Adolescents as victims and perpetrators of violence.

The hallmark of adolescent development is risk-taking behavior, mostly benign in nature, with no sequelae in adulthood. For that small number of adolescents for whom risk-taking behaviors are dangerous, for themselves and others, there are common childhood factors that may lead to those behaviors. In studies of adolescent victims, as well as perpetrators, a common theme can be identified, ie, maltreatment. The adolescent who visits Internet chat rooms, meets unknown individuals, and is later sexually assaulted by that individual is often a victim of sexual abuse in earlier childhood. Studies demonstrate that when adolescents are perpetrators of violent acts, they have a history of childhood physical abuse and often ongoing exposure to violence in their homes. For victims and perpetrators, there can be a common source of primary prevention in children rather than secondary interventions later in adolescence. That source can be a medical care provider in a medical home. Discussion of Internet usage with a 10-year-old by a medical provider may prevent later victimization. Identification and provision of services to families involved in domestic violence situations can help children establish positive adult roles with peers and future partners.