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Young adults experiencing homelessness (YAEH) are disproportionately exposed to direct and indirect gun violence and carry a heavy burden of PTSD symptoms. Prosocial adults, both informal (non-family adults and family) and formal (service staff), are theorized to buffer trauma by providing support, yet empirical evidence is limited for the context of YAEH with gun violence exposure. This study used ego-centric social network analysis to test whether prosocial adult relationships moderate associations of gun exposure with PTSD among YAEH.
Methods
Cross-sectional survey data were collected from 686 YAEH ages 18-25 recruited from drop-in centers in Los Angeles and St. Louis from 2023 through 2025. PTSD symptoms were assessed using the 4-item Primary Care PTSD Screen (PC-PTSD), dichotomized at ≥3. Prosocial adult ties were defined as relationships with others who were ≥5 years older than the participant and who provided the participant with mental health support, support of goals, self-care guidance, or crisis advice. Prosocial adults were categorized into formal (staff), informal family, and non-family domains. Lifetime gun violence exposures included witnessing gun-related violence/death, having a gun pulled on them, being shot at, and gunshot injury. Covariates included race/ethnicity, gender identity, LGBQ identity, time homeless, past-year unsheltered status, ever arrested, and foster care history. Twelve multivariable logistic regression models were estimated, examining each relationship domain across gun exposure types for PTSD symptoms, with adjusted odds ratios (aORs) reported.
Results
Prosocial adult relationships were not consistently protective. Interactions between prosocial adult relationships and gun violence exposure types were non-significant across all models with only 2 models showing marginal (p<.10) significance. Across models, Trans/gender-nonconforming YAEH had 4.4 times higher odds of PTSD compared to cisgender males (p<.001), and cisgender females also had elevated odds (aOR 1.79, p≤.004). However, all other predictors show great variation across gun violence exposures and adult relationship types. Longer duration of homelessness was associated with increased PTSD risk among YAEH who witnessed gun violence, had been shot at, and been injured by gunshot (aOR 1.15, p=.013). Living unsheltered was associated with higher odds of PTSD (aOR 1.49, p=.02) in staff models for witnessing gun violence, being shot at, and gunshot injury, in family models across all exposures and in non-family models, only for being shot at and gunshot injury.
Conclusion and Implications
Among YAEH, gun violence exposure and structural vulnerabilities markedly elevate PTSD symptom burden, but existing prosocial adult relationships, both informal and service-based, do not appear to buffer this risk. The long history of positive youth development literature, as well prior work on YAEH, emphasize that supportive adults as being critical to youth health and well- being, these benefits may not extend to trauma from gun violence exposure revealing important unmet needs. Programs aiming to leverage prosocial adults as a trauma buffer for YAEH may consider redesigning staff roles, intensifying training in trauma-informed relational care, and intentionally structure non-family adult relationships to address gun-related trauma.