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Harvard Public Health Review/Summer 2002

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Dangerous Liaisons

Teenage girls today seem more in charge and confident than ever, striding down the street pierced, tattooed, and provocatively dressed like their older sisters, clutching cell phones and cigarettes, and ever quick with a comeback for the weary parent or teacher. Yet findings from a recent Harvard School of Public Health study indicate that the image of teenage "girl power" may be far from accurate. One in five girls between the ages of 14 and 18 report being hit, slapped, or forced into sexual activity by their dating partners, according to the research led by Jay Silverman, director of Violence Prevention Programs at the School's Division of Public Health Practice and assistant professor of health and social behavior.

"We saw relatively high levels of dating violence in all ethnic and racial groups we looked at," says Silverman. The study, published in the Journal of the American Medical Association, summarized results from 4,163 girls across Massachusetts who participated in the 1997 and 1999 Massachusetts Youth Risk Behavior Surveys. In both years, almost 75 percent of the participating students were white, with smaller percentages of Hispanic, black, and Asian students. "The temptation of many is to assume there is profile of those who are truly at risk--that it won't happen at my school because it doesn't happen to these kinds of kids. This kind of thinking is a tremendous mistake and disservice," he emphasizes. Silverman considers dating violence a huge public health problem because of the high prevalence rates and the broad array of associated health risks found in the study. "Girls who experience dating violence are also more likely to become pregnant, smoke heavily, abuse alcohol and other substances, use laxatives and vomiting for weight loss--and they are more vulnerable to suicide," he explains.

And what about their boyfriends? Male adolescents often repeat violent behaviors they see modeled at home and are encouraged by friends who are also abusive, says Silverman. He explains teenage dating violence in the context of the broader culture of the United States, where more than 1.5 million women are physically and/or sexually abused by an intimate partner each year and 25 percent of all women experience violence from their partners at some point during their lifetimes. "We've seen lots of other types of crime go down, but when you look in the literature, one of the few areas to remain stable is violence against women," he notes. In a culture that accepts these rates of gender-based violence, it is not surprising that boys feel entitled to control their girlfriends. As Silverman illustrates: "A jealous or angry teenage boy may think, 'She has no right to do that--I'm the man and have the right to stop her.'"

Understanding that gender-based violence is different than other types of violence is critical in structuring prevention programs for teenagers, says Silverman. He advocates training adults who work with teenagers, including teachers and pediatricians, to identify girls who may be in abusive relationships and directing them to prompt, confidential help. But, he is quick to add, "We must hold boys accountable for their behavior. While girls should receive as much information and support as possible, it's not reasonable to assume that the way to prevent dating violence is for girls to have an amazing system to detect potentially violent dating partners--abusive behavior is often not evident in the initial stages of a relationship." Silverman recommends additional research to better understand and redirect boys who abuse their girlfriends. He notes that Massachusetts has begun to set up pilot programs to work with abusive teenage boys--the only state to fund these kinds of initiatives: "We're beginning to look at boys referred from youth services, the criminal justice system, and the Department of Social Services--but this is just the tip of the iceberg of those who perpetrate these behaviors."

Gabriele Amersbach

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