[Researcher Comment] Teen dating violence is associated with adverse health outcomes

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Study author, Deinera Exner-Cortens, talks to 2 Minute Medicine: Cornell University, Ithaca, NY

The clinical importance of your study for physicians: “We found that unhealthy relationship experiences in adolescence were associated with poorer health and well-being in young adulthood, including substance use and suicidal thoughts. Dating violence in adolescence was also associated with re-victimization in young adulthood, potentially because unhealthy experiences skew an adolescent’s understanding of what a healthy relationship looks like. 

This study adds to evidence showing that dating violence is an extremely important public health problem that needs more attention. In particular, it is a problem that we need to address through early education, prevention and intervention. “

The relevance of your study for medical students in training: “The American Academy of Pediatrics recommends that pediatricians start this discussion with their early adolescent patients. Health care providers can also have helping resources on hand, such as hotline phone numbers and pamphlets, so that adolescents can access information in a comfortable way. 

For medical students in training, we encourage them to learn how to have discussions about dating and dating violence with their patients. For example, Futures Without Violence has created an assessment tool for health care providers that can be used to ask adolescent patients about dating violence.”

Key study points:

1.  Female victims of teen dating violence had higher rates of heavy alcohol usage, depressive symptoms, suicidal ideation, smoking, and adult partner violence victimization.

2.  Male victims of teen dating violence had higher rates of antisocial behaviors, suicidal ideation, marijuana use, and adult partner violence victimization.

Primer: Surveys conducted by the Center for Disease Control in 2011 showed that nine percent of adolescent high school students experience physical violence in romantic relationships and eight percent experience forced sexual intercourse.  Overall, these rates are equivalent in boys and girls; however, more recent studies reveal that the psychological effects of dating violence are more significant in females compared to males.  Previous investigations on the outcomes of teen dating violence have been conducted using a cross-sectional analysis or small populations.   To better understand the role of teen dating violence in determining adult health outcomes, this study employs a longitudinal cohort design.

Background reading:

1. Trends in the Prevalence of Behaviors that Contribute to Violence, National YRBS: 1991–2011

2.  Dating Violence Against Adolescent Girls and Associated Substance Use, Unhealthy Weight Control, Sexual Risk Behavior, Pregnancy, and Suicidality

This [prospective cohort] study: included adolescents in grades 7-12 selected from 80 high schools and 52 middle schools. When contacted 1 to 2 years later, 30.8% of the participants reported experiencing partner violence since the first interview. Partner violence included being called names, threatened, and/or physically hurt. After 5 years, follow-up questionnaires assessed for depression, poor self-esteem, antisocial behavior, risky sexual behaviors, extreme weight control, suicidality, substance abuse, and adult inter-partner violence victimization.

At follow-up, female violence victims (compared to non-victims) had higher rates of heavy alcohol usage, depressive symptoms, suicidal ideation, smoking, and adult partner violence victimization, compared to non-victims.  Male victims had fewer sequelae, but did have higher rates of antisocial behaviors, suicidal ideation, marijuana use, and adult partner violence victimization. Analyses controlled for sociodemographics, child maltreatment, and pubertal status.

In sum: Adolescents that were victims of dating violence are more likely to have adverse health outcomes in young adulthood, with females experiencing more persisting effects. The study demonstrated that nearly a third of the adolescents sampled experienced dating violence. It is imperative that health care providers screen regularly for teen dating violence, as they may miss the opportunity for intervention.  Ultimately, primary and secondary prevention strategies must be employed to reduce the long-term burden of victimization.

Click to read the study in Pediatrics

By [SS] and [DB]

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