Partner violence in the United States has received ubiquitous media attention over the past several months, with an overdue sexual assault reckoning unfolding across the country. This stance has resulted in a seismic shift in the cultural acceptance of traditional gender norms and decreased tolerance for dating violence perpetration. Thus, the timeliness of Cohen et al’s1 article, “Predicting Teen Dating Violence Perpetration,” cannot be understated. Their focus on developing an algorithm to identify which adolescents are most likely to perpetrate partner violence has significant ramifications, not only for adolescents but also for their broader social ecology. In this commentary, we draw attention to the risks and benefits of using such a screening process in research and clinical work as well as to the need for a more balanced assessment of multilevel protective factors. Last, we highlight the value of using syndemics2 (ie, the co-occurrence of multiple epidemics) as a guiding theory for future research on teen-aged dating violence.
Cohen et al1 are to be commended for their innovative research, in which they used statistically driven methods (ie, net reclassification improvement) to approximate the most central variables in predicting teen-aged dating violence perpetration. This unique analytic approach revealed that domestic violence exposure, childhood maltreatment, and deficits in conflict resolution predicted physical violence perpetration, whereas sexual violence victimization, emotional violence perpetration, and attitudes that are accepting of dating violence predicted sexual violence perpetration. Through these novel findings, the authors highlighted the multidimensionality of partner violence by examining both physical and sexual violence and showing differential predictors of each type. Additionally, some of the key factors identified (eg, conflict resolution skills) are mutable, revealing promise for future intervention research.
Despite these numerous strengths, there is apprehension about the idea of labeling adolescents as perpetrators of future violence so early in the life course. Specifically, study authors consistently highlight the detrimental impact of labeling3,4; in the current context, labeling adolescents as perpetrators of future dating violence could be highly stigmatizing and inadvertently create a self-fulfilling prophesy if these youth believe they are destined to follow a path of violence. Additionally, adolescents who are fearful of being labeled as perpetrators may not accurately respond to screening questions about their adversity. The ethical conundrums of screening for perpetration among adolescents who have experienced intergenerational violence is worth considering. Youth who endure family and environmental trauma may be further stigmatized by labeling because such screening tools do not currently account for the multiple external processes that lead to dating violence. Thus, if such screenings are to be implemented in clinical and school settings, it is critical that this process be intentional and conservative.
Although the authors of this article clearly move the field forward with their broad evaluation of risk factors for physical and sexual perpetration, a more balanced assessment of functioning is necessary. The examination of multilevel protective factors (in addition to risk) would provide a more comprehensive exploration of ways to attenuate future teen-aged dating violence perpetration. Additionally, examining predictors of positive outcomes (ie, involvement in a nonviolent, healthy relationship) is also warranted. Relevant protective factors may include spirituality, social support, and resilience.5 In addition, expanding beyond these individual and relational variables is a natural bridge to current conceptualizations of protective factors across the social ecology. This would then allow for a more inclusive examination of community (eg, connectedness, neighborhood safety) and cultural (eg, ethnic identity, acculturation) domains, in addition to individual and relational factors.6
Given the numerous risk and protective factors associated with dating violence perpetration, a guiding theory to select relevant study variables would be innovative. One such theory that did not garner attention in the Cohen et al1 study is syndemics.2 This theory postulates that 3 adversities (ie, substance abuse, violence, and AIDS and/or HIV) co-occur at high rates and interact synergistically to impose a greater burden of poor health among individuals. Although this theory has primarily been applied to adults living in poor urban settings, it is relevant to the examination of teen-aged dating violence given the high emergence of these sexual, substance, and violence risk factors during this developmental period. To advance this work, future researchers are encouraged to select predictive factors guided by this syndemic framework.
Cohen et al1 found that the assessment of risk beyond a history of perpetration is a worthwhile endeavor in clinical and school settings. Future researchers and clinicians should expand their work by using multimethod (self-report and observation) and multi-informant (partner, parent, teacher) assessments. In addition, Cohen et al’s1 selection of a key developmental transition period is laudable because it allowed for examination of a high-risk group during a critical window in the life course. Future focused exploration of other key demographic factors, such as sex, race and/or ethnicity, sexual orientation, and socioeconomic status would offer novel direction for developing culturally responsive interventions. In conclusion, caution is warranted in applying perpetration screening tools without considering contextual variables and the stigmatizing consequences of labeling.
- Accepted January 11, 2018.
- Address correspondence to Idia B. Thurston, PhD, Department of Psychology, The University of Memphis, 310 Psychology Building, Memphis, TN 38152. E-mail:
Opinions expressed in these commentaries are those of the authors and not necessarily those of the American Academy of Pediatrics or its Committees.
FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.
FUNDING: No external funding.
POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.
COMPANION PAPER: A companion to this article can be found online at www.pediatrics.org/cgi/doi/10.1542/peds.2017-2790.
- Copyright © 2018 by the American Academy of Pediatrics