Introduction

Teen Dating Violence (DV) refers to physical, sexual, psychological, and stalking behaviours that occur in the context of a close relationship between teenagers. DV is considered to be a type of intimate partner violence [1]. New concerns are emerging due to its damaging short and long-term effects on teenagers’ health and wellbeing [2]. In the international context, it has been estimated that the prevalence of physical violence among adolescents aged 13 to 18 is 20% and that the prevalence of sexual violence is 9% [3]. According to data from the last Macro Survey on Gender Violence in Spain [4], 46.6% of women aged 16–24 that have had a partner declared having experienced some type of violence on behalf of that person. The prevalence in women over age 25 was 32.4%. DV victimization is also common among male adolescents, although its consequences seem to be worse for girls [2].

There is also evidence that shows that social and economic factors are associated with a higher risk for DV, such as being of older age, experiencing lower socioeconomic conditions and belonging to a minority ethnic group [5, 6]. An increased risk of DV victimization has been also reported by female and male adolescents who have been exposed to other forms of violence (childhood exposure or witnessing different forms of violence, bullying), poor quality friendships and family relationships, and the presence of harmful attitudes such as sexism, machismo, or violence acceptability [7–10]. Conversely, a higher sense of attachment to school and teachers seems to be associated with a lower likelihood of both DV victimization and perpetration [11].

The influence of sexual orientation and identity on DV is an emerging field. Research has shown that LGB youth (lesbian, gays, bisexuals) may have a higher risk of physical and/or sexual DV victimization than heterosexual adolescents [12]. According to the U.S. National School Climate Survey, nearly 85% of LGB/Transgender students have experienced verbal harassment, and 27% have been physically harassed at school [13]. The most common form of violence includes the use of homophobic language and/or spreading sexual orientation rumours or mocking students who are perceived as non-normative compared to a monogamic heterosexual norm [14, 15]. Research has shown that the likelihood of DV may be higher among male and female adolescents who are not sure of their sexual identity [16].

Although there is some prior research, the evidence is still weak concerning DV among both male and female adolescents in Europe [17–19]. There is a need for studies that integrate the wide variety of protective factors and potential precursors to DV, which may contribute to public health strategies to prevent DV and promote healthy and equitable relationships.

During the 2019–2020 period, we conducted an educational interventional project titled “Promotion of Gender Violence Protective Assets Among Adolescents and Pre-adolescents” in secondary education schools. The project was funded by the Spanish Ministry of Economy, Industry and Competitiveness and the Carlos III Institute (Ref. PI18/00590 and PI18/00544) in 2019 and 2021. This project was based on a prior European project: Lights, Camera and Action against Dating Violence -Lights4Violence, an educational intervention carried out in six European countries to promote positive relationships among adolescents [20]. In the latter project, the educational intervention program aimed to promote personal and external dating relationship assets among a sample of adolescents ages 13–18 from two Spanish cities, Alicante and Terrassa (Barcelona), both of which are located on the Mediterranean coast of Spain.

In this paper, we used the baseline data to analyse the prevalence and different factors associated with DV victimization among female and male adolescents schooled in two cities of Spain, considering their socioeconomic circumstances, sexual orientation and the presence of different violence-related attitudes and experiences in 2019–2020.

Materials and methods

This study had a cross-sectional design. A total of eight high schools participated (6 public, 2 subsidized), with 35 classes from the 2nd course and 34 classes from the 3rd course (years 9 and 10 in secondary school, respectively). The selection of the schools was carried out by contacting different secondary schools that met the characteristics of the study (non-random sample). We estimated that this number of schools would allow us to reach the estimated sample size for our intervention. In order to calculate the sample size, we used the GRANMO software. Calculating a rate of losses to follow-up of 20% and with an alpha risk of 0.05 and a beta risk <0.02 in a bilateral contrast, we estimated that 279 subjects (CG) would be needed for the intervention group and 279 subjects in the control group to detect a statistically significant difference between two proportions (expected to be 0.1 for the intervention group and 0.2 for the control group). Lost to follow-up ratio was estimated at 30%, as is usually expected in studies with these characteristics.

From among the total of the students (n = 1,846) at the selected high schools, 1,561 (84.6%) were offered the opportunity to participate in the survey because they were present at school. Of those invited, 1,538 students and their teachers accepted (98.5% of those contacted). The final study population of the baseline survey was 1,422 students (91% of those invited). In this study we selected 640 high school students ages 13 to 17 (51.3% girls), who reported having had a partner. The sample was selected from the four schools in Alicante (n = 359, 50.1% girls) and the four in Terrassa, Barcelona (n = 281, 51.9% girls).

Data was collected through an online questionnaire distributed to the different schools in Alicante and Terrassa between October 2019 and February 2020. Surveys were personally and confidentially self-administered. The students answered the questionnaire on separate computers with total privacy. Members of our research team were present in the classroom throughout the survey (which lasted approximately one hour). This facilitated access to the survey, helped resolve possible language barriers and ensured that each participant answered their questionnaire confidentially. The teachers were asked to remain outside the classroom, although this was not always possible. Methodological details of the survey are based on previously published study [20].

The students from the eight centres included in the project agreed to participate, through prior informed consent for them and their legal guardians. The project was approved by two ethical committees, CEIm-Parc de Salut Mar (2019-8914-I) and CEIC Alicante University (UA-2018-02-28).

Results

The prevalence of DV was 23.5% in girls and 23.4% in boys. Around 5.5% of girls and 8.7% of boys reported having experienced physical and/or sexual violence at some time in their lives. About 22% of girls and 20.5% of boys reported having experienced violence related to control/fear (Fig 1).

Download:

• PPT
  PowerPoint slide
• PNG
  larger image
• TIFF
  original image

Fig 1. Prevalence of violence by sex.

https://doi.org/10.1371/journal.pone.0258994.g001

Heterosexual girls presented lower prevalence of DV (19.3%) than girls with other types of sexual orientations (36.7%) p = 0.004. In boys, the prevalence of DV for those born in a foreign country was 43.8%, 28.1% in boys born in Spain with foreign-born parents and 19.0% for those born in Spain (p = 0.005) (Table 1).

Download:

• PPT
  PowerPoint slide
• PNG
  larger image
• TIFF
  original image

Table 1. Prevalence of teen dating violence victimization by sex according to sociodemographic characteristics and variables related to exposure to violence.

https://doi.org/10.1371/journal.pone.0258994.t001

We also observed that earlier experiences of abuse and/or violence in childhood prior to age 15 and having been a victim of bullying and cyberbullying were statistically significantly related to greater DV prevalence, in both girls and boys. In the case of girls, the prevalence of DV increased when they were aggressors in bullying or cyberbullying situations. Also, in both girls and in boys, there was greater average machismo and acceptance of violence when they had experienced DV. Furthermore, there were significant differences among girls in terms of family relationships (p = 0.021) and in terms of school satisfaction (p = 0.041) (Table 2).

Download:

• PPT
  PowerPoint slide
• PNG
  larger image
• TIFF
  original image

Table 2. Teen dating violence victimization by sex according to sexism, machismo, empathy, assertiveness and capacity for conflict resolution.

https://doi.org/10.1371/journal.pone.0258994.t002

Girls who were born in a foreign country had 2.1 times greater probability of experiencing DV than those who were born in Spain and had foreign-born parents (confidence interval (CI) 95%: 1.1–3.9). Having an LGB sexual orientation was also associated with a greater risk of DV in girls (aPR: 1.9; CI95%: 1.3–2.9). Girls with prior experiences of abuse and/or violence in childhood presented a 60% greater chance of experiencing DV (aRP: 1.7; CI95%: 1.1–2.8). Greater machismo was also associated with greater probability of DV (aPR: 1.0; CI95%: 1.0–1.1), while greater acceptance of violence was associated with a lower probability of DV (aPR: 0.9; IC95%: 0.9–1.0). Those girls with a poor relationship with teachers also showed greater probability of experiencing DV (aPR: 1.6; CI95%: 1.1–2.3) (Table 3).

Download:

• PPT
  PowerPoint slide
• PNG
  larger image
• TIFF
  original image

Table 3. Main associated factors of teen dating violence victimization among girls and boys.

https://doi.org/10.1371/journal.pone.0258994.t003

Regarding the boys, those born in a foreign country presented a 90% greater likelihood of experiencing DV than those born in Spain with foreign-born parents (RP: 1.9: CI95%: 1.0–3.6). Those who experienced physical and/or sexual abuse showed a 70% greater likelihood of having experienced DV (aRP: 1.7; CI95%: 1.1–2.6). Greater machismo was associated with a greater likelihood of experiencing DV in boys (aPR: 1.0; CI95%: 1.0–1.1) (Table 3).

Discussion

Nearly one fourth of students aged 13–18 reported having been exposed to physical-sexual violence and/or control and fear. Among them, the registered prevalence among lesbian/bisexual girls and those who have not defined their sexual orientation yet are noteworthy; as is that of boys who were born outside Spain and those born in Spain with foreign-born parents; and female and male adolescents with poor relationships with friends, family and/or teachers. Being foreign-born and scoring a higher level of machismo were common factors associated with an increased likelihood of DV among girls and boys. In addition, boys who suffered physical and/or sexual abuse in childhood were 70% more likely to have suffered DV, and girls who witnessed these abuses in childhood were 60% more likely. In the case of girls, other DV associated factors included being lesbian, bisexual or unsure about one’s sexual orientation and having a poor relationship with teachers.

In accordance with previous research [29, 30], DV victimization is present in both girls and boys. In the case of girls, data published by the European Union Agency for Fundamental Rights Violence Against Women Survey of 2012 shows similar prevalences to what we obtained in our study, despite the different methodologies used in both surveys [19]. A meta-analysis carried out by Wincentak [3] shows that, in the case of sexual DV victimization, the prevalence is significantly greater in girls (14%) than in boys (8%). In our study, however, the observed prevalence of DV among girls and boys was similar. We need to look at this from a feminist perspective, because in heterosexual relationships, the mechanisms and severity by which violence operates differ between the sexes. Thus, men’s violence against women escalates faster and is more socially legitimized than the reverse. In this sense, violence is directional. On the other hand, we must discuss how men and women perceive violence. Based on the literature, heterosexual women have normalized much of everyday violence, to that they do not perceive it as such. Men, on the other hand, clearly identify when women use control or aggression, and this often occurs in response or reaction to previous violence by men [31].

In relation to the observed DV associated factors in this study, worth noting is the greater probability of foreign-born girls and boys to experience dating violence, compared to the young population born in Spain. On the one hand, in interpreting this result, it is important to consider that the immigrant population may have different conceptualizations of love, and may be more tolerant of certain behaviours considered violent compared to the native-born population [32, 33]. On the other hand, the immigrant population from low-income countries that migrates for economic reasons may be exposed to greater social and economic inequality than the native-born population [34, 35]. These inequalities are expressed in the context of systematic discrimination, violence and poverty that condition social opportunities and intergenerational life circumstances of the immigrant population. The social and health situation of the immigrant population requires an intersectional approach, given that inequalities operate simultaneously and are complex in their economic, social and gender dimensions, among others [36].

In this study, we confirmed the important influence of previous experiences of violence (suffered or witnessed) on the likelihood of current DV victimization among both girls and boys [18, 29]. Research suggests that a violent family culture may provide youth a biased model of interpersonal interaction, which normalizes aggressive behaviours and may make boys and girls learn that physical and verbal coercion are adequate and acceptable strategies for changing someone else’s behaviour and solving conflicts in their dating relationships [37]. This shows how important it is to detect childhood abuse situations and implement interventions early to prevent, as far as possible, the development of violent attitudes during adolescence and adulthood [38].

The results of this study also found that DV victimization among both girls and boys was associated with higher levels of machismo. Machismo has been associated with an increase in the level of conflicts in a relationship, making adolescents more vulnerable to becoming victims of violence and aggression and more emotionally dependent to the relationship [9]. The results of our study also showed that the likelihood of DV victimization in girls decreases with higher levels of violence acceptation. Adolescents with a higher tolerance of violence may display lower awareness of their rights, which may in turn lead them to justify their actions [39]. This finding highlights the importance of interventions focused on training social and emotional skills in young people at high risk of machismo and acceptation of use of violence given these variables may operate as precursor of violence and victimization.

In agreement with prior research [2, 4], the prevalence of DV in both girls and boys was higher among LGB adolescents and those who are not sure of their sexual orientation. In addition, an association was also confirmed between DV and being lesbian, bisexual or unsure about one’s sexual orientation in the case of girls. The literature suggests that internalized homophobia could explain this association between non-heterosexual orientation and IPV victimization in girls [40]. The discrimination (based on the feelings/beliefs of others) related to sexual orientation is related to individuals’ own feelings regarding their orientation (i.e., stigma conscientiousness). Likewise, the psychosocial stress that LGB groups may experience in coping with repeated situations of discrimination and marginalization could also be a risk factor for IPV victimization [40]. Interventions that address violence during dating relationships should include information on heterosexual and non-heterosexual relationships and promote school support groups and LGB-heterosexual partnerships [41].

Those adolescents that reported higher prevalence in DV victimization were those who reported poor relationships with their close circles–family and school environment for girls and school environment for boys. In addition, the likelihood of DV victimization in girls was higher for those who had a poor relationship with the school’s teaching staff. This finding is consistent with previous studies that have shown that the likelihood of suffering physical and/or sexual DV decreased when school social support increased [10]. Other studies have shown a moderating effect of social support in terms of physical and psychological DV victimization and relationship satisfaction in girls [42]. These results evidence the importance of social support resources to which teens can turn to seek help [43].

There are some limitations that should be taken into account when interpreting these results. First, the sample used was not representative of both cities or of the country of Spain, and our sampling was non-probabilistic, as it was designed for a pilot school program (quasi-experimental study). Second, we were unable to collect information about students who refused to take part in the survey. Third, the cross-sectional design of our study did not allow us to identify a cause-and-effect relationship between the observed associated variables. Despite, these limitations, this study provides evidence of the risk factors associated with dating violence among girls and boys in Spain. We used a large sample with statistical power to detect significant differences, which may solidify our results. Also, the current study has important implications that may contribute to public health strategies to prevent DV and promote healthy relationships. Thus, implementing prosocial interventions focused on developing emotional and interpersonal skills among adolescent students may be important strategies to prevent risky behaviours, including violence and victimization. Likewise, it’s necessary to draw up strategies with a gender perspective, to address the different mechanisms through which boys and girls participate in heterosexual relationships with DV. These strategies should be a priority among vulnerable adolescents, including LGB and foreign-born adolescents, since these subgroups with high levels of DV may require additional support from community services.

Conclusions

The magnitude of different forms of DV among girls and boys registered in this study shows the need for improvement in violence prevention programs and the promotion of healthy and equitable relationships. According to our results, DV is socially patterned and is worse among the foreign-born, adolescents who reported prior experiences of violence in childhood and LGB groups (especially in the case of girls) who must cope with experiences of social discrimination and harassment. Future intervention programs, such as those promoted by the Spanish State Agreement against Gender Violence in 2017 [44, 45], should be improved by considering these social inequalities in the likelihood of DV and by reinforcing adolescents’ abilities to develop skills and recognize different social support sources in their own close circles to cope with machismo.

Supporting information

Acknowledgments

To all schools and students from the different involved settings for their time and valuable contribution in this project.