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Conduct disorder behaviors, childhood family instability, and childhood abuse as predictors of severity of adult homelessness among American veterans.

Tsai J, Rosenheck RA. Conduct disorder behaviors, childhood family instability, and childhood abuse as predictors of severity of adult homelessness among American veterans. Social psychiatry and psychiatric epidemiology. 2013 Mar 1; 48(3):477-86.

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PURPOSE: Despite US federal efforts to end and prevent homelessness among veterans, there has been limited examination of pre-military factors like childhood problems, associated with adult homelessness. This study examined childhood problems among homeless veterans and its relation to severity of homelessness and outcomes in supported housing. METHODS: Using data from 1,161 homeless veterans at 19 sites enrolled in the Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) program, three types of childhood problems were examined: conduct disorder behaviors, family instability, and childhood abuse. Multiple regressions were conducted to examine the association between childhood problems and severity of homelessness before supported housing, and childhood problems and outcomes after supported housing. RESULTS: About one-third reported conduct disorder behaviors, over half reported family instability, and 40% reported childhood abuse. Greater childhood problems were found in this sample compared to published samples of non-homeless veterans. Conduct disorder behaviors, family instability, and childhood abuse were each weakly associated with lifetime homeless episodes. One year after enrollment in the HUD-VASH program, past conduct disorder behaviors and family instability were not predictive of outcomes, except childhood abuse was related to less social support and lower quality of life. CONCLUSIONS: These findings demonstrate not only the potential impact of childhood abuse on social relationships and quality of life in adulthood, but also the resilience of homeless veterans from adverse childhoods to be successfully housed in a supported housing program.

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