Becoming a sexual being: The 'elephant in the room' of adolescent brain development

Feeling loved in mixed-gender adolescent romantic relationships in the face of daily stress and support: A dyadic diary study

A profound developmental experience is the emergence of adolescent romantic relationships and first feelings of love. However, the daily nature of feeling loved in adolescents' everyday lives is poorly understood. We investigated how daily stress severity was associated with adolescents' levels of feeling loved and whether romantic partner support moderated these associations. Furthermore, we investigated this for non-interpersonal and interpersonal stressors. N = 97 mixed-gender adolescent romantic couples (age M = 16.38, SD = 1.02) from an ethnically diverse sample (42.2% Hispanic/Latino/a/x, 44.7% White) participated in dyadic diary assessments twice a week for 12 consecutive weeks. Both partners independently completed open-ended questions about a daily stressor, indicating stress severity, perceived partner support, and feeling loved. Daily stressors were coded for non-interpersonal and various types of interpersonal stressors. Results from the dyadic multilevel model showed that days with lower than average support from a romantic partner amplify the adverse effects of stress severity on feeling loved, especially when the partner is involved in the stressor. We discuss the spillover of stress in romantic relationships and the stress-buffering functions of adolescent romantic partner support. Adolescent romantic partners are potentially essential regulators of stress, increasing adolescents' feelings of love. RESEARCH HIGHLIGHTS: Romantic love is central in adolescents' lives; we showed that adolescents generally feel loved by romantic partners. Feeling loved fluctuates daily as adolescents feel less loved on stressful days. However, when adolescents perceive their partner as supportive, there is no association between stress and feeling loved. Partner support is protective for feeling loved. The current study provides essential insights into when adolescents and why adolescents feel loved.

Wanting to matter and learning to care: A neurodevelopmental window of opportunity for (Pro) social learning?

Wanting to matter-to feel socially recognized, appreciated, and capable of actions that benefit others-represents a fundamental motivation in human development. The motivational salience of mattering appears to increase in adolescence. Evidence suggests this is related to pubertal increases in the incentive salience for gaining social value and personal agency. This can provide a useful heuristic for understanding motivational proclivities (i.e. wanting to matter) that influence action-outcome learning as young adolescents are exploring and learning how to navigate increasingly complex social and relational environments. Adolescence also brings new capacities, motives, and opportunities for learning to care about and contribute to the benefit of others. Together, these create a window of opportunity: a sensitive period for learning to gain salient feelings of mattering through caring prosocial actions and valued societal contributions. Successfully discovering ways of mattering by doing things that matter to others may contribute to formative socio-emotional learning about self/other. Advances in understanding these social and relational learning processes and their neurodevelopmental underpinnings can inform strategies to improve developmental trajectories of social competence and wellbeing among adolescents growing up in a rapidly changing and increasingly techno-centric world.

Menarche, pubertal timing and the brain: female-specific patterns of brain maturation beyond age-related development

BACKGROUND

Puberty depicts a period of profound and multifactorial changes ranging from social to biological factors. While brain development in youths has been studied mostly from an age perspective, recent evidence suggests that pubertal measures may be more sensitive to study adolescent neurodevelopment, however, studies on pubertal timing in relation to brain development are still scarce.

METHODS

We investigated if pre- vs. post-menarche status can be classified using machine learning on cortical and subcortical structural magnetic resonance imaging (MRI) data from strictly age-matched adolescent females from the Adolescent Brain Cognitive Development (ABCD) cohort. For comparison of the identified menarche-related patterns to age-related patterns of neurodevelopment, we trained a brain age prediction model on data from the Philadelphia Neurodevelopmental Cohort and applied it to the same ABCD data, yielding differences between predicted and chronological age referred to as brain age gaps. We tested the sensitivity of both these frameworks to measures of pubertal maturation, specifically age at menarche and puberty status.

RESULTS

The machine learning model achieved moderate but statistically significant accuracy in the menarche classification task, yielding for each subject a class probability ranging from 0 (pre-) to 1 (post- menarche). Comparison to brain age predictions revealed shared and distinct patterns of neurodevelopment captured by both approaches. Continuous menarche class probabilities were positively associated with brain age gaps, but only the menarche class probabilities-not the brain age gaps-were associated with age at menarche.

CONCLUSIONS

This study demonstrates the use of a machine learning model to classify menarche status from structural MRI data while accounting for age-related neurodevelopment. Given its sensitivity towards measures of puberty timing, our work suggests that menarche class probabilities may be developed toward an objective brain-based marker of pubertal development.

Sexual Self-Concept After Child Maltreatment: The Role of Resilient Coping and Sexual Experience Among U.S. Young Adults

Evidence supports sexual experience as normative and health-promoting for many, but this picture is less clear for people with histories of adversity. Amazon Mechanical Turk (MTurk) was used to garner data from a sample of 362 young adults (aged 18-25) wherein 44.5% (n = 161) identified as women. We assessed longitudinal associations between child maltreatment and sexual self-concept, as mediated by sexual behaviors and sexual partners, and whether resilient coping moderated these associations using structural equation modeling. Although both child maltreatment and resilient coping were directly associated with aspects of sexual experience, only resilient coping was directly associated with sexual self-concept. In addition, we found support for sexual experience as a mediator between child maltreatment/resilient coping and sexual self-concept. Specifically, cumulative maltreatment was associated with more sexual partners, which was associated with higher sexual self-monitoring. Resilient coping was associated with more sexual partners and more sexual behaviors, which was associated with higher sexual self-monitoring and higher sexual self-consciousness, sexual assertiveness, sexual self-esteem, and sexual motivation, respectively. Thus, sexual behaviors and sexual partners operated independently. Findings contrast messaging that sexual experience is universally risky regardless of maltreatment history. Rather, sexual experience may foster positive sexual self-concept for some. Sexual health advocates must attend to differences between sexual behaviors and sexual partners in relation to sexual well-being, and support resilience in the sexual domain.

Domain adapted brain network fusion captures variance related to pubertal brain development and mental health

Puberty demarks a period of profound brain dynamics that orchestrates changes to a multitude of neuroimaging-derived phenotypes. This complexity poses a dimensionality problem when attempting to chart an individual's brain development over time. Here, we illustrate that shifts in subject similarity of brain imaging data relate to pubertal maturation in the longitudinal ABCD study. Given that puberty depicts a critical window for emerging mental health issues, we additionally show that our model is capable of capturing variance in the adolescent brain related to psychopathology in a population-based and a clinical cohort. These results suggest that low-dimensional reference spaces based on subject similarities render useful to chart variance in brain development in youths.

"I Just Want to Feel Good Without Making You Feel Bad": Sexual Assertiveness Negotiation in Adolescent Romantic Relationships

Sexual assertiveness is often conceptualized as an individual's ability to express one's own sexual needs, desires, and limits. Given that sexual assertiveness is embedded in interactions and can affect not only both partners' sexual well-being but also relationship satisfaction, dyadic approaches are needed to investigate sexual assertiveness negotiation within adolescent romantic relationships. This qualitative study aimed to document adolescents' ability to negotiate their sexual needs, desires, and limits with their partners during interactions where they discussed their sexual concerns. A directed content analysis, based on the life positions of the transactional analysis theory, was conducted on the interactions of 40 adolescent romantic dyads aged 14-19 years (M = 16.65; SD = 1.49). The results revealed four categories of strategies: (1) mutual assertiveness: negotiation of one's own sexual needs, desires, and limits with those of the partner; (2) singular passiveness: repression of one's own sexual needs, desires, and limits to privilege those of the partner; (3) singular aggressiveness: prioritization of one's own sexual needs, desires, and limits over those of the partner; and (4) mutual lack of negotiation skills: neglecting both partners' sexual needs, desires, and limits. Among other things, adolescents' ability to be sexually assertive was hindered by anticipations, including assumptions leading to disregarding one's own sexual needs, desires, and limits or fearing to ignore the partner's. To promote mutually rewarding sexual activities and prevent sexual violence, sexual education initiatives should support adolescents' ability to assertively negotiate their sexuality with their partner and avoid passiveness, aggressiveness, and lack of negotiation.

"I Can Tell You Wanna F***": A Content Analysis of Sexual Communication in Popular Song Lyrics

Given that exposure to sexual messages in song lyrics can influence sociocultural norms and expectations surrounding consent communication between partners, we sought to understand the types of messages regarding sexual initiation and consent language that are available to media consumers. Through the lens of sexual script theory, we conducted a quantitative content analysis of sexual consent in pop (n = 197), hip-hop (n = 193), and country songs (n = 194) from 2016 to 2019. Differences in these messages were examined across singer gender, music genre, and time (pre- vs. post-#MeToo). Results indicated that references to sexual demands (e.g., "Strip that down") and sexual preferences (e.g., "I want it slow") were the most common types of sexual communication, appearing in approximately one-third of the singing parts included in the sample. Sexual suggestions (e.g., "Let's get nasty") and sexual requests (e.g., "Can I hit it?"), on the other hand, were the least common. References to inferred consent (e.g., "I can tell you wanna f***") appeared in approximately one-fifth of the singing parts. Both sexual demands and sexual preferences were more likely to appear in pop compared to hip-hop and country songs; however, these sexual communication messages did not significantly differ by male and female singers. Sexual requests were significantly more likely to appear in pre-#MeToo song lyrics. The messages embedded in popular songs may help to reinforce problematic scripts around sexual consent.

The Hamburg Youth Prevention Project (HYPP) for adolescents with sexual interest in children

Paedophilic sexual interest is often linked to an emergence during adolescence, but concrete empirical knowledge on its development and early viable treatments remains scarce. The aim of this article is to provide an overview about the current state of research on juveniles with sexual interest in children as well as to introduce the Hamburg Youth Prevention Project (HYPP). The HYPP aims to better comprehend the development of sexual interests in adolescents and seeks to find a basis for improved treatment strategies during this critical developmental period. In this perspective, we outline the framework, goals, and treatment approach for this project. It addresses adolescents who are sexually attracted to younger children or engage in sexual acts with children and who have not yet been in contact with the justice system. The project offers a diagnostic process, anonymous counselling, and treatment. It is grounded in a biopsychosocial perspective on psychosexual development and an integrative family-centred approach. The project is based on the core assumption that in adolescent participants, there is still great flexibility for development, including their sexual interests.

Socio-cultural factors perceived to influence sexual behaviours of adolescents in Ethiopia

BACKGROUND

Adolescence is a period of transition from childhood to adulthood. It is the age of experimentation. They are vulnerable to the undesirable effect of sexual and reproductive health (SRH) problems such as human immunodeficiency virus, sexually transmitted infections and unsafe abortion and childbirth-related risks.

AIM

To explore and describe perceived organisational, community and societal level factors that influence sexual behaviours among adolescents in Ethiopia.

SETTING

The study was conducted by public health care organisations, youth centres and non-governmental organisations in Addis Ababa, Ethiopia.

METHODS

A qualitative descriptive study design was conducted with purposively selected health professionals and adolescents in Addis Ababa from June 2019 to February 2020. The data were collected using in-depth interviews, key informant interviews and focus group discussions. Transcribed interviews were imported to ATLAS. ti 7 for coding, categorising and creating themes using thematic analysis. Lincoln and Guba's model was used to ensure trustworthiness and ethical standards were applied.

RESULTS

Poor school involvement, social norms on sexual behaviour and lack of condom acceptability by the general population, financial problems and the gap in law enforcement were found perceived factors influencing sexual behaviour of adolescents.

CONCLUSION

Adolescents are engaging in various risky sexual behaviours because of various organisational, community level and societal level factors, which emphasises the need to introduce social and culturally acceptable age-appropriate comprehensive sexuality education for adolescents and other multilevel interventions.Contribution: Provide an in-depth understanding of the influence of sociocultural issues related to adolescent sexual behaviour for health system stakeholders.

Expecting the unexpected: a review of learning under uncertainty across development

Many of our decisions take place under uncertainty. To successfully navigate the environment, individuals need to estimate the degree of uncertainty and adapt their behaviors accordingly by learning from experiences. However, uncertainty is a broad construct and distinct types of uncertainty may differentially influence our learning. We provide a semi-systematic review to illustrate cognitive and neurobiological processes involved in learning under two types of uncertainty: learning in environments with stochastic outcomes, and with volatile outcomes. We specifically reviewed studies (N = 26 studies) that included an adolescent population, because adolescence is a period in life characterized by heightened exploration and learning, as well as heightened uncertainty due to experiencing many new, often social, environments. Until now, reviews have not comprehensively compared learning under distinct types of uncertainties in this age range. Our main findings show that although the overall developmental patterns were mixed, most studies indicate that learning from stochastic outcomes, as indicated by increased accuracy in performance, improved with age. We also found that adolescents tended to have an advantage compared with adults and children when learning from volatile outcomes. We discuss potential mechanisms explaining these age-related differences and conclude by outlining future research directions.

Differences in the sexual health information parents/guardians give their adolescent sexual minority sons by outness

Introduction

Parents and guardians are a potentially valuable source of sexual health information for adolescent sexual minority males (ASMM). The current study examines what sexual health topics ASMM report discussing with a parent/guardian and whether topics differ by outness about sexual attraction to other males.

Methods

ASMM (N=154; ages 14-17) in the United States completed the baseline of an online sexual health intervention pilot in 2020. They reported which of twelve sexual health topics they discussed with a parent/guardian and if they had disclosed their sexual attraction to other males. Associations between topics discussed and outness to a parent/guardian were examined with Firth logistic regression.

Results

Eighty-eight (57%) participants reported being out to a parent/guardian. Six sexual health topics were significantly more likely to be discussed if participants were out. The three categories with the largest differences by outness were how to: discuss with a partner what they would not like to do sexually (aOR = 7.0, 95% CI: 2.0-24.6), use condoms (aOR = 5.9, 95% CI: 2.3-15.1), and prevent HIV/AIDS (aOR = 3.5, 95% CI = 1.4-8.7).

Conclusions

Interventions on parental/guardian provision of sexual health information are needed to ensure ASMM receive relevant sexual health knowledge.

Behavioral Measures to Assess Adolescent Sexual Communication with Partners: A Scoping Review and Call for Further Studies

Sexual communication with partners is important for adolescents' sexual and socioemotional well-being. Behavioral assessments of partner sexual communication capture the complex and nuanced process of communication and are commonly used with adults, yet the existing literature among adolescents overwhelmingly relies on self-report measures. In the current paper, we reviewed the literature on adolescent partner sexual communication, identifying 14 studies including 2,043 participants (M age = 16) that used behavioral assessments (i.e., dyadic observations, role-plays with confederates, role-plays with vignettes). We also identify key gaps in the current literature: First, only one study recruited couples; studies that assessed dyadic interactions largely relied on confederates. Second, assessments often assumed that participants engaged in heterosexual sex, and no studies specifically recruited LGBTQ+ adolescents. Third, behavioral tasks often involved assumptions of participants' sexual goals (e.g., desire to refuse sex) and focused almost exclusively on sexual refusal and condom negotiation. Additionally, coding schemes lacked standardization and micro-analytic strategies (e.g., coding change over time). Finally, observational methods have been almost exclusively used to assess intervention efficacy, rather than to understand associations between behaviorally-assessed communication skills and sexual outcomes or self-reported communication in basic research. We discuss recommendations for future research, including regular use of behavioral observation methods with diverse samples, to triangulate across multiple methodologies and identify correspondence between behavioral and self-report measures.

Structural violence in South African primary healthcare facilities: insights from discussions with adolescents and young people seeking sexual and reproductive health needs

Introduction. South Africa has an enabling legislative and policy framework that promotes the protection of adolescents and young people’s sexual and reproductive health and rights. Much of the literature in this field has identified discriminatory and hostile attitudes from healthcare workers as a major underlying factor to negative sexual and reproductive health outcomes for this age cohort. Not as well understood is the role of structural violence although this type of violence, through its structures of injustice and inequalities, is closely associated with stigma and discrimination. Data and sources. To contribute to closing this research gap, this paper draws on the findings of a larger qualitative study, specifically focus group discussions with young people aged 15–24 years. Results. The consequences of these attitudes within the structural violence framework are illuminated as are recommendations for enhancing access to sexual and reproductive health and services by adolescents and young people. Discussion and conclusion. Key among the latter is that young people’s sexual and reproductive health needs and wellbeing should be pursued through a multisectoral approach that encompasses stigma reduction interventions involving the young people, families, and communities collaborating with healthcare workers.

The price of love: an investigation into the relationship between romantic love and the expression of obsessive-compulsive disorder

BACKGROUND

The present study explored the influence of romantic love on the expression of several obsessive-compulsive disorder (OCD) characteristics, including symptom severity, symptom dimensions, age at onset, sensory phenomena (SP), and developmental course, as well as other related comorbid disorders. It was hypothesized that love-precipitated OCD would be associated with a set of distinct characteristics and exhibit greater rates of comorbid disorders.

METHODS

The analyses were performed using a large sample (n = 981) of clinical patients with a primary diagnosis of OCD (Females = 67.3%, M age = 35.31).

RESULTS

Love-precipitated OCD was associated with greater severity of SP and later age at onset of obsessions. However, symptom severity, symptom dimension, developmental course, and psychiatric comorbidities were not associated with love-precipitated OCD.

CONCLUSION

It was concluded that romantic love does shape the expression of OCD, especially with regard to SP and onset age. These findings encourage further exploration to determine its clinical significance as a phenotype.

A Learning Experience? Enjoyment at Sexual Debut and the Gender Gap in Sexual Desire among Emerging Adults

Gender differences in experience of first intercourse are among the largest in sexuality research, with women recalling less pleasure and satisfaction than men. This "enjoyment gap" has not been considered in explanations of gender differences in sexual desire. Yet, reinforcement and incentive learning feature prominently in recent models of women's sexual desire, and nonhuman animal models demonstrate their impact at sexual debut. We examined whether women's lower sexual desire is explained by their gender or by gendered experience of enjoyment at sexual debut. Emerging adults (N = 838) provided retrospective accounts of physical (orgasm) and affective (satisfaction) enjoyment at (hetero)sexual debut. We replicated gender differences across behavioral, general, and multidimensional measures of trait sexual desire; however, they were contingent on experience and measurement method. When its cognitive multidimensional properties were appreciated, women's sexual desire varied with experience of orgasm at sexual debut and diverged from men's only when orgasm did not occur. Such effects were not observed for satisfaction, nor for men. Nor did effects of a control event - masturbatory debut - extend beyond solitary sexual desire. Findings underscore the importance of orgasm equality, and suggest its absence at sexual debut may play an unacknowledged role in differentiating sexual desire.

Perceptions and Experiences of Pakistani-Descent Female Adolescents Living in Canada, on Developing Sexuality and Self-Identity

Immigrant adolescents make up a substantial proportion of newcomers to Canada. Most newcomer youth from South Asia aged 15 to 24 are from racialized “visible minority” backgrounds. The sexual health needs of female immigrant adolescents in Canada have been largely unmet and have increased in magnitude over the last few years. For immigrant female adolescents, the silence around issues of sexuality needs can affect their physical, emotional, sexual health, and overall well-being as well as their ability to reach their full potential. Evidence suggests that immigrant adolescents lack sexual and reproductive health knowledge and use fewer sexual health-related services and sex education resources than non-immigrant youth. In Pakistani immigrant adolescents, this difference appears to be associated with socio-cultural and religious practices. The purpose of this study was to qualitatively explore the experience of developing sexuality and its relationship to well-being in middle- to late-female adolescents of Pakistani-descent, living in a large urban area in Canada. The study aimed to establish space for dialogue and to bridge the perceived cultural divide on issues of sexuality using the postmodern feminist lens, which often arises between individuals from different cultural backgrounds. Using the interpretive descriptive methodology, a purposive sample of 21 female adolescents who were of first- or second-generation Pakistan-descent was obtained. Participants included female adolescents aged from 14 to 19 years. Data were collected using a semi-structured interview guide and a timeline. A total of 21 first interviews and seven follow up interviews were conducted. The narratives and timelines presented in this study tell the story of female Pakistani adolescents, their narratives, and the timelines reflect the complexities of the sexuality of female adolescents and how they perceive and attribute meanings to their experiences. The study found that living in a bicultural world can cause significant stress and anxiety among female adolescents, especially when making personal life decisions related to sexuality. Moreover, silence around all aspects of female sexuality negatively affects the capacity for desire and pleasure. In addition, the intersection of gender and patriarchy have created layers of power and oppression in adolescent lives that tightly control their sexuality. The participants’ stories reveal the complex interaction of factors that influence the behavior of female adolescents related to sexuality and sexual health. These findings establish the need for cultural awareness while viewing each girl’s experience in relation to the intersectionality of social spheres such as race, ethnicity, culture, and religion. Finally, this study provides implications to policymakers to revise the existing policies and create youth-friendly policies for immigrant youth to draw attention to the hidden voices of female adolescents and increase the awareness of ways to address issues arising in evolving sexuality.

Behavioral activation / inhibition systems and lifestyle as predictors of mental disorders in adolescent athletes during Covid19 pandemic

The following study investigates the correlational relationship between behavioral activation/inhibition systems, lifestyle and mental disorders in Adolescent Athletes during the Covid-19 pandemic. Methods: Research methods are descriptive and correlational; “Of the eligible participants who were available during a COVID-19 quarantine period from June through August 2020 (N = 180), the Krejcie and Morgan Sampling Method was used to simplify the process of determining the sample size for a finite population [46], resulting in a calculation of N = 130 sample participants. to respond to Carver & White’s Behavioral activation/inhibition systems Scale (BIS/BAS), Mille’s Lifestyle Questionnaire and Goldberg & Williams’s General Health Questionnaire (GHQ-12). Data was analyzed using linear regression analysis and Pearson’s correlation coefficient. Results: Findings showed a positive correlation of statistical significance between behavioral inhibition systems (BIS) and mental disorders in Adolescent Athletes at the 0.01 level and a negative correlation of statistical significance between scaling components of the behavioral activation systems (BAS), lifestyle and mental disorders in Adolescent Athletes at the 0.05 level. Conclusions: Analyzing the data, it can thus be concluded that whilst behavioral inhibition and activation systems seem to work together to significantly predict mental disorders, lifestyle cannot.

Why do young people engage in dating relationships during early adolescence? An inter-generational qualitative analysis from Blantyre, Malawi

Engagement in dating relationships plays an important role in the health trajectories of young people, particularly during the early adolescent period between ages 10-14. Yet little is known about such relationships among youth in low resource contexts. This study sought to contribute to the literature on this topic by exploring reasons why school-going young people aged 12-14 years engage in dating relationships in Blantyre, Malawi. A thematic analysis was used to code and analyse in-depth interview data from 23 young people and 19 caregivers. Against the backdrop of growing sexual desires and feelings of attraction, participants stressed harassment from boys and coercion from older men, peer pressure, social status attainment, financial deprivation and encouragement during initiation ceremonies as reasons for engaging in dating relationships. Girls were found to be subject to multiple power dynamics-including gender power relations, as well as power dynamics within same-gender peer groups-that influenced their sex and relationship involvement. These findings carry implications for the design and timing of sexual and reproductive health youth programmes in Sub-Saharan Africa and emphasise the need for multi-level interventions to address the multiple influences in young people's dating lives.

The Impact of COVID-19 Among Black Girls: A Social-Ecological Perspective

Objective

To explore the impact of the COVID-19 pandemic on Black adolescent girls’ physical, psychological, and sexual development.

Methods

Semistructured interviews were conducted with 25 girls (9–18 years old) primarily across the Midwestern United States. Interviews were conducted until theoretical saturation was reached. We conducted a conventional content analysis by reviewing transcripts, coding data, and developing themes.

Results

Utilizing the social-ecological model findings revealed themes related to the individual-, interpersonal-, institutional-, and community-level changes that Black girls experienced during the COVID-19 pandemic.

Conclusions

Black adolescent girls need opportunities to discuss the changes, receive relevant resources, and have spaces to support their physical, psychological, and sexual development. Systems such as families, schools, and clinics should implement programming to facilitate discussions around the impact of COVID-19 on Black girls.

Risky Sexual Behavior Profiles in Youth: Associations With Borderline Personality Features

Adolescence and young adulthood are peak periods for risky sexual behaviors (RSB) and borderline personality disorder (BPD) features. RSB is a major public health concern and adolescents with BPD may be particularly vulnerable to RSB, but this is understudied. The aim of this study was to identify distinct RSB profiles in youth and determine whether a specific profile was associated with BPD features. Participants were 220 adolescents and young adults (age 14-21) recruited from the community. To identify groups of adolescents and young adults who engage in similar RSB, a latent profile analysis (LPA) was conducted on sexually active youth (57%). Next ANOVA was used to identify how profiles differed in terms RSB dimensions and BPD features. We identified three distinct RSB profiles: (1) a Low RSB profile that was manifested by the majority (77.7%) of youth; (2) an Unprotected Sex in Relationships profile (13.3%) and; (3) an Impulsive Sex Outside Relationships profile (12%) which was manifested by youth with significantly higher BPD features. The findings shed light on the difficulties youth with BPD manifest around integrating sexuality, intimacy, fidelity, and love. This contrasts with the majority of youth who are sexually active in the context of relationships and engage in little or no RSB. The findings have important clinical implications. Adolescent sexuality is frequently in the blind spot of clinicians. To address the elevated risk of RSB in adolescents with BPD, interventions are needed to help adolescents navigate this period and improve their understanding of the reasons for RSB while addressing difficulties in establishing sexual and attachment relationships.

Adolescent Sexual Behavior Patterns, Mental Health, and Early Life Adversities in a British Birth Cohort

This study tested adolescent sexual behavior patterns at age 14, their association with mental health at age 17 (psychological well-being, substance use, and self-harm attempts), and the influence of early life adversities upon this association. A British birth cohort (5,593 boys and 5,724 girls from the Millennium Cohort Study) was used. Latent class analysis suggested five subgroups of adolescent sexual behaviors: a "no sexual behavior" (50.74%), a "kisser" (39.92%), a "touching under clothes" (4.71%), a "genital touching" (2.64%), and an "all sexual activities" class (1.99%). Adolescents from the "kisser," "touching under clothes," "genital touching," and "all sexual activities" classes reported significantly more substance use and self-harm attempts compared to adolescents from the "no sexual behavior" group. The associations became weaker after controlling for early life adversities (reducing around 4.38% to 37.35% for boys, and 9.29% to 52.56% for girls), and reduced to a smaller degree after further controlling for mental health variables at 14. The associations between sexual behaviors and psychological well-being became non-significant after controlling for early life adversities. Adolescents who have engaged in low-intensity sexual activities at early age may have poorer reported mental health, a pattern that is stronger for girls and early life adversity may partially explain this association.

“It Was a Mistake, but We Knew That Something Might Happen”: Narratives of Teenage Girls' Experiences With Unintended Teenage Pregnancy

It has been over a quarter of a century since the sexual reproductive health of young people came under the spotlight. The upsurge in human immunodeficiency virus (HIV) infections spurred on an era of intense development of services and strategies to ensure people's reproductive health rights were attainable, including the right to choose when to fall pregnant and have a baby. The statistics on teenage pregnancy are more than just numbers, but a represent stark reality for some girls in South African schools. Given that pregnancy in the teenage years is largely unintentional, prevention strategies need to extend beyond addressing risky sexual behavior; gaining deeper insights into teenagers' experiences and the events leading up to pregnancy would serve to better inform pregnancy prevention programs. This study explored the experiences of teenage mothers and pregnant teenagers, with the objective of acquiring a broader understanding of alternative approaches to preventing unintended pregnancy. A qualitative study was conducted in Ekurhuleni's township in the east of Johannesburg, South Africa. Fifteen narrative interviews with girls aged 13–19 years were conducted between July 2015 and July 2016, and were analyzed chronologically through narrative analysis. The findings revealed that participants who had engaged in socio-sexual and romantic relationships had no intention of falling pregnant and were familiar with existing strategies to prevent pregnancy. Social-sexual relationships were presented as an important aspect of their lives and demonstrated their ability to create spaces and opportunities to spend time with their social sexual partners and engage in sexual activity. Focusing on how teenage girls evaluate their sexual activity against the consequences of their actions is critical. However, sexual and reproductive health programs should refrain from representing young people's sexual behavior as a pathological condition, framing it instead as an integral component of creative sexual development. Programs should include relevant practical advice in relation to sexual engagement and be considered an extension of the State's existing Road to Health program.

The Self-Identification, LGBTQ+ Identity Development, and Attraction and Behavior of Asexual Youth: Potential Implications for Sexual Health and Internet-Based Service Provision

While often included in the spectrum of sexual minority identities, asexuality receives comparatively little attention. Awareness and understanding remains limited, and knowledge has been generated primarily from adult populations. This paper employs a sample of 711 self-identified asexual youth (aged 14-24, M = 17.43 years) who identified as members of the LGBTQ+ community to consider the implications of a number of different areas for service provision. Two-thirds (66.8%) of participants identified as gender minorities within the spectrum of transgender and non-binary identities. Findings include aspects of participants' LGBTQ+ developmental processes, including that only 14.3% had disclosed their LGBTQ+ status to everyone in their lives. However, just 2.4% had disclosed to no one. Their attraction and sexual activity were also explored, with 27.1% having never experienced any kind of romantic or sexual attraction and 20.6% having ever been sexually active. Findings regarding participants' accessing of LGBTQ+ health information and engagement in a range of offline and online LGBTQ+ community activities are also provided. Participants acquired more health information online than offline-including sexual health information. Recommendations for service provision, particularly implications for sexual health and Internet-based services, are discussed.

Identifying Factors Influencing Attention in Adolescents with a Co-Created Questionnaire: A Citizen Science Approach with Secondary Students in Barcelona, Spain

Studies on factors that can influence attention in healthy adolescents are recent and focus on recurrent topics. Students' contribution to public health research often revolves around collecting data but rarely around creating data collection instruments. The ATENC!Ó project reunited secondary students and scientists to create a questionnaire including factors that students thought could affect their attention. We conducted a cross-sectional study to assess whether the factors included in this questionnaire had an effect on attention in adolescents. A total of 1667 students (13-16 years old) from 28 schools in Barcelona performed a validated attention test and answered the questionnaire. The response speed consistency (attentiveness), expressed as hit reaction time standard error (HRT-SE, in ms), was used as the primary outcome. Analyses were conducted using conditional linear regression with school as strata, adjusted for sociodemographic characteristics and further stratified by gender and maternal social class. Some factors showed a negative influence on attention, including taking medication and not reading regularly. We found a significant 14.3% (95% confidence interval: 3.4%, 25.3%) higher median of HRT-SE (increase inattentiveness) among students who reported not having a good relationship with classmates. Students' input into research is relevant for advancing the knowledge production in public health.

Leisure Boredom, Timing of Sexual Debut, and Co-Occurring Behaviors among South African Adolescents

Sex during adolescence is normative; however, there are substantial individual differences in the timing and context of sexual debut. Leisure boredom is an underexplored correlate of sexual behavior that is associated with many adolescent health outcomes. We investigated if and how individual differences in leisure boredom may be associated with timing of sexual debut, and whether individuals engage in safe or risky behaviors at debut. Survival analysis, logistic regression, and Poisson regression were applied to eight-wave longitudinal data obtained from 3,088 South African adolescents (baseline M_age = 13.9 years) to examine associations between leisure boredom and cumulative hazard of sexual debut across adolescence, odds of co-occurring sexual behaviors, and incidence rate of co-occurring sexual risk behaviors at debut. Higher levels of leisure boredom were associated with elevated hazard cumulatively across adolescence. Higher levels of leisure boredom were also associated with lower odds of safe sex and higher odds of substance use during sex and transactional sex at sexual debut, but not casual sex or condom non-use at sexual debut. Although odds of singular risk behaviors were lower for girls than for boys, the association between leisure boredom and the number of risk behaviors at sexual debut was stronger for girls than boys. Higher trait leisure boredom was associated with elevated hazard of sexual debut, greater likelihood that risky behaviors accompanied sexual debut, and greater number of co-occurring risky behaviors at sexual debut. Results support leisure boredom as a potential target for preventing sexual risk behavior among South African adolescents.

Puberty Initiates Cascading Relationships Between Neurodevelopmental, Social, and Internalizing Processes Across Adolescence

Adolescence is a period of dramatic developmental transitions-from puberty-related changes in hormones, bodies, and brains to an increasingly complex social world. The concurrent increase in the onset of many mental disorders has prompted the search for key developmental processes that drive changes in risk for psychopathology during this period of life. Hormonal surges and consequent physical maturation linked to pubertal development in adolescence are thought to affect multiple aspects of brain development, social cognition, and peer relations, each of which have also demonstrated associations with risk for mood and anxiety disorders. These puberty-related effects may combine with other nonpubertal influences on brain maturation to transform adolescents' social perception and experiences, which in turn continue to shape both mental health and brain development through transactional processes. In this review, we focus on pubertal, neural, and social changes across the duration of adolescence that are known or thought to be related to adolescent-emergent disorders, specifically depression, anxiety, and deliberate self-harm (nonsuicidal self-injury). We propose a theoretical model in which social processes (both social cognition and peer relations) are critical to understanding the way in which pubertal development drives neural and psychological changes that produce potential mental health vulnerabilities, particularly (but not exclusively) in adolescent girls.

Earlier age of sex and substance use initiation is associated with unique hormone profiles during social evaluative threat in Mexican American adolescents

Latinx adolescents are at a disproportional risk for poor sexual and reproductive health outcomes (STIs, adolescent pregnancy) compared to other ethnic groups. They also report high rates of alcohol and drug use that are similar to non-Hispanic White youth. The hormonal underpinnings of the emergence of sex and substance use behaviors among Latinx adolescents remain understudied however. Pubertal shifts in motivation and reward-seeking in social situations are closely tied to the emergence of risky sexual and substance use behaviors. The experience of developing earlier or later than same age peers may increase stress (cortisol) reactivity during social evaluative situations leading to more risky behavior. Further, testosterone can be responsive to social evaluative threat (SET) and is linked to status-seeking behavior, including risk-taking. The current study sought to unravel the complex relationship between cortisol and testosterone responsivity to social evaluative threat, pubertal status, and the emergence of sex and drug use among US-born Mexican-origin youth growing up in an agricultural community. Mexican American 14-year olds (N = 234, 54% female) from the Center for Health Assessment of Mothers and Children (CHAMACOS) participated in the Trier Social Stress Test. Cortisol and testosterone were assayed from saliva. At 16, youth reported on age at vaginal and oral sex initiation, and alcohol and marijuana use initiation. Hierarchical regressions examined cortisol and testosterone reactivity, and pubertal status within each sex to predict the onset of these risky behaviors. Results indicated that boys who were less developed than their same-aged peers or with lower testosterone reactivity and elevated cortisol reactivity to the TSST reported the earliest sex and substance use initiation. For girls, higher cortisol reactivity predicted earlier alcohol use initiation, and higher testosterone reactivity predicted earlier oral sex. Our results suggests it is important for health care providers to not overlook Latinx boys who may look younger in discussions about mitigating risk. Latinx girls under increased stress may be more likely to try to self-medicate with alcohol, and potentially other drugs.

Emotions relating to romantic love-further disruptors of adolescent sleep

OBJECTIVE

Early-stage romantic involvement may resemble hypomania in its manifestation on behavioral, physiological, and psychological levels. Previous research suggests that self-reported sleep duration may diminish as a result of falling in love during adolescence. We investigated how feelings of infatuation are related to subjective and objective measures of sleep duration, quality, and timing.

METHODS

1374 adolescents (66% girls; mean age: 16.9, SD=0.6 years) selected from the population register responded to online questionnaires regarding romantic love, mental well-being, and sleep behavior. A subsample (n=309) underwent a week-long actigraphy measurement (GENEActiv Original). We compared the sleep duration, quality, and timing of those who reported being in the early stages of love to those who were not.

RESULTS

11% of all participants reported being in the early stages of romantic love. Those girls and boys who were in love had higher scores of depression and anxiety than others. Girls who were in love reported poorer sleep quality, later sleep timing, and shorter sleep duration both on weekdays (mean difference: 32 minutes, p≤0.001) and at weekends (15 minutes, p=0.037) than those who were not in love. Actigraphy measurements were similar (sleep duration mean difference: 27 minutes, p=0.04).

CONCLUSIONS

We conclude that romantic love is one further cause for short or poor quality sleep in girls and may relate to symptoms of depression and anxiety in both sexes. However, feelings of infatuation contain important developmental lessons.

The Invisible Product: Preferences for Sustained-Release, Long-Acting Pre-exposure Prophylaxis to HIV Among South African Youth

BACKGROUND

Long-acting injectable and implantable approaches aim to overcome some of the documented challenges with uptake and adherence to current HIV prevention methods. Youth are a key end-user population for these methods. We used qualitative methods to examine product attributes and preferences for current and future long-acting HIV prevention approaches.

METHODS

Ninety-five South African youth aged 18-24 years, of whom 62 were female and 33 male, completed 50 interviews and 6 focus groups. We purposively selected for previous product experience, including oral pre-exposure prophylaxis, injectable pre-exposure prophylaxis, or the vaginal ring, to ensure participants' opinions were rooted in actual experience.

RESULTS

Irrespective of previous method-use experience, gender, or sexual orientation, the majority expressed a preference for prevention methods formulated as injectables or implants. Several mentioned that their top priority in any product was efficacy, and for some, this overrode other concerns; for example, even if they feared pain, an implant or an injectable would be used if fully protective. Although efficacy was a top priority, there was also a clear desire across all subgroups for a product that would not interfere with sex, would stay in the system to provide protection, and that caused minimal burden, or was not apparent to others, and these characteristics were most salient for long-acting methods.

CONCLUSIONS

Narrative explanations for preferences converged thematically around different dimensions of "invisibility" including invisibility to oneself, one's partner and household members, and community members. End-user preferences can be used to inform product development of long-acting HIV prevention approaches formulated as injections or implants to optimize adherence and impact.

Interdisciplinary Work Is Essential for Research on Puberty: Complexity and Dynamism in Action

Puberty is associated with changes in behavior and psychosocial well-being, and is important in lifelong health. We present five different facets regarding interdisciplinary research that are important to puberty. A short history of philosophical issues instrumental in promoting early interdisciplinary research is first presented. We discuss then what is hard and what is easy about interdisciplinary research, the purpose of which is to alert scientists to challenges and opportunities for interdisciplinary research on puberty. Readers then are introduced to advances and obstacles in interdisciplinary research on development. Recommendations for tailoring graduate education toward interdisciplinarity are introduced. Finally, issues related to publication, education of scientists, and policy makers are described. The report concludes with a discussion of funding and policy issues.

Next Steps in Puberty Research: Broadening the Lens Toward Understudied Populations

Decades of puberty research have yielded key scientific discoveries. Building on the field's rich history, we highlight four understudied populations: youth of color, boys, sexual minority youth, and gender minority youth. We explore why scientific study has been slow to evolve in these groups and propose paths forward for exciting new work. For ethnically racially diverse youth, we discuss the need to incorporate culture and context. For boys, we highlight methodological issues and challenges of mapping existing conceptual models onto boys. For sexual and gender minority youth, we discuss unique challenges during puberty and suggest ways to better capture their experiences. With an eye toward a new era, we make recommendations for next steps and underscore the importance of transdisciplinary research.

Puberty and the human brain: Insights into adolescent development

Alongside the exponential flourish of research on age-related trajectories of human brain development during childhood and adolescence in the past two decades, there has been an increase in the body of work examining the association between pubertal development and brain maturation. This review systematically examines empirical research on puberty-related structural and functional brain development in humans, with the aim of identifying convergent patterns of associations. We emphasize longitudinal studies, and discuss pervasive but oft-overlooked methodological issues that may be contributing to inconsistent findings and hindering progress (e.g., conflating distinct pubertal indices and different measurement instruments). We also briefly evaluate support for prominent models of adolescent neurodevelopment that hypothesize puberty-related changes in brain regions involved in affective and motivational processes. For the field to progress, replication studies are needed to help resolve current inconsistencies and gain a clearer understanding of pubertal associations with brain development in humans, knowledge that is crucial to make sense of the changes in psychosocial functioning, risk behavior, and mental health during adolescence.

A resilience framework: Sexual health trajectories of youth with maltreatment histories

There is a wealth of knowledge regarding negative sexual outcomes experienced by youth with childhood maltreatment (CM) histories, yet a dearth of research examines healthy sexual development among these youth. This gap exists despite evidence of resilience highlighting alternative and healthy physical, social, and psychological futures for youth who were abused. This study tested whether trajectories of resilience identified in studies of psychological functioning were applicable to sexual health. Using data from the first four waves of the National Longitudinal Study of Adolescent to Adult Health, latent class growth analysis was conducted among individuals with histories of CM (N = 1,437). On average, participants were 15, 16, 21, and 28 years old, respectively, by waves of data collection. About half of the sample was female (55%), the majority were White (66%), and a sizeable portion had experienced multiple forms of CM prior to Wave I (38%). Controlling for CM severity, three distinct sexual health trajectory classes were identified: resilient, survival, and improving, which were differentiated by age and biological sex. Older participants' sexual health was more likely to diminish over time, girls were more likely to show gains in sexual health over time, and significant differences in levels of sexual behaviors between the classes were only present during adolescence. Findings support the need for increased attention on the potential for sexual health despite experiences of CM, and highlight the applicability of resilience theory to youth sexuality.

Importance of investing in adolescence from a developmental science perspective

This review summarizes the case for investing in adolescence as a period of rapid growth, learning, adaptation, and formational neurobiological development. Adolescence is a dynamic maturational period during which young lives can pivot rapidly-in both negative and positive directions. Scientific progress in understanding adolescent development provides actionable insights into windows of opportunity during which policies can have a positive impact on developmental trajectories relating to health, education, and social and economic success. Given current global changes and challenges that affect adolescents, there is a compelling need to leverage these advances in developmental science to inform strategic investments in adolescent health.

The Role of Religiosity in Adolescents' Compulsive Pornography Use: A Longitudinal Assessment

Despite increasing concerns that adolescent men are vulnerable to developing compulsive pornography use, little research has been done in this area. Given recent theorizing and research concerning moral incongruence, we hypothesized that symptoms of compulsive pornography use should generally be associated with higher levels of pornography use and increased growth in male adolescent pornography use over time, but that this pattern would be attenuated among very religious participants. These hypotheses were tested with mixed effects growth models using two independent panel samples of male Croatian adolescents. As expected, adolescent men who reported features of compulsive pornography use tended to exhibited higher levels of pornography use. However, contrary to expectations, increased growth in pornography use was limited to more religious compulsive users. Compared to nonreligious compulsive users, these adolescents started with lower initial levels of pornography use and their use increased over time at a greater rate of change. This study's results are the first to suggest that some adolescent men who report high levels of pornography use tend to exhibit symptoms of compulsive use, which highlights a need for counseling and therapeutic attention. Our findings also have implications for the emerging theory of moral incongruence.

The physiology of adolescent sexual behaviour: A systematic review

Objectives: To examine physiological influences of adolescent sexual behaviour, including associated psychosocial factors. Methods: Systematic review. Results: Thirteen studies met the inclusion criteria relating to adolescents, physiology and sexual behaviour. We excluded studies relating to abnormal development. Findings highlighted hormonal and gender differences. Females appear to be more influenced by psychosocial aspects, including the effects of peers, than males. Males may be more inclined to engage in unprotected sex with a greater number of partners. Early maturing adolescents are more likely to be sexually active at an early age. Conclusions: Hormonal, psychosocial context, and sexual preference need to be acknowledged in intervention development. Stage of readiness to receive information may differ according to gender and physiological maturity.