Dating violence among teenagers is common, and a new study, the largest on this issue to date, suggests that ED staff should screen all patients in this at-risk population. According to the survey study, nearly one in six adolescents seeking care in the ED reported being a victim or perpetrator of dating violence, which is distinct from intimate partner violence because of the shorter-term nature of dating and relationships among youths and young adults. Identifying dating violence in youths could help to prevent future violence, especially intimate partner violence.

Figure. His 18-year-old daughter's death at the hands of an ex-boyfriend prompted Malcolm Astley to push for classroom education on dating violence. Photo by Charlie Mahoney / Prime.

Both sexes are at risk. The 4,089 participants, who ranged in age from 14 to 20 years, filled out a confidential 20-minute survey on a touch-screen computer in the ED. One in five female adolescents and one in eight male adolescents screened reported being either a victim or perpetrator of dating violence in the previous year. Acts reported included throwing objects, hitting, kicking, punching, shoving, shaking, slapping, and hair pulling. A history of alcohol or drug use, or depression, raised the risk of having experienced dating violence.

Female respondents were more likely to be perpetrators and less likely to be victims than male respondents. However, the study addressed only nonsexual physical violence (and not sexual or emotional violence); also, the severity of injuries could not be assessed. Any past visit to the ED for intentionally inflicted injuries raised the risk of experiencing dating violence (either as a victim or an aggressor), particularly among female patients. Young women with injuries especially should be asked whether the injuries were the result of dating violence.

ED staff should ask, "How did you get that injury?" says lead author Vijay Singh, clinical lecturer in the Department of Family Medicine at the University of Michigan in Ann Arbor. Unfortunately, victims often don't want to disclose that information, even when doing so could be an opportunity to break the cycle of violence. However, he says, "It may take repeated questioning in a sensitive way to find out more." Screening teens for dating violence "could help us understand whom to target for screening and refer them to programs that could help them. Intervening with adolescents experiencing dating violence is crucial to prevent adult intimate partner violence," says Singh.

Also, as Singh points out, "Nurses play a central role in the identification of and response to dating violence. They often administer screening questions to identify [victims of] teen dating or adult intimate partner violence." He recommends telling at-risk adolescents about the teen-focused Web site Love is Respect (http://www.loveisrespect.org or [866] 331-9474) or the National Domestic Violence Hotline (http://www.ndvh.org or [800] 799-7233 [SAFE]), which is also available in Spanish.-Carol Potera

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