Associations Between Parental Monitoring and Multiple Types of Youth Violence Victimization: A Brief Report

Abstract

Youth violence victimization continues to be pervasive and a significant cause of adolescent mortality. Since their 2014 “Connecting the Dots” report, the Centers for Disease Control and Prevention have encouraged researchers to identify shared protective factors that prevent multiple forms of youth violence. Parental monitoring, a bidirectional construct encompassing parental knowledge and regulation of their child’s activities with children’s concurrent perception of their parent’s awareness of such activities, could be such a cross-cutting protective factor. In this study, we examined associations between parental monitoring and multiple types of violence victimization among a school-based sample of adolescents. We conducted a cross-sectional analysis of an anonymous survey of health risk and protective behaviors completed by students across Pittsburgh Public Schools (N = 2,426). In separate analyses, we used logistic regression to examine associations between youth-reported parental monitoring and multiple experiences of youth violence victimization, ranging from school- and electronic-based bullying to different forms of sexual and physical violence. We found that many experiences of youth violence victimization were consistent with nationally representative data. In addition, we determined that higher parental monitoring was significantly and inversely associated with all violence victimization outcomes examined (school-based bullying, electronic-based bullying, threatening someone with a weapon, adolescent relationship abuse, sexual assault, and exchange sex) at the p < .05 threshold. Overall, this study is one of the first that examines how parental monitoring relates to multiple forms of youth violence victimization, including exchange sex, which is a critical but less-studied violence experience. This work adds to the growing literature on how parental monitoring may serve as a shared protective factor for multiple forms of violence victimization.

Keywords

adolescent parental monitoring violence victimization relationship abuse community violence

Introduction

Violence victimization among youth is pervasive, broad, and diverse across multiple forms. Youth experience many types of violence including adolescent relationship abuse (ARA; physical, sexual, or emotional violence in the context of an adolescent relationship), community violence, and bullying. While some types of violence have been well-studied, others are less well-studied. An important example is exchange sex, or the exchange of sex for drugs, money, food, or shelter, which impacts 3.5%-7.4% of U.S. adolescents (Boyer et al., 2017; Head et al., 2020; Ulloa et al., 2016). Exchange sex is rooted in sexual coercion and associated with several adverse youth outcomes, including higher rates of sexually transmitted diseases, food insecurity, illicit drug use, and experiencing other forms of abuse (Boyer et al., 2017; Head et al., 2020; Ulloa et al., 2016). Additionally, the majority of research on youth violence has been conducted in silos, examining only one type of violence. Multiple types of youth violence often occur concurrently and share common etiologies. To protect adolescents, preventative efforts have shifted to understand and address the root causes of multiple forms of violence, including those that are less recognized and studied. In particular, the Centers for Disease Control and Prevention (CDC) strongly encourages research that explores the shared risk and protective factors affecting multiple forms of youth violence (Centers for Disease Control and Prevention, 2016).

Recognizing that many structural factors (i.e., poverty, racism) may impact exposure to multiple forms of youth violence (David-Ferdon & Simon, 2014; Foster et al., 2007; Sumner et al., 2015), supportive parental relationships, particularly through parental monitoring, is a modifiable and encouraging intervention target. Parental monitoring is a multidimensional construct comprising a parent’s knowledge of their child’s activities, a child’s disclosure and communication of their activities to a parent, and active parental structuring of their child’s environment (e.g., parental rule setting) (Dishion & McMahon, 1998; Smetana, 2008). Of note, child disclosure is an integral part of parental monitoring and may influence health-affecting behaviors among youth (Booth & Shaw, 2019; Dishion & McMahon, 1998; Moilanen et al., 2009; Stattin & Kerr, 2000). Parental monitoring serves a unique role in helping teenagers better assess and manage risks in a way that reduces negative health outcomes. For example, a parent’s greater knowledge of their child’s individual behaviors, friends, peer activities, and potential challenges in their environment helps to better guide youth and allow for more informed risk-taking behaviors that are necessary for adolescent development (Dishion & McMahon, 1998; Laird et al., 2010).

Moreover, higher levels of parental monitoring have been inversely associated with behaviors that endanger adolescent health (i.e., impulsivity, sexual initiation, substance use) (Barnes et al., 2006; Beck et al., 2004; Nash et al., 2005). Furthermore, parental monitoring has also been inversely linked with some forms of violence victimization. Past literature has shown associations between higher levels of parental monitoring and decreased ARA (East & Hokoda, 2015; Hébert et al., 2017) and community violence perpetration (Gorman-Smith et al., 2004; Matjasko et al., 2013). However, less is known about how parental monitoring may be linked to multiple types of violence victimization, especially less studied forms of violence (i.e., exchange sex).

Recognizing the complex interrelationships between multiple forms of youth violence, we sought to further study how parental monitoring relates to a variety of youth violence outcomes, with a focus to expand our work to less studied forms of adolescent violence victimization. We believe that the protective role of parental monitoring against adolescent risk-affecting health behaviors will also hold true against multiple forms of violence victimization, beyond ARA and community violence. Therefore, we conducted a cross-sectional analysis of a school-based survey of adolescents from Pittsburgh, Pennsylvania. Our primary research aim was to examine associations between parental monitoring and six different violence victimization outcomes. Our secondary objective was to describe the prevalence in a school-based sample of certain less studied forms of adolescent violence victimization, namely exchange sex.

Methods

Study Sample and Setting

This work was a partnership between Pittsburgh Public Schools (PPS), the Allegheny County Health Department (ACHD), and the Division of Adolescent and Young Adult Medicine at the University of Pittsburgh Medical Center (AYA). A panel of AYA physicians, public health researchers, and social workers reviewed the 2018 National Youth Risk Behavior Survey (YRBS) questionnaire and proposed additional relevant constructs that were not yet included in the standard survey. While ultimately a vast majority of the items included in the questionnaire came directly from the national survey, additional constructs (mainly protective factors) were incorporated based on internal ranking and brevity given the length of the full survey. The surveys were administered by AYA across PPS, entered and processed by ACHD, and then analyzed by our team. PPS School Board approved this assessment and University of Pittsburgh IRB deemed this cross-sectional analysis exempt from review.

Participants

In total, 4,207 ninth through twelfth graders from 13 high schools within PPS completed an anonymous school-based survey of health risk and protective behaviors in 2018 modeled on the CDC YRBS (United States, High School Youth Risk Behavior Survey, 2019).

Measures

Parental monitoring (child disclosure).

Parental monitoring was measured using Stattin and Kerr’s five-item child disclosure scale (Stattin & Kerr, 2000). Each item employed the same 5-point Likert scale ranging from strongly disagree to strongly agree (α = 0.81). These items comprised one subscale of a larger parental monitoring measure and focused on youth communication to parents/guardians about their peer relationships, whereabouts, and activities. A mean score was calculated from the five items to generate an overall parental monitoring level. Of note, these items were located near the end of the survey.

Violence outcomes.

Outcomes assessed are as follows: past 12-month histories of experiencing bullying on school property (1 item), electronic bullying (1 item), threats with a weapon (1 item), physical or sexual adolescent relationship abuse (ARA; 1 item on sexual coercion and 1 item on physical violence), or sexual assault (1 item), and lifetime history of receiving money, shelter, or food in exchange for sex (exchange sex; 1 item). ARA was specifically operationalized if a participant answered affirmatively to at least one of the two relevant survey items. Of the 4,207 youths surveyed, those who completed at least one parental monitoring and one violence item were included in this cross-sectional analysis (N = 2,462, 58.5%).

Data Analysis

We used logistic regression to separately examine associations between parental monitoring (continuous variable) and each violence measure (operationalized as any/none). Models were adjusted for age, race, and ethnicity (White non-Hispanic, Black non-Hispanic, and multiracial/other), sex assigned at birth, identification as sexual or gender minority, and parental education (graduating vs. not graduating high school). These covariates were selected a priori based on existing literature and were included in the final models if they were associated with the exposure and outcome of interest (p < .2) and changed the primary association by >10%. Parental monitoring scores were normally distributed, and variance inflation factors were all less than two for all covariates in study models, suggesting no multicollinearity. Sensitivity analyses were conducted with parental monitoring operationalized as a dichotomous variable (high: ≥4, low: <4), and results were consistent. All analyses were conducted using R version 3.6.3 (2020-02-29).

Results

In total, 2,462 participants were included in this study. Mean age of youth was 15.7 ± 1.3 years (Table 1). 42% of participants identified as male. A quarter (24%) of youth identified as Black non-Hispanic, 47% as White non-Hispanic, and 27% as Hispanic, Asian, multiracial, or other. The mean parental monitoring score for all youth in the sample was 3.36 ± 0.88. Experiences of youth violence victimization were common with 498 (20.2%) being bullied on school property last year, 5.6% (132) reporting history of being threatened with a weapon, and 5.9% (146) experiencing lifetime history of exchange sex.

Table 1.

Demographics of YRBS Sample Participants (n = 2,462).

Demographic Characteristic		No. (%)
Age (years): Mean, SD		15.7, 1.3
Race	White	1,190 (48.3%)
	Black or African American	664 (27.0%)
	Multiracial/other	420 (17.1%)
	Asian	108 (4.4%)
	American Indian/Alaska Native	35 (1.4%)
	Native Hawaiian or other Pacific Islander	21 (0.9%)
Ethnicity	Non-Hispanic	2,182 (88.6%)
Ethnicity	Hispanic	207 (8.4%)
Sex assigned at birth	Female	1,403 (57.0%)
Sex assigned at birth	Male	1,032 (41.9%)
Self-identification as sexual or gender minority (SGM)	Yes	673 (27.3%)
Self-identification as sexual or gender minority (SGM)	No	1,701 (69.1%)
Parental education (graduated high school)	Yes	1,861 (75.6%)
Parental education (graduated high school)	No	553 (22.5%)
Parental monitoring (rated from 0 to 5): mean, SD	3.36, 0.88

Source:

Higher levels of parental monitoring were significantly and inversely associated with all violence outcomes examined, including past 12-month histories of being bullied on school property (aOR 0.82, CI: 0.72-0.92), electronically bullied (aOR 0.72, CI: 0.62-0.81), threatened with a weapon (aOR 0.65, CI: 0.53-0.80), ARA (aOR 0.62, CI: 0.52-0.74), and sexual assault (aOR 0.75, CI: 0.66-0.86) as well as lifetime history of exchange sex (aOR 0.77, CI: 0.63-0.95) (Table 2).

Table 2.

Associations Between Parental Monitoring and Multiple Forms of Adolescent Violence Victimization.

Type of Violence Victimization	Prevalence of Violence No. (%)	Association Between Parental Monitoring and Violence Victimization AOR (95% CI) ^a
Being bullied on school property^b	498 (20.2%)	0.82 (0.72-0.92)
Being electronically bullied^b	365 (14.8%)	0.71 (0.62-0.81)
Being threatened with a weapon^b	132 (5.6%)	0.65 (0.53-0.80)
Physical or sexual adolescent relationship abuse^b	216 (8.8%)	0.62 (0.52-0.74)
Sexual assault^b	342 (13.9%)	0.75 (0.66-0.86)
Exchange sex^c	146 (5.9%)	0.77 (0.63-0.95)

Note. ^aOdds ratios adjusted for age, race/ethnicity, sex assigned at birth, self-identification as a sexual/gender minority, and parental education; ^bPast 12-month history; ^cLifetime history of receiving money, shelter, or food in exchange for sex. AOR = adjusted odds ratio.

Discussion

This study is one of the first to our knowledge to examine associations between parental monitoring and multiple types of youth violence victimization. We found that the prevalence of ARA, sexual assault, bullying, and being threatened with a weapon were consistent with nationally representative data (United States, High School Youth Risk Behavior Survey, 2019). Our study builds upon this work by assessing youth reports of multiple forms of violence victimization in a school-based setting. In particular, our work describes the prevalence of adolescent exchange sex, a less-studied yet pervasive form of violence. The prevalence of adolescent exchange sex was similar to those reported in the recent emerging work on this topic (Head et al., 2020; Ulloa et al., 2016). Future research should consider including exchange sex when examining youth-reported experiences of violence victimization.

This study expands understanding of how parental monitoring relates to multiple types of adolescent-reported violence victimization (Stattin & Kerr, 2000). Aligned with past research, we found inverse and significant inverse associations between parental monitoring and ARA as well as community violence. By examining several additional violence outcomes, our study suggests parental monitoring may be a cross-cutting protective factor against multiple forms of violence. A critical component of parental monitoring that may be relevant to such a protective relationship is the level of comfort and trust children have about confiding in their parents about whether they are experiencing violence (Dishion & McMahon, 1998; Moilanen et al., 2009). Youth who feel close enough to their parents/guardians to disclose they are experiencing harm from others may consequentially gain more parental support and monitoring that ultimately can better help to lessen ongoing or future violence victimization.

Our study is one of the first to examine associations between parental monitoring and less-studied forms of violence victimization, especially exchange sex. We believe the inverse association observed between parental monitoring and exchange sex may function in a similar way to the protective effects of parental monitoring and ARA. For example, youth who may feel close enough to their parents to discuss topics around puberty, friendships, and dating may gain additional parental support and guidance about what constitutes healthy relationships and/or avoid abusive relationships that may perpetuate ARA and exchange sex. Parental monitoring may, in part, be protective in similar ways as it is for other youth health outcomes, potentially by helping youth form friendships with peers who are less likely to be involved in violence.

One important consideration and limitation to this study is our inability to assess unmeasured stressors, particularly neighborhood and structural level factors, that can also impact both a youth’s exposure to violence as well as the ability of parents and caregivers to engage in high levels of parental monitoring. The Family Stress Model is a theoretical framework that proposes that poverty and economic inequities compound upon other individual, interpersonal, neighborhood, and structural drivers (i.e., racism, poverty) and increase parental emotional distress, which ultimately results in greater childhood behavioral problems (Conger et al., 1992). The health risk and protective behavior survey from which this cross-sectional analysis emerged did not include measures of neighborhood or structural factors. Our study was thus unable to specifically examine how these factors affected parental monitoring in our sampled adolescent population. Recognizing that parental monitoring must be viewed through a lens of neighborhood and structural level oppressions, we encourage future work studying parental monitoring to include how systemic drivers impact family stress. This includes longitudinal studies to better explore causal mechanisms through which racism and other structural inequities impact the relationship between parental monitoring and youth violence victimization (e.g., mediate, effect modifier).

We recognize several other limitations to this study, including high frequency of missing responses on parental monitoring (relevant items were located near the end of the survey suggesting a nonresponse bias), using only youth reports of parental monitoring, and a cross-sectional study design that precludes assessing directionality and causation. Moreover, Stattin and Kerr’s full parental monitoring measure includes three subsections: parental knowledge about activities, child disclosure, and parental solicitation (Stattin & Kerr, 2000). Due to limited space in the Pittsburgh YRBS, survey designers only included the five-item child disclosure scale, though this child disclosure scale was highly correlated with the other subscales. Child disclosure is an integral part of parental monitoring; however, we recognize that parental monitoring is multidimensional and includes other constructs such as parental knowledge and ruling setting. Therefore, we recommend that future studies examine how these other constructs of parental monitoring relate to youth violence victimization. Further, this study was limited to youth-reported parental monitoring since parental monitoring is bidirectional, additional work is also needed to explore how parent-reported parental monitoring relates to violence victimization. We also used a school-based sample of youth in Pittsburgh, and therefore recognize that the generalizability of these results may also differ across other demographic populations and communities based on geographic constraints and nonschool-based sampling.

Implications

These findings highlight the importance of parental monitoring in on-going youth violence prevention efforts. Longitudinal and experimental studies (i.e., following youth before puberty and through their adolescence) that examine both youth and parental report of monitoring can further elucidate how bidirectional monitoring relates to violence victimization among adolescents. These studies should also assess neighborhood and structural level drivers impacting parental monitoring. Possible strategies for incorporating parental monitoring in violence prevention interventions include engaging in family-based discussions about communication around violence, showing parents healthy monitoring of youth, and discussing positive reinforcement and limit setting. These programs designed to promote parental monitoring should also identify strategies for how parents navigating concurrent structural oppressions (i.e., racism, poverty) can best engage in parental monitoring and protect teens. Aligned with the CDC’s Connecting the Dots report (Centers for Disease Control and Prevention, 2016), our results support the growing emphasis to build violence prevention interventions that tackle multiple forms of violence victimization simultaneously.

Supplemental Material

Supplemental material for this article is available online.

Supplemental Material for Associations Between Parental Monitoring and Multiple Types of Youth Violence Victimization: A Brief Report by Susheel K. Khetarpa, Nicholas Szoko, Alison J. Culyba, Daniel Shaw, and Maya I. Ragavan, in Journal of Interpersonal Violence

Footnotes

Acknowledgments

The data collection was supported by the Heinz Endowments and the Grable Foundation. Funding and administrative support for Susheel Khetarpal’s time and effort was provided by the University of Pittsburgh Clinical Scientist Training Program and the Clinical and Translational Science Institute (NIH UL1TR001857). This study was additionally supported in part by the following grants: KL2TR001856 (Scholar: Maya Ragavan) and K23HD098277-01 (PI: Alison Culyba). We also thank the Allegheny County Health Department for their role in data collection and for the use of these data as well as Pittsburgh Public School Board Leadership for their collaboration.

Declaration of Conflicting Interests

Funding

The author(s) disclosed the receipt of the following financial support for the research, authorship, and/or publication of this article: The financial support is given by National Center for Advancing Translational Sciences (Grant KL2TR001856), Grable Foundation, Heinz Endowments, Eunice Kennedy Shriver National Institute of Child Health and Human Development (Grant K23HD098277-01), and National Institutes of Health (Grant NIH UL1TR001857).

ORCID iDs

Susheel K. Khetarpal

Alison J. Culyba

Maya I. Ragavan

Author Biographies

Susheel K. Khetarpal, BS, is a medical student at the University Pittsburgh, currently working on his master’s in clinical research studying protective factors against youth violence. He is interested in becoming a child behavioral health provider, looking forward to developing and designing interventions aimed at improving adolescent mental health and well-being.

Nicholas Szoko, MD, is a pediatric chief resident and rising adolescent medicine fellow at UPMC Children’s Hospital of Pittsburgh. His research interests include youth empowerment and youth participatory action frameworks among marginalized groups, as well as resilience-building strategies for young people living in areas with concentrated disadvantage.

Alison J. Culyba, MD, PhD, MPH, is an assistant professor in the Division of Adolescent and Young Adult Medicine, UPMC Children’s Hospital of Pittsburgh and the University of Pittsburgh. Her research examines the role of family, community, and environmental factors in protecting youth from violence and translates findings into community-based interventions.

Daniel Shaw, PhD, is a distinguished professor in the Department of Psychology at the University of Pittsburgh. He is an internationally recognized expert in parent-child interaction, parental monitoring, and developing parenting interventions, with over 300 peer-reviewed publications.

Maya I. Ragavan, MD, MPH, MS, is an assistant professor of pediatrics in the Division of General Academic Pediatrics at the University of Pittsburgh. Her research focused on supporting survivors of dating and domestic violence, with a particular interest in immigrant and English learn communities.

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