Startseite Gender beliefs and legitimization of dating violence in adolescents
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Gender beliefs and legitimization of dating violence in adolescents

  • Sónia Brás Ferreira , Mayana Bonfim Ferreira , Nadirlene Pereira Gomes ORCID logo und Amâncio António de Sousa Carvalho ORCID logo EMAIL logo
Veröffentlicht/Copyright: 17. April 2025
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Open Medicine
Aus der Zeitschrift Open Medicine Band 20 Heft 1

Abstract

Background and aim

Knowing the gender beliefs (GB) that legitimize dating violence (DV) it is important for the prevention of this phenomenon. The aim is to evaluate the impact of GB interventions that legitimize DV.

Methods

Single group quasi-experimental study, with a sample of 148 Portuguese adolescents. A questionnaire was used to collect data, with data processing carried out using SPSS, using descriptive and inferential statistics.

Results

The interventions included an infographic on gender asymmetries, a video about DV, and posters on the topic and Health Education sessions. The largest group fell into the less conservative GB (40.5%) and the categories of non-violent relationship and considerably violent relationship had the same percentage (38.5%). The rank mean of the gender belief inventory scale before and after the interventions was, respectively, 35.24 and 33.06 points, while the same measurements of the violent youth relations inventory scale were 2.74 and 1.63 points. There were statistically significant differences (Wilcoxon: p = 0.01) between the GB score before and after the interventions, as well as in the violent youth relations (VYR) scale score (Wilcoxon: p = 0.000).

Conclusion

The interventions had a significant impact on reducing the GB legitimizing the DV and VYR, and were effective.

Keywords: beliefs; gender studies; violence; adolescent; community health nursing; public health

1 Introduction

The word adolescence derives from the Latin adolescere, meaning to grow, to become great [1]. Adolescence is considered the transition period between childhood and adulthood; however, its chronological delimitation differs depending on the sources. The World Health Organization [2] places adolescence at the age of between 10 and 19 years. Other authors [3] consider that a more comprehensive definition of adolescence is necessary, placing this phase of the human life cycle between 10 and 24 years of age. In fact, this vision aligns more with current patterns of growth and maturity, in addition to social standards.

Regarding the duration of adolescence, it is possible to subdivide it into three distinct phases based on chronological age: initial adolescence (between 10 and 13 years old), intermediate adolescence (between 14 and 17 years old), and late adolescence (between 18 and 24 years old). The first phase is characterized by puberty, changes especially at a physical level and reactions to these same changes, while in the second phase there is great social pressure to imitate peers and emphasize appearance and material goods, and in late adolescence, they assume roles closer to adult life [1].

These phases of adolescence do not coincide with the education cycles in Portugal (third cycle). The third cycle of education includes students in the seventh, eighth, and ninth year of schooling, in which students are usually 12, 13, and 14 years old. The study only included ninth grade students (14 years old), and there may be younger students (13 years old) because they were admitted to school early and older than 14 years old, aged between 15 and 17 years old, as they had failed the previous years, from one to three times during their school career.

All these changes require adolescents to make efforts to adapt to new realities, which involve relationships between adolescents and their context, namely with family, school, peers, and the community. This transition, although it marks in a certain way the break with childhood, must be seen in the form of a positive adaptive process, since the adolescent builds their individual beliefs at this stage, dissociates themselves from their family, and progressively acquires psychosocial autonomy [1].

In addition to all these aspects, adolescence is also the period of awakening to sexual attraction and when romantic relationships begin to occur, being a favorable phase for the development of beliefs related to the idealization of love and romantic myths. Thus, the myths of romantic love reside mainly in the obsessive search for the perfect partner, synonymous with complete happiness, and it is common to consider that suffering is natural if such a complement is not found. These authors found evidence that love myths related to the idealization of love are accepted as natural by adolescents. Furthermore, they observed a set of beliefs related to gender roles associated with these romantic myths, in the same way as the normalization of attitudes of violence against the partner was observed in association with the same myths. Their study also revealed that the increase in sexist attitudes, whether hostile or benevolent, appears to lead to the mythification of love. These attitudes and beliefs constitute risk factors for the establishment of unbalanced dating relationships with a tendency toward violence [4].

Achieving gender equality has been one of the biggest challenges faced by societies worldwide, in all spheres of human life. Therefore, the United Nations (UN) included gender equality in the Sustainable Development Goals (SDGs) for the 2030 Agenda, known as SDG5. The 2030 Agenda and the 17 SDGs constitute the common vision for humanity, establishing a contract between world leaders and people to improve the planet and its people [5]. SDG5 includes nine objectives to promote gender equality, as a tool for the sustainable development of the world, the first being essential to guarantee effective equality, as it aims to end all forms of discrimination against all women and girls worldwide.

At Portugal level, it is possible to understand that the goals, in addition to being shared, are extremely important, as, according to the European ranking Gender Equality Index [6], Portugal is in 15th place, with 5.8 points below the European score. Despite still being in a fragile position compared to other European Union (EU) countries, the Portuguese score has increased since 2010 by 9.1 points, which led to an increase of four places.

Despite the need for many improvements in this area, the majority of adolescents have positive attitudes toward gender equality, while at the same time believing in traditional gender roles [7]. This duality demonstrates that gender inequalities in adolescence derive mainly from the learning of traditional gender roles and characteristics imposed since early childhood, through the repetition of behaviors, concepts, and attitudes that reiterate the authoritarian and dominant leadership attitudes of men and the posture dependent and submissive of women [8]. However, with the evolution of society, the media coverage of inequalities, and inclusion policies, adolescents are receptive to reducing these same inequalities.

In this way, the view that teenagers attribute to gender roles in the context of dating is directly related to the concept of ambivalent sexism, defined by Glick and Fiske in 1996 [9]. This particular type of sexism encompasses two components for women: hostile sexism and benevolent sexism. The first is characterized by the presence of dominating attitudes of boys toward girls, based on the premise of male superiority in economic, political, and social institutions. The second occurs when the man expresses attitudes of protection and affection toward the woman with the aim of highlighting his dependence on the man in the emotional and sexual aspects. This second type of sexism leads to a devaluation of women, which can be as negative as that resulting from hostile sexism.

Ambivalent sexism thus promotes the maintenance of gender stereotypes, which generates deep-rooted inequalities in society. This phenomenon in particular leads to a greater acceptance of violence in dating relationships [9].

Hence, it is possible to understand that many of the beliefs that legitimize violence are related to inequality between men and women, in which men, seen as the element with more power, have the privilege of controlling other members of the family, often with the approval of women, children, and society. These are the models that teenagers have as a reference throughout their growth, leading to the replication of what they have observed and learned over the years [9].

Also Hunt et al. [10] state that attitudes supporting gender inequality in society and relationships can encourage dating violence (DV) victimization. Scientific evidence indicates that maintaining attitudes that promote traditional gender roles perpetuates gender inequality and promotes violence against women.

Thus, in the context of adolescence, support from society in general and peers for traditional gender roles that normalize the more aggressive attitudes of young males in relationships are strong predictors of DV. Studies indicate that this type of legitimation is strongly based on patriarchal culture, being linked to racism, heterosexism, and poverty. Although much of the literature examines perpetration with regard to gender inequality, it is unclear how attitudes toward traditional gender roles and gender inequality are associated with dating victimization in both sexes [10].

This topic is extremely important, as violence in intimate relationships is not, at all, a phenomenon exclusive to relationships between adults. National studies by the Portuguese Victim Support Association and other international studies reveal that this is also a problem in relationships between younger people [11].

In fact, romantic relationships are important throughout the life cycle, contributing to personal well-being, generally starting in adolescence. It is at this stage that adolescents go through the construction of their self and hetero-perceived identity through their peers, as well as a deeper connection with regard to interpersonal relationships outside the household. Since violence can arise in different ways in the context of dating, it is important to know at an earlier stage of adolescence the gender belief (GB) that legitimize DV, as well as the prevalence of victimization in adolescents in the eighth and ninth grades of schooling (third cycle) [12].

According to the Plano i Association [12], in its study called “National study on dating violence in a university context: beliefs and practices – 2017/2020,” around 53.9% of respondents have already suffered at least one act of violence in dating, 35% have participated in at least one act of DV, in addition, 3.6% of women and 15.4% of men agree that jealousy is a proof of love. Other data related to the type of violence carried out were also obtained: 14.5% of women and 11.5% of men have already suffered violence due to blackmail and threats and 16.4% of women and 14.7% of men have had their social networks hacked, mobile phone, email, or other means of communication/interaction. However, little is known about this problem in third-grade adolescents, in particular.

It is within the scope of this problem that this study emerges, with the general objective of evaluating the impact of interventions in GB that legitimize DV on the adolescents in the sample.

2 Methods

This is a quasi-experimental, single-group, longitudinal study with a quantitative approach [13]. In terms of study design, we began by making a situation diagnosis (Moment 1 of data collection), using an instrument that includes the Gender belief inventory (GBI) and the violent youth relations inventory (VYRI) in ten classes from three school groups, the context of this study. We then proceed with data processing and analysis. Based on the results found, we planned four interventions that took place between November 25, 2022 and January 17, 2023. After 13 days, we carried out the second data collection (Moment 2), using the same data collection instrument. The data were, again, processed and analyzed and this article is being prepared based on them.

2.1 Population and sample

The population was defined using the following inclusion criteria: (i) adolescents enrolled in the 2022/2023 school year, in the ninth year of schooling, in three groups of public schools in the third cycle of a municipality in the North of Portugal; (ii) adolescents aged between 13 and 17 years old. After applying these inclusion criteria and according to data from the General Directorate of Education and Science Statistics (DGEEC, 2021), it was estimated that the population consisted of around 346 students enrolled in the ninth year of public education, from the aforementioned municipality.

Since it was not possible to study the entire population, there was a need to select a representative sample of the population, with the following exclusion criteria being defined: (i) adolescents who did not present informed consent duly signed by their guardian/tutor and (ii) adolescents who did not complete at least 80% of the questionnaire. After applying the defined exclusion criteria, the sample consisted of 148 adolescents, i.e., around 42.8% of the target population. We opted for non-probabilistic sampling, for convenience, which, according to Fortin et al. [14], it consists of elements with easy access, at a specific time and place.

Students enrolled in public education, in the 2022/23 school year, in the ninth year of schooling, in the municipality of the Northern Region of Portugal, involving three school groups, were 346 young people. The ten classes of the three school groups selected for this study were made up of 210 students. To respect ethical principles, we need to obtain the consent of parents/guardians, having asked the students to take them. Therefore, we delivered 210 informed consent forms. During this procedure, only 148 consents were given to us, so the sample consisted of 148 students. None of the students were excluded from the sample for not having completed at least 80% of the questions.

2.2 Data collection instrument

For this study, the data collection instrument selected was the questionnaire, as it is a quick-to-complete tool that protects anonymity and is low-cost, which best adapted to the nature of this study. It consisted of three parts: the first part of the questionnaire included sociodemographic data, which allowed the sample to be characterized; the second part included the scale called the GBI, whose objective is to assess the beliefs of the adolescents in the sample about social gender relations; and the third part consisted of the VYRI and consists of two subscales: the first collects data on DV suffered and/or perpetrated, in addition to characterizing the psychological, physical, sexual, and social violence suffered and/or practiced; the second subscale assesses beliefs regarding victimization in the context of DV. Both the GBI like the second subscale of VYRI were subjected to internal consistency assessment for the Portuguese population by Neves et al., within the scope of the National Study on Dating Violence in a University Context: Beliefs and Practices – 2017/2020 [15].

2.2.1 GBI

The GBI has 24 items on a Likert scale, with the following response options: “I don’t agree,” “I neither agree nor disagree,” and “I agree”. The variable “Gender beliefs” (GB) is determined using the sum of the scores of all 24 items, after inverting items GB4, GB9, GB10, GB15, and GB19. The scale score ranges from 24 to 72 points, with higher values corresponding to more conservative beliefs. No boundary value or cutoff points were defined by the scale author. The GBI scale allows us to assess adolescents’ beliefs about gender relations and meets the objectives of this study. This scale was validated for the Portuguese adolescent population, only through the assessment of internal consistency, having obtained a Cronbach’s alpha of 0.742 [15]. The authors of this subscale did not perform factor analysis.

2.2.2 VYRI

The VYRI consists of two subscales. The first consists of 21 items with the following response options: “It’s never happened to me,” “I’ve already suffered,” and “I’ve already done it”. In this subscale: (i) the proportion of violence suffered is determined by counting the number of “I have already suffered” responses in the 21 items and divided by 21 (number of items); (ii) the proportion of violence perpetrated is determined by counting the number of “I have already done” responses in the 21 items and divided by 21 (number of items); (iii) variable “I suffered violence”: 0 – No; 1 – Yes, if you respond to at least 1 item with “I have already suffered,” then “I suffered violence” = 1; (iv) variable “I did violence”: 0 – No; 1 – Yes, if you respond to at least 1 item with “I’ve already done it,” then “I’ve done it violence” = 1. The data are processed according to response proportions, so the values obtained will be in accordance with psychological, physical, sexual, and social victimization and/or perpetration. The items that identify with the different types of violence are (a) psychological violence: items 1, 2, 7, 10, 12; (b) physical violence: items 8, 13, 14, 15, 18; (c) social violence: items 3, 5, 11, 17, 19; (d) sexual violence: items 4, 16, 20, 21; and (e) economic violence: item 6 and (f) persecution: item 9. It is possible to determine the variables indicated from (i) to (iv) for each type of violence, using the items identified from (a) to (e) [15]. The first subscale of the VYRI aims to assess violence suffered and perpetrated, is validated for the population of Portuguese adolescents and is aligned with the objectives of the present study. In this manuscript, only the first subscale will be used. For this first subscale, internal consistency was not assessed, because the response options for the items are not ordinal, but rather dichotomous nominal responses No and Yes.

2.3 Data collection

Regarding the application of a questionnaire in a school context, since adolescents are minors, there is a need to obtain duly signed informed consent from their guardians for their participation in the study. After obtaining authorization from the group directors, the present study was approved at the different Pedagogical Council meetings of the three school groups, with the distribution of informed consent statements being the responsibility of the schools, with the collaboration of the class director teachers. They distributed 210 copies of the informed consent to guardians, with 148 duly completed being returned. The discrepancy between the initial number of consents and those returned may be related to an outbreak of influenza A in schools in the municipality, in addition to teacher strikes, not forgetting students’ forgetfulness regarding the delivery of consent. All data for this study were collected through the application of an online, self-administered, and anonymous questionnaire during class hours, ensuring that both teachers and students were informed about its anonymity and confidentiality. Students were free to leave the classroom and withdraw from completing the questionnaire at any time. Data collection was carried out under the supervision of Science or Citizenship teachers, as decided by the respective coordinators of the Health Education Project of each school, accessing it online, through a Google Forms ® file, using students’ computers or their cell phones. Thus, starting from a population of 346 students, we obtained a sample of 148 students, which coincides with the sample size at the first moment of data collection. The first data collection took place from 8 to 25 of November 2022, after verifying and collecting the informed consent statements duly signed by the guardians of 148 students, having answered the questionnaire. The second collection moment took place between January 30 and February 10, 2023, in which 33 students did not complete the questionnaire because they were absent that day, due to illness or because they lost the completion code, which allowed us to pair the cases. The sample was reduced to 115 students, which coincides with the size of the evaluation sample. The researcher was only present at the beginning of this procedure, in order to guarantee the safeguarding of ethical issues and in order to present the study and its objectives, but without interfering with it.

2.4 Intervention process

The interventions included the release of a video on DV, entitled “Who loves you, doesn’t attack you,” by the Commission for Citizenship and Gender Equality (Portugal), which was published in the schools’ space, from November 25 to December 16 and from January 9 to 27, 2023, the provision of an infographic on gender inequalities in Portugal, entitled “Asymmetries,” created in the context of this project, released in the week of December 5–9, 2022, the preparation and posting of three posters created exclusively for this project and disseminated within the scope of preventing DV, in the same period of time before, entitled “Dating Violence” aimed at the entire school community and two Health Education sessions in the classes that participated in the project. The first session consisted of a group dynamic on gender equality inspired by the “Earthquake Game” from the CoolBox guide – games for gender equality and non-violence [16], in which content on gender stereotypes and warning signs were covered for violent dating relationships, using the expository, interactive, and role play method, lasting 50 min. The second session consisted of an interactive online game on the Kahoot!© about violence in dating “Do you want me badly or do you love me?,” in which students accessed the online game link, in pairs, using a numerical code, about gender equality and non-violence, using the expository and interactive method, lasting 50 min. The first Health Education session took place on January 10, 2023 and the second session on January 17, 2023. During the study, no external interventions were carried out with the students in the sample, within the scope of the themes of GB and DV.

2.5 Data processing

Before starting the analysis itself, the completion of the questionnaires was checked, since one of the exclusion criteria refers to the imperative of completing at least 80% of the questionnaire. In this study, the questionnaires were completed in their entirety, meaning there was no need to exclude any of the cases. Subsequently, a database was built from the questionnaires, where the data were numbered, inserted, grouped, and processed using the software Statistical Package for the Social Sciences (SPSS, version 25.0), with statistical analysis carried out using descriptive statistics and inferential statistics. The interpretation of statistical tests was carried out based on a significance level of 5%. Regarding inferential statistics and in the case of nominal measurement variables, frequencies (absolute and relative) and mode were determined. Regarding scalar measurement level variables, in addition to absolute and relative frequencies, measures of central tendency and dispersion were used. In terms of inferential statistics, the normality of the sample was verified using the Kolmogorov–Smirnov and Shapiro–Wilk tests, verifying the homogeneity of variances with the Levene test [17]. To verify the association between the variable sex with the GB and VYR, Student’s t parametric test was used, in the case of the association between the age group with GB and VYR the Mann–Whitney test was used, and in the case of the association between the school group with GB and VYR, the ANOVA test was used. To analyze whether there were significant statistical differences between the rank mean of the GB scale score of the adolescents before and after the intervention, we used the Wilcoxon test. The Wilcoxon test, among the tests for non-parametric paired samples, within the scope of bivariate analysis is recommended. Using a multivariate analysis would have been better to eliminate the effects of extraneous variables and potential biases. This was not possible because the study design did not predict these variables [18].

  1. Ethical approval: In developing this study, the ethical principles inherent to the Declaration of Helsinki and the Oviedo Convention were respected. To this end, requests for authorization to carry out the study were made to the different directors of the grouped and non-grouped schools chosen to take part in the study, having obtained a favorable opinion from all of them. After obtaining the aforementioned authorizations from the School Management, a request for an opinion was made to the UTAD Ethics Committee, which received a favorable opinion (Ref. Doc84-CE-UTAD-2022 of 19-10-2022).

3 Results

Of the total sample (n = 148 students, Moment 1), the majority of adolescents were female (52.0%), fell into the 13–14 age group (87.8%), lived in urban areas (53.4%), and the largest group belonged to school group B (36.5%) (Table 1). The average age of the students was 14.05 ± 0.604 years, the minimum value was 13 years and the maximum was 17 years old (data not included in the table).

Table 1

Sociodemographic characterization of the sample

Variables n Percentage
Sex
Masculine 69 46.6
Feminine 77 52.0
Rather not answer 2 1.4
Age
Between 13 and 14 years old 130 87.8
Between 15 and 17 years old 18 12.2
Housing environment
Urban environment 79 53.4
Countryside 69 46.6
School grouping
Group A 42 28.4
Group B 54 36.5
Group C 52 35.1

Of the responses obtained regarding the GBI scale, those obtained in four items stand out, which highlight the need for clarification and deconstruction regarding the vision of the roles attributed to the gender of the adolescents in the sample. The first item with a higher response rate than the rest was item 15 “Women are as violent as men,” in which the majority of adolescents questioned reported neither agreeing nor disagreeing (60.1%), followed by item 1 “The family should be a priority for women,” in which the majority of the sample neither agreed nor disagreed (47.3%) and, in third place, item 17 “Jealousy is a proof of love,” with 40.5% of those in the sample indicated that they neither agree nor disagree and 33.1% agreed with the statement. The responses obtained in relation to this last statement highlight the need to deconstruct the myth of romantic love associated with jealousy, taking into account that 73.6% of the adolescents in the sample chose the wrong answer option.

Regarding the results that show less conservative GB, the answers relating to item 4 “Men can be as good fathers as women can be good mothers” stand out, in which 96.6% of adolescents agreed with the statement, to item 19 “Men and women must have equal rights and duties” in which 92.6% of the sample chose to agree and, finally, to item 9 “Men and women must share household tasks” in which the option “Agree” was chosen by 91.9% of adolescents, which reveals that in the fundamental issues of rights and roles attributed to gender, the majority of adolescents who participated in the study understood gender equality as essential and normalized (Table 2).

Table 2

Percentage of each response option obtained for each item on the GBI scale

GBI scale items I do not agree (%) I do not agree nor disagree (%) I agree (%)
1. The family must be a priority for women 39.9 47.3 12.8
2. Women who behave badly should be punished by their partners 89.9 7.4 2.7
3. Women who do not want to be mothers are not true women 89.9 9.5 0.7
4. Men can be just as good fathers as women can be good mothers 0.7 2.7 96.6
5. Women appreciate aggressive men 73.6 23.6 2.7
6. If women did not work outside the home, children would be better educated 70.9 25.7 3.4
7. Women are victims of sexual violence because they provoke men 83.8 11.5 4.7
8. A woman who invests more in her career than in her family is neither a good mother nor a good companion 53.4 35.8 10.8
9. Men and women must share household tasks 4.1 4.1 91.9
10. Men must take parental leave 29.1 27.7 43.2
11. It is gratifying for women to hear jokes 77.0 17.6 5.4
12. Men have more skills than women for leadership positions 64.2 26.3 9.5
13. Women should be more modest than men 75.0 20.9 4.1
14. Some situations of domestic violence are caused by women 45.3 29.0 25.7
15. Women are as violent as men 16.9 60.1 23.0
16. Boys and girls must be educated differently 81.1 11.5 7.4
17. Jealousy is a proof of love 26.4 40.5 33.1
18. Women are more sensitive than men 24.3 39.9 35.8
19. Men and women must have equal rights and duties 3.4 4.1 92.6
20. Men must assume leadership of the family 58.1 34.5 7.4
21. Women who have positions of power behave like men 60.1 33.1 6.8
22. Domestic violence is a problem that must be resolved at home 66.2 20.3 13.5
23. Every woman’s dream is to get married 52.7 41.2 6.1
24. Women who stay in violent love relationships are masochists 65.5 24.3 10.1

The mean score on the GBI scale, at the first moment of data collection, differed significantly between students of different genders (Student’s t: p = 0.000), with boys obtaining a higher mean than girls (43.32 > 38.75 points). In other words, the boys held more conservative beliefs.

No statistically significant differences were observed between the mean ranking of the GBI scale score among students with different age groups (Mann–Whitney: p = 0.381), as well as between the mean GBI scale score of students from different school groups (ANOVA: p = 0.056).

Violence in dating relationships was assessed through the application of the first subscale of the VYRI. The answer option “Never happened to me” was mostly marked in all items. However, checking the answers in order to understand the existing victimization, it is possible to verify that the items in which the answer option “I have already suffered” was chosen most times were item 1 “Blame, criticize, insult, defame, accuse without reason” (38.6%), item 12 “Ignore, despise, humiliate, embarrass or treat with indifference” (22.3%), and item 7 “Messing with personal things without authorization (e.g., email account, profile of social networks, coat pockets, cell phone, wallet, diary)” (17.5%), classified as psychological violence and item 17 “Saying bad things or starting rumors at school or in places or groups regularly frequented” (18.9%), as a form of social violence.

In turn, the least marked items in the response option “I’ve already done it” and “I’ve already suffered and I’ve already done it” were item 6 “Keeping all the money or limiting/controlling personal expenses” with 0.6% of responses, item 13 “Threatening or injuring using weapons (e.g., knife, baton, pistol) and/or physical force” and item 18 “Strangling, asphyxiating, running over or seriously injuring or attempting to do so” with 0.7% of responses, obtained, respectively, indicate that, although there are cases of aggravated economic and physical violence, these rarely occurred in the sample under study, so any type of intervention in the community will essentially be from the perspective of primary prevention.

Regarding violence perpetrated (response option “I’ve done it”), the items with the highest number of responses were item 14 “Physically hurting, pushing, kicking, slapping or punching or headbutting” (6.0% of responses “I’ve done it” marked), followed by item 1 “Blame, criticize, insult, defame, accuse without reason” with 4.7% of responses, item 3 “Do not allow them to work, study and/or go out alone” (3.4% of the participants responded that they have already done it), and finally with 2.7% of the answers “I have already done it” marked, respectively, there is item 7 “Messing with personal things without authorization (e.g., email account, profile social networks, coat pockets, cell phone, wallet, diary)” and item 10 “Threatening verbally or through behaviors that cause fear (e.g., shouting, breaking objects, tearing clothes)”. Thus, with regard to perpetration, the most frequently mentioned form of violence is physical violence, followed by psychological violence and social violence.

Item 5 “Prevent contact with family, friends, neighbors (e.g., prohibit speaking to anyone, take away or turn off your cell phone)” and item 20 “Forcing sexual intercourse” with 0.0% of the answers, respectively, i.e., they were not marked by the students in the sample, which indicates that in the context of our sample, sexual violence and isolation (social violence) did not constitute forms of violence exercised (Table 3).

Table 3

Percentage of response options obtained in the first subscale of the VYRI

VYRI scale items Never happened to me (%) I have already suffered (%) I have done (%) I have already suffered and I have already done (%)
1. Blame, criticize, insult, defame, accuse without reason 54.7 38.6 4.7 2.0
2. Using communication technologies to threaten or blackmail (e.g., WhatsApp, Instagram, Facebook, cell phone, email or others) 88.5 10.8 0.7 0.0
3. Do not allow them to work, study and/or go out alone 93.2 2.7 3.4 0.7
4. Forcing unwanted sexual behavior (e.g., watching pornography, having oral sex, having anal sex or having sexual relations with other people) 96.6 2.7 0.7 0.0
5. Prevent contact with family, friends, neighbors (e.g., prohibit speaking to anyone, taking away or turning off your cell phone) 94.6 5.4 0.0 0.0
6. Keep all the money or limit/control personal expenses 98.0 0.6 1.4 0.0
7. Touching personal things without authorization (e.g., email account, social media profile, coat pockets, cell phone, wallet, diary) 79.1 17.5 2.7 0.7
8. Make death threats, attempt against life or cause injuries that require medical treatment 93.9 5.4 0.7 0.0
9. Appearing suddenly in public places to monitor or control (e.g., school) and/or pursue (e.g., on foot, in a car or on a motorbike) or ask others to do so 95.9 2.7 1.4 0.0
10. Threatening verbally or through behaviors that cause fear (e.g., shouting, breaking objects, tearing clothes) 83.1 12.8 2.7 1.4
11. Control the way you dress, your hairstyle or image, the places you frequent or your friendships or company 88.5 10.1 1.4 0.0
12. Ignore, despise, humiliate, embarrass, or treat with indifference 74.3 22.3 2.0 1.4
13. Threatening or injuring using weapons (e.g., knife, baton, pistol) and/or physical force 98.6 0.7 0.7 0.0
14. Physically hurting, pushing, kicking, slapping or punching or headbutting 81.8 10.8 6.0 1.4
15. Physically hurt or threaten to hurt people close to you (e.g. 93.2 3.4 2.7 0.7
16. Distribute personal images or videos of a sexual nature without consent 98.0 1.4 0.7 0.0
17. Saying bad things or starting rumors at school or in places or groups regularly frequented 79.7 18.9 0.7 0.7
18. Strangling, suffocating, running over or seriously injuring or attempting to do so 98.6 0.7 0.7 0.0
19. Threatening, defaming or attacking anyone who reports or expresses a desire to report the violence suffered to third parties 97.3 1.3 1.4 0.0
20. Forcing to have sexual intercourse 96.6 3.4 0.0 0.0
21. Threatening to publicly disclose sexual orientation 93.9 5.4 0.7 0.0

We recoded the response options to the first subscale of the VYRI by adding the response options to the items, in which the No option was assigned a score of zero and the Yes option one point, in which the highest score corresponds to greater violence suffered and/or perpetrated.

No statistically significant differences were found between the mean score of the VYRI subscale of students of different genders (Student’s t: p = 0.679), nor between the mean ranking of the VYRI subscale of students of different age groups (Mann–Whitney: p = 0.255), nor between the mean score of students from different school groups (ANOVA: p = 0.204).

The majority of students in our sample reported not having a dating relationship (51.4%), denying dating, or ever having a boyfriend. Regarding violence suffered, the majority of the sample reported having already been a victim (56.1%) and not having perpetrated DV (79.1%).

When analyzing DV victimization, psychological violence was the type of violence most reported by the adolescents in the sample (50.0%), followed by social violence (28.5%). Students could indicate several types of violence simultaneously, so the percentages obtained are not cumulative. With regard to perpetrated violence, psychological violence practiced by 64.5% of adolescent perpetrators also stands out, followed by physical violence (45.2%) and social violence (38.7%).

The rank mean of the GBI scale before interventions was 35.24 points and after the interventions was 33.06 points. There were significant statistical differences between the Rank Means of GBI of the adolescents in the sample before (Moment 1) and after the interventions (Moment 2) (Wilcoxon: p = 0.01), with 25% of the adolescents reducing their score on the GBI scale. These adolescents were those who had the highest scores, i.e., those students with more conservative beliefs (Table 4).

Table 4

Relationship between the sample’s GB score before and after the interventions

Dimension M2 – Dimension M1 N Mean/rank mean Test value p value Proportion (%)
M2 GB – M1 GB Negative ratings 29 23.55 25.00
Positive ratings 15 20.47 Wilcoxon = −2.372 0.01 13.00
Ties 71 62.00

Negative ratings – M2 g GB < M1 GB; positive ratings – M2 GB > M1 GB; ties – M2 GB = M1 GB; p – probability.

In the GBI subscale, which assesses the level of conservatism of GB, the subscale score decreased from the moment before the intervention (Moment 1) to the moment after the intervention (Moment 2). This decrease is mainly due to the decrease in percentage values in item 15 “Women are as violent as men,” item 1 “The family should be a priority for women,” and item 17 “Jealousy is a proof of love,” in which the largest group in the sample responded “Neither agreed nor disagreed” whose percentages decreased, respectively, to 60.0, 40.9, and 17.4% and in the response option “I agree,” in which the same items obtained a percentage value, respectively, of 18.3, 7.8, and 7.8%, which indicate a decrease in conservatism regarding these items.

Regarding the VYRI subscale, which assesses the violence suffered and perpetrated, the mean rank of the VYRI scale before interventions was 2.74 and after interventions was 1.63 points, decreasing from Moment 1 to Moment 2. This decrease is visible in the percentage values of item 1 “Blame, criticize, insult, defame, accuse without reason,” item 12 “Ignore, belittle, humiliate, embarrass or treat with indifference,” and item 7 “Messing with personal things without authorization (e.g., email account, profile of social networks, coat pockets, cell phone, wallet, diary),” whose percentage values in the answer option “I have already suffered” decreased, respectively, to 20.0, 14.8, and 8.7% and in the answer option “I have done,” whose percentage values also decreased, being, respectively, 4.3, 0.9, and 0.0%. This decrease in GBI and VYRI subscale scores and proportions may be due to the interventions carried out.

There were significant statistical differences between the Rank Means of VYRI score of the adolescents in the sample before (Moment 1) and after the interventions (Moment 2) (Wilcoxon: p = 0.000), with 46% of the adolescents reducing their score on the VYRI score scale. These adolescents were those who had the highest score also, i.e., those students with more violence suffered and/or perpetrated (Table 5).

Table 5

Relationship between the sample’s VYRI score before and after the interventions

Dimension M2 – Dimension M1 N Mean/rank mean Test value p value Proportion (%)
M2 VYRI score – M1 VYRI score Negative ratings 53 37.75 46.00
Positive ratings 18 30.86 Wilcoxon = −4.174 0.00 16.00
Ties 44 38.00

Negative ratings – M2 GB < M1 GB; positive ratings – M2 GB > M1 GB; ties – M2 GB = M1 GB; p – probability.

4 Discussion

With regard to GB, these results are considered to be very worrying, as it would be expected that social changes and the reduction of the gap between gender roles in society would be translated in a more impactful way in such a young sample. Furthermore, scientific evidence demonstrates that more conservative or sexist attitudes and beliefs increase the risk of legitimizing DV, especially in relation to myths of romantic love and benevolent sexism [19].

In turn, Linares et al. [20] report that there is an association between more conservative GB and psychological violence on the internet exercised against their partners by male teenagers, especially in terms of romantic jealousy and other traditional forms of psychological violence. Thus, young people, influenced by certain myths about romantic love, would start to consider jealousy and control over their partner as an expression of love, which makes it difficult to recognize that certain behaviors are forms of violence and promotes the legitimization of DV. In the present study, when evaluating the degree of agreement with the statement “jealousy is a proof of love,” 33.1% of the adolescents in the sample responded that they agreed with the statement, which may translate into an attitude of legitimization from DV. Taking into account the issue of the romanticization of jealousy, this view of romantic love can lead to legitimizing DV on a psychological level related to these issues.

A study carried out in mainland Portugal and Autonomous Regions [21], with a sample of 5,916 young people between 11 and 25 years old identified that young men legitimized all forms of violence more, in line with the present study.

For Cuadrado-Gordillo et al. [9], the idealization that some adolescents have of romantic relationships justifies violent behaviors based on the myths of “romantic love,” and behaviors such as jealousy, psychological control, or emotional blackmail, is mainly perpetuated by female adolescents, these being behaviors almost as desired. This type of beliefs seems to justify violence and normalize it in social terms, which results in a normalization of violence as a normal way of interacting within the couple, making abuse invisible.

In the present study, the majority of adolescents reported not having a dating relationship (51.4%), which does not match the results obtained by a study carried out in the Northeast of Brazil (Pernambuco – Brazil) [22], with a sample of 270 young people between 12 and 19 years old, in which the vast majority of the sample (83.3%) reported having dating relationships. This difference could be explained by cultural differences between the samples being compared and by the fact that young Brazilians are older.

Regarding the violence suffered in this study, the percentage of victims was 56.1%, while in the study carried out at national level [21], this percentage of young people who were victims of some form of violence perpetrated by their peers was 65.2%, being more expressive than in the present study. Comparing our results regarding victimization with those obtained in the study carried out in the Brazilian Northeast [22], we found that the predominant type of violence suffered is psychological violence (50.0%), which converges with the study in the Brazilian Northeast [22], although the percentage obtained in this study is much higher (81.8%).

With regard to perpetrated violence, the most perpetrated type of violence in this study was psychological violence (64.5%), followed by physical violence (45.2%), much higher percentages than in the national study [21], in which these percentages were 45.1 and 12.2%, respectively, a difference that could be due to the different age, with the study sample being older in comparison. However, the predominant type of violence coincides in both studies. When comparing the same results relating to this study with those obtained by the Brazilian Northeast Study [22], it is clear that the findings of this study record a higher percentage in psychological violence (86.2%), but lower in the type of physical violence (37.6%), with the predominance of psychological violence remaining.

The results obtained regarding DV victimization in the sample are consistent with the findings of Farmer et al. [23] in their meta-analysis, involving DV in a school context, since these authors found that the prevalence of DV was between a quarter and a third of adolescents in studies from several Western countries, leaving, however, a possibility for these values reach around two thirds of students, depending on the context. In relation to the present study, VYR constitute more than half of the sample (61.5% of the responses obtained), i.e., practically double the minimum prevalence in the study by Farmer et al. [23] and very close to the maximum estimate of two-thirds.

In the study by Mineo et al. [24], there are differences regarding psychological violence, which affected 16% of the sample, in contrast to 50% of the adolescents in the sample of the present study, who reported having suffered this form of DV. However, the issue of sexual violence in the present study represents less than half of the results obtained by those authors in a study on DV in Italian adolescents. This can be explained by the fact that the study in comparison included sexual offenses at a verbal level, which in the questionnaire used in this study is not explicitly covered, i.e., in the applied scale (VYRI) it was only asked about the dissemination of images of a sexual nature on the internet and disclosing one’s sexual orientation to other people.

The GBI scale score decreased after the interventions in 25% of the adolescents in the sample as opposed to 13% of adolescents in which it increased, which means that in the largest group of adolescents in the sample the GB became less conservative and legitimizing DV. The VYRI subscale score also decreased after the interventions in 46% of the adolescents of the sample as opposed to 16% of adolescents in which it increased, meaning that the violence suffered and/or perpetrated appears to have decreased. These results allow us to conclude, with some caution due to study limitations that the interventions carried out may have had a positive impact on reducing the conservative beliefs of the adolescents in this sample and the violence suffered and/or perpetrated, while safeguarding the uncertainty of these conclusions due to the limitations of the study.

The main limitations of this study may be the fact that there was no control group, and there may have been interference from extraneous variables in the impact of the interventions performed and the use of a control group will allow obtaining a higher level of scientific evidence. Another limitation is related to the fact that it was a convenience sample (non-random), which may have affected the generalization of the sample results to our population.

This study may have implications for the professional practice of the nursing team, who do school health, which will now have a diagnosis of the situation with regard to GB and VYR and develop more targeted and effective interventions in the context of VYR prevention. These interventions may also allow these adolescents to experience healthier sexuality.

Acknowledgments

The authors would like to thank the three groups of public schools in the third cycle of the municipality of Amarante, for their availability and collaboration in this study.

  1. Funding information: This study had the financial support of CIEC (Research Center on Child Studies), by the Strategic Project UID/CED/00317/2013, through the National Funds through the FCT (Foundation for Science and Technology), and co-financed by European Regional Development Funds (FEDER) through the Competitiveness and Internationalization Operational Program (POCI) with the reference POCI-01-0145-FEDER-007562.

  2. Author contributions: Study conception and design: S.B.F., M.B.F., N.P.G., A.A.S.C.; data collection: S.B.F.; data analysis and interpretation: S.B.F., M.B.F., N.P.G., A.A.S.C.; drafting of the article: S.B.F., M.B.F., N.P.G., A.A.S.C.; critical revision of the article: S.B.F., M.B.F., N.P.G., A.A.S.C.

  3. Conflict of interest: The authors state no conflict of interest. One of the authors (A.A.S.C.) is an editor with Open Medicine, but this did not affect the peer review process, and the authors were not aware of who the peer reviewers were.

  4. Data availability statement: The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Received: 2024-04-15
Revised: 2025-03-25
Accepted: 2025-03-28
Published Online: 2025-04-17

© 2025 the author(s), published by De Gruyter

This work is licensed under the Creative Commons Attribution 4.0 International License.

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  121. Development of a nomogram for predicting cancer-specific survival in patients with renal pelvic cancer following surgery
  122. Inhibition of ATG7 promotes orthodontic tooth movement by regulating the RANKL/OPG ratio under compression force
  123. A machine learning-based prognostic model integrating mRNA stemness index, hypoxia, and glycolysis‑related biomarkers for colorectal cancer
  124. 10.1515/med-2025-1282
  125. Review Articles
  126. The effects of enhanced external counter-pulsation on post-acute sequelae of COVID-19: A narrative review
  127. Diabetes-related cognitive impairment: Mechanisms, symptoms, and treatments
  128. Microscopic changes and gross morphology of placenta in women affected by gestational diabetes mellitus in dietary treatment: A systematic review
  129. Review of mechanisms and frontier applications in IL-17A-induced hypertension
  130. Research progress on the correlation between islet amyloid peptides and type 2 diabetes mellitus
  131. The safety and efficacy of BCG combined with mitomycin C compared with BCG monotherapy in patients with non-muscle-invasive bladder cancer: A systematic review and meta-analysis
  132. The application of augmented reality in robotic general surgery: A mini-review
  133. The effect of Greek mountain tea extract and wheat germ extract on peripheral blood flow and eicosanoid metabolism in mammals
  134. Neurogasobiology of migraine: Carbon monoxide, hydrogen sulfide, and nitric oxide as emerging pathophysiological trinacrium relevant to nociception regulation
  135. Plant polyphenols, terpenes, and terpenoids in oral health
  136. Laboratory medicine between technological innovation, rights safeguarding, and patient safety: A bioethical perspective
  137. End-of-life in cancer patients: Medicolegal implications and ethical challenges in Europe
  138. The maternal factors during pregnancy for intrauterine growth retardation: An umbrella review
  139. Intra-abdominal hypertension/abdominal compartment syndrome of pediatric patients in critical care settings
  140. PI3K/Akt pathway and neuroinflammation in sepsis-associated encephalopathy
  141. Screening of Group B Streptococcus in pregnancy: A systematic review for the laboratory detection
  142. Giant borderline ovarian tumours – review of the literature
  143. Leveraging artificial intelligence for collaborative care planning: Innovations and impacts in shared decision-making – A systematic review
  144. Cholera epidemiology analysis through the experience of the 1973 Naples epidemic
  145. Risk factors of frailty/sarcopenia in community older adults: Meta-analysis
  146. Case Reports
  147. Delayed graft function after renal transplantation
  148. Semaglutide treatment for type 2 diabetes in a patient with chronic myeloid leukemia: A case report and review of the literature
  149. Diverse electrophysiological demyelinating features in a late-onset glycogen storage disease type IIIa case
  150. Giant right atrial hemangioma presenting with ascites: A case report
  151. Laser excision of a large granular cell tumor of the vocal cord with subglottic extension: A case report
  152. EsoFLIP-assisted dilation for dysphagia in systemic sclerosis: Highlighting the role of multimodal esophageal evaluation
  153. Rapid Communication
  154. Biological properties of valve materials using RGD and EC
  155. Letter to the Editor
  156. Role of enhanced external counterpulsation in long COVID
  157. Expression of Concern
  158. Expression of concern “A ceRNA network mediated by LINC00475 in papillary thyroid carcinoma”
  159. Expression of concern “Notoginsenoside R1 alleviates spinal cord injury through the miR-301a/KLF7 axis to activate Wnt/β-catenin pathway”
  160. Expression of concern “circ_0020123 promotes cell proliferation and migration in lung adenocarcinoma via PDZD8”
  161. Corrigendum
  162. Corrigendum to “Empagliflozin improves aortic injury in obese mice by regulating fatty acid metabolism”
  163. Corrigendum to “Comparing the therapeutic efficacy of endoscopic minimally invasive surgery and traditional surgery for early-stage breast cancer: A meta-analysis”
  164. Corrigendum to “The progress of autoimmune hepatitis research and future challenges”
  165. Retraction
  166. Retraction of “miR-654-5p promotes gastric cancer progression via the GPRIN1/NF-κB pathway”
  167. Special Issue Advancements in oncology: bridging clinical and experimental research - Part II
  168. Unveiling novel biomarkers for platinum chemoresistance in ovarian cancer
  169. Lathyrol affects the expression of AR and PSA and inhibits the malignant behavior of RCC cells
  170. The era of increasing cancer survivorship: Trends in fertility preservation, medico-legal implications, and ethical challenges
  171. Bone scintigraphy and positron emission tomography in the early diagnosis of MRONJ
  172. Meta-analysis of clinical efficacy and safety of immunotherapy combined with chemotherapy in non-small cell lung cancer
  173. Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part IV
  174. Exploration of mRNA-modifying METTL3 oncogene as momentous prognostic biomarker responsible for colorectal cancer development
  175. Special Issue The evolving saga of RNAs from bench to bedside - Part III
  176. Interaction and verification of ferroptosis-related RNAs Rela and Stat3 in promoting sepsis-associated acute kidney injury
  177. The mRNA MOXD1: Link to oxidative stress and prognostic significance in gastric cancer
  178. Special Issue Exploring the biological mechanism of human diseases based on MultiOmics Technology - Part II
  179. Dynamic changes in lactate-related genes in microglia and their role in immune cell interactions after ischemic stroke
  180. A prognostic model correlated with fatty acid metabolism in Ewing’s sarcoma based on bioinformatics analysis
  181. Special Issue Diabetes
  182. Nutritional risk assessment and nutritional support in children with congenital diabetes during surgery
  183. Correlation of the differential expressions of RANK, RANKL, and OPG with obesity in the elderly population in Xinjiang
  184. A discussion on the application of fluorescence micro-optical sectioning tomography in the research of cognitive dysfunction in diabetes
  185. 10.1515/med-2025-1253
  186. Special Issue Biomarker Discovery and Precision Medicine
  187. CircASH1L-mediated tumor progression in triple-negative breast cancer: PI3K/AKT pathway mechanisms
https://doi.org/10.1515/med-2025-1188
Schlagwörter für diesen Artikel
beliefs; gender studies; violence; adolescent; community health nursing; public health
Creative Commons
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Artikel in diesem Heft

  1. Research Articles
  2. Network pharmacological analysis and in vitro testing of the rutin effects on triple-negative breast cancer
  3. Impact of diabetes on long-term survival in elderly liver cancer patients: A retrospective study
  4. Knockdown of CCNB1 alleviates high glucose-triggered trophoblast dysfunction during gestational diabetes via Wnt/β-catenin signaling pathway
  5. Risk factors for severe adverse drug reactions in hospitalized patients
  6. Analysis of the effect of ALA-PDT on macrophages in footpad model of mice infected with Fonsecaea monophora based on single-cell sequencing
  7. Development and validation of headspace gas chromatography with a flame ionization detector method for the determination of ethanol in the vitreous humor
  8. CMSP exerts anti-tumor effects on small cell lung cancer cells by inducing mitochondrial dysfunction and ferroptosis
  9. Predictive value of plasma sB7-H3 and YKL-40 in pediatric refractory Mycoplasma pneumoniae pneumonia
  10. Antiangiogenic potential of Elaeagnus umbellata extracts and molecular docking study by targeting VEGFR-2 pathway
  11. Comparison of the effectiveness of nurse-led preoperative counseling and postoperative follow-up care vs standard care for patients with gastric cancer
  12. Comparing the therapeutic efficacy of endoscopic minimally invasive surgery and traditional surgery for early-stage breast cancer: A meta-analysis
  13. Adhered macrophages as an additional marker of cardiomyocyte injury in biopsies of patients with dilated cardiomyopathy
  14. Association between statin administration and outcome in patients with sepsis: A retrospective study
  15. Exploration of the association between estimated glucose disposal rate and osteoarthritis in middle-aged and older adults: An analysis of NHANES data from 2011 to 2018
  16. A comparative analysis of the binary and multiclass classified chest X-ray images of pneumonia and COVID-19 with ML and DL models
  17. Lysophosphatidic acid 2 alleviates deep vein thrombosis via protective endothelial barrier function
  18. Transcription factor A, mitochondrial promotes lymph node metastasis and lymphangiogenesis in epithelial ovarian carcinoma
  19. Serum PM20D1 levels are associated with nutritional status and inflammatory factors in gastric cancer patients undergoing early enteral nutrition
  20. Hydromorphone reduced the incidence of emergence agitation after adenotonsillectomy in children with obstructive sleep apnea: A randomized, double-blind study
  21. Vitamin D replacement therapy may regulate sleep habits in patients with restless leg syndrome
  22. The first-line antihypertensive nitrendipine potentiated the therapeutic effect of oxaliplatin by downregulating CACNA1D in colorectal cancer
  23. Health literacy and health-related quality of life: The mediating role of irrational happiness
  24. Modulatory effects of Lycium barbarum polysaccharide on bone cell dynamics in osteoporosis
  25. Mechanism research on inhibition of gastric cancer in vitro by the extract of Pinellia ternata based on network pharmacology and cellular metabolomics
  26. Examination of the causal role of immune cells in non-alcoholic fatty liver disease by a bidirectional Mendelian randomization study
  27. Clinical analysis of ten cases of HIV infection combined with acute leukemia
  28. Investigating the cardioprotective potential of quercetin against tacrolimus-induced cardiotoxicity in Wistar rats: A mechanistic insights
  29. Clinical observation of probiotics combined with mesalazine and Yiyi Baitouweng Decoction retention enema in treating mild-to-moderate ulcerative colitis
  30. Diagnostic value of ratio of blood inflammation to coagulation markers in periprosthetic joint infection
  31. Sex-specific associations of sex hormone binding globulin and risk of bladder cancer
  32. Core muscle strength and stability-oriented breathing training reduces inter-recti distance in postpartum women
  33. The ERAS nursing care strategy for patients undergoing transsphenoidal endoscopic pituitary tumor resection: A randomized blinded controlled trial
  34. The serum IL-17A levels in patients with traumatic bowel rupture post-surgery and its predictive value for patient prognosis
  35. Impact of Kolb’s experiential learning theory-based nursing on caregiver burden and psychological state of caregivers of dementia patients
  36. Analysis of serum NLR combined with intraoperative margin condition to predict the prognosis of cervical HSIL patients undergoing LEEP surgery
  37. Commiphora gileadensis ameliorate infertility and erectile dysfunction in diabetic male mice
  38. The correlation between epithelial–mesenchymal transition classification and MMP2 expression of circulating tumor cells and prognosis of advanced or metastatic nasopharyngeal carcinoma
  39. Tetrahydropalmatine improves mitochondrial function in vascular smooth muscle cells of atherosclerosis in vitro by inhibiting Ras homolog gene family A/Rho-associated protein kinase-1 signaling pathway
  40. A cross-sectional study: Relationship between serum oxidative stress levels and arteriovenous fistula maturation in maintenance dialysis patients
  41. A comparative analysis of the impact of repeated administration of flavan 3-ol on brown, subcutaneous, and visceral adipose tissue
  42. Identifying early screening factors for depression in middle-aged and older adults: A cohort study
  43. Perform tumor-specific survival analysis for Merkel cell carcinoma patients undergoing surgical resection based on the SEER database by constructing a nomogram chart
  44. Unveiling the role of CXCL10 in pancreatic cancer progression: A novel prognostic indicator
  45. High-dose preoperative intraperitoneal erythropoietin and intravenous methylprednisolone in acute traumatic spinal cord injuries following decompression surgeries
  46. RAB39B: A novel biomarker for acute myeloid leukemia identified via multi-omics and functional validation
  47. Impact of peripheral conditioning on reperfusion injury following primary percutaneous coronary intervention in diabetic and non-diabetic STEMI patients
  48. Clinical efficacy of azacitidine in the treatment of middle- and high-risk myelodysplastic syndrome in middle-aged and elderly patients: A retrospective study
  49. The effect of ambulatory blood pressure load on mitral regurgitation in continuous ambulatory peritoneal dialysis patients
  50. Expression and clinical significance of ITGA3 in breast cancer
  51. Single-nucleus RNA sequencing reveals ARHGAP28 expression of podocytes as a biomarker in human diabetic nephropathy
  52. rSIG combined with NLR in the prognostic assessment of patients with multiple injuries
  53. Toxic metals and metalloids in collagen supplements of fish and jellyfish origin: Risk assessment for daily intake
  54. Exploring causal relationship between 41 inflammatory cytokines and marginal zone lymphoma: A bidirectional Mendelian randomization study
  55. Gender beliefs and legitimization of dating violence in adolescents
  56. Effect of serum IL-6, CRP, and MMP-9 levels on the efficacy of modified preperitoneal Kugel repair in patients with inguinal hernia
  57. Effect of smoking and smoking cessation on hematological parameters in polycythemic patients
  58. Pathogen surveillance and risk factors for pulmonary infection in patients with lung cancer: A retrospective single-center study
  59. Necroptosis of hippocampal neurons in paclitaxel chemotherapy-induced cognitive impairment mediates microglial activation via TLR4/MyD88 signaling pathway
  60. Celastrol suppresses neovascularization in rat aortic vascular endothelial cells stimulated by inflammatory tenocytes via modulating the NLRP3 pathway
  61. Cord-lamina angle and foraminal diameter as key predictors of C5 palsy after anterior cervical decompression and fusion surgery
  62. GATA1: A key biomarker for predicting the prognosis of patients with diffuse large B-cell lymphoma
  63. Influencing factors of false lumen thrombosis in type B aortic dissection: A single-center retrospective study
  64. MZB1 regulates the immune microenvironment and inhibits ovarian cancer cell migration
  65. Integrating experimental and network pharmacology to explore the pharmacological mechanisms of Dioscin against glioblastoma
  66. Trends in research on preterm birth in twin pregnancy based on bibliometrics
  67. Four-week IgE/baseline IgE ratio combined with tryptase predicts clinical outcome in omalizumab-treated children with moderate-to-severe asthma
  68. Single-cell transcriptomic analysis identifies a stress response Schwann cell subtype
  69. Acute pancreatitis risk in the diagnosis and management of inflammatory bowel disease: A critical focus
  70. Effect of subclinical esketamine on NLRP3 and cognitive dysfunction in elderly ischemic stroke patients
  71. Interleukin-37 mediates the anti-oral tumor activity in oral cancer through STAT3
  72. CA199 and CEA expression levels, and minimally invasive postoperative prognosis analysis in esophageal squamous carcinoma patients
  73. Efficacy of a novel drainage catheter in the treatment of CSF leak after posterior spine surgery: A retrospective cohort study
  74. Comprehensive biomedicine assessment of Apteranthes tuberculata extracts: Phytochemical analysis and multifaceted pharmacological evaluation in animal models
  75. Relation of time in range to severity of coronary artery disease in patients with type 2 diabetes: A cross-sectional study
  76. Dopamine attenuates ethanol-induced neuronal apoptosis by stimulating electrical activity in the developing rat retina
  77. Correlation between albumin levels during the third trimester and the risk of postpartum levator ani muscle rupture
  78. Factors associated with maternal attention and distraction during breastfeeding and childcare: A cross-sectional study in the west of Iran
  79. Mechanisms of hesperetin in treating metabolic dysfunction-associated steatosis liver disease via network pharmacology and in vitro experiments
  80. The law on oncological oblivion in the Italian and European context: How to best uphold the cancer patients’ rights to privacy and self-determination?
  81. The prognostic value of the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and prognostic nutritional index for survival in patients with colorectal cancer
  82. Factors affecting the measurements of peripheral oxygen saturation values in healthy young adults
  83. Comparison and correlations between findings of hysteroscopy and vaginal color Doppler ultrasonography for detection of uterine abnormalities in patients with recurrent implantation failure
  84. The effects of different types of RAGT on balance function in stroke patients with low levels of independent walking in a convalescent rehabilitation hospital
  85. Causal relationship between asthma and ankylosing spondylitis: A bidirectional two-sample univariable and multivariable Mendelian randomization study
  86. Correlations of health literacy with individuals’ understanding and use of medications in Southern Taiwan
  87. Correlation of serum calprotectin with outcome of acute cerebral infarction
  88. Comparison of computed tomography and guided bronchoscopy in the diagnosis of pulmonary nodules: A systematic review and meta-analysis
  89. Curdione protects vascular endothelial cells and atherosclerosis via the regulation of DNMT1-mediated ERBB4 promoter methylation
  90. The identification of novel missense variant in ChAT gene in a patient with gestational diabetes denotes plausible genetic association
  91. Molecular genotyping of multi-system rare blood types in foreign blood donors based on DNA sequencing and its clinical significance
  92. Exploring the role of succinyl carnitine in the association between CD39⁺ CD4⁺ T cell and ulcerative colitis: A Mendelian randomization study
  93. Dexmedetomidine suppresses microglial activation in postoperative cognitive dysfunction via the mmu-miRNA-125/TRAF6 signaling axis
  94. Analysis of serum metabolomics in patients with different types of chronic heart failure
  95. Diagnostic value of hematological parameters in the early diagnosis of acute cholecystitis
  96. Pachymaran alleviates fat accumulation, hepatocyte degeneration, and injury in mice with nonalcoholic fatty liver disease
  97. Decrease in CD4 and CD8 lymphocytes are predictors of severe clinical picture and unfavorable outcome of the disease in patients with COVID-19
  98. METTL3 blocked the progression of diabetic retinopathy through m6A-modified SOX2
  99. The predictive significance of anti-RO-52 antibody in patients with interstitial pneumonia after treatment of malignant tumors
  100. Exploring cerebrospinal fluid metabolites, cognitive function, and brain atrophy: Insights from Mendelian randomization
  101. Development and validation of potential molecular subtypes and signatures of ocular sarcoidosis based on autophagy-related gene analysis
  102. Widespread venous thrombosis: Unveiling a complex case of Behçet’s disease with a literature perspective
  103. Uterine fibroid embolization: An analysis of clinical outcomes and impact on patients’ quality of life
  104. Discovery of lipid metabolism-related diagnostic biomarkers and construction of diagnostic model in steroid-induced osteonecrosis of femoral head
  105. Serum-derived exomiR-188-3p is a promising novel biomarker for early-stage ovarian cancer
  106. Enhancing chronic back pain management: A comparative study of ultrasound–MRI fusion guidance for paravertebral nerve block
  107. Peptide CCAT1-70aa promotes hepatocellular carcinoma proliferation and invasion via the MAPK/ERK pathway
  108. Electroacupuncture-induced reduction of myocardial ischemia–reperfusion injury via FTO-dependent m6A methylation modulation
  109. Hemorrhoids and cardiovascular disease: A bidirectional Mendelian randomization study
  110. Cell-free adipose extract inhibits hypertrophic scar formation through collagen remodeling and antiangiogenesis
  111. HALP score in Demodex blepharitis: A case–control study
  112. Assessment of SOX2 performance as a marker for circulating cancer stem-like cells (CCSCs) identification in advanced breast cancer patients using CytoTrack system
  113. Risk and prognosis for brain metastasis in primary metastatic cervical cancer patients: A population-based study
  114. Comparison of the two intestinal anastomosis methods in pediatric patients
  115. Factors influencing hematological toxicity and adverse effects of perioperative hyperthermic intraperitoneal vs intraperitoneal chemotherapy in gastrointestinal cancer
  116. Endotoxin tolerance inhibits NLRP3 inflammasome activation in macrophages of septic mice by restoring autophagic flux through TRIM26
  117. Lateral transperitoneal laparoscopic adrenalectomy: A single-centre experience of 21 procedures
  118. Petunidin attenuates lipopolysaccharide-induced retinal microglia inflammatory response in diabetic retinopathy by targeting OGT/NF-κB/LCN2 axis
  119. Procalcitonin and C-reactive protein as biomarkers for diagnosing and assessing the severity of acute cholecystitis
  120. Factors determining the number of sessions in successful extracorporeal shock wave lithotripsy patients
  121. Development of a nomogram for predicting cancer-specific survival in patients with renal pelvic cancer following surgery
  122. Inhibition of ATG7 promotes orthodontic tooth movement by regulating the RANKL/OPG ratio under compression force
  123. A machine learning-based prognostic model integrating mRNA stemness index, hypoxia, and glycolysis‑related biomarkers for colorectal cancer
  124. 10.1515/med-2025-1282
  125. Review Articles
  126. The effects of enhanced external counter-pulsation on post-acute sequelae of COVID-19: A narrative review
  127. Diabetes-related cognitive impairment: Mechanisms, symptoms, and treatments
  128. Microscopic changes and gross morphology of placenta in women affected by gestational diabetes mellitus in dietary treatment: A systematic review
  129. Review of mechanisms and frontier applications in IL-17A-induced hypertension
  130. Research progress on the correlation between islet amyloid peptides and type 2 diabetes mellitus
  131. The safety and efficacy of BCG combined with mitomycin C compared with BCG monotherapy in patients with non-muscle-invasive bladder cancer: A systematic review and meta-analysis
  132. The application of augmented reality in robotic general surgery: A mini-review
  133. The effect of Greek mountain tea extract and wheat germ extract on peripheral blood flow and eicosanoid metabolism in mammals
  134. Neurogasobiology of migraine: Carbon monoxide, hydrogen sulfide, and nitric oxide as emerging pathophysiological trinacrium relevant to nociception regulation
  135. Plant polyphenols, terpenes, and terpenoids in oral health
  136. Laboratory medicine between technological innovation, rights safeguarding, and patient safety: A bioethical perspective
  137. End-of-life in cancer patients: Medicolegal implications and ethical challenges in Europe
  138. The maternal factors during pregnancy for intrauterine growth retardation: An umbrella review
  139. Intra-abdominal hypertension/abdominal compartment syndrome of pediatric patients in critical care settings
  140. PI3K/Akt pathway and neuroinflammation in sepsis-associated encephalopathy
  141. Screening of Group B Streptococcus in pregnancy: A systematic review for the laboratory detection
  142. Giant borderline ovarian tumours – review of the literature
  143. Leveraging artificial intelligence for collaborative care planning: Innovations and impacts in shared decision-making – A systematic review
  144. Cholera epidemiology analysis through the experience of the 1973 Naples epidemic
  145. Risk factors of frailty/sarcopenia in community older adults: Meta-analysis
  146. Case Reports
  147. Delayed graft function after renal transplantation
  148. Semaglutide treatment for type 2 diabetes in a patient with chronic myeloid leukemia: A case report and review of the literature
  149. Diverse electrophysiological demyelinating features in a late-onset glycogen storage disease type IIIa case
  150. Giant right atrial hemangioma presenting with ascites: A case report
  151. Laser excision of a large granular cell tumor of the vocal cord with subglottic extension: A case report
  152. EsoFLIP-assisted dilation for dysphagia in systemic sclerosis: Highlighting the role of multimodal esophageal evaluation
  153. Rapid Communication
  154. Biological properties of valve materials using RGD and EC
  155. Letter to the Editor
  156. Role of enhanced external counterpulsation in long COVID
  157. Expression of Concern
  158. Expression of concern “A ceRNA network mediated by LINC00475 in papillary thyroid carcinoma”
  159. Expression of concern “Notoginsenoside R1 alleviates spinal cord injury through the miR-301a/KLF7 axis to activate Wnt/β-catenin pathway”
  160. Expression of concern “circ_0020123 promotes cell proliferation and migration in lung adenocarcinoma via PDZD8”
  161. Corrigendum
  162. Corrigendum to “Empagliflozin improves aortic injury in obese mice by regulating fatty acid metabolism”
  163. Corrigendum to “Comparing the therapeutic efficacy of endoscopic minimally invasive surgery and traditional surgery for early-stage breast cancer: A meta-analysis”
  164. Corrigendum to “The progress of autoimmune hepatitis research and future challenges”
  165. Retraction
  166. Retraction of “miR-654-5p promotes gastric cancer progression via the GPRIN1/NF-κB pathway”
  167. Special Issue Advancements in oncology: bridging clinical and experimental research - Part II
  168. Unveiling novel biomarkers for platinum chemoresistance in ovarian cancer
  169. Lathyrol affects the expression of AR and PSA and inhibits the malignant behavior of RCC cells
  170. The era of increasing cancer survivorship: Trends in fertility preservation, medico-legal implications, and ethical challenges
  171. Bone scintigraphy and positron emission tomography in the early diagnosis of MRONJ
  172. Meta-analysis of clinical efficacy and safety of immunotherapy combined with chemotherapy in non-small cell lung cancer
  173. Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part IV
  174. Exploration of mRNA-modifying METTL3 oncogene as momentous prognostic biomarker responsible for colorectal cancer development
  175. Special Issue The evolving saga of RNAs from bench to bedside - Part III
  176. Interaction and verification of ferroptosis-related RNAs Rela and Stat3 in promoting sepsis-associated acute kidney injury
  177. The mRNA MOXD1: Link to oxidative stress and prognostic significance in gastric cancer
  178. Special Issue Exploring the biological mechanism of human diseases based on MultiOmics Technology - Part II
  179. Dynamic changes in lactate-related genes in microglia and their role in immune cell interactions after ischemic stroke
  180. A prognostic model correlated with fatty acid metabolism in Ewing’s sarcoma based on bioinformatics analysis
  181. Special Issue Diabetes
  182. Nutritional risk assessment and nutritional support in children with congenital diabetes during surgery
  183. Correlation of the differential expressions of RANK, RANKL, and OPG with obesity in the elderly population in Xinjiang
  184. A discussion on the application of fluorescence micro-optical sectioning tomography in the research of cognitive dysfunction in diabetes
  185. 10.1515/med-2025-1253
  186. Special Issue Biomarker Discovery and Precision Medicine
  187. CircASH1L-mediated tumor progression in triple-negative breast cancer: PI3K/AKT pathway mechanisms
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