An Indicated Dating Violence and HIV Prevention Program for High-Risk Adolescent Girls: A Preliminary Report of Intervention Effects On Proposed Mediators

Background: A growing body of research reveals that dating violence (DV) plays a significant role in adolescent girls’ HIV risk. DV has been associated with less condom use, younger age at first intercourse, having multiple sex partners and alcohol use prior to sexual encounters. Helping adolescent females address the common skills deficits underlying dating violence and sexual risk taking may be essential to preventing these co-occurring issues.  The goal of this project is to compare a group-based, cognitive-behavioral intervention for adolescent girls with histories of physical dating violence to a knowledge-only curriculum matched for time and attention (6 two-hour weekly sessions and one booster session). Since data collection is ongoing, data presented here will focus on the preliminary effects of the study intervention on proposed mediators. The primary hypothesis is that participants in the CBT intervention will experience greater reductions in violence-promoting attitudes and depressive symptoms, as well as more frequent utilization of skills-based coping and assertive communication, relative to participants in the knowledge-only group.

Methods: Adolescent girls (ages 15-17) with histories of physical dating violence were recruited from five, urban high schools. Subjects were randomized to either the CBT group (n = 29) or the knowledge-only group (n = 22). Dating violence severity and history of sexual activity were balanced across arms. Participants completed measures of skills-based coping (e.g. problem solving, cognitive restructuring, support seeking), depressive symptoms (BDI-II; Beck et al., 1996), couples violence attitudes (ACV; Foshee et al., 1998), and couples communication (CCS; Harper & Grello, 2001) at baseline (T1) and 3 months later (T2) using laptop computers. Data collection is ongoing.

Results: Data were obtained, thus far, on 51 adolescent girls (M = 15.3, SD = 1.01). Due to the small sample size, effect sizes are reported. At the 3 month follow-up, teens in the knowledge-only condition were more than twice as likely to report accepting attitudes regarding couple violence (moderate effect size). Teens in the CBT-skills condition also reported greater utilization of skills-based coping and more frequent use of assertive couple communication (medium to large effect sizes). Both groups showed reductions in depressive symptoms over the three month period.

Conclusion: This study provides preliminary evidence for the use of CBT-skills as a way of decreasing theoretical mediators of DV and sexual risk outcomes among a high risk group of adolescent girls already involved in physically violent dating relationships.