Screening Teens for Violent Behavior
It is important for health care professionals to talk with youth about strategies for avoiding or resolving interpersonal conflicts with family, friends, peers, and dating partners. It is also necessary to talk with all youth about whether they have been involved in fights in the past and to assess their risk for future involvement in violence. One approach to screening is to use the FISTS mnemonic to ask about Fighting, Injuries, Sex, Threats, and Self-Defense:
Fighting
- How many fights have you been in during the past year?
- When was your last fight?
Injuries
- Have you ever been injured in a fight?
- Have you ever injured someone else in a fight?
Sex
- Has your partner ever hit you?
- Have you ever hit (hurt) your partner?
- Have you ever been forced to have sex against your will?
- Do you think that couples can stay in love when one partner makes the other one afraid?
Threats
- Has someone carrying a weapon ever threatened you?
- What happened?
- Has anything changed since then to make you feel safer?
Self-Defense
- What do you do if someone tries to pick a fight with you?
- Have you ever carried a weapon in self-defense?
To learn more about using the FISTS screening tool, see Recognizing and Preventing Youth Violence: A Guide for Physicians and Other Health Care Professionals (2001) from the Massachusetts Medical Society.
Another valuable resource is the Oppositional and Aggressive Behaviors section of Bright Futures in Practice: Mental Health (2002) from the Maternal and Child Health Bureau, U.S. Department of Health and Human Services. It provides suggestions for assessment and intervention by primary care health professionals, as well as guidelines for referral.