Pregnant Adolescents As Perpetrators and Victims of Intimate Partner Violence

The Association Between Teen Dating Violence and Concussion

PURPOSE

In adults, intimate partner violence victimization and traumatic brain injuries, including concussion, are strongly connected. However, no prior research has explored this association among youth. This study explores the association between teen dating violence (TDV) and concussion to inform clinical care for these at-risk groups.

METHODS

We used data from ninth and 10th grade youth in the 2017/18 Health Behavior in School-Aged Children nationally representative Canadian dataset (N = 2,926). TDV in the past 12 months was measured using three items for victimization and three for perpetration. Youth were asked if they had been told by a doctor or nurse that they had had a concussion in the past 12 months and where they were and what they were doing when they had the concussion. We used coarsened exact matching to create equivalent groups of TDV victims and nonvictims, and then explored the association between TDV and concussion using doubly robust logistic regression models. We also explored effect modification by gender.

RESULTS

TDV was related to higher odds of concussion, both overall and when restricted to nonsport settings. In nonsport settings, youth who reported mutual TDV reported the highest odds of past-year concussion (adjusted odds ratio = 2.14, 95% confidence interval: 1.07, 4.28, p = .032). We also found that girls and nonbinary youth reported elevated risk of concussion in the context of TDV.

DISCUSSION

We found that TDV was associated with increased risk for concussion. Findings can be used to inform future research and may assist adolescent health providers who treat youth with concussion.

Associations between intimate partner violence profiles and mental health among low-income, urban pregnant adolescents

Background

Intimate partner violence (IPV) during pregnancy is associated with adverse maternal and child health outcomes, including poor mental health. Previous IPV research has largely focused on women’s victimization experiences; however, evidence suggests young women may be more likely to engage in bilateral violence (report both victimization and perpetration) or perpetrate IPV (unilateral perpetration) during pregnancy than to report being victimized (unilateral victimization). This study examined prevalence of unilateral victimization, unilateral perpetration, and bilateral violence, and the association between these IPV profiles and mental health outcomes during pregnancy among young, low-income adolescents.

Methods

Survey data were collected from 930 adolescents (14–21 years; 95.4% Black and Latina) from fourteen Community Health Centers and hospitals in New York City during second and third trimester of pregnancy. Multivariable regression models tested the association between IPV profiles and prenatal depression, anxiety, and distress, adjusting for known predictors of psychological morbidity.

Results

Thirty-eight percent of adolescents experienced IPV during their third trimester of pregnancy. Of these, 13% were solely victims, 35% were solely perpetrators, and 52% were engaged in bilateral violence. All women with violent IPV profiles had significantly higher odds of having depression and anxiety compared to individuals reporting no IPV. Adolescents experiencing bilateral violence had nearly 4-fold higher odds of depression (OR = 3.52, 95% CI: 2.43, 5.09) and a nearly 5-fold increased likelihood of anxiety (OR = 4.98, 95% CI: 3.29, 7.55). Unilateral victims and unilateral perpetrators were also at risk for adverse mental health outcomes, with risk of depression and anxiety two- to three-fold higher, compared to pregnant adolescents who report no IPV. Prenatal distress was higher among adolescents who experienced bilateral violence (OR = 2.84, 95% CI: 1.94, 4.16) and those who were unilateral victims (OR = 2.21, 95% CI: 1.19, 4.12).

Conclusions

All violent IPV profiles were associated with adverse mental health outcomes among pregnant adolescents, with bilateral violence having the most detrimental associations. Comprehensive IPV screening for both victimization and perpetration experiences during pregnancy is warranted. Clinical and community prevention efforts should target pregnant adolescents and their partners to reduce their vulnerability to violence and its adverse consequences.

Trial registration

ClinicalTrials.gov, NCT00628771. Registered 29 February 2008.