Emily F. Rothman

Longitudinal Associations Between Teen Dating Violence Victimization and Adverse Health Outcomes

OBJECTIVE: To determine the longitudinal association between teen dating violence victimization and selected adverse health outcomes. METHODS: Secondary analysis of Waves 1 (1994–1995), 2 (1996), and 3 (2001–2002) of the National Longitudinal Study of Adolescent Health, a nationally representative sample of US high schools and middle schools. Participants were 5681 12- to 18-year-old adolescents who reported heterosexual dating experiences at Wave 2. These participants were followed-up ∼5 years later (Wave 3) when they were aged 18 to 25. Physical and psychological dating violence victimization was assessed at Wave 2. Outcome measures were reported at Wave 3, and included depressive symptomatology, self-esteem, antisocial behaviors, sexual risk behaviors, extreme weight control behaviors, suicidal ideation and attempt, substance use (smoking, heavy episodic drinking, marijuana, other drugs), and adult intimate partner violence (IPV) victimization. Data were analyzed by using multivariate linear and logistic regression models. RESULTS: Compared with participants reporting no teen dating violence victimization at Wave 2, female participants experiencing victimization reported increased heavy episodic drinking, depressive symptomatology, suicidal ideation, smoking, and IPV victimization at Wave 3, whereas male participants experiencing victimization reported increased antisocial behaviors, suicidal ideation, marijuana use, and IPV victimization at Wave 3, controlling for sociodemographics, child maltreatment, and pubertal status. CONCLUSIONS: The results from the present analyses suggest that dating violence experienced during adolescence is related to adverse health outcomes in young adulthood. Findings from this study emphasize the importance of screening and offering secondary prevention programs to both male and female victims.

The prevalence of sexual assault against people who identify as gay, lesbian, or bisexual in the United States: a systematic review.

This article systematically reviews 75 studies that examine the prevalence of sexual assault victimization among gay or bisexual (GB) men, and lesbian or bisexual (LB) women, in the United States. All studies were published between 1989 and 2009 and report the results of quantitative research. The authors reviewed the reported prevalence of lifetime sexual assault victimization (LSA), and where available, childhood sexual assault (CSA), adult sexual assault (ASA), intimate partner sexual assault (IPSA), and hate crime-related sexual assault (HC). The studies were grouped into those that used a probability or census sampling technique (n = 25) and those that used a non-probability or ‘‘community-based’’ sampling technique (n = 50). A total of 139,635 gay, lesbian, and bisexual (GLB) respondents participated in the underlying studies reviewed. Prevalence estimates of LSA ranged from 15.6-85.0% for LB women and 11.8—54.0% for GB men. Considering the median estimates derived from the collective set of studies reviewed, LB women were more likely to report CSA, ASA, LSA, and IPSA than GB men, whereas GB men were more likely to report HC than LB women. Across all studies, the highest estimates reported were for LSA of LB women (85.0%), CSA of LB women (76.0%), and CSA of GB men (59.2%). With some exceptions, studies using non-probability samples reported higher sexual assault prevalence rates than did population-based or census sample studies. The challenges of assessing sexual assault victimization with GLB populations are discussed, as well as the implications for practice, policy, and future research.

Beyond correlates: a review of risk and protective factors for adolescent dating violence perpetration.

Dating violence is a serious public health problem. In recent years, the U.S. Centers for Disease Control and Prevention and other entities have made funding available to community based agencies for dating violence prevention. Practitioners who are tasked with developing dating violence prevention strategies should pay particular attention to risk and protective factors for dating violence perpetration that have been established in longitudinal studies. This has been challenging to date because the scientific literature on the etiology of dating violence is somewhat limited, and because there have been no comprehensive reviews of the literature that clearly distinguish correlates of dating violence perpetration from risk or protective factors that have been established through longitudinal research. This is problematic because prevention programs may then target factors that are merely correlated with dating violence perpetration, and have no causal influence, which could potentially limit the effectiveness of the programs. In this article, we review the literature on risk and protective factors for adolescent dating violence perpetration and highlight those factors for which temporal precedence has been established by one or more studies. This review is intended as a guide for researchers and practitioners as they formulate prevention programs. We reviewed articles published between 2000 and 2010 that reported on adolescent dating violence perpetration using samples from the United States or Canada. In total, 53 risk factors and six protective factors were identified from 20 studies. Next steps for etiological research in adolescent dating violence are discussed, as well as future directions for prevention program developers.

The effect of a college sexual assault prevention program on first-year students' victimization rates

Objective: Although a variety of sexual assault prevention programs are currently available to college health professionals, there is a dearth of information about the effect of these programs on sexual assault victimization rates. Participants: The authors evaluated the efficacy of a sexual assault prevention program for first-year students at a college in the Northeast (N = 1,982). Methods: They used a retrospective cohort design and assessed the prevalence of sexual assault victimization among students exposed to the sexual assault prevention program and students 1 year their senior who were not exposed. Results: Students who had no exposure were more likely to report that they were sexually assaulted during their first year of college (odds ratio = 1.74, 95% confidence interval [1.32-2.29]). Results suggest that the program was effective for males and females, but not for students with a prior history of sexual assault victimization. Gay, lesbian, and bisexual students were at increased risk for victimization as compared with heterosexual students, and students who drank alcohol or engaged in binge drinking were at increased risk as compared with alcohol abstinent students. Conclusions: Findings suggest that this program had a positive effect on victimization rates for certain sub-groups of students.

Parents’ Supportive Reactions to Sexual Orientation Disclosure Associated With Better Health: Results From a Population-Based Survey of LGB Adults in Massachusetts

This study investigated associations between coming out to parents, experiences of parental support, and self-reported health behaviors and conditions among a population-based sample of LGB individuals using data collected via the 2002 Massachusetts Behavioral Risk Factor Surveillance System (BRFSS; N = 177). We explored the following two hypotheses: 1) Lesbian, gay, and bisexual (LGB) individuals who had never disclosed their sexual orientation to a parent would report higher levels of risk behaviors and poorer health conditions than those who had come out; and 2) among LGB respondents who had come out to their parents, the individuals whose parents had reacted unsupportively would report higher levels of risk behaviors and poorer health conditions than those who had come out to parents who were supportive. Approximately two thirds of gay and bisexual (GB) males and lesbian and bisexual (LB) females reported receiving adequate social and emotional support from the parent to whom they first disclosed their sexual orientation. Among LB females, no disclosure of sexual orientation to a parent was associated with significantly elevated levels of past-month illicit drug use (AOR 12.16, 95% CI 2.87–51.54), fair or poor self-reported health status (AOR 5.71, 95% CI 1.45–22.51), and >15 days of depression in the past month (AOR 5.95, 95% CI 1.78–19.90), controlling for potential confounders. However, nondisclosure to a parent by GB males was not associated with greater odds of any of the health indicators assessed. Among GB males, those with unsupportive parents were significantly more likely to report current binge drinking (AOR 6.94, 95% CI 1.70–28.35) and >15 days depression in the past month (AOR 6.08, 95% CI 1.15–32.15), and among LB females, those with unsupportive parents were significantly more likely to report lifetime illicit drug use (AOR 11.43, 95% CI 2.50–52.30), and >15 days depression in the past month (AOR 5.51, 95% CI 1.36–22.36). We conclude that coming out may be associated with better health for LB women, and that parents who react nonsupportively when their children disclose LGB sexual orientation may contribute to childrens increased odds of depression and hazardous substance use.

Childhood Abuse and Early Menarche: Findings From the Black Women's Health Study

OBJECTIVES We examined the association between childhood abuse and early menarche in a sample of US Black women. METHODS We conducted multivariable log-binomial regression on data from 35 330 participants in the Black Womens Health Study to estimate risk ratios and 95% confidence intervals for the relation of childhood physical and sexual abuse with early age at menarche (i.e., < 12 years). RESULTS In adjusted analyses, sexual abuse was positively associated with early menarche, and the risk of early menarche increased with increasing frequency of sexual abuse incidents. We observed a weak but statistically significant association between physical abuse and early menarche. Associations between sexual abuse and early menarche were stronger when we used a more stringent cutpoint for early menarche (i.e., < 11 years). CONCLUSIONS Our data suggest an increased risk of early menarche among Black women who experienced childhood sexual abuse. Evidence for an association between childhood physical abuse and early menarche was equivocal.

Past 15-year trends in adolescent marijuana use: Differences by race/ethnicity and sex

BACKGROUND The potential for increases in adolescent marijuana use is an important concern given recent changes in marijuana policy. The purpose of this study was to estimate trends in marijuana use from 1999 to 2013 among a national sample of US high school students. We examine changes over time by race/ethnicity and sex. METHODS Data are from the National Youth Risk Behavior Survey (YRBS), which involves biennial, school-based surveys that generate nationally representative data about 9th-12th grade students in the United States. Students self-reported sex, race/ethnicity, and marijuana use (i.e., lifetime use, past 30-day use, any use before age 13). We generated national estimates of the prevalence of marijuana use for the time period, and also tested for linear and quadratic trends (n=115,379). RESULTS The prevalence of lifetime marijuana use decreased modestly from 1999 to 2009 (44% to 37%), and has increased slightly since 2009 (41%). Other marijuana use variables (e.g., past 30-day use) followed a similar pattern over time. The prevalence of past 30-day use from 1999 to 2013 for all groups and both sexes was 22.5%, and it was lowest among Asians and highest among American Indian/Alaska Natives. Although boys have historically had a higher prevalence of marijuana use, results indicate that male-female differences in marijuana use decreased over time. CONCLUSION Despite considerable changes in state marijuana policies over the past 15 years, marijuana use among high school students has largely declined. Continued surveillance is needed to assess the impact of policy changes on adolescent marijuana use.

Perpetration of Physical Assault Against Dating Partners, Peers, and Siblings Among a Locally Representative Sample of High School Students in Boston, Massachusetts

OBJECTIVES To assess the co-occurrence of past-month physical assault of a dating partner and violence against peers and siblings among a locally representative sample of high school students and to explore correlates of dating violence (DV) perpetration. DESIGN Cross-sectional survey design. SETTING Twenty-two public high schools in Boston, Massachusetts. PARTICIPANTS A sample of urban high school students (n = 1398) who participated in the Boston Youth Survey, implemented January through April of 2008. MAIN OUTCOMES MEASURES Self-reported physical DV in the month before the survey, defined as pushing, shoving, slapping, hitting, punching, kicking, or choking a dating partner 1 or more times. RESULTS Among the respondents, 18.7%, 41.2%, and 31.2% of students reported past-month perpetration of physical DV, peer violence, and sibling violence, respectively. Among violence perpetrators, the perpetration of DV only was rare (7.9%). Controlling for age and school, the association between sibling violence and DV was strong for boys (adjusted prevalence ratio, 3.81; 95% confidence interval, 2.07-6.99) and for girls (1.83; 1.44-2.31), and the association between peer violence and DV perpetration was strong for boys (5.13; 3.15-8.35) and for girls (2.57; 1.87-3.52). Dating violence perpetration was also associated with substance use, knife carrying, delinquency, and exposure to community violence. CONCLUSIONS Adolescents who perpetrated physical DV were also likely to have perpetrated peer and/or sibling violence. Dating violence is likely one of many co-occurring adolescent problem behaviors, including sibling and peer violence perpetration, substance use, weapon carrying, and academic problems.

Neighborhood-Level Factors Associated with Physical Dating Violence Perpetration: Results of a Representative Survey Conducted in Boston, MA

Neighborhood-level characteristics have been found to be associated with different forms of interpersonal violence, but studies of the relationship between these characteristics and adolescent dating violence are limited. We examined 6 neighborhood-level factors in relation to adolescent physical dating violence perpetration using both adolescent and adult assessments of neighborhood characteristics, each of which was aggregated across respondents to the neighborhood level. Data came from an in-school survey of 1,530 public high school students and a random-digit-dial telephone survey of 1,710 adult residents of 38 neighborhoods in Boston. Approximately 14.3% of the youth sample reported one or more acts of physical aggression toward a dating partner in the month preceding the survey. We calculated the odds of past-month physical dating violence by each neighborhood-level factor, adjusting for school clustering, gender, race, and nativity. In our first 6 models, we used the adolescent assessment of neighborhood factors and then repeated our procedures using the adult assessment data. Using the adolescent assessment data, lower collective efficacy (AOR = 1.95, 95% CI = 1.09–3.52), lower social control (AOR = 1.92, 95% CI = 1.07–3.43), and neighborhood disorder (AOR = 1.19, 95% CI = 1.05–1.35) were each associated with increased likelihood of physical dating violence perpetration. However, when we used the adult version of the neighborhood assessment data, no neighborhood factor predicted dating violence. The implications and limitations of these findings are discussed.

Social and Environmental Contexts of Adolescent and Young Adult Male Perpetrators of Intimate Partner Violence: A Qualitative Study

The purpose of the current study was to examine qualitatively the life contexts of young males enrolled in programs addressing perpetration of intimate partner violence (IPV). Semistructured interviews were conducted with 19 males recruited from these programs. Interviews were coded to examine life contexts and analyzed using a content analysis approach. Five themes emerged across interviews: (a) disruptive home environment; (b) lack of positive male role models; (c) a peer context characterized by substance use, gang involvement, and behaviors supporting the sexual maltreatment of girls; (d) school circumstances characterized by a lack of academic support; and (e) community exposures to violence. These factors were often interrelated within the various contexts of participants. Further research is needed to provide insight into whether and how these issues may contribute to IPV perpetration. Efforts to support young males regarding a broad array of concerns should be included in programming to reduce IPV perpetration.