Effects of self-esteem and academic performance on adolescent decision-making: an examination of early sexual intercourse and illegal substance use

A cross-sectional historical study on the changes in self-esteem among Chinese adolescents from 1996 to 2019

This study aimed to investigate the changes in self-esteem levels among Chinese adolescents from 1996 to 2019. In this cross-sectional historical study, 109 articles using the Rosenberg Self-esteem Scale (SES) were selected from three Chinese and five English databases. The results showed that: (1) The self-esteem level of Chinese adolescents was positively correlated with the period, indicating that the self-esteem of Chinese adolescents was gradually increasing. (2) The increase in self-esteem level of girls was higher than that of boys. (3) The increase in the self-esteem level of only child was higher than that of non-only child. (4) The self-esteem level of rural adolescents increased year by year. However, the self-esteem level of urban adolescents was not significantly correlated with the years. (5) The changes in macro social factors can significantly predict the upward trend of the self-esteem level of Chinese adolescents.

Structural model of resilience based on parental support: the mediating role of hope and active coping

Resilience is an essential trait in the academic and non-academic lives of students that has been associated with positive psychological and non-psychological outcomes. Given the importance and role of resilience, the main goal of this study was to create a structural model of resilience based on parental support and emphasizing the mediating role of hope and coping. The research design was correlational in nature and used structural equation modeling (SEM). The population of this study included high school students in Tehran city in 2019-2020 school year, and the sample consisted of 560 students selected by cluster sampling method. By applying Spearman correlation analysis and structural equation modeling, a significant relationship between hope, coping, resilience, and parental support was found. Both the SEM measurement and structural models provided a good fit. The significant findings of the present study include the direct and significant effect of parental support on resilience. The indirect and significant effect of parental support on resilience through the mediating role of hope and coping was also confirmed. Overall, the results of this study show that the effect of parental support on resilience can be improved by promoting hope and coping styles.

The role of primary school composition in affective decision-making: a prospective cohort study

PURPOSE

School-level characteristics are known to be associated with pupils' academic and cognitive ability but also their socioemotional development. This study examines, for the first time, whether primary school characteristics are associated with pupils' affective decision-making too.

METHODS

The sample included 3,141 children participating in the Millennium Cohort Study with available data on their school's characteristics, according to the National Pupil Database, at age 7 years. Decision-making was measured using the Cambridge Gambling Task at age 11 years. We modelled data using a series of sex-stratified linear regression analyses of decision-making (risk-taking, quality of decision-making, risk adjustment, deliberation time, and delay aversion) against four indicators of school composition (academic performance and proportions among pupils who are native speakers of English, are eligible for free school meals and have special educational needs).

RESULTS

After adjustment for individual and family-level confounding, schools with a higher average academic performance showed more delay aversion among males, and among females, higher deliberation time and lower risk-taking. Schools with proportionally more native English speakers had higher deliberation time among males. Schools with proportionally more pupils eligible for free school meals showed lower scores on quality of decision-making among males. Schools with proportionally more children with special educational needs showed better quality of decision-making among males and lower risk-taking among females.

CONCLUSION

The findings of this study can be used to target support for primary schools. Interventions aiming to support lower-achieving schools and those with less affluent intakes could help to improve boys' affective decision-making.

How Can Unintended Pregnancies Be Prevented among Adolescents Who Engaged in Sexual Intercourse at Earlier Ages? The Role of Female Education and Partner Age Difference

Several studies have identified explicative factors for adolescents' sexual risk behaviors and related outcomes such as unintended pregnancy; however, less is known about the mechanisms through which such factors act. Our study explored the role of female education and partner age difference as explicative mechanisms of the association between age at first sexual intercourse (AFSI) and unintended pregnancy while controlling for the role of other contextual factors (i.e., socioeconomic status, ethnicity, religious beliefs, and place of residence) and sexual-related mechanisms (i.e., number of sexual partners) that are known to be associated with adolescent pregnancy. The sample consisted of 613 sexually experienced female adolescents who did not intend to become pregnant: 349 were pregnant for the first time, and 264 had never been pregnant. Mediation and moderation analyses were performed. An earlier AFSI was associated with unintended pregnancy 1-6 years after first sexual intercourse by increasing the adolescents' likelihood of having less education and being involved with partners older than themselves. There was no significant direct effect of AFSI on pregnancy occurrence after controlling for the mediators. Our findings bring to light nonsexual mechanisms that must be considered in public health interventions aimed at preventing unintended pregnancies among adolescents who engaged in sexual intercourse at early ages. Specific implications are discussed.

Thinking about the past, present, and future: Time perspective and self-esteem in adolescents, young adults, middle-aged adults, and older adults

We examined time perspective and self-esteem in adolescents, young adults, middle-aged adults, and older adults. Time perspective was measured with scales that assess relative orientations and relationships among the past, present, and future. Age effects were examined with standard analytic strategies to determine categorical differences between age groups and with new statistical techniques designed to show continuous age patterns. Findings indicated that (1) thinking about the future was greatest for adolescents and young adults and lowest for middle-aged and older adults, and thinking about the present increased across ages; (2) fewer adolescents and middle-aged participants perceived that the time periods were interrelated compared to younger and older adults; and (3) across ages, a greater emphasis towards the past compared to other time periods was associated with lower self-esteem, whereas emphasizing the present and the future jointly was associated with higher self-esteem.

The Occurrence of Sexual Risk Behaviors and Its Association With Psychological Well-Being Among Kenyan Adolescents

Objective: Sexual risk behavior during adolescence is an important public health problem. Self-esteem and hopefulness are potentially important psychological factors that may play a role in the behavioral regulation mechanisms of adolescents. These factors are inadequately explored in sub-Saharan Africa. This study aimed at exploring patterns and associated factors for sexual risk behavior (SRB), self-esteem, and hopefulness among adolescents from a resource-poor setting in Kenya.

Method: A cross-sectional study conducted in 2019 among 296 adolescents (12–17 years old) from rural Kilifi (n = 133) and urban informal settings of Nairobi (n = 163) in Kenya. Participants completed the Kilifi Health Risk Behavior Questionnaire, Rosenberg self-esteem questionnaire, and Hope scale administered via computerized tablets. A binary outcome variable based on the experience of adolescents of at least one of the five forms of SRB: transactional sex, sexual violence, intergenerational sex, early sexual debut, and condom non-use was generated. Bi-variate analysis was conducted to summarize various social-demographic and psychosocial factors. A multivariable logistic regression model was fitted to investigate factors associated with the occurrence of SRB, self-esteem, and hopefulness among adolescents.

Results: About 13% of the participants had experienced a form of SRB, and among these, 36% reported co-occurrence of multiple forms of SRB. Adolescent SRB was largely characterized by having experienced sexual violence, as well as intergenerational and transactional sex. Higher scores of hopefulness were reported among adolescents who never experienced SRB (P = 0.03) at bivariate analysis level. However, both self-esteem and hopefulness were not significantly associated with the occurrence of SRB in the adjusted logistic regression analysis. Having depressive symptoms (Adj. OR = 3.8, 95% CI: 1.39–10.4), feeling unsafe in the neighborhood (Adj. OR = 3.4, 95% CI: 1.6–7.2), and being in higher compared with lower primary education level (Adj. OR = 0.3, 95% CI: 0.1–0.8) were statistically significantly associated with the occurrence of SRB.

Conclusion: Targeted reproductive health interventions, designed with the cognizance of structural and social drivers of adolescent SRB, are needed to concurrently tackle multiple forms of SRB. It is important to integrate mental health promotion within these interventions. More research is needed to understand the mechanisms and implications of self-esteem and hopefulness for adolescent sexual and reproductive health.

A very present help: The role of religious support for Black adolescent girls' mental well-being

This study explored religious emotional support as a mediator of the association between organized religious involvement (ORI) and mental well-being among African American and Caribbean Black girls. Data are drawn from a nationally representative survey of Black adolescents. The sample was composed of African American (n = 412) and Caribbean Black (n = 165) girls, aged 13-17. Structural equation modeling tested direct and indirect effects of ORI on mental well-being, through religious emotional support. For African American girls, ORI was not directly related to any of the mental well-being outcomes. Religious emotional support mediated the association between ORI and self-esteem, mastery, and life satisfaction. For Caribbean Black girls, ORI was negatively associated with mastery and life satisfaction. Religious emotional support mediated the association between ORI and life satisfaction. Results suggest that the well-being benefits of ORI for Black girls only remain significant in the presence of religious emotional support and are different for ethnic subgroups.

Adventure-based training to enhance resilience and reduce depressive symptoms among juveniles: A randomized controlled trial

There is growing concern about mental health problems among juveniles. Evidence shows that adventure-based training can reduce depressive symptoms in school children. However, a rigorous empirical investigation of the effectiveness of such training in enhancing resilience among juveniles has not yet been performed. In this study, a randomized controlled trial was conducted to examine the effectiveness of adventure-based training in enhancing resilience and self-esteem and reducing depressive symptoms among juveniles. Secondary school students from grades 7 to 9 (aged 12-16 years) who attended the Integrated Children and Youth Services Centre in a large public housing estate in Hong Kong from December 20, 2018 to November 25, 2019 were invited to participate in this study. We randomly assigned 228 eligible adolescents to an experimental group (n = 115) that received a 2-day/1-night adventure-based training or a placebo control group (n = 113) that received 2 days of leisure activities organized by the Integrated Children and Youth Services Centre. Data were collected at baseline and 3 and 6 months after the corresponding interventions. The primary outcome was resilience at 6 months. The secondary outcomes were depressive symptoms and self-esteem at 6 months. Compared with the placebo control group, the experimental group showed significantly higher resilience (p = 0.001) and fewer depressive symptoms (p = 0.02) at 6 months, and significantly higher self-esteem at 3 months (p = 0.04), but not at 6 months (p = 0.12). However, the generalizability of the findings is limited as we used a convenience sample.

Local realities or international imposition? Intersecting sexuality education needs of Ghanaian adolescents with international norms

The content of comprehensive sexuality education (CSE) programmes is contested in many parts of the world, yet we know less about what primary beneficiaries (learners) consider as (in) appropriate school curriculum. I examined this phenomenon in Ghana. Data generated from focus group discussions suggests that, overall, participants used positive phrases to describe the need for sexuality education. The prevalent and recurrent needs of adolescents centred around personal reproductive health hygiene, pregnancy prevention, healthy relationships, reproductive infections and control, reproductive physiology and maturation, gender differences and sexual orientations, and sexual pleasure and pain. However, these needs varied in some ways between males and females and between early adolescents and older adolescents. The study shows that what adolescents seek to learn fall within international norms/standards on CSE. However, some of these concepts were not covered in the guidelines proposed for Ghana. The prevalent view among many opponents that CSE is not driven by local need may not be consistent with adolescents' own aspirations and realities. The voices of children and adolescents should constitute part of the discussions on the form and content of sexuality education.

Correlates of depression among Black girls exposed to violence

Depression rates for youth remanded to juvenile detention is double that of the general population and Black girls are especially vulnerable. A dearth of literature analyzes the factors that are correlated with depression among system-involved Black girls, ages 12-17 years old. We utilized personal agency to examine the relationship between risk factors (i.e., abuse history, and fear of condom negotiation) and protective factors (i.e., condom self-efficacy, and perceived social support) that might correlate with depression among Black girls exposed to violence. Findings indicate that fear of condom negotiation, abuse history and low condom self-efficacy are correlated with depressive symptomology while self-esteem and perceived social support are protective factors that may serve as a buffer against girls' feelings of helplessness and hopelessness. The findings of this study suggest several implications for prevention and intervention efforts to reduce the depression-related risks among justice-involved Black females, including strategies that promote healing within their social support networks.

School Well-Being and Drug Use in Adolescence

This research is part of the last study Drugs and School IX developed in the Basque Country (Spain) by the Instituto Deusto de Drogodependencias (Deusto Institute of Drug Addiction) of the University of Deusto (The study had the support of the Public Health and Addictions Directorate of the Deputy Health Ministry from the Health Department of the Basque Country.) and the data gathered by means of cluster sampling in two stages. The sample is made up of N = 6,007 girls and boys ranging from 12 to 22 years of age in secondary education, and the aims, on the basis of those parameters, are as follows: (1) describe the reality of drug consumption and some psychosocial variables in this sample, as well as analyze several relations between variables; (2) analyze the role of school well-being (SWB), self-esteem, and self-concept regarding consumption; (3) take a close look at the moderating role of age and gender on the relationship of school well-being, self-concept, and self-esteem with consumption; and (4) understand the existing interaction between all these variables, by studying the moderating role of self-esteem and self-concept in the influence of school well-being on consumption. With the use of a correlation, hierarchical regression, and mediation analysis with SPSS (v. 26) and Amos (v. 26) applications, three main conclusions were reached. Firstly, educational and academic well-being, academic self-concept, and self-esteem seem to play the role of protecting factors in adolescence, whereas assertiveness is linked to a higher consumption level. Secondly, academic self-concept has a mediating effect between well-being and consumption. Some of these relations are moderated by the variables of gender and age. Thirdly, age and gender are very relevant sociodemographic variables that must be taken into account in order to understand this phenomenon. Age has shown its covariant effect, which is especially relevant in the influence of academic well-being measured as being held back years. It has also proved to be important in order to understand its experiential or experimental and transitory character. Moreover, significant differences in consumptions have been found based on gender.

Adolescent Mediators of Unplanned Pregnancy among Women with and without Childhood ADHD

We aimed to identify adolescent mediators of the significant and sizable link between childhood attention deficit/hyperactivity disorder (ADHD) and later unplanned pregnancy in our prospectively followed, all-female sample. Participants included an ethnically diverse (47% non-White) sample of women with (n = 140) and without (n = 88) childhood ADHD who were assessed 4 times across childhood, adolescence, and adulthood. Potential mediators were measured via self, parent, and teacher report on questionnaires and interviews and by objective testing. We tested 5 early adolescent variables in three domains (personality, behavioral, and academic) as components of serial mediation pathways from (a) childhood ADHD status to (b) the early adolescent putative mediator to (c) risky sexual behavior in late adolescence and finally to (d) unplanned pregnancy by early adulthood. Of these, academic achievement (indirect effect = .1339, SE = .0721), 95% confidence interval (CI) [.0350, .3225] and substance use frequency (indirect effect = .0211, SE = .0167), 95% CI [.0013, .0711] operated through late-adolescent risky sexual behavior to explain rates of unplanned pregnancy, even adjusting for the effects of age, IQ, and family socioeconomic status (SES). When these 2 indirect effects were entered simultaneously, only the pathway from childhood ADHD to low academic achievement to higher rates of risky sexual behavior to unplanned pregnancy was significant (indirect effect = .0295, SE = .0145), 95% CI [.0056, .0620]. We discuss the significance of these early adolescent mediators, particularly academic engagement, as potential intervention targets intended to reduce rates of later unplanned pregnancies among female individuals with ADHD.

Effects of a life-skills-based prevention program on self-esteem and risk behaviors in adolescents: a pilot study

BACKGROUND

Risk behaviors among young people are a major social and public health issue. This study aims to assess the impact of a life-skills-based prevention program (called Mission Papillagou) on self-esteem, well-being, and risk behaviors among adolescents.

METHOD

In a two-arm controlled study involving 520 school pupils aged between 10 and 15 years old, participants taking part in the prevention program (the Papillagou group) were compared to pupils who did not take part (the control group). Two assessment sessions were performed, one at baseline, and one after either the Mission Papillagou program (Papillagou group) or usual lessons (control group). Participants self-reported on their self-esteem, well-being, behaviors, interests and opinions.

RESULTS

The Mission Papillagou program significantly improved Self-Esteem scores (ηρ² = .035). Well-being (Cramér's V = .14) and mood ("feeling of depression": Cramér's V = .503; "feeling hopelessness about the future": Cramér's V = .357; "waking up at night": Cramér's V = .343) also improved in the Papillagou group compared to the control group. Regarding risk behaviors, the prevention program produced a decrease in the frequency of insults (Cramér's V = .267) and rumor-spreading (Cramér's V = .440), and a change of opinion toward the possibility of smoking an electronic cigarette in the future (Cramér's V = .372).

CONCLUSION

This study suggests that life-skills-based risk prevention programs are effective.

Teen Girls' Reproductive Attitudes and the Timing and Sequencing of Sexual Behaviors

PURPOSE

Teen girls consider not only health outcomes, such as pregnancy or contracting a sexually transmitted infection (STI), but also social outcomes, such as guilt or embarrassment, when making decisions about sexual behaviors.

METHODS

Following a sample of female virgins aged 15-18 years from wave I through wave IV of the National Longitudinal Study of Adolescent to Adult Health (N = 2,376), we tested whether adolescent girls' attitudes toward sex, contraception, pregnancy, and STIs influence the timing of coital debut, using discrete time event history logistic regression, and whether oral sex precedes coital debut, using logistic regression.

RESULTS

Concerns about negative social consequences of sex were associated with later coital debut (adjusted odds ratio [AOR]=.79, p = .000), whereas perceived physical benefits of sex and positive attitudes toward contraception were associated with earlier coital debut (AOR = 1.09, p = .049 and AOR = 1.17, p = .002, respectively). Worries about pregnancy were not associated with the timing of coital debut but did predict having oral sex before vaginal sex (AOR = 1.33, p = .007). Favorable birth control attitudes and positive attitudes toward sex also increased the odds of oral sex before vaginal sex (AOR = 1.38, p = .008 and AOR = 1.47, p = .000, respectively).

CONCLUSIONS

Teen girls' worries about the emotional and social consequences of sex may be a more salient predictor of the timing of coital debut than concerns about the risk of pregnancy or STIs. Teen girls' fears coexist with positive views about sex and contraception, which are associated with earlier sex and sexual sequencing.

Perceived factors influencing the initiation of methamphetamine use among Akha and Lahu youths: a qualitative approach

Background

Methamphetamine use not only impacts health and the economy but also causes social impairment, particularly among the poorly educated and underprivileged young populations among the hill tribes in northern Thailand. Youths are the most vulnerable population for methamphetamine use due to various factors, including parenting styles, childhood exposure, and location of the village. This qualitative approach aimed to investigate the perceived factors influencing the initiation of methamphetamine use among the Akha and Lahu youths in northern Thailand.

Methods

A qualitative approach was used to elicit the information from key informants of Akha and Lahu youths who lived in villages in Chiang Rai province. A sixteen-question guideline was developed and examined for quality by three experts in the field and piloted before use. In-depth interviews were conducted among 19 Akha and 22 Lahu youths, serving as key informants from four villages, in a private and confidential room in their villages between June and August 2018. Each interview lasted approximately an hour. A thematic analysis was performed to evaluate the information.

Results

In total, 41 participants (19 Akha and 22 Lahu) from 4 villages participated in the study. According to the context and content obtained, four major perceived factors (low self-esteem, family member use, positive expectation regarding methamphetamine use, and availability), and five supportive factors (social norm perception, school dropout, family level problems, poor economic, and no Thai citizenship) were found to contribute to the initiation of methamphetamine use among the Akha and Lahu youths in northern Thailand.

Conclusions

Akha and Lahu youths are initiating methamphetamine use due to several factors, including living in a poor family and in a remote area. All relevant government agencies with a mission to prevent and protect against methamphetamine use should consider the perceived factors influencing the initiation of methamphetamine use in these populations in order to develop a powerful program to stop methamphetamine use.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-7226-y) contains supplementary material, which is available to authorized users.

Unpacking the Longitudinal Associations between the Frequency of Substance Use, Substance Use Related Problems, and Academic Achievement among Adolescents

Previous research repeatedly observed associations between academic achievement and substance use during adolescence. However, the simple frequency of substance use was not differentiated from the emergence of substance use related problems, such as abuse and dependence. This study presents autoregressive cross-lagged models describing inter-relations between academic achievement, frequency of substance use, and substance use related problems among a sample of 1034 seventh graders (46% female; 83% White North Americans; Mage = 12.64 years, SD_age = 0.65) who participated in a four-year longitudinal study. The stability of measurement structure of frequency of substance use and substance use related problems was supported. Higher frequency of substance use and substance use related problems did not predict lower academic achievement. A higher academic achievement predicted a later increase in frequency of substance use and substance use related problems in boys, whereas a higher academic achievement predicted a lower frequency of substance use in girls. Although substance use related problems were mainly predicted by frequency of substance use, substance use can remain, nonetheless, non-problematic during adolescence.

School Contextual Factors and Race Differences in Adolescent Sexual Behaviors

While there exist a voluminous number of studies examining predictors of adolescent sexual behavior, few studies have explored the role of the school social context in influencing teen sexual activity generally and specifically, the role that school contextual factors play in helping understand race differences in risky sexual behaviors. Using data from a nationally-representative school-based survey of American youth in grades 7-12, we find support for our core hypothesis that school contextual factors are associated with risky sexual behavior, number of sexual partners, and ever having sex, albeit it nuanced ways and that such factors cannot account for much of the race gap in adolescent sexual behavior. We interpret these findings to be more supportive of a social contagion model (versus a school climate model).

Adolescents' Sexual Wellbeing in Southwestern Uganda: A Cross-Sectional Assessment of Body Image, Self-Esteem and Gender Equitable Norms

Measures of sexual wellbeing and positive aspects of sexuality in the World Health Organization definition for sexual health are rarely studied and remain poorly understood, especially among adolescents in Sub-Saharan Africa. The objective of this study was to assess sexual wellbeing in its broad sense-i.e., body image, self-esteem, and gender equitable norms-and associated factors in young adolescents in Uganda. A cross-sectional survey of adolescents ages 10-14 years in schools was carried out between June and July 2016. Among 1096 adolescents analyzed, the median age was 12 (Inter-Quartile Range (IQR): 11, 13) and 58% were female. Self-esteem and body image scores were high with median 24 (IQR: 22, 26, possible range: 7-28) and median 22 (IQR: 19, 24, possible range: 5-25) respectively. Gender equitable norms mean score was 28.1 (SD 5.2: possible range 11-44). We noted high scores for self-esteem and body image but moderate scores on gender equitable norms. Girls had higher scores compared to boys for all outcomes. A higher age and being sexually active were associated with lower scores on gender equitable norms. Gender equitable norms scores decreased with increasing age of adolescents. Comprehensive and timely sexuality education programs focusing on gender differences and norms are recommended.

Early Sexual Initiation and Mental Health: A Fleeting Association or Enduring Change?

The present research examined how the within-person association between sexual initiation and internalizing symptoms decays over time, using data with annual measurement occasions across adolescence (N = 1,789) and statistical models of within-person change. Sexual initiation was associated with increased levels of internalizing symptoms for early-initiating girls (ninth grade, approximately age 15), but not for on-time-initiating girls or for boys. The association between girls' early sexual initiation and internalizing symptoms declined precipitously over time. Indeed, 1 year after sexual debut, early-initiating girls were similar to on-time or noninitiating girls on internalizing symptoms, suggesting early sexual initiation does not produce lasting detriments to girls' mental health. Findings inform how researchers perceive sexual initiation, both as a developmental milestone and as a prevention target.

Teachers and Coaches in Adolescent Social Networks Are Associated With Healthier Self-Concept and Decreased Substance Use

BACKGROUND

Poor academic (eg, "I am a bad student") and behavioral (eg, "I am a troublemaker") self-concepts are strongly linked to adolescent substance use. Social networks likely influence self-concept. However, little is understood about the role teachers and athletic coaches play in shaping both academic and behavioral self-concepts.

METHODS

We analyzed cross-sectional surveys of 929 9th-12th grade low-income minority adolescents in Los Angeles assessing self-concept, social networks, and 30-day use of alcohol, marijuana and other drugs. We performed generalized estimating equations, accounting for clustering at the school level and controlling for family and peer influences and contextual factors. We also tested whether self-concept-mediated associations between relationships with teachers or coaches and 30-day substance use.

RESULTS

More perceived teacher support was associated with lower odds of marijuana and other drug use and better academic and behavioral self-concepts. Behavioral self-concept mediated the associations between teacher support and substance use.

CONCLUSIONS

By facilitating relationships with adults and improving teachers' capacity to build supportive environments, schools may positively shape how adolescents see themselves, which might help reduce adolescent substance use.

Age at Time of Initial Sexual Intercourse and Health of Adolescent Girls

Adolescence is characterized by marked changes in the body, psychology, and sexual behavior due to increasing production of hormones. In this review we aimed to assess the effect of age at the time of first sexual intercourse (sexarche) on the health of adolescent girls, and identify factors that might protect against early initiation of sexual relations in girls. The PubMed, Lilacs, and Google Scholar databases were searched for clinical trials, comparative studies, case-control studies, cross-sectional studies, cohort studies, multicenter studies, observational studies, meta-analyses, and systematic reviews published up to December 2014 on this theme. The search terms were: "sexual debut," "coitarche," "sexarche," and "young people," "adolescent," "unplanned pregnancy," "adolescent contraception," and "STDs." Data were extracted from 28 studies and 41 references were used to introduce the theme and to support the discussion. Sexarche has been occurring in increasingly younger girls. A young age at sexarche can lead to subsequent risky sexual behavior. Girls who have sexarche when they are 14 years old or younger are less likely to use contraception on this occasion, take more time before they start using contraception in subsequent sexual relations, are more likely to have several sex partners, have a higher risk for depression, have lower self-esteem and more episodes of repentance, and have a higher risk for a sexually transmitted disease and cervical cancer. Girls with low educational, socioeconomic, and cultural status, little parental monitoring, parental separation, and absence of religiosity tend to experience sexarche at a younger age. Adolescent girls who postpone sexarche until they are 16 years old are physically and psychologically healthier than those who have sexarche at a younger age. This suggests that providing adolescent girls with appropriate education about sexual relations might reduce the negative effect of sexual relations at a young age.

Risk and protective factors associated with adolescent girls' substance use: Data from a nationwide Facebook sample

BACKGROUND

Despite overall reductions in teenage substance use, adolescent girls' rates of substance use remain unacceptably high. This article examines whether girls' substance use is associated with general risk and protective factors (goal setting, problem solving, refusal skills, peer use, and self-efficacy) and gender-specific risk and protective factors (communication style, coping skills, self-esteem, body image, perceived stress, anxiety, and depression).

METHODS

Cross-sectional data were collected in 2013 via online surveys from a nationwide sample of adolescent girls (N = 788), aged 13 and 14 years, who were recruited through Facebook.

RESULTS

In multivariate analyses, controlling for correlates of adolescent substance use, 11 of the 13 general and gender-specific risk and protective factors were consistently associated with past-month alcohol, cigarette, and other drug use in the expected direction; past-month marijuana use was associated with 8 of the 13 factors. Refusal skills, peer use, coping, and depressive mood were most consistently and strongly associated with substance use.

CONCLUSIONS

Substance abuse prevention programs targeting adolescent girls should focus on such general risk and protective factors as problem solving, refusal skills, peer influences, and self-efficacy, as well as such gender-specific risk and protective factors as communication style, coping, self-esteem, body image, perceived stress, and mood management.

Effectiveness of Positive Youth Development Interventions: A Meta-Analysis of Randomized Controlled Trials

Positive youth development is thought to be essential to the prevention of adolescent risk behavior and the promotion of thriving. This meta-analysis examined the effects of positive youth development interventions in promoting positive outcomes and reducing risk behavior. Ten databases and grey literature were scanned using a predefined search strategy. We included studies that focused on young people aged 10-19 years, implemented a positive youth development intervention, were outside school hours, and utilized a randomized controlled design. Twenty-four studies, involving 23,258 participants, met the inclusion criteria and were included in the analysis. The impact of the interventions on outcomes including behavioral problems, sexual risk behavior, academic achievement, prosocial behavior and psychological adjustment were assessed. Positive youth development interventions had a small but significant effect on academic achievement and psychological adjustment. No significant effects were found for sexual risk behaviors, problem behavior or positive social behaviors. Intervention effects were independent of program characteristics and participant age. Low-risk young people derived more benefit from positive youth development interventions than high-risk youth. The studies examined had several methodological flaws, which weakened the ability to draw conclusions. Substantial progress has been made in the theoretical understanding of youth development in the past two decades. This progress needs to be matched in the intervention literature, through the use of high-quality evaluation research of positive youth development programs.

RELATIONSHIP OF ASSESS SELF-ESTEEM AND LOCUS OF CONTROL WITH QUALITY OF LIFE DURING TREATMENT STAGES IN PATIENTS REFERRING TO DRUG ADDICTION REHABILITATION CENTERS

Objective:

Thus, the present research was carried out aimed at determining the relationship between self-esteem and locus of control and quality of life during treatment stages in the patients referring to drug addiction rehabilitation centers of Borujen city, Iran.

Methods:

The current study was a sectional research of descriptive correlation type. The research sample was 150 individuals of patients referring to addiction rehabilitation centers of Borujen city. For data gathering, Rosenberg Self-esteem Scale, Rotter’s Locus of Control Scale, and SF36 Quality of Life Questionnaire were used. Following collection of questionnaires, the data were analyzed using SPSS/16 software.

Results:

According to the results, in the 12^th day of treatment, 96 patients exhibited moderate self-esteem, 102 patients had internal locus of control, and the score of their overall quality of life was 40.43±12.71. Furthermore, Pearson’s correlation coefficient indicated that a significant and positive relationship was observed between locus of control and quality of life during different treatment stages.

Conclusion:

It seems that quality of life improves during addiction treatment stages due to improvement of personality traits including locus of control and self-esteem. Therefore, consultation methods as a very crucial priority in addiction rehabilitation centers shall be taken into account by the health sector authorities and managers and can play an essential role in enhancing quality of life.

Decreasing Risk Factors for Later Alcohol Use and Antisocial Behaviors in Children in Foster Care by Increasing Early Promotive Factors

Children in foster care are at high risk for poor psychosocial outcomes, including school failure, alcohol and other substance abuse, and criminal behaviors. Promoting healthy development by increasing broad-impact positive skills may help reduce some of the risk factors for longer-term negative outcomes. School readiness has been linked to a number of positive outcomes across childhood, adolescence, and adulthood, and may also boost intermediary positive skills such as self-competence. This paper presents findings from a longitudinal study involving 192 children in foster care who were 5 years old at the start of the study. They participated in a randomized controlled trial of a school readiness program to prepare them for kindergarten. Outcomes were assessed at third grade (9 years old) on variables associated with risk for later involvement in substance use and delinquency. These included positive attitudes towards alcohol use, positive attitudes towards antisocial behaviors, and involvement with deviant peers. Results showed that the intervention decreased positive attitudes towards alcohol use and antisocial behaviors. Further, the mediating role of children's self-competence was tested. The intervention positively influenced children's third-grade self-competence, which in turn, decreased their involvement with deviant peers. Findings suggest that promoting school readiness in children in foster care can have far-reaching, positive effects and that increased self-competence may be a mechanism for reducing risk.

An ecological analysis of secondary school students' drug use in Hong Kong: A case-control study

BACKGROUND

Youth drug use is a significant at-risk youth behaviour and remains as one of the top priorities for mental health services, researchers and policy planners. The ecological characteristics of secondary school students' behaviour in Hong Kong are understudied.

AIM

To examine individual, familial, social and environmental correlates of drug use among secondary students in Hong Kong.

METHOD

Data were extracted from a school survey with 3078 students. Among the 3078 students, 86 students reported to have used drugs in the past 6 months. A total of 86 age- and gender-matched controls with no drug-use behaviour in the past 6 months were randomly selected from the remaining students. Multiple logistic analysis was used to examine differential correlates between those who used and did not use substance in the past 6 months.

RESULT

Positive school experience and perspective to school and parental support are protective factors of drug use. Lower self-esteem, lower self-efficacy against using drugs and higher level of permissive attitude towards drugs were associated with drug use. Students who were low in self-esteem and rather impulsive tend to use drugs.

CONCLUSION

To prevent students from drug use, efforts in individual, family, school and community-levels should be addressed.

Longitudinal family effects on substance use among an at-risk adolescent sample

OBJECTIVE

Adult and peer factors may influence whether adolescents use alcohol and other drugs (AOD). This longitudinal study examined the direct effects of adult monitoring, perceived adult AOD use, and cultural values on adolescent AOD use.

METHODS

Participants were 193 at-risk adolescents referred to a California diversion program called Teen Court for a first-time AOD offense. We assessed youth reports of past 30day AOD use (any alcohol use, heavy drinking, marijuana use), demographics, changes in parental monitoring and family values (from baseline to follow-up 180days later), as well as family structure and perceived adult substance use at follow-up.

RESULTS

Adolescents who reported that a significant adult in their life used marijuana were more likely to have increased days of drinking, heavy drinking, and marijuana use at follow-up. Higher levels of familism (importance the teen places on their family's needs over their own needs) and being in a nuclear family served as protective factors for future alcohol use. Additionally, poor family management was associated with increased alcohol use and heavy drinking.

CONCLUSION

Findings highlight how family management and perceptions of adult marijuana use influence subsequent adolescent AOD use, and how an increase in familism over time is associated with a decrease in adolescent drinking. Tailoring interventions, by including the teen's family and/or providing support to adults who use AOD may be crucial for improving interventions for adolescent AOD use.

Correlates of high school freshman girls' reported reasons for engaging in sexual intercourse

BACKGROUND

Intrapersonal and external factors, including social pressures and the desire for acceptance from peers, influence sexual activity among adolescents. This study examined how personal characteristics, risky behaviors, normative beliefs, household factors, and engagement in extracurricular activities were related to high school freshman girls' reported reasons for having sexual intercourse.

METHODS

Baseline data were analyzed from 158 girls enrolled in high school-based abstinence-only-until-marriage education programs during their freshman year. Binary logistic regression was performed to identify factors associated with Pressures and Reasons for Engaging in Sex Scale (PRESS) scores.

RESULTS

Results indicate that girls with high PRESS scores were significantly more likely to have had sex (OR = 4.29), consumed alcohol within the previous year (OR = 6.13), reported strict household rules (OR = 1.49), and thought more girls their age had sex (OR = 1.67).

CONCLUSION

School- and family-based interventions should be developed to encourage and strengthen parent-teen communication within the household and reinforce self-worth and positive self-perceptions among adolescent girls.

Sex differences in associations of school connectedness with adolescent sexual risk-taking in Nova Scotia, Canada

BACKGROUND

Associations of lower school connectedness have been seen with adolescent sexual risk behaviors, but little is known about gender differences with respect to these relationships. Understanding any such differences could contribute to better supporting the school environment to promote youth sexual health.

METHODS

We used provincially representative cross-sectional data from 1415 sexually active students in grades 10 to 12 in Nova Scotia, Canada, to determine whether lower school connectedness was associated with students' sexual risk behaviors using multivariate logistic regression, stratifying by sex.

RESULTS

In boys, lower connectedness was associated with three risk behaviors, having  ≥ 2 partners in the previous year (odds ratio [OR] 1.07; 95% confidence interval [CI] 1.01-1.13), no condom use at last intercourse (OR 1.06; 95% CI 1.01-1.12), and having unplanned intercourse due to substance use (OR 1.09; 95% CI 1.03-1.15). No such associations were seen in girls.

CONCLUSIONS

These results demonstrate that gender differences may exist for associations of school connectedness and sexual risk behaviors; connectedness may be more important for boys than for girls in this area of adolescent health. Educators should consider gender differences when designing interventions to maximize youth sexual health through school-based interventions. Further research on school connectedness and risk-taking should examine genders separately.

Associations among text messaging, academic performance, and sexual behaviors of adolescents

BACKGROUND

Text messaging is an increasingly common mode of communication, especially among adolescents, and frequency of texting may be a measure of one's sociability. This study examined how text messaging ("texting") frequency and academic performance are associated with adolescent sexual behaviors.

METHODS

A cross-sectional survey was administered to students at a public charter high school in Los Angeles County, CA. Two hundred fifty-six high school students aged 14-20 years participated. Outcome measures were history of vaginal sex, condom use, and worries about pregnancy. The main predictors were text messaging frequency and self-reported academic performance.

RESULTS

In general, students with lower grades were more likely to have had vaginal sex. Greater texting frequency, however, was associated with vaginal sex only among students with higher grades. In addition, despite similar rates of condom use, sexually active students who both had good grades and texted frequently were more likely than others to have thought they or their partner might be pregnant.

CONCLUSIONS

The association between texting and sexual behaviors may vary based on adolescent's academic performance. Adolescent sexual health interventions may benefit from using a combination of sociability measures (such as texting frequency) and academic performance as risk predictors.

Sexual behavior among Brazilian adolescents, National Adolescent School-based Health Survey (PeNSE 2012)

OBJECTIVE: This study describes the sexual behavior among students who participated in the National Adolescent School-based Health Survey (PeNSE) 2012 and investigates whether social inequalities, the use of psychoactive substances and the dissemination of information on sexual and reproductive health in school are associated with differences in behavior. METHODOLOGY: The response variable was the sexual behavior described in three categories (never had sexual intercourse, had protected sexual intercourse, had unprotected sexual intercourse). The explanatory variables were grouped into socio- demographic characteristics, substance use and information on sexual and reproductive health in school. Variables associated with the conduct and unprotected sex were identified through multinomial logistic regression, using "never had sexual intercourse" as a reference. RESULTS: Over nearly a quarter of the adolescents have had sexual intercourse in life, being more frequent among boys. About 25% did not use a condom in the last intercourse. Low maternal education and work increased the chance of risky sexual behavior. Any chance of protected and unprotected sex increased with the number of psychoactive substances used. Among those who don't receive guidance on the prevention of pregnancy in school, the chance to have sexual intercourse increased, with the largest magnitude for unprotected sex (OR = 1.41 and OR = 1.87 ). CONCLUSION: The information on preventing pregnancy and STD/AIDS need to be disseminated before the 9th grade. Social inequalities negatively affect risky sexual behavior. Substance use is strongly associated with unprotected sex. Information on the prevention of pregnancy and STD/AIDS need to be disseminated early.

Latent class analysis of substance use among adolescents presenting to urban primary care clinics

BACKGROUND

Polysubstance use during adolescence is a significant public health concern. However, few studies have investigated patterns of substance use during this developmental window within the primary care setting.

OBJECTIVES

This study used an empirical method to classify adolescents into substance use groups, and examines correlates of the empirically defined groups.

METHODS

Data came from patients, ages 12-18 years, presenting to an urban, primary care community health clinics (Federally Qualified Health Centers) in two cities in the Midwestern United States (n = 1664). Latent class analysis (LCA) was used to identify classes of substance users. Multinomial logistic regression was used to examine variables associated with class membership.

RESULTS

LCA identified three classes: class 1 (64.5%) exhibited low probabilities of all types of substance use; class 2 (24.6%) was characterized by high probabilities of cannabis use and consequences; and class 3 (10.9%) had the highest probabilities of substance use, including heavy episodic drinking and misuse of prescription drugs. Those in class 2 and class 3 were more likely to be older and have poorer grades, poorer health, higher levels of psychological distress and more sexual partners than those in class 1. Individuals in class 3 were also less likely to be African-American than those in class 1.

CONCLUSION

Findings provide novel insight into the patterns of substance use among adolescents presenting to low-income urban primary care clinics. Future research should examine the efficacy of interventions that address the complex patterns of substance use and concomitant health concerns among adolescents.

Protective and risk factors of early sexual initiation in youth subcultures

OBJECTIVES

To assess the association between subculture affiliation (Hip-hop, Techno-scene, Metal, Punk, Skinheads) and early sexual initiation, and whether gender, family affluence, peer influence, lack of parental bonding and lack of parental monitoring explain this association.

METHODS

We collected data on 15-year-old primary school pupils who participated in the Health Behaviour in School-aged Children 2009/2010 study. The association of subculture affiliation with early sexual initiation was adjusted for gender, family affluence, peer influence, lack of parental bonding and lack of parental monitoring in five consecutive models using logistic regression.

RESULTS

Nearly 50% of the adolescents had a subculture affiliation. These youths were significantly more likely than other adolescents to have had sexual intercourse. Peer influence explained 49% of this association. Adding lack of parental bonding and lack of parental monitoring into the model weakened the association of subculture affiliation with early sexual initiation (20%), but this association remained statistically significant.

CONCLUSION

Youth subculture affiliation is strongly correlated with early sexual initiation. This association is mediated for a large part by peer influence and defective parental monitoring and bonding. Health promotion regarding early sexual initiation should therefore in particular target adolescents under strong influence of peers and with weak parental relationships.

Early sexual debut and condom nonuse among adolescents in South Korea

BACKGROUND

The purpose of this study was to investigate the factors related to sexual debut among adolescents, and to examine the association between subject characteristics and condom nonuse among those who experienced sexual intercourse in South Korea.

METHODS

Data were obtained from the 2009 Korean Youth Risk Behaviour Survey, a nationally representative sample. Logistic regression analysis was conducted to investigate the factors related to sexual debut, associations of condom nonuse and subject characteristics.

RESULTS

Among male adolescents, age, early age at first emission, low academic achievement, living with a step-parent, perceived low level of household income, frequent drinking and smoking, and depressive feelings were associated with early sexual debut. Attending a coeducational school, living with a single biological parent and step-parent, risky health behaviour such as drinking and smoking, and depressive feelings were related risks factors for early sexual debut among female students. Factors associated with condom nonuse included early sexual debut (less than 16 years of age) (odds ratio (OR)=1.79, 95% confidence interval (CI)=1.32-2.43) and frequent smoking behaviour (OR=1.49, 95% CI=1.08-2.05) for males and early sexual debut (OR=4.37, 95% CI=1.02-18.68) and frequent drinking (OR=2.05, 95% CI=1.12-3.75) for females.

CONCLUSIONS

Appropriate interventions should be implemented for adolescents in Korea to delay sexual debut and educate them on the proper use of condoms.

Moving beyond the trait conceptualization of self-esteem: the prospective effect of impulsiveness, coping, and risky behavior engagement

Past research has largely focused on examining self-esteem as an independent as opposed to a dependent variable. At the same time, research suggests that during adolescence, self-esteem is subject to yearly, monthly, as well as daily change, and consequently, it is important to identify underlying vulnerability factors and behaviors, which shape self-esteem lability. In the current multi-wave, longitudinal study, 142 adolescents between the ages of 12-18 completed monthly assessments across 4 months. At the initial assessment, adolescents provided self-report data pertaining to impulsiveness, maladaptive coping, risky behavior engagement, and self-esteem. At each of the follow-up assessments, adolescents provided information about risky behavior engagement and self-esteem. Results of time-lagged, idiographic multilevel mediation analyzes indicated that risky behavior engagement mediated the relationship between impulsiveness/maladaptive coping and subsequent low self-esteem. Critically, when included in the same model, impulsiveness was significant above and beyond maladaptive coping. Additionally, the reverse model with self-esteem as the predictor and risky behavior included as the dependent variable was not significant suggesting that our effect was unidirectional. As a whole, these findings suggest that impulsive youth may engage in behaviors, which ultimately precipitate negative self-evaluations and transient declines in self-esteem.