Psychometric properties of a direct violence scale and its behavioral mediation
Main Article Content
Keywords
Violence, Adolescent, Stress Disorder, Postraumatic, Mental Health, Alcohol Drinking
Abstract
Background: The lack of valid instruments to assess direct violence (DV) limits the understanding of its impact on mental health, including post-traumatic stress disorder (PTSD) and substance use.
Objective: To validate an expanded DV subscale as an autonomous measure in Mexican adolescents and to examine its association with PTSD and abusive alcohol consumption (AAC) through a mediation model.
Material and methods: A quantitative study with a mediation analysis approach was conducted in a sample of 3963 adolescents aged 14 to 19 from eleven Mexican cities. A subset of items from the DV factor of the Exposure to community violence in aolescents scale was used, with the addition of three context-specific items and the response format. PTSD symptoms and AAC were also assessed. Exploratory and confirmatory factor analyses were performed, along with a mediation model.
Results: Findings support the psychometric validity of the standalone EVDA-10 scale. Mediation analysis showed that physical-verbal violence was significantly associated with AAC, through the PTSD symptom of intrusion.
Conclusions: The study highlights the relevance of trauma-related symptoms as intermediate mechanisms explaining the impact of violence on risk behaviors, and underscore the need for early detection and trauma-informed interventions targeting post-traumatic symptoms in adolescents.
References
1. World Health Organization. Violence agaisnt children. 2022. Disponible en: https://www.who.int/news-room/fact-sheets/detail/violence-against-children
2. Organización Mundial de la Salud. Violencia Juvenil. 2020. Disponible en: https://www.who.int/news-room/fact-sheets/detail/violence
3. Miliauskas CR, Faus DP, da Cruz VL, et al., Community violence and internalizing mental health symptoms in adolescents: A systematic review. BMC Psychiatry. 2022;22(1):253. doi: 10.1186/s12888-022-03873-8
4. Romero-Méndez CA, Rojas-Solís JL, Greathhouse-Amador LM. Co-ocurrencia de distintos tipos de violencia interpersonal en adolescentes mexicanos. Pedagog Soc Rev Interuniv. 2021;38:137-50. Disponible en: http://recyt.fecyt.es/index.php/PSRI/
5. García-García P, Hinojosa-García L, Jiménez-Martínez AA, et al. Violencia en el noviazgo asociada al consumo de alcohol en mujeres estudiantes de preparatoria en Matamoros, Tamaulipas. SANUS Rev Enferm. 2023;(19):e359. doi: 10.36789/revsanus.vi1.359
6. Raman U, Bonanno PA, Sachdev D, et al. Community Violence, PTSD, Hopelessness, Substance Use, and Perpetuation of Violence in an Urban Environment. Community Ment Health J. 2021;57(4):622-30. doi: 10.1007/s10597-020-00691-8
7. Boumpa V, Papatoukaki A, Kourti A, et al. Sexual abuse and post-traumatic stress disorder in childhood, adolescence and young adulthood: a systematic review and meta-analysis. Child Adolesc Psychiatry. 2024;33(6):1653-73. doi: 10.1007/s00787-022-02015-5
8. Alemán-Martínez H. ¿Es la violencia juvenil un objeto de estudio que tiene una claridad irrebatible? Consideraciones teóricas. Argumentos. 2021;86:357-79. doi: 10.24275/uamxoc-dcsh/argumentos/202299-14
9. Nuño-Gutiérrez BL. Salud, violencia, drogas y narcotráfico. Una observación desde el occidente. Guadalajara: Universidad de Guadalajara; 2022. p. 159-75.
10. Nuño-Gutiérrez BL. Adaptación y validación de la Escala de Exposición a Violencia Indirecta en Adolescentes Mexicanos. Acta Investig Psicol. 2024;14(1):50-9. doi: 10.22201/fpsi.20074719e.2024.1.526
11. Chaidez-Villalobos ID, Valdés-Cuervo AA, Ramos-Lira L, et al. Validación de la Escala de Exposición a la Violencia en la Comunidad en Adolescentes (EVC-A). Acta Investig Psicol. 2023;13(3):78-89. doi: 10.22201/fpsi.20074719e.2023.3.516
12. Narita ZC, Miyashita M, Furukawa TA, et al. Key considerations in mediation analysis for psychiatric research. JAMA Psychiatry. 2025;82(7):645-652. doi: 10.1001/jamapsychiatry.2025.0566
13. Schuler MS, Cofman DL, Stuart EA, et al. Practical challenges in mediation analysis: a guide for applied researchers. J Quant Criminol. 2024;40(2):487-512. doi: 10.1007/s10742-024-00327-4
14. Li J, Zhu Y, Qiu Z, et al. Measuring health-related quality of life among school adolescents across Chinese Human Geography Regions: psychometric validation and norm development of the Mandarin Chinese self-reported KIDSCREEN-10 index. BMC Pshychol 2024;29(12):600-1738. Disponible en: https://doi.org/10.1186/s40359-024-01876-6
15. Kaplow JB, Rolón-Arroyo B, Layne CM, et al. Validation of the UCLA Brief COVID-19 Screen for Child/Adolescent PTSD. Child Psychiatry Hum Dev. 2022;53(5):913-925. doi: 10.1007/s10578-021-01209-4
16. Nuño-Gutiérrez BL. Validación de la escala de Estrés Postraumático CRIES-8 en adolescentes mexicanos. Rev Psicol Univ Auton Estado Mex. 2025;14(44).
17. Villatoro-Velázquez J, Bustos-Gamiño M, Fregoso-Ito D, et al. Contextual factors associated with marijuana use in school population. Salud Ment. 2017;40(3):93-102. Disponible en: https://www.scielo.org.mx/pdf/sm/v40n3/0185-3325-sm-40-03-00093.pdf
18. Lloret-Segura S, Ferreres-Traver A, Hernández-Baeza A, et al. El análisis factorial exploratorio de los ítems: una guía práctica, revisada y actualizada. An Psicol. 2014;30(3). doi: 10.6018/analesps.30.3.199361
19. JASP Team. JASP (Version 0.18.1.0) [Computer software]. 2022. Disponible en: https://jasp-stats.org
20. Lubbe D. Parallel analysis with categorical variables: Impact of category probability proportions on dimensionality assessment accuracy. Psychol Methods. 2019;24(3):339-51. doi: 10.1037/met0000171
21. Sanbonmatsu DM, Cooley EH, Butner JE. The Impact of Complexity on Methods and Findings in Psychological Science. Front Psychol. 2021;11:580111. doi: 10.3389/fpsyg.2020.580111
22. Brown T. Confirmatory factor analysis for applied research. New York: Guilford Publications; 2015.
23. Hayes A, Coutss J. Use Omega rather than Cronbach´s Alpha for estimating reliability. But ... Commun Methods Meas. 2020;14(1):1-24. doi: 10.1080/19312458.2020.1718629
24. Alfons A, Ates NY, Groenen PJF. A robust bootstrap test for mediation analysis. Organ Res Methods. 2022;25(3):591-617. doi: 10.1177/1094428121999096
25. Briggs EC, Nooner K, Amaya-Jackson LM. Assessment of PTSD in children and adolescents. In: Friedman MJ, Schnurr PP, Keane TM, editors. Handbook of PTSD: Science and Practice. 3rd ed. New York: The Guilford Press; 2021. p. 299-313.
26. Cousin L, Roucoux G, Petit AS, et al. Perceived stigma, substance use and self-medication in night-shift healthcare workers: a qualitative study. BMC Health Serv Res. 2022;22(1):698. doi: 10.1186/s12913-022-08018-x
27. Akbari M, Seydavi M, Hosseini Z, et al. Experiential avoidance in depression, anxiety, obsessive-compulsive related, and posttraumatic stress disorders: a comprehensive systematic review and meta-analysis. J Contextual Behav Sci. 2022;24:65-78.
28. Allwood MA, Robinson JN, Kim H. Youth exposure to gun, knife, and physical assaults: assessing PTSD symptoms across types of assaults, race, ethnicity, sex, and context. J Interpers Violence. 2023;38(21-22):11545-11568. doi: 10.1177/08862605231185300
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