Given the study findings on the pervasiveness of adolescent dating violence and its consequences, here are my thoughts about what we can do to change prevention efforts and help those who have been violated.

First, I think it's very important to remember that dating violence can occur against girls as well as boys. Second, prevention efforts such as those by families, schools, religious and community organizations, and clubs, should include forums to discuss appropriate dating interactions and safer dating formats, and to strategize ways to handle high-risk situations when they arise. Furthermore, provide ample resources and opportunities for youth to talk about their dating experiences, such as by having pamphlets in guidance and doctors' offices, and offering small group or one-to-one discussions. Third, it's important to be sensitive to the fact that adolescence is a time of normative changes to the body, and it is often difficult for all youth to integrate a positive body image into their sense of self. Yet abusive experiences violate the body and consequently can create difficulties in the development of a positive body image. Disordered eating behaviors may be ways in which adolescents attempt to render the body "unattractive," possibly to deter further abuse or punish the body as the site of the abuse, or may help to alleviate or reduce the painful emotions related to abuse. Despite the perceived helpful nature of eating disorder symptoms, the medical and psychological consequences are highly detrimental and warrant effective treatment. Finally, it's valuable to understand that adolescent dating violence is a nonspecific risk factor for mental health problems. What does this mean? This means that not everyone who is violated by a dating partner will develop the same problems as another peer who is violated; it also means that we cannot assume that a teen who is struggling with alcohol problems or eating disorders has been abused by a dating partner. It does mean that we need to protect our youth from dating violence, help them navigate dating relationships, and provide opportunities for talking and healing when violence does occur.

If you have been abused by a dating partner or know someone who has, you can receive support and guidance by visiting the National Teen Dating Abuse Helpline at http://loveisrespect.org.

Because of my clinical work in eating disorders, which predominantly affect younger individuals, I have had the joy of working with many adolescents. Yet I have been alarmed in hearing of numerous unhealthy dating experiences, either their own or those of their friends. Subsequently, one of my primary areas of focus has been on adverse dating experiences among adolescents.

• In 2002, we published the largest study to date on adolescent dating violence. In a survey of over 81,247 Minnesota youth, we found that a worrisome 9% of girls and 6% of boys had experienced either physical or sexual violence by a dating partner. Of further concern, dating violence was found to be associated with higher rates of disordered eating behaviors (such as binge-eating, fasting or skipping meals, taking diet pills, self-induced vomiting, and taking laxatives) and suicidal thoughts and attempts, and lower scores on measures of emotional well-being and self-esteem. Visit the American Psychological Association's press release for this article.
• In 2003, we published a follow-up study of over 3,000 youth who completed the Commonwealth Fund Survey of the Health of Adolescent Boys and Girls. With this nationally representative population-based sample, and using a different definition of physical or sexual violence by a dating partner, our findings showed that an alarmingly high 17% of girls and 9% of boys reported adolescent dating violence. Dating violence was found to be associated with a broad range of behavioral and mental health risks, including dieting, binge-eating and purging behaviors, cigarette smoking, alcohol consumption, drug use, suicidal thoughts, depression, and poorer self-esteem for both girls and boys. Of particular concern was our finding that approximately 50% of girls and boys who had experienced physical and sexual dating violence also reported staying in relationships out of fear of physical harm.

Several weeks ago, in a meeting with several colleagues in the field of eating disorders, we discussed the role of family members in preventing eating disorders. This came on the heels of an excellent presentation by an MPH student who conducted interviews with individuals receiving treatment for an eating disorder, and who were asked to identify how parents could prevent eating, weight, and shape concerns.

This is not to say that family members are responsible for causing eating disturbances, but to assert that they can be part of the solution in preventing them (obviously other parts are shared with schools, coaches, the media, role models, etc.).

The question is, “How can we provide guidance to families on prevention practices (such as not engaging in or tolerating weight/shape-related teasing, promoting healthy eating without emphasizing dieting and weight status, being a role model for positive body image, etc.) without family members feeling blamed?”

I’d welcome your thoughts on this concern so that we can provide prevention practices in a manner that is encouraging and welcoming. Thank you.