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Date Violence Common For Adolescent Girls

Related to drug use, pregnancy, suicide

TUESDAY, July 31, 2001 (HealthDayNews) -- One of every five adolescent girls has been abused physically or sexually by a dating partner, and that abuse is associated with drug use, risky sexual behavior, unwanted pregnancy and suicide attempts, a new study finds.

The violence appears to cause those problems rather than being a result of them, says Jay G. Silverman, assistant professor of health and social behavior at the Harvard School of Public Health and leader of the study, which appears in the Aug. 1 issue of the Journal of the American Medical Association.

The clearest link is between violence and teen pregnancy, says Silverman, who is also director of violence prevention programs at the school. Adolescent girls subjected to violence by dating partners are four to six times more likely to become pregnant, the study finds.

"Within an abuse relationship, inherent fear is created on the part of the victim by coercion on the part of the perpetrator," he says. There is fear about discussing the use of condoms and other methods to prevent pregnancy, he says, and "it makes sense that that conduct makes the girl more vulnerable to becoming pregnant."

While cause-and-effect evidence is less clear about other problems, Silverman says, "Women who experience violence are less likely to have a high value of their health and themselves. This study can be seen as establishing a preliminary association. From these data, we need to go much more in depth to establish a causal relationship."

In what he says is the largest study of its kind, Silverman and his colleagues used data from two studies of more than 2,000 girls in grades 9 through 12 in 1997 and 1999. They found that 20.2 percent of the girls in the 1997 study and 18 percent of those in the 1999 study reported physical or sexual abuse, or both, by someone they dated.

"There was no evidence, especially among adolescents, that certain economic or racial or ethnic groups are at greater risk. We saw the same numbers across all the categories we looked at," Silverman says.

The abused high school girls were eight to nine times more likely to attempt suicide than their non-abused classmates, the researchers say. The girls also were more likely to be sexually active before age 15, to have multiple sexual partners, to smoke heavily, to use cocaine, to engage in binge drinking and to try risky weight control measures, such as using diet pills and laxatives.

The high incidence of dating violence calls for more vigilance by doctors and other healthcare professionals to screen adolescents for signs of abuse and to refer them for professional help, the report says.

Silverman says, "There is nothing in our data about preventive measures, but from other studies and what we know of the problem, we need to be focusing on the behavior of young men. Dating violence is a way of controlling young women. Violence is a learned behavior. We need to work with young men."

Some social factors appear to be associated with violent behavior of young men, including a family history of violence and exposure to media violence, Silverman says.

"But we know very little about how these factors interact with other characteristics of young men. There is a great need for rigorous longitudinal research to understand the development of violent behavior and to gain knowledge about how to interrupt its development," he says.

What To Do

Even before more research is done, Silverman says, "All adults should be doing something. Pediatricians should be routinely screening their patients for violence. On a broader level, people in schools and others working with youths should be aware of the high prevalence of the problem." As for parents, he says, "Adolescence is a difficult time for parent-child communication. Parents need to maintain a level of trust and to be observant when there are changes in a child's behavior that coincide with involvement in an intimate relationship."

Basic information about date violence is offered by the National Center for Injury Prevention and Control. And for more on youth violence in general, try the U.S. Department of Justice.

SOURCES: Interview with Jay G. Silverman, assistant professor of health and social behavior, Harvard School of Public Health, Boston; Aug. 1, 2001 Journal of the American Medical Association
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