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et al 2004 Emotional Dating Begins Early About 1 in 2 sixth graders report ever having a boyfriend or girlfriend Unpublished data, Me & You Study Perpetration among 6th grade daters 70 60 50 % 40 30 58.8 20 10 27.4 8 0 Physical Me & You, Unpublished data Emotional Sexual 14.5 Electronic Victimization among 6th grade daters 60 50 40 % 30 55.9 20 10 23.1 16 15.9 Sexual Electronic 0 Physical Me & You,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? 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