Off-campus WSU users: To download campus access dissertations, please use the following link to log into our proxy server with your WSU access ID and password, then click the "Off-campus Download" button below.

Non-WSU users: Please talk to your librarian about requesting this dissertation through interlibrary loan.

Access Type

WSU Access

Date of Award

January 2021

Degree Type


Degree Name




First Advisor

Rosalind M. Peters


Problem: Over 60% of adults in the U.S. report experiencing childhood adversity, with 1 in 6 reporting experiencing more than 4 different types of adversity before the age of 18. Childhood traumas are associated with negative health outcomes leading to early morbidity, early mortality, loss of productivity, and economic burden. A paucity of research exists regarding childhood adversity and health outcomes in young adults, especially Black young adults. Further, little is known regarding the potential mediating role of coping is in the childhood adversity and health outcome relationship. Purpose: The overarching purpose of this study was to examine the relationship between childhood adversities, negative health outcomes, and potential mediators among young adults. This study was guided by four aims that examined prevalence of childhood adversity, the relationship between childhood adversity and health outcomes, the mediating role of coping in the adversity-health outcome relationship, and predictive validity of childhood adversity measures. Methods: A descriptive, cross-sectional study was conducted with 100 Black and 100 White young adults between the ages of 18 and 34. Participants, through Zoom and Qualtrics completed a demographic questionnaire and other 10 measures that assessed childhood adversity, dispositional coping, substance use (alcohol and cannabis use, cigarette and electronic cigarette dependence), emotional well-being (depressive and anxious symptomology, perceived current stress). Results: First, childhood adversity was prevalent in the overall sample, with Black young adults reporting higher prevalence compared to White young adults. Second, health outcomes were prevalent even in young adulthood. However, weak relationships between childhood adversity and substance use were noted; stronger relationships were identified between childhood adversity and emotional well-being. Third, dispositional coping fully mediated the relationship between adversity and substance use, smoking, and emotional well-being. Lastly, no difference in predictive validity was identified between measures of adversity. Discussion: The study provides four salient findings: (1) there was a high prevalence of childhood adversity in the sample, (2) childhood adversity was associated with health outcomes, especially poorer emotional well-being, (3) disengaged coping mediated the adversity and health outcome relationship and (4) the study tested and supported a middle range theory derived from the Neuman Systems Model. Conclusion: Nurses and healthcare providers need to screen young adults for childhood adversity and coping styles. Screening will allow nurses to identify high-risk patients for long-term sequelae and help facilitate the development of adaptive coping strategies.

Off-campus Download