Terri was 18, a high school senior going through a tough time. Her grades weren't great; her relationship with her parents wasn't stable. Then she started dating a guy at her school.
Though he was unpopular and known to be volatile, she believed he was the only one who really cared for her. But as time went on, Terri began feeling stifled. He would call up to five times a night, he'd drive by her house. "I couldn't get away from him," she recalled. Then, after a heated confrontation one night, he punched her in the side.
Terri, now 23 and speaking on condition that her full name not be used, had become a victim of dating violence.
Her story is far from unique. A study published this month in the Journal of the American Medical Assn. suggests that almost one in five high school girls suffer physical or sexual assault by their dating partners.
Analyzing data from the 1997 and 1999 Massachusetts Youth Risk Behavior Surveys, researchers at the Harvard School of Public Health found that almost 10% of female public high school students had been shoved, slapped or hit; an additional 4% had been sexually assaulted, absent other physical violence; and more than 5% had been physically and sexually assaulted.
Jay Silverman, the study's lead author and the school's director of violence prevention programs, emphasized that dating violence can go hand-in-hand with other health risks, such as substance abuse, pregnancy, unhealthy weight control and suicide.
"People shouldn't assume that dating violence causes these problems," said Silverman, "but we need more research to sort out the exact relationship between the two. What we do know is that these girls are more likely to be involved with these risks relative to non-abused girls."
Appalling as the numbers are, experts on violence hope that the study will call long-overdue attention to the problem of date violence--and its impact.
"Young girls are the most silent victims, because they rarely reach out for help," said Gail Abarbanel, director of the rape treatment center at Santa Monica-UCLA Medical Center. "Due to developmental and age reasons, they feel a profound sense of shame. They feel their parents are angry at them."
Parents and other adults need to listen and keep open the lines of communication with young women, said Susan Herman, executive director of the National Center for Victims of Crime. They should show concern rather than judgment, she said.
Added Carole Sousa, a member of the Massachusetts Governor's Commission on Domestic Violence: Too often adults don't take teen relationships seriously enough. "There is a denial that violence can occur," she said.
Dawn Alexander, project director of Delaware-based Project PRIDE (Promoting Respect in Dating Experiences), said girls often don't realize what the boundaries in dating are.
"With rape as well as other types of abuse, most girls don't know what to expect. They don't know how to set real limits," Alexander said. "Teenage girls have a lot of pressure to have boyfriends. That pressure leads to putting up with things they wouldn't otherwise."
Dating violence can have a lifelong effect on physical and mental health, leading, for example, to serious depression. Violence can also continue in future relationships. Many times, battered girls become battered women, suffering a lifetime of abuse if they don't get help breaking the cycle.
More has to be done in terms of intervention and prevention, said Richard Lieberman, school psychologist with the Los Angeles Unified School District Suicide Prevention Unit.
"We know what lowers risk in kids .... We need primary prevention programs," he said. He and others suggested more counseling in schools as well as collaboration between schools and community agencies with expertise in this area.
Some programs do exist. The rape treatment center at Santa Monica-UCLA Medical Center, for example, has a high school sexual abuse and assault awareness program for 30 schools in Los Angeles County. The program includes workshops and role-playing activities to help prevent violence, said Marybeth Roden, the assistant director of the rape treatment center.
Massachusetts is the only state that has a program specific to dating violence, said Sousa, who helped formulate the program in the mid-'90s. This program, run by the Massachusetts Department of Education, gives money to schools to develop comprehensive anti-violence curricula and work with community agencies.
"What I hear from the schools is that the [program] has helped change the culture of the school," Sousa said. "Gender-based violence is not acceptable."
Girls need to be aware of warning signs in their partners, experts say: Extreme jealousy and possessiveness, sudden and severe mood swings, excessive dependence, isolating the girl from friends and family and never taking responsibility for problems.
But girls, fundamentally, are not the problem.