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Research report
Adverse childhood experiences and risk of physical violence in adolescent dating relationships
  1. Elizabeth Miller1,
  2. Joshua Breslau2,
  3. W-J Joanie Chung2,
  4. Jennifer Greif Green3,
  5. Katie A McLaughlin4,
  6. Ronald C Kessler4
  1. 1Department of Pediatrics, University of California Davis School of Medicine, Sacramento, California, USA
  2. 2Department of Internal Medicine, University of California Davis School of Medicine, Sacramento, California, USA
  3. 3School of Education, Boston University, Boston, Massachusetts, USA
  4. 4Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to Dr Elizabeth Miller, UC Davis School of Medicine, Ticon II, 2516 Stockton Boulevard, Room 382, Sacramento, CA 95817, USA; elizabeth.miller{at}


Background This study evaluates associations of commonly co-occurring childhood adversities with physical violence in dating relationships to identify potential strategies for refining and targeting dating violence prevention programmes.

Methods Data on 5130 adult respondents to a nationally representative survey with at least one dating relationship before the age of 21 years were analysed. Logistic regression models assessed associations between 12 childhood adversities and physical dating violence (PDV).

Results Adjusting for the number of co-occurring adversities, 10 of the 12 childhood adversities were significantly associated with PDV perpetration or victimisation (OR 1.5–2.8). The population attributable risk proportion of PDV due to all 12 childhood adversities was 53.4%. Childhood adversities with the highest attributable risk proportions were sexual abuse (13.8%), interparental violence (11.6%) and parent mental illness (10.7%). Multivariate prediction equations ranked respondents by their childhood adversity risk profiles; 46.4% of PDV cases occurred in the top two risk deciles.

Conclusions Assessment of a broad range of childhood exposures to familial adversities may help to identify adolescents at particularly high risk of PDV and to guide prevention efforts.

  • Adolescents CG
  • child abuse
  • child health
  • mental disorders
  • mental health DI
  • poverty
  • violence RB

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  • Funding This study was supported by grants from Building Interdisciplinary Research Careers in Women's Health to EM (BIRCWH, K12 HD051958–National Institute of Child Health and Human Development (NICHD); Office of Research on Women's Health (ORWH); Office of Dietary Supplements (ODS); National Institute of Aging (NIA)) and National Institute of Mental Health KO1 MH66057 to JB. Other funders: The National Comorbidity Survey Replication (NCS-R) is supported by the National Institute of Mental Health (NIMH; U01–MH60220) with supplemental support from the National Institute on Drug Abuse (NIDA), the Substance Abuse and Mental Health Services Administration (SAMHSA), the Robert Wood Johnson Foundation (RWJF; Grant 044780), and the John W. Alden Trust. Collaborating NCS-R investigators include Ronald C. Kessler (Principal Investigator, Harvard Medical School), Kathleen Merikangas (Co-Principal Investigator, NIMH), James Anthony (Michigan State University), William Eaton (The Johns Hopkins University), Meyer Glantz (NIDA), Doreen Koretz (Harvard University), Jane McLeod (Indiana University), Mark Olfson (New York State Psychiatric Institute, College of Physicians and Surgeons of Columbia University), Harold Pincus (University of Pittsburgh), Greg Simon (Group Health Cooperative), Michael Von Korff (Group Health Cooperative), Philip S. Wang (NIMH), Kenneth Wells (UCLA), Elaine Wethington (Cornell University), and Hans-Ulrich Wittchen (Max Planck Institute of Psychiatry; Technical University of Dresden). The views and opinions expressed in this report are those of the authors and should not be construed to represent the views of any of the sponsoring organizations, agencies, or US Government. A complete list of NCS publications and the full text of all NCS-R instruments can be found at Send correspondence to ncs{at} The NCS-R is carried out in conjunction with the World Health Organization World Mental Health (WMH) Survey Initiative. We thank the staff of the WMH Data Collection and Data Analysis Coordination Centres for assistance with instrumentation, fieldwork, and consultation on data analysis. These activities were supported by the National Institute of Mental Health (R01 MH070884), the John D. and Catherine T. MacArthur Foundation, the Pfizer Foundation, the US Public Health Service (R13–MH066849, R01–MH069864, and R01 DA016558), the Fogarty International Center (FIRCA R03-TW006481), the Pan American Health Organization, Eli Lilly and Company, Ortho-McNeil Pharmaceutical, Inc., GlaxoSmithKline, and Bristol-Myers Squibb. A complete list of WMH publications can be found at

  • Competing interests RCK, the senior author, has been a consultant for AstraZeneca, Analysis Group, Bristol-Myers Squibb, Cerner-Galt Associates, Eli Lilly and Company, GlaxoSmithKline Inc., HealthCore Inc., Health Dialog, Integrated Benefits Institute, John Snow Inc., Kaiser Permanente, Matria Inc., Mensante, Merck and Co, Inc., Ortho-McNeil Janssen Scientific Affairs, Pfizer Inc., Primary Care Network, Research Triangle Institute, Sanofi-Aventis Groupe, Shire US Inc., SRA International, Inc., Takeda Global Research and Development, Transcept Pharmaceuticals Inc. and Wyeth-Ayerst; has served on advisory boards for Appliance Computing II, Eli Lilly and Company, Mindsite, Ortho-McNeil Janssen Scientific Affairs and Wyeth-Ayerst, and has had research support for his epidemiological studies from Analysis Group Inc., Bristol-Myers Squibb, Eli Lilly and Company, EPI-Q, GlaxoSmithKline, Johnson and Johnson Pharmaceuticals, Ortho-McNeil Janssen Scientific Affairs., Pfizer Inc., Sanofi-Aventis Groupe and Shire US, Inc. Of note, the National Comorbidity Survey Replication (NCSR), on which this manuscript is based, is a public use dataset; there is no apparent conflict of interest relevant to the subject presented in this manuscript.

  • Ethics approval This study was conducted with the approval of the Harvard Medical School and University of Michigan (for National Comorbidity Survey Replication primary data collection).

  • Provenance and peer review Not commissioned; externally peer reviewed.