Author ORCID Identifier

https://orcid.org/0000-0003-0489-3400

Semester

Summer

Date of Graduation

2024

Document Type

Dissertation

Degree Type

PhD

College

School of Public Health

Department

Social and Behavioral Sciences

Committee Chair

Alfgeir L. Kristjansson

Committee Co-Chair

Robin A. Pollini

Committee Member

Robin A. Pollini

Committee Member

Christa L. Lilly

Committee Member

Traci Jarrett

Committee Member

Keith Zullig

Abstract

Background. Adolescent health outcomes are vitally important for public health. One such outcome includes adolescent violence, a persistent and prevalent public health issue in the United States. Adolescent violence in rural areas is particularly understudied and some measures of rural violence are underreported compared to violence metrics in urban areas. A key risk factor for adolescent violence, is anger. By examining known key risk factors for adolescent anger through a primary prevention and socioecological perspective, it may be possible to reduce or prevent downstream violence in adolescence and later adulthood. Identifying specific systemic, environmental, and interpersonal factors related to anger may help inform interventions to prevent the onset of adolescent anger and therefore mitigate risks for later downstream violence. Aims. This dissertation aimed to: (Aim 1) Develop a conceptual model grounded in theoretical framework that connects systemic, environmental, interpersonal, and individual-level factors that influence adolescent anger; (Aim 2) test the variable relationships within the conceptual model by incorporating its key factors into a cross-sectional quantitative analysis; and (Aim 3) test the conceptual model and examine adolescent anger over time by incorporating key factors into a longitudinal quantitative analysis. Methods. (Aim 1) A conceptual model was designed based on known risk factors for adolescent anger and/or violence. This model organizes and connects risk factors into a novel arrangement previously unavailable in the public health literature. A conceptual manuscript grounded in theoretical framework was then written to advocate for the primary prevention of the structural, community, and interpersonal factors that affect adolescent anger. (Aims 2 and 3) Self-reported survey data from the Young Mountaineer Health Study (YMHS), a cohort study in which middle school students were surveyed twice per year for six years, was used for Aims 2 and 3. (Aim 2) utilized cross-sectional data from Wave 2 of the YMHS cohort (N=1,649). The dependent variable was anger, measured using the SCL-90 scale. Independent variables were inequality, individual socioeconomic status (SES), neighborhood characteristics, family structure, social support from adults at home and school, and harsh parenting. Gender was an effect modifier. Two Poisson regression models were employed, for main effects and gender interaction effects. Parameter estimates were exponentiated and interpreted as Rate Ratios (RR). (Aim 3) utilized all six waves (three years) of the YMHS data (N=2,861 unique cases). As in Aim 2 the dependent variable was anger, measured using the SCL-90 scale. Independent variables were the same as in Aim 2. A series of generalized estimating equation (GEE) Poisson regression models was employed to examine the most significant factors related to anger. The models also examined whether gender was an effect modifier between any of the key factors and anger. Results. (Aim 1) Known risk factors for adolescent anger and/or violence were reviewed and arranged into a singular conceptual model grounded in General Strain Theory, Relative Deprivation Theory, and the Socioecological Model. (Aim 2) Significant main effects between independent variables and anger included perceived safety from crime (RR=0.979, p(Aim 3) At the structural level, SES (RR=.985, pConclusion. This dissertation focused on rural adolescent anger from a primary prevention, socioecological perspective. (Aim 1) The conceptual model in this manuscript proposed that adolescent anger development in rural United States is rooted in systemic economic inequality which drives the epidemic and reproduction of violence in this country. The manuscript called for public health research examining and addressing structural conditions in addition to solely interpersonal experiences that may lead to adolescent anger and downstream violence. (Aim 2) While boys were found to self-report lower anger levels than girls, this study found that harsh parental discipline may be particularly harmful to boys. Further research into gender differences in anger and its associated risk factors among rural adolescents is needed. (Aim 3) Variables measuring SES and inequality were found to be significantly associated with adolescent anger. This finding supports the assertion in the conceptual model that systemic inequality could be ultimately driving adolescent anger which may influence the violence epidemic in America. More research into the myriad factors relating to rural adolescent anger, including gender differences in these relationships, is needed.

Embargo Reason

Publication Pending

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