Teen Dating Violence; Co-Occurrence with Bullying among African American Teens in South Florida.

Chapter 1: Introduction to the Study

Introduction

Teen dating violence and bullying are major public health issues (Center for

Disease Control and Prevention, 2014a; Espelage, Basile, & Hamburger, 2012). The

burden of teen dating violence and bullying is not only carried by the individual but the

larger society. In a 2011 survey, 9.45% of students reported being victims of teen dating

violence during the previous 12 months and 16.2% reported having been bullied

electronically during the previous 12 months (Center for Disease Control and Protection,

2014a). Additionally, 20.1% of students reported being bullied while on school property

during the previous 12 months (Center for Disease Control and Prevention, 2014a). Both

teen dating violence and bullying are associated with negative outcomes which include

psychological, physical, and behavioral distrubances (Center for Disease Control and

Prevention, 2014a; Kowalski & Limber, 2013). Although teen dating violence and

bullying among teens occurs within simialr social sphere (Foshee V. A., et al., 2014),

there is limited research on the co-occurrence of both forms of violence. Futhermore,

African American teens have been reported as having higher prevalence rates of dating

violence; whereby, they were more likely to report victimization than their White and

Hispanic counterparts (Centers for Disease Control and Prevention, 2010). Despite these

findings, there is limited research which examines aspects of teen dating violence and co-

occurrence with other forms of violence such as bullying among African American teens.

Research which examines the co-occurrence of teen dating violence and bullying among

African American teens may help inform violence prevention programs which target this

population . Changing the conditions that contribute to teen dating violence would be a

positive social change. It is possible that the results of this study might inform

community organizations on the relationship among various forms of violence which

could help in targeting teen programs in their communities to include the impact of

neighborhood violence on teens as it relates to dating violence and bullying. On a family

level, social change may occur based on results of this study as it relates to the role of

spending time with a parent on occurrence of dating violence and bullying. Furthermore,

on the individual level, social change may occur as it relates to informing teens thorough

teen dating programs about bullying as a potential risk factor for potential dating violence

victimization.

This chapter will include the background of the study that will summarize the

research literature and gaps in knowledge as it relates to teen dating violence and

bullying. Furthermore, the problem statement based on primary research occurring within

the past 5 years is presented. Additionally, I will discuss the purpose of the study based

on the study intent and research questions and hypotheses. Next, I will discuss the

theoretical and conceptual framework of the study before addressing the nature of the

study that includes a description of the variables, methodology, and definitions of terms.

Furthermore, clarification of assumptions, which are critical to the meaningfulness of the

study, are discussed as well as the scope and any limitations as it relates to internal and

external validity, bias and boundaries of the study. I will end by discussing the

significance of the study based on social change and how knowledge gained could benefit

the field of public health as it relates to teen dating violence and bullying among African

Americans. To end the chapter, a summary of the main points with a transition to Chapter

2 is presented.

Background

Responding to the 2011 Youth Risk Behavior Survey, 9.4 %of high school

students reported experiencing dating violence as defined as being hit, slapped, or

physically hurt by someone they defined as their boyfriend or girlfriend during the

previous 12 months (Center for Disease Control and Prevention, 2013). Researchers have

reported that teens who are victims of dating violence are more likely to do poorly in

school, abuse substances, and attempt suicide (Exner-Cortens, Eckenrode, & Rothman,

2013; Maas, Fleming, Herrenkohl, & Catalano, 2010). Several researchers reported that

gender plays a role in teen dating violence where females are more likely to be victims

and suffer longer lasting injury as a result of victimization (Alleyne, Coleman-Cowger,

Crown, Gibbons, & Vines, 2011;Coker et al., 2014; Exner-Cortens, Eckenrode, &

Rothman, 2013; Maas, et al., 2010)

There is limited focus in the literature as it relates to ethnicity/race and teen dating

violence. Responding to the 2009 Youth Risk Behavior Survey (YRBS), African

American teens reported the highest rate of teen dating violence victimization during the

previous 12 months (Center for Disease Control and Prevention, 2010). Despite the

YRBS results, researchers are conflicted as to the impact of race/ethnicity on teen dating

violence. (Temple & Freeman, 2011; Tyler, Brownridge, & Melander, 2011). The

conflict within the literature appears to exist due to limited studies that have focused on

examining the relationship between race/ethnicity and teen dating violence. Studies

consist of majority white populations and researchers who conduct analysis of their

limited nonwhite samples as part of their overall results, find it difficult to draw definitive

relationships between race/ethinicity and teen dating violence. Furthermore, few studies

target African American teens where majority of the studies targeted majority white

populations.

Risk factors for teen dating violence as reported in the literature include low self

esteem, low income, low academic achievement, aggressive or delinquent behavior,

history of mental illness, history of alchol abuse, drug abuse, impulsive or aggressive

tendencies, laws that maintain unequal access to goods, services and opportunities, or

societial norms that support violence and male dominance (Center for Disease Control

and Prevention, 2012a). Protective factors include nurturing parenting skills, stable

family relationships, connectedness between teens and their neighborhoods, after school

and recreational programs, and communities that take responsibility as it relates to

violence prevention (Center for Disease Control and Prevention, 2012a).

For the purposes of this study, bullying is defined as any repetitive unwanted

aggressive behavior by another teen or group of teens who are not related or currently

dating partners that involves observed or perceived imbalance of power (Center for

Disease Control and Prevention, 2015). Furthermore, aggression related to bullying will

include, physical, verbal, social/relational, and/or electronic (Center for Disease Control

and Prevention, 2015).The literature on bullying among teens has focused on various

forms of bulllying such as face-to-face bullying, Cyberbullying, sexual bullying and

school bullying. The majority of recent research in the area of bullying has centered

around Cyberbullying due to the increased use of technolgy among youth (Slonje, Smith,

& Frisen, 2013). Additionally, several researchers have examined co-occurrence of

various forms of bullying (Kowalski & Limber, 2013; Wang, Iannotti, & Nansel, 2009).

Co-occurrence of bullying and teen dating violence was limited in the literature ( Miller,

et al., 2013; Yahner, Dank, Zweig, & and Lachman, 2014; Zweig, Dank, Yahner, &

Lachman, 2013). When bullying and teen dating violence were studied, the focus was on

examining if perpretation of bullying predicted teen dating violence as teens moved from

early to late adolescence ( Ellis & Wolfe, 2014; Foshee, et al., 2014).

Studies which focused primarily on African Americans as it related to bullying

was limited. Despite finding few studies which targeted African Americans as it related

to bullying, the authors who discussed race/ethnicity described an association between

bullying and race/ethnicity as being prevalent (Bauman, Toomey, & Walker, 2013;

Bradshaw, Waasdorp, Goldweber, & Johnson, 2013; Goldweber, Waasdrop, &

Bradshaw, 2013; Kowalski & Limber, 2013; Williams & Peguero, 2013). When results

were given along race/ethnicty lines, AfricanAmerican teens were at greater risk of bully

victimization (Goldweber et al., 2013;Williams & Peguero, 2013) as well as perpretration

of bullying (Wang et al.,, 2009).

Despite extensive research in teen dating violence and bullying, there is minimal

research as it relates to co-occurrence of teen dating violence and other forms of violence

and substantially less relating to co-occurrence of teen dating violence and bullying.

Although some researchers have shown an association between bullying in early

adolescence and experiencing or perpetrating dating violence in later adolscence, further

research is needed as it relates to teen dating violence, bullying and race/ethnicity (Ellis

& Wolfe, 2014; Foshee, et al., 2014; Miller, et al., 2013). Research which explores the

relationship among teen dating violence victimzation, bully victimization and

race/ethniciy may help to inform current and future violence prevention programs which

target African American youth. This study will help to add to the field of teen dating

violence especially as it relates to the African American teen population which reported a

higher rate of teen dating violence victimization (Center for Disease Control and

Prevention, 2010).

Problem Statement

Teen dating violence and bullying are major public health issues. During a

nationwide survey, 23% of females and 14% of males, who reported experiencing

intimate partner violence, stated that their first occurrence was between the age of 11 and

17 (Center for Disease Control and Prevention, 2014a) . Both teen dating violence

victimization and bully victimization contribute to negative psychological and physical

outcomes (Foshee, et al., 2014). Negative impact of teen dating violence and bullying

contribute to unacceptable societal and economical consequences (Center for Disease

Control and Prevention, 2012a). African American teens reported higher rates of teen

dating violence victimization (Centers for Disease Control and Prevention, 2010), and

researcher have reported in several studies that race/ethnicity may be associated with

bullying (Bradshaw et al., 2013;Goldweber et al., 2013; Wang et al., 2009). Currently,

prevention programs which focus on teen dating violence and bullying occur in isolation

of each other (Niolon, et al., 2015). Research suggest that there may be an association

among teen dating violence and various forms of violence (Foshee, et al., 2014; Niolon,

et al., 2015). There is a gap in the field of teen dating violence as it relates to co-

occurrence with bullying which widens as it relates to African American teens

(Goldweber et al., 2013).

Purpose of the study

The purpose of this quantitative study using archival data from the 2013 YRBSS

for Palm Beach County Florida was to examine the relationship between race/ethnicity,

gender, age, substance use, and age of first sexual intercourse and bully and teen dating

violence victimization. I also examined the effect of protective factor spending time with

a parent as a potential mediating variable.

Research Questions and Hypotheses

Research Question 1: What is the relationship between race, gender, substance

abuse, age, and age of first sexual intercourse and the likelihood of being a victim of (a)

bullying, (b) teen dating violence, and (c) bullying and teen dating violence?

1a: There is no relationship between race, gender, substance abuse, age, and

age of first sexual intercourse and the likelihood of being a victim of bullying.

1a: There is a relationship between race, gender, substance abuse, age, and age

of first sexual intercourse and the likelihood of being a victim of bullying.

1b: There is no relationship between race, gender, substance abuse, age, and

age of first sexual intercourse and the likelihood of being a victim of teen dating violence.

1b: There is a relationship between race, gender, substance abuse, age, and age

of first sexual intercourse and the likelihood of being a victim of teen dating violence.

1c: There is no relationship between race, gender, substance abuse, age, and

age of first sexual intercourse and the likelihood of being a victim of bullying and teen

dating violence.

1c: There is a relationship between race, gender, substance abuse, age, and age

of first sexual intercourse and the likelihood of being a victim of bullying and teen dating

violence.

Research Question 2: Does spending time with a parent mediate any relationships

between experiencing bully victimization and experiencing teen dating violence when

controlling for race, gender, substance abuse, age, and age of first sexual intercourse.

2: Spending time with a parent does not mediate the relationships between

experiencing bully victimization and experiencing teen dating violence after accounting

for race, gender, substance abuse, age, and age of first sexual intercourse.

2: Spending time with a parent does mediate the relationships between

experiencing bully victimization and experiencing teen dating violence after accounting

for the influence of race, gender, substance abuse, age, and age of first sexual intercourse.

Theoretical and/or Conceptual Framework for the Study

Research that focuses on social and cultural factors as it relates to human behavior

frequently reference social learning theory (McCullough Chavis, 2012). Social learning

theory is based on the premise that environment, personal factors and behaviors are

constantly interacting and influencing each other (Bandura, 2001). Furthermore, the

theory proposes that human behavior is a result of observational learning and vicarious

reinforcement which is a foundation of social learning theory (Bandura, 2001) . How

behaviors, once acquired, are expressed and regulated by individual and external forces is

another key component of social learning theory (Bandura, 1973). Teen dating violence

and bullying occurs most often within the social circle in which teens abide. Therefore,

based on social learning theory, examining the relationship among various forms of

violence which occurs among teens within the school setting such as bullying, offers an

opportunity to change violent behavior which occurs within the teen social circle.

A lengthy description as it relates to social learning theory and how it relates to

the focus of this study was presented in Chapter 2.

Nature of the study

Identifying associations among various forms of violence such as teen dating

violence and bullying is essential in meeting the needs of teens within violence

prevention programs and those that might be struggling with these issues on their own.

Currently, teen dating violence and bully prevention programs operate in isolation of

each other (Espelage et al., 2012) and may not be meeting the needs of the teen

population. In this study, I used a quantitative cross sectional survey design to examine

the relationship between dependent variable teen dating violence victimization and the

independent variable bully victimization while controlling for age, gender, race/ethnicity,

substance abuse, and age of first sexual intercourse. I also tested spending time with

parents for its effect.

Archival data collected in 2013 for the Palm Beach County Youth Risk Behavior

Survey (YRBS) was used to examine the variables. The YRBS, used in Palm Beach, was

developed by the Center for Disease Control and Prevention for describing the prevalence

of health-risk behaviors among youth (Center for Disease Control and Prevention,

2014b). It also assesses trends in health-risk over time with a goal of providing public

health professionals with the tools needed to evaluate and improve policies and programs

that target youth (Center for Disease Control and Prevention, 2014c). The Palm Beach

County YRBS collected data in the spring of 2013 from 2,376 high school students using

in-school questionnaires ( Center for Disease Control and Prevention, 2014b). The

dataset for the Palm Beach County YRBS is available through the Center for Disease

Control and Prevention. Once I have received approval from Walden University IRB, I

requested the dataset from Palm Beach County Department of Health as this is required

in order for Center for Disease Control and Prevention to release the data. To answer the

research questions, I used archival data from 1,836 respondents. The YRBS is

appropriate for my study as it was one of few self-reported data sets that targets high

school students and includes questions specific to teen dating violence victimization,

bully victimization, and variables which act as risk and protective factors (e.g., substance

abuse, age of first sexual intercourse, and spending time with parent).

IBM Statistical Package for Social Sciences (SPSS) Amos version 21 was used to

analyze the data collected for the 2013 Palm Beach YRBS. I conducted measures related

to central tendency and dispersion using descriptive statistics. Logistic regression was

used to analyze the impact of bully victimization, gender, and race/ethnicity on teen

dating violence victimization. Mediating variables spending time with a parent was added

with logistic regression anlysis to examine the effects. Regression analysis was used to

determine the direction and/or strength of being African American, female, and age of

first sexual experience on teen dating violence victimization and bully vitimization .

Futher description of the methods for this study is included in Chapter 3.

Definitions

The following are concise definition of the independent variable, dependent

variables and covariates as it relates to understanding their meaning in this study. A more

detailed analysis of coding and descriptions of the variables were included in Chapter 3.

Bully victimization: When one or more students who are not dating partners tease,

threaten, spread rumors about, hit, shove, or hurt another student over and over again

(Center for Disease Control and Protection, 2014c). It includes electronic bullying (being

bullied through e-mail, chat rooms, instant messaging, websites, or texting.) (Center for

Disease Control and Protection, 2014c).

Spending time with a parent: Eating dinner with a parent.

Substance use: Includes use of alcohol and drugs (marijuana, cocaine, sniffed glue,

breathed contents of aerosol spray cans or inhaled paints or sprays for the purposes of

getting high, heroin, methamphetamines, ecstasy, steroid pills or shots, prescription drug

use without a doctor’s prescription, synthetic marijuana and injection of illegal drugs)

(Center for Disease Control and Protection, 2014c). Alcohol was defined as beer, wine,

wine coolers, and liquor which included rum, gin, vodka, or whiskey but excluded just

taking a few sips of wine intended for religious purposes (Center for Disease Control and

Protection, 2014c).

Teen dating violence victimization: Being physically hurt on purpose by someone they

were dating or being forced to do sexual things by someone they were dating (Center for

Disease Control and Protection, 2014a).

Assumptions

Due to extensive research which stated that bullying begins in early

adolescents/middle school (Ellis & Wolfe,2014; Espelage et al., 2012;Foshee, et al.,

2014; Olweus, 1994), I assumed that as teens move into later adolescents whereby the

nature of their social relationships changed to mixed gender and romantic, bullying

would have an impact on dating. As I was not present for the administration of the survey

and did not have access to the participants or their parents, I made the assumption that

appropriate consent procedures were followed. Additionally, I assumed that the

participants took the survey voluntarily and confidentiality protocols were followed.

Lastly, I assumed that school personnel and proctors who administered the Palm Beach

YRBS did so without inserting bias and were appropriately trained as to not influence the

responses of the participants.

Scope and Delimitations

Internal Validity

In the current study, I considered bullying as it contributes to teen dating violence

and more specifically victimization. I examined the relationship among risk factors of

age, gender, race/ethnicity, substance use, and age of first sexual intercourse with teen

dating violence victimization and bully victimization. Furthermore, I examined the

effects of a protective factor; spending time with a parent as it relates to victimization.

Specific aspects of the research problem that was addressed are whether there is an

association among teen dating violence, bully victimization, and ethnicity/race. I chose

the specific focus in order to fill current gaps in research as it relates to co-occurrence of

teen dating violence, bullying, and race/ethnicity. Outcomes of this study may help to

inform violence prevention programs that target teens and more specifically, African

American teens who reported the highest rate of teen dating violence victimization

(Centers for Disease Control and Prevention, 2010).

External Validity

Archival data, which was collected in 2013 for the Palm Beach County YRBS, is

available for this study and the resulting dataset was used for this study. Participants for

the YRBS were public high school students in grades 9 to 12 in the spring of 2013

(Center for Disease Control and Prevention, 2014b). All 23 high schools in the county of

Palm Beach were eligible to participate and participated in the survey ( Center for

Disease Control and Prevention, 2014b). Students who attended on the day of the survey

were eligible to participate. Home schooled and private high school students were not

included in the YRBS. The YRBS is not appropriate for non-English speaking students as

the questionnaire is only available in English.

The following studies have been used in prior studies related to dating violence:

• Attachment theory: Lack of parental warmth contributes to aggressive

behaviors in youth Powell & Ladd, 2010).

• Male peer support theory: Patriarchal beliefs are at the core of intimate

partner violence (Sellers, Cochran, & Branch, 2005).

• Intergenerational transmission theory: Witnessing or experiencing

violence in childhood leads to violent behavior and victimization in later

life including in intimate partner relationships ( Eriksson & Mazerolle,

2015;Sellers, Cochran, & Branch, 2005).

Social learning theory presents as an all-inclusive theory that incorporates the influence

of individual, relationship, community, and societal factors related to violent behavior

that is amenable to the cultural/ethnic/racial aspects of the selected population for this

study.

Generalizability

The Palm Beach County YRBS is based on generating responses from a

representative sample of all public high school students in Palm Beach County. As such,

results from this study cannot be generalized to all high school teens, as the current

sample did not include home schooled and private high school students. However, the

results of this study, which is limited to Palm Beach County, may be used to inform

future studies that use the National YRBSS data examining co-occurrence of various

forms of violence and implications along racial/ethnic lines.

Limitations

There were limitations with this study as it relates to the reliance on self-report

survey design. Issues related to recall bias on questions, which required respondents to

recall incident that occurred in the past, may have occurred whereby there may be an

underreporting or over reporting. However, reliance on self-reporting survey design has

been used for studies of this nature on multiple occasions and has been an effective

method of measurement (Creswell, 2009;Frankfort-Nachmias & Nachmias, 2008).

The Palm Beach County YRBS is a school-based design survey and may not

represent teens that are not enrolled in school or any form of educational system.

Participants who attend private schools, home schools, and those in the juvenile justice

system were not included in the YRBS. I reported results as it relates to this sample

without generalization to the larger population in order to address this potential bias.

The potential for selection threats as all the respondents were from the same

county which may predispose them to emit similar responses is possible. The sampling

frame, which included all public high schools with a systematic equal probability

sampling with a random start time to select the classes for participation in the survey, was

used by the Center for Disease Control and Prevention and may decrease the impact of

selection threats (Center for Disease Control and Protection, 2014c).

The construct of spending time with a parent was measured based on having

dinner with a parent during the previous 7 days. Responses to this question may not

adequately describe the nature of the parent-child dyad. In reporting of the results,

number of times spent eating dinner with a parent may be more relevant in determining

an association, thereby limiting construct issues . Additionally, the construct age of first

intercourse does not provide information as to context in which sexual intercourse

occurred but results from this study may help frame future studies which will explore this

contruct in more detail.

In constucting the substance use variable, an aggregate of 13 variables related to

substance use was conducted. All except for one variable were specific as it related to

frequency of the respondent’s substance use. The inclusion of age of first alcohol use as a

variable as part of the aggregate for substance use may have posed construct issues as it

was not specific to frequency. However, prior studies have shown a positive trajectory of

early substance use to frequency of use (Adams, Milich, Lynam, & Charnigo, 2013;

Pilatti, Godoy, Brussino, & Pautassi, 2013).

Significance

Currently most research and prevention programs targeting teen dating violence

and bullying occurs in silos (Grych & Swan, 2012). There is research on various forms of

violence which impact youths but few studies that explored the interconnectedness of

these forms of violence (Grych & Swan, 2012;Hamby, Finkelhor, & Turner, 2012).

Subsequently, evidence based practice prevention programs that are based on the results

of research may not be the most effective in addressing the problem of violence amongst

teen, especially as it relates to bullying and teen dating violence.

Bullying and dating violence amongst teens occur within the same social sphere

(Ellis & Wolfe, 2014). Prior researchers suggested that bullying begins in early

adolescence; whereas, dating violence occurs most often in later adolescence as the social

context of relationships emerge into mixed gendered and romantic type relations. Dating

violence and bullying have been shown to occur in the same individuals (Miller, et al.,

2013) . Despite these results, there exist a gap in the literature as it relates to co-

occurrence of bullying and teen dating violence. Furthermore, there is limited research

which examines race/ethnicity, specifically African Americans despite having the highest

rate of reported dating violence vicimization.

Results of this current study may decrease the gap which currently exist related to

co-occurrence of various forms of violence amongst teens, specifically dating violence

victimization and bully victimization. Furthermore, results from this study may help to

target limited resources which are designed to develop evidence based prevention

programs . For decades most prevention programs have focused their efforts on single

issue forms of violence (Grych & Swan, 2012). Although the field of co-occurrence of

various forms of violence is beginning to emerge, research on teen dating violence

victimization, bully victimization along racial/ethnic lines is still lacking.

Potential contributions as it relates to positive social change as a result of this

study could be a shift in how public health practitioners target resources to address the

problems of teen dating violence and bullying. Although the results from this study may

not be generalized to populations outside of the sample, researchers in the field of

prevention of teen dating violence, youth violence, bullying, and intimate partner

violence could build on this study to better impact how public health workers advocate

for funding and frame public policy. Furthermore, prevention of teen dating violence may

lead to decreases in rates of intimate partner violence as there has been an established

link between victimization and

perpetration of dating violence in youth and adult

intimate partner violence (Grych & Swan, 2012). This research has the potential to

transform how researchers approach studies involving not only teen dating violence but

also adult initimate partner violence. Researchers may consider studying co-occurrence

of bullying and adult intimate partner violence. Socal change may occur as programs

which aim to address teen dating violence might include in their programming an

understanding regarding how bully victimization relates to teen dating violence

victimization which would educate teens to montior for identified risk factors and/or how

to change behaviors. Additionally, social change may occur on the community level as

community organizations examine how they promote violence prevention within their

community. Communities have the power to influence teens by working to reduce

various forms of violence through sanctioned appropriate behavior within communities

(Bandura , 1973).

Summary

Teen dating violence and bullying are major public health concerns. In a 2011

survey, 9.45% of students reported being victims of teen dating violence during the

previous 12 months and 16.2% reported having been bullied electronically during the

previous 12 months (Center for Disease Control and Prevention, 2014c). Teens who are

victims of dating violence and bullying experience negative psychological and physical

outcomes which impact them long into adulthood (Feldman Hertz, Donato, & Wright,

2013). Additionally, there are financial cost associated with medical care, criminal justice

costs, and social services (Center for Disease Control and Prevention, 2012b). The

purpose of this study was to examine the relationships between the dependent variable

teen dating violence victimization and the independent variable bully victimization. Most

research and prevention programs in the field of teen dating violence and bullying

operate in silos (Grych & Swan, 2012). Although the field has begun to move towards

examining co-occurrence of various forms of violence, a gap exist as it relates to co-

occurrence of teen dating violence and bullying especially as it relates to race/ethnicity.

By examining the co-occurrence of bully victimization and teen dating violence, this

study may help to inform public health as it moves towards primary prevention of dating

violence, bullying, youth violence and intimate partner violence. Social change may

occur as programs change the lives of teens by preventing victimization.

This chapter provided the background of the study, problem statement, purpose of

the study, research questions and hypotheses, theoretical framework, nature of the study,

definitions, assumptions, scope and delimitations, limitations, and significance. The next

chapter provides a concise synopsis of current literature based on research between 2009

and 2015, gaps in the field, and how the results inform my current study.

Chapter 2: Literature Review

Introduction

Teen dating violence and bullying are major public health concerns due to the

impact on the psychological and physical health of teens (Center for Disease Control and

Prevention, 2014a). Despite acknowledgement by a major public health organization such

as Center for Disease Control and Prevention that bullying ( victimization and

perpetration) and teen dating violence create an undue burden for teens, limited research

exist as to the co-occurrence of both forms of violence which occurs within the same

social sphere (Hamby et al.,2012;Yahner et al., 2014). Furthermore, understanding the

impact of racial/ethnic differences as it relates to teen dating violence and bullying has

been recommended in various studies as an area that still requires further exploration

(Patton, Hong, Williams, & Allen-Meares, 2013; Seaton, Neblett Jr., Cole, & Prinstein,

2013). Teen dating violence is defined as the occurrence of physical, sexual emotional

and/or psychological violence that occurs within teen dating relationships (Center for

Disease Control, 2014a). Olweus (1994) who was one of the earlier researchers of the

1970s who defined the term bullying, defined it as persistent and repetitive acts of

aggression over a period of time whereby, there is a power imbalance. Both dating

violence and bullying occur within similar social context (Ellis & Wolfe, 2014; Foshee,

et al., 2014). Furthermore, prevalence of teen dating violence was found to be highest for

African-American teens (Center for Disease Control and Prevention, 2010). Gender has

been associated with teen dating violence whereby females have been reported as being

impacted more than males because of violence within their relationships (Exner-Cortens

et., 2013). Additionally, as it relates to gender and bullying, boys have been found to be

bullies; whereas, girls were more likely to be victims of bullying (Wang et al.,2009) .

Substance abuse has been associated with dating violence victimization (Exner-Cortens et

al., 2013) and bullying whereby substance use has been linked to aggressive behavior and

to both perpetration and victimization (Radliff, Wheaton, Robinson, & Morris, 2012).

Early substance use may impair social and dating relationship, leading to early stressors

and victimization (Maas et al., 2010). Bullying often begins in early adolescence and has

been found to predict physical dating violence later in life (Ellis & Wolfe, 2014; Foshee,

et al., 2014;). Futhermore, bullying predicted teen dating violence victimization and

perpetrtation (Ellis & Wolfe, 2014). Childhood sexual abuse has been associated with

victimization and perpretation of intimate partner violence and bullying (Davis, et al.,

2012).Positive relationship ( defined as limited levels of hostitility and autonomy-

promoting negotiations) with parents has been found to be a protective factor for bullying

(victimization and perpetration) (Wang et al., 2009), and a predictor for healthy teen

dating relationships (Miga, Gdula, & Allen, 2012). Depression has been associated with

bully victimization (Feldman Hertz et al., 2013) and dating violence victimatization

(Center for Disease Control and Prevention, 2014). Researchers have found that teens

help seeking behavior as it related to interpersonal problems centered around friends and

family (Black, Weisz, Preble, & Sharma, 2015) . Teens who self-reported victimization

of dating violence were more likely to be victims of other types of violence versus those

with no history of dating violence (Hamby et al., 2012). African Americans have a

history of discrimination (Patton et al., 2013) and disparities against them; therefore,

examination of the literature as it relates to efforts to understand how teen dating violence

occurs among this group and any association that may help promote and or enhance

dating violence programs was explored through this literature review.

Synopsis of current literature

Teen dating violence and bullying are preventable. Behaviors that cause harm to

others and self and can be prevented (Center for Disease Control and Prevention, 2012a).

Bullying and violence that occurs within teen dating relationships affects not only the

physical health but the less visible inside which relates to emotional health (Feldman

Hertz et al., 2013) . The effects of teen dating violence and bullying may not always

leave outward scars but the damage done can cause internal and emotional damage

leaving unseen scars which last a lifetime (Feldman Hertz et al., 2013).

There are financial cost associated with medical care, criminal justice cost, and

social services (Center for Disease Control and Prevention, 2012a). The impact of teen

dating violence and bullying can reduce the potential of a future generation of leaders.

Teens that experienced dating violence may choose unhealthy relationships into their

adult life (Center for Disease Control and Prevention, 2014a). Research has shown that

teens who are involved in teen dating violence are more likely to be involved in adult

intimate partner violence (Exner-Cortens et al., 2013). The financial cost of adult intimate

partner violence was $8.3 billion in 2003 and there were 1,336 deaths in 2010 related to

adult intimate partner violence (Center for Disease Control and Prevention, 2012a) which

translates into an unsustainable cost and significant loss of lives if teen dating violence is

not prevented. Furthermore, teen dating violence and bullying which impacts the African

American population serves to further promote disparities that exist within communities

of color. African Americans who live in low-income neighborhood may be at greater risk

of teen dating violence and bullying as higher levels of unemployment may contribute to

higher rates of neighborhood violence (Patton et al., 2013). As such, research which

offers knowledge into the co-occurrence of various forms of violence such as this study,

may help to promote positive changes in violence prevention programs which target

teens.

Preview of major sections

As part of my research related to gaps in the field of teen dating violence, I

conducted a literature review that was the focus of this chapter. The literature review

included exploring research in the area of co-occurrence of teen dating violence with

other forms of violence along ethnic/racial and gender context. In this chapter, I discuss

research strategies, social learning theory as the theoretical foundation, and review

literature that features a description of the variables teen dating violence victimization,

bully victimization, gender, and race/ethnicity. Additionally, risk and protective factors

are also discussed.

Literature search strategy

Using the search dates of 2009-2015, a search for peer reviewed and full text

articles was conducted in PROQUEST, ACADEMIC SEARCH, Thoreau, SAGE, and

SocINDEX using the search terms teen dating violence, bullying, and African American

teen dating. Individual searches for the term bullying, resulted in the most results (1,786),

and followed by teen dating violence (524) and African American teen dating violence

(17). Search terms combining teen dating violence and bullying returned five results;

whereas a search of combined terms African American and bullying returned 87 results.

When search terms included African American, teen dating violence, and bullying, there

were zero results. Much of the literature related to bullying returned articles covering

workplace bullying while a narrowing of the search to include teens returned 159 results.

A review of all the searches resulted in the selection of 37 articles as having relevance to

my research including nine focused on co-occurrence of teen dating violence with other

forms of violence. There were no dissertations that examined the co-occurrence of teen

dating violence with other forms of violence.

Theoretical Foundation

Social learning theory

How teens relate to each other and those around them, contributes to teen dating

violence and bullying. Social learning theory premises that environment, personal factors,

and behaviors are continually influencing each other (Bandura, 2001). Environment

relates to aspects within the social and physical environment that can influence behavior

(Bandura, 2001). Social environment relates to family and friends; physical environment

relates to the larger community such as schools and neighborhoods (Bandura, 2001).

Personal factors relates to cognitive, affective, and biological components of the

individual (Bandura, 2001). Bandura (2001) argued that behavior is a result of

observational learning and vicarious reinforcement. How teens operationalized their

thoughts around violence in their dating relationships and bullying and how these

thoughts influence their behavior is a result of their social experience. It is for this reason

that social learning theory is the most applicable theory to examine the co-occurrence of

bullying and teen dating violence as both are influenced by similar factors

(environmental, social, and personal).

Social learning theory referenced aggressive behavior as producing both personal

(psychological and physical) and destruction of property as well as social labeling

(Bandura,1973). Aggression unlike other social behaviors does not require mutual

acceptance in order for the effects of such aggression to be responsive (Bandura, 1973).

Aggressive behavior such as teen dating violence and bullying that is perceived as

punishing for the victim can be rewarding for the perpetrator. Bandura’s (1973) assertion

that aggressive actions produces outcomes other than producing injury, aligns with

established far reaching impact of teen dating violence and bullying. Both teen dating

relationships and nondating relationships occur in a social context in which aggressive

actions can occur. Such aggressive actions can stem from the value placed on aggression

as a form of instilling or maintaining power within the peer group (Bandura, 1973). It is

the social labeling which determines the within peer group acceptance or rejection of

aggressive behavior (Bandura, 1973). It is therefore conceivable that such acceptance or

rejection within the peer group would create a fertile ground for both teen dating violence

and bullying to occur within the same individuals.

Social learning theory focuses on how behavior, once acquired, is expressed and

regulated by the individual and external forces (Bandura, 1973). Behaviors that are found

to be successful or reinforced by peers such as within teen dating and nondating social

circles are the behaviors perpetrated, while behaviors rejected by peers are discarded.

This process is what Bandura (1973) referred to as differential reinforcement. The

rewarding and punishment of an action, determines whether the action is continued

(Bandura, 1973). Teen dating violence and bullying, if observed and perceived as

rewarded actions, continue violent actions are fostered. The theory lends itself to the

possibility that victims of bullying may also be victims of teen dating violence as outside

actors who observe the occurrence of one form of victimization (teen dating violence)

may perpetrate other forms of violence (bullying) towards the same individual.

External sources of influence are not the only predictors of behavior (Bandura,

1973). The cognitive process one engages in as it relates to the behavior, serves to

reinforce or reject the behavior (Bandura, 1973). The ability to recognize the

reinforcement or rejection of one’s behavior requires insight that is a cognitive process

(Bandura, 1973) .Understanding acceptable behaviors and consequences of teen dating

violence and bullying requires an awareness that involves cognitive processes which

regulates the decision on whether to act. Social learning theory would explain why

victims of one form of violence such as bullying might process such actions in a way that

makes them more susceptible to being a victim of teen dating violence.

Social learning theory and changing behavior

Theoretical concepts of social learning which apply to how teen bullying and

dating violence occurs can be used to modify the behavior. Social learning theory can be

applied to how teen bullying and dating violence occurs through observational learning

and cognitive processes. Bullying and teen dating violence occurs under situational,

cognitive, and reinforcement conditions similarly in the same way new behaviors can be

learned through the alteration of situations, cognitive, and reinforcement conditions

within the peer group (Bandura, 1973). Bandura (1973) asserted that group problems

required a group solution whereby the social dynamics and reinforcement practices are

altered.

Social learning theory proposes that through suitable role models and valued

incentives, new behaviors that create better benefits than previously defiant behaviors can

be normalized and sustained (Bandura, 1973). Influence of role models occurs when such

role models are closely associated to those being influenced (Bandura, 1973).

Relationship with parents is one such influence on the lives of teens and the nature of the

parent-child relationship whether positive or negative, may influence acceptance or

rejection of violence. Influences that contribute to teen bullying and dating violence must

first be altered in order to create change in the behavior.

Modeling influence, which relates to observational learning, can be used to both

promote aggression as well as modify aggressive behavior (Bandura, 1973). Influence

plays a crucial role in the learning of more effective ways of managing situations that

lead to bullying and dating violence. Social learning theory proposes that defiant

behavior is maintained and valued because of a lack of better alternatives (Bandura,

1973). Influencers can model alternatives such as better ways of handling interpersonal

conflicts to change teen bullying and dating violence behavior.

In order for modeling of influence to be most effective, alternative behavior has to

repetitively model by multiple people within the circle of influence (Bandura, 1973).

Opportunities to practice the modeled behavior with positive rewards and arrangement of

successful experiences because of behaving differently, fulfills reinforced modeling

(Bandura, 1973). Demonstration, guided practice, and successful experiences produce

sustained change in behavior. Observation by itself does little to change behavior long

term; whereas, acquiring the resources to learn successful ways of behaving is the

foundation of changing behavior based on social learning theory (Bandura, 1973). Teens

that are socially and verbally unskilled with limited means of handling discord are more

likely to become engaged in bullying and dating violence, especially within a social

context that views such behavior favorably (Bandura, 1973). Therefore, creating

opportunities/influences whereby teens can learn, be rewarded, and successfully

implement new behaviors can foster long-term changes within the teen social sphere.

Social learning theory may help explain the positive influence of positive relationship

with parents on teen dating violence and bully victimization.

Social ecological model

The social ecological model, which is used by Center for Disease Control and

Prevention, allows public health to understand what causes risk and what protects teens

from various forms of violence (Center for Disease Control and Prevention, 2012a).

Individual, relationship, community, and societal are four levels within the social

ecological model (Center for Disease Control and Prevention, 2012a). The individual

level relates to biological and personal factors such as age, gender, drugs, trust, and

history of aggressive behavior or experiencing violence (Center for Disease Control and

Prevention, 2012a). Relationship factors relate to family and peers or more specifically,

interactions between two or more individuals (Center for Disease Control and Prevention,

2012a). The variable spending time with parents would fit into the relationship factors as

this is a time whereby teens would interact with parents. The community level relates to

school, work, and neighborhood (Center for Disease Control and Prevention, 2012a). The

final level is societal which relates to economic, cultural norms, media, policy and laws,

discrimination, health, education, and social policy that foster discrimination (Center for

Disease Control and Prevention, 2012a). Of all the levels of social ecological model, the

societal factors affect all the other factors. Societal factors which create a level of

acceptance, tolerance for violence, or creates and sustains gaps between segments of

society such as discrimination, impacts individual, relationship, and community factors.

Social learning theory and social ecological model combined

Social learning theory use of influence on creating and changing behaviors can be

combined with the social ecological model whereby the individual, relationships,

community, and societal factors function as influence on teens’ behaviors as it relates to

bullying and dating violence. The individual level is where personal aspects can create or

change bullying and dating violence behavior. Individual experience of violence can

become operationalized as an influence on bullying and dating violent behavior.

Relationship levels, which include family and peers, can influence whether or not teen

dating violence and bullying is accepted or rejected. Community factors, as it relates to

schools where teens spend most of their time, can act as an influence on promoting or

condemning violence. Societal factors such as policies and cultural norms that hinder or

promote violence acts as an influence on teen’s behavior.

The power of influence and cognitive processes on behavior is paramount to the

social learning theory as it relates to understanding how behavior is operationalized and

altered (Bandura, 1973). When applied to the social ecological model, teen dating

violence and bullying can be understood within the context of a multifaceted matrix

where teens learn to accept or reject violence as a resource of how they relate to each

other. It is this aspect of the theory that makes it conceivable that bullying and teen dating

violence would co-occur within the same individual. Changing the resources available to

teens through influencing the individual, relationship, community, and societal aspects of

the world in which teens resides, is a sustainable method to change the scope of teen

dating violence and bullying. Bandura (1973) stated that aggressive behavior is often

used due to a lack of resources that provide other appropriate ways of handling

interpersonal conflict. Additionally, the influence of those close to the subject through

modeling, practice, positive rewards, and successful implementation of new behavior is

paramount to maintaining the new behavior (Bandura, 1973).

Social learning theory literature and teen dating violence

A review of the literature as it related to social learning theory and teen dating

violence resulted in few studies which focused on attitudes and exposure as it related to

teen dating violence. Miga et al., (2012) conducted a study using social learning theory as

the explanation for their findings that autonomy promoting behavior displayed within the

inter-parental sphere influenced teens’ autonomous approach to conflicts within peer and

romantic relationships (p.443). Tyler, Brownridge, & Melander (2011) also applied social

learning theory framework to hypothesize that child maltreatment and low levels of

parental warmth would be directly associated with victimization and perpetration of teen

dating violence. Each of these studies built their framework around the observational

aspects of social learning theory.

Social learning theory has been stated as one of the most used theory in research

focused on social and cultural factors as it relates to human behavior (McCullough

Chavis, 2012) . This study which focuses on teen behavior within the social context of

the African American teen population makes application of social learning theory

appropriate. Observation learning as well as imitation and modeling as an explanation for

how humans acquire, retain, and reject behaviors makes social learning theory applicable

to research in the area of human behavior (McCullough Chavis, 2012). Regarding the

cultural aspects of behavior, culture plays a very important role in behavior and the social

environment (McCullough Chavis, 2012). The social environment and cultural aspects of

African American teens plays an important role in understanding behaviors, which is in

line with social learning theory and social ecological model which incorporates internal

and external sources of how behavior is acquired and maintained. In order to change

behavior, an understanding of how behaviors are acquired and rejected is warranted.

Although there are limited studies with specific application of social learning theory as it

relates to teen dating violence, the quest to understand human behavior in order to alter it,

allows researchers to use social learning theory as a framework in various aspects of

unhealthy behaviors in teens. There were several studies that applied social learning

theory to other aspects of changing behavior in teens. Social learning theory was applied

most often in studies related to teen’s dietary behaviors, physical activity, and substance

abuse (Bukhari, 2011; Connor, 2011; Dewar, 2012 Lee, 2012;McCabe, 2015; Nguyen,

2011;Roy, 2011;Shadur, 2014;Smith, 2011).

Social learning theory literature and bullying

Review of the literature on social learning theory and bullying resulted in several

studies. Prati, (2012) conducted a study of 863 students where social cognitive theory an

extension of social learning theory was used as a framework to analyze self-reported

homophobic aggression. The author examined how attitudes towards gay males mediated

the relationship between observation of peer homophobic aggression such as bullying

among school mates (Prati, 2012). Social cognitive processes such as observations of

peer aggression predicted self-reported homophoic aggression towards those who were

preceived as gay (Prati, 2012). Prati (2012) stated that the use of social cognitive theory

was appropriate as it focused on how humans process and intergrate information based on

social experiences.

Shafer & Silverman, (2013) applied social learning theory as a framework to

understand behaviors and cognition of school aged bullies and victims in order to design

a music therapy intervention. Pronk, Goossens, Olthof, De Mey, & Willemen, (2013)

conducted a study examining differences in the cognitions of outsiders and defenders in

bullying victimization situations. Using the self-efficacy aspect of social learning theory,

the reserachers hypothesized that the belief that one has the tools to handle bullies, would

determine whether they intervened on the victims behalf (Shafer & Silverman, 2013).

Study results were reported as outsiders and defenders differed in their actions when

witnessing victimization based on their beliefs about their abilities; whereby, outsiders

intervened indirectly rather than directly and defenders intervened directly rather than

indirectly (Pronk, Goossens, Olthof, De Mey, & Willemen, 2013). Additionally, both

outsiders and defenders reported that they would intervene if the victim was a friend

verses a peer (Pronk et al., 2013).

In a more general context as it related to overall violence among teens, Bradshaw,

Rodgers, Ghandour, & Garbarino, (2009) examined the association between youth

violence exposure and aggression where they hypothesized that the effects would be

greatest for total exposure to violence because of cumulative risk. Social cognitive theory

was applied based on the assumption that experiences shape thoughts and behavior;

therefore, exposure to violence influenced the formation of beliefs about the appropriate

application and effectiveness of violence as a way to handle threats (Bradshaw et al.,

2009). It is this conceptualation of social learning theory as it relates to how experiences

shape thoughts that makes the theory appropriate for this study as the experience of being

a victim of one form of violence ( bullying) may influence the potential of becoming a

victim of other forms of violences ( teen dating violence).

Literature review related to key variables

Teen dating violence

The Center for Disease Control and Prevention (2014a) reported that teens who

experience violence within their relationship are more likely to view violence as an

appropriate means of dealing with anger within relationships, use alcohol, come from

communities or homes where they witnessed violence, have a peer group whereby

violence is condoned, suicidal thoughts, increased sexual risk, suffer from depression or

anxiety, and have a history of aggressive behavior. In exploring the literature on teen

dating violence, most studies referenced risk factors as stated by the Center for Disease

Control and Prevention as a rational for understanding how these risk factors help inform

prevention of teen dating violence. Furthermore, in a nationwide survey 23% of females

and 14% of males, who reported ever experiencing intimate partner violence, stated that

their first occurrence was between the age of 11 and 17 (Center for Disease Control and

Prevention, p. 2014a) . Considering that first dating violence experiences appear to occur

during the teen years (Center for Disease Control and Prevention, 2014a), and bullying

occurs most often among youths, (Robers, Zhang, & Truman, 2011), this research could

advance the field of intimate partner violence by testing possible association between

teen dating violence and bullying.

Definintion of teen dating violence

Teen dating violence includes physical, psychosocial or sexual harm by a dating

partner (Center for Disease Control and Prevention, 2014a). This type of violence occurs

as a continum which ranges from single espisode to chronic severe battering (Center for

Disease Control and Prevention, 2014a). Physical violence includes shoving, punching,

slaping kicking, choking, use of a weapon, or restraining (Center for Disease Control and

Prevention, 2014a). Sexual violence relates to unwanted touching, physically forcing a

partner to have sex against their will whether completed or not (Center for Disease

Control and Prevention, 2014a). Consent for sex was not obtained or freely given by the

partner (Center for Disease Control and Prevention, 2014a).

Risk and protective factors

Risk and protective factors for teen dating violence falls into four categories. The

four categories are individual, relationship, community and society (Center for Disease

Control and Prevention, 2012a). Individual risk factors for teen dating violence are low

self esteem, low income, low academic achievement, aggressive or delinquent behavior,

history of mental illness, history of alcohol abuse, drug abuse, and impulsive or

aggressive tendencies (Center for Disease Control and Prevention, 2012a). Relationship

protective factors for teen dating violence are nurturing parenting skills and stable family

relationships (Center for Disease Control and Prevention, 2012a). Postitive relationships

with parents may act as a protective factor as it relates to involvement in violent

relationships both intimate and social (Black et al., 2015; Maas et al., 2010) . Community

protective factors for teen dating violence are connectedness between teens and their

neighborhoods, after school and recreational programs, and communities that take

responsibility as it relates to violence prevention (Center for Disease Control and

Prevention, 2012a). Societial risk factors are laws that maintain unequal access to goods,

services and opportunities, or societal norms that support violence and male dominance

(Center for Disease Control and Prevention, 2012a).

The goal of public health as it relates to teen dating violence is to reduce risk

factors and increase protective factors. Protective factors which may prevent against

violence have not been studied as much as risk factors (Center for Disease Control and

Prevention, 2012a). Research on teen dating violence has focused on identifying risk

factors in search of protective factors. Research on teen dating violence makes the

assumption that if risk factors are identified, such identification will help to prevent

violence. In actuality, as much as we know about risk factors, little is known about the

causes of teen dating violence. Without an understanding of the cause(s) of teen dating

violence, primary prevention is dismal. To fully understand what protects against teen

dating violence, research needs to start at the beginning of life, before one has been

exposed to indiviudal, relationship, community, and societal risk factors which puts them

at risk for dating violence. Researchers would need to conduct experimental studies with

a true control group of teens who were not exposed to any risk factors and this is not

practical. As a result, research in the area of teen dating violence continues to work

backwards where analysis occurs after exposure .

Application of risk and protective factors in the literature

In conducting the literature review, several studies were guided by the risk factors

as identified by the Center for Disease Control and Prevention. Maas et al., (2010)

conducted a study using prospective and retrospective longitudinal methods to identify

childhood predictors of teen dating violence among 941participants. The authors reported

that bonding to parents and social skills protected females against teen dating violence in

part by reducing alcohol use; whereas, childhood bonding to parents was indirectly

related to teen dating violence victimization for males (Maas et al., 2010). Similar to

Maas et al., ( 2010) study, Makin-Byrd & Bierman, (2013) study examined aspects of

childhood which could predict dating violence in late adolesence. Makin-Byrd &

Bierman ( 2013) conducted a 12 year longitiudal study involving 401 children from

kindergarten to age 18) . The focus of the study was to examine whether aggressive

family dynamics predicted development of dating violence, both perpertration and

victimization. The authors reported results as aggressive family dynamics during

childhood and early adolesence having a postive influence on the development of both

perpetration and victimization of dating violence in late adolescence (Makin-Byrd &

Bierman, 2013). Another study which focused on childhood risk factors for teen dating

violence was conducted by Tyler et al., (2011), where they studied the effects of poor

parenting on victimzation and perpertration of teen dating violence of approximately 900

males and females in grades 7 to 12 . This longitudinal, study results were reported as

more physical abuse and low parenting warmth being linked to victimization and

perpertration of dating violence (Tyler et al., 2011) In a more broader context,

McNaughton Reyes, Foshee, Bauer, & Ennett, (2012) conducted a study examining

family, peer, and neighborhood violence as it related to alcohol use and teen dating

violence. The authors reported that teens exposed to higher levels of family violence and

friend dating violence had heavier alcohol use and dating violence (McNaughton Reyes

et al., 2012). The study conducted by Maas et al., (2010) confirmed the link between

alcohol use and teen dating violence where they reported that early adolescence alcohol

consumpton increased risk of late adolescence teen dating violence. Although the

timeframes for substance use may differ between the two studies, the link between

alcohol use among teens and dating violence is evident . These results demonstrate the

mulitfacted aspects to teen dating violence which makes it difficult for a one size fits all

approach to prevention. Despite the acknowledgement that teen dating violence is

complex, risk factors which focus on how race/ethnicity protects or is a risk factor for

teen dating violence is limited in the literature.

Gender and teen dating violence

Gender dominates the literature as it is related to teen dating violence. Several

researchers stated that females are more likely to be victims of dating violence and/or

experience more adverse effects (Alleyne et al., 2011; Coker, et al., 2014; Exner-Cortens

et al., 2013; Maas et al., 2010). Most of these findings regarding gender were

supplementary finding in those studies and not the primary focus of the study. However,

the study conducted by Tyler et al., (2011) focused on gender where the authors pointed

out that females were more likely to report having perpetrated dating violence. Another

study which reported gender differences between types of dating violence perpetration

was conducted by Niolon, et al., (2015) where they stated finding that more girls than

boys reported perpetrating verbal/emotional, threatening behaviors and physical abuse

towards partners while boys were more likely to report perpetrating sexual abuse towards

their partner. Additionally, Maas et al., (2010) reported their findings based primarily

along gender lines where they stated that female’s higher bonding to parents predicted

lower risk of being a victim of dating violence.

Although the primary focus of the Coker, et al., (2014) study was not gender,

results related to gender were reported by the authors who conducted a study using a

school-based sample of 14,190 to examine dating violence victimization and perpetration

rates among high school students . The authors reported that females had a higher rate of

victimization and perpetration of dating violence than males (Coker, et al., 2014). Exner-

Cortens et al., (2013) conducted a longitudual study using the National Longitudinal

Study of Adolescent Health of 5,681 participatants where they explored associations

between teen dating violence and adverse health outcomes. The authors reported that the

results demonstrated that female victims reported adverse outcomes related to physical

and psychological victimization; whereas, males reported adverse outcomes related to

psychological victimization only (Exner-Cortens et al., 2013). Additionally, female

victims had longer lasting adverse health outcomes than male victims (Exner-Cortens et

al., 2013). In examining predisposing factors related to dating violence, one study

reported that males from maltreated families had greater risk of threatening and physical

abuse in dating relationships (Wolfe et al., 2009). Despite recognizing issues related to

gender as it related to teen dating violence, what was absent from the literature were

studies which focused on/or reported results related to differences in gender along racial

lines. The Center for Disease Control and Prevention (2008, 2010) reported that based on

a national survey, Black and Hispanic teens reported higher levels of dating violence than

their white counterpart. Despite these results by the Center for Disease Control and

Prevention, limited knowledge regarding gender and African Americans can be gained

based on current research due to the lack of attention to African Americans as it relates to

teen dating violence. Such limitations thwart prevention efforts by public health, as

programs may not address the needs of all populations. Although the current study results

cannot be generalized to all African Americans, presenting results as it relates to gender

and race will help fill existing gaps in the literature.

Power and teen dating violence

Researchers appear to question whether or not power plays a role in teen dating

relationships as it does in adult intimate partner violence. Questions regarding power

issues within romantic relationships involving teens exist due to findings that female

perpetrate violence at a similar rate as males (O'Leary, Smith Slep, Avery-Leaf, &

Cascardi, 2008;Renner & Whitney, 2010) . Giordano, Soto, Manning, & Longmore,

(2010) reported in their study of 956 adolescence that mutual violence ( victimization and

perpetration) was the most common forms of dating violence and power balance within

theses relationships were negatively associated with reports of violence where

respondents who reported less favorable power balance, had greater odds of violence

with males perpretators reporting having less favorable power balance. Further findings

from the study showed no significant difference between relationships where violence

occurred and did not occur as it related to intimacy ( levels of love, self disclosure, and

perceived partner caring) (Giordano et al., 2010). These results signify that there is more

to teen dating violence that warrants further exploration. A balanced relationship does not

mean that the relationship is equal (Emerson, 1962). As long as the relationship involves

needs, someone will always be in the position of dependency. Blau (1964) stated that

each individual associate with others for what benefits it brings. There could be a benefit

from having a need met within or by the relationship, or there could be a benefit from

being able to fulfill a need within the relationship. Both the giver and the receiver have

something to gain by being involved with the relationship.

Aspects of the relationship do not always go as smooth as one may expect.

Power-dependency theory pointed to what happens in relationships that are unbalanced or

unequal. The person that is in the position of dependency has various options which can

be utilized to either decrease the cost of obtaining the needed benefit and or employ

alternatives in accessing the benefit. Both decreasing the cost and utilizing alternatives

can reduce power and bring balance to the relationship. However, balance does not mean

equal. There is still an element of power within the relationship despite the relationship

being balanced.

Within teen relationships where the relationship is unbalanced, Emerson’s (1962)

perspective focuses on the complexity of the relationship which creates powers of one

individual over another. For example, if the relationship between the two teens were

intimate, the nature of intimacy between the two would create dynamics that may be

different within a non-dating relationship situation. Therefore, when examining the power

structure of teen relationships, power has to be defined not based on whether the teen

with the power (perpetrator) is male or female but rather on the dynamics of the

relationship that contribute to the power structure.

It is possible that teens’ definition of intimacy impacts how they respond to

questions about control within their relationship (Martin, Houston, Mmari, & Decker,

2012). Cultural norms within various ethnic groups may also play a role in perceptions of

power within dating relationships. Norms of a culture will often dictate what acceptable

use of power is; therefore, if the use of power conforms to cultural norms, the norms

would have to be challenged before the use of power can be addressed (Patton et al.,

2013) One’s cultural background helps to define what is considered to be appropriate

(Cheek, 1976) . The issue of power is relevant for the purposes of this study due to the

focus on teen dating violence and bullying; whereby, bullying is centered around power

(Olweus & Limber, 2010).

Bullying

The literature on bullying focused on sexual bullying, Cyberbullying, face-to-face

bullying, and school bullying. Most studies focused on perpetration of bullying. There

were some studies that examined co-occurrence of teen dating violence with other forms

of violence (Miller, et al., 2013;Yahner et al., 2014; Zweig et al., 2013), where a majority

focused on sexual violence/harassment and bullying (including cyberbullying).

Most of the literature referenced the definition of bullying developed by Olweus

of Norway who conducted one of the first comprehensive studies on bullying in the

1970’s. Olweus’s definition references the issue of power imbalance as part of a

repetitive aggressive behavior which is intended to cause harm to another (Olweus,

1994). Blau, (1964) attributed power to the individual where the focus was on how the

individual attained power by imposing his or her will on the other individual . Blau’s

(1964) perspective focused on the actions of the individual that creates power imbalances

rather than the imbalance of the relationship itself. This distinction is significant in

examining the relevance of power within teen social context. Blau’s (1964) perspective’s,

offers an opportunity to focus on the mechanism utilized by teens in order to get the other

to conform to his or her desire, which created the power structure. In this case, it is the

action of each teen that leads to one having power over the other regardless of the nature

of the relationship. Those who bully, usually have a strong need to portray dominance

and power, while enjoying the control they erect over those whom they perceive as weak

(Powell & Ladd, 2010).

Aggressive behavior that is defined as bullying could be direct or indirect. Direct

bullying is face to face and includes picking on the other person and/or hitting or

slapping; whereas, indirect bullying is social exclusion and spreading rumors (Foshee, et

al., 2014). Boys have been found to perpetrate more direct bullying than girls; whereas,

there was no significance found as it related to indirect bullying for either boys or girls

(Foshee, et al., 2014). However, girls and boys are both victims and perpertators of

bullying (Siyahhan, Aricak, & Cayirdag-Acar, 2012). Olweus developed a survey which

is now referred to as the Olweus Bullying Survey which included a sample of 25,000 to

50,000 (Fredland, 2008). It is the issue of power imbalance that made it appropriate to

undertake this study for association between teen dating violence and bullying among

African-American teens. In a broader context, intimate partner violence has been linked

to power (Wagers, 2015;Whiting, Oka, & Fife, 2012). Although there are still questions

as to whether or not power and control issues exist within teen dating relationships,

bullying has a key component of power where there is an imbalance of power (Olweus &

Limber, 2010). Similarly, African-Americans are an ethnic group known to be

stigmatized and discriminated against (Patton et al., 2013) which may create a power

imbalance within our society.

Bullying and teen dating violence in the literature

Several studies focused on comparing various forms of bullying. Kowalski &

Limber, (2013) conducted a study examining co-occurrence of traditional bullying and

cyberbullying among a sample of 931 6

through 12

graders. Schneider et al, (2012)

conducted a study using a national data to examine prevalence of school bullying,

cyberbullying and psychological distress among 9

to 10

graders. Wang et al., (2011)

conducted a study comparing cyber and traditional bullying as it related to depression

among 6

to 10

graders. In an earlier study by the same authors, Wang et al., (2009)

conducted a study where they examined school bullying and compared physical, verbal,

relational and cyber bullying among 7,182 6

to 10

graders. All of these authors

reported that there was overlap among the various forms of bullying being examined .

There were some studies that examined co-occurrence of teen dating violence

with other forms of violence such as bullying (Miller, et al., 2013; Yahner et al., 2014;

Zweig et al., 2013), where a majority focused on sexual violence/harassment and

bullying( including cyberbullying). In a longitudinal study of 1,154 adolescents Foshee,

et al., (2014) hypothesized that perpretation of bullying in sixth grade would predict onset

of perpretation of physical dating violence by eight grade. Results were reported as boys

reported significantly more direct bullying than girls, black students reported more direct

bullying than whites, onset of physical dating violence was less likely for boys than girls

and more likely for black adolescents, and perpertation of direct bullying in the sixth

grade was associated with physical dating violence by eight grade (Foshee, et al., 2014).

The authors discussed how changes within the social context of adolescents as they move

into mixed gender and dating relationships, transitions bullying behavior in early

adolescents to violence towards their dating partner in later adolescence (Foshee, et al.,

2014). Taking this perspective into consideration, it is feasible that the current study

which examines the co-occurrence of dating violence and bullying among teens

especially African American teens will help fill existing gaps in the literature as it relates

to such association. A simiar study by (Ellis & Wolfe, 2014) of 585 adolescents who

completed self-report assessment related to bullying and dating violence perpetration and

victimization, results were reported as bullying positively predicting dating violence

perpetration and victimization(p.1) . Additionally, bullying of boys was significantly

related to dating violence perpetration (Ellis & Wolfe, 2014) . Studies such as these and

Miller, et al., (2013) who reported that dating violence and bullying co-occurred in the

same adolescents warrants the need for further studies which specifically focus on co-

occurrence of bullying and teen dating violence as such studies are limited . Viewing

early aggression in the form of bullying which occurs in early adolescents as a prelude to

later dating violence as the social context of adolescence relationships change, presents

justification from a public health perspective to examine potential associations.

Cyberbullying

Cyberbullying among teens has exploded in the literature and the media such that

most of the recent research on bullying has centered around cyberbullying. As technology

expands, cybertools such as texting, video messaging, social networking has changed the

way teens communicate with each other. With these new tools, teens have used this

method for bullying peers and dating partners(Alvarez, 2012). The literture on bullying

has began to focus on the use of cybertools to control dating partners but is very limited.

Due to the ability to reach a wide audience and remain anonymous; cyberbullying may be

more menacing that traditional bullying (Burton, Florell, & Wygant, 2013). Futhermore,

research on cyberbullying suggest that this form of bullying may impact depression and

suicidal ideation more than traditional bullying (Bonanno & Hymel, 2013; Patchin &

Hinduja, 2010).

In a longitudinal study of 1,154 adolescents conducted by Foshee, et al., (2014),

the authors reported that direct bullying (perpetration) in sixth grade predicted onset of

dating violence perpetration in eight grade (p.439). Similar to Foshee, et al study, Ellis &

Wolfe, (2014) reported that bullying predicted victimization and perpretation of dating

violence in their study of 585 9

through 11

graders in a Canadian public high school

(p.5). Both studies reported results by gender, but Foshee, et al., (2014) reported on

results related to race whereby African Americans reported more direct bullying

(perpetration) than whites and prediction of the onset of physical dating violence

perpetration was more likely for African American teens . Zweig et al., (2013) conducted

a study of 5,647 youth where they examined cyber dating abuse among teens and other

forms of violence. The authors defined cyber dating abuse as use of technology to

commit abusive acts within a dating relationship. Results were reported by the authors as

over 25% of respondents reporting experiencing cyber dating abuse victimization with

females reporting greater victimatzation of cyber bullying specifically sexual cyber

dating abuse (Zweig et al., 2013). Similarly, Lucero, Weisz, & Smith-Daren, (2014)

conducted a qualitative study of 23 10

graders in Michican whereby they examined

gender differences in technology use /abuse among teens. Study results were reported as

texting and social networking being the most common type of socially interactive

technology used for abusive actions such as spying/ monitoring, sexting, and password

access as a consequence of distrust and jealousy (Lucero et al., 2014).

Several studies focused on cyberbullying as it related to teens in general. Included

in cyberbullying was the issue of cyberdating abuse. Additionally, Schneider et al.,

(2012) used data from a Massachusetts census of high school students where they

examined prevalence of cyberbullying and school bullying victimization and association

with psychological distress. Results were reported as a majority of those who reported

being victims of cyberbullying were also victims of school bullying . Additionally,

psychological distress was higher for those who reported both cyberbullying and school

bullying (Schneider et al., 2012). Futhermore, the authors stated that there was little to no

difference as it related to race/ethnicity (Schneider et al., 2012). Similar to Schneider et

al., (2012), Wang et al., (2011) reported that depression was associated with cyber

bullying and traditional bullying but victims of cyberbullying reported higher levels of

depression than perpetrators. There was one study whereby the authors reported that

African American teens were more involved in physical, verbal or cyber bullying and less

likely to to be verbally or relationally victimized (Wang et al., 2009). Another study

involving 10,254 middle school youth had results which the authors reported related to

race where African American youths were more likely to report bully-victim and victim

than groups not involved in bullying (Goldweber et al., 2013). It was difficult to find

African American teens as a focus in studies on bullying whereby most of the studies

included predominantly white samples.These results point to the gap in the literature

whereby African American teens are absent. Futhermore, the negative effects of bullying

on the health of teens contributes to the need for research to further understand the

complexities associated with African American teen dating violence for better targeted

programs.

Sexual bullying

Sexual bullying is built on the definition of bullying by adding sexual interest and

usually begins in early adolescence (middle school). This type of bullying occurs when

there is repetitive teasing, taunting, harassment, and threats with malicious intent where

one party has a sexual interest (Fredland, 2008). The perpetrator may present as having a

romantic interest in the victim but there is a lack of consideration for the victim and there

exist a power imbalance (Fredland, 2008). As adolescences grow older, sexual bullying

has the potential to escalate into other forms of violence including emotional, physical,

teen dating violence and sexual assault (Fredland, 2008). In a longitudinal study on

bullying perpetration and subsequent sexual violence perpetration conducted by Espelage

et al., (2012) reported that bullying perpetration and homophobic teasing were significant

predictors for sexual harassment in a sample of 820 middle school students (p. 60).

Additionally, the authors hypothesized that as these adolescents move into opposite

gender peer relationships, perpertation of sexual violence is likely but although their

results suggest this might be true, this was not shown by their research as this required a

longer study (Espelage et al., 2012) . In a longtitudal study of 1,734 adolescents

conducted by Chiodo, Wolfe, Crooks, Hughes, & Jaffee, (2009), results were reported as

sexual harrassment victimization in early adolescence being associated with higher risk

of other forms of relationship type violence including physical dating violence 2.5 yrs

later (p.246). The Center for Disease Control and Prevention, (2012b) stated that the

connection between bullying and sexual violence cannot be over looked and research

which focuses on examining the association is needed as middle schoolers move from

same sex peer relationships to opposite sex social context, bullying behavior could lead to

sexual violence. The literature makes reference to the possibility that bullying of a sexual

nature could lead to other forms or violence and the lack of appropriate research;

therefore, this current study will expand the research on bullying by examining

association with teen dating violence.

School bullying

School bullying occurs within the educational setting (Serra-Negra, et al., 2015).

Types of school bullying include verbal, physical, relational and indirect such as

spreading rumors (Serra-Negra, et al., 2015). Schools are where teens spend most of their

time and during that time, they are involved in social relations, which makes the school

setting an ideal place for the occurrence of bullying (Serra-Negra, et al., 2015) .

In a cross-national study, data was collected through anonymous self-report

questionnaires of 7,182 6

to 10

graders where on the question of bullying ( victim or

perpretator) at school in the previous 2 months, 20.8% reported physical, 53.6% verbal,

51.4% social and 13.6% electronic (Wang et al., 2009). Similar results were found in a

study of 20,406 9

through 12

graders in MetroWest Massachuseets using a survey,

25.9% reported school bullying in during the previous 12 months (Schneider et al.,,

2012). Futhermore, school bullying has been linked to lower school performance and

school attachment (Schneider et al., 2012). School bullying has drawn national attention

due to recent cases of suicides related to school bullying. It is well documented in the

literature that school related bullying negatively impacts the emotional health of victims

(Williams & Peguero, 2013).The most public cases of school bullying did not involve

African American teens which may send the wrong message to policy makers as they

allocate resources to programs to address bullying. African American children are more

likely to be labeled as aggressive by their teachers and peers (Goldweber et al.,

2013).This brings into question whether or not the school system is adequately equipped

to meet the needs of African American children especially as they move through the

educational system into high school. African American teens may have special needs not

readily addressed by current school based anti-bullying programs and without research

which primarily targets this population, perpetual marginalzation will continue.

Ethnicity/race

Dating violence and bullying among teens are major public health issues

deserving of research to understand risk and protective measure with a goal of primary

prevention. Currently there is limited research which examines the complexities of

African Americans within communities where African Americans constitute a large

portion of the population. Most studies although reporting results related to race, fail to

target their samples within large African American populations. The social context

whereby African American teens reside plays an important role in how they

operationalized their dating and social relationships. African American teens are more

likely than their white counterparts to live in communities where prevalence of violence

is higher (Martin et al., 2012; Patton et al., 2013).

Teen dating violence and ethnicity/race

Despite an overwhelming focus in the literature on risk factors for teen dating

violence and negative impact of dating violence, few studies examined teen dating

violence in the context of ethnicity/race as the targeted population (Black, et al., 2014;

Boothe M. A.et al., 2014;Bradshaw et al., 2013;Freeman & Temple, 2010;Henry &

Zeytinoglu, 2012;Redhawk Love & Richards, 2013;Temple & Freeman, 2011).

Furthermore, there was a gap in the literature regarding teen dating violence with co-

occurrence with bullying among African American teens as such studies to date did not

exist.

A disparity within the literature existed whereby, unless a study targeted African

American teens (Black, et al.,2014 ; Boothe et al., 2014; Redhawk Love & Richards,

2013), most studies were conducted using a majority white sample . Additionally, the

majority of the studies albeit few, which targeted African American youth was conducted

in low income urban areas (Niolon, et al., 2015) . Results from studies where the sample

came from populations of low income urban areas, may not represent the full spectrum of

African American teens but it is understandable why researchers in the field of dating

violence would choose their sample from low income urban areas in order to capture

large samples of African Americans and the link between low income urban communities

and prevalence of violence.

When race/ethnicity was discussed in the literature, there were contradictions as

to whether or not race/ethnicity was associated with teen dating violence. Temple &

Freeman, (2011) reported that in their study of 1,565 ethnically diverse teens in southeast

Texas, they did not see an association between dating violence and being African

American, white or Hispanic (p.701) . Contrast to the Temple & Freeman study, the

Youth Risk Behavior Surveillance ( YRBS) 2009 showed that African American teens

had the highest rate of teen dating violence victimatization (Center for Disease Control

and Prevention, 2010). The study conducted by Tyler et al., (2011) aligned with the

YRBS data where the authors conducted a study consisting of 1,025 adolescence (49.8%

white, 24% black, 11.5% Hispanic, and 14.7% other) and reported findings of black

youth being more likely to be victims of dating violence than their white counterparts.

Bullying and ethnicity/race in the literature

Although there were few studies where the sampling of African American youth

were predominant, an association between bullying and race/ethniciy was prevalent

throughout the literature. Kowalski & Limber, (2013) stated that their sample of 931

students from grades 6 to 12 was conducted in a school where the population was 95%

white. Futhermore, race was not recorded on the self administered surveys (Kowalski &

Limber, 2013) . Another study conducted by Bauman et al., (2013) using the 2009

Arizona Youth Risk Behavior Survey of 1,491 high school students included a sample of

4.4% African-Americans. There was one study which focused on race, urbanicity, and

patterns of bullying where the authors reported that their sample was ethnically diverse

while stating that 62.4% where Caucasian, 19.0% African American and 5.6% were

Hispanic (Goldweber et al., 2013). This brings into question the definition of diversity in

research.

Bradshaw et al., (2013) conducted a study of 16,302 adolescent where they

examined various subtypes of bullying and association to health risk. The authors

reported results as African American adolscents being more likely to being involved in a

gang. Additionally, in a study involving 7,182 teens from grade six through ten, the

authors reported that African American adolescence perpertated verbal, physical, and

cyber bullying and less victimization as it related to verbal and relational bullying (Wang

et al., 2009). Furthermore, Goldweber et al., (2013) reported that their results from a self

report of 10,254 middle school youth revealed that African American youth were at

greater risk of bully victimatizaton (p.213) . Additionally, Boothe et al., (2014) conducted

a study using the 2009 Youth Risk Behavior Survey where they examined difference in

sexual behavior among various ethnic groups and reported that sexual behaviors were

associated with race/ethnicity and dating violence. As it related to the impact of academic

achievement, Williams & Peguero, (2013) reported that Blacks who were higher

achievers reported higher bullying vicitimization in a study where African American’s

were oversampled in order to obtain adequate representation for analysis.

Conclusion

This literature review demonstrated that there is a major gap in the literature as it

relates to teen dating violence and co-occurrence with bullying among African American

teens. The literatrue related to teen dating violence clearly established the negative

impact of teen dating violence and bullying although this variable was examined

separately in most studies. Programs geared towards addressing the problem of teen

dating violence and bullying occur in isolation of each other which may not be meeting

the needs of teens. In examining the relationship among teen dating violence, bullying,

and race/ethnicity this study could help to better target program resources.

Chapter 3: Research Method

The purpose of this quantitative study was to explore and test the relationship

between experiencing bullying and experiencing dating violence. The data was drawn

from the 2013 YRBS. African American teens were compared to teens that self-identified

as White or Hispanic in the survey. The following chapter includes the research design

and rationale (purpose, design, and rational), methodology (definition of the population,

sampling and sampling procedures, data access and collection, instrumentation and

operationalization of constructs, and data analysis), and threats to validity

(internal/external threats) and ethical considerations.

Research Design and Rationale

To explore and test the relationship between experiencing bullying and

experiencing dating violence, I used a quantitative survey design. An analysis of the

relationship between the dependent variable (teen dating violence victimization) and the

independent variable (bully victimization) while controlling for race/ethnicity, age,

substance abuse, and age of first sexual intercourse was conducted. Possible mediating

variable (spending time with a parent) was evaluated. The quantitative cross-sectional

research design used for this study relies on data previously collected from a self-

administered school-based national survey. The secondary data was from the self-

administered questionnaires of Palm Beach County public high school students in the

spring of 2013 for use in the Center for Disease Control YRBS. Participants who were in

attendance on the day of the survey completed the questionnaires during a class period.

Their responses were entered on a computer scannable answer sheet and booklet (Center

for Disease Control and Protection, 2014c).

Cross-sectional design is often used in research which employ surveys as the

method for data collection (Frankfort-Nachmias & Nachmias, 2008). The research

questions for this study focused on describing patterns of relationship between variables

which is a common application of cross-sectional design (Frankfort-Nachmias &

Nachmias, 2008) . Responses to survey questions regarding victimization of bullying and

teen dating violence, does not allow for manipulation of the independent variables

bullying, race/ethnicity, and gender. As a result, before and after comparisons will not be

possible which prevents causality. Use of a cross-sectional design will allow for analysis

which utilize statistical methods to compensate for the inability to show causality while

demonstrating the relationship between the variables (Frankfort-Nachmias & Nachmias,

2008).

The YRBS included the relevant data to analyze the relationship between bully

victimization and teen dating violence victimization. Using a cross-sectional design

allowed analysis of survey responses from the most recent YRBS which is one of the few

datasets that captured bully victimization and teen dating violence victimization within

South Florida. The National Survey of Children’s Exposure to Violence [NatSCEV] is a

large national representation sample of over 4,500 children ages 17 and younger which

focuses on estimating various types of violence, crime and abuse including bullying,

sexual victimization and domestic violence (U.S. Department of Justice: Office of Justice

Programs, 2011). Despite being a data source for violence victimization related to

bullying, the NatSCEV did not assess teen dating violence victimization and did not

provide data for indvidual states or locatities such as Palm Beach Florida (U.S.

Department of Justice: Office of Justice Programs, 2011) . Another large national survey

which collected data on violence among teens but did not meet the needs of my study due

to lack of data on teen dating violence and bully victimization was The National

Longitudinal Study of Adolescent to Adult Health[NLSA]. The NLSA collects data on

students in grade 7-12 at Wave I (1994-1995) with follow-ups at Wave II( 1996), III

(2001 and 2002), and IV(2008 and 2009) (Harris, et al., 2009). Due to reliance on

archival data which was readily available for public use, there was no time or resource

constraints.

Cross-sectional design is the most applied design within the social sciences

(Frankfort-Nachmias & Nachmias, 2008).The application of cross sectional design using

national survey’s has been documented in the literature as it related to dating violence

and bullying . Bauman et al., (2013) used data from the 2009 Arizona YRBS to examine

relationships among depression, suicidal behaviors and bully victimization and

perpetration of bullying. Boothe, Rula, Lassiter, & Holland, (2015) conducted a study

using data from the 2009 YRBS where they examined differences in sexual behaviors

among various female ethnic groups who reported exposure to dating and sexaul

violence. Rice, et al., (2015) conducted a study of middle schoolers using data generated

from the 2012 YRBS in Los Angeles; whereby, the researchers examined associations

between gender,race and sexual idenity and technology use and cyberbullying

experiences and behaviors. In a study conducted by Hamby et al., (2012), a cross

sectional design was used based on data from the NatSCEV to examine co-occurrence of

physical teen dating violence with other forms of vicitimization. These previously

published studies support the design and analysis of my dissertation study.Use of cross-

sectional design for research allows examination of various public health concerns among

youths. Surveys which are designed to accommodate the daily school schedule ( class

periods) such as the YRBS, allows for collection of large amounts of data from a large

sample; whereby, analysis of various health-risk behaviors and subsequent associated

factors can transpire, furthering the knowledge of the field (Center for Disease Control

and Prevention, 2014a).

Methodology

Population

The population for this study was Palm Beach County public high school students

in grades 9 to 12. The 2013 Palm Beach County YRBS targeted all public high school

students in grades 9 to 12. All 23 high schools in Palm Beach County were eligible to

participate in the survey and all 23 participated.

Sampling and Sampling Procedures

The 2013 Palm Beach County YRBS included 2,376 students in the sample

(Center for Disease Control and Prevention, 2014b). I reviewed a total of 1,849

completed questionnaires of which 1,836 were usable after postdata editing; whereby,

questionnaires which failed quality controls(less than 20 remaining responses after

editing or had the same answers for greater than/equal to 15 consecutive questions were

considered unusable (Center for Disease Control and Protection, 2014b) . Twenty-three

public high schools in Palm Beach County completed the survey in the spring of 2013

(Center for Disease Control and Protection, 2014b). There was a 77% response rate

which was calculated as number of participating schools/ number of eligible sampled

schools x number of usable questionaires/number of eligible students sampled rounded to

the nearest integer (Center for Disease Control and Protection, 2014b). A two stage

sampling design was used for the 2013 YRBS. An initial sample of all public high

schools that had 9-12 grades was selected, followed by a probablity sampling of classes

with a random start in each selected school; whereby, each student within a required

subject or all classes meeting during a particular period of day were invited as particpants

Center for Disease Control and Protection, 2014b). Participants questionnaries were

weighted for representation of all Palm Beach county public high school students and to

reduce bias as it compensated for differences in patterns of non response (Center for

Disease Control and Protection, 2014b).

Power analysis

To determine the power of the sample size, I selected a medium effect size at .15,

statistical power level was set at .80, probability level was set at .05 and predictor was 3.

Using prior Sample Size Calculator for Multiple Regression, the resulting sample size

was 76. Based on these results, a sample of 2,376 used for the Palm Beach County 2013

YRBS was appropriate.

Archival Data

This study was a secondary analysis of archival data collected from a sample of

public high school students in Palm Beach County in Florida during the spring of 2013.

Due to the use of archival data for this study, I did not have contact with the students who

completed the original survey. All measures for this study were unobtrusive; whereby,

the method of data collection did not include my direct contact with events, interactions,

or behavior of the participants under investigation. The Center for Disease Control and

Prevention provided funding for the collection of data within Palm Beach counties Center

for Disease Control and Protection, 2014b).

Upon approval by Walden IRB and assignment of an IRB number, a request for

data was completed and submitted to the Center for Disease Control and Prevention and

Palm Beach County Department of Health in order to gain access to the data .

Instrumentation and Operationalization of Constructs

Instrumentation

The YRBS used in Palm Beach was developed by the Center for Disease Control

and Prevention for the purposes of (a) describing the prevalence of health-risk behaviors

among youth and (b) assessing trends in health-risk over time with a goal of providing

public health professionals with the tools needed to evaluate and improve policies and

programs which target youth (Center for Disease Control and Protection, 2014a) . The

first YRBS survey was developed in 1991 and has been conducted biannually nationally

in schools based in state, territorial, tribal, and large urban school districts (Center for

Disease Control and Protection, 2014c) . In 1997 the Center for Disease Control and

Prevention reviewed the questionnarie and made adjustment to the questions in order to

meet the Healthy People 2010 health objectives (Center for Disease Control and

Protection, 2014c). The current 2013 questionnarie includes minor changes based on

feedback from experts within and outside of Center for Disease Control and Prevention

(Center for Disease Control and Protection, 2014c). Suggested changes to questions were

placed on a ballot accessible by YRBS coordinators at each site, whereby votes for or

against additions, deletion, or changes occurred (Center for Disease Control and

Protection, 2014c).

The national standard questionnaire is available to states, tribes, and counties.

Sites are able to request to modify the national survey but there are parameters which

include keeping two-thirds of the questions unchanged, a limit of eight mutually

exclusive options for responses, and no skip patterns, grid formats, or fill-in responses

Center for Disease Control and Protection, 2014c).

Additonally, questions related to height and weight must be retained as Question

6 and Question 7 and no more than 99 questions are allowed (Center for Disease Control

and Protection, 2014c). The Center for Disease Control and Protection limits the number

of questions due to concerns about student’s ablity to complete the survey within one

class period (Center for Disease Control and Protection, 2014c). Sites wishing to modify

the questionnaires are provided with a list of optional questions which were already

tested for reliability and validity. Sites who wish to develop their own questions, are

provided with assistance by the Center for Disease Control and Protection to assure

reading level appropriateness and alignment with the YRBS.

The YRBS has been used by several researchers to study health-risk and

behaviors of youths (Bauman et al., 2013; Boothe et al., 2015; Mueller, James, Abrutyn,

& Levin, May 2015) . Few surveys collect data on a large scale within the social sphere

of teens the school setting; whereby, county level data is available that provides insight

into the behaviors of teens. The intended goal of using of the YRBS in research is to

allow public health professionals to inform policies and programs which target youth (

Center for Disease Control and Prevention, 2014c). The results from this current study

could help to inform public health professionals in their development of programs which

focus on teen dating violence by demonstrating whether or not there is an association

among dating violence and bullying, race/ethnicity and gender.

Permission to use the instrument was not necessary as the data which was

generated from the instrument is available with permission from Palm Beach Secondary

Curriculum Department.

In 1992 and 2000, the Center for Disease Control and Prevention conducted two

test-retest reliablity studies of the national YRBS questionnaries where no significant

difference was found between the prevalence estimates each time the questionnaire were

used in 1992 (Center for Disease Control and Protection, 2014c). Additionally, responses

were found to be less consistent for those in the seventh grade verses those in 9-12 grades

which demonstrated that the instrument was appropriate for the intended grades of 9-12

(Center for Disease Control and Protection, 2014c). In the 2000 reliability study, the

questionnaries were adminstered 2 weeks apart on two occasions whereby significant

differences related to prevalence was found for 10 questions, which resulted in a revision

or deletion for future questionnaires due to concerns about reliability (Center for Disease

Control and Protection, 2014c).

Validity of the instrument which requests self-reported behavior information has

not been studied (Center for Disease Control and Protection, 2014c). The Center for

Disease Control and Prevention conducted a review of the literature as it related to

assessing cognitive and situational factors that could impact validity of self-reporting

behavior and found that there was no threat to validity of self-reports despite being

affected by cognitive and situational factors (Center for Disease Control and Protection,

2014c).

Operationalization

Teen dating violence

Two items on the 2013 Palm Beach YRBS were used to measure teen dating

violence victimization. Teen dating violence victimization was defined as being

physically hurt on purpose by someone they were dating or being forced to do sexual

things by someone they were dating. For the purposes of this study, dependent variable

(teen dating violence victimization) was operationalized using variable Q22 and Q23.

Q22. During the past 12 months, how many times did someone you were dating

or going out with physically hurt you on purpose? (Count such things as being hit,

slammed into something, or injured with an object or weapon.)

The measure was coded as follows: 0. I did not date or go out with anyone during

the past 12 months; 0. 0 times; 1. 1 time; 2. 2 or 3 times; 4. 4 or 5 times; 6. 6 or more

times

Q23. During the past 12 months, how many times did someone you were dating

or going out with force you to do sexual things that you did not want to do? (Count such

things as kissing, touching, or being physically forced to have sexual intercourse.)

The measure was coded as follows: 0. I did not date or go out with anyone during

the past 12 months; 0. 0 times; 1. 1 time; 2. 2 or 3 times; 4. 4 or 5 times; 6. 6 or more

times

These two variables (Q22 and Q23) were aggregated together to create a teen

dating violence victimization score (VioScoreAggregate).

Bully victimization

The independent variable bully victimization was measured and defined as when

one or more students tease, threaten, spread rumors about, hit, shove, or hurt another

student repeatedly ( Center for Disease Control and Prevention, 2014) . Bully

victimatization variable was operationalized using variable Q24, Q25, Q88,and Q89

Q24. During the past 12 months, have you ever been bullied on school property?

The measure was coded as follows: 0. no; 1. yes

Q25. During the past 12 months, have you ever been electronically bullied?

(Count being bullied through e-mail, chat rooms, instant messaging, websites, or

texting.).

The measure was coded as follows: 0. no; 1. yes

Q88. During the past 12 months, have you ever been the victim of teasing or name calling

because of your weight, size, or physical appearance?

The measure was coded as follows: 0. no; 1. yes

Q89. During the past 12 months, have you ever been the victim of teasing or name calling

because someone thought you were gay, lesbian, or bisexual?

The measure was coded as follows: 0. no; 1. yes Bully victimization score was 0-

4 points based on counting the number of yes and no responses to questions 24, 25, 88,

and 89.

Race/ethnicity

Control variable race/ethnicity was measured based on response to questions on

the 2013 Palm Beach YRBS. Respondents were asked to self-identify their race/ethnicity

by selecting American Indian or Alaska Native, Asian, Black or African American,

Native Hawaiian or Other Pacific Islander or White. Race/ethnicity was operationalized

using variables Q4 and Q5.

Q4. Are you Hispanic or Latino?

The measure was coded as follows: 0. Not Hispanic; 1. Hispanic

Q5. What is your race? (Select one or more responses)

The measure was coded as follows: 0. Other; 1. White; 2. Black or African

American.

Gender

Control variable gender was measured by reported sex. Gender was

operationalized using variable Q2 on the 2013 Palm Beach YRBS.

Q2. What is your sex?

The measure was coded as follows: 1. female; 2. male

Spending time with a parent

The mediating variable spending time with a parent was measured by responses to

eating dinner at home with a parent. Spending time with a parent was operationalized

using variable Q97.

Q97. During the past 7 days, on how many days did you eat dinner at home with

at least one of your parents or guardians?

The measure was coded as follows: 1. 0 days; 2. 1 day; 3. 2 days; 4. 3 days; 5. 4 days; 6.

5 days; 7. 6 days; 8. 7 days

Age

Participants’ age was a control variable and operationalized by responses to the

question of age on the 2013 Palm Beach county YRBS.

Q1. How old are you?

1. The measure was coded as follows: 1. 12 years old or younger; 2. 13 years old; 3.

14 years old; 4. 15 years old; 5. 16 years old; 6. 17 years old; 7. 18 years old or

older

Age at first sexual intercourse

Control variable age at first sexual intercourse was operationalized by a positive

response to the question of having had sexual intercourse.

Q60. How old were you when you had sexual intercourse for the first time?

The measure was coded as follows: 1. I have never had sexual intercourse; 2. 17 years

old or older; 3. 16 years old; 4. 15 years old; 5. 14 years old; 6. 13 years old; 7. 12 years

old; 8. 11 years old or younger

Substance use

The control variable substance use which included alcohol and drugs was

measured using the 2013 Palm Beach YRBS. Alcohol was defined as beer, wine, wine

coolers, and liquor which included rum, gin, vodka, or whiskey but excluded just taking a

few sips of wine intended for religious purposes ( Center for Disease Control and

Prevention, 2014b). Two variables was used to operationalize alcohol consumption

whereby one determined history of alcohol consumption; whereas, the second variable

was used to operationalize current consumption of alcohol.

Q41. During your life, on how many days have you had at least one drink of

alcohol?

The measure was coded as follows: 1. 0 days; 2. 1 or 2 days; 3. 3 to 9 days; 4. 10

to 19 days; 5. 20 to 30 days; 6. 40 to 99 days; 7. 100 or more days

Q42. How old were you when you had your first drink of alcohol other than a few

sips? The measure was coded as follows: 1. Never drank alcohol; 2. 17 years or older; 3.

15 or 16 years old; 4. 13 or 14 years old; 5. 11 or 12 years old; 6. 9 or 10 years old; 7. 8

years or younger.

Drug use was operationalized by using variables related to marijuana, cocaine, sniffed

glue, breathed contents of aerosol spray cans or inhaled paints or sprays for the purposes

of getting high, heroin, methamphetamines, ecstasy, steroid pills or shots, prescription

drug use without a doctor’s prescription, synthetic marijuana and injection of illegal

drugs ( Center for Disease Control and Prevention, 2014b).

Q47. During your life, how many times have you used marijuana?