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Intimate Partner Abuse and Teen Dating Violence Risk Factors and Interventions

Written by Evolve's Behavioral Health Content Team:

Alyson Orcena, LMFT • Melissa Vallas, MD • Shikha Verma, MD • Ellen Bloch, LCSW • Lianne Tendler, LMFT • Megan Johnston, LMFT

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Expanding Our Understanding of Dating Abuse and Violence

In an article called “INTIMATE PARTNER SEXUAL ABUSE:  Who Are the Victims, What Are the Risks? Adults, Teens, and Children” published in the judicial periodical The Judge’s Journal last year, author Lynn Hecht Shafran addresses a serious problem in our society: sexual violence between people who are married, in a relationship, or otherwise intimate – including teenagers.

This a separate issue than rape by a stranger – another serious and horrifying problem in our country and worldwide – and involves a level of nuance and clarity that we need, as a society, to wrap our minds around in order to move forward.

Why?

Because at the moment, victims of intimate partner sexual abuse (IPSA) may not be taken seriously. Lynn Shafran quotes a report from a 1986 New York State Judicial Task Force that, unfortunately, is relevant close to thirty years later:

“Although there has been some improvement, it appears that some societal attitudes persist in considering rape occurring within marriage or when the parties know each other as less pernicious than rape involving strangers—and to some degree impact upon the prosecution of these cases.”

The fact that archaic “societal attitudes” may impact the prosecution of sex crimes, even “to some degree” is disturbing, particularly on the heels of the #METOO movement and our gradually increasing understanding of the long-term emotional, psychological, and social consequences of intimate partner sexual abuse.

We’ll define intimate partner sexual abuse and offer prevalence statistics in a moment. First, though, we’ll address an aspect of the nuance we mention above, with regards to the big-picture consequences of IPSA:

“The destruction of the ability to trust was the most common long-term effect of rape in marriage. [It is] a violation. The shock experienced by a woman who was sexually brutalized by the man she had loved and trusted above all others did not wane quickly.”

We can substitute any gender in either role above, substitute teen intimate partner for marriage, and arrive at the same conclusion: sexual abuse by a trusted and loved partner is devastating and can have decades-long consequences.

And it happens more often that most of think.

Intimate Partner Sexual Abuse: A Current Definition

In teens, IPSA is known at Teen Dating Abuse and Violence (TDAV). The types of behavior that most people consider TDVAM include the following types of physical, sexual, and/or emotional abuse:

Physical:

Shoving, punching, grabbing and not letting go, slapping, pinching, hitting, kicking, hair pulling choking

Emotional:

Name calling, threats, extreme jealousy, irrational ultimatums, trying to control behavior, including what the victim does, when, and with whom

Sexual:

Unwanted kissing/touching, forced intercourse, forced sexual activity of any kind

However, the author of the paper we cite above – as well as the National Judicial Education Program – now defines the following as IPSV/TDAV:

  • Coercive control and possessiveness related to sex, including:
    • Inspecting underwear for signs of sexual activity with someone else
    • Coercing a partner to have sex with someone else
      • Punishing them when they do
    • Coercing pregnancy by denying or sabotaging birth control
      • Then coercing abortion
    • Coercing a partner to view, imitate, or participate in pornography
    • Sexual torture
    • Extorting sex by refusing to pay for family necessities
    • Threatening to sexually abuse their or their partner’s children
    • Technology-enabled noncontact IPSA:
      • When an abuser shares intimate photographs and videos of a current or former partner online without consent

That’s a significant expansion of what most of us might have considered IPSV, or TDAV, before reading that list. But there’s no question that these behaviors constitute abuse. That’s one of the primary points of the paper published in the Judge’s Journal we cite above. The author seeks to persuade judges – and anyone involved in any intimate partner violence case – that the consequences of non-contact abuse are as damaging as the consequences of abuse involving contact, i.e. rape.

That’s what we want parents and teens reading this to understand, as well: dating violence and abuse is not limited to forced physical contact. It includes a host of behaviors that are every bit as damaging, disruptive, and associated with negative as physical sexual violence.

Before we move on to the prevalence statistics, we have one more thing to share, which speaks to this point.

In her book “In Love and in Danger: A Teen’s Guide to Breaking Free of Abusive Relationships,” author Bary Levy asked a group of teenage girls who’d experienced TDAV:

“What are some of the ways you have been sexually abused?”

Here’s what they said:

My intimate partner…

  • Referred to me by degrading sexual names
  • Expected sex after striking me
  • Forced me walk home nude
  • Wanted sex all the time
  • Got angry if I didn’t want sex
  • Made me do things I thought were disgusting
  • Bit, pinched my breasts
  • Threatened to find another girlfriend
  • Made me to have intercourse without birth control

To be clear, for all the teenage girls and parents reading this, most of the things on this list are illegal, and anything that involves sexual coercion or physical abuse on this, or the previous lists in this article, is illegal and punishable by law.

That’s important to know.

Laws protect the victims of sexual violence. We’ll talk about how individuals and families can seek legal help later in this article.

Now, however, we’ll look at the TDAV prevalence statistics.

Teen Dating Abuse and Violence: Facts and Figures

Here are the latest statistics on TDAV from the Centers for Disease Control (CDC). These figures come from data collected in 2017:

  • Around 20% of women and 14% of men experience physical, emotional, or sexual violence during their teen years.
  • About 33% of women and 25% of men will experience relationship violence at some point during their lives.
  • About 1.5 million high school students in the U.S. experience physical abuse from a dating partner each year.
  • Only 33% of teens who experience violence in their relationships tell someone about it

The CDC indicates that teens who experience TDAV are at heightened risk of:

  • Developing an alcohol and substance use disorder (AUD/SUD)
  • Developing an eating disorder
  • Participating in risky sexual behavior
  • Experiencing domestic violence late in life

Teenage girls and adult women who experience relationship violence also experience the following negative outcomes:

  • 94% experience symptoms of post-traumatic stress disorder (PTSD) within two weeks of rape or assault
  • 30% report PTSD symptoms nine months after the rape or assault
  • 33% of victims think about attempting suicide
  • 13% of victims attempt suicide

Female victims of sexual assault are:

  • Six times more likely to become pregnant as teens
  • Twice as likely to contract an STD

That’s not all. The following statistics apply to anyone who experiences sexual violence, rape, or assault, whether they’re female, male, adolescent, or adult:

  • 38% have issues at work or school
  • 37% have issues with family and friends, including:
    • More arguments
    • Less trust for loved ones
  • 84% report moderate to severe emotional issues

We’ll end this section with a quote from the “In Love and in Danger” book we introduce above. One of the girls interviewed explains how her experience of intimate partner violence – she was forced to have sex without birth control – affected her:

“There were a lot of after-effects…The rapes kept coming into my mind like a broken record. I could not function. It felt like the PTSD, anxiety, paranoia, anorexia, and suicidal thoughts had completely taken over my life.”

That’s a first-person testimonial that sums up why we want to raise awareness on this topic: the consequences are life changing, and if left unaddressed, can last for decades.

With all that said, let’s take a moment to recap: we’ve established we need an expanded, nuanced view of TDAV. We’ve discussed the consequences and shared the statistics on TDAV. We should also note that while we focus on teenage girls in this article, TDAV happens to teenage boys, too, and many of the statistics – and everything that follows – applies to them as well.

Now we’ll talk about how parents can determine whether their teenager is in an abusive relationship, and discuss what they can do if they are.

Teen Dating Violence: Risk Factors

Based on a full understanding of TDAV, it’s clear that some risk factors are more subtle than a partner who is violent, and that some signs of TDAV may be more subtle than bruises, although both those examples are flashing red lights that should tell teens to stay away or convince parents their daughter must leave the relationship now.

We’ll start with a list of the factors which, if present, indicate that the risk of dating violence is increased, compared to a relationship in which these factors are not present. Parents or teens can read the following questions with either pronoun in parentheses.

Teen Dating Violence Risk Factors

In the relationship, does the dating partner:

  1. Get jealous when (they/you) spend time of become friends with other people?
  2. Attempt to control what (they/you) wear?
  3. Try to control what (they/you) do?
  4. Attempt to control who (they/you) spend time with?
  5. Try to keep you from doing things (they/you) enjoy?
  6. Demand constant contact, such as frequent check-in calls, texts, or instant messages?
  7. Insist on full commitment right away?
  8. Declare love in a very short time?
  9. Demand (they/you) reciprocate the commitment/exclusivity/feelings of love right away?
  10. Force or pressure (them/you) to do sexual things when (they/you) aren’t ready?
  11. Say things like, “If you loved me, then you’d __________.”
  12. Manipulate (them/you) emotionally?
  13. Lash out at (them/you) when they’re angry?
  14. Blame (them/you) for their emotions?
  15. Enjoy rough play, such as wrestling or holding you down?
  16. Act violent or aggressive toward other people (they/you) know?
  17. Act violently – including breaking objects – in front of (them/you), in response to (their/your) words or actions?
  18. Threaten self-harm if (they/you) break up with them?
  19. Follow through on their self-harm threat when (they/you) want to break up, take a time out, or ask for space?
  20. Hit, punch, push, grab, restrain, or use physical force against (they/you) in any way?

If your teen answers yes to any of the questions above, or you’ve witnessed any of the behavior in your teen’s dating partner, that’s a red flag. If you’re a teen, the best thing to do is talk to an adult. They can bring perspective to the situation and help you understand whether your dating partner is dangerous. If you’re a parent, the best thing you can do is talk to your teen directly and ask them all of the questions above.

Evaluating the Answers

Both teens and parent also have to be logical: a yes answer to one or two of the questions may not be an indicator of TDAV. For instance, a teenager may fall in love quickly and profess love way too fast, or get jealous and not know how to handle it. In isolation, those things aren’t red flags. Combined with the other behaviors on the list – those plus several more yes answers – those behaviors are red flags, and the teen involved in the relationship should reevaluate the entire situation from the ground up and decide whether it’s a healthy or a toxic. If it’s toxic, the answer is simple, even if it takes help and support: leave the relationship.

Now let’s look the warning signs of teen dating abuse and violence

Teen Dating Abuse and Violence: Warning Signs

The risk factors things we present above are behavioral. They describe actions performed by a dating partner that are considered abusive and violent. The next list – the warning signs – describe the consequences of that behavior on their partner, the victim of TDAV.

Teen Dating Violence/Abuse Warning Signs

  • Unexplained bruises or injuries
  • Discoloration, pain, or bleeding in, on, or around genitals
  • Pain during urination or bowel movements
  • Symptoms of sexually transmitted diseases. Click here for a CDC fact sheet on STDs.
  • Abrupt changes in academic performance
  • Anxiety
  • Mood swings
  • Depressive symptoms: persistent sadness, withdrawal from friends or activities, changes in sleep patterns, loss of appetite
  • Suicidal behavior: talk about suicide, plans for suicide
  • Self-harming behaviors
  • Abrupt change in personal habits: decreased personal hygiene and reduced attention to appearance
  • Alcohol or drug use

If you’re the parent of a teen who’s the victim of TDAV, or you’re a teen victim of TDAV, there are three important steps to take.

TDAV: Steps to Take

1. Talk About It

This is true for parents and teens. If you’re a parent, talk to your teen and intervene. If you’re a teen, talk to your parents or an adult you trust. We encourage teens who are scared of talking to parents or authority figures for your own reasons to call one of the hotlines below: they know what to do and they know how to help.

2. Establish a Paper Trail

This also applies to both parents and teens:

  • Write down the specifics of any incident, no matter how small.
  • Include details:
    • Describing the incident itself: location, date, time, witnesses.
  • Save every relevant communication, including:
    • Emails
    • Texts
    • Voicemails
    • Instant/direct message.

The more information you have, the better. Every detail can help if you need to get the authorities involved. If you’re unsure how to record the important information, use this template or follow these guidelines.

The first link takes you to a document designed for cyber stalking victims but works to document teen dating violence, while the second takes you to a set of instructions designed specifically for people in abusive relationships.

3. End It

If you’re a teen, you need to end the relationship right away. You come first: your physical, emotional, social, and psychological health are the most important thing here. Take care of yourself first. If you don’t know how to end it, call one of the crisis lines below, or follow this safety plan.

If you’re a parent, you need to help your teen get out of this relationship immediately. Gather all the information you need, staring with the information above, contact the authorities, and keep your teen from seeing the abusive partner again. They may be angry with you about this, but the fact is that by stepping in, you will save them from significant emotional and psychological consequences. In some cases, you may be saving their life.

Treatment for TDAV Survivors

When an individual experiences a traumatic event such as rape or prolonged sexual or emotional abuse, they often develop complex post-traumatic stress disorder (CPTSD). CPTSD is a serious emotional disorder and is characterized by:

  1. Emotion dysregulation:
    • Extreme emotional reactivity
    • Anger
    • Irritability
    • Temper outbursts
  2. Negative self-concept, including feelings of:
    • Being damaged
    • Feeling defeated
    • Feeling worthless
  3. Interpersonal problems
    • Avoidance of social engagement/activities
    • Difficulty building/maintaining relationships

These symptoms occur in a majority of victims of sexual assault, including TDAV. However, a recent study shows that specific types of therapy can help victims reduce and manage their CPTSD symptoms and heal from the trauma associated with sexual assault. You can read our full report on the study here, or read our summary now.

Treatment for CPTSD: What Works

Research indicates that the following therapeutic modes, when administered by a qualified psychiatrist, therapist, or counselor in the context of cognitive behavioral therapy (CBT), can help improve symptoms in victims of sexual assault:

  • Eye movement desensitization and reprocessing (EMDR)
  • Cognitive processing therapy (CPT)
  • Prolonged exposure therapy (PE)
  • Systematic Desensitization (SD)
  • Brief psychoeducation (PEI)
  • Psychological support (PS)

These treatments/therapies can reduce CPTSD symptoms such as depression, anxiety, avoidance, fear, and sexual dysfunction. That’s a big deal for survivors: in many cases, the trauma of rape and assault can last for decades. When it happens in the teen years, it can throw an entire life off-course. The anxiety, fear, depression, and avoidance associated with CPTSD can disrupt educational plans, career plans, long-term relationship and family plans, and overall physical health and well-being. The fact that there’s help for victims of sexual is life-changing.

It may be more than that.

It may be lifesaving.

Here’s what leading expert Avanti Adhia (University of Washington School of Medicine) said in an interview on National Public Radio (NPR) in 2019:

“People think that intimate partner violence among adolescents is less serious than among adults. It’s important to highlight that this can really lead to death. It’s not something to brush off as ‘This is just an argument between kids.’”

That should be enough to convince anyone that treatment is essential: the quote refers to the potential for escalation to violence, but also highlights the overall seriousness of the issue. Teen dating violence damages its victims, and in some cases, can lead to death.

That’s why we teach all teens and families the maxim:

ONE TIME IS TOO MANY

Finding Help: Resources

If you’re seeking treatment for your teen with CPTSD, please navigate to our page How to Find the Best Treatment Programs for Teens and download our helpful handbook, A Parent’s Guide to Mental Health Treatment for Teens.

In addition, the American Academy of Child and Adolescent Psychiatry (AACAP) is an excellent resource for locating licensed and qualified psychiatrists, therapists, and counselors in your area. Both the National Institute of Mental Health (NIMH) and the National Alliance on Mental Illness also provide and high-quality online resources, ready and waiting for you right now.

We’ll end by offering resources that can help parents and teens understand more about teen dating violence. Before we offer those resources, though, we want to reiterate something for teens: if you’re in danger or you feel threatened in a dating situation, call 911. If you’re not in imminent danger, here’s a list of resources that can help right away:

  • Victim Connect Hotline: 1 (855) 484-2846
  • National Domestic Violence Hotline: 1 (800) 799-7233 En Espanol: 1 (800) 787-3224
  • The National Sexual Assault Hotline: 1 (800) 656-4673
  • The National Sexual Assault Online Hotline: https://hotline.rainn.org/online/

Finally, teens can learn how to establish and maintain healthy relationships at the following websites:

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