or brother will hurt me bad somebody .498 .210 .490 .722
5. My sister or brother beats me up .320 .041 .513 .758
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Factor analysis was conducted using principal component analysis (PCA) and oblimin rotations with Kaiser normalization. The bolded factor loadings represent variable, respectively

*Represents the revers coded item. Factor 1 = Exposure to Family Violence, Factor 2 = Depressive Symptoms, Factor 3 = Substance Use, and Factor 4 = Sibling Aggression Victimization

Pertaining to parents, increasing parental support through warmth and an authoritative parenting style, which consists of listening, using positive disciplinary tactics, allowing autonomy, and establishing a positive parent–child relationship (Masud et al., 2019; Romm & Metzger, 2021; Szkody et al., 2021) often protects against internalizing (Janssen et al., 2021; Lawrence, 2022) and externalizing symptoms among adolescents (Cox et al., 2021; Lawrence & Mcfield, 2022; 2018).

Limitations, Future Research, and Conclusion

Although this study found various interesting results, there are apparent limitations. One limitation is that we could not specify the preexisting relationship between parent–child, which could play a role in the development of depressive symptoms and the likelihood to use substances. Therefore, future studies should account for the parent–child relationship to test the robustness of the current study’s results. Another limitation could be the degree to which family violence leads to depressive symptoms, and substance use might change over time. Therefore, future studies should consider using a longitudinal design to examine whether this pattern changes over time with various moderators. Lastly, another limitation is that perhaps gender also moderates the relationship between family violence and substance use. Future studies should examine this relationship to highlight which gender is at a higher risk to use substances because of family violence.

The current study provided new insight on the effects of exposure to family violence on depressive symptoms and substance use and the moderating role of gender. Overall, exposure to family violence can lead to adolescent substance use. Additionally, depressive symptoms link the relationship between exposure to family violence and substance use. Finally, adolescent males are at a greater risk to develop depressive symptom and use substances as a result of exposure to family violence regardless of the occurrence of sibling aggression victimization. Thus, it may be beneficial for both educational administers and community mental health advocates to first assess the occurrence of family violence within the home, and provide treatment within schools, the community, and if needed, contact child protective services.

Declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Footnotes

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Contributor Information

Timothy I. Lawrence, Email: Tlawrence3@pvamu.edu

Ariel A. Mcfield, Email: mcfield_a@utpb.edu

Madeleine M. Byrne, Email: Madeleine.M.Byrne@dallascounty.org

Sheree S.Tarver, Email: Sheree.Tarver@dallascounty.org.

Tiah K. Stewart, Email: Tstewart45@PVAMU.EDU

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