Event-level analysis of antecedents for youth violence: comparison of dating violence with non-dating violence.

Background: Dating violence (DV) has emerged as a major concern among youth with links to substance use, injuries, and death. The emergency department (ED) provides an opportunity for violence screening and prevention interventions. Additional data are needed regarding antecedents of DV versus non-dating violence (NDV; e.g., acquaintance, stranger) to develop ED-based violence interventions for youth.

Methods: Participants were 575 patients screening positive for past 6-month drug use in an urban ED who completed timeline follow-back aggression modules at baseline and 6- and 12-months, indicating event-specific antecedents of violence. Multi-level logistic regressions using event-level data, nested by individual and time (i.e. baseline, 6- and 12-month assessment intervals), were used to examine antecedents of DV vs. NDV. Post-hoc analyses examined substance use×reasons and gender interactions.

Results: Prescription sedative/opioid misuse was more likely to be reported prior to DV whereas alcohol only, and co-ingested alcohol and marijuana only, were more likely to be reported prior to NDV. Reasons for DV included: "personal belongings", "angry/bad mood," "jealousy," "drunk/high on drugs" and "arguing about sex". Reasons for NDV included: "rumors," "retaliation," "personal space" and "aid (someone) due to physical attack". Substance use before/during conflicts and reasons for conflicts were both uniquely associated with DV versus NDV. Two gender interactions were found.

Conclusions: ED based interventions for urban youth need to be tailored by gender, substance use (alcohol, cocaine, sedatives), reasons for violence, and type of violence (DV vs. NDV).