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Dating violence is a serious public health problem. In recent years, the U.S. Centers for Disease Control and Prevention (CDC) 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 2000–2010 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.
Adolescent dating violence is a relatively new area of public health inquiry. The first published studies appeared in the 1980s (e.g., Makepeace, 1981). In the early 2000s, national estimates of the prevalence of physical dating violence victimization among U.S. high school-attending youth were first made available; these ranged from 9–10% for both males and females. Given the potential for severe sequelae, including injury, death, and mental health problems, (Campbell, 2002; Ackard, Eisenberg, and Neumark-Sztainer, 2007; Johnson, Yanda, andde Vise, 2010; Wiklund, Malmgren-Olsson, Bengs, and Ohman, 2010), and an emerging focus on primary prevention, the issue of dating violence has moved to the forefront of public health injury control efforts. Over the past decade and through initiation of the CDC DELTA initiative (Domestic Violence Prevention Enhancement and Leadership Through Alliances; Martin, Coyne-Beasley, Hoehn, et al. 2009; CDC, 2012), there has been a surge of interest in the development of primary prevention strategies to curb it.
Unfortunately, progress in the area of dating violence prevention has been hampered in part because of confusion about the state of the science on factors that contribute to dating violence perpetration. In their 2001 review of correlates of dating violence, Lewis and Fremouw concluded that in the future “scientists will be more able to conduct prospective research and consider causal variables [for dating violence perpetration], reducing their reliance on correlational, cross-sectional methods of investigation. This will allow for more direct and cost-effective primary preventive strategies, resulting in more efficacious treatment” (Lewis and Fremouw, 2001, pg 124). At that time, no longitudinal studies of dating abuse had been published, and so the Lewis and Fremouw literature review was limited to cross-sectional studies. While the review identified several potentially causal factors for dating violence perpetration, such as witnessing interparental violence, experiencing child abuse, and attitudes about aggression, the authors correctly noted that no causal inferences could be made from the underlying studies that were available. The lack of longitudinal data about risk and protective factors for dating violence perpetration led to problems for practitioners who were tasked with designing prevention programs in the next decade. As Lewis and Fremouw predicted, practitioners had to design prevention programs to target correlates of dating violence, since superior information about potentially causal factors was unavailable. Today, we are fortunate to have the results of multiple longitudinal research studies about dating violence perpetration upon which to draw, although to date these results have not been reviewed. Therefore, our goal in undertaking the present review was to cull from the relatively large body of research about dating violence a comprehensive list of factors that have been found—by at least one study—to predict dating violence perpetration and to have preceded it temporally. We have been catholic and uncritical in our inclusion of factors, because our goal is to offer the field a base of information which can be used to shape future empirical investigations.
There are different schools of thought about what criteria must be met for an exposure to be considered a likely causal factor (Rothman, 2012). The most widely known list of criteria is Hill’s Criteria of Causation, which suggests that features such as the strength of an association, its consistency, specificity, plausibility, gradient (or dose-response relationship), coherence with existing evidence, and the temporal relationship with the outcome be considered. Of these, temporal order is arguably the most convincing of a potential causal relationship, yet there have been relatively few studies of adolescent dating violence that have established temporality. Although temporal order alone is insufficient to prove causality, those factors that are associated positively with dating violence perpetration and precede it represent the best available targets for prevention programs presently. For this reason, we have conducted a comprehensive review of the longitudinal etiological research on dating violence perpetration. For this review, we considered temporal precedence to be established when the authors provided information about an exposure (or predictor variable) which took place at time point prior to the outcome (i.e., dating abuse).
For the purposes of this review, we define adolescent dating violence as a form of intimate partner violence that occurs between people who are 10–24 years old (herein referred to as adolescents) who are current or former dating partners. Although youth ages 10–24 years old are diverse developmentally, this age range is appropriate to consider if our interest is in adolescent dating abuse, because it includes the periods of early, middle, and late adolescence (Gutgesell and Payne, 2004). Because modern adolescent relationships can be amorphous (Furman and Hand, 2006; Noonan and Charles, 2009), a myriad of relationship types can be considered dating relationships (e.g., “hooking up,” “going with,” “friends with benefits”). Aggression in dating relationships also can take different forms: physical, emotional (sometimes referred to as psychological), or sexual. Physical violence includes acts such as intentionally scratching, hitting, shoving, choking, or kicking a partner; emotional or psychological violence involves threatening a partner or harming his or her sense of self-worth, name calling, shaming, embarrassing on purpose, or keeping him/her away from friends and family; and sexual violence includes coercing or forcing a partner to engage in a sex act when he or she does not or cannot consent (Saltzman, Fanslow, McMahon, and Shelley, 2002). Stalking behaviors towards a partner, whether in person or carried out through an electronic medium (e.g., repeated texting, posting denigrating information or photos on social networking sites), are considered forms of dating violence as well. Thus, defining adolescent dating violence is complex because each component (adolescent, dating, and violence) is identified by a wide variety of characteristics.
The goal of the current review was to produce a comprehensive list of risk and protective factors for adolescent dating violence perpetration, culled from studies that established temporal order, which can be used to inform prevention strategies. We defined risk factors as those variables: that were reported more frequently among individuals who perpetrated dating violence than those who did not (Gutman, Sameroff, and Eccles, 2002); and for which there was evidence that the exposure occurred prior to the outcome (i.e., temporal order was established, meaning that the predictor variables were measured at Time 1 and the outcome (i.e., adolescent dating violence) was measured at Time 2. Similarly, we defined protective factors as those that were both directly associated with less dating violence perpetration and for which there was evidence that the exposure (measured at Time 1) preceded the outcome (measured at Time 2). We accepted any definition of dating violence that underlying studies used, and also included two studies identified (Connolly, Friedlander, Pepler, Craig, and Laporte, 2010; Wolfe, Wekerle, Scott, Straatman, & Grasley, 2004) where the outcome dating violence reflected the presence of either perpetration or victimization or both (i.e., bidirectional dating violence).
Two electronic literature searches were conducted in early 2011 using PsycINFO (American Psychological Association, Washington DC) and PubMed (US National Library of Medicine, National Institutes of Health, Bethesda, Maryland). Studies were included in this review if they were published between 2000–2010, the mean age of the sample was between 10 and 24 years old at outcome, the outcome was dating violence perpetration, and the study identified risk or protective factors that preceded this outcome temporally. Studies published in languages other than English, or where the sample was not from the U.S. or Canada, were excluded. The rationale for limiting our search to publications printed between 2000–2010 was that there was an absence of research studies on longitudinally identified risk factors prior to the year 2000.
We used the following search terms in PsycINFO: adolescent or teenage or teen or youth or college or young adult AND violence or abuse or aggression or perpetration AND dating or relationship or partner. This search resulted in 810 articles. We also searched PubMed, using combinations of The National Library of Medicine’s Medical Subject Headings (MeSH) (adolescent and violence) and general terms (teen, youth, dating, relationship, risk factors, protective factors, predictors, perpetration, aggression, and longitudinal). These searches resulted in 356 articles. Of the articles identified from the searches in PsycINFO and PubMed (of which there was overlap), 20 met the criteria for inclusion in this review. Common reasons for exclusion were that the study did not examine risk/protective factors of adolescent dating violence (e.g., descriptive studies, reviews), were not longitudinal, and focused on victimization instead of perpetration. Studies were also excluded if the study sample was from outside the U.S. or Canada or if the dating violence occurred past college (when the mean age of the sample was greater than 24 years old). Two reviewers (authors KV and NL) independently reviewed the literature for relevant articles, and all authors came to consensus when discrepancies arose.
Once the 20 articles were identified, we extracted the study sample size, study sample description, age when the exposure was assessed, age when dating violence perpetration was assessed, the way that dating violence was defined in the underlying study, the type of analysis used, the crude and adjusted measures of association between any identified risk or protective factors and dating violence perpetration, any covariates (both significant and not) of the exposure that were included in the analyses, whether results applied to only a particular sex (e.g., males only), and how baseline perpetration of adolescent dating violence was accounted for in the statistical models. Crude measures of effect are those that provide an estimate of the relationship between the exposure and outcome without controlling for any potential confounders. Adjusted effect measures are those that reflect the relationship between the exposure and outcome when additional variables which could confound that relationship have been included in the model. Wherever possible, we present results stratified by the biological sex of the respondent. This information is listed in Table 1. Table 2 presents each risk and protective factor that we identified and the citation for each study that found support for that factor. In Table 2, factors are arranged by levels of the social-ecological model (Bronfenbrenner, 1979; CDC, 2004) (see Table 2).
Of the 20 articles included, 19 examined risk factors associated with perpetrating adolescent dating violence at either the individual or relationship levels of the social ecology (two of these articles identified both risk and protective factors). The 20th study (Schumacher and Smith Slep, 2004) identified protective factors rather than risk factors. A total of 53 risk factors were identified from the 19 articles that assessed perpetration (see Table 2). These 53 risk factors fit into the following general categories: mental health problems (e.g., depression, anxiety), aggressive thoughts/cognitions (e.g., acceptance of violence in dating relationships), youth violence (e.g., fighting, general antisocial behavior), substance use (e.g., alcohol use, marijuana use), risky sexual behaviors (e.g., sexually active in 8th grade, high number of sex partners), poor relationship and friendship quality (e.g., hostile couple interactions, involvement with antisocial peers, low friendship quality), poor family quality (e.g., parental marital conflict, childhood physical abuse), demographics (e.g., child’s sex, race), and the use of aggressive media.
Risk factors for adolescent dating violence perpetration that appeared in multiple studies included depression (Cleveland, Herrera, and Steuwig, 2003; McCloskey and Lichter, 2003; Foshee, Reyes, and Ennett, 2010), general aggression (Kerr and Capaldi, 2010; O’Donnell, Stueve, Myint-U, Duran, Argonick, and Wilson-Simmons, 2006), having a history of sexual aggression (Gidycz, Warkentin, and Orchowski, 2007; Ozer, Tschann, Pasch, and Flores, 2004), prior dating violence (Tschann, Pasch, Flores, VanOss Marin, Baisch, and Wibbelsman, 2009; Wolfe et al., 2004), race/ethnicity (Connolly et al., 2010; Foshee, Linder, MacDougall, and Bangdiwala, 2001; Foshee et al., 2010), engagement in peer violence (Foshee, et al., 2010; Ozer et al., 2004), having friends who perpetrate adolescent dating violence (Arriaga and Foshee, 2004; Foshee, et al., 2010), and parental marital conflict (Stocker and Richmond, 2007; Tschann et al., 2009). Five of these risk factors (depression, general aggression, history of sexual aggression, prior dating violence, and race) are individual level risk factors. Three others (engagement in peer violence, friends perpetrating adolescent dating violence, and parental marital conflict) occur at the relationship level of the social ecology. It is important to note that determining within which level of the social ecological model a factor falls is not always straight-forward, such that a relationship-level variable is often measured at the individual level (e.g., friends who perpetrate adolescent dating violence).
There were very few protective factors identified. From the 20 articles reviewed, only three identified protective factors. The three studies identified six distinct protective factors. Four of these protective were identified at the individual level of the social ecology: high cognitive dissonance about perpetrating dating violence, which is when adolescents who perpetrated adolescent dating violence realized that what they were doing was wrong (Schumacher and Smith-Slep, 2004), high empathy (McCloskey and Lichter, 2003), better grade-point-average (Cleveland et al., 2003), and (higher) verbal IQ (Cleveland et al., 2003). Two additional protective factors were found at the relationship level of the social ecology: having a positive relationship with one’s mother (Cleveland et al., 2003) and feeling a sense of attachment to your school (Cleveland et al., 2003).
In an effort to compile the evidence about risk and protective factors for adolescent dating violence perpetration, we reviewed the literature for those factors that have been found to be both associated with dating violence perpetration and for which temporal order has been established. We categorized the risk and protective factors identified in the reviewed studies by levels of the social ecology. These factors should be investigated in future research studies that aim to elucidate the etiology of dating abuse perpetration, and used to inform the development, implementation, and evaluation of adolescent dating violence perpetration prevention strategies.
Across the 20 studies reviewed, there were a total of 53 risk factors identified. Many of these factors cluster together in several key dimensions. For example, a range of mental health problems were found to predict dating violence perpetration. Attitudes, such as acceptance of violence in dating relationships, were also found to predict adolescent dating violence perpetration. Certain behaviors also were longitudinal predictors of subsequent adolescent dating violence perpetration, and these included the use of aggressive media, aggressive behavior towards peers or others, substance use, precocious sexual behavior, and having antisocial peers. Additionally, having a hostile relationship with one’s partner or friends also predicted dating violence perpetration. Finally, demographic factors, including age, child’s sex, and race, were found to be longitudinal predictors of dating violence perpetration. Only behaving in a manner towards one’s dating partner that is discrepant with one’s attitudes about dating abuse (cognitive dissonance), empathy, good grades, verbal IQ, having a positive relationship with one’s mother, feeling a sense of school attachment, and were found to be protective. In short, the results of this review suggest that effective prevention programs may be those that target youth who have experienced maltreatment and other adverse childhood events, who have particular mental health problems, behave aggressively and have aggressive attitudes, use substances, and are in hostile or unhealthy dating relationships.
Many of the risk factors for adolescent dating violence that have been identified are also risk factors for other types of violence perpetration. For example, substance use, depression, and parenting practices are also risk factors for sexual violence and youth violence (DeGue et al., in press; Hong, Espelage, Grogan-Kaylor, and Allen-Meares, 2012; Tolan, Gorman-Smith, and Henry, 2003). Therefore, there is the potential that prevention programs targeting these behaviors may affect multiple forms of violence. Given the time and resource burdens on schools, prevention programs that demonstrate effectiveness in multiple areas of adolescent risk and violence have the potential to increase efficiency of school-based prevention and enable schools to implement comprehensive evidence-based prevention programs even with limited time and resources. Although many adolescent dating violence prevention programs are not evaluated for multiple outcomes, a few notable exceptions exist, such as Fourth R which reduced physical dating violence and increased condom use among boys (Wolfe et al., 2009).
The results of this review are consistent with the background-situational model of dating violence (Riggs and O’Leary, 1989). The model suggests that background risk factors for violence (such as childhood physical abuse, mental health problems, and attitudes accepting of violence) are useful in identifying who is at risk for perpetrating violence, whereas situational risk factors (such as drinking alcohol or having a conflict with a dating partner) are useful in identifying when violence is likely to occur. The results of the present literature review provide support for the background-situational model, and extend it by (1) introducing the six protective factors (i.e., cognitive dissonance related to dating violence, empathy, good grades, verbal IQ, having a positive relationship with one’s mother, and school attachment); and (2) suggesting that there is evidence that particular exposures precede dating abuse perpetration temporally, strengthening the plausibility that the background-situational model describes a causal framework. In other words, the background-situational model appears to be a good model to continue to use to explain why some youth perpetrate dating abuse.
Notably, no studies that focused solely on assessing sexual violence perpetration in teen dating relationships met the criteria for inclusion in the present review. Two common methodological reasons for these exclusions are worth noting. Studies examining sexual violence perpetration within the context of adolescent (e.g., Sears, Byers and Price, 2007) or college dating relationships (e.g., Abbey, McAuslan, Zawacki, Clinton, and Buck, 2001; Christopher, Madura, and Weaver, 1998; Forbes, Adams-Curtis, Pakalka, and White, 2006; Simons, Burt, and Simons, 2008) were either cross-sectional, or were longitudinal but did not specify whether the sexual violence occurred in the context of a dating relationship (e.g., Abbey and McAuslan, 2004; Borowsky, Hogan, and Ireland, 1997; Hilton, Harris, and Rice, 2003; Maxwell, Robinson, and Post, 2003; McWhorter, Stander, Merrill, Thompsen, and Milner, 2009; Pepler, Craig, Connolly, and Henderson, 2002; Teten, Ball, Valle, Noonan, and Rosenbluth, 2009; White and Smith, 2004). Future studies that examine sexual violence should specify the relationship between perpetrator and victim in order to contribute to the evidence base about dating violence as well.
Our findings suggest that practitioners who are designing programs to prevent dating violence perpetration should target multiple factors, and address both background risk factors and situational ones. In addition, because many of the identified risk and protective factors for dating violence perpetration are also relevant to other youth risk behaviors (e.g., gang violence perpetration, substance use, self-harm and suicide), dating violence prevention programmers could benefit from allying themselves with prevention programmers from other, related fields. Some practitioners may fear that programs that target multiple factors may “water down” (i.e., detract from) education about the dynamics of dating abuse. Research has yet to establish whether programs that target multiple factors that underlie dating abuse and other youth heath issues are any more or less effective than those that focus solely on dating abuse. However, to prevent dating violence effectively, it may be possible to address a factor such as adolescent depression or trauma, without ever overtly teaching the basic facts about dating violence such as the prevalence of dating abuse or what counts as dating abuse (commonly referred to as “DV 101” by practitioners). By way of example, teaching people in communities the prevalence of lung cancer or what counts as lung cancer is not as important a method of reducing lung cancer as helping people to quit smoking or to reduce their use of tobacco. Therefore, in the case of dating violence, prevention programs that do not overtly discuss dating violence perpetration at all, but instead focus on one of the salient risk factors (such as emotional distress), may be effective at reducing risk for dating violence perpetration. For example, healthy emotional development is linked to academic success and the prevention of a wide range of problem behaviors and mental health concerns (e.g., anxiety, general aggression) that are linked to teen dating violence perpetration and victimization (e.g., Catalano, Berglund, Ryan, Lonczak, and Hawkins, 2004; Greenberg, Domitrovich, and Bumbarger, 2001). The results from this review suggest the need to evaluate the effects of such strategies on dating violence perpetration.
Through the process of conducting this review, we identified several important gaps in the existing literature on this topic. First, little research has been conducted to assess factors at the outer levels of the social ecology (i.e., the community and social levels). Neighborhood-level factors, in particular, may be important determinants of dating violence perpetration, given that cross-sectional studies suggest effects at the neighborhood level (Banyardand Modecki, 2006; Champion, Foley, Sigmon-Smith, Sutfin, and DuRant, 2008; Jain, Buka, Subramanian, and Molnar, 2010; Rothman, Johnson, Young, Weinberg, Azrael, and Molnar, 2011). Furthermore, as noted above, very few protective factors have been identified. Greater attention needs to be paid to protective factors that act as buffers between specific risk factors and adolescent dating violence.
The results of this review are limited in several ways. First, even evidence from longitudinal studies may not be conclusive about whether a relationship between an exposure and outcome is causal. In other words, although we now have strong evidence that mental health problems predict future dating violence perpetration, both the mental health problems and dating aggression may be the result of a third factor, such as child maltreatment. Second, almost all dating violence perpetration studies rely on self-reports of the exposures and outcome. Participants may minimize their own aggressive behavior (i.e., underreport), or they may report exposures inaccurately due to poor recall (i.e., recall bias). Third, the goal of this article was to compile a list of all risk and protective factors for dating abuse perpetration for which there was evidence of a positive association and temporal order could be discerned utilizing at least two time points. However, it should be noted that we did not censor factors which were found to be significantly related to dating violence perpetration in one article but nonsignificant in another. In other words, if there was conflicting evidence about a factor, the factor remained in our list. The implication is that this list is a starting point for conceiving of future investigations and prevention program design, but should not be interpreted as definitive. Fourth, some of the underlying studies failed to control for potentially confounding factors, including individuals’ baseline dating violence perpetration score, which may have biased results away from the null (i.e., made certain predictors look more important than they might be in actuality). Future longitudinal studies that assess dating violence perpetration should include both Time 1 and Time 2 assessments. Finally, for this review we chose to only include studies that had at least two time points, where the exposure was measured at Time 1 and the outcome (i.e., adolescent dating violence) was measured at Time 2. An argument can be made, however, that valuable information can also be ascertained from studies that assess exposure and outcome at the same time point, as long as the exposure was measured retrospectively. This may be especially true for risk and protective factors that deal with early childhood issues, such as child maltreatment and trauma.
In conclusion, this review of a decade of research on dating violence perpetration found that there have been numerous studies that have established temporal order between no fewer than 64 different exposures and subsequent dating violence perpetration. Now that we are amassing evidence about what may be contributing causes of dating violence perpetration, both researchers and practitioners will be able to refine their approaches. Importantly, entities that fund dating violence prevention programming will now be able to consider more easily whether proposed strategies address one or more of the factors for which there is at least some degree of evidence that a causal relationship may exist.
Author note: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Kevin J. Vagi, Centers for Disease Control and Prevention.
Emily Rothman, Boston University School of Public Health.
Natasha E. Latzman, Centers for Disease Control and Prevention.
Andra Teten Tharp, Centers for Disease Control and Prevention.
Diane M. Hall, Centers for Disease Control and Prevention.
Matthew J. Breiding, Centers for Disease Control and Prevention.