Background
Methods
Sample
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Study 1, conducted from March, 2011 to April, 2011, involved randomly sampling 730 students from the registrar’s office, from a total of 32,716 students age 18 to 21 enrolled at Ohio State University [22]. Using students’ university email account, we sent a recruitment email, which included the study description and link to the online survey. Two follow-up reminders were sent by email, three and seven days after the initial email. The cumulative response rate at each recruitment email was as follows: initial email (31.6%, 231/730); second email (41.0%, 300/730); final email (46.7%, 341/730) [22]. Subjects who completed the survey were credited $20 to their university account. Of the 341 subjects who completed the survey, 44 were excluded because they were older than age 21 (n = 7) or because they never had a dating partner from age 13 to 19 (n = 37). After these exclusions, the eligible analytic sample comprised 297 subjects who had a dating partner from age 13 to 19 (n = 190 females; n = 107 males).
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Study 2, conducted from May, 2011 to March, 2012, involved recruiting students ages 18 to 21 enrolled in four undergraduate Human Development and Family Science courses at The Ohio State University. Through an introductory email which included the study description and survey link, instructors offered completing the survey as extra credit coinciding with the coverage of relationship-related topics in class. A total of 311 students completed the survey; according to the class rosters, this represented 98% of eligible students. Of the 311 students, the eligible analytic sample comprised 288 subjects who had a dating partner from age 13 to 19 (n = 255 females and 33 males). The over-distribution of females in the sample is consistent with the gender distribution in the Human Development and Family Science undergraduate program.
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Our current analysis combined the two samples, totaling 585 subjects (n = 297 from the first study plus 288 from the second study). The over-distribution of females in Study 2 (recruited from undergraduate classes) compared to Study 1 (recruited through the university registrar) represented the main difference between the two samples, with otherwise similar characteristics between the two samples due to our narrow eligibility criteria (e.g., subjects had to be between the ages of 18 and 21).
Survey
Health and health behaviors
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Depressive symptoms over the last two weeks were assessed using two questions from the nine-item Patient Health Questionnaire [45], which have a sensitivity of 74% for detecting depressive symptoms among adolescents relative to the Diagnostic and Statistical Manual of Mental Disorders [46]. The two questions included:○ Having little interest in doing things;○ Feeling down/hopeless.
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The two depression questions were scored as separate items, not as a composite measure; the response options for each question ranged from 0 (not at all) to 3 (nearly every day). In the analysis, the item responses were collapsed into a binary category (0 = not at all; 1 = experienced symptoms on any day).
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Unhealthy/disordered eating behaviors were assessed using three questions from the Youth Risk Behavior Surveillance System [47], including whether subjects ever:○ Fasted, vomited, or took diet aids to lose weight (each its own separate question).
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Response options to the questions were binary (yes/no).
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Binge drinking and smoking were assessed using questions from the Youth Risk Behavior Surveillance System [47], including:○ Ever smoked daily for 30 or more days;○ Had 5 or more drinks on six or more days over last month.
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Response options to the questions were binary (yes/no).
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Sexual behavior was assessed by asking about subjects’ ever engagement (yes/no) in vaginal/penile intercourse, oral sex, and anal sex, and the number of partners they engaged in the sexual activity with (subjects reported the number of partners). The cut point for frequent oral and vaginal sex was defined as having five or more partners. Anal sex was less common, so the definition included having had any anal sex. While these measures are likely to indicate sexual health risk from sexual transmitted infections and unwanted pregnancy, they may not constitute equivalent risk.
Relationship and dating violence histories
Physical/sexual | |
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…hit, slapped, or physically hurt you on purpose? | |
… pressured you to participate in sexual activities by begging or arguing with you, or by threatening to end your relationship? | |
… pressured you to participate in sexual activities by threatening you with physical force (i.e., twisting your arm or holding you down)? | |
Non-physical
| |
…threatened to hit or slap you, to spread rumors about you, to destroy something belonging to you, or to harm you in some other way? | |
…tried to control your behavior by always checking up on you, telling you who your friends could be, or telling you what you could do and when? | |
…called you names, put down your looks, or said things to hurt your feelings on purpose? | |
…shouted, yelled, insulted, or sworn at you? | |
…made unwanted phone calls, send unwanted text messages, emails, or gifts, or showed up in person and waited for you when you didn’t want them to? |
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Physical and/or sexual dating violence exposure included subjects who reported experiencing physical and/or sexual types of dating violence. Subjects in this group could also have exposure to non-physical abuse. We included exposure to sexual pressure involving either (or both) verbal and physical coercion, as verbally coerced sexual acts have been shown to have lasting trauma for victims [25, 43].
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Non-physical only dating violence exposure included subjects who were not exposed to physical/sexual dating violence, but who reported experiencing any of the non-physical dating violence types listed in Table 1. For ease in reporting, this group is referred to as the “non-physical TDV” group.
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Non-exposed subjects included those who reported never experiencing physical, sexual, or non-physical types of dating violence from age 13 to 19.
Other (non-dating) abuse exposures
Analysis
Female | Male | |
---|---|---|
Total | N = 445 | N = 140 |
Age, mean (SD) | 19.8 (1.0) | 19.8 (1.0) |
Year in college | ||
Freshman | 114 (25.8) | 45 (32.1) |
Sophomore | 149 (33.7) | 41 (29.3) |
Junior | 139 (31.5) | 41 (29.3) |
Senior | 40 (9.1) | 13 (9.3) |
Missing | 3 | 0 |
Race | ||
White | 377 (85.1) | 116 (82.9) |
Black | 26 (5.9) | 12 (8.6) |
Asian | 24 (5.4) | 11 (7.9) |
Other | 16 (3.6) | 1 (0.7) |
Missing | 2 | 0 |
Sexual orientation | ||
Heterosexual | 410 (92.3) | 127 (90.7) |
Bisexual | 16 (3.6) | 1 (0.7) |
Homosexual | 6 (1.4) | 7 (5.0) |
Asexual | 12 (2.7) | 5 (3.6) |
Missing | 1 | 0 |
Ever been bullied (age 13 to 19) | ||
No | 247 (55.9) | 78 (56.1) |
Yes | 195 (44.1) | 61 (43.9) |
Missing | 3 | 1 |
Physical child abuse | ||
No | 410 (92.8) | 127 (91.4) |
Yes | 32 (7.2) | 12 (8.6) |
Missing | 3 | 1 |
Sexual child abuse | ||
No | 387 (88.0) | 135 (97.1) |
Yes | 53 (12.0) | 4 (2.9) |
Missing | 5 | 1 |
Results
Characteristics of the study sample
Prevalence of dating violence victimization
Female (N = 445) | Male (N = 140) | |||||
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# Reporting abuse | Prevalence (95% CI) | RSE† | # Reporting abuse | Prevalence (95% CI) | RSE† | |
Physical/sexual
| ||||||
Physical | 25 | 5.6 (3.5, 7.8) | 19.4 | 17 | 12.1 (6.7, 17.6) | 22.8 |
Sexual – verbal coercion | 112 | 25.3 (21.2, 29.3) | 8.3 | 13 | 9.4* (4.5, 14.2) | 26.5 |
Sexual – physical force | 24 | 5.4 (3.3, 7.5) | 19.9 | 1 | 0.7* (0.0, 2.1) | 100 |
Any physical/sexual
| 126 | 28.4 (24.2, 32.6) | 7.8 | 27 | 19.3 (12.7, 25.9) | 17.7 |
Non-physical
| ||||||
Threaten | 53 | 12.0 (9.0, 15.0) | 13.0 | 14 | 10.1* (5.0, 15.1) | 25.4 |
Controlling behavior | 124 | 27.9 (23.7, 32.1) | 7.7 | 29 | 20.7 (14.0, 27.5) | 16.5 |
Put down, name calling | 152 | 34.3 (29.9, 38.7) | 6.7 | 25 | 17.9 (11.5, 24.2) | 18.6 |
Yell, swore, insulted | 211 | 47.6 (43.0, 52.3) | 5.0 | 57 | 40.7 (32.5, 48.9) | 10.1 |
Unwanted calls, texts, visits | 128 | 28.9 (24.7, 33.1) | 7.6 | 36 | 25.7 (18.4, 64.7) | 14.3 |
Any non-physical
| 287 | 64.6 (60.2, 69.1) | 3.6 | 79 | 56.4 (48.2, 64.7) | 7.4 |
Any TDV
| 300 | 67.4 (63.0, 71.8) | 3.3 | 80 | 57.1 (48.9, 65.4) | 7.3 |
Bivariate analysis
Female | Male | |||||
---|---|---|---|---|---|---|
No TDV | Any TDV | p-value | No TDV | Any TDV | p-value | |
N = 145 | N = 300 | N = 60 | N = 80 | |||
Ever smoked daily for 30+ days | ||||||
No | 141 (97.2) | 265 (88.3) | 0.002 | 57 (95.0) | 67 (83.8) | 0.038 |
Yes | 4 (2.8) | 35 (11.7) | 3 (5.0) | 13 (16.3) | ||
5+ drinks on 6 or more days in past 30 days | ||||||
No | 127 (87.6) | 249 (83.0) | 0.21 | 49 (81.7) | 60 (75.0) | 0.35 |
Yes | 18 (12.4) | 51 (17.0) | 11 (18.3) | 20 (25.0) | ||
Depression (past 2 weeks)
| ||||||
Have little interest in doing things | ||||||
No | 95 (65.5) | 137 (45.7) | <0.001 | 39 (65.0) | 44 (55.0) | 0.23 |
Yes | 50 (34.5) | 163 (54.3) | 21 (35.0) | 36 (45.0) | ||
Feel down, hopeless | ||||||
No | 107 (73.8) | 166 (55.3) | <0.001 | 46 (76.7) | 47 (58.8) | 0.026 |
Yes | 38 (26.2) | 134 (44.7) | 14 (23.3) | 33 (41.2) | ||
Disordered eating (ever)
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Fasted 24+ hours to lose weight | ||||||
No | 138 (95.2) | 238 (79.3) | <0.001 | 57 (95.0) | 71 (88.8) | 0.19 |
Yes | 7 (4.8) | 62 (20.7) | 3 (5.0) | 9 (11.3) | ||
Taken diet aids to lose weight | ||||||
No | 126 (86.9) | 231 (77.3) | 0.016 | 57 (95.0) | 67 (83.8) | 0.038 |
Yes | 19 (13.1) | 68 (22.7) | 3 (5.0) | 13 (16.2) | ||
Vomited to lose weight | ||||||
No | 139 (95.9) | 258 (86.3) | 0.002 | 60 (100.0) | 76 (95.0) | 0.08 |
Yes | 6 (4.1) | 41 (13.7) | 0 (0.0) | 4 (5.0) | ||
Number of sexual partners
| ||||||
Intercourse | ||||||
<5 | 128 (89.5) | 219 (75.0) | <0.001 | 52 (91.2) | 66 (83.5) | 0.19 |
5 or more | 15 (10.5) | 73 (25.0) | 5 (8.8) | 13 (16.5) | ||
Oral sex | ||||||
<5 | 124 (86.7) | 224 (76.5) | 0.012 | 50 (86.2) | 65 (81.3) | 0.44 |
5 or more | 19 (13.3) | 69 (23.6) | 8 (13.8) | 15 (18.8) | ||
Anal sex | ||||||
None | 133 (92.4) | 241 (80.9) | 0.002 | 53 (89.8) | 66 (83.5) | 0.29 |
1 or more | 11 (7.6) | 57 (19.1) | 6 (10.2) | 13 (16.5) |
Multivariable analysis
Among female respondents | |||||
---|---|---|---|---|---|
No TDV | Physical and/or sexual | Non-physical only | Physical/sexual vs. No TDV | Non-physical only vs. No TDV | |
N = 145 | N = 126 | N = 174 | |||
n (%) | n (%) | n (%) | PR (95% CI) | PR (95% CI) | |
Ever smoked daily for 30+ days | 4 (2.8) | 17 (13.5) | 18 (10.3) | 3.95 (1.38, 11.3) | 3.61 (1.25, 10.5) |
5+ drinks on 6 or more days in past 30 | 18 (12.4) | 18 (14.3) | 33 (19.0) | 1.05 (0.57, 1.96) | 1.51 (0.89, 2.56) |
Depression (past 2 weeks)
| |||||
Have little interest in doing things | 50 (34.5) | 81 (64.3) | 82 (47.1) | 1.79 (1.37, 2.34) | 1.36 (1.03, 1.79) |
Feel down, hopeless | 38 (26.2) | 69 (54.8) | 65 (37.4) | 2.00 (1.45, 2.76) | 1.41 (1.01, 1.97) |
Disordered eating (ever)
| |||||
Fasted 24+ hours to lose weight | 7 (4.8) | 33 (26.2) | 29 (16.7) | 4.71 (2.12, 10.5) | 3.37 (1.53, 7.45) |
Taken diet aids to lose weight | 19 (13.1) | 32 (25.6) | 36 (20.7) | 1.98 (1.17, 3.36) | 1.59 (0.96, 2.65) |
Vomited to lose weight | 6 (4.1) | 22 (17.6) | 19 (10.9) | 4.33 (1.72, 10.9) | 2.66 (1.09, 6.51) |
Number of sexual partners
| |||||
Intercourse (5 or more) | 15 (10.5) | 34 (27.4) | 39 (23.2) | 2.49 (1.43, 4.32) | 2.20 (1.27, 3.80) |
Oral sex (5 or more) | 19 (13.3) | 35 (28.2) | 34 (20.1) | 2.02 (1.22, 3.33) | 1.53 (0.92, 2.54) |
Anal sex (1 or more) | 11 (7.6) | 28 (22.6) | 29 (16.7) | 2.82 (1.46, 5.45) | 2.18 (1.15, 4.13) |
Among male respondents
| |||||
No TDV | Physical and/or sexual | Non-physical only | Physical/sexual vs. No TDV | Non-physical only vs. No TDV | |
N = 60 | N = 27 | N = 53 | |||
n (%) | n (%) | n (%) | PR (95% CI) | PR (95% CI) | |
Ever smoked daily for 30+ days | 3 (5.0) | 3 (11.1) | 10 (18.9) | 2.28 (0.50, 10.3) | 3.91 (1.18, 13.0) |
5+ drinks on 6 or more days in past 30 | 11 (18.3) | 9 (33.3) | 11 (20.8) | 1.94 (0.92, 4.07) | 1.18 (0.71, 2.46) |
Depression (past 2 weeks)
| |||||
Have little interest in doing things | 21 (35.0) | 9 (33.3) | 27 (50.9) | 0.94 (0.50, 1.78) | 1.43 (0.93, 2.20) |
Feel down, hopeless | 14 (23.3) | 11 (40.7) | 22 (41.5) | 1.68 (0.88, 3.23) | 1.69 (0.98, 2.92) |
Disordered eating (ever)*
| 6 (10.0) | 3 (11.1) | 16 (30.2) | 1.08 (0.29, 4.02) | 2.93 (1.24, 6.95) |
Number of sexual partners
| |||||
Intercourse (5 or more) | 5 (8.8) | 4 (14.8) | 9 (17.3) | 1.78 (0.52, 6.09) | 2.09 (0.75, 5.81) |
Oral sex (5 or more) | 8 (13.8) | 6 (22.2) | 9 (17.0) | 1.52 (0.60, 3.82) | 1.14 (0.47, 2.73) |
Anal sex (1 or more) | 6 (10.2) | 3 (11.1) | 10 (19.2) | 1.10 (0.29, 4.15) | 1.90 (0.73, 4.96) |