Background: Child maltreatment (CM) and early-life homelessness are significant public health concerns that independently increase susceptibility to adverse mental health symptomatology and engagement in potentially harmful behaviors. Although cumulative disadvantage theory suggests that experiencing multiple forms of trauma may compound risk, there is limited research examining the interplay between CM victimization and early-life homelessness as risk factors for such outcomes.

Objective: The objective of this dissertation was to examine direct associations between CM victimization experienced prior to the sixth grade and behavioral and mental health outcomes in early adulthood. Early-life homelessness experienced prior to the age of 28 was examined as a mediator in these relationships.

Methods: Data come from the National Longitudinal Study of Adolescent to Adult Health, with sample sizes of 10,838 and 11,886 across analytic models. CM victimization variables, including CM occurrence, CM count (i.e., number of CM types), and specific CM types (i.e., supervisory neglect, physical neglect, physical abuse, and sexual abuse), and early-life homelessness were measured in Wave 3 (ages 18-27). Outcome variables, including depressive symptoms, criminal offending, binge drinking likelihood and frequency, and illicit drug use likelihood and frequency were measured in Wave 4 (ages 24-34). Weighted probit and linear regression models were conducted in Mplus.

Results: Results indicated that all forms of CM were directly and indirectly associated with higher depressive symptoms, with exception to sexual abuse, which only had a direct association with depressive symptoms via early-life homelessness. Similarly, all forms of CM directly and indirectly predicted a greater likelihood of offending via early-life homelessness, with exception to physical neglect, which directly predicted a lower likelihood of offending and indirectly predicted a greater likelihood of offending via early-life homelessness. Likelihood of binge drinking was not predicted by any form of CM. However, CM occurrence and physical abuse directly predicted more frequent binge drinking, and physical neglect and sexual abuse directly predicted less frequent binge drinking. All forms of CM except sexual abuse were indirectly associated with more frequent binge drinking via early-life homelessness. Regarding illicit drug use, CM occurrence, CM count, and supervisory neglect were directly and indirectly associated with an increased likelihood and frequency of illicit drug use, while physical neglect and physical abuse were only indirectly associated with a greater likelihood and frequency of illicit drug use via early-life homelessness. Sexual abuse had no significant associations with illicit drug use.

Conclusions: The present study supports the relative importance of CM victimization and early-life homelessness in shaping behavioral and mental health trajectories in early adulthood. Findings highlight the critical importance of accessible programs that prevent CM, evidence-based treatment services that promote positive coping immediately following experiences of CM, and policy efforts that seek to increase affordable and accessible housing for families supported by child welfare, behavioral health, and housing service systems.