Longitudinal associations between violence exposure and adolescent conduct problems in a high‐adversity, South African setting

BACKGROUND: Violence exposure is a well-established risk factor for adolescent conduct problems, yet longitudinal research in high-adversity, low- and middle-income countries (LMICs) remains limited. This study investigated whether early adolescent violence exposure predicts concurrent and longer-term conduct problems, and explored potential bidirectional associations and sex differences in a peri-urban South African community with high rates of poverty and violence. METHODS: Data were drawn from the Thula Sana birth cohort (n = 357; 51.5% female), a longitudinal intervention study in Khayelitsha, South Africa. Adolescents were assessed at early (ages 12-14) and late adolescence (ages 16-19). Violence exposure was measured using adolescent self-report. Conduct problems were measured using adolescent and caregiver report in early adolescence and adolescent self-report in late adolescence. Multiple linear regressions tested cross-sectional associations, and cross-lagged panel models examined longitudinal and bidirectional associations, adjusting for contextual adversity and intervention status. Missing data were addressed using multiple imputation, and findings were confirmed through sensitivity analyses. RESULTS: Violence exposure was associated with higher concurrent conduct problems in early adolescence (β = .15-.19, p < .01) and predicted higher conduct problems in late adolescence (β = .12-.14, p < .05). The reverse pathway, from conduct problems to subsequent violence exposure, was not significant (β = .08-.11, p > .05). Interaction analyses did not provide evidence that associations differed by sex. CONCLUSIONS: Violence exposure in early adolescence represents a prospective risk factor for conduct problems in a high-adversity South African setting. Findings highlight the importance of early, contextually grounded violence prevention and the need for further research to test sex-specific pathways and inform the development of gender-responsive intervention strategies.