Longitudinal associations between teen dating violence victimization and adverse health outcomes

Childhood Gender Nonconformity and Intimate Partner Violence in Adolescence and Young Adulthood

Childhood gender nonconformity has been associated with numerous adverse experiences, including peer bullying and homophobic violence. However, little is known about gender nonconformity in the context of intimate relationships, independent of sexual orientation. This study aimed to examine associations between childhood gender nonconformity and intimate partner violence (IPV) in adolescence and early adulthood. Using data from the 2007 wave of the U.S. Growing Up Today Study (N = 7,641, mean age = 22.8 years), we estimated risk ratios (RRs) for the association of gender nonconformity up to age 11 years and lifetime IPV victimization and perpetration. Models were adjusted for demographic characteristics, including sexual orientation identity. We assessed effect modification by gender and examined whether childhood abuse mediated the association between nonconformity and IPV. Males in the top decile of nonconformity were at elevated risk of IPV victimization (RR = 1.40, 95% confidence interval [CI] = [1.15, 1.71]) and IPV perpetration (RR = 2.34, 95% CI = 1.54, 3.56) compared with those below median nonconformity, adjusting for sexual orientation and demographic characteristics. There was no evidence of a similar association for females in the top decile of gender nonconformity. Childhood abuse did not mediate IPV disparities by gender nonconformity. We identify gender nonconformity as an important risk indicator for IPV victimization and perpetration among young adult males, independent of sexual orientation. Findings highlight the vulnerability of boys and men who do not conform to societal gender norms and the importance of studying gender expression as a determinant of violence. IPV prevention efforts may be improved with more explicit focus on socially constructed gender norms and support for diverse gender expressions. Further research into the pathways between nonconformity and IPV and in more diverse populations is needed to build a more comprehensive understanding of the unique experiences gender nonconforming youth face.

Peer Victimization and Dating Violence Victimization: The Mediating Role of Loneliness, Depressed Mood, and Life Satisfaction

Peer victimization and dating violence victimization have serious negative effects on adolescents' health, and they seem to be related. However, the mediating processes in this relationship have not been sufficiently analyzed. The purpose of this study was to analyze the direct and indirect relationships between peer victimization and dating violence victimization, considering the possible mediator role of loneliness, depressed mood, and life satisfaction. These relationships are analyzed in boys and girls, and in early and middle adolescence. From an initial sample of 1,038 Spanish adolescents, those who had or had had in the past 12 months a dating relationship (647 adolescents; 49.1% boys, M = 14.38, SD = 1.43) were included in this study. Multigroup structural equation modeling was used to test a double mediation model simultaneously for boys and girls, testing the invariance of the relationships among variables across genders. The same technique was used to test the model simultaneously for early and middle adolescence, testing the invariance of the relationships among variables across age groups. Results revealed a positive direct relationship between peer victimization and dating violence victimization, as well as the partial mediating role of loneliness and life satisfaction in this relationship. The mediator role of depressed mood was not supported. The same mediational model was confirmed in boys and girls, and in early and middle adolescence. These results highlight the important role of loneliness and life satisfaction to explain the link between peer victimization and dating violence victimization in adolescence. These findings may be useful for developing intervention programs aimed at preventing situations of multiple victimization during adolescence.

A Latent Class Analysis of Early Adolescent Peer and Dating Violence: Associations With Symptoms of Depression and Anxiety

Violence within peer and dating contexts is prevalent among early adolescents. Youth may be victims and/or aggressors and be involved in violence across multiple contexts, resulting in negative outcomes. This study identified patterns of perpetration and victimization for peer and dating violence, using a latent class analysis (LCA), and examined how different patterns of engaging in or experiencing violence among early adolescents were associated with symptoms of depression and anxiety. Participants included a sample of 508 racially and ethnically diverse youth (51% male) who had dated in the past 3 months. Youth were in the seventh grade within 37 schools and were primarily from economically disadvantaged communities across four sites in the United States. LCA identified three classes: (a) a low involvement in violence class, (b) a peer aggression and peer victimization class, and (c) a peer and dating violence class. Youth involved with multiple forms of violence displayed significantly higher levels of depressive and anxious symptoms than those with low involvement in violence. Study findings revealed the importance of understanding how peer and dating violence co-occur, and how different patterns of aggression and victimization were related to internalizing symptoms. Prevention efforts should address the intersection of victimization and perpetration in peer and dating contexts in potentially reducing internalizing symptoms among early adolescents.

Relationship between Emotional Intelligence and Violence Exerted, Received, and Perceived in Teen Dating Relationships

Emotional intelligence plays a critical role in adolescence since it involves a change towards psychological, social, and sexual maturity; a stage in which the foundations of intimate social relationships are established. Emotional competences regulate the quality of these relationships in adolescence and can provide protection against or facilitate the use of violence within them. Based on the above, this study aims to analyze the relationship between emotional intelligence and violence exercised, received, and perceived by adolescents in dating relationships. A sample of 254 subjects (43.1% men and 56.9% women) between 12 and 18 years old was analyzed through the Emotional Intelligence Questionnaires of BarOn ICE:NA and Violence Exercised Perceived and Received by Adolescents VERA. The results of the research have shown that there is a significant and inverse relation between the dimensions of emotional intelligence and the violence exercised by adolescents in their dating relationships, and a positive and significant relation between emotional intelligence and the perception of violent behavior. For this reason, the importance of educating people about emotional intelligence from childhood within both the academic and family sphere is highlighted. This is fundamental to preventing the appearance of such violent behaviors and promoting an adequate adaptation to the environment.

Factors Related to Intentions to Commit Dating Violence among Taiwanese University Students: Application of the Extended Theory of Planned Behavior

Dating violence (DV) constitutes a major public health and safety issue worldwide; however, only limited research into this important subject has been conducted in Taiwan. This study examined university students’ intention to commit DV, based on the expanded theory of planned behavior (TPB), with a history of family violence and gender stereotyping also included as further factors in the original TPB model. A total random sample consisting of 450 university students from four universities in four regions in Taiwan, namely, the northern, southern, central, and eastern regions, participated. Of these participants, 365 (81.1%) completed all of the parts of the questionnaires, which included a survey of demographic data, such as any history of family violence; a gender stereotyping questionnaire; and a DV behavioral intention questionnaire. The results showed that the three main variables of the TPB—that is, subjective norms, attitudes, and perceived behavioral control—significantly related to university students’ intentions to commit DV. More specifically, university students’ attitudes and subjective norms emerged as significant related factors of their intention to commit DV behaviors. Overall, the expanded TPB explained 30.4% of the variance in DV intentions, and attitude was the most significant factors after controlling the background variables. These findings can hopefully be used to help design and implement programs for the prevention of DV behaviors among university students.

Preventing Sexual Violence in Adolescence: Comparison of a Scientist-Practitioner Program and a Practitioner Program Using a Cluster-Randomized Design

Numerous school-based prevention programs have been developed by scientists and practitioners to address sexual violence in adolescence. However, such programs struggle with two major challenges. First, the effectiveness of many well-established practitioner programs has not been rigorously evaluated. Second, effective scientific programs may be hard to implement into everyday school practice. Combining the knowledge of scientists and practitioners in a scientist-practitioner program could be a helpful compromise. The aim of the present study is to evaluate the effects of a scientist-practitioner program and a practitioner program using a cluster-randomized experimental design. Twenty-seven school classes were randomly assigned to either one of two programs or a control group. Outcome variables (knowledge, attitudes, behavior, and iatrogenic effects) were assessed at pretest, posttest, and a 6-month follow-up for 453 adolescents (55% female, Mage = 14.18). Short-term effects were found in both programs regarding general knowledge, knowledge of professional help, and victim-blaming attitudes. Long-term effects were found in both programs regarding general knowledge and knowledge of professional help and, in the practitioner program, in a reduction of victimization. No other effects were found on attitudes and behavior. No iatrogenic effects in the form of increased anxiety were found. Both the scientist-practitioner and the practitioner program show promise for the prevention of sexual violence in adolescence; in particular, the practitioner program may be a more cost-effective method.

Introduction to a Special Section on the Effects of the Dating Matters Model on Secondary Outcomes: Results from a Comparative Effectiveness Cluster Randomized Controlled Trial

Teen dating violence (TDV) affects millions of young people in the USA each year (Basile et al. 2020) and is associated with a myriad of negative consequences across the lifespan, including placing individuals at greater risk for experiencing intimate partner violence (IPV) in their more permanent relationships in adulthood (Exner-Cortens et al. Pediatrics 131(1):71-78 Exner-Cortens et al. 2013; Exner-Cortens et al. Journal of Adolescent Health 60(2):176-183 Exner-Cortens et al. 2017). The CDC developed the Dating Matters®: Strategies to Promote Healthy Teen Relationships comprehensive prevention model to prevent TDV and its consequences among young people, and it was found to be effective at reducing TDV perpetration and victimization compared with another evidence-based program (Niolon et al. American Journal of Preventive Medicine 57(1):13-23 Niolon et al. 2019). Dating Matters addresses multiple risk and protective factors for TDV through its multiple components, many of which are shared risk and protective factors for other forms of violence and risk behaviors among adolescents. This article introduces this special section, which includes three papers examining these secondary outcomes of the Dating Matters comparative effectiveness, multi-site, longitudinal cluster randomized controlled trial and concludes with an invited commentary by Debnam and Temple (2020). This introduction briefly discusses the Dating Matters comprehensive prevention model, the comparative effectiveness trial used to evaluate effectiveness, the outcomes examined by the three papers included in this special section and the commentary from external reviewers. This special section makes an important contribution to the field of violence prevention, highlighting a preventive intervention for TDV that addresses a constellation of risk and protective factors and demonstrating its effects on multiple adolescent risk and violence outcomes.

Electronic Vapor Product Use and Violence Victimization Among a Nationally Representative Sample of Adolescents

PURPOSE

We examined associations between electronic vapor product use (vaping) and violence victimization (adolescent relationship abuse (ARA), youth violence, bullying, and experiencing all three types of violence).

METHODS

Data were drawn from the 2017 National Youth Risk Behavioral Survey. Logistic regression examined associations between vaping and violence victimization, adjusting for sex, age, race, identification as a sexual minority, and use of other substances.

RESULTS

After adjusting for demographic characteristics, vaping was significantly and positively associated with ARA, youth violence, bullying, and experiencing all three types of violence (ARA: adjusted odds ratio (aOR) 3.0, 95% CI: 2.5-3.5; youth violence: aOR 3.0, CI: 2.4-3.6; bullying: aOR 1.5, CI: 1.4-1.7; all three types of violence: 10, CI: 6.3, 15.8). When use of other substances was added into the model, these associations attenuated, and, for bullying, lost significance.

CONCLUSIONS

Vaping is associated with increased violence victimization, particularly for youth experiencing ARA, youth violence, and polyvictimization. Further longitudinal studies are needed to determine directionality of these associations and guide prevention efforts.

Effects of Dating Matters® on Sexual Violence and Sexual Harassment Outcomes among Middle School Youth: a Cluster-Randomized Controlled Trial

Sexual violence (SV), including sexual harassment (SH), is a significant public health problem affecting adolescent health and well-being. This study extends prior research by evaluating the effectiveness of a comprehensive teen dating violence prevention model, Dating Matters, on SV and SH perpetration and victimization, inclusive of any victim-perpetrator relationship, among middle school students. Dating Matters includes classroom-delivered programs for youth in 6th, 7th, and 8th grades; community-based programs for parents; a youth communications program; training for educators; and community-level activities. Middle schools in four urban areas in the USA were randomly assigned to receive Dating Matters (DM, N = 22) or a standard-of-care intervention (SC, N = 24) over four consecutive school years (2012-2016). The analytic sample included two cohorts who entered the study in 6th grade and completed 8th grade by the end of the study allowing for full exposure to Dating Matters (DM: N = 1662; SC: N = 1639; 53% female; 50% black, non-Hispanic; 6 waves of data collection for each cohort). Structural equation modeling was employed with multiple imputation to account for missing data. Dating Matters was associated with significant reductions in SV and SH perpetration and victimization scores in most-but not all-sex/cohort groups by the end of 8th grade relative to an evidence-based TDV prevention program. On average, students receiving Dating Matters scored 6% lower on SV perpetration, 3% lower on SV victimization, 4% lower on SH perpetration, and 8% lower on SH victimization by the end of middle school than students receiving an evidence-based violence prevention program. Overall, Dating Matters shows promise for reducing SV and SH, occurring both within and outside dating relationships, through middle school. Clinicaltrials.gov Identifier: NCT01672541.

Relationship dynamics with male partners among girls in low-income communities of Ibadan, Nigeria: Risk for violence and health related consequences

INTRODUCTION

This study explored the motivations for and relationship dynamics that may promote girls' vulnerability for intimate partner violence and sources of support reported in unhealthy relationships among girls residing in low-income communities in Ibadan, Nigeria.

METHODS

Focus group discussions (n = 14; 122 girls) were conducted among girls aged 15-19 years, who reported having been in a relationship lasting at least 3 months. Girls were recruited from schools and worksites where partner violence has been reported in high proportions. Data were analysed using conceptual content analyses and independently coded by two researchers.

RESULTS

Adolescent girls reported keeping their relationships secret from their parents. While girls reported that sometimes relationships were out of love, relationships were also often motivated by girls' financial need. The financial and secretive nature of these relationships appeared to place girls at risk for intimate partner violence, with sexual coercion, resulting in multiple adverse social and health outcomes, including sexually transmitted infections and unintended pregnancy. Girls reported that leaving an abusive relationship is especially difficult when girls rely financially, were sexually involved, pregnant, or have had a child with the male partner. Friends/peers, rather than girls' family, were often the source of support for intimate partner violence.

CONCLUSION

Early identification of unhealthy relationships and supporting girls to be financially independent appear to be critical to reduce vulnerability to violence. Peer-based interventions may be most appropriate, given that girls' friends, rather than parents, were most often the source of support for intimate partner violence and other relationship challenges.

Risk Behaviours Associated with Dating and Relationship Violence among 11-16 Year Olds in Wales: Results from the 2019 Student Health and Wellbeing Survey

(1) Background: This study examines the associations between risk behaviours and adolescent emotional and physical dating and relationship violence (DRV) victimisation and perpetration, and how these vary by gender. The risk behaviours explored include bullying, cyberbullying, sexting, alcohol, and cannabis use; (2) Methods: Cross-sectional self-report data from the School Health Research Network (SHRN) 2019 Student Health Wellbeing (SHW) survey of 48,397 students aged 11–16 from 149 schools across Wales were analysed using single and multiple-behaviour logistic regression models to explore the associations between each risk behaviour and emotional and physical DRV victimisation and perpetration; (3) Results: Bivariate analyses revealed a statistically significant association between DRV and all risk behaviours. In multivariate analyses, students who reported bullying, cyberbullying, sexting, and substance use, compared to those that had not, had significantly higher odds of experiencing and perpetrating emotional and physical DRV; and (4) Conclusions: Future studies on DRV should consider a mixed-methods approach to explore the context in which DRV and risk behaviours interrelate. Results from this study indicate the possibility that prevention and intervention programmes in school settings that seek to develop healthy school environments and peer-to-peer relationships, could inadvertently reduce the occurrence of future DRV and associated risk behaviours.

Design and Validation of the Scale TDV-VP Teen Dating Violence: Victimisation and Perpetration [Violencia en Parejas Adolescentes: Victimización y Perpetración] for Spanish Speakers

Background: This study offers the design and validation of a scale for measuring violence in adolescent couples from the perspective of victimisation and perpetration for young Spanish speakers. Method: Validation study using exploratory and confirmatory factor analysis with online self-selected sampling and the participation of 422 subjects who met the requirements of being between 13 and 21 years old and currently or recently having a partner. Results: A scale of victimisation in adolescent partner relationships was obtained with 25 items and a scale of violence perpetration with 22 items. Both scales presented five factors: psychological violence, verbal violence, control, jealousy, and sexual violence. Significant differences were found between men and women in victimisation and perpetration of sexual violence. Conclusions: The Teen Dating Violence—Victimisation and Perpetration (TDV)—VP complies with the reliability and validity indices, constituting a very useful instrument for the detection and measurement of violence in Spanish-speaking adolescent couples in health-promotion work.

Gender violence among youth: an effective program of preventive socialization to address a public health problem

Gender violence among youth is a worldwide public health problem. Youth is increasingly exposed to violence in sexual-affective relationships, both stable and sporadic, and the age of victimization decreases. This adverse life experience affects many areas of youth's life, such as education, social relationships and, especially, their physical and mental health, with consequences that can be very harmful in the short and long-term. This situation has given rise to many anti-violence programs for adolescents and youth, yet as some worldwide prestigious organizations, like the American Psychological Association, have pointed out, many of those programs do not work. In this article, we present a program of preventive socialization of gender violence addressed to adolescents that has proven effectiveness. The program was composed of seven interventions based on the social impact of the evidence on preventive socialization of gender violence. It was applied at a group level in groups of 15-16 years old teenagers in three high schools in Barcelona. The interventions were conducted over a period of one school year and shared the trait of discussing research evidence on preventive socialization of gender violence with the youth through egalitarian dialogue. These interventions have proved to have a preventive effect of gender violence victimization on the participating teenagers by raising their critical consciousness regarding a coercive dominant discourse in society that associates attractiveness and violence, supporting the transformation of their memories of violent sexual-affective relationships, and providing them tools to better analyze their and their friends' sexual-affective relationships along the lines of identifying gender violence and being more prepared to help others in this regard. The manuscript describes every intervention applied.

Implications of Severe Polyvictimization for Cardiovascular Disease Risk Among Female Survivors of Violence

In this study, we examined the impact of severe polyvictimization on 30-year cardiovascular disease (CVD) risk among female survivors of intimate partner violence (IPV). Data were collected from 34 participants in the "Leave it on the Mat" pilot study. The study was conducted in an urban city in a Midwestern state from August 2012 to April 2014. Severe polyvictimization was considered present if participants reported a history of three or more forms of victimization (childhood exposure to domestic violence, being psychologically or physically abused in childhood, and lifetime sexual assault) in addition to IPV. CVD risk factors included smoking, body mass index (BMI), and systolic blood pressure (SBP). A Framingham-based prediction model was used to estimate 30-year CVD risk. A linear regression model, adjusted for age, education, race/ethnicity, and family history of CVD, was calculated. Fifty percent (n = 17) of the study participants reported severe polyvictimization and the average 30-year risk of CVD in the full sample was 22.3. Participants who experienced severe polyvictimization had higher 30-year CVD risk scores when compared to participants who experienced two or fewer forms of victimization. The findings revealed that severe polyvictimization was prevalent among survivors of IPV and was associated with increased scores on the 30-year CVD risk model. Screening for abuse history could aid identification of individuals at high CVD risk.

Bidirectional Relations Between Dating Violence Victimization and Substance Use in a Diverse Sample of Early Adolescents

Substance use and dating violence victimization are common in adolescence and represent significant public health concerns. Although theoretical accounts suggest a bidirectional association between substance use and victimization within dating relationships, this has not been tested during early adolescence. Thus, the current study examined bidirectional associations between physical and psychological dating violence victimization and substance use across 6 months among an ethnically diverse sample of early adolescents. Sex was also examined as a moderator. Participants included two cohorts of sixth graders from 37 schools who were in dating relationships in the last 3 months at Wave 1, in the fall of sixth grade, and 6 months later at Wave 2, in the spring of sixth grade (n = 2,022; 43% female; 55% Black, 17% Latino/a, 16% White, 9% as multiracial, and 3% as another race/ethnicity). Students reported on the frequency of dating violence in the past 3 months and substance use in the past 30 days. Multilevel models, with students at Level 1 and classes (i.e., clusters of students in the same cohort at the same school; n = 74) at Level 2, tested hypotheses that positive reciprocal relations between physical and psychological dating violence victimization and substance use would be found over time, and that relations would be stronger for girls than boys. Sex, race/ethnicity, and family structure variables were included as Level 1 covariates; intervention condition and neighborhood concentrated disadvantage were included as Level 2 covariates. Results showed that higher levels of physical dating violence victimization at Wave 1 predicted increased substance use at Wave 2. Higher levels of substance use at Wave 1 predicted increased physical and psychological dating violence victimization at Wave 2. Findings highlight the importance of prevention efforts for dating violence and substance use early in adolescence.

Romantic Relationship Characteristics and Adolescent Relationship Abuse in a Probability-Based Sample of Youth

This study examines the longitudinal association between baseline adolescent romantic relationship characteristics and later adolescent relationship abuse (ARA). Data are from the first two waves of the National Survey on Teen Relationships and Intimate Violence (STRiV). Girls and boys ages 10 to 18 were recruited randomly from the children of adults participating in a larger national household probability sample panel. About three quarters of the sample identified as White, non-Hispanic. Controlling behavior by a romantic partner consistently predicted later ARA. Higher levels of controlling behavior in the relationship was associated with higher rates of sexual and/or physical ARA victimization and higher rates for similar acts of perpetration. More controlling behavior by the partner was also associated with higher rates of psychological ARA victimization (and higher rates for psychological ARA perpetration). Our results suggest that ARA prevention programs should have explicit discussions of the deleterious effects of controlling behavior with adolescents. Respondents reporting higher feelings of passionate love were also at higher risk of experiencing sexual and/or physical ARA victimization. This finding will need to be considered by clinicians and prevention specialist in their work with youth as a potential risk marker for ARA. Baseline reports of at least one form of ARA were predictive of 1-year follow-up rates of ARA in all of our models, underscoring a long line of research that past aggressive or violent behavior is one of the strongest predictors of current aggressive or violent behavior. We also observed that female respondents were twice as likely to be perpetrators of physical and/or sexual ARA as male respondents. Prevention messaging often is focused on girls as ARA victims and our results imply that messaging should also be directed toward girls as perpetrators.

Who, When, How, and Why Bystanders Intervene in Physical and Psychological Teen Dating Violence

Teen dating violence victimization is associated with a host of adverse mental and physical health problems. A number of bystander-focused interventions have been developed to mitigate the occurrence of abuse but with varying effectiveness. There remains a need to understand more about bystander behaviors used by adolescents to ensure that existing intervention components match with bystanders' attitudes and behaviors about intervening. The current study is a scoping review of existing literature on adolescents' use of bystander behaviors to determine who, when, how, and why adolescents intervene. Seventeen articles met inclusion criteria, the majority of which used qualitative or observational survey designs. Adolescents who either feel a sense of responsibility and confidence to intervene or are directly involved with or know the individuals involved in the dating violence are more likely to intervene. Adolescents intervene when they are able to define an act as dating violence and tend to intervene when the victim is female and when they have a supportive relationship with at least one teacher in their school. The various ways how bystander intervention is engaged in ranges from verbally or physically confronting the abuser, distracting the abuser, seeking support from an adult, to passively accepting the abuse. Reasons why adolescents intervene include believing the abuse is wrong and that intervening will diffuse the situation and help the victim. A number of barriers to bystander intervention emerged from analysis including individual attitudes and school climate factors. Implications for strengthening bystander intervention programs are discussed.

Associations of number of victimizations with mental health indicators and health-risk behaviours among a nationally representative sample of in-school adolescents in Curaçao

PURPOSE

The study aimed to estimate the association of experiencing a higher number of victimizations with mental health and health-risk behaviours among adolescents in the 2015 Curaçao Global School-Based Student Health Survey (GSHS).

METHODS

In all, 2,765 in-school adolescents with a median age of 15 years from Curaçao responded to the cross-sectional GSHS.

RESULTS

Results indicate that from six forms of victimization (bullied, parental physical victimization, physically attacked, physical intimate partner violence victimization, forced sex and violent injury) assessed, 29.6 % reported one type of victimization, 11.3 % two types and 4.9 % three or more types of victimization. In adjusted logistic regression analyses, PV was associated with four poor mental health indicators (worry-induced sleep disturbance, suicidal ideation, loneliness, and suicide attempt) and eleven health-risk behaviours (current tobacco use, current alcohol use, current cannabis use, early sexual debut, sex among students who were drunk, multiple sexual partners, non-condom use at last sex, school truancy, carrying a weapon, short sleep and skipping breakfast).

CONCLUSION

Almost one in six students reported poly-victimization (≥2 types). Higher frequency of victimization was positively associated with four poor mental health indicators and eleven health-risk behaviours.

“Then Who Are You?”: Young American Indian and Alaska Native Women Navigating Cultural Connectedness in Dating and Relationships

Despite disproportionately high rates of intimate partner violence among American Indian and Alaska Native (AI/AN) women and associations between adolescent dating violence and partner violence in adulthood, little to no research has focused on dating and relationships among AI/AN adolescents. Using exploratory thematic analysis with focus group data (N = 16), we explore this topic among a sample of young AI/AN women (ages 15–17). Results suggest that dating may enhance or inhibit connections to culture or tribal identity. Moreover, responsibility for sustaining cultural knowledge, practices, and lineage may influence choices of reproductive partners for Native women living within colonial structures of governance. The greatest threat in relationships were similar to those from settler colonialism—loss of culture and consequently, self. Promoting healthy relationships among this population should include cultural safety, identity, and involvement, as well as a focus on broader systems, including enrollment policies, that may influence these relationships. Supportive networks and mentorship related to identity and cultural involvement should be available for young AI/AN women. In response to this Special Issue’s call for work that offers creative approaches to conveying knowledge and disruptions to what are considered acceptable narrative approaches we offer illustrations as well as text.

Effect of a Community-Based Gender Norms Program on Sexual Violence Perpetration by Adolescent Boys and Young Men: A Cluster Randomized Clinical Trial

IMPORTANCE

Engaging adolescent boys and young men in preventing violence against women is a potentially impactful public health strategy.

OBJECTIVE

To evaluate the effectiveness of a community-based, gender-transformative program (ie, Manhood 2.0) on perpetration of gender-based violence by adolescent boys and young men.

DESIGN, SETTING, AND PARTICIPANTS

In this unblinded cluster randomized clinical trial, neighborhoods were designated as the unit of clustering (1:1 allocation). Three-month (ie, time point 2 [T2]) and 9-month (ie, time point 3 [T3]) follow-ups were conducted. The trial took place in 20 Pittsburgh, Pennsylvania, neighborhoods and 1 centrally located site with concentrated disadvantage. Pittsburgh-based adolescent boys and young men (ages 13 to 19 years) were recruited between July 27, 2015, and June 5, 2017, through youth-serving organizations and community-based alternatives to residential placement for juvenile justice-involved youth. Intention-to-treat analysis was conducted from June 2018 to November 2019.

INTERVENTIONS

Manhood 2.0, an international program adapted for adolescent boys and young men in US urban communities, encourages these individuals to challenge gender norms that foster violence against women and unhealthy sexual relationships. Individuals in the control population received job-readiness training. Each program was 18 hours.

MAIN OUTCOMES AND MEASURES

The primary outcome was change in participant-level perpetration of sexual violence (SV) or adolescent relationship abuse (ARA) at T3.

RESULTS

Among 866 participants, 465 individuals (54%) enrolled in 11 intervention clusters and 401 individuals (46%) enrolled in 10 control clusters. In the intervention group, 325 participants (70%) were analyzed at T2 and 334 participants (72%) were analyzed at T3; in the control group, 262 participants (65%) were analyzed at T2 and 301 participants (75%) were analyzed at T3. Mean (SD) age was 15.5 (1.6) years; 609 participants (70%) self-identified as non-Hispanic Black, and 178 (20%) self-identified as Hispanic, multiracial, or other race/ethnicity other than White. Among individuals in the intervention group, 296 participants (64%) reported any SV or ARA perpetration at baseline, and 173 participants (52%) reported any SV or ARA perpetration at T3. Among individuals in the control group, 213 participants (53%) reported any SV or ARA perpetration at baseline, and 124 participants (41%) reported any SV or ARA perpetration at T3). The difference in reduction between groups was not significant. There was no evidence of an intervention effect for the primary outcome (adjusted odds ratio [OR], 1.32; 95% CI, 0.86-2.01; P = .20).

CONCLUSIONS AND RELEVANCE

The findings from this evaluation of a community-based gender-transformative program for adolescent boys and young men did not show a significant intervention effect in reducing SV or ARA perpetration between Manhood 2.0 and a job-readiness control program. Combining gender-transformative approaches with job-readiness programs may be relevant for violence prevention in low-resource urban settings. Attention to improving implementation and strategies to sustain such community-based efforts are needed.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT02427061.

Psycho-Emotional Violence, Its Association, Co-Occurrence, and Bidirectionality with Cyber, Physical and Sexual Violence

Using data from a cross-sectional sample of seventh to twelfth graders who attended northeastern schools between 2011 and 2012, we examined the associations between psycho-emotional dating violence and cyber, physical, and sexual violence Overall, we found that respondents experienced more than one type of dating violence simultaneously, indicating the prevalence of co-occurrence in dating violence. Further, being a victim of psycho-emotional violence was associated with perpetrating similar types of violence, suggesting the bidirectional nature of this type of aggression. Among the covariates, we found that peer bullying, cyber bullying, cell phone usage, the respondents' age, gender, and grades were risk factors for psycho-emotional violence. The findings may be used to guide dating violence intervention efforts and the development of school based and family-oriented treatment plans.

Prevalence, Gender and Age Differences of Dating Aggression Among Italian Adolescents

The present study represents an effort to expand and deepen the scant literature on Adolescent Dating Aggression (ADA) within the Italian context; adolescent dating aggression is a public health issue of interest due to its increasing frequency among adolescents. The prevalence of verbal-emotional and physical ADA was examined as well as gender and age differences in a sample of Italian adolescents. Participants included 436 adolescents (47.7% males; 52.3% females) living in northern Italy, aged 16 to 18 years (M = 17.11). Participants completed the Conflict in Adolescent Dating Relationships Inventory measuring abusive behaviors between adolescent dating partners. Non-parametric analyses were computed. Verbal-emotional ADA perpetration and victimization were much more common than physical ADA perpetration and victimization. Females reported higher levels of verbal-emotional and physical ADA perpetration than males. To fully investigate gender differences single behaviors were analyzed and described. Finally, age differences emerged only for perpetrated verbal-emotional abuse with such aggression being highest at age 18. This research suggests that in order to prevent the onset of dating aggression in teens in northern Italy, prevention programs may need to begin earlier than previously provided in junior high school. Another core conclusion is that physical aggression against partners is a problem for both males and females, thus intervention for the empowerment of interpersonal skills are needed.

Adolescent-to-Parent Violence: Psychological and Family Adjustment

Adolescent-to-Parent Violence (APV) or Child-to-Parent Violence (CPV) is a specific form of violence that has remained inconspicuous until recently, but is becoming a mounting social issue and is increasingly the focus of scientific research. Of the variables related to APV, the study assessed the characteristics of the family system and its relationship to the psychosocial adjustment of adolescents, an aspect scarcely examined in the literature. Thus, a field study was performed on a community sample of 210 adolescents aged 12–17 years (51.4% girls) who were assessed on measurements of APV, parenting (parental socialization), victimization, and psychological adjustment (personal, family, and school). The results revealed higher rates of psychological APV, and no gender effects in violence exercised against either parent. The adolescents involved in APV exhibited a greater psychological maladjustment in the different areas under analysis. Moreover, adolescents engaging in psychological APV reported a parental socialization style characterized by severe strictness and supervision in comparison to non-aggressors not implicated in psychological APV. Finally, adolescents exercising APV who were victimized by their parents showed more psychological, personal, and school maladjustment. These results have implications for needs analysis and the planning of community prevention strategies.

Myths about Sexual Aggression, Sexual Assertiveness and Sexual Violence in Adolescent Romantic Relationships

Sexual violence is a worldwide health and social issue. However, little is known about the sexual violence that occurs in the context of romantic relationships. This study analyzes the existence of sexual violence in adolescents’ romantic relationships, the possible associations between such violence (both committed and suffered) and myths about sexual aggression and sexual assertiveness, and the possible gender-related distinctions. A sample of 329 students aged between 15 and 19 (M = 16.3; SD = 0.79) was surveyed; all participants were in a romantic relationship when the data were collected. The results reveal that both genders report the existence of sexual violence in their romantic relationships; however, in heterosexual relationships, males were more often the perpetrators of sexual violence. Additionally, myths about sexual aggression and sexual assertiveness were found to be significantly associated with both perpetration and victimization. Accordingly, these predictors should be focal points in prevention programs for adolescent sexual violence. The findings of this study show the de-prioritization of sexuality education in the Spanish educational system, as well as the need to strengthen the competence of adolescents in this area.

Adolescent dating violence prevention programmes: a global systematic review of evaluation studies

Adolescent dating violence negatively affects millions of young people worldwide. Through a global systematic review, we synthesised evidence from rigorous studies of prevention programmes for adolescent dating violence. Our aims were to: (1) describe the breadth of research in this area and evidence of programme effects, and (2) identify gaps in the evidence base. We included experimental and controlled quasi-experimental programme evaluations, published before Jan 1, 2020, that assessed effects on victimisation or perpetration, or both, in adolescent dating violence and in which at least half of the study population was 10-19 years old. Study design, programme elements, and outcomes were compared between evaluations implemented in high-income countries (HICs) and low-income and middle-income countries (LMICs). 52 evaluations met inclusion criteria, of which 20 (38%) were implemented in LMICs. Evaluations in HICs were more likely to assess effects on adolescent dating violence victimisation and perpetration, rather than just victimisation, than those in LMICs, and they were also more likely to include boys and girls, as opposed to just a single sex. Overall, 26 (50%) of the 52 evaluations reported a significant preventive effect on at least one outcome for adolescent dating violence, of which nine were implemented in LMICs. Across LMICs and HICs, findings suggest research is needed to shed light on how adolescent dating violence prevention programmes work and to identify whether programme effects generalise across different settings, outcomes, and subgroups. TRANSLATIONS: For the Chinese, French and Spanish translations of the abstract see Supplementary Materials section.

Emancipated Foster Youth and Intimate Partner Violence: An Exploration of Risk and Protective Factors

Due to their high rates of parental maltreatment and violence exposure, youth in the foster care system are considered particularly vulnerable to experiencing intimate partner violence (IPV) in adolescence and young adulthood. Those who have emancipated from foster care may be at a heightened risk, as they are significantly more likely to struggle in a variety of critical domains (i.e., mental health, substance use, and delinquency). This longitudinal study is the first to explore the impact of demographic, individual, family, and foster care system factors on IPV involvement for foster care alumni at age 23/24. Analyses were conducted on three waves of quantitative data from the Midwest Evaluation of the Adult Functioning of Former Foster Youth (the Midwest Study). We find that approximately 21% of the young adults in our sample were involved in some type of IPV at age 23/24, with bidirectional violence the most commonly reported form. Males were more likely than females to report IPV victimization, whereas females were more likely than males to report IPV perpetration and bidirectional violence. Young adults who reported parental IPV prior to foster care entry were more likely to be involved in bidirectionally violent partnerships than nonviolent partnerships in young adulthood, as were young adults who reported neglect by a foster caregiver and those who reported greater placement instability while in the foster care system. Anxiety at baseline increased the odds of IPV perpetration at age 23/24, and posttraumatic stress disorder (PTSD) at baseline decreased the odds of IPV perpetration at age 23/24. Understanding the characteristics and experiences that place these young adults at risk for IPV will allow for more effective and targeted prevention efforts.

The Role of Gender in Adolescent Dating Abuse: An Interpretive Meta-Synthesis of the Qualitative Literature

The role of gender has received considerable attention in the academic literature on intimate partner violence (IPV). The Grand Challenges for Social Work take a gender-neutral approach, without regard to the influence of gender on adolescent development and dating relationships. This positioning is inconsistent with gender mainstreaming approaches that have been integrated into international framings of IPV. The purpose of this article is to conduct a qualitative interpretive meta-synthesis to investigate how gender is represented in research on adolescent dating abuse across qualitative literature (N = 17 articles). Results underscore that gender influences the impact of abuse, with female adolescents more likely to be fearful in relationships, at higher risk for damage to their social standing, and more likely to be blamed for the abuse. Gender-specific attitudes affect perceptions of the seriousness of abuse, antecedents of abuse, and rationales for perpetrating violence. Findings across the studies indicate that adolescents have internalized gender scripts. Therefore, strategies to prevent dating abuse need to be cognizant of the socializing role of gender and the myriad ways it influences adolescents' lived experiences. Therefore, the American Academy of Social Work and Social Welfare should consider revising the language of the existing challenges to mainstream gender.

Association Between Dating Violence and Behavioral and Health Outcomes Among Early Adolescents From Denmark: The Role of Exposure to Childhood Maltreatment

AIM

To examine the unique contribution of child maltreatment victimization on the association between adolescent dating violence (ADV) and four negative behavioral and health-related factors.

METHOD

In total, 2,934 7th grade students (M = 13.5, SD = .5) filled out questionnaires at school. Binominal logistic regression was performed to assess the impact of child maltreatment on the relationship between ADV and behavioral and health-related factors.

RESULTS

After child maltreatment was taken into account, associations between ADV and the negative behavioral and health-related factors became weaker.

CONCLUSIONS

The findings from the present study suggest that focusing on one victimization type (such as ADV) when examining psychological outcomes, can be problematic as the causal relationship may be misrepresented when an adolescent's broader victimization profile and context is not considered.

The mediating role of school connectedness in the associations between dating and sexual violence victimization and substance use among high school students

Dating and sexual violence victimization affect a significant portion of teenagers and result in a wide array of negative health and behavioral outcomes, including increased alcohol and drug use. In some cases, students who have been victimized may develop feelings of being unsupported by or disconnected from peers and adults in their school community, placing them at even higher risk for negative health outcomes. Using a prospective design, the present study sought to explore this possibility by examining the direct and indirect associations between dating violence (DV) and sexual violence (SV) victimization, school connectedness, and alcohol and marijuana use at baseline (T1) and 2-month follow-up (T2) in a sample of high school students (N = 1752). Results of multiple regression analyses supported a hypothesized mediation model of these associations; both forms of victimization were positively associated with heavy drinking at T1 and marijuana use at T1 and T2, and negatively associated with school connectedness. Furthermore, school connectedness was negatively associated with both forms of substance use at T1 and T2, and partially mediated the effects of DV and SV victimization on heavy drinking at T1, and marijuana use at T1 and T2. These findings elucidate the importance of addressing intermediary cognitive processes such as perceptions of school connectedness in order to improve health and functional outcomes among high school victims of dating and sexual violence.

Peer Victimization and Mental Health Outcomes for Lesbian, Gay, Bisexual, and Heterosexual Youth: A Latent Class Analysis

BACKGROUND

Lesbian, gay, bisexual, and questioning (LGBQ) adolescents are at increased risk of poor mental health due to minority stress, a chronic stress associated discrimination, social rejection, and victimization brought on by prejudicial attitudes towards LGBQ individuals. To improve understanding of the differential impact of various kinds of victimization on mental health outcomes for LGBQ adolescents, we analyzed data from the 2015 Youth Risk Behavior Survey (YRBS) for victimization and mental health symptom clusters and associations high school youth and compared by sexual orientation and gender.

METHODS

Separate Latent Class Analysis (LCA) was conducted to identify profiles of both victimization and mental health symptoms for participants (N = 15,624). Subsequently, stratified weighted logistic regression models were used on an eligible analytic sample of 11,458 to assess differences in the association of victimization and mental health between LGBQ and heterosexual high school students.

RESULTS

In each LCA, participants were assigned to one of 3 classes for victimization (minimal, 81.3%; bullying, 12.5%; or physical/sexual violence, 6.2%) and 1 of 2 classes for mental health symptoms (minimal, 81.2%; severe, 18.8%). LGBQ participants were overrepresented in physical/sexual violence and bullying victimization profiles. Both bullying and physical/sexual violence profiles were associated with almost 5 times the odds of endorsing severe mental health symptoms.

CONCLUSIONS

This study expands our understanding of the relationship between types and effect of peer victimization for LGBQ and heterosexual youth with implications for school health and prevention efforts through increased positive school climate for LGBQ students.

Physical and Sexual Teen Dating Violence Victimization and Sexual Identity Among U.S. High School Students, 2015

Lesbian, gay, and bisexual (LGB) youth are at risk for many negative behaviors associated with teen dating violence victimization (TDVV). This study describes the prevalence of physical and sexual TDVV by sexual identity and quantifies the increased risk for TDVV among LGB youth compared with heterosexual youth. The participants for this study were students in Grades 9 to 12 participating in the 2015 national Youth Risk Behavior Survey (YRBS) who responded to questions ascertaining sexual identity and both physical and sexual TDVV. Data were analyzed by sexual identity, stratified by sex, and controlled for race/ethnicity and grade in school. Frequencies of physical and sexual TDVV and prevalence of TDVV from a combined TDVV measure were calculated. Associations between these behaviors and sexual identity were identified. Generally, LGB youth had greater prevalence and frequency of TDVV compared with heterosexual youth. Prevalence of TDVV within sexual identity subgroups further differed by sex. Students who were not sure of their sexual identity had the highest risk of most categories of TDVV when adjusting for sex, race/ethnicity, and grade in school. These results are the first to use a nationally representative sample to describe frequency of TDVV and to determine prevalence of a combined physical and sexual TDVV measure by sexual identity among youth. Schools, communities, and families can help prevent teen dating violence and ameliorate the potential impacts of these victimizations.

Male Perpetration of Adolescent Dating Violence: A Scoping Review

Male violence against females most often occurs within intimate relationships, and when that occurs during youth, it is termed adolescent dating violence (ADV). A scoping review focused on male perpetration of ADV was conducted to synthesize existing evidence and offer insights about what influences male adolescents to perpetrate ADV. The current scoping review explored the findings drawn from 16 research studies conducted in the United States, Spain, South Africa, and Italy, to distil modifiable factors related to male perpetration of ADV. Three themes were extrapolated from the 16 studies: (a) entitlement; (b) adverse childhood experiences (ACE); and (c) ineffective conflict management. Entitlement as a theme was characterized by attitudes and beliefs aligning to violence, hierarchical and marginalizing masculine norms, traditional gender roles, and male superiority, which in various configurations influenced the perpetration of ADV. ACE as a theme highlighted how male adolescents who had experienced, observed, and/or initiated abuse were at increased risk of perpetrating ADV. Male adolescents with ineffective conflict management (theme 3), including alcohol use and/or emotional dysregulation, were also at higher risk of perpetrating ADV. Tailored prevention efforts are often delinked from issues of male entitlement, ACE, and ineffective conflict management; therefore, we make suggestions for trauma-informed care to guide primary care providers (PCPs) in the assessment and management of ADV.

Family Functioning among Rural Teens and Caregivers: Interactive Influence on Teen Dating Violence

Multi-informant assessment of family functioning is considered best practice in research and clinical settings. However, in the area of teen dating violence, multi-informant assessment of family functioning has received limited attention. The current study investigated whether and to what extent caregiver and adolescent perceptions of family functioning interact in their influence on adolescent dating violence. Participants were 493 adolescents and their primary caregivers from a rural southeastern community in the United States. As hypothesized, a paired-samples t test showed that adolescents' scores on the family functioning measure were significantly lower than their caregivers' scores. Logistic regressions revealed that adolescents' positive views of family functioning were significantly associated with a lower likelihood of dating violence victimization but not perpetration and that caregivers' views on family functioning moderated the impact of adolescent-reported family functioning on both dating violence outcomes. Post hoc analyses showed that adolescents with negative perceptions of family environment were most likely to be victims and perpetrators of dating violence when their parents also reported more negative views of family environment. The article concludes with a discussion of how these findings can: (a) advance our understanding of the impact of family functioning on teen dating relationships and (b) inform practical efforts aimed at preventing dating aggression among teens.

Co-occurrence of Dating Violence Victimization Subtypes: Assessing the Influence of Family Factors, Dating Attitudes, Risky Behaviors, and the Moderating Effect of Gender Among School-Aged Teens

Using data from a nationally representative sample of school-aged teens (n = 795), this study examined covariates associated with three subtypes of dating violence victimization (physical violence, emotional abuse, and imposed isolation). We asked the research questions: What were the family factors, dating attitudes, and risky behaviors associated with three subtypes of dating violence victimization across two time points? Second, were these relationships moderated by gender? Overall, we found widespread co-occurrence of victimization. Contrary to our predictions, not all earlier experiences with dating violence victimization worsened or persisted overtime. Regarding family factors, we did not find substantial statistically significant effects on victimization, with the exception that greater openness with parents was associated with increased occurrence of emotional abuse at Wave 1. In terms of dating attitudes, we found that when respondents condoned violence against a girlfriend, they were more likely to experience physical violence victimization at both waves. Respondents who believed that it is okay to use violence to control a boyfriend's behavior were more likely to report emotional abuse at Wave 1. Similarly, respondents who believed that it is okay to date more than one person, as well as those who condoned sexual intercourse outside of a romantic relationship, were more susceptible to emotional abuse. Regarding risky behaviors, we found that the respondents' victimization experience did not increase with a greater sexual partner acquisition; rather, it exerted the opposite effect on their experience with physical violence victimization. These risky behaviors, however, were only statistically significant at Wave 1. Finally, the moderating effect of gender is noted in the study. Implications from the study are discussed.

Prospective associations among relationship abuse, sexual harassment and bullying in a community sample of sexual minority and exclusively heterosexual youth

INTRODUCTION

Sexual minority youth (SMY) are at significantly greater risk for experiencing adolescent relationship abuse (ARA) than exclusively heterosexual youth, yet little is known about the factors that elevate their risks for such abuse. Peer victimization (i.e., bullying, sexual harassment) has been associated with ARA among heterosexual youth. SMY experience higher rates of peer victimization than heterosexual youth, suggesting that it may be a risk factor for ARA among these youth. Using longitudinal data from a community sample of adolescents recruited from the northeastern US, we examined whether sexual identity was associated prospectively with ARA, and whether that relationship would be indirect, and mediated via bullying and sexual harassment at a 12-month follow-up. We expected to find higher rates of peer victimization and ARA among SMY than heterosexual youth, and we expected that sexual harassment and bullying would predict subsequent relationship abuse.

METHODS

Adolescents (N = 800; 58% female; 81% European-American; 19% SMY) between 13 and 15 years (M = 14.45, SD = 0.85) completed a web survey at baseline, 6-months and 12-months.

RESULTS

Consistent with prior studies, SMY reported higher rates of bullying, sexual harassment, and relationship abuse than heterosexual youth. SMY who reported sexual harassment at baseline were more likely to report relationship abuse over time. Contrary to our expectations, however, bully victimization did not predict subsequent relationship abuse.

CONCLUSIONS

Sexual harassment can be particularly harmful for SMY because it targets gender and sexual identity at a formative developmental period and puts youth at risk for relationship abuse.

Dating Violence Victimization, Nonsuicidal Self-Injury, and the Moderating Effect of Borderline Personality Disorder Features in Adolescent Inpatients

The aim of the study was to examine whether Borderline Personality Disorder (BPD) features moderate the relation between dating violence victimization (DVV) experiences and nonsuicidal self-injury (NSSI) in adolescent inpatients. A total of 184 adolescent inpatients completed measures on DVV, BPD features, and NSSI at admission to treatment. Bivariate analyses revealed significant relations between DVV, BPD features, and NSSI. Hierarchical multiple regression analyses demonstrated a moderating effect of BPD features such that in the low BPD features group, more severe DVV was associated with greater NSSI frequency; adolescents in the high BPD group endorsed elevated, though stable, levels of NSSI at all levels of DVV. BPD features differentially affect the relationship between DVV and NSSI. Low BPD adolescents exposed to high DVV appear to self-injure more frequently and at rates similar to high BPD adolescents when faced with more severe DVV, while DVV appears neither necessary nor sufficient to be the cause of NSSI in high BPD adolescents. Our results indicate that DVV may be a particularly important focal point for treating adolescents who self-injure and have been victimized by a dating partner. As such, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and Dialectical Behavior Therapy (DBT) may serve as valuable clinical interventions.

Associations of physical partner violence and sexual violence victimization on health risk behaviours and mental health among university students from 25 countries

BACKGROUND

The study aimed to investigate the associations between physical partner violence victimization (IPV) and/or sexual violence victimization and various health risk behaviours and mental health in university students in 25 countries.

METHODS

Using a cross-sectional study design, 18,335 university students with a median age of 20 years from 25 countries in Africa, the Americas and Asia, replied to self-reported measures of interpersonal violence, health compromising behaviours, mental health measures and protective factors.

RESULTS

In adjusted logistic regression analysis, physical IPV and/or sexual violence victimization was associated, among men and/or among women, with sexual risk behaviours (multiple sexual partners, alcohol use in the context of sex, diagnosed with HIV and pregnancy), violence related behaviour (in a physical fight and carrying a weapon), poor mental health (depression, loneliness, post-traumatic stress disorder, sleeping problem and short sleep), addictive behaviour (binge drinking, tobacco and drug use), and other health risk behaviour (skipping breakfast and frequent salt intake).

CONCLUSIONS

We found evidence that physical IPV and/or sexual violence victimization among female and/or male university students was associated with 4 of 5 sexual risk behaviours, 2 violence related behaviours, 5 of 5 poor mental health indicators, 3 of 3 addictive behaviours and 2 of 7 other health risk behaviours.

Effect of fear of victimization on hazardous alcohol drinking, tobacco, and marijuana use among university students: A tale of two sexes

BACKGROUND

Fear of victimization has been associated with poorer physical and mental health, yet is understudied in public health. Few studies have examined sex differences in the effects of fear of victimization on substance use. We examined associations between fear of victimization and hazardous alcohol drinking, tobacco, and marijuana use among female and male university students.

METHODS

A cross-sectional study was conducted among university students in an urban location (n = 1415). Socio-demographics, substance use, and fear related to various crimes were measured using online surveys. All fear types were summed into a total fear score and categorized into quartiles: no/little fear, moderate fear, high fear, and very high fear. Chi-square tests and multiple logistic regression models were used to examine associations between fear of victimization, hazardous alcohol drinking, tobacco and marijuana use, by sex.

RESULTS

Females were more likely to report high and very high fear of victimization (26.6% and 33.1%) than male students (19.8% and 16.3%; p < 0.001). In multiple logistic regression models, associations differed by sex: moderate, high, and very high fear were all independently associated with hazardous drinking among females but not males. Female students with very high fear of victimization were more likely to report tobacco use. High and very high fear was also independently associated with marijuana use among female only.

CONCLUSIONS

Higher fear of victimization was associated with substance use among females but not male students. Public health and health care professionals should acknowledge fear of victimization as a potential risk factor for substance use, particularly among women.

Teen-dating violence: conception of adolescents in a Brazilian metropolis

Background:

Teen-dating violence (TDV) can lead to health problems for those involved, especially females, including homicides and is predictive of intimate partner violence in adulthood.

Methods:

To analyze the adolescents' perception of definitions, justifications and consequences of TDV, a qualitative study through 13 focus groups with 132 high school students from public and private schools of Rio de Janeiro city, including 70 girls and 62 boys was conducted. We followed a guide with questions about interpersonal violence and participants completed a self-administered questionnaire on socio-demographic data. The data analysis included reading and comprehension of the textual data; coding of the reports according to the emerged categories; identification of the meanings attributed by the subjects to the questions raised; comparative dialogue with literature; and elaboration of interpretative synthesis.

Results:

Most adolescents affirmed that TDV is not justifiable. However, in practice, they found it acceptable in certain situations. The narratives of the boys were based on the role of the perpetrator and the girls on that of the victim. Violence occurs when the man feels his power challenged and is influenced by situations of violence experienced in his own family as victims or witnesses. The TDV consequences are for the women and include, in addition to physical and psychological damage, relational problems in other spheres such as family, friends and school. The experience of violence was more common among public school students.

Conclusions:

The adolescents’ narratives reflect the gender patterns of society in which violence results from inequality of power. The data of this study offer subsidies to policies on TDV prevention and its consequences. They can contribute to training primary care professionals to identify on clinical consultations signs and symptoms of violence and to develop interventions to reduce the health problems of victims.

Longitudinal association between adolescent negative emotions and adulthood cardiovascular disease risk: an opportunity for healthcare quality improvement

Purpose

While cardiovascular disease (CVD) is the leading cause of death globally, over 80% of the cases could be prevented through early lifestyle changes. From the perspective of quality management in healthcare, this may offer an effective prevention window if modifiable CVD risk factors are identified and treated in adolescence. The purpose of this research is to examine the negative emotions in adolescents and determine if it independently increases CVD risk later in life.

Design/methodology/approach

Longitudinal data from 12,350 participants of the Add Health study, which conducted a multi-wave survey for 14 years from adolescence (Wave 1) through adulthood (Wave 4), were used to test the research hypothesis. Four items (perception of life, self-reported depression, perceived loneliness and fearfulness) reflective of adolescent negative emotion were identified from the Wave 1 questionnaire, and factor analysis was conducted to confirm the hypothesized structure. The outcome variable, 30-year adulthood CVD risk category (high or low risk), was estimated using biomarkers, biological data and other factors collected during the 14-year follow-up in Wave 4. A logistic regression analysis was employed to assess the impact of adolescent negative emotions on adulthood CVD risk after adjusting for common risk factors such as sociodemographic characteristics, socioeconomic status and medical conditions in adolescence.

Findings

The results indicated adolescent negative emotion to be significantly associated with CVD risk category (p-value < 0.0001), even after controlling for common risk factors. A unit increase in the level of adolescent negative emotion increased the chance of being in the high CVD risk group in adulthood by 8% (odds ratio = 1.08 ± 0.03).

Practical implications

Healthcare providers and organizations could capitalize on the research findings by screening for negative emotions early in life through individual and societal interventions. The findings also provide an opportunity for implementing quality improvement initiatives to deliver robust preventive care, which, in turn, could improve the overall population health, reduce healthcare costs and improve care quality.

Originality/value

Although previous studies showed a strong link between adolescent physiological factors (e.g. obesity) and adulthood cardiovascular disease (CVD), the association between adolescent outlook/attitude (negative emotion) and CVD risk has not been examined.

Prevalence of physical and sexual violence and psychological abuse among adolescents and young adults living with HIV in Zambia

BACKGROUND

Little is known about violence against HIV-positive adolescents and young adults (AYA) in sub-Saharan Africa. This analysis examines experiences of violence victimization, and the perpetrators of this violence, among AYA living with HIV, aged 15-24 years, in Zambia.

METHODS

We analyzed baseline data from 272 AYA (60.1% female, 71.0% perinatally infected) enrolled in Project YES! (Youth Engaging for Success), a randomized controlled trial conducted in four HIV clinics in Ndola, Zambia. Violence measures were adapted from the ICAST-C and the WHO Multi-Country Study on Women's Health and Domestic Violence. Youth could report up to 12 perpetrator types for past-year experiences of violence. We estimated lifetime and past-year prevalence of physical violence, psychological abuse, and forced sex, disaggregated by sex and age group. Estimates were weighted using sex and age data from the 2013-14 Zambian Demographic and Health Survey to be representative of HIV-positive AYA in Zambia.

RESULTS

Estimated lifetime prevalence of any violence victimization was 78.2%. Past-year prevalence was 72.0% among males and 74.5% among females. Almost half of AYA (46.1%) had ever experienced polyvictimization (2+ types of violence). Psychological abuse was most common (70.4% lifetime, 65.3% past-year), followed by physical violence (50.8% lifetime, 44.7% past-year) and forced sex (10.4% lifetime, 4.7% past-year). Among past-year victims, males experienced more violence than females from a friend/peer (74.3% vs. 45.1%, p<0.001); females experienced more violence than males from a romantic partner (33.3% vs. 5.0%, p<0.001), parent/caregiver (32.4% vs. 17.6%, p = 0.02), and stranger (19.7% vs. 5.2%, p<0.001).

CONCLUSION

The widespread and overlapping prevalence of multiple types of violence highlights the critical need for prevention and response efforts that are tailored to youths' sex and the perpetrator type. Future research should explore violence victimization and HIV outcomes, and the measurement of psychological abuse and sexual violence, among HIV-positive AYA in the region.

Prevalence of teen dating violence and the associations with substance use and externalizing behaviors in Nicaraguan early adolescents

Purpose

Despite being a significant public health problem, teen dating violence and related risk behaviors are yet to be examined in Nicaragua. This study aims to examine the prevalence of in-person dating violence and cyber dating abuse and to test the associations between teen dating violence and substance use (i.e. alcohol, cigarette, marijuana and e-cigarette) as well as externalizing behaviors.

Design/methodology/approach

Survey responses were collected from a school-based sample of 1,799 Nicaraguan early adolescents (average age = 13.04 years).

Findings

The prevalence was 41% for in-person dating violence victimization, 39% for in-person dating violence perpetration, 30% for cyber dating abuse victimization and 26% for cyber dating abuse perpetration. The majority (56%) of the adolescents reported engagement in externalizing behaviors, but substance use prevalence was relatively low, ranging from 1–9% depending on the substance type. Multivariate regression analyses suggest that in-person dating violence perpetration was positively associated with all types of substance use and externalizing behaviors, while victimization was only associated with externalizing behaviors.

Originality/value

Despite the descriptive nature, the study is the first to examine the prevalence of teen dating violence and its relationships with other risk behaviors in Nicaraguan adolescents and have important health implications.

"I feel like… their relationship is based on the media": Relationship Between Media Representation and Adolescents' Relationship Knowledge and Expectations

Teen dating violence (TDV) is a serious public health issue associated with negative physical and behavior outcomes that disproportionately impact African-American adolescents. Despite the emergence of effective TDV prevention strategies, more knowledge is needed about how African American adolescents understand healthy and unhealthy relationships. Adolescents' analysis of media representations can provide important insight into social norms around adolescent romantic relationships, which can inform the development of TDV prevention strategies. We conducted nine focus groups (n = 86) to explore perceptions of healthy and unhealthy relationships and the influence of media representations on romantic relationships. We transcribed focus group interviews verbatim and coded them line by line. Participants were primarily African American (90%), female (67%), and high school aged (13-17 years). Consistent with other studies, participants reported significant engagement across traditional and social media platforms that exposed them to a wide variety of fictional, celebrity, and peer relationships. A modified constructivist grounded theory analytic approach produced four major relationship themes: commitment, authenticity, privacy, and maturity. These themes captured participants' reflections about romantic relationships and how the media interact with relationship processes and perceptions. Results show that adolescents are using media representations of romantic couples to clarify their own romantic relationship expectations and desires. Future prevention strategies should support youths' use of critical thinking, perspective taking, and analysis to help align their relationship choices and expectations with their own values and preferences.

Experience of violence and self-rated health: Do youths disclose their experiences when visiting a Youth Centre in Sweden

Background: Being exposed to violence is a global health problem, increasing the risk of suffering from ill health. The main aim of this study was to estimate the prevalence of emotional, physical and sexual violence victimisation and its association to self-rated health among youths. The second aim was to investigate whether the youths had disclosed to healthcare professionals at a Youth Centre or others about being exposed. Methods: The cross-sectional study includes data from a web survey of youths, aged 15–25 (n=500), collected in Sweden. Descriptive statistics and univariate analyses were used for the analyses. Results: In all, emotional, physical or sexual violence during their lifetime was reported by 43.2% and 22.8% of youths during the last year. In total, 88% of the respondents assessed their self-rated health as good, very good or excellent. Those who had been exposed to emotional, physical or sexual violence during their lifetime reported statistically significant lower self-rated health (fair and poor) than those who were not victimised. When healthcare professionals at the Youth Centre asked youths about exposure during their lifetime, one-fifth disclosed having been exposed. Conclusions: Youths who reported any type of violence during their lifetime showed lower self-rated health compared to those who were not exposed. Youth Centres have an important role in identifying youths who are exposed to violence and/or self-report their health as low. Still, only a minority of youths who have been exposed to violence told health professionals at a Youth Centre about it when asked. It is necessary to further investigate how the issues can be best addressed.

Stay or Leave Abusive Dating Relationships: Portuguese Victims’ Reasons and Barriers

The decision to stay or leave an abusive relationship is multifactorial and frequently involves a cyclic process involving several phases. This article presents a qualitative analysis regarding the reasons and barriers to stay or leave an abusive dating relationship, as well as the challenges that it implies. A semi-structured, in-depth interview was used to collect data from thirteen dating victims, aged 17–30 years and mainly female (n = 12). The emotional and affective dependence of the partner and the belief that behaviour may change emerge as the main reasons presented by the victims to remain in an abusive relationship. Shame, fear of losing the partner, and failure to recognize the abusive relationship were reported as the main barriers to leave the abusive relationship, thus making it difficult to seek help. Understanding reasons to stay in, or barriers to leave, an abusive relationship is fundamental to promoting help-seeking behaviours in victims of dating violence (DV), particularly in the case of young people, since it has serious implications in the developmental pathway of this age group.

Variation in State Laws on Access to Civil Protection Orders for Adolescents Experiencing Intimate Partner Violence

PURPOSE

Intimate partner violence (IPV) is prevalent among adolescents. Civil protection orders (CPOs) are the most common legal remedy used by individuals experiencing IPV to prevent recurrence. However, laws on whether adolescents can access CPOs vary by state. We assessed the landscape of state legislation regarding adolescents' access to CPOs for IPV.

METHODS

We systematically assessed statutes across all 50 U.S. states and the District of Columbia for 5 indicators: whether minors can be granted CPOs, whether minors can file on their own behalf, whether dating relationships are eligible, definitions of abuse qualifying for CPOs, and whether a CPO prohibits firearm possession and requires surrender of firearms.

RESULTS

A total of 48 states (94%) explicitly allow minors to obtain CPOs. Fourteen states (27%) explicitly allow minors to file for a CPO on their own behalf. Forty-four states (86%) recognize dating relationships as qualifying relationships for a CPO. A CPO may be issued for physical violence in all 51 states (100%), sexual violence in 46 states (90%), threats of physical or sexual violence in 47 states (92%), stalking in 44 states (86%), and psychological/emotional violence in 28 states (55%). In 22 states (43%), an individual subject to a CPO is prohibited from possessing firearms and is required to surrender firearms they already have.

CONCLUSIONS

There is a significant variation in states' CPO statutes related to adolescent IPV. Improvements in legislation that reduce the barriers to legal relief for those experiencing violence can be an important part of a comprehensive solution to reducing IPV among adolescents.