Journal of Interpersonal

Violence
http://jiv.sagepub.com/

Dating Violence and Substance Use Among Ethnically Diverse

Adolescents
Jeff R. Temple and Daniel H. Freeman, Jr
J Interpers Violence 2011 26: 701 originally published online 28 June 2010
DOI: 10.1177/0886260510365858
The online version of this article can be found at:
http://jiv.sagepub.com/content/26/4/701

Published by:
http://www.sagepublications.com

On behalf of:
American Professional Society on the Abuse of Children

Additional services and information for Journal of Interpersonal Violence can be found at:
Email Alerts: http://jiv.sagepub.com/cgi/alerts
Subscriptions: http://jiv.sagepub.com/subscriptions
Reprints: http://www.sagepub.com/journalsReprints.nav
Permissions: http://www.sagepub.com/journalsPermissions.nav
Citations: http://jiv.sagepub.com/content/26/4/701.refs.html

>> Version of Record - Feb 28, 2011

OnlineFirst Version of Record - Jun 28, 2010
What is This?
Downloaded from jiv.sagepub.com at West Uni from Timisoara on November 24, 2014

Article

Dating Violence and

Substance Use Among
Ethnically Diverse
Adolescents

Journal of Interpersonal Violence

26(4) 701718
The Author(s) 2011
Reprints and permission: http://www.
sagepub.com/journalsPermissions.nav
DOI: 10.1177/0886260510365858
http://jiv.sagepub.com

Jeff R. Temple1 and

Daniel H. Freeman, Jr.1

Abstract
Teen dating violence is a serious public health concern with numerous and longlasting consequences. Although alcohol and drug use have been associated
with dating violence, little is known about the role of specific substances,
especially the use of club drugs and the nonmedical use of prescription
drugs. Thus, the authors examined the association between dating violence
victimization and the use of a variety of licit and illicit substances among
1,565 ethnically diverse and economically disadvantaged high school students
in southeast Texas. Past year dating violence victimization was reported by
14.1% of boys and 11.3% of girls. Compared to their nonabused counterparts,
youth who experienced dating violence were more likely to smoke cigarettes,
drink alcohol, binge drink alcohol, sniff glue to get high, use marijuana, use
ecstasy, use Vicodin, and use Xanax. However, with the exception of alcohol
and cigarettes, all substances were reduced to nonsignificance in multivariate
analyses. No differences were found in the rate of dating violence between
African American, White, and Hispanic adolescents.
Keywords
dating violence, substance use, adolescents, ethnicity

University of Texas Medical Branch at Galveston

Corresponding Author:
Jeff R. Temple, PhD, Department of Obstetrics & Gynecology, University of Texas Medical
Branch at Galveston, 301 University Boulevard, Galveston, TX 77555-0587
Email: jetemple@utmb.edu

Downloaded from jiv.sagepub.com at West Uni from Timisoara on November 24, 2014

702

Journal of Interpersonal Violence 26(4)

Conservative estimates suggest that approximately 1 in 4 adolescents will

experience some form of dating violence, and about 1 in 10 will experience
severe dating violence (Eaton et al., 2008; Silverman, Raj, Mucci, &
Hathaway, 2001). In the most recent national Youth Risk Behavior Survey
(Centers for Disease Control and Prevention [CDC], 2007), 8.8% of females
and 11% of males reported a past year history of experiencing physical
dating violence. Higher rates have been reported in regional and high-risk
samples (Hickman, Jaycox, & Aronoff, 2004; Watson, Cascardi, AveryLeaf, & OLeary, 2001). For example, in a sample of middle and high school
students, Holt and Espelage (2005) found that 32% of females and 43% of
males had been physically victimized by a dating partner.
Adolescents with a history of dating violence, compared to those without,
generally exhibit higher rates of depression, anxiety, suicidal ideation,
substance use, risky sexual behavior, and eating disorders (Ackard &
Neumark-Sztainer, 2002; Coker et al., 2000; Silverman et al., 2001). They
are also more likely to perform poorly in school and experience difficulties
in future relationships (Smith, White, & Holland, 2003). Perhaps most
alarming is the frequency with which violence in adolescence predicts violence in adulthood. Victims of dating violence are three times more likely to
be victimized in college when compared to students who were not victimized as adolescents (Smith et al., 2003). Furthermore, violence in adolescent
relationships has been shown to relate to more severe forms of violence in
adult relationships (Murphy & OLeary, 1989; OLeary, Malone, & Tyree,
1994). Thus, it is essential that efforts are made to prevent the onset or stall
the progression of adolescent dating violence.
Despite this critical need, very few dating violence prevention programs
exist, and empirical research evaluating their efficacy is minimal (Foshee,
Benefield, Ennett, Bauman, & Suchindran, 2004; Whitaker et al., 2006; Wolfe
et al., 2003). This entire area of research is handicapped by insufficient
knowledge of factors that cause or contribute to the occurrence of dating
violence. Substance abuse, however, is one factor that has been associated
with violence in adolescent relationships (Howard, Qiu, & Boekeloo, 2003;
OKeefe, 1997) and has repeatedly been linked to intimate partner violence
perpetration and victimization in adult relationships (Leonard, 2005;
Temple, Weston, Stuart, & Marshall, 2008). For example, a recent study by
Chase, Treboux, and OLeary (2002) found that 64% of female alcohol
patients reported experiencing IPV victimization, three to five times the rate
of violence in the general population (Straus & Gelles, 1990; Tjaden &
Thoennes, 2000).

Downloaded from jiv.sagepub.com at West Uni from Timisoara on November 24, 2014

Temple and Freeman

703

Several theories have been advanced to account for the relationship

between substance use and partner violence. One explanation is that the
psychopharmacological effects of substances, including impaired cognitive
functioning, increased arousal, and irrational behavior, contribute to violence (Pihl & Peterson, 1995; Virkkunen & Linnoila, 1993; White, 1997).
Although on the surface this theory appears more relevant for violence perpetration, it may also help explain increased victimization among substance
users. For example, it could be that substance use directly increases the risk
of victimization by making youth vulnerable to high-risk situations that
they would otherwise avoid or be equipped to protect themselves (sexual
situations with partner, verbal arguments with partner).
Another possible explanation for the relationship between substance use
and dating violence is the notion that risky and problematic behaviors cluster together (Dryfoos, 1990; Jessor, 1991; Resnick et al., 1997). Howard and
Wang (2003) posited the problem behavior model on finding that weapon carrying, substance use, fighting, risky sexual behaviors, and feeling depressed
all predicted dating violence victimization among a national sample of adolescent females. Furthermore, substance use by victims of violence is highly
related to substance use by the perpetrator (e.g., Koss, Dinero, & Seibel, 1988;
Testa & Parks, 1996). Thus, if an adolescent uses substances on a date, it is
likely that their partner is also using, and numerous studies have found a relationship between substance use and partner violence perpetration (e.g., Stuart,
Moore, Kahler, & Ramsey, 2003).
It is likely that multiple explanations account for the relationship between
substance use and violence and that this association is dependent on the widely
varying physiological and behavioral effects of different substances. For
example, although the sedative effects of alcohol may decrease the ability to
resist assault (Abbey, 2002; Ullman & Brecklin, 2000), the stimulating effects
of cocaine may increase agitation and aggressiveness, which could result in
violence perpetration, one of the strongest predictors of victimization (Watson
et al., 2001). A link between partner violence and specific substances, such as
alcohol, cigarette use, cocaine, marijuana, and other illicit drugs, has been
observed in adult populations (El-Bassel, Gilbert, Wu, Go, & Hill, 2005;
Moore & Stuart, 2005; Stuart et al., 2006, 2008; Stuart, Temple, & Moore,
2007; Testa, Livingston, & Leonard, 2003). However, with few exceptions
(e.g., Howard & Wang, 2003), less is known about the relationship between
specific drugs and adolescent dating violence, especially with respect to the
role of emerging substances such as prescription drugs and so-called club
drugs (e.g., MDMA or ecstasy). Given their high prevalence, we should be

Downloaded from jiv.sagepub.com at West Uni from Timisoara on November 24, 2014

704

Journal of Interpersonal Violence 26(4)

examining the association of these substances with dating violence and other
problematic social issues.

Nonmedical Use of Prescription Drugs

The 2007 Monitoring the Futures survey revealed that nearly 10% of 12th
graders have used Vicodin in the past year (Johnston, OMalley, Bachman, &
Schulenberg, 2008). Across 6 years of data collection (2002-2007), the
National Survey on Drug Use and Health has shown that 3% to 4% of adolescents between the ages of 12 and 17 reported using nonprescription
psychotherapeutics in the past month (Substance Abuse and Mental Health
Services Administration [SAMHSA], 2008). Given the similar effects of certain pain relievers (e.g., Vicodin, OxyContin) and tranquilizers (e.g., Xanax)
to alcohol, there is reason to believe that these substances may also be associated with interpersonal aggression in general (Hoaken & Stewart, 2003) and
dating violence in particular. Furthermore, adolescents who participate in
the risky act of taking nonmedical prescription drugs may be inclined to partake in other risky behaviors that have been associated with dating violence
(e.g., sexual risk taking, alcohol use; Silverman et al., 2001).

Ecstasy
National estimates for ecstasy use among adolescents have ranged from 0.3%
to 0.9% for past month use and between 1.8% and 3.8% for lifetime use
(SAMHSA, 2008). Although less prevalent than the abuse of prescription
drugs, ecstasy may be worth examining in relation to dating violence because
of the high-risk situations often surrounding its use (e.g., clubs, parties).
Although existing research, albeit limited, is mixed on whether ecstasy is
directly related to interpersonal aggression (Hendrickson & Gerstein, 2005;
Hoaken & Stewart, 2003; Reyes et al., 2004), one study found ecstasy use to
be associated with domestic violence victimization among gay/bisexual men
(Klitzman, Greenberg, Pollack, & Dolezal, 2002).

Present Study
The primary purpose of the present study is to investigate the association of
self-reported dating violence victimization with students substance use and
extend existing research by examining the use of two nonmedical prescription
drugs (Vicodin and Xanax) and a popular club drug (ecstasy). A secondary
purpose is to determine the influence of individual substances on the occurrence of teen dating violence.

Downloaded from jiv.sagepub.com at West Uni from Timisoara on November 24, 2014

705

Temple and Freeman

Table 1. Dating Violence Victimization by Student Characteristics

Dating Violence Victimization

% Yes

Variable

Total
12.23
1,565
Gender
Male
13.88
706
11.25
818
Female
Grade
Nine
13.81
478
11.11
477
Ten
Eleven
9.65
342
Twelve
14.56
261
Race/ethnicity
Non-Hispanic White only
12.41
411
12.36
437
Non-Hispanic Black only
Hispanic any race
11.62
611
Non-Hispanic multiple race
14.89
94
Living arrangement
Both parents
9.74
770
14.88
773
Other
Parent education
Did not complete HS
14.88
242
12.78
407
HS graduate
Some college
10.26
302
College graduate
12.22
589

c2(1) = 2.4093, p = .12

c2(3) = 5.1168, p = .16

c2(3) = 0.8514, p = .84

c2(1) = 9.4271, p < .01

c2(3) = 2.7026, p = .44

Note: Pearson chi-squares used to compare groups. HS = high school.

Method
Participants and Procedures
Data collection occurred at a southeast Texas high school during mandatory
English classes in the spring of 2007. Nearly 49% of the students are classified
as economically disadvantaged, 37% are Hispanic, 31% are Black, and 29%
are White (Texas Education Agency, 2008; Table 1). On the day of the assessment, 2,356 students were enrolled at the high school. Of these, 1,668 returned
usable forms. An additional 11 were removed due to invalid data, which
yielded a response rate of 71%. A total of 92 students were removed from the
analyses because of inconsistent responses to questions on substance use (e.g.,
reported past month use but no lifetime use) or for not answering the question
on dating violence, resulting in a final sample size of 1,565 students. Information regarding the number of students present on the day of the administration

Downloaded from jiv.sagepub.com at West Uni from Timisoara on November 24, 2014

706

Journal of Interpersonal Violence 26(4)

versus those who chose not to participate was not assessed. However, the
great majority of nonrespondents were either absent or not in their assigned
classrooms. Although the anonymous nature of the assessment made it
impossible to compare respondents to nonrespondents, study participants
closely matched the age, grade, gender, and ethnic distribution of the enrolled
population.
The questionnaire was based on the Youth Risk Behavior Survey (CDC,
2007), which is a biannual and nationally representative survey of high
school students with the goal of tracking the various causes of morbidity and
mortality among adolescents. Students in the present study were informed
that their responses would be entirely anonymous and were instructed to not
place identifying marks on the questionnaires. Tests were distributed by
teachers. On completion, the questionnaires were sealed in envelopes and
sent for processing by a local university. All forms were reviewed and blank
or damaged forms were deleted, as were forms with identifying information.
Forms were then optically scanned into an electronic database and converted
to a SAS database for analysis. Summary reports were prepared for the school
district to meet specific program planning and evaluation needs. Copies of
the electronic data for this report were released to the authors by the school
district. This study received approval from the Institutional Review Board of
the University of Texas Medical Branch at Galveston.

Measures
Primary variables. Dating violence victimization was assessed by asking
students the following yes/no question: During the past 12 months, did your
boyfriend or girlfriend ever hit, slap, or physically hurt you on purpose?
Students also reported the number of days in the past month they smoked
cigarettes, used marijuana, had at least one drink of alcohol, had five or more
drinks of alcohol in a row, or sniffed glue. Students also reported whether
they had ever used ecstasy, Vicodin, or Xanax.
Control variables. In addition to standard demographic questions (age, race/
ethnicity), students were asked who they live with and provided with several
choices (i.e., both parents, one parent, grandparent, relatives, and friends).
For present analyses, participants were categorized into two groups based on
whether they lived with both parents. In addition, students reported on their
parents education, with the highest education level obtained from either parent
(i.e., did not complete high school, high school graduate, some college,
college graduate) used for the present analyses.

Downloaded from jiv.sagepub.com at West Uni from Timisoara on November 24, 2014

Temple and Freeman

707

Data Analyses
Basic questions were addressed with cross-tabulations of variables against
dating violence. The distribution of dating violence victimization was compared across levels of risk factors using Pearson chi-square statistics. Because
several variables could affect the associations with dating violence and
because of the use of dichotomous variables, logistic regression was used to
estimate adjusted odds ratios (ORs). For all analyses, variables were termed
significantly associated with dating violence for p values less than or equal
to .05. The interpretations of the associations are based on OR and the
corresponding 95% confidence intervals. The OR is the antilog of the usual
logistic regression parameter estimate. This has the convenient interpretation
that, for example, an OR of 2.0 means the risk is doubled. Moreover, joint
ORs can be obtained by multiplying the individual ORs. All computations
were conducted with SAS version 9.1 (SAS, 2004).

Results
All alcohol, tobacco, and drug variables were strongly associated with dating
violence victimization in bivariate analyses (p < .0001). As displayed in Table
2, the magnitude of the associations was addressed by the estimation of ORs
and 95% confidence intervals. The strongest associations were for recent
inhalant use (OR [95% Confidence Interval]3.964 [2.233, 7.036]) and lifetime ecstasy use (4.671 [3.156, 6.920]), whereas the weakest association was
for cigarette smoking (2.461 [1.734, 3.495]). In addition, lifetime use of any
controlled substance (i.e., marijuana, inhalants, ecstasy, Vicodin, or Xanax)
was associated with dating violence victimization (3.119 [2.281, 4.264]).
Age, race/ethnicity, and parents education were not associated with dating
violence victimization. However, adolescents living with both parents were
less likely to report dating violence victimization than were adolescents
living in any other situation.
We next used logistic regression to examine whether any of the substance
use variables were individually associated with dating violence when all variables were included in the model (Table 3). Drinking alcohol (1.617 [1.032,
2.534]) and smoking cigarettes (1.568 [1.036, 2.373]) in the past month were
the only variables significantly associated with dating violence victimization.
However, lifetime use of ecstasy (1.742 [.994, 3.052]) and Vicodin (1.491
[.930, 2.390]) had confidence intervals that just crossed the null value of 1. In
addition, lifetime use of any controlled substance significantly increased the

Downloaded from jiv.sagepub.com at West Uni from Timisoara on November 24, 2014

708

Journal of Interpersonal Violence 26(4)

Table 2. Bivariate Associations Between Substance Use and Dating Violence

Victimization

Dating Violence
Victimization

Variable

% Yes

Recent smoking
Yes
No
Recent marijuana use
Yes
No
Recent alcohol use
Yes
No
Recent binge drinking
Yes
No
Recent inhalant use
Yes
No
Lifetime ecstasy use
Yes
No
Lifetime Vicodin use
Yes
No
Lifetime Xanax use
Yes
No
Lifetime any controlled
substance
Yes
No

95% Confidence
Interval
Odds Ratio

Lower

Upper

22.31
10.45

242
2.461***
1.734
1,311

3.495

22.26
9.57

319
2.705***
1.955
1,233

3.744

18.11
8.00

624
2.542***
1.856
912

3.480

22.19
8.95

365
2.901***
2.111
1,173

3.987

33.33
11.20

57
3.964***
2.233
1,482

7.036

34.31
10.06

137
4.671***
3.156
1,412

6.920

25.00
9.83

248
3.058***
2.174
1,282

4.302

24.81
9.67

258
3.081***
2.198
1,282

4.319

22.92
8.70

384
3.119***
2.281
1,172

4.264

***p < .0001.

likelihood of reporting dating violence, even after controlling for demographic

variables and alcohol use (2.203 [1.525, 3.183]). In fact, adolescents who used
both alcohol and controlled substances were 3.49 times more likely to report
dating violence victimization than adolescents who abstained from substance
use altogether.

Downloaded from jiv.sagepub.com at West Uni from Timisoara on November 24, 2014

709

Temple and Freeman

Table 3. Associations Between Substance Use and Dating Violence Victimization

Controlling for Other Substance Use, Age, Gender, Parent Education, and Living
Situation

95% Confidence Limits

Variablea
Past 30 day use
Cigarettes
Marijuana
Alcohol
Binge drink alcohol
Inhalants
Lifetime use
Ecstasy
Vicodin
Xanax

Adjusted Odds Ratios

Lower

Upper

1.568**
1.191
1.585**
1.548*
1.252

1.036
0.760
1.021
0.972
0.605

2.373
1.790
2.460
2.465
2.589

1.742*
1.491*
1.297

0.994
0.930
0.781

3.052
2.390
2.152

a. All listed variables have 1 degree of freedom.

*p < .10. **p < .05.

To assess potential bias, we also estimated a model in which the students

with discrepant drug reports were included. No appreciable changes were
detected, increasing the confidence in our findings. All models were tested for
goodness of fit using the Hosmer-Lemeshow test with 8 degrees of freedom.
The chi-square test varied between 4.14 and 10.61 depending on the estimated
model. None were statistically significant, indicating a reasonable fit of the
model to the data.

Discussion
From the bivariate logistic regression analyses, it was evident that several different types of substance abuse were related to dating violence victimization.
Adolescent victims of dating violence were 2.5 to 4 times more likely to report
smoking cigarettes, using marijuana, sniffing glue, drinking alcohol, and
binge drinking alcohol than were their nonabused counterparts. Similarly,
youth who experienced dating violence were more than 3 times likely to use
the prescription drugs Xanax and Vicodin and more than 4.5 times likely to
use the club drug ecstasy than youth in nonviolent relationships. These results
are consistent with the literature demonstrating that adolescents who use substances are at greater risk of dating violence than are adolescents who abstain

Downloaded from jiv.sagepub.com at West Uni from Timisoara on November 24, 2014

710

Journal of Interpersonal Violence 26(4)

from substance use (Chase et al., 2002; Foshee et al., 2004; Howard et al.,
2003; Silverman et al., 2001). However, with the exception of alcohol and
cigarettes, all bivariate associations (specific substances) decreased to nonsignificance in the multivariate analyses, in which demographic factors and all
remaining substance abuse variables were included in the model. In other
words, alcohol and cigarettes were the only substances that were associated
with dating violence above and beyond the influence of other substances.
The fact that specific drugs became nonsignificant in the multivariate analyses indicates that the use of any given drug was not, in and of itself, predictive of victimization. It is possible that drug use and violence are both caused
(and thus related) to a third underlying variable, such as antisocial personality
disorder or experiencing child maltreatment. The lack of significance in the
multivariate analysis could also be attributed to multicollinearity because of
the tendency for drug use to co-occur. In fact, when controlled substances
were combined to form one variable, their association with violence emerged,
above and beyond the effects of alcohol use and demographic factors.
Notably, the relationship between ecstasy and dating violence and Vicodin
and dating violence approached significance even when controlling for all
other substances and demographic factors. Considering the number of youth
who use these drugs and the recent rise in popularity of prescription drugs
(SAMHSA, 2008), identifying their relationship to risky behavior and addressing them in substance abuse intervention programs is essential.
It is important to note that although we should never blame violence victims, these results do imply a potential important vulnerability to victimization that is associated with substance use. Moreover, although prevention and
intervention programs should continue targeting the perpetrators of violence,
it may also be beneficial to inform potential victims of the increased risk of
experiencing date violence if they too are using substances.

Gender, Ethnicity, and Living Situation

Our finding that more than 12% of adolescents were physically assaulted by
a dating partner is consistent with previous research and reinforces the claim
that adolescent dating violence is a major public health concern worthy of
immediate attention. Moreover, this is likely an underestimate of the true
prevalence of dating violence because our sample encompassed all students,
including those who have never been on a date. The past year prevalence
of dating violence victimization for boys (14%) and girls (11%) was slightly
higher than national Youth Risk Behavior Surveillance (YRBS) rates (11%
and 9%, respectively; CDC, 2007). The fact that adolescent boys were more

Downloaded from jiv.sagepub.com at West Uni from Timisoara on November 24, 2014

Temple and Freeman

711

likely than their female counterparts to be victims of dating violence is consistent with other dating violence studies (Avery-Leaf, Cascardi, OLeary, &
Cano, 1997; OLeary, Smith-Slep, Avery-Leaf, & Cascardi, 2008). Notably,
the difference between genders was maintained even after adjusting for all
substance use and demographic variables. Accumulating research on adolescent and adult samples suggest that females are as or more likely than males
to perpetrate intimate partner violence and that violent relationships are generally characterized by mutual violence, in which both the male and female
partners engage in aggressive behavior (Archer, 2000; Swahn , Simon, Arias,
& Bossarte, 2008; Temple, Weston, & Marshall, 2005). Although females are
substantially more likely to be injured, sustain sexual aggression, and be otherwise harmed (Temple et al., 2005; Foshee, 1996), the reality of mutual
violence indicates that prevention and intervention programs must consider
the couple dyad in addressing partner violence (Capaldi, Kim, & Shortt,
2007; Capaldi, Shortt, & Crosby, 2003; Stuart et al., 2007). This conclusion
is further supported by research showing that 35% of high school teens
reportedly respond to dating violence victimization with the perpetration of
abuse (Watson et al., 2001).
As with domestic violence in adults, research is mixed on the significance
of ethnicity as a risk marker for adolescent dating violence. Although the
national YRBS found higher rates of dating violence victimization among
African American adolescents (CDC, 2007; Howard & Wang, 2003), the current study found no differences between African American, White, and
Hispanic youth. Because minority populations are disproportionately poor, it is
possible that previously reported differences by ethnicity may be better
explained by differences in sociodemographic factors, such as education and
socioeconomic status (OKeefe, 1997). The fact that our results were based on
a mostly low-income tri-ethnic sample supports this claim. Interestingly,
despite finding no differences between African American, White, and Hispanic
youth, adolescents of multiethnic descent were substantially more likely to
report experiencing dating violence than their counterparts. Although the relatively small sample size of this group makes it difficult to draw conclusions,
this finding warrants additional attention.
Consistent with limited previous research (Champion, Wagoner, Song,
Brown, & Wolfson, 2008), adolescents living with both parents were significantly less likely to report a past year history of dating violence victimization
than were adolescents living in another situation. In fact, on closer examination, the further removed an adolescent was from a traditional household
(i.e., one parent, grandparents, other relatives, friends), the greater their risk
of experiencing dating violence. It is possible that the reason a child is no

Downloaded from jiv.sagepub.com at West Uni from Timisoara on November 24, 2014

712

Journal of Interpersonal Violence 26(4)

longer living with his/her parents (e.g., divorce, incarcerated parents, parental
drug use, child physical abuse, death of parents) increases the risk for psychological problems and delinquent behavior, which may then increase their
likelihood of experiencing dating violence. It is also possible that increasing
family dissolution results in less parental monitoring, a factor that has been
associated with teen dating violence (Howard et al., 2003). Although additional research is needed, these findings suggest that resources should be
allocated to nontraditional households to enhance the social and psychological functioning of the surrogate parents and the children they care for
(Thomas, Sperry, & Yarbrough, 2000). In addition, high school administrators, teachers, and counselors could provide focused attention to students
living in nontraditional households as well as being a resource for their
guardians. Furthermore, prevention and intervention programs could specifically target youth living in nontraditional homes to circumvent their participation in risky behavior.

Limitations
The cross-sectional nature of the data restricts us from knowing whether adolescents drug and alcohol use preceded or followed their experiences with
dating violence. It could be that adolescent victims of dating violence maladaptively use drugs and alcohol to cope with the physical and emotional
pain of being abused (Testa & Leonard, 2001). Longitudinal studies that
explicitly account for the time sequence are needed. Moreover, future research
could examine event-specific data to determine whether drugs and alcohol
are used on the day or at the time of a dating violence incident. Research with
adult populations has shown that about half of partner violence incidents
co-occur with drinking by the perpetrator, victim, or both (Brookoff, OBrien,
Cook, Thompson, & Williams, 1997, Caetano, Cunradi, Clark, & Schafer,
2000; Murphy, Winters, OFarrell, Fals-Stewart, & Murphy, 2005). In addition, the reliance on single-item dichotomous questions and the use of selfreport data limits the generalizability of the findings. Because of the
questionnaire design, we are unable to determine whether a positive response
to the dating violence question indicates a less harmful slap on the wrist, a
life-threatening blow to the head, or somewhere in between. The inability to
determine the context surrounding the violence further limits the generalizability of our findings. Future research should include multi-item violence
scales as well as questions on context, as this would better capture a complex
social issue like interpersonal violence. Furthermore, because data collection
occurred at school and during one class day, we did not assess dropouts or

Downloaded from jiv.sagepub.com at West Uni from Timisoara on November 24, 2014

Temple and Freeman

713

absent students, which could arguably be composed of a disproportionate

number of high-risk youth.
Despite these limitations, the current study extends previous research by
examining the relationship between dating violence and substance use among
a low-income, ethnically diverse sample of adolescents. Although a single crosssectional study cannot be definitive, the present findings suggest several steps.
First, it is clear that we need to continue examining the risk and protective factors
of teen dating violence for girls and boys. Given the severe consequences, we
cannot overlook the opportunity for early interventions to remediate the effects.
Second, the strong relationship identified between licit and illicit substance use
and dating violence victimization reinforces the need to address substance abuse
in any dating violence prevention or intervention program and vice versa.
Acknowledgment
This work would not have been possible without the permission and assistance of the
Galveston Independent School District.

Declaration of Conflicting Interests

The authors declared that they had no conflicts of interests with respect to their
authorship or the publication of this article.

Funding
The authors disclosed that they received the following support for their research
and/or authorship of this article: Dr. Temple is supported by Award Number
K23HD059916 from the Eunice Kennedy Shriver National Institute of Child Health
& Human Development. The content is solely the responsibility of the authors and
does not necessarily represent the official views of the Eunice Kennedy Shriver
National Institute of Child Health & Human Development or the national Institutes of
Health. Dr. Freeman is supported, in part, by the Edgar Gnitzinger Distinguished
Professorship in Aging, the Department of Preventive Medicine and Community
Health, and the UTMB presidents cabinet.

References
Abbey, A. (2002). Alcohol-related sexual assault: A common problem among college
students. Journal of Studies on Alcohol, 14, 118-128.
Ackard, D. M., & Neumark-Sztainer, D. (2002). Date violence and date rape among
adolescents: associations with disordered eating behaviors and psychological
health. Child Abuse & Neglect, 26, 455-473.
Archer, J. (2000). Sex differences in aggression between heterosexual partners:
A meta-analytic review. Psychological Bulletin, 126, 651-680.

Downloaded from jiv.sagepub.com at West Uni from Timisoara on November 24, 2014

714

Journal of Interpersonal Violence 26(4)

Avery-Leaf, S., Cascardi, M., OLeary, K. D., & Cano, A. (1997). Efficacy of a dating
violence prevention program on attitudes justifying aggression. Journal of Adolescent Health, 21, 11-17.
Brookoff, D., OBrien, K. K., Cook, C. S., Thompson, T. D., & Williams, C.
(1997). Characteristics of participants in domestic violence: Assessment at the
scene of domestic assault. Journal of the American Medical Association, 277,
1369-1373.
Caetano, R., Cunradi, C. B., Clark, C. L., & Schafer, J. (2000). Intimate partner
violence and drinking patterns among White, Black, and Hispanic couples in the
U.S. Journal of Substance Abuse, 11, 123-138.
Capaldi, D. M., Kim, H. K., & Shortt, J. W. (2007). Observed initiation and reciprocity of physical aggression in young, at-risk couples. Journal of Family Violence,
22, 101-111.
Capaldi, D. M., Shortt, J. W., & Crosby, L. (2003). Physical and psychological
aggression in at-risk young couples: Stability and change in young adulthood.
Merrill-Palmer Quarterly: Journal of Developmental Psychology, 49, 1-27.
Centers for Disease Control and Prevention. (2007). Youth Risk Behavior Survey.
http://www.cdc.gov/yrbss
Champion, H., Wagoner, K., Song, E. Y., Brown, V. K., & Wolfson, M. (2008). Adolescent date fighting victimization and perpetration from a multi-community
sample: Associations with substance use and other violent victimization and perpetration. International Journal of Adolescent Medicine and Health, 20, 419-429.
Chase, K. A., Treboux, D., & OLeary, K. D. (2002). Characteristics of high-risk
adolescents dating violence. Journal of Interpersonal Violence, 17, 33-49.
Coker, A. L., McKeown, R. E., Sanderson, M., Davis, K. E., Valois, R. F., &
Huebner, E. S. (2000). Severe dating violence and quality of life among South Carolina high school students. American Journal of Preventive Medicine, 19, 220-227.
Dryfoos, J. G. (1990). Adolescents at risk. New York: Oxford University Press.
Eaton, D. K., Kann, L., Kinchen, S., Shanklin, S., Ross, J., Hawkins, J., et al. (2008).
Youth risk behaviors surveillanceUnited States, 2007. MMWR Surveillance
Summary, 57, 1-136.
El-Bassel, N., Gilbert, L., Wu, E., Go, H., & Hill, J. (2005). Relationship between
drug abuse and intimate partner violence: A longitudinal study among women
receiving methadone. American Journal of Public Health, 95, 465-470.
Foshee, V. A. (1996). Gender differences in adolescent dating abuse prevalence, types
and injuries. Health Education Research, 11, 275-286.
Foshee, V. A., Benefield, T. S., Ennett, S. T., Bauman, K. E., & Suchindran, C. (2004).
Longitudinal predictors of serious physical and sexual dating violence victimization during adolescence. Preventive Medicine, 39, 1007-1016.

Downloaded from jiv.sagepub.com at West Uni from Timisoara on November 24, 2014

Temple and Freeman

715

Hendrickson, J. C., & Gerstein, D. R. (2005). Criminal involvement among young

male ecstasy users. Substance Use and Misuse, 40, 1557-1575.
Hickman, L. J., Jaycox, L. H., & Aronoff, J. (2004). Dating violence among adolescents: Prevalence, gender distribution, and prevention program effectiveness.
Trauma, Violence, & Abuse, 5, 123-142.
Hoaken, P. N., & Stewart, S. H. (2003). Drugs of abuse and the elicitation of human
aggressive behavior. Addictive Behaviors, 28, 1533-1554.
Holt, M. K., & Espelage, D. L. (2005). Social support as a moderator between dating
violence victimization and depression/anxiety among African American and
Caucasian adolescents. School Psychology Review, 34, 309-328.
Howard, D., Qiu, Y., & Boekeloo, B. (2003). Personal and social contextual correlates
of adolescent dating violence. Journal of Adolescent Health, 33, 9-17.
Howard, D. E., & Wang, M. Q. (2003). Risk profiles of adolescent girls who were
victims of dating violence. Adolescence, 38, 1-14.
Jessor, R. (1991). Risk behaviors in adolescents: A psychological framework for
understanding and action. Journal of Adolescent Health, 12, 597-605.
Johnston, L. D., OMalley, P. M., Bachman, J. G., & Schulenberg, J. E. (2008).
Monitoring the future national results on adolescent drug use: Overview of key
findings, 2007 (NIH Publication No. 08-6418). Bethesda, MD: National Institute
on Drug Abuse.
Klitzman, R. L. Greenberg, J. D., Pollack, L. M., & Dolezal, C. (2002). MDMA
(ecstasy) use and its association with high risk behaviors, mental health, and
other factors among gay/bisexual men in New York City. Drug and Alcohol
Dependence, 66, 115-125.
Koss, M. P., Dinero, T. E., & Seibel, C. A. (1988). Stranger and acquaintance rape: Are
there differences in the victims experience. Psychology of Women Quarterly, 12, 1-24.
Leonard, K. E. (2005). Alcohol and intimate partner violence. When can we say that
heavy drinking is a contributing cause of violence? Society for the Study of Addiction,
100, 422-425.
Moore, T. M., & Stuart, G. L. (2005). A review of the literature on marijuana and
interpersonal violence. Aggression and Violent Behavior, 10, 171-192.
Murphy, C. M., & OLeary, K. D. (1989). Psychological aggression predicts physical
aggression in early marriage. Journal of Consulting and Clinical Psychology, 57,
579-582.
Murphy, C. M., Winters, J., OFarrell, T. J., Fals-Stewart, W., & Murphy, M. (2005).
Alcohol consumption and intimate partner violence by alcoholic men: Comparing
violent and nonviolent conflicts. Psychology of Addictive Behaviors, 19, 35-42.
OKeefe, M. (1997). Predictors of dating violence among high school students. Journal
of Interpersonal Violence, 12, 546-568.

Downloaded from jiv.sagepub.com at West Uni from Timisoara on November 24, 2014

716

Journal of Interpersonal Violence 26(4)

OLeary, K. D., Malone, J., & Tyree, A. (1994). Physical aggression in early marriage:
Prerelationship and relationship effects. Journal of Consulting and Clinical
Psychology, 62, 594-602.
OLeary, K. D., Smith-Slep, A. M., Avery-Leaf, S., & Cascardi, M. (2008). Gender
differences in dating aggression among multiethnic high school students. Journal
of Adolescent Health, 42, 473-479.
Pihl, R. O., & Peterson, J. B. (1995). Alcoholism: The role of different motivational
systems. Journal of Psychiatry and Neuroscience, 20, 372-396.
Resnick, M. D., Bearman, P. S., Blum, R. W., Bauman, K. E., Harris, K. M., Jones, J.,
et al. (1997). Protecting adolescents from harm: Findings from the National Longitudinal Study of Adolescent Health. Journal of the American Medical Association,
278, 823-832.
Reyes, J. C., Moscoso, M., Veliez, C. N., Rodriguez, F., Colon, H. M., Robles, R.,
et al. (2004). Risk and protective factors associated with youth violence among
secondary school students in a nationally representative sample in Puerto Rico.
Alcohol Dependence, 66, 115-125.
SAS Institute Inc. (2004). SAS/STAT 9.1 users guide. Cary, NC: Author.
Silverman, J. G., Raj, A., Mucci, L. A., & Hathaway, J. E. (2001). Dating violence
against adolescent girls and associated substance use, unhealthy weight control,
sexual risk behavior, pregnancy, and suicidality. Journal of the American Medical
Association, 286, 572-579.
Smith, P. H., White, J. W., & Holland, L. J. (2003). A longitudinal perspective on
dating violence among adolescent and college-age women. American Journal of
Public Health, 93, 1104-1109.
Straus, M. A., & Gelles, R. J. (1990). Physical violence in American families: Risk
factors and adaptations to violence in 8,145 families. New Brunswick, NJ:
Transaction Books.
Stuart, G. L., Meehan, J., Temple, J. R., Moore, T. M., Hellmuth, J., Follansbee, K., et al.
(2006). Readiness to quit cigarette smoking, intimate partner violence, and substance
abuse among arrested violent women. American Journal on Addictions, 15, 396-399.
Stuart, G. L., Moore, T. M., Kahler, C. W., & Ramsey, S. E. (2003). Substance
abuse and relationship violence among men court-referred to batterer intervention programs. Substance Abuse, 24, 107-122.
Stuart, G. L., Temple, J. R., Follansbee, K., Bucossi, M., Hellmuth, J., & Moore, T. M.
(2008). The role of drug use in a conceptual model of intimate partner violence in
men and women arrested for domestic violence. Psychology of Addictive Behaviors,
22, 12-24.
Stuart, G. L., Temple, J. R., & Moore, T. M. (2007). Improving batterer intervention programs through theory-based research. Journal of the American Medical
Association, 298, 560-562.

Downloaded from jiv.sagepub.com at West Uni from Timisoara on November 24, 2014

Temple and Freeman

717

Substance Abuse and Mental Health Services Administration (SAMHSA). (2008).

Results from the 2007 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 08-4343, NSDUH Series H-34). Rockville,
MD: Author.
Swahn, M. H., Simon, T. R., Arias, I., & Bossarte, R. M. (2008). Measuring sex
differences in violence victimization and perpetration within date and same-sex
peer relationships. Journal of Interpersonal Violence, 23, 1120-1138.
Temple, J. R., Weston, R., & Marshall, L. L. (2005). Physical and mental health outcomes of women in nonviolent, unilaterally violent, and mutually violent relationships. Violence and Victims, 20, 335-359.
Temple, J. R., Weston, R., Stuart, G. L., & Marshall, L. L. (2008). The longitudinal
association between alcohol use and intimate partner violence among ethnically
diverse community women. Addictive Behaviors, 33, 1244-1248.
Testa, M., & Leonard, K. E. (2001). The impact of marital aggression on womens
psychological and marital functioning in a newlywed sample. Journal of Family
Violence, 16, 115-130.
Testa, M., Livingston, J. A., & Leonard, K. E. (2003). Womens substance use and
experiences of intimate partner violence: A longitudinal investigation among a
community sample. Addictive Behaviors, 28, 1649-1664.
Testa, M., & Parks, K. A. (1996). The role of womens alcohol consumption in sexual
victimization. Aggression and Violent Behavior, 1, 217-234.
Texas Education Agency. (2008). 2006-07 academic excellence indicator system.
Retrieved February 2, 2010, from http://ritter.tea.state.tx.us/perfreport/aeis/2007/
index.html
Thomas, J. L., Sperry, L., & Yarbrough, M. S. (2000). Grandparents as parents:
Research findings and policy recommendations. Child Psychiatry & Human
Development, 31, 3-22.
Tjaden, P., & Thoennes, N. (2000). Prevalence and consequences of male-to-female
and female-to-male intimate partner violence as measured by the National Violence Against Women Survey. Violence Against Women, 6, 142-161.
Ullman, S. E., & Brecklin, L. R. (2000). Alcohol and adult sexual assault in a national
sample of women. Journal of Substance Abuse, 11, 405-420.
Virkkunen, M., & Linnoila, M. (1993). Brain serotonin, Type II alcoholism and
impulsive violence. Journal of Studies on Alcohol, 11, 163-169.
Watson, J. M., Cascardi, M., Avery-Leaf, S., & OLeary, K. D. (2001). High school
students responses to dating aggression. Violence and Victims, 16, 339-348.
Whitaker, D. J., Morrison, S., Lindquist, C. A., Hawkins, S. R., ONeil, J. A.,
Nesius, A. M., et al. (2006). A critical review of interventions for the primary
prevention of perpetration of partner violence. Aggression and Violent Behavior,
11, 151-166.

Downloaded from jiv.sagepub.com at West Uni from Timisoara on November 24, 2014

718

Journal of Interpersonal Violence 26(4)

White, H. R. (1997). Alcohol, illicit drugs, and violence. In D. M. Stoff, J. Breiling, &
J. D. Maser (Eds.), Handbook of antisocial behavior (pp. 511-523). New York: John
Wiley.
Wolfe, D. A., Wekerle, C., Scott, K., Straatman, A. L., Grasley, C., & Reitzel-Jaffe, D.
(2003). Dating violence prevention with at-risk youth: A controlled outcome
evaluation. Journal of Consulting and Clinical Psychology, 71, 279-291.

Bios
Jeff R. Temple, PhD, is an assistant professor in the department of obstetrics & gynecology at the University of Texas Medical Branch at Galveston. He has been
conducting research on intimate partner violence (IPV) since he began his graduate
studies at the University of North Texas and later as a predoctoral intern and postdoctoral research fellow at Brown University. His research interests include violence
prevention and intervention, along with the mental and physical health effects of IPV
and on factors that influence this relationship (e.g., substance misuse, social
support).
Daniel H. Freeman, Jr., PhD, holds a tenured professorship in the University Texas
Medical Branch at Galvestons School of Medicine. Before coming to Galveston, he
served on the faculty at Yale University and Dartmouth Medical School. He has
mentored dozens of master of public health students and doctoral students. His academic interests include aging, adolescent health and community based participatory
research. He has written more than 160 peer reviewed papers, one book and numerous
book chapters. He currently is a referee for the Journal of the American Medical
Association, the American Journal of Public Health, and Medical Care, as well as
statistical editor of the International Journal of Psychiatry in Medicine.

Downloaded from jiv.sagepub.com at West Uni from Timisoara on November 24, 2014