































Graduate Student Journal of Psychology          Copyright 2012 by the Department of Counseling and Clinical Psychology 
2012, Vol. 14               Teachers College, Columbia University 

30 

 
School Violence Exposure and Adolescent Substance Use: 

A Rural Investigation 
 

Elizabeth W. Milligan, Heidi L. Radunovich, & Brenda A. Wiens 
University of Florida 

 
The purpose of this study was to examine the relationship between school violence exposure and 
adolescent substance use.  The study looked at three types of school violence (witnessed violence, 
violent victimization, and violence perpetration) and their relationship to substance use frequency 
(marijuana use and the use of other illicit substances) during adolescence.  A total of 766 high 
school students from a rural school district participated in this study by completing a survey used to 
assess youth risk behaviors over the past 12 months.  Although results found that overall school 
violence exposure and adolescent substance use were highly correlated, increased frequency of 
witnessing violence at school in particular were related to increased frequency of substance use.  
No significant relationships were identified between violence perpetration or victimization at 
school and adolescent substance use.  Potential implications of these findings for substance use 
prevention, particularly for adolescents residing in rural areas, are discussed. 

 
 

Recent findings from the National Survey on Drug Use 
and Health (Substance Abuse and Mental Health Services 
Administration [SAMHSA], 2009) indicate a connection 
between youth violence and substance abuse.  Results from 
the SAMHSA study suggest that adolescents between the 
ages of 12 and 17 who engage in violent behavior are more 
likely to have also used illicit substances within the last 30 
days (SAMHSA, 2009).  Violence exposure in community 
settings has demonstrated a severe emotional impact on 
children, resulting in impaired social relationships and 
externalizing problems (Cooley-Quille, Turner, & Beidel, 
1995), and according to Timmermans and colleagues (2008), 
externalizing behaviors are linked to adolescent substance 
use.  Additionally, experiencing acts of physical and sexual 
assault have been shown to increase the risk for adolescent 
alcohol and substance use and lower the age of substance use 
onset (Kilpatrick et al., 2000).   

Sullivan et al.  (2007) suggest that exposure to violence 
results in numerous negative outcomes for youth, including 
substance use.  Specifically, research suggests that those who 
report having witnessed violence at a greater frequency also 
report higher levels of substance use (Sullivan et al., 2007), 
and witnessing violence almost triples the risk of substance 
use disorders in adolescence (Kilpatrick et al., 2000).  
Witnessing violence has also proven to be a better predictor 

                                                 
Elizabeth Milligan, Department of Family, Youth and 

Community Sciences, University of Florida; Heidi L. Radunovich, 
Department of Family, Youth and Community Sciences, University 
of Florida; Brenda A. Wiens, Department of Clinical and Health 
Psychology, University of Florida.  

Elizabeth Milligan is now at the School of Professional 
Psychology, Pacific University. 

Correspondence concerning this article should be addressed to 
Elizabeth Milligan, School of Professional Psychology, Pacific 
University, 190 SE 8th Ave, Hillsboro, OR 97123. Email: 
mill2080@pacificu.edu  

of externalizing behavior problems than victimization 
(Cooley-Quille et al., 1995; Janosz et al., 2008).  

Recent statistics on violence and substance use suggest 
high prevalence rates among adolescents (SAMHSA, 2009).  
In 2003, nearly one-tenth of high school students reported 
being threatened or injured with a weapon at school (Brener, 
Lowry, Barios, Simon, & Eaton, 2004), and in 2007, 1.5 
million students between the ages of 12 and 18 were victims 
of nonlethal crimes at school (Dinkes, Kemp, Baum, & 
Synder,,2009).  According to Dinkes and colleagues (2009), 
school crime rates for students between the ages of 12 and 18 
remained constant from 1992 to 2007, illustrating that school 
violence remains a persistent problem.  In addition, 
adolescence is the developmental period that assumes the 
greatest risk for substance use onset (Perkonigg et al., 2006), 
and early adolescence is a distinct period of vulnerability for 
youth, with rates of substance use increasing drastically 
(Abbey, Jacques, Hayman, & Sobeck, 2006).   

According to Perkonigg and colleagues (2006), the 
overall prevalence of adolescent substance use in the United 
States is exceptionally high in comparison to some European 
countries, with about half of all adolescents in the U.S. having 
tried at least one illicit substance prior to graduating.  A study 
funded by the National Institute on Drug Abuse, the 
Monitoring the Future Study (National Institute on Drug 
Abuse [NIDA], 2009), suggests that current rates of substance 
use among youths are a cause for concern.  Between 10.3% 
and 31.7% of students in grades 8-12 have used marijuana at 
least once in the year prior to being surveyed, while 3.7% to 
8.3% had used inhalants, 1.8% to 4.4% had used cocaine, and 
1.5% to 4.5% had used MDMA (ecstasy).  These results 
indicate that marijuana use among adolescents is reported 
more often than all other illicit substances, a finding which 
has been supported by other studies showing that marijuana is 
the most popular illicit substance among students (McCrystal, 
Percy, & Higgins, 2006).  Therefore, it is important to explore 



MILLIGAN, RADUNOVICH, & WIENS  
 

31 

marijuana and illicit substance use as separate entities to 
better understand substance use behaviors in adolescence as 
well as the relationship between the use of marijuana and 
other illicit substances, if any. 

According to Sussman and Ames (2001), it is important 
to explore trends of adolescent substance use because 
substance use among adolescents differs from adult substance 
use in several ways.  First, frequent substance use in 
adolescence may be classified as abuse more readily because 
of the potential for such use to impede developmental growth 
and to compromise adjustment tasks, whereas similar use may 
or may not be considered abuse in adults.  Secondly, 
adolescents may display less physical dependence and fewer 
physical symptoms in relation to substance use and can also 
use a smaller amount to achieve a similar effect.  Substance 
use during adolescence has been linked to many negative 
outcomes, including continued substance use, lower 
educational attainment, and frequent displays of delinquent 
behavior such as violence (Abbey et al., 2006).  

Furthermore, it is essential to study the effects of 
violence exposure as a whole, as well as the effects of 
exposure to individual types of violence because individual 
types of violence exposure have been found to have 
differential effects on substance use, such as increased risk 
for developing a substance use disorder and increased 
impairment in cognitive coping abilities (Kilpatrick et al., 
2000; Brady, Tschann, Pasch, Flores, & Ozer, 2009).  
Previous research studies have not examined all types of 
violence-related behaviors simultaneously.  Thus, this study 
examined school violence exposure and substance use among 
adolescents, and specifically investigated whether overall 
school violence exposure or a specific category of school 
violence exposure (witnessed violence, experienced violence, 
or perpetrated violence) had any impact on the frequency with 
which adolescents reported using illicit substances.   

Martino, Elickson, and McCaffrey (2008) suggest that 
living in a rural area might serve as a protective factor against 
various forms of substance use because adolescent substance 
use has primarily been an issue in metropolitan areas.  
However, rates of substance use among urban and rural 
youths are becoming more comparable as rates of violence 
are beginning to increase in rural communities (Martino et al., 
2008).  Geographic estimates of prevalence have also been 
confounded by the relative dearth of research in rural areas.  
Historically, much of the research on violence exposure in 
adolescence has been conducted within community settings 
and has focused on violence within that community (i.e., 
drive-by shootings, murders, etc.).  Thus, little is known 
about the types of violence and the extent to which youth are 
exposed to violence in rural areas (Slovak & Singer, 2002).  
However, frequent community violence is likely an 
uncommon experience for adolescents living in rural areas.  
Therefore, in order to evaluate the extent to which 
adolescents are being exposed to violence in rural areas and 
how this exposure might be related to substance use 
frequency, it is important to study these factors in an 
environment in which adolescents spend much of their time, 

such as the school.  According to researchers, current research 
in schools is lacking, especially in rural areas (Reid, Peterson, 
Hughey, & Garcia-Reid, 2006; Lowry et al., 1999).   

Based on the existing literature, it was expected that as 
rates of overall school violence exposure increased, rates of 
substance use would also increase.  It was also expected that 
students who reported frequent incidents of witnessing school 
violence would report using substances more frequently than 
those who reported perpetrating violence at school and those 
who reported experiencing violent victimization at school.  
Comparing violence-related behaviors in this way may 
provide unique findings about violence exposure at school 
and its relationship to illicit substance use in adolescence. 

 
Method 

 
Participants 

 The sample for this study included participants from a 
federally funded prevention and intervention program for 
youth risk behaviors and consisted of all students attending 
public high schools (grades 9-12) in a rural county in Florida, 
excluding students enrolled in Educable Mentally 
Handicapped classes.  All students in attendance on the day of 
testing were asked to complete an anonymous questionnaire 
during the first class period of the day; only students who 
were absent on the day of testing or who chose not to fill out 
the survey were excluded from this study.  A total of 1859 
surveys were collected from the 2,720 students enrolled in 
grades 9-12 in 2008, resulting in an initial response rate of 
approximately 68%.  The following criteria were used as 
validity checks to identify invalid surveys:   

1. The endorsement of the use of a fictional drug (i.e., 
“xanthidol”). 

2. The use of an invalid response pattern (e.g., entering the 
same response for each question or “Christmas Treeing” 
responses).  

3. Reports of “daily” use of cocaine, hallucinogen, or 
ecstasy use, or the “daily” occurrence of being physically 
hurt by a student with a knife (extremely unlikely over a 
12-month period). 

4. Answering “no” to the question, “Have you answered the 
items on this questionnaire truthfully?” 

5. The occurrence of mismatching demographic 
information (i.e., reporting an age of 20 and reporting 
being in the 6th grade).   
As a result of these screening procedures, a total of 288 

surveys (approximately 15% of the surveys collected) were 
discarded and not included in the data set for the federally 
funded program from which the data for this study were 
obtained.  This left a total of 1571 valid surveys.  For the 
purposes of this study, however, only surveys completed by 
high school students that assessed for substance use and 
violence-related behaviors within the past 12 months were 
used. This resulted in a total of 766 valid surveys.  A 
breakdown of participants by grade level and demographic 
characteristics is provided in Table 1.   



SCHOOL VIOLENCE AND ADOLESCENT SUBSTANCE USE 
 

32 

 
While questions regarding socioeconomic status were not 

included due to school board policies and doubts regarding 
adolescents’ abilities to accurately estimate family income, it 
is important to note that data was collected in a rural school 
district with a relatively low socioeconomic status.  
Approximately 24% of the county’s population under the age 
of 18 falls below the poverty level and 60% of students in this 
particular district qualify for free or reduced lunch (Education 
Information and Accountability Services, 2009). 

 
Materials and Procedure 

The data used for this study were collected as part of a 
larger questionnaire designed to evaluate a federally funded 
prevention and intervention program for youth risk behaviors.  
The measure used in this study was the Risk Incidence for 
Schools Inventory (RIScI).  This measure was developed by 
faculty in the department of Clinical and Health Psychology 
at the University of Florida.  Questions used in this measure 
were adapted from measures shown to be reliable and valid 
when used in the Monitoring the Future Survey and other 
studies evaluating substance use among adolescents 
(Bachman, Johnston, & O’Mally, 2001).  The university’s 
Institutional Review Board approved the use of this data for 
research purposes.  Per school district policy, parents are 
informed that their children will be asked to participate in 
district-wide surveys and are given the opportunity to decline 

participation.  Students were also provided with the 
opportunity to choose not to complete the questionnaire.   

This study includes data collected during the spring 
semester of 2008 as part of an ongoing program evaluation 
that began in 2003.  Students were asked to anonymously 
report the frequency with which each behavior occurred over 
the last 12 months.  The 2008 RIScI consisted of 84 
questions.  For the purposes of this study, eight questions 
related to substance use frequency and 12 questions related to 
violence exposure were selected as the primary foci for 
analyses.  Hierarchical linear regression analyses were 
performed to determine which outcome variables were 
influenced by overall school violence exposure and to 
examine any relationships between specific school violence-
related behaviors and adolescent substance use.  Analyses 
were conducted in two parts: once using marijuana use 
frequencies as the dependent variable, and once using illicit 
substance use frequencies as the dependent variable.   

 
Results 

 
Race/ethnicity, age, and sex were collected from all 

participants (N = 766).  These data are presented in Table 1.  
Race/ethnicity was collapsed into four categories: White, 
African American, Hispanic, and Other (Asian/Pacific 
Islander, Native American, and Mixed Origin).  The majority 
of participants identified as White (66.2%, or n = 506).  
Breakdowns of race/ethnicity for this sample (66.2% White, 
19.9% African American, 6.5% Hispanic, and 7.4% Other) 
appear to be relatively similar to demographic information 
gathered on this particular school district from the 
Department of Education (DOE): 69.67% White, 21.45% 
African American, 4.14% Hispanic, and 4.73% Other (Florida 
Department of Education, Education Information & 
Accountability Services, 2010).  The average age of 
respondents was 16.1 (SD = 1.23) and the male to female 
ratio was very close with 46.7% of the participants being 
male (n = 355) and 53.5% being female (n = 405).  According 
to information gathered by the DOE on high schools in this 
county, the gender breakdown found within this sample is 
similar to that of the population, which is 48.85% male and 
51.15% female (Florida Department of Education, Education 
Information & Accountability Services, 2010).  Therefore, the 
sample included in this study should be considered a 
representative sample of the population from which it was 
drawn. 

Frequencies of substance use behaviors and violence-
related behaviors were determined using a response scale 
ranging from 1 (“never”) to 6 (“daily”).  Substance use was 
divided into two variables: the use of marijuana and the use of 
other illicit substances (cocaine, ecstasy, inhalants, and 
hallucinogens).  Given that students reported more frequent 
use of marijuana than other illicit substances, separate 
analyses were conducted for each substance use variable to 
reduce effects on results.  For marijuana use, possible scores 
ranged from 1 to 6.  Actual sample scores ranged from 1 to 6, 
with a mean of 1.48 (SD = 1.19).  The illicit substance use 

Table 1   
 
Summary Statistics for Demographic Variables (N=766) 
 
 n % 
Grade   

9 242 31.6 
10 220 28.7 
11 206 26.9 
12 98 12.8 
Total 766 100.0 

Race/Ethnicity   
White 506 66.2 
African American 152 19.9 
Hispanic 50 6.5 
Other 56 7.4 
Total 764 100.0 

Sex   
Male 355 46.7 
Female 405 53.3 
Total 760 100.0 

Age   
14 68 9.0 
15 191 25.2 
16 226 29.8 
17 181 23.9 
18 75 9.9 
19 13 1.7 
20 3 0.5 
Total 757 100.0 



MILLIGAN, RADUNOVICH, & WIENS  
 

33 

variable was created for each student by adding their answers 
to each of the four illicit substance use questions and using 
the total score in the analysis, resulting in a possible range of 
4 to 24.  Actual sample scores ranged from 4 to 12, with a 
mean of 4.13 (SD = 0.77). 

Types of violence were identified as witnessed violence, 
violent victimization, or violence perpetration.  Items used to 
assess witnessing violence involved students witnessing 
violent acts committed by another student (e.g., “In the past 
12 months, in general, how often have you seen another 
student carrying a knife, gun, or other weapon?”).  Items used 
to assess violent victimization involved students experiencing 
violence at the hands of a fellow student (e.g., “In the past 12 
months, in general, how often have you been threatened with 
a gun, knife, or other weapon by a student?”) and items used 
to assess violence perpetration involved students admitting to 
committing violence against a fellow student (e.g., “In the 
past 12 months, in general, how often have you hurt a student 
by using a knife, gun, or other weapon?”).  Again, responses 
for each item ranged from 1 (“never”) to 6 (“daily”). 

Violence category scores were created for a particular 
student by summing their answers to each question within 
that category and using the total score in the analysis.  The 
possible range for the witnessing violence category was 5 to 
30, the possible range for the violent victimization category 
was 4 to 24, and the possible range for the violence 
perpetration category was 4 to 24.  Actual scores ranged from 
5 to 30 for witnessed violence (M = 8.00, SD = 4.12), from 4 
to 22 for violent victimization (M = 4.91, SD = 1.98), and 
from 4 to 19 for violence perpetration (M = 5.48, SD = 2.68).  
To determine the internal consistency of these variables, 
inter-item reliability tests were conducted.  The Cronbach’s  
for each category of violence are as follows: witnessing 
violence,  = .828; violent victimization,  = .637; and 
violence perpetration,  = .641. 

Correlations between demographic information, type of 
violence, and substance use frequencies are presented in 
Tables 2 and 3.  These correlational analyses suggest that all 
types of violence were highly correlated with one another and 
were also highly correlated with the outcome variables 
(frequency of marijuana use [Table 2] and frequency of illicit  

 
Table 2 
 
Marijuana Use Frequency Correlations 
 

 (1) (2) (3) (4) 

(1) Marijuana Use Frequency -- .222* .113* .182* 

(2) Witness  -- .535* .568* 

(3) Victimization   -- .535* 

(4) Perpetration    -- 
 

Notes. N = 766. Reported marijuana use and exposure to violence-
related behaviors were assessed using a 12-month time frame. *p < 
.001. 
 

substance use [Table 3]).  Next, two sets of hierarchical 
regression analyses were conducted.  In spite of the large 
sample size, the data were positively skewed.  Based on 
tolerance values for the data, there was no evidence of 
multicollinearity among variables.  Variables were introduced 
into the regression model in the following order: (a) 
demographic variables (i.e., race/ethnicity, age, and sex); (b) 
witnessing violence; (c) violent victimization; and (d) 
violence perpetration.  These analyses were run once using 
frequency of marijuana use as the dependent variable and 
once using frequency of illicit substance use as the dependent 
variable.  Hierarchical regression results indicate a significant 
relationship between overall school violence exposure and 
marijuana use frequencies, f2 = 0.06, p <  .001 (Table 4) as 
well as illicit substance use frequencies, f2 = 0.12, p < .001 
(Table 5).   

 

Table 3 
 
Illicit Substance Use Frequency Correlations  
 
 (1) (2) (3) (4) 
(1) Illicit Substance Use 
Frequency  

-- .326* .174* .222* 

(2) Witness  -- .534* .568* 

(3) Victimization   -- .533* 

(4) Perpetration    -- 

 
Notes. N = 766.  Reported illicit substance use and exposure to 
violence-related behaviors were assessed using a 12 month time 
frame. * p < .001 
 
 

 
Table 4 
 
Hierarchical Regression for Marijuana Use Frequency  
 

 R2 R2  95% CI 
Step 1  .008 .012   
Race/Ethnicitya   .066 [-.007, .131] 
Sex   -.092 [-.389, -.043] 
Ageb   .014 [-.059, .086] 
Step 2  .056 .051*   
Witness   .188* [.026, .077] 
Victimization    -.042 [-.079, .028] 
Perpetration   .090 [.000, .082] 
 
Notes. N = 766. aRace/Ethnicity = White, African American, 
Hispanic/Latino(a), Asian/Pacific Islander, Native American, 
Mixed Origin, and other; bAge = 10-20; CI= Confidence Interval. 
All information, including reported marijuana use and exposure to 
violence-related behaviors were assessed using a 12 month time 
frame. *p < .001. 



SCHOOL VIOLENCE AND ADOLESCENT SUBSTANCE USE 
 

34 

 
These relationships suggest that increased exposure to 

overall school violence is related to increased marijuana and 
illicit substance use.  The addition of witnessing violence,  
specifically, accounted for a significant amount of variance 
over and above the relationship between demographic 
variables and outcome variables, suggesting a relationship 
between witnessing violence and increased marijuana use, sr2 
= 0.03, p < .001 (Table 4) and illicit substance use, sr2 = 0.05, 
p < .001 (Table 5).  Thus, increased levels of witnessing 
violence were related to increased frequencies of marijuana 
use and illicit substance use.  Results did not suggest any 
significant relationships between substance use frequencies 
and violence perpetration or violent victimization. 

 
Discussion 

 
The purpose of this study was to examine the 

relationships between school violence exposure and 
adolescent substance use.  The study explored the relationship 
between overall school violence, as well as specific violence-
related behaviors, and adolescent substance use frequencies.  
The violence-related behaviors examined in this study 
included witnessed violence, violent victimization, and 
violence perpetration.  In addition, adolescent substance use 
was divided into two categories: the use of marijuana and the 
use of other illicit substances. 

The first hypothesis posited that as overall exposure to 
school violence increased, the frequency of substance use 
would also increase.  Results showed that the addition of 
overall school violence exposure into the regression models 
for both marijuana use and other illicit substance use 
frequencies accounted for a significant amount of variance.  
Thus, findings indicate that overall school violence exposure 
was related to increased frequencies of marijuana use and 
increased frequencies of other illicit substance use.  Next, it 
was hypothesized that students who reported high levels of 
witnessing violence at school would report using substances 

more frequently than those who reported perpetrating 
violence or being victimized by violence at school.   

Findings from this study indicate that witnessing 
violence was significantly related to both increased marijuana 
use and increased illicit substance use.  These findings are 
consistent with other research (Cooley-Quille et al., 1995; 
Janosz et al., 2008) on witnessing violence in adolescence.  
However, no significant relationships were found between 
violence perpetration or violent victimization and adolescent 
substance use when witnessing violence was included in the 
model.   

Although research suggests that physical aggression, 
which can be associated with violence perpetration, appears 
to be the best predictor of health risk behaviors in 
adolescence (Timmermans et al., 2008), the current study did 
not support a relationship between violence perpetration and 
substance use behaviors when accounting for witnessing 
violence.  Other research suggests that violent victimization is 
not associated with adolescent substance use (Brady et al., 
2009); these conclusions were supported from the findings of 
this study. 

The finding that witnessing violence is related to 
increased frequencies of substance use is supported by 
previous research, which suggests that witnessing violence is 
among the most influential risk factors for substance use 
(Kilpatrick et al., 2000) and that witnessing violence and 
substance use may share a common set of risk factors 
(Sullivan, Kung, & Farell, 2004).  However, these risk factors 
have not yet been identified.  Previous research has also 
shown that witnessing violence is a strong risk factor for poor 
adolescent adjustment, and that this exposure often results in 
feelings of powerlessness, insecurity, and fear (Janosz et al., 
2008).  Poor adjustment and increased feelings of 
powerlessness and fear may be a reflection of poor coping 
skills that may potentially result in increased substance use, 
whereby substances are used as a coping method.  Therefore, 
the relationship between witnessing violence and substance 
use should be examined further to determine underlying 
mechanisms that link these two variables (Sullivan et al., 
2004).   

In addition, increased exposure to overall school violence 
was related to increased frequencies of substance use, for 
both marijuana use and other illicit substance use.  Although 
previous research in this area has not examined how all three 
types of school violence exposure are related to adolescent 
substance use, results from this study highlight the 
importance of understanding the consequences associated 
with exposure to witnessing violence because of its 
relationship to increased frequency of substance use.  It may 
be true that those who are more likely to witness violence at 
school associate with violent classmates and may also be 
more likely to participate in other deviant behaviors, such as 
substance use.  Findings from this study suggest a 
relationship between the two; however, these results do not 
prove causality or directionality in any way.  Therefore, it is 
impossible to know whether violence exposure leads to 
increased substance use or whether increased substance use 

Table 5 
 
Hierarchical Regression for Illicit Substance Use Frequency 

 
 R2 R2  95% CI 

Step 1  .003 .007   
Race/Ethnicitya   .049 [-.016, .076] 
Sex   -.056 [-.202, .027] 
Ageb   .042 [-.020, .076] 
Step 2  .106 .106*   
Witness   .300* [.038, .017] 
Victimization    -.019 [-.042, .027] 
Perpetration   .060 [-.009, .045] 
 
Notes. N = 766. aRace/Ethnicity = White, African American, 
Hispanic/Latino(a), Asian/Pacific Islander, Native American, Mixed 
Origin, and other; bAge= 10-20; CI= Confidence Interval.  
reported marijuana use and exposure to violence-related behaviors 
were assessed using a 12 month time frame. *p < .001. 



MILLIGAN, RADUNOVICH, & WIENS  
 

35 

leads to violent behaviors, or if there is any causal 
relationship at all.   

As with all studies, this study had several limitations.  
First, although we attempted to obtain a representative sample 
of an adolescent population by providing surveys to all high 
schools located within this rural county, no measures were 
taken to ensure that students absent on the day of testing were 
able to fill out surveys later.  This could pose a threat to the 
generalizability of this study, because those students who 
were absent on the day of testing may have provided unique 
responses regarding substance use and violent behaviors in 
relationship to their peers.   

In addition, data presented in Table 1 reveal that students 
in the 12th grade were underrepresented in comparison to 
other grades.  Participation in on-the-job training (a program 
in which students receive vocational training off-site during 
school hours) could help to explain this discrepancy, but a 
more representative sample of this grade level could have 
provided useful responses for both substance use behaviors 
and school violence exposure.  Given that substance use 
behaviors were more common among older students, the 
inclusion of more high school seniors may have provided 
more data on these behaviors in particular.  However, it is 
expected that overall absences occurred randomly and in 
small numbers, so it is not expected that this missing data 
should seriously impact results.    

Second, although many validity checks were employed to 
ensure that data included in the study was accurate, the use of 
self-reported data can sometimes compromise the validity of 
results.  However, according to Sullivan et al. (2007), self-
reported data may provide the best source of information on 
witnessing violence and violent victimization as well as an 
important perspective on adolescents’ experience of 
externalizing behaviors.  Additionally, although the sample 
size of the study was relatively large, the number of students 
who reported the use of illicit substances other than marijuana 
was fairly low, which most likely impacted the results of this 
study.  To reduce these effects, separate analyses were 
conducted for marijuana use and for the use of all other illicit 
substances.   

Next, types of violence explored in this study differed 
somewhat from previous research.  Violence-related 
behaviors identified within this study are strictly related to the 
school environment.  Previous research involving violence 
exposure in adolescents typically dealt with more extreme 
types of violence within the community and within the home.  
Experiencing extreme exposure to violence in this context 
may have a very different impact on adolescents than typical 
violence experienced at school.  Furthermore, the sample 
included in this study involved adolescents from one rural 
county.  The type of violence exposure and the availability of 
substances for potential use may deviate from those 
experienced in a more metropolitan area, or in other parts of 
the country.  These factors could potentially limit the 
generalizability of the findings from this study; however, they 
may also provide a unique perspective on school violence 

exposure and substance use behaviors in a rural school 
setting.   

Future research in this area should consider focusing on 
identifying the set of risk factors common to those who 
experience violence and substance use during adolescence in 
hopes of understanding more fully the repercussions 
associated with violence exposure and its relationship to 
adolescent substance use.  Specifically, longitudinal studies 
that assess risk behaviors, violence exposure, and substance 
use may be useful in determining a causal link between 
violence exposure and frequency of substance use.  Findings 
from this study suggest that there are differences in substance 
use behaviors for marijuana relative to other illicit substances; 
adolescents reported using marijuana more often and more 
frequently than other illicit substances.  Therefore, it would 
also be important to evaluate perceptions about marijuana use 
relative to other illicit substances and to determine what 
protective factors exist to deter adolescents from using any 
and all substances.   

Findings from this study may also play an important role 
for violence and substance use prevention programs within 
schools.  Results suggest that witnessing violence bears a 
significant relationship to adolescent substance use, 
specifically in its association with increased frequencies of 
use of marijuana and other illicit substances.  Witnessing 
violence has become an important area of interest for school 
personnel and counselors and should be incorporated as a risk 
factor in substance use prevention programs to address the 
needs of students who witness threats and fights at school 
(Flannery, Wester, & Singer, 2004), as well as to educate 
students on how to avoid unsafe areas and to handle 
adaptively thoughts and emotions associated with witnessing 
violence (Sullivan et al., 2007).   

Substance use during adolescence remains a cause for 
concern in today’s society.  There are many factors related to 
the frequency with which adolescents use substances.  
Students who witness violence are at risk for more frequent 
substance use.  Exposure to violence-related behaviors may 
affect individuals in very different ways, but results from this 
study suggest a relationship between witnessing violence and 
adolescent substance use.  In essence, it is important to 
understand the developmental pathways associated with 
adolescent substance use in order to reduce any long-term 
consequences or health-risks accompanying these behaviors.  
In order to reduce the impact of substance use in adolescence, 
we must understand what factors contribute to this 
phenomenon and work to minimize their effects. 

 
Acknowledgment 

 
The data used for this study were collected as part of 

Project CATCh, which was funded by Safe Schools/Healthy 
Students Initiative (S184L020327).  

 



SCHOOL VIOLENCE AND ADOLESCENT SUBSTANCE USE 
 

36 

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