Adolescent Dating Violence

Domestic Violence in the home can have a detrimental impact on adolescents.

School age children and adolescents can show:

  • Chronic somatic complaints, depression, and anxiety
  • Increased difficulties with learning and school functioning
  • They are also more likely to commit suicide, abuse drugs and alcohol, run away from home, engage in teenage prostitution, have an undesired pregnancy, contract an STD, and use violence against peers.
  • Many teenage boys commit homicide while protecting their mothers

Assessment
Adolescents should be screened for domestic violence without the parent in the room. They should also be aware that if they are being abused, you will have to report it to Child Protection Services.

Framing Question

  • “Violence is an issue that unfortunately affects many people today, so I started asking all my patients about exposure to violence.
  • "Can I ask you a few questions?”

Direct Questions

  • “ Have you ever been hurt/threatened by someone in your home?”
  • “Do you feel safe in your home?"
  • "How are disagreements handled in your family?”

Disclosing Exposure to Domestic Violence in the Home

If the adolescent discloses abuse:

  • Conduct a complete, unclothed physical exam.
  • Look for signs of previous injuries or sexual assault.
  • Ask about physical or psychological problems that may be associated with the abuse.
  • Talk to the abused parent about the family violence in the household.
  • Follow the guidelines given above about reporting to Child Protection Services, documentation, safety planning, and referrals to domestic violence resources in the community.

All adolescents should be assessed for the presence of dating violence.

  • Approximately one in five female high school students reports being physically and/or sexually abused by a dating partner.
  • In a survey of high school girls, 25% of teen girls who have been in a relationship report they were pressured into performing oral sex or engaging in sexual intercourse.
  • A Harvard School of Public Health study indicated that female teenagers who experienced dating violence are significantly more likely to engage in substance abuse, risky sexual behaviors, and suicide.

 

Control Tactics in Dating Violence

  • Intimidation/Threats
    • Yelling or screaming
    • Threatening to hurt self/partner
    • Making partner feel afraid
    • Constantly threatening to find someone else
  • Sexual Abuse
    • Pressuring partner to have sex
    • Rape
    • Using Drugs/Alcohol for sex
  • Emotional Abuse
    • Putting down partner
    • Name Calling
    • Humiliating partner in front of other people
  • Physical Abuse
    • Hitting, shoving, punching, kicking, grabbing
    • Holding so partner can’t leave
    • Slamming into locker or wall slapping
  • Possessiveness
    • Making all the decisions in the relationship
    • Using jealousy as a sign of love
    • Accusing partner of cheating
    • Not letting partner have other friends
    • Telling partner how to think, dress, act

 

Assessment

  • Framing Questions
    • “Many teens your age experience threats, name calling, physical and sexual abuse in their dating relationships, so I now ask all my teen patients about it.
    • May I ask you a few questions?”
  • Direct Questions
    • “Have you been hit, kicked, punched, or otherwise hurt by someone you are dating or have dated?“
    • “Have you ever been forced to have sex when you did not want to?”
    • “Are you scared of the person you are involved with?”

 

If Dating Violence is Disclosed

  • Communicate Concern: Let the teen know that violence is not an acceptable part of any relationship.
  • Educate patient about how violence can escalate over time and result in severe physical harm or rape.
  • Complete a detailed history of the abuse and medical or psychological problems resulting from the abuse
  • Complete a complete physical exam and document evidence of injuries and sexual abuse.
  • Encourage the patient to talk to parents or counselor about the abuse. If the violence is severe, inform the patient that you may need to inform parents or state protective services.
  • Offer to work out a safety plan with the patient.
  • Review and refer services in the community that are available to adolescents dealing with dating violence, family violence, or sexual assault.