Dating violence victimization across the teen years: Abuse frequency, number of abusive partners, and age at first occurrence

ABSTRACT: BACKGROUND: Prior longitudinal studies have shown high cumulative dating violence exposure rates among U.S adolescents, with 36 percent of males and 44 percent to 88 percent of females experiencing victimization across adolescence/young adulthood. Despite promising information characterizing adolescents' dating violence experiences longitudinally, prior studies tended to concentrate on physical and sexual types of violence only, and did not report information on the number of times dating violence was experienced across multiple abusive partners. We used a method similar to the timeline follow-back interview method to query adolescents about their experiences of dating violence from age 13 to 19--including dating violence types (physical, sexual, and psychological), frequency, age at first occurrence, and number of abusive partners. METHODS: A total of 730 subjects were randomly sampled from university registrar records and invited to complete an online survey, which utilized methods similar to the timeline follow-back interview method, to retrospectively assess relationship histories and dating violence victimization from age 13 to 19 (eight questions adapted from widely-used surveys covering physical, sexual, and psychological abuse/stalking). Then, for each dating violence type, we asked about the number of occurrences, number of abusive partners, and age at first occurrence. Of 341 subjects who completed the survey, we included 297 (64 percent females; 36 percent males) who had a dating partner from age 13 to 19. RESULTS: Fully 64.7 percent of females and 61.7 percent of males reported dating violence victimization between age 13 and 19, with most experiencing multiple occurrences. More than one-third of abused females had two or more abusive partners: controlling behavior (35.6 percent); put downs/name calling (37.0); pressured sex (42.9); insults (44.3); slapped/hit (50.0); and threats (62.5). Males also had two or more abusive partners, as follows: controlling behavior (42.1 percent); insults (51.2); put downs (53.3); threats (55.6); and unwanted calls/text messages (60.7). Among abused females, 44.7 percent first experienced controlling behavior between age 13 and 15, whereas the majority (62.5 percent) first experienced pressured sex between age 16 and 17. Among males, for most abuse types, 16 percent to 30 percent of victimization began before age 15. CONCLUSIONS: Our study adds information to a substantial, but still growing, body of literature about dating violence frequency, age of occurrence, and number of abusive partners among adolescents.     

Prevalence of physical and sexual assault in pregnant adolescents.

Few studies have addressed the prevalence of violence among pregnant adolescents. We interviewed 342 pregnant teenagers 17 years of age or younger for a history of assault; 9% reported physical assault, 8% sexual assault, and 8% both physical and sexual assault. Of those physically abused, 40% had been hit during pregnancy. The most common perpetrator of physical assault was a member of their family of origin as compared to a mate (46% versus 33%), although a boyfriend or spouse was the attacker in 80% of cases in which abuse had increased during pregnancy. The face or neck was the most common site of contact. A total of 14% reported being hit in the abdomen, one-third of them while pregnant. We conclude that a significant proportion of pregnant teenagers have experienced violence and therefore should be screened routinely for a history of abuse.     

Prevalence of partner violence in same-sex romantic and sexual relationships in a national sample of adolescents.

PURPOSE: To present the first national prevalence estimates of psychological and physical intimate partner violence between adolescents in same-sex relationships. METHODS: Analyses focus on 117 adolescents aged 12-21 years (50% female) from Wave II of the National Longitudinal Study of Adolescent Health who reported exclusively same-sex romantic or sexual relationships in the 18 months before interview. Items from the Conflict Tactics Scale were used to measure partner violence victimization. Data analysis included computation of prevalence estimates and a logistic regression analysis to assess associations between sociodemographic characteristics and violence victimization. RESULTS: Almost one-quarter of adolescents with same-sex romantic or sexual partners reported some type of partner violence victimization; about 1 in 10 reported physical victimization. Significant sex differences were found (OR = .29, CI = 0.08, 1.00), with males being less likely than females to report "any violence." Of six other sociodemographic characteristics examined, importance of religion (OR = .27, CI = 0.07-1.07) and school size (OR = .32, CI = 0.09-1.11) were associated with victimization at the p < .10 level. Adolescents who reported that religion was important to them and adolescents who attended larger schools were at lower risk of "any violence." CONCLUSIONS: As with opposite-sex relationships, psychological and minor physical violence victimization is common among adolescents involved in same-sex intimate relationships. Males reporting exclusively same-sex relationships were less likely than females to report experiencing the violence behaviors examined.     

How do women in Spain deal with an abusive relationship?

OBJECTIVES: To determine the different responses adopted by women in Spain who are victims of intimate partner violence (IPV); identify the different sociodemographic profiles associated with each response; analyse the factors contributing to adopting a response; and study the association between the different types of response and the different types of IPV. DESIGN: Cross sectional study. SETTING: 23 volunteer general practices in Spain. PARTICIPANTS: 1402 randomly selected women. MAIN OUTCOME MEASURE: Women's response to IPV: none, partner separation, reporting the case to the police, seeking help from healthcare professionals and seeking help from associations for battered women. RESULTS: Lifetime prevalence of any type of IPV (physical, psychological, and/or sexual) was 32%. Sixty three per cent of abused women took some kind of action to overcome IPV. Women who separated from their partners were mostly younger, with a smaller number of children and higher income and educational levels, compared with those abused women who reported the abuse to the police or sought help from healthcare professionals or associations for battered women. Independent factors associated with presenting a response to IPV were: being separated/divorced/widowed, having social support, having experienced IPV frequently, and having experienced physical and psychological abuse (compared with psychological abuse alone). Women who experienced the three types of abuse were also more likely to respond to violence. CONCLUSIONS: Identifying the factors that have an influence on the response adopted by abused women allows us to better understand the support needed by them to abandon an abusive relationship.     

Sexual orientation, sexual abuse, and HIV-risk behaviors among adolescents in the Pacific Northwest

OBJECTIVES: We explored HIV risk behaviors, sexual orientation, and sexual abuse among 5 school-based cohorts in Seattle, Wash (SEA95 and SEA99:N=7477 and N=6590), and British Columbia (BC92, BC98, and BC03 [weighted]: N=239975, N=281576, and N=265132). METHODS: An HIV risk scale of 7 items assessed risky sexual behaviors and injection drug use. Self-identified sexual orientation included heterosexual, bisexual, gay/lesbian, and, in British Columbia only, mostly heterosexual. Analyses of covariance were conducted separately by gender and were adjusted for age and sexual abuse when comparing means. RESULTS: Gay/lesbian and bisexual adolescents had higher mean age-adjusted risk scores compared with heterosexual and mostly heterosexual adolescents. After we controlled for sexual abuse history, mean scores were 2 to 4 times higher among abused students than among nonabused students in each sexual orientation group. Age/abuse-adjusted models better explained the variance in risk scores (R(2)=0.10-0.31), but sexual orientation remained an independent predictor. CONCLUSION: Sexual minority adolescents who attended school reported higher HIV risk behaviors, and higher prevalence of sexual victimization may partially explain these risks.     

Physical dating violence among high school students--United States, 2003

Dating violence is defined as physical, sexual, or psychological violence within a dating relationship. In a study of dating violence victimization among students in grades 7-12 during 1994-1995, the 18-month prevalence of victimization from physical and psychological dating violence was estimated at 12% and 20%, respectively. In addition to the risk for injury and death, victims of dating violence are more likely to engage in risky sexual behavior, unhealthy dieting behaviors, substance use, and suicidal ideation/attempts. Dating violence victimization can be a precursor for intimate partner violence (IPV) victimization in adulthood, most notably among women. Among adult women in the United States, an estimated 5.3 million IPV incidents occur each year, resulting in approximately 2 million injuries and 1,300 deaths. By using data from the 2003 Youth Risk Behavior Survey (YRBS), CDC analyzed the prevalence of physical dating violence (PDV) victimization among high school students and its association with five risk behaviors. The results indicated that 8.9% of students (8.9% of males and 8.8% of females) reported PDV victimization during the 12 months preceding the survey and that students reporting PDV victimization were more likely to engage in four of the five risk behaviors (i.e., sexual intercourse, attempted suicide, episodic heavy drinking, and physical fighting). Primary prevention programs are needed to educate high school students about healthy dating relationship behaviors, and secondary prevention programs should address risk behaviors associated with dating violence victimization.     

Childhood Abuse as a Risk Factor for Adolescent Pregnancy in El Salvador

PURPOSE: To determine whether having been abused as a child increases the risk of adolescent pregnancy in El Salvador and whether intimate partner violence during adolescence affects the association. METHODS: Using data from 3753 women between the ages of 15 and 24 from a nationally representative household health survey of Salvadoran women (FESAL 2002/2003), the association between history of childhood abuse (emotional, physical, or sexual abuse, and witnessing abuse of one's mother) and adolescent pregnancy was explored using multiple logistic regression analyses. The effect of intimate partner violence during adolescence on the relationship was explored among a subgroup of 15-19-year-olds. RESULTS: The risk of adolescent pregnancy was significantly higher among women abused as children. Women who were sexually abused, physically abused, or who experienced any type of abuse had a 48%, 42%, and 31% higher risk, respectively, of adolescent pregnancy than those without a history of abuse, after adjusting for confounding factors. Intimate partner violence during adolescence was also strongly and significantly linked with adolescent pregnancy risk. CONCLUSIONS: This is the first study from a Latin American country to demonstrate a relationship between childhood abuse and adolescent pregnancy. Greater efforts are needed to promote detection of abuse, expand knowledge about sexual and reproductive health, protect vulnerable youth, and to advocate for greater rights and social protections to Salvadoran children and adolescents.     

Child and adolescent sexual abuse history in a sample of 1,490 women sexual partners of injection drug-using men.

Subjects for this study were 1490 community-recruited women sexual partners of injection drug-using men who were interviewed in three U.S. cities during 1990-'92. Data were collected on respondents' childhood and adolescent sexual abuse history, identity of abuse perpetrators and duration of abuse. Over 56 percent of respondents reported a history of sexual victimization by age 18, including 39 percent who were abused before age 12 and over 53 percent who were victimized by abuse involving bodily contact by age 18. One in three women were victimized by unwanted penetration by age 18. White women more likely than African-American and Hispanic women to have been the victims of virtually every type of abusive act investigated here. Overall, nearly two out of three White women had experienced some form of sexual abuse by age 18, including almost 42 percent who were the victims of unwanted penetration by this age. Acts of forced sexual touching and penetration occurring in childhood were most likely to have been carried out by an uncle or other relative of the victim; family members were much less likely to be the perpetrators of adolescent contact abuse. Based on these findings, it appears that many in this special population of women are likely to be at substantial risk for some of the long-term effects of early life sexual abuse, including those that may reduce victims' ability to take preventive action against HIV risk. Recommendations are offered for those who function as caregivers to this population, including drug treatment personnel.     

Teenage pregnancy and associated risk behaviors among sexually abused adolescents

CONTEXT: Previous research suggests a link between adolescent pregnancy and sexual abuse history, but most studies have used clinical samples of females only and single measures of abuse. METHODS: Associations between pregnancy involvement, risk behaviors and sexual abuse were examined in sexually experienced teenagers from the Minnesota Student Surveys of 1992 (N=29,187) and 1998 (N=25,002). Chi-square tests assessed differences in pregnancy involvement and related risk behaviors among four groups of adolescents, categorized by type of abuse experienced: none, incest only, nonfamilial only or both. Odds ratios for pregnancy involvement and risk behaviors, adjusted for grade level and race, were calculated for each gender by using logistic regression analysis. RESULTS: Sexual abuse was reported by 6% of males and 27% of females in 1992, and by 9% and 22% in 1998. Reports of pregnancy involvement were significantly more common among abused adolescents (13-26% of females and 22-61% of males, depending on type of abuse) than among nonabused adolescents (8-10%). Abused adolescents were more likely than others to report risk behaviors, and teenagers reporting both abuse types had the highest odds of pregnancy involvement and risk behaviors. The differential in the odds of pregnancy involvement and most behaviors was larger between nonabused and abused males than between nonabused and abused females. CONCLUSIONS: Teenage pregnancy risk is strongly linked to sexual abuse, especially for males and those who have experienced both incest and nonfamilial abuse. To further reduce the U.S. teenage pregnancy rate, the pregnancy prevention needs of these groups must be adequately addressed.     

Reconceptualizing adolescent sexual behavior: beyond did they or didn't they?

CONTEXT: Adolescent sexual behavior is typically studied as a dichotomy: Adolescents have had sex or they have not. Broadening this view would lead to a greater understanding of teenagers' sexual behavior. METHODS: Interview data from 907 high school students in Alabama, New York and Puerto Rico were used to examine the relationships between sexual experience and a variety of social, psychological and behavioral variables. Four groups of teenagers are compared: those who did not anticipate initiating sex in the next year (delayers), those who anticipated initiating sex in the next year (anticipators), those who had had one sexual partner (singles) and those who had had two or more partners (multiples). RESULTS: Compared with delayers, anticipators reported more alcohol use and marijuana use; poorer psychological health; riskier peer behaviors; and looser ties to family school and church. Similarly, multiples reported more alcohol and marijuana use, riskier peer behaviors and looser ties to family and school than singles. Risk behaviors, peer behaviors, family variables, and school and church involvement showed a linear trend across the four categories of sexual behavior. CONCLUSIONS: The traditional sex-no sex dichotomy obscures differences among sexually inexperienced teenagers and among adolescents who have had sex. Prevention efforts must be tailored to the specific needs of teenagers with differing sexual experiences and expectations, and must address the social and psychological context in which sexual experiences occur.     

性暴力与生殖健康研究

目的:了解未婚人工流产(人流)女青少年中的性暴力发生现状及其对生殖健康的影响。方法:于2002年10月~2003年2月在北京、郑州、深圳、南宁市8所医院对2002名自愿要求人流的未婚女青少年进行了自填式问卷调查和妇科检查以及有关性传播疾病(STDs)的实验室检测。结果:2002名未婚人流女青少年中有282名报告曾遭受了性暴力,其发生率为14·08%。在首次性行为和近1年中曾遭受了性暴力的比例分别为7·99%和8·39%。性暴力施暴者中最常见的是男朋友(76·24%)。在性暴力受害者中,有46·10%的人被证实目前患有STDs(包括滴虫性阴道炎、念珠菌性阴道炎、沙眼衣原体感染、淋病、尖锐湿疣、生殖器疱疹)。性暴力受害者更可能首次性行为年龄<18岁、有多个性伴侣、在月经期有性行为、受教育程度低和有吸烟、饮酒嗜好。单因素分析显示,性暴力受害者中有STDs感染史和目前有STDs感染的比例明显高于无性暴力的女青少年,差异有极显著性(P<0·01);多因素分析表明,性暴力经历、首次性交年龄<18岁、性伴侣数≥2个、不使用避孕方法、父母关系不良是未婚人流女青少年是否感染性传播疾病的预测因子。与未遭受性暴力的女青少年相比,性暴力受害者目前有STDs感染的风险增加了1·3倍。结论:未婚人流女青少年中有较高的性暴力发生率和性传播疾病患病率,对未婚人流女青少年的生殖健康造成了明显的影响。     

Caractéristiques associées à la dépression et aux symptômes de stress post-traumatique chez les femmes victimes d’agression sexuelle durant l’enfance

BackgroundA significant proportion of childhood sexual abuse victims suffer from psychological sequelae in adulthood. Factors that provide a better understanding for the reasons why some victims develop these sequelae remain under-explored. In this context, the main objective is to examine the specific contribution of the contextual characteristics of childhood sexual abuse, multitype childhood maltreatment and adolescent suicide attempts on the development of depression and post-traumatic stress disorder in adulthood among sexually abused women as children. A secondary objective aimed to establish the prevalence of various forms of childhood maltreatment, adult onset post-traumatic stress disorder and depression among those women.MethodsThe sample included 479 women victims of childhood sexual abuse who participated in two separate surveys taken by women in the province of Quebec.ResultsMore than half of these women reported at least one other form of childhood maltreatment, 30% of them presented post-traumatic disorder and 40% suffered from depression in adulthood. Regression analysis indicates that post-traumatic stress disorder was associated with early onset childhood sexual abuse and intergenerational continuity of sexual victimization, as well as childhood physical maltreatment and negligence. Depression was associated with childhood psychological maltreatment and negligence, a non-supportive response following child sexual abuse related disclosure and suicide attempt in adolescence.ConclusionThese results confirm the need to consider the cumulative effects of various childhood adversity factors in the psychosocial assessment of sexually abused women in early life, thus helping to better understand and treat their psychological sequelae.     

Violence involvement, substance use, and sexual activity among Mexican-American and European-American adolescents

PURPOSE: This study examined longitudinal associations between violence involvement, substance use, and sexual activity. METHODS: A total of 302 urban Mexican-American and European-American adolescents were randomly selected and recruited from the membership lists of a large health maintenance organization. Data were obtained from interviews conducted when the mean ages of adolescents were 15, 18, and 19 years. RESULTS: Independent of age, gender, ethnicity, family socioeconomic status, and previous levels of health risk behavior, adolescents who had been victimized by violence at age 15 were more likely to use tobacco at age 19. Adolescents who had been victimized by or perpetrated violence at age 18 had a greater number of sexual partners and were more likely to use marijuana at age 19. In addition, adolescents who had perpetrated violence at age 18 engaged in greater alcohol use at age 19. A second set of analyses showed that independent of demographics and previous violence involvement, adolescents who had used marijuana at age 15 were more likely to report violence involvement at age 19. Adolescents who had used tobacco or who had a greater number of sexual partners at ages 15 or 18 were more likely to report violent victimization at age 19. CONCLUSIONS: Associations between violence involvement and other forms of health risk behavior are bidirectional. Adolescents involved with violence are at risk for increases in substance use and sexual behavior over time. Adolescents who engage in substance use and sexual behavior with multiple partners are also at risk for later violence involvement.     

Sexual abuse as a factor in adolescent pregnancy and child maltreatment.

Two-thirds of a sample of 535 young women from the state of Washington who became pregnant as adolescents had been sexually abused: Fifty-five percent had been molested, 42 percent had been victims of attempted rape and 44 percent had been raped. Compared with adolescent women who became pregnant but had not been abused, sexually victimized teenagers began intercourse a year earlier, were more likely to have used drugs and alcohol and were less likely to practice contraception. The abused adolescents were also more likely to have been hit, slapped or beaten by a partner and to have exchanged sex for money, drugs or a place to stay. Young women in the abused group were also more likely to report that their own children had been abused or had been taken from them by Child Protective Services.     

Prevalence of intimate partner violence and related factors in a local city in Japan

OBJECTIVES: This study sought to assess the prevalence of intimate partner violence in a local city of Fukui Prefecture, and whether the subjects' and their partners' demographic characteristics, alcohol use, and violence experienced in the families in which they were raised might be related risk factors. METHODS: We conducted a mail survey of 1,000 subjects aged 20-69 in the city randomly sampled from the population of 45,220 that were stratified by 10 years of age and sex and pulled 100 from each group. Data from two 248 respondents were eligible for analysis. The self-administered questionnaire included items on; 1) whether they were the victims of physical, sexual, social-economic and psychological violence from their intimate partners, and whether they perpetrated violence or not on their partners; 2) demographic characteristics of the subjects and their partners with information on gender, age, occupation, educational background, annual income, the cohabitants, and their alcohol use; 3) the subjects' experience of violence in the family in which they had grown up; exposure to violence between their parents, and being abused by them. RESULTS: Out of 248 subjects, men accounted for 41.5%. The prevalence rate of any violence experienced from intimate partners was 46.4%, and that of having perpetrated any violence on the partner was 43.1%. Women reported experiencing more "sexual violence" from their partners than did men. In addition, men admitted to more "physical, sexual, and psychological violence" on their partners than women. Those who had themselves been exposed to violence between parents or were victimized by their parents significantly had more experience of violence from their partners and perpetration than those who did not. CONCLUSION: The results suggest that questioning about the experience of violence in the family is useful for the early detection of intimate partner violence.     

Sexual violence and its prevalence among adolescents,Brazil

OBJECTIVE: To assess the prevalence o sexual violence among adolescents of public schools. METHODS: Fifty-two public elementary schools of Porto Alegre, Brazil, were selected through random sampling stratified by school size. An 8th grade class was selected in each school through simple random sampling and all adolescents attending the classes who agreed to participate were included in the study. The Screening Survey of Children's Exposure to Community Violence was used to identify adolescents who were victims, witnesses or knew someone who had been a victim of sexual violence. RESULTS: There were 1,193 adolescents included in the study, representing 10.3% of all students enrolled on 8th grade classes in the city's public schools. Twenty-seven adolescents (2.3%) reported being victims of sexual violence, 54 (4.5%) reported witnessing some episode of sexual violence and 332 (27.9%) reported knowing someone who was a victim of sexual violence. CONCLUSIONS: Exposure to sexual violence in any of the three forms of contact was a common event among the studied adolescents. Studies focusing sexual violence as a broad social phenomenon with multiples associated factors are necessary to support preventive and treatment strategies at the community level.     

The impact of current and past interpersonal violence on women's mental health

Violence against women, and more particularly male partner violence, is frequent. Although there are many studies on the consequences of violence on women's mental health, a number of aspects are still unclear. The impact of violence is seldom studied in the context of other risk factors of mental distress, psychological abuse is rarely considered, and older women are generally excluded from the sample. This study aims to analyze the relationships between current and past violence and three indicators of current women's health--psychological distress, the use of psychoactive drugs and a subjective evaluation of health--controlling for demographic and social characteristics. We conducted a cross-sectional survey among patients of family practices in an Italian town and 444 women responded to a self-administrated questionnaire: 20% of them had experienced some kind of abuse in the last 12 months and 5.2% reported physical or sexual aggression, mostly (4%) inflicted by a partner or ex-partner. Current violence was strongly associated with psychological distress, the use of psychoactive drugs and a negative evaluation of health. Experiencing solely psychological abuse with no sexual or physical violence was also associated with impaired health. The relationship between current violence and health was independent of age. After controlling for age, education, children, marital and employment status, women victims of partner violence were around 6 times more likely to be depressed and to feel in bad health, and 4 times more likely to use psychoactive pills than other women. Moreover, there was a strong association between past and current violence. Compared to women who reported no violence, women who reported both types were 5.95 times, women who reported only current but no past violence were 4.81 times, and women who reported only past but no current violence were 3.01 times more likely to report psychological distress.     

A Systematic Review of Family Victimization Experiences Among Sexual Minority Youth

Sexual minority youth experience substantially higher rates of family victimization than their heterosexual peers. No systematic review has yet identified the predictors and consequences in this vulnerable population of childhood abuse, exposure to sibling abuse and domestic violence, and sibling aggression. This systematic review aims to (a) describe differences in these family victimization rates by sexual orientation, gender, and race/ethnicity; (b) identify potential sexual minority and non-sexual minority-specific risk factors; and (c) identify physical, mental, and behavioral health and extrafamilial victimization correlates. The systematic review, which followed PRISMA guidelines, yielded 32 articles that met study inclusion criteria. Rates of childhood physical, sexual, and emotional abuse were consistently higher for sexual minority youth than for their heterosexual peers. Bisexual youth appear to be at greater risk for physical abuse than their gay and lesbian peers. Younger age at sexual minority milestones (first awareness, disclosure, and same-sex sexual contact) and higher levels of sexual minority-specific (sexuality disclosure, gender non-conformity) and non-sexual minority-specific (delinquent behaviors, parental drinking) risk factors were associated with higher rates of family victimization. Sexual minorities who experienced some form of childhood abuse reported more frequent physical (higher rates of HIV, higher BMIs, lower levels of perceived health), mental (higher rates of depression, PTSD symptoms, experiential avoidance, internalized homophobia), and behavioral (higher rates of suicidality, substance misuse, earlier sexual debut, unprotected anal sex) health problems relative to heterosexual or non-abused sexual minority peers. Sexual minority females who experienced childhood physical or sexual abuse were at greater risk than abused sexual minority males for sexual assault later in life. We conclude this systematic review with recommendations for future research, including the necessity for longitudinal research that utilizes a poly-victimization conceptual framework to identify the developmental pathways connecting risk factors, different types of family victimization, and health and extrafamilial victimization consequences.