Preventing Intimate Partner Violence, Is Screening Enough?

According to a recent study, the answer is “No.”

Screening for domestic violence followed by referral to a clinician does not reduce the recurrence of violence among women, according to a study for the the McMaster Violence Against Women Research Group, published in the August 5, 2009, issue of the Journal of the American Medical Association. (Full text here.) In the published editorial on the study, the authors have this to say:

[This study] should dispel any illusions that universal screening with passive referrals to community services is an adequate response to violence in intimate relationships.

The findings are not overly surprising to me…. And it reminds me of how that “Are you safe at home?” questions is addressed whenever I visit doctors offices, the emergency room, walk-in clinics etc. The question in terms of words varies only slightly (from “Are you safe” to “Do you feel safe” to “How would you rate your sense of safety at home?” etc.), but the manner and tone in which it’s asked varies quite a bit.

For some, it’s such a routine question, it seems as if your answer isn’t even going to register. Others try to toss it in with the litany of other questions, like a sneaky curve ball, hoping you’ll be caught off guard and give away the truth you might otherwise resist. Still others seem embarrassed to ask it — but they are fine with my “dignity” hanging out the back of a paper gown.

I wonder if there have been any studies on how effective the actual questioning aka screening itself is.

All Hail MTV’s Thin Line On Abuse?

MTV has launched a multi-year initiative aimed at stopping the spread of digital abuse and harassment. Called “A Thin Line,” the goal of the initiative is to empower America’s youth to identify, respond to and stop the spread of sexting, cyberbullying, harassment, and whatever forms of digital dating abuse are out there:

According to a new study released on Thursday by MTV and The Associated Press that explores the full scope of digital abuse, 50 percent of 14-to-24-year-olds have been the target of some form of digital abuse, 30 percent have sent or received nude photos of other young people on their cell phones or online and 12 percent of those who have sexted have contemplated suicide, a rate four times higher than those who haven’t. The study explores the pervasiveness of digital abuse, how it’s affecting America’s youth, how they’re responding to it, their concerns and much more.

(Please also see the Enhancing Child Safety and Online Technologies report by the Internet Safety Technical Task Force.)

I think the program would be more effective if MTV, along with sister VH1 (mother f-er of the Ward-rape mess), played more music videos (and less sexist violent stuff at that), as opposed to their lusty depraved programming; but at least someone is trying something to address dating violence.

The Facts About Children, Sex, Predators & The Internet

Last year the Internet Safety Technical Task Force released the Enhancing Child Safety and Online Technologies, the Final Report of the Internet Safety Technical Task Force to the Multi-State Working Group on Social Networking of State Attorneys General of the United States, but I wouldn’t have heard of it if it weren’t for the recent article by Michael Castleman at Psychology Today:

Last year, the attorneys general of 49 states created the Internet Safety Technical Task Force to investigate sexual solicitation of children by molesters who troll for targets using sites popular with kids, among them, MySpace and Facebook. The 278-page report concluded that there’s no real problem.

The task force, led by Harvard researchers, looked at reams of scientific data dealing with online sexual predation and found that children and teens were rarely propositioned for sex by adults who made contact via the Internet. In the handful of cases that have been documented-and highly publicized-the researchers found that the victims, almost always older teenagers, were usually willing participants already at risk for exploitation because of family problems, substance abuse, or mental health issues.

The report concluded that MySpace and Facebook “do not appear to have increased minors’ overall risk of sexual solicitation.” The report said the biggest risk to kids using social networks was bullying by other kids.

“This study shows that online social networks are not bad neighborhoods on the Internet,” said John Cardillo, whose company tracks sex offenders. “Social networks are very much like real-world communities that are inhabited mostly by good people who are there for the right reasons.”

The bottom line is, the actual threat to children from sexual predators online is negligible.

So I’m guessing the reason I hadn’t heard of this before was that the findings, though incredibly clear, aren’t willing to be heard & accepted by the population at large. Instead of shouting from the rooftops that the internet is as safe a place as any for children, or even breathing a sign of relief, people would prefer far more salacious, fear-mongering headlines.

In truth, the actual Internet Safety Technical Task Force report says that, “Bullying and harassment, most often by peers, are the most frequent threats that minors face, both online and offline.” Which means parents should be paying a lot more attention to what their children are experiencing (and dispensing) at school, with their friends, etc., than they should be about the invisible “they” known as internet boogie men.

From the report:

Much of the research based on law-enforcement cases involving Internet-related child exploitation predated the rise of social networks. This research found that cases typically involved post-pubescent youth who were aware that they were meeting an adult male for the purpose of engaging in sexual activity.

And if you think that’s only gotten worse because kids today are bombarded by internet porn, well, that’s just plain wrong too; from the report:

The Internet increases the availability of harmful, problematic and illegal content, but does not always increase minors’ exposure. Unwanted exposure to pornography does occur online, but those most likely to be exposed are those seeking it out, such as older male minors.

In other words, most kids ignore it, but those (mostly male) youths who want it go for it — just like those meeting with adults or others for sex. Because teens have sex drives, so you’d better be prepared to deal with the issue.

However, the report does not ignore the few times where child molesters have connected with youth online. It says that in the small number of cases, the internet was the first of several steps — the rest of which are no different than how “real world” hook-ups are made. So, if the sexual predator finds prey on the internet & the prey responds, the next step is telephone contact (right under their parents’ noses), followed by eventual meetings in person.

Here’s what the report suggests in terms of advice (I’ve bullet-pointed them, so they are easier to read):

Careful consideration should be given to what the data show about the actual risks to minors’ safety online and how best to address them, to constitutional rights, and to privacy and security concerns.

Parents and caregivers should:

• educate themselves about the Internet and the ways in which their children use it, as well as about technology in general
• explore and evaluate the effectiveness of available technological tools for their particular child and their family context, and adopt those tools as may be appropriate
• be engaged and involved in their children’s Internet use
• be conscious of the common risks youth face to help their children understand and navigate the technologies
• be attentive to at-risk minors in their community and in their children’s peer group
• and recognize when they need to seek help from others.

All of this, though, ignores the basic facts regarding child molestation: Most rapes, sexual assaults, and abuse is perpetuated by someone that the victim and their family knows and trusts.

And I guess that’s the real reason I hadn’t heard of this report & its findings before; people still prefer to pretend they are safe at home, that the unknown danger is “other” and locked outside — or on the internet rather than look around at the people they have already allowed into their own lives and the lives of their children.

Less Physical Dating Violence & Greater Condom Use — Among Boys Only?

Research done at the Centre for Addiction and Mental Health Centre for Prevention Science in London, Canada, reveals that a course on dating violence and healthy relationships may provide benefits for high school students, particularly boys.

According to ModernMedicine.com:

David A. Wolfe, Ph.D., of the Centre for Addiction and Mental Health Centre for Prevention Science in London, Canada, and colleagues analyzed data from 1,722 ninth-grade students attending schools that were randomly assigned to the intervention or to serve as controls. The intervention was a 21-lesson program led by teachers, integrating dating violence prevention with core lessons about sexual health, substance abuse prevention and healthy relationships.

After 2.5 years, the researchers found that physical dating violence was higher in control versus intervention students (adjusted odds ratio, 2.42). Although boys in intervention schools were less likely than the controls to engage in dating violence, girls in both groups had similar physical dating violence rates. Condom use was higher among sexually active boys in intervention schools (67.9 versus 58.6 percent).

“We found support for the hypothesis that teaching youth about healthy relationships and ways to avoid physical dating violence in Grade 9 Health classes would reduce physical dating violence 2.5 years later, but this effect may be limited to boys,” the authors write. “Although overall rates of substance use and peer violence were unaffected by the intervention, exploratory analyses indicated that boys in the intervention schools reported safer sexual practices (indicated by always using condoms).”

Before I say anything else, let me give a great big “Hooray!” that more young men were using condoms!

And a giant “Wo0t!” as the kids would say, that the boys were less likely to be involved in dating violence.

But isn’t it interesting that while the boys in the class were less likely to participate in dating violence, the girls in class were still experiencing the same amount of dating violence…

That sorta changes that “Wo0t!” to a “Shoot.”

Do we conclude that there was some gender bias in teaching &/or course work, and so the girls didn’t learn or accept the information as readily as the boys?

Do we conclude that a large number of the girls date boys outside those classes — and that the girls “knew better” but in the intimidation of the moment(s), they fell prey to boys with a more predatory nature?

Are there just a few bad boys dating all the girls?

Or do we conclude there is some sort of discrepancy between what the boys reported and what the boys did — *cough* LIARS!

Because the abstract gives very little information & reading the full report & findings published in the August issue of the Archives of Pediatrics & Adolescent Medicine requires a fee, I can’t really say for certain what I think…

What We Can Learn From Teen Dating Violence

Talk about burying the lead…

A recent survey commissioned by the Family Violence Prevention Fund and Liz Claiborne Inc. and conducted by Teenage Research Unlimited (TRU) set out to explore “how the economy has impacted dating relationships among young adolescents and to determine the level and impact of parental engagement in the issue of teen dating violence and abuse.” The survey, Impact of the Economy and Parent/Teen Dialogue on Dating Relationships and Abuse, titled their press release New Research Finds Possible Link between Troubled Economy and High Levels of Teen Dating Abuse, despite the fact that the findings were about far more then the “media popular” word “economy.”

A new survey reports today that teens nationwide are experiencing significant levels of dating abuse, and the economy appears to be making it worse. Nearly half of teens (44 percent) whose families have experienced economic problems in the past year report that they have witnessed their parents abusing each other. Sixty-seven percent of these same teens experienced some form of violence or abuse in their own relationships and report a 50 percent higher rate of dating abuse compared to teens who have not witnessed domestic violence between their parents.

While it’s not exactly news that domestic violence increases with stressers such as economic troubles, failure to focus on the horror of parents abusing each other (and in such a high percentage as 44%) is a bit disturbing on several levels — even if the survey was about teens. Put a pin in this; we’ll be back to it in a few minutes.

The survey findings continue:

For the first time, data also shows that despite the fact that the majority of parents say they are comfortable talking about these issues, parents are not effective in educating their children about the dangers of dating abuse. 74 percent of sons and 66 percent of daughters say they have not had a conversation about dating abuse this past year. Even more troubling, the majority of teens who are in abusive relationships report they have not talked to their parents. Of the fewer than one-third who do confide in their parents, 78 percent report staying in these abusive relationships despite their parents’ advice.

Note the glaring statistic: 74 percent of sons and 66 percent of daughters say they have not had a conversation about dating abuse this past year. Evidence that we are not talking to our sons about violence, which leaves them vulnerable to abuse, but also perpetuates the BS that it’s a “women’s issue” and not the responsibility of men.

Arg!

But now, in the “Hurray! We’re doing something!” part, something else disturbs me…

“This poll shows a disconnect between what some parents think is happening with their teenage children and what teens say they are experiencing,” said Family Violence Prevention Fund President (FVPF), Esta Soler. “Not enough parents recognize behaviors that may be warning signs of abuse. It concerns us that about one-third of parents don’t recognize that isolation from family, being kept away from family by a dating partner, and isolation from friends can be danger signs. We are making progress educating parents, but we’d like those numbers to be higher. So we have more work to do. Dating violence is a huge problem in this country, and we need parents, schools and everyone to take responsibility for helping keep teens safe. Macy’s is leading the way with its support for the RESPECT! campaign, which offers the tools parents need to define and promote healthy relationships, and intervene effectively if abuse begins.”

Remember when I asked you to put a pin in that part about domestic violence in the teens’ homes? Well, if 44% of the teen homes surveyed had “parents abusing each other,” then the following can easily be concluded:

Both the parent being abused and their partner (spouse, co-parent, etc.), would be under the influence of domestic violence. They might see the abuse mirrored in their child’s dating relationship, but either A), as the abuser, think it’s OK, B), as the one abused, have no power or influence to intervene (they even may have tried to intervene but were punished for it), &/or C), as the one abused, they too are isolated — and discredited.

Similarly, the teens themselves would be stuck in belief that it’s OK, be dismissive of parents’ comments because they themselves are “living it,” &/or feel powerless in general because of living with domestic violence in the household.

I’m not saying that teen dating violence should not be of any concern, but the data in this survey reveals that the prevalence of domestic violence, especially when combined with gender-skewed safety education, means that such violence prevails because we are too busy providing reasons such as “it’s a tough economy” that “explain” violence rather than flat out condemn it.