ANN ARBOR, Mich. — Dating during the teen years takes a violent turn for nearly 1 in 6 young people, a new study finds, with both genders reporting acts like punching, pulling hair, shoving, and throwing things.
The startling number, drawn from a University of Michigan Medical School survey of more than 4,000 adolescent patients ages 14 to 20 seeking emergency care, indicates that dating violence is common and affects both genders.
Probing deeper, the study finds that those with depression, or a history of using drugs or alcohol, have a higher likelihood to act as the aggressor or victim.
The findings, from the largest-ever study of the issue in a health care setting, suggests a need for health care providers to ask both young women and men about whether their relationships have ever turned violent, and to guide them to resources. The results are published online in the Annals of Emergency Medicine.
"It's important to think about both genders when trying to identify teen dating violence, especially when there are other conditions we may be trying to assess in the health care setting," says Vijay Singh, M.D., MPH, MS, the study's lead author and a U-M clinical lecturer in the Departments of Emergency Medicine and Family Medicine.
"These data remind us that teen relationships are not immune to violence and should encourage providers to ask adolescent patients about this important issues," he adds. "In addition, this could help us understand whom to target for screening and referral to, or development of, programs that could help them."
Relationships in adolescence set up patterns for adult relationships, he notes. Intervening with adolescents experiencing dating violence is crucial to prevent adult intimate partner violence.
Singh and his colleagues at the U-M Injury Center analyzed data from a larger survey of teens and young adults aged 14 to 20 years who visited the U-M Health System's emergency department for any reason between late 2010 and early 2013. The teens took the surveys on touch-screen tablet computers in private, though those under age 18 needed their parents' consent to take part.
While the researchers didn't ask about the gender of the teen's partner or about emotional or sexual abuse, the new data give new insight into teen dating violence that builds on school-based and smaller healthcare-based studies.
In all, 1 in 5 young women said they had been the victim or aggressor in a violent situation in the last year with a romantic partner, and 1 in 8 young men reported the same, suggesting that Emergency Departments can aid in identifying dating violence.
Interestingly, teen girls who had sought emergency care for an intentional injury in the last year had twice the odds of reporting violence in their dating relationships.
That finding, Singh says, lends credence to the idea that the ED could be an important site for screening.
"We may ask 'How did you get that injury?,' but often if someone has been a victim of violence, they don't want to disclose that, and it takes repeated questioning in a sensitive way to find out more," he explains.
He notes that, last year, the top national panel for preventive health services recommended that all women between the ages of 14 and 46 be asked about relationship violence during health care visits.
But the lack of data on men as both victims and aggressors means there isn't a similar recommendation for screening them. The new study, he hopes, will add to the understanding of how dating violence affects young men.
"This affects people of both genders, so let's assess them both," Singh says. "Especially in the teen years, when young people are figuring out their relationship roles, changing partners more often than adults, and likely not living together."
His colleagues and co-authors on the new study, Maureen Walton, Ph.D., MPH, of the U-M Department of Psychiatry, and Injury Center director Rebecca Cunningham, M.D., of the U-M Department of Emergency Medicine, are testing a behavioral intervention tool in urban emergency departments that aims to help teens understand how to reduce violence of all kinds in their lives.
Singh also co-wrote guidance on screening for intimate partner violence for primary care providers, published in the June issue of Primary Care: Clinics in Office Practice.
Singh urges all teens, and those who love them, to be aware of phone and online resources that can help them identify and respond to unhealthy tendencies in their relationships – and get help when things threaten to turn violent.
That includes the toll-free, 24-hour, multi-language National Domestic Violence Hotline, 800-799-SAFE and its website http://www.ndvh.org, as well as Love is Respect, http://www.loveisrespect.org, which focuses on teens.
In addition to Singh, Walton and Cunningham, the study's authors include Lauren K. Whiteside, MD, MS, Sarah Stoddard, Ph.D., Quyen Epstein-Ngo, Ph.D. and Stephen T. Chermack, Ph.D. Singh, Walton and Cunningham are all members of the U-M Institute for Healthcare Policy and Innovation.
Funding for the study came from National Institute on Alcoholism and Alcohol Abuse (grant AA018122, with additional support from the U-M injury Center, which is supported by the Centers for Disease Control and Prevention (grant 5R49CE002099).
Reference: Annals of Emergency Medicine, http://dx.doi.org/10.1016/j.annemergmed.2014.05.027
Primary Care: Clinics in Office Practice: http://www.sciencedirect.com/science/article/pii/S0095454314000098
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