TOPIC: Dating violence and interpersonal abuse among middle school and high school students.

PURPOSE: To review the current literature and evaluate the need of conducting further study in order to create early interventions for the prevention of relationship abuse.

SOURCES USED: Case report and review of the literature.

CONCLUSIONS: Dating violence among middle school and high school youth must be addressed by screening risk and offering anticipatory guidance during each health maintenance visit in order to prevent victimization of youth in dating and attraction relationships.

When young adolescents hurt each other within the contexts of attraction and dating, questions emerge concerning the etiology and prevention of such actions. The subject of dating violence among teens has been studied in the literature since 1981 (Makepeace, 1981). The purpose of this work is to present a case report regarding relationship abuse and to review the literature on the subject of dating violence prevention in middle school and high school youth. The case report was generated from a health care maintenance visit conducted at a hospital-based middle school clinic located in the Bronx, New York. The review will examine the problem of relational abuse among young dating adolescents, risk factors, gender differences, and current program strategies for intervention. This paper will also discuss additional strategies to assist teens in the acquisition and carry-over of newly-learned relationship skills as they apply to the development of intimate relationships.

Case Study:

A.M. is a 12-year-old female in a large urban middle school in Bronx, New York. She is currently dating a-14-year-old boy. They have been sexually active for the past 3 months. She reports that she engages in unprotected vaginal intercourse with her boyfriend more than three times per week. This is her first sexual relationship. She is his third partner. A.M. has many risk behaviors including poor choice of nutrition, alcohol use, and avoidance of birth control and safe sex precautions. She recently terminated her first pregnancy and resumed sexual activity 2 days following the procedure. A.M. considers herself a jealous and possessive person. If she senses that her boyfriend is inattentive, or that he is speaking to a person she dislikes, she acts out physically against him. She reports that her anger causes her to hit, scratch or pummel him with her fists. He refuses to retaliate. She reports that she does not like it when he refuses to defend himself. She sees it as a sign of weakness, and is therefore casting her attention toward another potential partner. When asked why she physically strikes out at him, she replies that her anger is relieved when she hits him. She states, "I can't stand it when he doesn't hit me back. I don't respect that. I can't be with a guy I don't respect. The first guy who hits me back, that's the man I'll marry."

Description of the Problem

The case of A.M. illustrates many problems associated with young adolescence including early sexual activity, pregnancy, poor conflict resolution, and disordered thinking relative to planning future intimate relationships. Young adolescents are at risk for many harmful behaviors owing to their sense of increasing independence and peer pressure (Wekerle, 1999). Social immaturity and impulsive behavior set a background against which caustic interpersonal transactions can escalate into abuse or violence. Relational abuse may be described as verbal/emotional or physical aggression that results in psychological or physical harm of the intended victim (Cohall, Cohall, Bannister, & Northridge, 1999).

Verbal/emotional abuse is comprised of the use of words or gestures intended to denigrate, humiliate, or threaten the safety of an individual. Examples of victimization resulting from this psychological aggression include a partner doing the following: making the victim feel jealous, damaging possessions, hurting their feelings, insulting them in front of others, blaming them for the aggression, and bringing something up from the past to hurt them. Physical aggression may involve pushing, shoving, slapping, punching, scratching, biting, hair-pulling, choking, physical restraint, forced sex or the use of a weapon intended to cause bodily harm to another person. (James, West, Deters, & Armijo, 2000). The common thread that underlies the relationship between perpetrator and victim in this regard is fear. Fear is assigned significance within the context of the relationship with the intended function of exerting control over the other person. (Wekerle, 1999; Wolfe & Feiring, 2000). When a person establishes dominance over another, the balance of power is shifted. The dominant partner maintains power by subjugating the other using tactics that intimidate or threaten them. The nondominant partner begins to behave in response to the fear created as he or she tries to avoid unpleasant or harmful outcomes.

Incidence

The literature reports the incidence of dating violence among adolescents to range from 10% to 35% (Bergman, 1992; Henton, Cate, Koval, Lloyd & Christopher, 1983; Avery-Leaf, Cascardi, O'Leary, & Cano, 1997; Foshee, Linder, Bauman, Langwick, & Arriaga, 1996; O'Keefe, 1997; Rybarik, Dosch, Gilmore, & Krajewski, 1995). One report states that verbal aggression and violence have been reduced over a 20-year period from 1976-1996 (Billingham, Bland, & Leary, 1999). Prevalence of perpetration and victimization is equal between the genders (Henton et al., 1983; Symons, Groer, Kepler-Youngblood, & Slater, 1994). Gender differences are found when victimization, perpetration, nonsexual attacks, sexual aggression and degrees of physical violence are taken into account (Foshee, Linder, MacDougall, & Bangdiwala, 2001; Foshee, Bauman, Arriaga, Helms, Koch, & Linder, 1998; Foshee et al., 1996). Most dating violence research has focused on young people of high school through college age (Avery-Leaf et al., 1997; Lavoie, Vezina, Piche & Boivin, 1995; Lonsway, Klaw, Berg, Waldo, Kothari, Mazurek, & Hegeman, 1998; Frazier, Valtinson, & Candel, 1995); and Jaffe, Suderman, Reitzal, & Killip 1992). Contemporary American culture, however has witnessed earlier physical maturation of adolescents, earlier dating behaviors, and earlier romantic/sexual liaisons. The pool of individuals who are engaged in "dating" relationships has not only grown, also, the age of these dating adolescents has shown a steady downward trend (McFee, Turano, & Roberts, 2001).

Background

Domestic violence historically has been studied relative to spousal abuse. Abusive behaviors between unmarried courting couples were first reported in a study by Makepeace in 1981. Since then, studies in the literature have defined behaviors, populations, gender differences, ethnic impact and intervention programs. While the body of literature is growing, the general age range of the experimental or observed group continues to be adolescents of high school age (grades 9-12) (Henton et al., 1983; Bergman, 1992; Avery-Leaf et al., 1997; O'Keefe, 1997; Symons et al., 1994). Early pubarche and coupling in very young adolescents lend focus on the need for the study of and the design of interventions for the younger set of middle school age children in grades 6-8 (Foshee et al., 2001; Krajewski, Rybarik, Dosch, & Gilmore, 1996; Macgowan, 1997; Weisz & Black, 2001).