Troubled teenage relationships can have lasting health consequences, new research finds

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Teenagers engaged in toxic, controlling dating relationships may be at risk for a variety of problems as they enter adulthood, including drug use, as well as mental and physical health struggles, new research finds.

The study, published Monday in the journal Pediatrics, also showed that such teens are likely to repeat patterns of unhealthy — potentially dangerous — intimate relationships.

“If an adolescent goes from one relationship to another, they are more likely to find themselves in the same situation in the future,” said study author Antonio Piolanti, a post-doctoral researcher in the Institute of Psychology at the University of Klagenfurt in Austria. “We have to try to break this cycle.”

Piolanti and his colleagues reviewed 38 studies conducted between 2004 and 2022 that focused on the effects of a variety of teen dating violence, including sexual, physical, cyber and psychological abuse. Most of the studies were done in the United States, and followed teens for at least one year.

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Altogether, the studies found that young people — most often women — who had been in troublesome romantic relationships during their teen years were more likely to repeat those dating patterns, as well as starting drinking alcohol and smoking cigarettes and marijuana.

Teen dating violence “was also significantly associated with increased sexual risk behaviors, such as unprotected sex or sexual intercourse under the influence of alcohol,” the study authors wrote.

Several of the reviewed studies linked teen dating violence with symptoms of depression in young women for up to six years following the teenage relationship.

The research adds to a worrisome body of evidence showing that girls in particular are at risk for intimate partner violence.

A February report from the Centers for Disease Control and Prevention found that in 2021, nearly 20% of teenage girls said they had been victims of violent sexual behavior. More than 1 in 10 said they had been raped.

In the new study, the overall prevalence of physical violence was 20%, while psychological abuse was much more common, at up to 88%. That includes verbal and nonverbal controlling behavior.

Psychological manipulation can be subtle, perhaps undetectable by the developing teenage brain, said Dr. Anisha Abraham, head of the Division of Adolescent and Young Adult Medicine at Children’s National in Washington, D.C.

“That might be really difficult for them to grasp, as they’re just trying to feel good about their relationship,” Abraham said. Abraham was not involved with the new research.

The new findings do not mean that all teenagers in violent relationships will suffer lasting negative consequences. But “adolescence is a really fundamentally important time where trajectories are set in terms of where young people are going and how they experience the rest of adulthood,” said Dr. Richard Chung, an adolescent medicine specialist at Duke Health in Durham, North Carolina.

“Experiences, whether positive or negative, whether helpful or hurtful, during adolescence can have a lot of consequences,” Chung, who was not involved with the new research, said.

The research review did not include data on LGBTQ teens, though Abraham noted that gay, lesbian and bisexual teenagers “certainly experience higher rates of physical and sexual dating violence compared to those people who are identified as heterosexual.”

What can parents do?

Talking with children as early as possible about healthy relationships is critical, experts agreed.

“There’s a natural default assumption to believe that you don’t have to have those conversations until your teen starts dating,” said Chung. “That’s probably too late.”

Abraham recommended modeling appropriate, respectful behavior among family members from the very beginning.

“It starts with the relationships that they see at home,” she said.

As kids get older, Abraham, who has two teenagers, recommends checking in regularly about what’s happening in their friend groups, finding out whether dating has begun among their peers.

“That is something that I do,” she said. “It’s really important to have conversations, not just with girls, but also with boys, in terms of what are normal healthy relationships.” That includes covering the topics of consent and respect.

Dr. Rina Lazebnik, head of the Division of General Pediatrics and Adolescent Medicine at UH Rainbow Babies and Children’s Hospital in Cleveland, regularly asks her teen patients about their dating and even sex lives.

“It’s a process. You have to talk to them in different ways based on their level of development,” Lazebnik said. “I don’t use a computer while I talk to them because I find that it is very important for me to make eye contact. That lets them know that they have all my attention. Generally, they are open.”

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