Adolescent Relationship Abuse

Adolescent Relationship Abuse (ARA) is a significant health concern for adolescents. Adolescent Relationship Abuse (ARA) refers to an escalating pattern of repeated acts that physically, sexually, or emotionally abuse a member of a heterosexual or homosexual couple in which one or both partners is a minor.  Physical and sexual violence victimization by an intimate partner affects an estimated 1 in 4 women across the lifespan,(1) with 1 in 5 adolescent girls reporting such abuse (2). Youth ages 16-24 experience the highest per capita rate of intimate partner violence of any age group – a rate nearly triple the national average (3). Intimate partner violence (IPV) and sexual assault disproportionately impact younger women, (4) and over three quarters of women sexually assaulted indicate that their first such experience occurred before the age of 25 (1, 5). A recent study found that teens 11-14 experience significant levels of abusive behavior in dating relationships, and teens report that abusive behavior increases dramatically in later teen years (6).  Adolescent Relationship Abuse crosses all social and economic classes, ethnicities, cultures, genders, and sexual orientations. Among California’s 11^th grade students, 8.2% report being “hit, slapped or physically hurt on purpose” by their partner in the past twelve months (7).  In teen relationships, abusive behaviors may include sexual and physical violence, as well as a range of other controlling behaviors: monitoring cell phone usage, telling a partner what s/he can wear, controlling where s/he goes, and manipulating contraceptive use. While the dynamics of relationship abuse in teen relationships are often similar to recognized patterns of domestic violence in adult relationships, adolescent relationship abuse has unique characteristics that both confound case identification and create challenges for intervention.

Often, ARA is minimized, as adolescent relationships are not considered “serious,” or violence is considered playful or “age-appropriate” behavior; as a result, adults are not necessarily attuned to the warning signs of abuse. Teen victims of  relationship abuse often lack the independence or the resources to avoid their abuser. For example, teens might not be able to change schools, leave home, or enter a shelter.  Cell phones, texts, and social networking sites are difficult for parents and others to monitor, and many teens may not recognize controlling behaviors such as constant texting as warning signs of abuse.  Health care providers who see adolescents are mandated reporters, and must be familiar with not only minor consent and confidentiality laws, but also how to report abuse in a safe manner that does not increase risk for lethality to the young person.  Knowledge of local victim advocacy agencies and what support they can provide adolescents, is critical before screening and meaningful intervention can take place.

The negative health consequences of adolescent relationship abuse are well documented. Teens in abusive relationships are at risk for long-term adverse consequences to their health:

• Teens in abusive relationships — both victims and perpetrators – have a higher likelihood of being in abusive relationships as adults (8).
• Teens in abusive relationships are 4-10 times more likely to become pregnant than non-abused teens (9).
• Adolescent Relationship Abuse is associated with increased substance abuse, unhealthy weight control behavior, sexual risk behaviors, pregnancy, and suicide (10).

Despite the extent of the adolescent relationship abuse epidemic, few adults in teens’ lives are aware of this problem, and teens are often reluctant to seek support from adults. In a survey of tenth graders, 83% say that they would report abuse to a friend rather than talk to a teacher, counselor, parent, or other caring adult (11).  Likewise, many adults are unprepared to address this issue. With training, however, these barriers can be overcome.

Health care providers are a critical component of any community-based response to violence.  Many at-risk teens routinely access health services – and will likely do so more than they will seek services from law enforcement or even dating violence prevention and intervention services.  Because of this, health care providers are critical to early identification and response to violence.  Qualitative studies indicate that victims support screening for interpersonal violence, and that receiving such screening enables victims to recognize a problem, even if they are not ready for help at that point (12).

Although many teens face barriers to care, teens who seek care in confidential settings report extremely high rates of relationship violence, generally twice that of population-based samples (13).  Thus, the health care setting is a critical site for reaching and influencing the health and safety of teens at-risk for relationship violence. One study of diverse teens in an urban setting suggests that teens would be receptive to healthcare provider’s communicating with them about ARA (14).   Another study suggests that teens had a more positive perception of those providers who discussed sensitive topics such as sexual behavior, conflict in the home, or substance abuse, and were more likely to report taking an active role in any treatment when their provider discussed sensitive topics. Findings such as these indicate that not only are teens responsive to providers who discuss personal and challenging issues, but actually want providers to ask them about difficult issues (15).

Learn More

Data and research are essential tools for raising awareness of adolescent health issues, to plan programs and service delivery, and to formulate policy at the state and local levels.  CAHC is committed to maintaining a website that serves as a gateway to a wide array of resources, and regularly updating our site to include the most up-to-date research.  Direct links are provided when possible, and abstracts are provided for journal articles.

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