Psychosocial Stress and Depressant Use Vulnerability: The Role of Coping Among Youth Experiencing Homelessness

Background and Purpose:
Youth and young adults experiencing homelessness (YAEH) face elevated exposure to chronic stressors that increase vulnerability to substance use, particularly central nervous system (CNS) depressants. While prior research links stress exposure to substance use, less is known about the mechanisms through which stress translates into risk behavior. Guided by Stress–Coping Theory, this study examines how street stress and recent homelessness duration influence depressant use through coping processes. This study builds upon prior research by testing a theory-driven mediation model that simultaneously evaluates active and avoidant coping as mechanisms linking stress to substance use among YAEH, with the goal of informing intervention strategies.

Methods:
Data were drawn from the Homeless Youth Risk and Resilience Study (HYRRS), a multisite survey of 1,335 youth and young adults (ages 18–26) recruited from shelters, drop-in centers, and outreach programs across seven major U.S. cities. Depressant use was measured as a composite of 30-day alcohol, heroin, and prescribed sedative use. Primary stressors included street stress and recent homelessness duration. Active and avoidant coping were assessed using the coping scale psychometrically tested by Brown et al. 2015, (active α= 0.78 avoidant α= 0.51). Covariates include age, gender identity, ethnic identity, and city. Structural equation modeling (SEM) with maximum likelihood estimation was used to test direct and indirect pathways, with mediation assessed using the delta method.

Results:
The sample was diverse across gender identity, ethnicity, and geographic location, with notable
variation in depressant use across cities. Bivariate analyses indicated that street stress was
positively associated with depressant use (r = .218, p < .001) and avoidant coping (r = .382, p
< .001), while avoidant coping was also positively associated with depressant use (r = .202, p
< .001). In the structural model, street stress was directly associated with higher depressant use
(b = 0.178, SE = 0.026, p < .001) and demonstrated a stronger total effect (b = 0.217, SE =
0.024, p < .001). Avoidant coping significantly mediated this relationship, amplifying risk
(indirect b = 0.069, SE = 0.012, p < .001), while active coping functioned as a protective
mediator, reducing depressant use (indirect b = −0.030, SE = 0.008, p < .001). Although both
pathways were significant, the avoidant coping pathway was stronger, resulting in an overall
positive indirect effect. Recent homelessness duration was not significantly associated with
depressant use in the mediated model.

Conclusions and Implications:
Findings support Stress–Coping Theory, identifying coping as the central mechanism linking chronic stress to substance use among YAEH. Avoidant coping emerged as the primary risk pathway, while active coping provided partial protection. Chronic street stress associated with depressant use vulnerability. Prevention and intervention efforts should move beyond substance use alone to target the stress–coping pathway by reducing avoidance-based coping and strengthening adaptive coping skills. These findings highlight the need for trauma-informed, coping-focused interventions embedded within homeless service settings and underscore the importance of theory-driven approaches to addressing substance use in structurally vulnerable populations.