Adolescents and Nonsexual Violence

Much professional and public attention has been given to women who are victims of or at risk for sexual violence, including child sexual abuse, date/acquaintance rape, and spousal sexual abuse. Professional and public attention also has been directed to nonsexual violence, especially in adult and adolescent males, both as perpetrators and as victims.

Limited attention has been given to adolescent females and nonsexual violence. Although adolescent females are less often involved in bullying, fighting, weapon carrying, or homicide than adolescent males, many do experience nonsexual violence. In the 2009 Youth Risk Behavior Survey, 23% of female high school students reported being in a physical fight in the past year and 2% of these had injuries requiring medical attention. Five percent said they felt that school was too unsafe to attend and 3% had carried a weapon to school at least once in the past 30 days. Six percent had been threatened or injured with a weapon and 21% had been bullied on school property at least once in the past 12 months. Younger students were more likely to have been in a fight, felt unsafe, or to have carried a weapon than older students. In addition, 1 in 10 high school students report being the victim of physical violence perpetrated by a romantic partner in the past year.

The CDC has identified violence to and by youth as a public health issue. Homicide is the second leading cause of death among adolescents and young adults ages 15 to 24 years. Most violence intervention/prevention strategies are designed for implementation by schools, health departments, community agencies, or coalitions but seldom by individual health professionals. Given the prevalence of violence among youth, most providers are likely to encounter patients who are, have been, or are at risk of becoming involved with violence, as victim and/or as perpetrator.

ACOG Fellows and other health professionals may wish to learn more about the prevalence, manifestations, and consequences of nonsexual violence involving female adoelescents. They may desire guidelines for recognition, managment, and prevention of violence and resources to share with patients and their families. This resource guide lists selected journal articles for professionals, monographs and reports, suggested reading for parents, pamphlets that may be distributed or recommended to adolescents, and websites for additional information. Although resources are included which address physical violence within relationships, this guide does not include resources on date/acquaintance rape or sexual abuse.

The following resources are available from ACOG:

American College of Obstetricians and Gynecologists. Guidelines for women's health care: a resource manual. 3rd ed. Washington, DC: ACOG; 2007.

American College of Obstetricians and Gynecologists. Violence. In: Tool kit for teen care, 2nd ed. Washington, DC: ACOG; 2009.

American College of Obstetricians and Gynecologists. Violence: a fact sheet for parents. In: Tool kit for teen care, 2nd ed. Washington, DC: ACOG; 2009.  

American College of Obstetricians and Gynecologists. Primary and preventive health care for female adolescents. In:

Tool kit for teen care. 2nd ed. Washington, DC: ACOG; 2009.

The resources listed below are for information purposes only. Referral to these sources and sites does not imply the endorsement of ACOG. Further, ACOG does not endorse any commercial products that may be adverstised or available from these organizations or on these web sites. These lists are not meant to be comprehensive. The exclusion of a source or site does not reflect the quality of htat source or site. Please note sites and URLs are subject to change without notice.

REFERENCES FOR PROFESSIONALS

General: Extent and Contributing Factors

Borowsky IW, Ireland M. Predictors of future fight-related injury among adolescents. Pediatrics 2004;113:530-6.

Coyne-Beasley T, Moracco KE, Casteel MJ. Adolescent femicide: a population-based study. Arch Pediatr Adolesc Med 2003;157:355-60.

Cunningham R, Walton M, Trowbridge M, Weber J, Outman R, Benway A, et al. Correlates of violent behavior among adolescents presenting to an urban emergency department. J Pediatr 2006;149:770-6.

Finkelhor D, Turner H, Ormrod R, Hamby SL. Violence, abuse, and crime exposure in a national sample of children and youth. Pediatrics 2009;124:1411-23.

Finkelhor D, Wolak J. Nonsexual assaults to the genitals in the youth population. JAMA 1995;274:1692-7.

Glew GM, Fan MY, Katon W, Rivara FP. Bullying and school safety. J Pediatr 2008;152:123-8, 128.e1.

Hennes H, Calhoun AD, editors. Violence among children and adolescents [special issue]. Pediatr Clin North Am 1998;45(2).

Juvonen J, Graham S, Schuster MA. Bullying among young adolescents: the strong, the weak, and the troubled. Pediatrics 2003;112:1231-7.

Murakami S, Rappaport N, Penn JV. An overview of juveniles and school violence. Psychiatr Clin North Am 2006;29:725-41.

Nansel TR, Overpeck M, Pilla RS, Ruan WJ, Simons-Morton B, Scheidt P. Bullying behaviors among US youth: prevalence and association with psychosocial adjustment. JAMA 2001;285:2094-100.

Nansel TR, Overpeck MD, Haynie DL, Ruan WJ, Scheidt PC. Relationships between bullying and violence among US youth. Arch Pediatr Adolesc Med 2003;157:348-53.

Pratt HD, Greydanus DE. Violence: concepts of its impact on children and youth. Pediatr Clin North Am 2003;50:963-1003.

Pratt HD, Greydanus DE. Adolescent violence: concepts for a new millennium. Adolesc Med 2000;11:103-25.

Rappaport N, Thomas C. Recent research findings on aggressive and violent behavior in youth: implications for clinical assessment and intervention. J Adolesc Health 2004;35:260-77.

Smart RG, Stoduto G, Adlaf EM, Mann RE, Sharpley JM. Road rage victimization among adolescents. J Adolesc Health 2007;41:277-82.

Smith-Khuri E, Iachan R, Scheidt PC, Overpeck MD, Gabhainn SN, Pickett W, et al. A cross-national study of violence-related behaviors in adolescents. Arch Pediatr Adolesc Med 2004;158:539-44.

Soriano FI, Rivera LM, Williams KJ, Daley SP, Reznik VM. Navigating between cultures: the role of culture in youth violence. J Adolesc Health 2004;34:169-76.

Turner HA, Finkelhor D, Ormrod R. Poly-victimization in a national sample of children and youth. Am J Prev Med 2010;38:323-30.

Walton MA, Cunningham RM, Goldstein AL, Chermack ST, Zimmerman MA, Bingham CR, et al. Rates and correlates of violent behaviors among adolescents treated in an urban emergency department. J Adolesc Health 2009;45:77-83.

Wang J, Iannotti RJ, Nansel TR. School bullying among adolescents in the United States: physical, verbal, relational, and cyber. J Adolesc Health 2009;45:368-75.

Consequences of Violence

Berenson AB, Wiemann CM, McCombs S. Exposure to violence and associated health-risk behaviors among adolescent girls. Arch Pediatr Adolesc Med 2001;155:1238-42.

Gini G, Pozzoli T. Association between bullying and psychosomatic problems: a meta-analysis. Pediatrics 2009;123:1059-65.

Kaminski JW, Fang X. Victimization by peers and adolescent suicide in three US samples. J Pediatr 2009;155:683-8.

Molnar BE, Browne A, Cerda M, Buka SL. Violent behavior by girls reporting violent victimization: a prospective study. Arch Pediatr Adolesc Med 2005;159:731-9.

Moskowitz H, Griffith JL, DiScala C, Sege RD. Serious injuries and deaths of adolescent girls resulting from interpersonal violence: characteristics and trends from the United States, 1989-1998. Arch Pediatr Adolesc Med 2001;155:903-8.

Roberts TA, Klein JD, Fisher S. Longitudinal effect of intimate partner abuse on high-risk behavior among adolescents. Arch Pediatr Adolesc Med 2003;157:875-81.

Swahn MH, Simon TR, Hertz MF, Arias I, Bossarte RM, Ross JG, et al. Linking dating violence, peer violence, and suicidal behaviors among high-risk youth. Am J Prev Med 2008;34:30-8.

van der Wal MF, de Wit CA, Hirasing RA. Psychosocial health among young victims and offenders of direct and indirect bullying. Pediatrics 2003;111:1312-7.

Family Violence

Adolescents as victims of family violence. Council on Scientific Affairs, American Medical Association. JAMA 1993;270:1850-6.

Falsetti SA. Screening and responding to family and intimate partner violence in the primary care setting. Prim Care 2007;34:641-57, viii.

Harrington D. Family violence and development during adolescence. Adolesc Med 1995;6:199-206.

Knapp JF, Dowd MD. Family violence: implications for the pediatrician. Pediatr Rev 1998;19:316-21.

Interpersonal Violence

Bair-Merritt MH. Intimate partner violence. Pediatr Rev 2010;31:145-50.

Boris NW, Heller SS, Sheperd T, Zeanah CH. Partner violence among homeless young adults: measurement issues and associations. J Adolesc Health 2002;30:355-63.

Halpern CT, Oslak SG, Young ML, Martin SL, Kupper LL. Partner violence among adolescents in opposite-sex romantic relationships: findings from the National Longitudinal Study of Adolescent Health. Am J Public Health 2001;91:1679-85.

Halpern CT, Spriggs AL, Martin SL, Kupper LL. Patterns of intimate partner violence victimization from adolescence to young adulthood in a nationally representative sample. J Adolesc Health 2009;45:508-16.

Lin AJ, Raymond M, Catallozzi M, Ryan O, Rickert VI. Relationship violence in adolescence. Adolesc Med State Art Rev 2007;18:530-43, viii.

Mollen CJ, Fein JA, Localio AR, Durbin DR. Characterization of interpersonal violence events involving young adolescent girls vs events involving young adolescent boys. Arch Pediatr Adolesc Med 2004;158:545-50.

Russell ST, Franz BT, Driscoll AK. Same-sex romantic attraction and experiences of violence in adolescence. Am J Public Health 2001;91:903-6.

Wolitzky-Taylor KB, Ruggiero KJ, Danielson CK, Resnick HS, Hanson RF, Smith DW, et al. Prevalence and correlates of dating violence in a national sample of adolescents. J Am Acad Child Adolesc Psychiatry 2008;47:755-62.

Prevention and Intervention

Adolescent assault victim needs: a review of issues and a model protocol. American Academy of Pediatrics Task Force on Adolescent Assault Victim Needs. Pediatrics 1996;98:991-1001.

Calles JL Jr. Psychopharmacology for the violent adolescent. Prim Care 2006;33:531-44.

Cheng TL, Schwarz D, Brenner RA, Wright JL, Fields CB, O'Donnell R, et al. Adolescent assault injury: risk and protective factors and locations of contact for intervention. Pediatrics 2003;112:931-8.

Cohen LR, Potter LB. Injuries and violence: risk factors and opportunities for prevention during adolescence. Adolesc Med 1999;10:125-35, vi.

Federal activities addressing violence in schools. Division of Adolescent and School Health, Centers for Disease Control and Prevention. J Sch Health 2000;70:119-61.

Ikeda RM, Farrell AD, Horne AM, Rabiner DL, Tolan PH, Reid J. editors. Prevention of youth violence: the multisite violence prevention project [special issue]. Am J Prev Med 2004;26(1 suppl).

Limbos MA, Chan LS, Warf C, Schneir A, Iverson E, Shekelle P, et al. Effectiveness of interventions to prevent youth violence a systematic review. Am J Prev Med 2007;33:65-74.

Mark GY, Cohen R, Reznik V, Marris P, Hernandez-Cordero LJ, editors. Community mobilization for the prevention of youth violence [special issue]. Am J Prev Med 2008;34(3 suppl).

Menden Anglin T. The medical clinician's roles in preventing adolescent involvement in violence. Adolesc Med 1997;8:501-15.

Molnar BE, Roberts AL, Browne A, Gardener H, Buka SL. What girls need: recommendations for preventing violence among urban girls in the US. Soc Sci Med 2005;60:2191-204.

Mytton JA, DiGuiseppi C, Gough DA, Taylor RS, Logan S. School-based violence prevention programs: systematic review of secondary prevention trials. Arch Pediatr Adolesc Med 2002;156:752-62.

Rickert VI, Davison LL, Breitbart V, Jones K, Palmetto NP, Rottenberg L, et al. A randomized trial of screening for relationship violence in young women. J Adolesc Health 2009;45:163-70.

Spivak H. Violence prevention: a call to action. Pediatrics 1994;94:577-8.

Role of the pediatrician in youth violence prevention. Policy Statement. American Academy of Pediatrics Committee on Injury, Violence, and Poison Prevention. Pediatrics 2009;124:393-402.

Steinberg A, Brooks J, Remtulla T. Youth hate crimes: identification, prevention, and intervention. Am J Psychiatry 2003;160:979-89.

Vreeman RC, Carroll AE. A systematic review of school-based interventions to prevent bullying. Arch Pediatr Adolesc Med 2007;161:78-88.

Weisbrot DM. Prelude to a school shooting? Assessing threatening behaviors in childhood and adolescence. J Am Acad Child Adolesc Psychiatry 2008;47:847-52.

Ybarra ML, Langhinrichsen-Rohling J, Friend J, Diener-West M. Impact of asking sensitive questions about violence to children and adolescents. J Adolesc Health 2009;45:499-507.

Violence and Pregnant Adolescents

Adams JA, East PL. Past physical abuse is significantly correlated with pregnancy as an adolescent. J Pediatr Adolesc Gynecol 1999;12:133-8.

Blinn-Pike L, Berger T, Dixon D, Kuschel D, Kaplan M. Is there a causal link between maltreatment and adolescent pregnancy? A literature review. Perspect Sex Reprod Health 2002;34:68-75.

Covington DL, Justason BJ, Wright LN. Severity, manifestations, and consequences of violence among pregnant adolescents. J Adolesc Health 2001;28:55-61.

Fiscella K, Kitzman HJ, Cole RE, Sidora KJ, Olds D. Does child abuse predict adolescent pregnancy? Pediatrics 1998;101:620-4.

Harrykissoon SD, Rickert VI, Wiemann CM. Prevalence and patterns of intimate partner violence among adolescent mothers during the postpartum period. Arch Pediatr Adolesc Med 2002;156:325-30.

Hillis SD, Anda RF, Dube SR, Felitti VJ, Marchbanks PA, Marks JS. The association between adverse childhood experiences and adolescent pregnancy, long-term psychosocial consequences, and fetal death. Pediatrics 2004;113:320-7.

Parker B, McFarlane J, Soeken K, Torres S, Campbell D. Physical and emotional abuse in pregnancy: a comparison of adult and teenage women. Nurs Res 1993;42:173-8.

*References on media and adolescent violence can be found in the Resource Guide: Children, Adolescents, and the Media on the ACOG website.

BOOKS FOR PROFESSIONALS - Books listed in this resource guide often may be found in university, secondary school, and/or public libraries along with similar books on this topic.

Coloros B. The bully, the bullied, and the bystander: from preschool to high school - how parents and teachers can help break the cycle of violence. New York (NY): HarperResource; 2003.

Espelage DL, Swearer SM, editors. Bullying in American schools: a social-ecological perspective on prevention and intervention. Mahwah (NJ): L. Erlbaum Associates; 2004.

Gellert GA. Confronting violence: answering questions about the epidemic destroying America’s homes and communities. 3rd ed. Washington, DC: American Public Health Association; 2010.

Gullotta TP, McElhaney SJ, editors. Violence in homes and communities: prevention, intervention, and treatment. Thousand Oaks (CA): Sage Publications; 1999.

Hampton RL, editor. Family violence: prevention and treatment. 2nd ed. Thousand Oaks (CA): Sage Publications; 1999.

Hardy KV, Laszloffy TA. Teens who hurt: clinical interventions to break the cycle of adolescent violence.  New York (NY): Guilford Press; 2005.

Kashani JH, Allan WD. The impact of family violence on children and adolescents. Thousand Oaks (CA): Sage Publications; 1998.

Ketterlinus R, editor. Youth violence: interventions for health care providers. Washington, DC: American Public Health Association; 2008.

Lassiter WL, Perry DC. Youth violence, resilience, and rehabilitation. Santa Barbara (CA): Praeger/ABC-CLIO; 2009.

Prothrow-Stith D, Spivak HR. Murder is no accident: understanding and preventing youth violence in America. San Francisco (CA): Jossey-Bass; 2004.

Putallaz M, Bierman KL, editors. Aggression, antisocial behavior, and violence among girls: a developmental perspective. New York (NY): Guilford Press; 2004.

Sexton-Radek K, editor. Violence in schools: issues, consequences, and expressions. Westport (CT): Praeger; 2005.

Thomas RM. Violence in America’s schools: understanding, prevention, and responses. Westport (CT): Praeger;2006.

RESOURCES FOR PROFESSIONALS

American Psychological Association. Violence and the family: report of the American Psychological Association Presidential Task Force on Violence and the Family. Washington, DC: APA; 1996.

Families in the Justice System; 2003. http://www.lfcc.on.ca/Youth_Justice_Handbook.pdf. Retrieved August 9, 2010.

Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Understanding youth violence. Fact sheet. Atlanta (GA): CDC; 2010. Available at: http://www.cdc.gov/ViolencePrevention/pdf/yv-factsheet-a.pdf. Retrieved August 9, 2010.

Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Youth violence. Facts at a glance. Atlanta (GA): CDC; 2010. Available at: http://www.cdc.gov/ViolencePrevention/pdf/yv-datasheet-a.pdf. Retrieved August 9, 2010.

Department of Justice (US), Bureau of Justice Statistics. Intimate partner violence in the United States. Washington, DC: DOJ; 2007. Available at: http://bjs.ojp.usdoj.gov/content/pub/pdf/ipvus.pdf. Retrieved August 9, 2010.

Department of Justice (US), Office of Juvenile Justice and Delinquency Prevention. Blueprints for violence prevention. Juvenile Justice Bulletin. Washington, DC: DOJ; 2001. Available at: http://www.ncjrs.gov/pdffiles1/ojjdp/187079.pdf. Retrieved August 9, 2010. 

Hertz MF, David-Ferdon C. Electronic media and youth violence: a CDC issue brief for educators and caregivers. Atlanta (GA): Centers for Disease Control and Prevention; 2008. Available

at: http://www.cdc.gov/violenceprevention/pdf/EA-brief-a.pdf. Retrieved August 9, 2010. 

In too deep: teens write about gangs. New York (NY): Youth Communication; 2005.

Juvenile bullying [special issue]. Prev Res 2004;11(3).

Leiderman S, Almo C. Interpersonal violence and adolescent pregnancy: prevalence and implications for practice and policy. Washington, DC: Healthy Teen Network; 2006.

National Center for Education in Maternal and Child Health. Adolescent maltreatment: youth as victims of abuse and neglect. Arlington (VA): NCEMCH; 1997.

National television violence study. Thousand Oaks (CA): Sage Publications; 1997.

School-based violence: history, evolution and prevention [special issue]. Prev Forum 1998;19(1).

Sege RD. Adolescent violence. Adolesc Health Update 1999;12(1):1-8.

Thornton TN, Craft CA, Dahlberg LL, Lynch BS, Baer K. Best practices of youth violence prevention: a sourcebook for community action (rev.). Atlanta (GA): Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2002. Available at: http://www.cdc.gov/violenceprevention/pub/YV_bestpractices.html. Retrieved August 9, 2010.

ORGANIZATIONS/WEBSITES FOR PROFESSIONALS

American Academy of Pediatrics
www.aap.org

American Psychological Association
www.apa.org

Centers for Disease Control and Prevention: Injury Prevention and Control: Violence Prevention
www.cdc.gov/ViolencePrevention/index.html

Centers for Disease Control and Prevention: Striving to Reduce Youth Violence Everywhere (STRYVE
www.safeyouth.gov/Pages/Home.aspx

Centre for Children and Families in the Justice System
www.lfcc.on.ca

Center for the Study and Prevention of Violence
www.colorado.edu/cspv

Health Resources and Services Administration: Stop Bullying Now
www.stopbullyingnow.hrsa.gov/kids

Healthy Teen Network
www.healthyteennetwork.org

Integrated Research Services, Inc.: The Prevention Researcher
www.tpronline.org

National Center for Education in Maternal and Child Health
www.ncemch.org

National Coalition Against Domestic Violence
www.ncadv.org

Prevention First
www.prevention.org/Default.asp

U.S. Department of Justice: Bureau of Justice Statistics
www.bjs.ojp.usdoj.gov

U.S. Department of Justice: Office of Juvenile Justice and Delinquency Prevention
http://ojjdp.ncjrs.gov

U.S. Department of Justice: Office on Violence Against Women
www.ovw.usdoj.gov

BOOKS FOR PARENTS AND/OR ADOLESCENTS

Giacabello J. You and violence in your family. New York (NY), Rosen, 2001.

Roberts A. Safe teen. Powerful alternatives to violence. Vancouver (BC), Polestar Press, 2001.

Romain T. Bullies are a pain in the brain. Minneapolis (MN), Free Spirit, 1997.

ORGANIZATIONS/WEBSITES FOR PARENTS AND/OR ADOLESCENTS

American Academy of Child and Adolescent Psychiatry
www.aacap.org           

Facts for Families: No. 13, Children and TV Violence
                                  No. 55, Understanding Violent Behavior in Children and Adolescents  
                                  No. 80, Bullying

American Academy of Pediatrics
www.aap.org

Brochures: Bullying: It’s Not OK
                    Teen Dating Violence: Tips for Parents
                    Expect Respect: Healthy Relationships

ETR Associates
www.etr.org

Pamphlets: Bullying ABCs
                    Bullying: Talking With Your Child
                    Bullying: Teens Talk With Teens
                    Hate Violence; Teens and Bullying
                    Domestic Violence
                    The Cycle of Violence
                    101 Ways to Say NO to Violence
                    Domestic Violence: Getting Out
                    Domestic Violence: Who Is At Risk?
                    Drinking and Violence; FAQs: Partner Violence
                    Dating Violence

Free Spirit Publishing
www.freespirit.com

Journeyworks Publishing
www.journeyworks.com           

Pamphlets: 20 Things You Can Do to Prevent Violence in Your School and Neighborhood
                    Dealing With Conflicts Without Violence
                    Bullying: It Hurts Everyone
                    25 Things Everyone Should Know About Bullying
                    How to Express Anger (Without Hurting Yourself or Others)

Youth Communication
www.youthcomm.org

Contact:

Caitlin Phelps, MA
Director of Gynecology
clinical@acog.org

Lyndona Charles
Special Assistant, Gynecology and Ethics
lcharles@acog.org