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Volume 45, Issue 1, Pages 77-83 (July 2009)


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Rates and Correlates of Violent Behaviors Among Adolescents Treated in an Urban Emergency Department

Maureen A. Walton, Ph.D.aCorresponding Author Informationemail address, Rebecca M. Cunningham, M.D.bd, Abby L. Goldstein, Ph.D.e, Stephen T. Chermack, Ph.D.a, Marc A. Zimmerman, Ph.D.d, C. Raymond Bingham, Ph.D.c, Jean T. Shope, Ph.D.cd, Rachel Stanley, M.D.b, Frederic C. Blow, Ph.D.a

Received 18 August 2008; accepted 4 December 2008. published online 20 February 2009.

Abstract 

Purpose

Violence is a leading cause of death for adolescents in inner–city settings. This article describes violent behaviors in relation to other risk behaviors (e.g., substance use) among adolescents screened in an urban emergency department (ED).

Methods

Patients aged 14–18 years were approached to self–administer a computerized survey assessing violent behaviors (i.e., physical aggression), substance use (cigarettes, alcohol, marijuana), and weapon carriage.

Results

A total of 1128 adolescents (83.8% participation rate; 45.9% male; 58.0% African–American) were surveyed. In the past year, 75.3% of adolescents reported peer violence, 27.6% reported dating violence, and 23.5% reported carrying a weapon. In the past year, 28.0% drank alcohol, 14.4% binge drank, 5.7% reported alcohol–related fighting, and 36.9% smoked marijuana. Logistic regression analyses predicting violent behaviors were significant. Teens reporting peer violence were more likely to be younger, African–American, on public assistance, carry a weapon, binge drink, and smoke marijuana. Teens reporting dating violence were more likely to be female, African–American, carry a weapon, binge drink, screen positive for alcohol problems, and smoke marijuana. Teens reporting alcohol–related fighting were more likely to carry a weapon, binge drink, screen positive for alcohol problems, and smoke marijuana.

Conclusions

Adolescents presenting to an urban ED have elevated rates of violent behaviors. Substance use (i.e., binge drinking and smoking marijuana) is an important risk factor for violent behaviors among urban adolescents. Universal screening and intervention protocols to address multiple risk behaviors, including violent behaviors and substance use, may be useful to prevent injury among adolescents presenting to the urban ED.

a Department of Psychiatry, University of Michigan, Ann Arbor, Michigan

b Department of Emergency Medicine and Hurley Medical Center, University of Michigan, Ann Arbor, Michigan

c Transportation Research Institute, University of Michigan, Ann Arbor, Michigan

d School of Public Health, University of Michigan, Ann Arbor, Michigan

e York University, Toronto, Ontario, Canada

Corresponding Author InformationAddress correspondence to: Maureen A. Walton, M.P.H., Ph.D., University of Michigan, Rachel Upjohn Building, 4250 Plymouth Road, Ann Arbor, MI, 48109.

PII: S1054-139X(08)00657-5

doi:10.1016/j.jadohealth.2008.12.005


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