Impulsivity profiles across five harmonized longitudinal childhood preventive interventions and associations with adult outcomes.

This study aimed to parse between-person heterogeneity in growth of impulsivity across childhood and adolescence among participants enrolled in five childhood preventive intervention trials targeting conduct problems. In addition, we aimed to test profile membership in relation to adult psychopathologies. Measurement items representing impulsive behavior across grades 2, 4, 5, 7, 8, and 10, and aggression, substance use, suicidal ideation/attempts, and anxiety/depression in adulthood were integrated from the five trials (N = 4,975). We applied latent class growth analysis to this sample, as well as samples separated into nonintervention (n = 2,492) and intervention (n = 2,483) participants. Across all samples, profiles were characterized by high, moderate, low, and low-increasing impulsive levels. Regarding adult outcomes, in all samples, the high, moderate, and low profiles endorsed greater levels of aggression compared to the low-increasing profile. There were nuanced differences across samples and profiles on suicidal ideation/attempts and anxiety/depression. Across samples, there were no significant differences between profiles on substance use. Overall, our study helps to inform understanding of the developmental course and prognosis of impulsivity, as well as adding to collaborative efforts linking data across multiple studies to better inform understanding of developmental processes.

Psychosis Symptom Trajectories Across Childhood and Adolescence in Three Longitudinal Studies: An Integrative Data Analysis with Mixture Modeling.

Psychotic-like experiences (PLEs) are common throughout childhood, and the presence of these experiences is a significant risk factor for poor mental health later in development. Given the association of PLEs with a broad number of mental health diagnoses, these experiences serve as an important malleable target for early preventive interventions. However, little is known about these experiences across childhood. While these experiences may be common, longitudinal measurement in non-clinical settings is not. Therefore, in order to explore longitudinal trajectories of PLEs in childhood, we harmonized three school-based randomized control trials with longitudinal follow-up to identify heterogeneity in trajectories of these experiences. In an integrative data analysis (IDA) using growth mixture modeling, we identified three latent trajectory classes. One trajectory class was characterized by persistent PLEs, one was characterized by high initial probabilities but improving across the analytic period, and one was characterized by no reports of PLEs. Compared to the class without PLEs, those in the improving class were more likely to be male and have higher levels of aggressive and disruptive behavior at baseline. In addition to the substantive impact this work has on PLE research, we also discuss the methodological innovation as it relates to IDA. This IDA demonstrates the complexity of pooling data across multiple studies to estimate longitudinal mixture models.

Perceived Neighborhood Safety and Depressive Symptoms: The Role of Perceived Neighborhood Cohesion and Perceived Control.

Few have examined mechanisms explaining the link between perceived neighborhood unsafety, neighborhood social processes, and depressive symptoms for Black adolescents. The goal of this study was to examine the role of perceived control as a mechanism linking perceptions of neighborhood unsafety and depressive symptoms, and neighborhood cohesion as a protective factor. Participants were 412 Black adolescents living in a major Mid-Atlantic urban center in the United States (49% female, Mage = 15.80, SD = 0.36). Participants reported perceptions of neighborhood unsafety at grade 10, neighborhood cohesion at grade 10, perceived control at grades 10 and 11 and depressive symptoms in grades 10 and 12. High neighborhood unsafety was associated with low perceived control and in turn high depressive symptoms only when neighborhood cohesion was high. The results highlight the role of neighborhood unsafety and perceived control in the development of depressive symptom and the possible downsides of neighborhood social factors.

Early Childhood Behavioral and Academic Antecedents of Lifetime Opioid Misuse among Urban Youth.

OBJECTIVE: Opioid misuse has become an epidemic in the United States. In the present study, we examine potential malleable early childhood predictors of opioid misuse including whether childhood achievement, aggressive behavior, attention problems, and peer social preference/likability in first grade predicted opioid misuse and whether these relationships differed depending on participant sex. METHOD: Data are drawn from three cohorts of participants (N = 1,585; 46.7% male) recruited in first grade as part of a series of elementary school-based, universal preventive interventions conducted in a Mid-Atlantic region of the US. In first grade, participants completed standardized achievement tests, teachers reported on attention problems, and peers nominated their classmates with respect to their aggressive behavior and social preference/likability. At approximately age 20, participants reported on their misuse of opioids defined as lifetime use of heroin or misuse of prescription opioids. RESULTS: Higher levels of peer nominations for aggressive behavior in first grade predicted a greater likelihood of opioid misuse. An interaction between participant sex and attention problems was observed such that females higher in attention problems were more likely to misuse opioids, particularly prescription opioids, than females lower in attention problems. An interaction was also found between participant sex and peer likability such that males lower in peer-nominated likability were more likely to misuse opioids relative to males higher in likability. CONCLUSION: Given the malleable nature of attention problems, aggression, and social skills in early childhood, prevention programs that target these behaviors during this developmental period may attenuate risk for opioid misuse.

Differential Impact of a Universal Prevention Program on Academic Self-Efficacy: the Moderating Role of Baseline Self-Control.

Self-control (SC) plays a critical role in development across the life course; poor SC is a common antecedent of outcomes with high public health and societal burden including lower educational and occupational attainment, problem substance use, depression, obesity, and antisocial behavior. Further, SC is associated with academic self-efficacy and academic success; therefore, optimizing SC in early childhood could have long-term health and educational implications. However, it remains unknown whether the impact of early childhood prevention programs varies by baseline levels of SC, and whether better SC in early childhood leads to better self-efficacy in adolescence. This study leverages a sample of predominately low-/middle-income Black participants (n = 678) who were part of a randomized universal preventive trial in first grade (1993-1995). Teacher-reported SC was measured at baseline. Utilizing a three-step latent transition analysis, transitions between SC classes and academic self-efficacy trajectories were explored. Intervention status was explored as a predictor of the transition. Results suggest that teacher-rated SC in early childhood predicts academic self-efficacy up to 11 years later. Moderation analyses suggest that there are individual differences in prevention program effectiveness by baseline behavioral regulation skills. Implications for school-based universal prevention programming having an impact on low risk children and methods for exploring moderation within a prevention context are discussed.

Promoting Voter Turnout: an Unanticipated Impact of Early-Childhood Preventive Interventions.

Preventive interventions in early childhood have a range of behavioral and health effects. However, there is an emerging literature extending this work to include acts of civic engagement, such as voting. Given that America has one of the lowest and most disparate rates of voter turnout in the world-and most of the current efforts aimed at boosting voter turnout and making the electorate more representative of the general public are proximal to the voting experience-there is a need for a better understanding of the potential long-term impact of early-childhood programming on civic engagement in adulthood. This paper builds on theories of political socialization and prior research demonstrating significant impacts of the Fast Track preventive intervention on voter turnout to examine the extent to which there are positive impacts on voter participation for other evidence-based preventive interventions targeting children's social and emotional capacities. Specifically, we leveraged data from a randomized controlled trial of the classroom-centered (CC) and the family school partnership (FSP) preventive interventions delivered in first grade. We analyzed data from approximately 700 urban, predominately African American, public school students who were randomly assigned to classrooms that either implemented (1) the classroom-centered intervention (which included the good behavior game), (2) the FSP intervention, or (3) the business as usual (i.e., control group). Data from the trial were combined with archival voter data when the youth were in their early 30s. Analyses demonstrated positive impacts of the CC preventive intervention on voter turnout more than two decades after exposure to the prevention program. Taken together, these findings provide additional evidence that some of the attributes that promote active participation in democracy can be fostered in early childhood-long before most interventions that have previously tried, and often failed, to increase voter turnout.

Residential mobility, neighborhood cohesion, and depressive symptoms among urban-dwelling African American adolescents.

Mechanisms linking residential mobility and depressive symptoms among urban-dwelling African American adolescents have received little attention. This study examined neighborhood cohesion as a possible mechanism. Participants were 358 urban-dwelling African American adolescents (Mage = 14.78; SD = 0.34) who reported their neighborhood cohesion in Grade 10 and depressive symptoms in Grades 9 and 11, and for whom residential address information was available. There was a significant indirect effect of past moves in middle school on depressive symptoms 1 year later through reduced neighborhood cohesion. However, the indirect effect was not significant in a propensity score-matched sample. Results from the full sample of adolescents suggest that neighborhood cohesion may play a role in the experience of depressive symptoms following past moves in middle school. Different findings for the propensity score-matched sample highlight the need for future studies of residential mobility to employ strategies to correct for possible selection bias.

Alcohol trajectories and subsequent risk for opioid misuse in a cohort of urban adolescents.

Background: The opioid epidemic is a public health emergency in the US. Alcohol is the most widely used addictive substance among all age groups; however, the contribution of different alcohol use trajectories throughout adolescence and young adulthood to the development of opioid misuse in young adulthood among urban minority youth has not been investigated. Methods: Data are from a study of 580 youth (85% African American, 67% low SES) residing in Baltimore City followed from ages 6-26. Alcohol trajectories were identified between ages 14 and 26 using group-based trajectory modeling. Opioid misuse was defined as using opioid painkillers without a prescription or using heroin between ages 19 and 26. Opioid misuse outcomes were also investigated separately. Logistic regression examined associations of alcohol trajectories with opioid misuse in young adulthood adjusting for socio-demographics, early use of tobacco and cannabis, neighborhood, and peer factors. Results: Six alcohol use trajectories were identified: Young adult increasing (21.4%), adult increasing (19.1%), abstaining (19.1%), experimenting (15.3%), adolescent increasing (14.8%), and adolescent limited (10.2%). In models fully adjusted for covariates, relative to the abstaining trajectory, the adolescent increasing trajectory was associated with an elevated risk of opioid misuse (aOR = 3.3, 95%CI = 1.4, 7.8) and prescription opioid misuse (aOR = 3.9, 95%CI = 1.4, 10.8) in young adulthood. Conclusions: Escalating alcohol use in adolescence and young adulthood is associated with an elevated risk of opioid misuse in young adulthood in a cohort of predominantly African American and socio-economically disadvantaged young people. Tailored interventions should target high levels of alcohol use during these developmental periods to reduce risk for opioid misuse among disadvantaged youth.

Genetic propensity for risky behavior and depression and risk of lifetime suicide attempt among urban African Americans in adolescence and young adulthood.

Suicide attempts (SA) among African Americans have increased at a greater rate than any other racial/ethnic group. Research in European ancestry populations has indicated that SA are genetically influenced; however, less is known about the genetic contributors that underpin SA among African Americans. We examined whether genetic propensity for depression and risky behaviors (assessed via polygenic risk scores; PRS) independently and jointly are associated with SA among urban, African Americans and whether sex differences exist in these relations. Participants (N = 1,157, 45.0% male) were originally recruited as part of two first grade universal school-based prevention trials. Participants reported in adolescence and young adulthood on whether they ever attempted suicide in their life. Depression and risky behaviors PRS were created based on large-scale genome-wide association studies conducted by Howard et al. (2019) and Karlson Línner et al. (2019), respectively. There was a significant interaction between the risky behavior PRS and depression PRS such that the combination of high risky behavior polygenic risk and low/moderate polygenic risk for depression was associated with greater risk for lifetime SA among the whole sample and African American males specifically. In addition, the risky behavior PRS was significantly positively associated with lifetime SA among African American males. These findings provide preliminary evidence regarding the importance of examining risky behavior and depression polygenic risk in relation to SA among African Americans, though replication of our findings in other African American samples is needed.

Pathways Between a Polygenic Score for Educational Attainment and Higher Educational Attainment in an African American Sample.

We investigated the extent to which performance on standardized achievement tests, executive function (EF), and aggression in childhood and adolescence accounted for the relationship between a polygenic score for educational attainment (EA PGS) and years of education in a community sample of African Americans. Participants (N = 402; 49.9% female) were initially recruited for an elementary school-based prevention trial in a Mid-Atlantic city and followed into adulthood. In first and twelfth grade, participants completed math and reading standardized tests and teachers reported on participants' aggression and EF, specifically impulsivity and concentration problems. At age 20, participants reported on their years of education and post-secondary degrees attained and their genotype was assayed from blood or buccal swabs. An EA PGS was created using results from a large-scale GWAS on EA. A higher EA PGS was associated with higher education indirectly via adolescent achievement. No other mediating mechanisms were significant. Adolescent academic achievement is thus one mechanism through which polygenic propensity for EA influences post-secondary education among urban, African American youth.

Polygenic and environmental influences on the course of African Americans' alcohol use from early adolescence through young adulthood.

The study examined (a) whether alcohol use subgroups could be identified among African Americans assessed from adolescence through early adulthood, and (b) whether subgroup membership was associated with the interaction between internalizing symptoms and antisocial behavior polygenic risk scores (PRSs) and environmental characteristics (i.e., parental monitoring, community disadvantage). Participants (N = 436) were initially recruited for an elementary school-based prevention trial in a Mid-Atlantic city. Youths reported on the frequency of their past year alcohol use from ages 14-26. DNA was obtained from participants at age 21. Internalizing symptoms and antisocial behavior PRSs were created based on a genome-wide association study (GWAS) conducted by Benke et al. (2014) and Tielbeek et al. (2017), respectively. Parental monitoring and community disadvantage were assessed at age 12. Four classes of past year alcohol use were identified: (a) early-onset, increasing; (b) late-onset, moderate use; (c) low steady; and (d) early-onset, decreasing. In high community disadvantaged settings, participants with a higher internalizing symptoms PRS were more likely to be in the early-onset, decreasing class than the low steady class. When exposed to elevated community disadvantage, participants with a higher antisocial behavior PRS were more likely to be in the early-onset, increasing class than the early-onset, decreasing and late-onset, moderate use classes.

The Role of Depressive Symptoms in Substance Use Among African American Boys Exposed to Community Violence.

Adolescents exposed to community violence (CV) are at increased risk for alcohol, marijuana, and tobacco use. The disproportionate exposure to CV among African American boys heightens their susceptibility to substance use and related problems. Depressive symptoms are linked to both CV exposure and adolescent substance use; however, their role in the link between CV exposure and substance use in African American male adolescents has received little attention. The current study examined whether depressive symptoms mediate or moderate the associations between CV exposure and substance use among African American male adolescents. Participants were 225 African American adolescent boys in Baltimore, Maryland who completed measures of CV exposure and depressive symptoms in 10th grade and measures of substance use in 10th and 11th grades. Hierarchal linear regression analyses indicated that depressive symptoms moderated associations between violent victimization and alcohol and tobacco use, R2 = .21-.30, ps < .001. There was a positive association between CV victimization and alcohol and tobacco use among those who reported high levels of depressive symptoms but not low levels. Depressive symptoms also moderated the link between witnessing CV and alcohol use such that witnessing CV was negatively related to alcohol use among those who reported high levels of depressive symptoms only. The findings suggest that depressive symptoms may play an important role in differentiating alcohol and tobacco use outcomes in CV-exposed African American boys. Prevention efforts should assess for depressive symptoms to identify adolescent boys with the highest risk of substance use.

Using Complier Average Causal Effect Estimation to Examine Student Outcomes of the PAX Good Behavior Game When Integrated with the PATHS Curriculum.

A growing body of research has documented a link between variation in implementation dosage and outcomes associated with preventive interventions. Complier Average Causal Effect (CACE; Jo in J Educ Behav Stat 27:385-409, 2002) analysis allows for estimating program impacts in light of variation in implementation. This study reports intent-to-treat (ITT) and CACE findings from a randomized controlled trial (RCT) testing the impacts of the universal PAX Good Behavior Game (PAX GBG) integrated with Promoting Alternative Thinking Strategies (i.e., PATHS to PAX) and PAX GBG only compared to a control. This study used ratings by 318 K-5 teachers of 1526 at-risk children who, at baseline, were rated as displaying the top 33rd percentile of aggressive-disruptive behavior. Leveraging a prior study on these data (Berg et al. in Admin Policy Ment Health Ment Health Serv Res 44:558-571, https://doi.org/10.1007/s10488-016-0738-1 , 2017), CACE was defined as the effect of intervention assignment for compliers, using two compliance cut points (50th and 75th percentile), on posttest ratings of student academic engagement, social competence, peer relations, emotion regulation, hyperactivity, and aggressive-disruptive behavior. The ITT analyses indicated improvements for students in the integrated condition on ratings of social competence compared to the control condition. The CACE analyses also indicated significant effects of the integrated intervention on social competence, as well as academic engagement and emotion regulation for students in high compliance classrooms. These findings illustrate the importance of considering variation in implementation within the context of RCTs.

Individual and Neighborhood Factors Associated With Sexual Behavior Classes in an Urban Longitudinal Sample.

BACKGROUND: This study aimed to increase understanding of the clustering of sexual behaviors in an urban sample of emerging adults, and the individual and neighborhood factors associated with sexual behavior patterns to provide insight into reducing the disproportionate burden of poor sexual outcomes among urban African Americans. METHODS: We draw on 2 cohorts of urban, predominantly African American youth first assessed at age 6 years and follow-up to emerging adulthood (mean age, 20 years; n = 1618). Latent class analyses by gender identified co-occurrence of sexual behavior. RESULTS: We found 3 classes for both males and females: high-risk (13% of males, 15% of females), low-risk (54% of males, 56% of females) and no-risk (33% of males, 29% of females). Membership in the high-risk class was associated with school dropout, a substance use disorder diagnosis, having a criminal arrest, pregnancy, and sexually transmitted diseases for both males and females. High-risk females also had higher rates of depression. Low-risk males and females also had elevated risk of pregnancy and parenthood. Neighborhood factors distinguished the high- and no-risk classes for males and females, including the neighborhood environment scale, which assessed poverty, safety, drug activity, and crime/violence in the neighborhood. Neighborhood religiosity was inversely associated with membership in the high-risk class compared with the no-risk class for females only. Neighborhood racism distinguished those in the high-risk class compared with the no-risk class for males. CONCLUSIONS: Future work should take into account the clustering of sexual risk behaviors. Specific neighborhood factors could be addressed to reduce sexual health disparities.

Violence exposure in an urban city: A GxE interaction with aggressive and impulsive behaviors.

BACKGROUND: Previous research has demonstrated a reciprocal relationship between community violence exposure and disruptive behavior problems among youth. No study to date, however, has explored the potential interaction between violence exposure in early adolescence and genetics. METHODS: We explore the gene x environment interaction's impact on teacher-rated aggressive and impulsive behaviors. Violence exposure during the middle school years was assessed using self-report. Genetic data collection occurred in emerging adulthood. A polygenic score was created using findings from a conduct disorder symptomatology genome-wide association study. RESULTS: Three longitudinal classes of teacher reported aggressive and impulsive behavior were identified. We found a significant relationship between violence exposure and class membership. There was a significant GxE interaction, such that those with below average levels of the polygenic score and who were exposed to violence were more likely to be in the moderately high aggressive and impulsive class as compared to the no to low class. CONCLUSIONS: These findings highlight the influence of genetic risk together with violence exposure on adolescent problem behavior. Although youth may have little control over the environments in which they live, interventions can and should focus on helping all youth.

How do collective student behavior and other classroom contextual factors relate to teachers' implementation of an evidence-based intervention? A multilevel structural equation model.

Building on prior work regarding the potential for peer contagion or deviance training in group delivered interventions (Dishion & Dodge, 2005, 2006; Dodge, Dishion, & Lansford, 2006), we leveraged data from a randomized trial, testing the integration of two preventive interventions (Promoting Alternative THinking Strategies and PAX Good Behavior Game), to explore the extent to which classroom contextual factors served as either a barrier to or a motivator for teachers to implement the evidence-based PAX Good Behavior Game with high frequency or dosage. We included students' baseline levels of behavior, measured with regard to both positive (i.e., engagement and social emotional skills) and negative (i.e., hyperactive and aggressive-disruptive) behaviors. Data were collected from 204 teachers in 18 urban elementary schools. A series of multilevel structural equation models were fit to the data. The analyses indicated that classrooms with higher classroom levels of aggressive behavior, on average, at baseline had teachers with lower implementation dosage (i.e., played fewer games) across the school year. In addition, teachers who reported higher baseline levels of emotional exhaustion, regardless of student behavior, also reported lower implementation dosage. Taken together, the results indicated that negative, but not positive, contextual factors at baseline were related to lower implementation dosage; this, in turn, suggests that negative contextual factors may serve as a barrier, rather than a motivator, of teachers' implementation dosage of classroom-based preventive interventions.

The Impact of the Urban Neighborhood Environment on Marijuana Trajectories During Emerging Adulthood.

Although there is little difference in rates of marijuana use between White and Black youth, Blacks have significantly higher rates of marijuana use and disorder in young adulthood. Theory suggests that factors tied to social disadvantage may explain this disparity, and neighborhood setting may be a key exposure. This study sought to identify trajectories of marijuana use in an urban sample during emerging adulthood, neighborhood contexts that predict these trajectories and social role transitions or "turning points" that may redirect them. Data are from a longitudinal cohort study of 378 primarily Black emerging adults who were first sampled in childhood based on their residence in low-income neighborhoods in Baltimore City and followed up annually. Group-based trajectory modeling identified three groups: No Use (68.8%), Declining Use (19.6%), and Chronic Use (11.7%). Living in close proximity to an alcohol outlet, and living in a neighborhood with more female-headed households and higher rates of violent crime increased the odds of membership in the Chronic Use group relative to No Use. Living in a neighborhood with more positive social activity increased the odds of membership in the Declining Use group relative to No Use. Not receiving a high school diploma or GED, pregnancy, and parenting also increased the odds of membership in the Declining Use group relative to No Use. These findings provide support that minority youth living in socially toxic and disordered neighborhoods are at increased risk of continuing on a trajectory of marijuana use during emerging adulthood while positive social activity in neighborhoods has the potential to redirect these negative trajectories. Besides taking on the responsibilities of parenting, emerging adults in the marijuana user groups had similar educational and family outcomes, suggesting that early marijuana use may have long-term implications.

Neighborhood context and transitions in marijuana use among urban young adults.

BACKGROUND: In emerging adulthood when many youth are maturing out of marijuana use, Blacks continue to have high rates of use and disorder. Theory suggests that factors tied to neighborhood disadvantage may partially explain this phenomenon but research is limited. OBJECTIVES: This study examines the influence of neighborhood physical and social disorder on transitions in marijuana use during emerging adulthood in a low-income urban sample. METHODS: 379 primarily Black young adults residing in low-income neighborhoods in Baltimore City were followed-up annually from ages 18 to 21. Neighborhood environment was evaluated using a valid and reliable field-rater assessment of the residential block. Longitudinal latent class and latent transition analyses were performed. RESULTS: Fit indices supported three-classes of marijuana use: no use, infrequent use and frequent use. Between ages 18 and 21, young adults tended to transition toward lower levels of use. However, neighborhood physical disorder was associated with transitioning to increased marijuana use (no use to frequent use; AOR = 2.712; p = .023) while positive neighborhood social activity was associated with a decreased risk (AOR = 0.002; p = .013). Neighborhood social activity was also associated with decreases in use (frequent to infrequent use; AOR = 2.342; p = .020). Conclusions/Importance: These findings demonstrate that physical disorder within the context of a low-income urban neighborhood adversely impacts marijuana use. However, even in the presence of physical disorder, interventions that foster collective efficacy among residents through positive social activity may prevent initiation and progression of marijuana use.

Polygenic Score × Intervention Moderation: an Application of Discrete-Time Survival Analysis to Model the Timing of First Marijuana Use Among Urban Youth.

The present study examines the interaction between a polygenic score and an elementary school-based universal preventive intervention trial and its effects on a discrete-time survival analysis of time to first smoking marijuana. Research has suggested that initiation of substances is both genetically and environmentally driven (Rhee et al., Archives of general psychiatry 60:1256-1264, 2003; Verweij et al., Addiction 105:417-430, 2010). A previous work has found a significant interaction between the polygenic score and the same elementary school-based intervention with tobacco smoking (Musci et al., in press). The polygenic score reflects the contribution of multiple genes and has been shown in prior research to be predictive of smoking cessation, tobacco use, and marijuana use (Uhl et al., Molecular Psychiatry 19:50-54, 2014). Using data from a longitudinal preventive intervention study (N = 678), we examined age of first marijuana use from sixth grade to age 18. Genetic data were collected during emerging adulthood and were genotyped using the Affymetrix 6.0 microarray (N = 545). The polygenic score was computed using these data. Discrete-time survival analysis was employed to test for intervention main and interaction effects with the polygenic score. We found main effect of the polygenic score approaching significance, with the participants with higher polygenic scores reporting their first smoking marijuana at an age significantly later than controls (p = .050). We also found a significant intervention × polygenic score interaction effect at p = .003, with participants at the higher end of the polygenic score benefiting the most from the intervention in terms of delayed age of first use. These results suggest that genetics may play an important role in the age of first use of marijuana and that differences in genetics may account for the differential effectiveness of classroom-based interventions in delaying substance use experimentation.

Temperament Moderators of Prospective Associations Between Community Violence Exposure and Urban African American Adolescents' Aggressive Behavior.

Research suggests that neighborhood risks are associated with internalizing symptoms for adolescents high on temperament characteristics related to the behavioral inhibition system (BIS). However, it is unclear whether newer conceptualizations of the BIS distinguishing fear from anxiety operate similarly. Furthermore, it is unclear whether the BIS attenuates community violence exposure effects on externalizing problems. The current study examined whether the BIS or the fight-flight-freeze system (FFFS) moderated associations between community violence exposure and internalizing and externalizing problems. Participants were 367 urban African American adolescents who reported on temperament characteristics in grade 9, and community violence exposure and adjustment problems in grades 9 and 10. Hierarchical linear regression analyses indicated that the FFFS, but not the BIS, moderated the association between community violence exposure and aggressive behavior. Grade 9 community violence exposure was positively associated with grade 10 aggression for adolescents low on FFFS, suggesting that the FFFS may partly differentiate community violence-exposed adolescents' aggressive behavior.