Adolescent Dating Violence
Melissa Peskin, PhD
Assistant Professor
Presentation Objectives
• Describe the prevalence of dating violence
among adolescents
• Describe evidence-based approaches for
preventing dating violence among young
people
• Recognize the role parents, schools, and
healthcare providers play in preventing teen
dating violence
What is Dating Violence?
• Between two people in a
close relationship
• In person or
electronically
• Repetitive
• Goal to maintain power
and control
CDC Definition, Futures without Violence-Miller & Levenson, 2013
Types of dating violence
Physical
• Intentional use of physical force with intent to cause
fear or injury
• Non-physical behaviors such as threats, insults,
constant monitoring, humiliation, intimidation,
Emotional
isolation, or stalking
Sexual
• Any action that impacts a person’s ability to control
their intimate behavior
Adapted from http://www.breakthecycle.org/dating-violence-101
Electronic dating violence
 Use of technology such as
texting and social
networking to bully, harass,
stalk, or intimidate a partner
http://www.loveisrespect.org/is-this-abuse/types-of-abuse/what-is-digital-abuse
Types of electronic dating violence
Restricts friends
on social media
Posts
embarrassing
images online
Monitors
through social
media
Sends negative
messages online
or phone
Pressure
unwanted
sexting
Steals
passwords
Sends constant
text messaging
Looks through
phone
frequently
Fear of not
responding to
calls/messages
Adapted from http://www.loveisrespect.org/is-this-abuse/types-of-abuse/what-is-digital-abuse
Students experience physical and sexual
dating violence
About 1 in 10
high school
students
YRBS, 2013 data
Trends in Physical and Sexual Dating
Violence Victimization
14
12
11.7
10.9
10.2
Percent
10
8
8.8
Physical
6
Sexual
4
2
0
9th
10th
YRBS, 2013 data, one more times in the past year
11th
12th
Students experience emotional dating
violence
About 1 in 3
young
people
(ages 12-21)
Halpern et al., 2001
Students in same-sex relationships also
experience dating violence
%
50
45
40
35
30
25
20
15
10
5
0
21.3
11.3
Physical
Halpern et al 2004
Emotional
Dating Begins Early
About 1 in 2 sixth
graders report
ever having a
boyfriend or
girlfriend
Unpublished data, Me & You Study
Perpetration among 6th grade daters
70
60
50
%
40
30
58.8
20
10
27.4
8
0
Physical
Me & You, Unpublished data
Emotional
Sexual
14.5
Electronic
Victimization among 6th grade daters
60
50
40
%
30
55.9
20
10
23.1
16
15.9
Sexual
Electronic
0
Physical
Me & You, Unpublished data
Emotional
Demographic differences
Gender differences inconsistently
reported
 Some studies show that females participate in
more physical and emotional DV
 However, males may participate in more sexual
violence and in more severe forms of physical
violence than girls
African-American and Hispanic teens may
be more at risk
Why are these statistics
important….
Cycle of violence
Experience of
adolescent dating
violence
Intimate partner violence
victimization and
perpetration as adults
Costs of intimate partner violence
$5.8 billion
dollars
per year
Max W, Rice DP, Finkelstein E, Bardwell RA, Leadbetter S. The economic toll of intimate partner violence against
women in the United States. Violence and Victims. 2004;19(3):259-272.; National Center for Injury Prevention and
Control. Costs of Intimate Partner Violence Against Women in the United States. Atlanta, GA: Centers for Disease
Control and Prevention; 2003.
There are health consequences
Somatic
complaints
Teen
Pregnancy &
STIs
Physical
Injury
Dating
Violence
Unhealthy
weight
behaviors
Death
Suicide and
depression
Substance
use
Susan Tortolero, UTPRC
Sexual risktaking
Why?
How can we impact
these factors?
Who can help?
Families
Schools
Health Care Professionals
Who can help?
Parents
are
primary
In a recent study, 55% of parents
discussed dating abuse with their child
in the past year.
Effective Curricula:
Families for Safe Dates
 Six booklets mailed to families with followup telephone calls from health educator
 Evaluated at 3 months
 Caregivers: greater perceived severity and
acceptance of TDV, greater knowledge and selfefficacy for communicating with their teen about
TDV and in their ability to prevent TDV
 Teens: lower physical DV victimization
Foshee et al., 2012
Who can help?
Schools
are
key
Perceptions of school personnel
 Over half perceive dating violence
to be a problem in school
 1 in 5 report witnessing dating
violence
 Few report protocol for responding
to dating violence
 Over 80% believe programs are
needed
Temple et al., 2013; Khubchandani, 2013
What are schools required to do to address
dating violence?
Texas law (House Bill 121) requires all school districts to
adopt and implement a DV policy by directing school
districts to:
•
address safety planning
•
enforcement of protective orders
•
school-based alternatives to protective orders
•
training for teachers and administrators
•
counseling for affected students
•
awareness education for students and parents
Effective Teen Dating Violence
Curricula
 Safe Dates
 Fourth R: Skills for Youth
Relationships
 Shifting Boundaries
 It’s Your Game…Keep it
Real
 Me & You (currently being
evaluated)
Characteristics of Effective Programs
Based on Theory
Integrates skillbuilding
activities
Reinforces key
messages
Sufficient in
length
Includes
activities on
social pressures
Interactive
Uses
personalization
Age and
culturally
appropriate
Culturally
appropriate
Includes school
and community
components
Involves parents,
teachers, other
adults
Source: Kirby, D. 2001. Emerging Answers. National Campaign for Teen Pregnancy Prevention &
De Koker et al., 2014
It’s Your Game…Keep It Real!
www.itsyourgame.org
For example…..It’s Your Game…Keep it Real
• Specific topics:
• Characteristics of healthy and
unhealthy friendships and dating
relationships
• Skills training related to
evaluating relationships, peer
pressure and social support
• Setting limits and respecting
other people’s limits related to
healthy relationships
• Recognizing peer norms related
to healthy relationships.
Teens delay all types of sex
Teens intend to abstain until marriage
Teens increase confidence to say “no”
Peer norms are changed
Dating violence is decreased
Who can help?
Healthcare
professionals
are critical
Perceptions of patients
• 1 in 3 female adolescent
patients reported that their
healthcare provider asked
them about experiences of
dating violence
 3 out of 4 patients reported
wanting their healthcare
provider to ask them about
dating violence
Miller et al., 2010
Role of healthcare providers
• Provider trainings
• Anticipatory Guidance=Universal
education messages for all patients
• Screening (Universal vs selected)
• Counseling
• Referral to outside resources
• Help patients think ahead (safety
plan)
• Make follow-up plan
• Discuss limits of confidentiality
Hermann et al., 2009, Futures without Violence-Miller & Levenson, 2013, AAP Policy statement on Youth violence, 2009;
Duke, 2014, Cutter-Wilson, 2011
Universal Education
• Discuss healthy vs unhealthy relationships
• Encourage youth to chose safe and healthy relationships
and to reject unhealthy ones
• Support youth to take action when they observe
unhealthy relationship behaviors among their peers
• Talk to sexually active patients about sexual coercion
and consent
• Create a safe environment so that patients feel
comfortable discussing relationships
Futures without Violence-Miller & Levenson, 2013
Resources for healthcare providers
It’s Your Game…Keep it Real-Kiosk version
(under development)
Other resources for healthcare providers
• 4-item screening questions: Erickson et al.,
2010
• Connected Kids: Safe Strong Secure
http://www2.aap.org/connectedkids/
• Hanging Out or Hooking Up: Clinical Guidelines
on Responding to Adolescent Relationship
Abuse, Futures without Violence, Miller &
Levenson, 2013
Take Home Messages
• Dating violence is prevalent among early
adolescents
• Talk to young people about the importance of
healthy relationships with partners and peers
• Support schools to implement effective
programs
• Implement universal healthy relationship
education in healthcare settings
• Screen adolescents, when appropriate, in
healthcare settings and refer them to
appropriate resources
Questions?
Melissa.F.Peskin@uth.tmc.edu
713-500-9759