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McCabe G, Godwin JW, Rothenberg WA, Goulter N, Lansford JE. Fast Track Intervention Effects and Mechanisms of Action Through Established Adulthood. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024:10.1007/s11121-024-01736-0. [PMID: 39392546 DOI: 10.1007/s11121-024-01736-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2024] [Indexed: 10/12/2024]
Abstract
Early preventive interventions can improve outcomes in childhood, but the most effective interventions can continue to deliver benefits through the life course. The Fast Track intervention, a randomized controlled trial for children at risk of conduct problems, has lowered psychopathology, substance use problems, and criminality and elevated happiness at age 25. However, research has not studied whether the intervention's effects continue further into established adulthood. In addition, little is known about the mechanisms through which the intervention may affect adult outcomes. We attempted to answer both questions by simultaneously estimating the intervention's direct effect on adult outcomes at age 31 and the intervention's indirect effects on those outcomes via interpersonal, intrapersonal, and academic competencies gained through the intervention. Participants included the Fast Track intervention (n = 445; 72.4% male) and high-risk control samples (n = 446; 66.4% male). Direct and total effects of random assignment to Fast Track on age 31 outcomes were not significant. However, our analyses showed that Fast Track's improvements to interpersonal and intrapersonal skills in childhood served as catalysts for better life outcomes at age 31. Higher interpersonal skills led to fewer externalizing, internalizing, and substance use problems, reduced criminality and sexual partners, in addition to increased general health and full-time employment. Improved intrapersonal skills led to greater strength. There were no significant indirect pathways via academic skills. Our findings inform understanding of how a childhood preventive intervention can improve adjustment and behaviors into established adulthood.
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Affiliation(s)
- George McCabe
- Duke University, Center for Child and Family Policy, Durham, USA
| | | | | | - Natalie Goulter
- Flinders University, College of Education, Psychology, & Social Work, Flinders Institute for Mental Health & Wellbeing, Adelaide, Australia.
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Ray AE, Mun EY, Lewis MA, Litt DM, Stapleton JL, Tan L, Buller DB, Zhou Z, Bush HM, Himelhoch S. Cross-Tailoring Integrative Alcohol and Risky Sexual Behavior Feedback for College Students: Protocol for a Hybrid Type 1 Effectiveness-Implementation Trial. JMIR Res Protoc 2023; 12:e43986. [PMID: 36716301 PMCID: PMC10131715 DOI: 10.2196/43986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/04/2023] [Accepted: 01/23/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Underage drinking and related risky sexual behavior (RSB) are major public health concerns on United States college campuses. Although technology-delivered personalized feedback interventions (PFIs) are considered a best practice for individual-level campus alcohol prevention, there is room for improving the effectiveness of this approach with regard to alcohol-related RSB. OBJECTIVE The aims of this study are to (1) evaluate the impact of a brief PFI that integrates content on alcohol use and RSB and is adapted to include a novel cross-tailored dynamic feedback (CDF) component for at-risk first-year college students and (2) identify implementation factors critical to the CDF's success to facilitate future scale-up in campus settings. METHODS This study uses a hybrid type 1 effectiveness-implementation design and will be conducted in 3 phases. Phase 1 is a stakeholder-engaged PFI+CDF adaptation guided by focus groups and usability testing. In phase 2, 600 first-year college students who drink and are sexually active will be recruited from 2 sites (n=300 per site) to participate in a 4-group randomized controlled trial to examine the effectiveness of PFI+CDF in reducing alcohol-related RSB. Eligible participants will complete a baseline survey during the first week of the semester and follow-up surveys at 1, 2, 3, 6, and 13 months post baseline. Phase 3 is a qualitative evaluation with stakeholders to better understand relevant implementation factors. RESULTS Recruitment and enrollment for phase 1 began in January 2022. Recruitment for phases 2 and 3 is planned for the summer of 2023 and 2024, respectively. Upon collection of data, the effectiveness of PFI+CDF will be examined, and factors critical to implementation will be evaluated. CONCLUSIONS This hybrid type 1 trial is designed to impact the field by testing an innovative adaptation that extends evidence-based alcohol programs to reduce alcohol-related RSB and provides insights related to implementation to bridge the gap between research and practice at the university level. TRIAL REGISTRATION ClinicalTrials.gov NCT05011903; https://clinicaltrials.gov/ct2/show/NCT05011903. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/43986.
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Affiliation(s)
- Anne E Ray
- Department of Health, Behavior & Society, College of Public Health, University of Kentucky, Lexington, KY, United States
| | - Eun-Young Mun
- Department of Health Behavior and Health Systems, School of Public Health, The University of North Texas Health Science Center at Fort Worth, Fort Worth, TX, United States
| | - Melissa A Lewis
- Department of Health Behavior and Health Systems, School of Public Health, The University of North Texas Health Science Center at Fort Worth, Fort Worth, TX, United States
| | - Dana M Litt
- Department of Health Behavior and Health Systems, School of Public Health, The University of North Texas Health Science Center at Fort Worth, Fort Worth, TX, United States
| | - Jerod L Stapleton
- Department of Health, Behavior & Society, College of Public Health, University of Kentucky, Lexington, KY, United States
| | - Lin Tan
- Department of Health Behavior and Health Systems, School of Public Health, The University of North Texas Health Science Center at Fort Worth, Fort Worth, TX, United States
| | | | - Zhengyang Zhou
- Department of Biostatistics and Epidemiology, School of Public Health, The University of North Texas Health Science Center at Fort Worth, Fort Worth, TX, United States
| | - Heather M Bush
- Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, United States
| | - Seth Himelhoch
- Department of Psychiatry, College of Medicine, University of Kentucky, Lexington, KY, United States
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Goulter N, Craig SG, McMahon RJ. Primary and secondary callous-unemotional traits in adolescence are associated with distinct maladaptive and adaptive outcomes in adulthood. Dev Psychopathol 2023; 35:274-289. [PMID: 34009113 DOI: 10.1017/s0954579421000481] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
While phenotypically indistinguishable with respect to callousness, individuals with primary and secondary callous-unemotional (CU) traits may show different developmental outcomes. This research predominantly comprised cross-sectional studies of male participants with a focus on maladaptive correlates. Thus, the present study examined whether youth with primary and secondary CU traits identified in Grade 7 reported distinct maladaptive outcomes (internalizing, externalizing, and substance use problems; criminal offenses; and sexual and partner experiences) and adaptive outcomes (health and wellbeing, education, and employment) in adulthood at age 25. We also examined sex differences. Participants included the high-risk control and normative samples from the Fast Track project (N = 754, male = 58%, Black = 46%). Youth with secondary CU traits reported higher levels of adult internalizing and externalizing psychopathology, a greater number of sexual partners and risky sexual behavior, and a greater number of violent offenses, compared with individuals with primary CU traits and those with low CU and anxiety symptoms. Conversely, youth with primary CU traits and low symptoms had higher wellbeing and happiness scores than those with secondary CU traits. Finally, there was differentiation on outcomes between female primary and secondary CU variants and male primary and secondary CU variants.
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Affiliation(s)
- Natalie Goulter
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Stephanie G Craig
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
- LaMarsh Centre for Child and Youth Research, York University, Toronto, ON, Canada
| | - Robert J McMahon
- Department of Psychology, Simon Fraser University, Burnaby, BC, Canada
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
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Cavalcante FDBF, Nepomuceno MV, Arruda Gomes DMDO, Câmara SF. Individual's Reproductive Strategies Moderates the Association Between Facial Width-to-Height and Risk-Taking Propensity. EVOLUTIONARY PSYCHOLOGY 2022; 20:14747049221096758. [PMID: 35791511 PMCID: PMC10355301 DOI: 10.1177/14747049221096758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 04/06/2022] [Accepted: 04/09/2022] [Indexed: 11/15/2022] Open
Abstract
Previous research has yielded mixed findings on the relationship between facial width-to-height ratio (fWHR), an androgen-dependent feature, and risk-taking propensity. We argue that mixed findings might result from overlooked variables. Given that risk-taking propensity might be ultimately linked to a search for mating opportunities, we analyze if reproductive strategies moderate the relationship between fWHR and risk-taking propensity. Our results, obtained from a sample of 434 male participants, show a positive association between fWHR and recreational and social risk-taking only for men who are more motivated to focus on mating effort over offspring survival. This finding aligns with research arguing that risk-taking may be a mating strategy since being social and recreational risk-prone might illustrate physical and psychological qualities and improve one's ability to attract mates. Our results support the notion that risk-taking might be a domain-specific construct. Overall, our research is in line with recent findings suggesting that the impact of testosterone exposure on risk-taking propensity is best understood when considering the role of contextual variables. Consequently, we add to previous research that studies related to risk-taking propensity should account for reproductive strategies.
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Elshiekh HF, de Vries H, Hoving C. Assessing sexual practices and beliefs among university students in Khartoum, Sudan; a qualitative study. SAHARA J 2021; 18:170-182. [PMID: 34872445 PMCID: PMC8654397 DOI: 10.1080/17290376.2021.2011390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
University students in Sudan are more at risk of contracting HIV than the general population, due to a high rate of sexual activity and low uptake of preventive measures such as condoms. Hence, they are considered an important target for HIV prevention programmes. This study explored students` beliefs about abstinence and pre-marital sex. Thirty semi-structured individual interviews were conducted, based on constructs from the Integrated Change (I-Change) Model. The study sample included 16 (53%) male and 14 (47%) female university students. Their average age was 21.2 years (Range 18–27 and SD 2.5). Both sexual abstainers (N = 19) and sexually active students (N = 11) perceived HIV severity and susceptibility. Most of the participants had a positive attitude towards abstinence. However, sexually active students also perceived some advantages of engaging in sexual practices, such as sexual pleasure and proving adulthood. Sexually active students more often mentioned being influenced in their sexual practices by their peers than by their families. Sexually active students reported lower self-efficacy to refrain from sex than abstainers. Interventions that seek to promote abstinence among those willing to achieve this should stress the advantages of abstinence from sex until marriage, offer tools to resist peer pressure and enhance self-efficacy to abstain. These findings can be used to develop comprehensive HIV prevention programmes that primarily promote abstinence among university students who are not yet sexually active but also consider promoting condom use and other safer-sex practices among those who are sexually active. These interventions should also be gender-sensitive to address the needs of both male and female students.
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Affiliation(s)
- Husameddin Farouk Elshiekh
- Department of Health Promotion, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Hein de Vries
- Department of Health Promotion, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Ciska Hoving
- Department of Health Promotion, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
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Lin YT, Hsu JW, Huang KL, Tsai SJ, Su TP, Li CT, Lin WC, Chen TJ, Bai YM, Chen MH. Sexually transmitted infections among adolescents with conduct disorder: a nationwide longitudinal study. Eur Child Adolesc Psychiatry 2021; 30:1187-1193. [PMID: 32725481 DOI: 10.1007/s00787-020-01605-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 07/20/2020] [Indexed: 10/23/2022]
Abstract
Studies have demonstrated that conduct disorder is related to risky sexual behaviors, the dominant risk factor for contracting a sexually transmitted infection (STI). However, the association between conduct disorder and STIs remains unclear. Using the Taiwan National Health Insurance Research Database, 5733 adolescents with conduct disorder and 22,932 age- and sex-matched controls without conduct disorder were enrolled from 2001 to 2009 and were subject to follow-up until the end of 2011. Participants who contracted any STI during the follow-up period were identified. Cox regression analysis was performed to examine the likelihood of subsequently contracting an STI for patients and controls. Patients with conduct disorder were more likely than controls to develop any STI (HR 3.95, 95% CI 2.97-5.26) after adjusting for demographic data, psychiatric comorbidities, and use of medications. Long-term use of second-generation antipsychotics (SGAs) was related to a reduced risk (HR 0.36, 95% CI 0.14-0.91) of developing an STI among patients with conduct disorder. Adolescents with conduct disorder had an increased risk of developing any STI later in life compared with those without conduct disorder. Long-term use of SGAs was associated with a lower risk of subsequent STI.
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Affiliation(s)
- Yu-Tse Lin
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, Taipei, 11217, Taiwan, ROC.,Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Ju-Wei Hsu
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, Taipei, 11217, Taiwan, ROC.,Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Kai-Lin Huang
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, Taipei, 11217, Taiwan, ROC.,Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, Taipei, 11217, Taiwan, ROC.,Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, Taipei, 11217, Taiwan, ROC.,Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.,Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan, ROC
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, Taipei, 11217, Taiwan, ROC.,Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Wei-Chen Lin
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, Taipei, 11217, Taiwan, ROC.,Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.,Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, Taipei, 11217, Taiwan, ROC. .,Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, Taipei, 11217, Taiwan, ROC. .,Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
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Voisin DR, Takahashi LM. The Relationship Between Violence Syndemics and Sexual Risk Behaviors Among African American Adolescents: Implications for Future Research. J Adolesc Health 2021; 68:937-944. [PMID: 33431249 DOI: 10.1016/j.jadohealth.2020.11.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/28/2020] [Accepted: 11/15/2020] [Indexed: 01/20/2023]
Abstract
PURPOSE We present a conceptual framework based on a review of the literature to highlight the interconnecting and reinforcing elements of a violence syndemic and how this syndemic influences sexual risk behaviors among African American heterosexual adolescents. METHODS We review existing peer-reviewed published research from 2000 to 2020 that links a violence syndemic (i.e., racism and race-related stress, neighborhood and police violence, peer violence, and family violence and disruptions) to adolescent sexual risk behaviors. Empirical findings and theoretical underpinnings are used to document this relationship and illuminate the factors that mediate this relationship. RESULTS Empirical studies support the links between specific types of violence and sexual risk behaviors among African American adolescents. Further, existing studies point to the important relationships among the specific types of violence, supporting a violence syndemic approach. CONCLUSIONS While more researchers are examining socio-ecological contextual factors as important predictors for sexual risk behaviors, there remains inadequate understanding about how violence types reinforce one another to heighten sexual risk behaviors among African American heterosexual adolescents. This article presents new directions for adolescent research, especially how a violence syndemic approach can be used to explain sexual risk, but also to refocus intervention design on the complex burdens experienced by this population.
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Affiliation(s)
- Dexter R Voisin
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada.
| | - Lois M Takahashi
- Sol Price School of Public Policy, University of Southern California, Los Angeles, California.
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Kovensky R, Khurana A, Guyer S, Leve LD. Childhood Adversity, Impulsivity, and HIV Knowledge as Predictors of Sexual Risk Outcomes in At-Risk Female Youth. ADOLESCENTS 2021; 1:56-69. [PMID: 33954297 DOI: 10.3390/adolescents1010006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Sexual risk behavior in adolescence can lead to adverse health consequences, particularly for female youth. Most interventions focus on imparting knowledge about the consequences of such behaviors, even though little research has examined whether increasing such knowledge results in desired behavioral changes. Further, individual factors such as impulsivity and childhood adversity might moderate this relationship. We examined associations between HIV knowledge and sexual risk behavior and condom use efficacy in a sample of 122 at-risk females, aged 13-18. HIV knowledge was unrelated to sexual risk behavior, but positively related to condom use efficacy. Impulsivity and childhood adversity had direct effects, with no interaction effects. Increasing HIV knowledge may play an important role in promoting proximal predictors of safer sex practices.
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Affiliation(s)
- Rachel Kovensky
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR 97403, USA
| | - Atika Khurana
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR 97403, USA
- Prevention Science Institute, University of Oregon, Eugene, OR 97403, USA
| | - Sally Guyer
- Prevention Science Institute, University of Oregon, Eugene, OR 97403, USA
| | - Leslie D Leve
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR 97403, USA
- Prevention Science Institute, University of Oregon, Eugene, OR 97403, USA
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Lansford JE, Godwin J, McMahon RJ, Crowley M, Pettit GS, Bates JE, Coie JD, Dodge KA. Early Physical Abuse and Adult Outcomes. Pediatrics 2021; 147:peds.2020-0873. [PMID: 33318226 PMCID: PMC7780955 DOI: 10.1542/peds.2020-0873] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/25/2020] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Because most physical abuse goes unreported and researchers largely rely on retrospective reports of childhood abuse or prospective samples with substantiated maltreatment, long-term outcomes of physical abuse in US community samples are unknown. We hypothesized that early childhood physical abuse would prospectively predict adult outcomes in education and economic stability, physical health, mental health, substance use, and criminal behavior. METHODS Researchers in two multisite studies recruited children at kindergarten entry and followed them into adulthood. Parents completed interviews about responses to the child's problem behaviors during the kindergarten interview. Interviewers rated the probability that the child was physically abused in the first 5 years of life. Adult outcomes were measured by using 23 indicators of education and economic stability, physical health, mental health, substance use, and criminal convictions reported by participants and their peers and in school and court records. RESULTS Controlling for potential confounds, relative to participants who were not physically abused, adults who had been abused were more likely to have received special education services, repeated a grade, be receiving government assistance, score in the clinical range on externalizing or internalizing disorders, and have been convicted of a crime in the past year (3.20, 2.14, 2.00, 2.42, 2.10, and 2.61 times more likely, respectively) and reported levels of physical health that were 0.10 SDs lower. No differences were found in substance use. CONCLUSIONS Unreported physical abuse in community samples has long-term detrimental effects into adulthood. Pediatricians should talk with parents about using only nonviolent discipline and support early interventions to prevent child abuse.
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Affiliation(s)
| | - Jennifer Godwin
- Center for Child and Family Policy, Duke University, Durham, North Carolina
| | - Robert J. McMahon
- Department of Psychology, Simon Fraser University and B.C. Children’s Hospital Research Institute, Burnaby, British Columbia
| | - Max Crowley
- Human Development and Family Studies, Pennsylvania State University, State College, Pennsylvania
| | - Gregory S. Pettit
- Human Development and Family Studies, Auburn University, Auburn, Alabama; and
| | - John E. Bates
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana
| | - John D. Coie
- Center for Child and Family Policy, Duke University, Durham, North Carolina
| | - Kenneth A. Dodge
- Center for Child and Family Policy, Duke University, Durham, North Carolina
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A long-term look at "early starters": Predicting adult psychosocial outcomes from childhood conduct problem trajectories. Dev Psychopathol 2020; 34:225-240. [PMID: 33004093 DOI: 10.1017/s0954579420000760] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Current evidence suggests that multiple pathways of "early-starting" conduct problems exist, including persisting and declining trajectories. Since relatively little is known about the early onset-declining pathway, this study examined the long-term outcomes of different childhood conduct problem trajectories in a disproportionately high-risk sample (N = 754). Parents reported on children's conduct problems at six time points (kindergarten to grade 7). At age 25, psychosocial outcomes were assessed across five domains (psychopathology, substance use, risky sexual behavior, antisocial behavior, and adaptive outcomes). Four childhood conduct problem trajectories were identified: extremely high increasing (EHI; 3.7%), high stable (HS; 22.0%), moderate decreasing (MD; 38.8%), and low decreasing (LD; 35.5%). The EHI and HS groups displayed the poorest psychosocial functioning at age 25, whereas the LD group exhibited the most positive adjustment. Although individuals in the MD group displayed relatively positive adjustment on some outcomes, they displayed more psychopathology and lower well-being in adulthood than the LD group. These findings suggest that there are diverse pathways of early-starting conduct problems, and that all early starters are at risk for later maladjustment. However, the degree and type of risk is related to the severity of conduct problems throughout childhood.
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Kovensky R, Anderson D, Leve LD. Early Adversity and Sexual Risk in Adolescence: Externalizing Behaviors as a Mediator. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2020; 13:173-184. [PMID: 32549929 PMCID: PMC7289910 DOI: 10.1007/s40653-019-00278-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Sexual risk behavior in adolescence can result in serious health consequences that persist across the lifespan, particularly for female youth. While adverse childhood experiences (ACEs) are linked to engagement in sexual risk behavior later in life, little research has examined pathways that may help explain this association. To address this gap, the present study examined whether internalizing and externalizing behaviors mediated the link between (ACEs) and sexual risk behavior in female youth. We examined data from 122 adolescent girls, ages 13-18, who were involved in the juvenile justice system or receiving social supports from local agencies and schools. Girls were asked to report their exposure to ACEs and engagement in sexual risk behavior and caregivers were asked to report on girls' internalizing and externalizing behaviors. Regression analyses indicated that girls who experienced more ACEs and exhibited more externalizing behaviors demonstrated higher rates of sexual risk. Further, externalizing behaviors partially mediated the association between ACEs and sexual risk behavior. Findings suggest that increased exposure to ACEs and higher incidence of externalizing behaviors may place girls at heightened risk for sexual risk behavior. Interventions aimed at decreasing externalizing behaviors may be particularly important in reducing sexual risk behavior among at-risk female youth.
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Affiliation(s)
- Rachel Kovensky
- Department of Counseling Psychology and Human Services, University of Oregon, 1215 University of Oregon, Eugene, OR 97403-1215 USA
| | - Daniel Anderson
- Behavioral Research and Teaching, University of Oregon, Eugene, OR USA
| | - Leslie D. Leve
- Department of Counseling Psychology and Human Services, University of Oregon, 1215 University of Oregon, Eugene, OR 97403-1215 USA
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12
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Houck CD, Barker DH, Hadley W, Menefee M, Brown LK. Sexual Risk Outcomes of an Emotion Regulation Intervention for At-Risk Early Adolescents. Pediatrics 2018; 141:peds.2017-2525. [PMID: 29748192 PMCID: PMC6317536 DOI: 10.1542/peds.2017-2525] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/26/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE With this study, we examined the efficacy of a health intervention program that was focused on emotion regulation (ER) skills in reducing sexual risk behaviors among early adolescents with suspected mental health symptoms. METHODS Seventh grade adolescents with suspected mental health symptoms participated in a 6-week, after-school sexual risk prevention trial in which a counterbalanced, within-school design comparing an ER focused program to a time- and attention-matched comparison group was used. Adolescents completed a computer-based survey regarding their sexual behavior at 6-month intervals for 2.5 years. RESULTS Adolescents who received ER skills training exhibited a delay in the transition to vaginal sex over 30 months compared with those in the comparison condition (adjusted hazard ratio = 0.61; 95% confidence interval [0.42 to 0.89]). They also reported fewer instances of condomless sex over the follow-up period (adjusted rate ratio = 0.36; 95% confidence interval [0.14 to 0.90]). Among those who were sexually active, those in the ER condition reported fewer instances of vaginal or anal sex (adjusted rate ratio = 0.57; 95% confidence interval [0.32 to 0.99]). CONCLUSIONS An intervention used to teach ER skills for the context of health decision-making resulted in lower risk among young adolescents with suspected mental health symptoms by delaying the onset of vaginal sex as well as reducing penetrative acts without a condom. Incorporating emotion education into health education may have important health implications for this age group.
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Affiliation(s)
- Christopher D. Houck
- Bradley Hasbro Children’s Research Center and Rhode Island Hospital, Providence, Rhode Island; and,Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - David H. Barker
- Bradley Hasbro Children’s Research Center and Rhode Island Hospital, Providence, Rhode Island; and,Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Wendy Hadley
- Bradley Hasbro Children’s Research Center and Rhode Island Hospital, Providence, Rhode Island; and,Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Maya Menefee
- Bradley Hasbro Children’s Research Center and Rhode Island Hospital, Providence, Rhode Island; and
| | - Larry K. Brown
- Bradley Hasbro Children’s Research Center and Rhode Island Hospital, Providence, Rhode Island; and,Warren Alpert Medical School, Brown University, Providence, Rhode Island
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Montano GT, McCauley HL, Miller E, Chisolm DJ, Marshal MP. Trends in Parental Monitoring and Knowledge Over Time Between Sexual Minority and Heterosexual Girls. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2017; 27:810-825. [PMID: 29152868 DOI: 10.1111/jora.12316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study assessed whether trajectories of parental monitoring components were different for sexual minority girls (SMGs) compared to heterosexual girls. We recruited 14-19-year-old girls from two adolescent medicine clinics. We estimated growth curve models to compare how components of parental monitoring-adolescent disclosure, parental solicitation, and parental knowledge-changed over 2 years for SMGs and heterosexual girls. SMGs and heterosexual girls had similar trajectory slopes and quadratic forms of adolescent disclosure, but SMGs had consistently lower adolescent disclosure scores. Parental knowledge trajectories indicated differential intercepts and slopes for SMGs compared to heterosexual girls, suggesting potential higher risk for maladaptive behaviors. Results of this study suggest that parental monitoring may operate differently over time for SMGs compared to heterosexual girls.
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Affiliation(s)
| | | | | | - Deena J Chisolm
- The Ohio State University College of Medicine
- The Ohio State University College of Public Health
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Predicting sexual coercion in early adulthood: The transaction among maltreatment, gang affiliation, and adolescent socialization of coercive relationship norms. Dev Psychopathol 2017; 28:707-20. [PMID: 27427801 DOI: 10.1017/s0954579416000262] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study tested a transactional hypothesis predicting early adult sexual coercion from family maltreatment, early adolescent gang affiliation, and socialization of adolescent friendships that support coercive relationship norms. The longitudinal study of a community sample of 998 11-year-olds was intensively assessed in early and middle adolescence and followed to 23-24 years of age. At age 16-17 youth were videotaped with a friend, and their interactions were coded for coercive relationship talk. Structural equation modeling revealed that maltreatment predicted gang affiliation during early adolescence. Both maltreatment and gang affiliation strongly predicted adolescent sexual promiscuity and coercive relationship norms with friends at age 16-17 years. Adolescent sexual promiscuity, however, did not predict sexual coercion in early adulthood. In contrast, higher levels of observed coercive relationship talk with a friend predicted sexual coercion in early adulthood for both males and females. These findings suggest that peers have a socialization function in the development of norms prognostic of sexual coercion, and the need to consider peers in the promotion of healthy relationships.
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Brooks Holliday S, Ewing BA, Storholm ED, Parast L, D'Amico EJ. Gender differences in the association between conduct disorder and risky sexual behavior. J Adolesc 2017; 56:75-83. [PMID: 28182979 PMCID: PMC5504918 DOI: 10.1016/j.adolescence.2017.01.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 01/13/2017] [Accepted: 01/30/2017] [Indexed: 10/20/2022]
Abstract
Despite suggestions that there are gender differences in the association between conduct disorder (CD) and risky sexual behavior, limited empirical research has examined this question. Youth (N = 616) were recruited from four primary care clinics and completed questions related to risky sexual behavior, alcohol and marijuana use, and CD. Results of stratified multivariate models indicated that the association between CD and having four or more lifetime partners, having two or more partners in the last 3 months, and engaging in condomless sex was stronger among female youth. However, the association between CD and alcohol and other drug use before sex was stronger in male youth. This is an important contribution to our understanding of gender-specific manifestations of conduct disorder, and has the potential to inform screening and brief intervention efforts for this population.
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Affiliation(s)
| | - Brett A Ewing
- RAND Corporation, 1776 Main Street, Santa Monica, CA, USA
| | | | - Layla Parast
- RAND Corporation, 1776 Main Street, Santa Monica, CA, USA
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Luk JW, Worley MJ, Winiger E, Trim RS, Hopfer CJ, Hewitt JK, Brown SA, Wall TL. Risky driving and sexual behaviors as developmental outcomes of co-occurring substance use and antisocial behavior. Drug Alcohol Depend 2016; 169:19-25. [PMID: 27750183 PMCID: PMC5140786 DOI: 10.1016/j.drugalcdep.2016.10.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 09/30/2016] [Accepted: 10/03/2016] [Indexed: 11/18/2022]
Abstract
PURPOSE To examine the associations between substance use and antisocial behavior trajectories and seven risky behaviors over time. METHOD Data were collected from a high-risk sample of adolescents followed into young adulthood. Five trajectory classes, identified based on dual development of substance use and antisocial behavior symptoms, were used to predict three risky driving and four risky sexual behaviors. RESULTS In this high-risk sample (n=530), participants reported notably high overall rates of reckless driving (55.5%) and unprotected sex under the influence (44.8%) in the past year. Risky behaviors that are typically of low base rates in population-based studies were also elevated, with 8.8% reporting past-year driving under the influence (DUI) charge, 17.6% reporting lifetime sexually transmitted infection (STI), and 10.4% reporting lifetime injection drug use. The Dual Chronic class had the highest levels of all seven risky behaviors, and were 3-4 times more likely to report risky driving, lifetime STI, and injection drug use than the Relatively Resolved class. Rates of past-year reckless driving and DUI were elevated among classes with persistent antisocial behavior, whereas rates of DUI, DUI charge, and unprotected sex under the influence were elevated among classes with persistent substance use. CONCLUSIONS Young adults with persistent co-occurring substance use and antisocial behavior engage in multiple very costly risky behaviors. Differential associations between risky behaviors and trajectory classes highlight the need for targeted interventions.
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Affiliation(s)
- Jeremy W Luk
- Department of Psychiatry, University of California, San Diego, United States.
| | - Matthew J Worley
- Department of Psychiatry, University of California, San Diego, United States; V.A. San Diego Health System, La Jolla, United States
| | - Evan Winiger
- Department of Psychiatry, University of California, San Diego, United States
| | - Ryan S Trim
- Department of Psychiatry, University of California, San Diego, United States; V.A. San Diego Health System, La Jolla, United States
| | | | - John K Hewitt
- Institute for Behavioral Genetics, University of Colorado, Boulder, United States
| | - Sandra A Brown
- Department of Psychiatry, University of California, San Diego, United States
| | - Tamara L Wall
- Department of Psychiatry, University of California, San Diego, United States; V.A. San Diego Health System, La Jolla, United States.
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Nogueira Avelar E Silva R, van de Bongardt D, van de Looij-Jansen P, Wijtzes A, Raat H. Mother- and Father-Adolescent Relationships and Early Sexual Intercourse. Pediatrics 2016; 138:peds.2016-0782. [PMID: 27940677 DOI: 10.1542/peds.2016-0782] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/15/2016] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To assess the prospective associations between mother-adolescent and father-adolescent relationship quality and early sexual intercourse initiation (ie, ≤16 years) among a large sample of Dutch adolescents. METHODS Two waves of data from the Rotterdam Youth Monitor, a longitudinal study in the Netherlands, were used. The analysis sample consisted of 2931 adolescents aged 12 to 16 years (Meanage@T1 = 12.5 years, SD = 0.61; Meanage@T2 = 14.3 years, SD = 0.60). Variables were assessed by means of self-report questionnaires. Prospective associations between mother-adolescent and father-adolescent relationships and early sexual initiation were assessed by logistic regression analyses, stratified by gender, controlling for various potential confounders. RESULTS We found that only girls (not boys) having a higher-quality relationship with mothers were significantly less likely to have initiated early sexual intercourse between T1 and T2. Bivariate findings showed that both girls and boys having a higher-quality relationship with their father at T1 were significantly less likely to have engaged in early sexual intercourse between T1 and T2, but when assessed multivariately, these associations were no longer significant, neither for boys nor for girls. CONCLUSIONS Our findings suggest that a higher-quality relationship between adolescents and their parents, especially between mothers and daughters, may help to protect against early sexual initiation. Pediatricians and other health care professionals should be able to explain to parents that early sexual intercourse initiation can be associated with negative health outcomes, but that parents can play an important role in promoting healthy sexual behaviors.
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Affiliation(s)
| | - Daphne van de Bongardt
- Research Institute of Child Development and Education (research priority area YIELD), University of Amsterdam, Amsterdam, the Netherlands
| | - Petra van de Looij-Jansen
- Department of Research and Business Intelligence, Municipality of Rotterdam, Rotterdam, the Netherlands; and
| | - Anne Wijtzes
- Department of Kinesiology, KU Leuven, Leuven, Belgium
| | - Hein Raat
- Department of Public Health, Erasmus Medical Center, Erasmus University Rotterdam, Rotterdam, the Netherlands
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Capaldi DM, Kerr DCR, Eddy JM, Tiberio SS. Understanding Persistence and Desistance in Crime and Risk Behaviors in Adulthood: Implications for Theory and Prevention. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2016; 17:785-93. [PMID: 26454855 PMCID: PMC4826854 DOI: 10.1007/s11121-015-0609-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Recent theoretical advances related to the development and course, including persistence and desistance, of antisocial behaviors and conduct problems, violent behaviors, and related problem behaviors are discussed. Integrative theoretical models, including the Dynamic Developmental Systems (DDS), are discussed. Aspects of the DDS model regarding the development of and change in antisocial behavior and violence across adolescence and early adulthood are illustrated with findings from the Oregon Youth Study, an ongoing, long-term examination of the causes and consequences of antisocial behavior for a community-based sample of men (and their romantic partners) who were raised in neighborhoods with high delinquency rates. Preventive implications of the model are discussed.
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Affiliation(s)
- Deborah M Capaldi
- Oregon Social Learning Center, 10 Shelton McMurphey Blvd, Eugene, OR, 97401, USA.
| | - David C R Kerr
- Oregon Social Learning Center, 10 Shelton McMurphey Blvd, Eugene, OR, 97401, USA
- School of Psychological Science, Oregon State University, Corvallis, OR, 97331, USA
| | - J Mark Eddy
- Partners for Our Children, University of Washington, Seattle, WA, USA
| | - Stacey S Tiberio
- Oregon Social Learning Center, 10 Shelton McMurphey Blvd, Eugene, OR, 97401, USA
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Houck CD, Hadley W, Barker D, Brown LK, Hancock E, Almy B. An Emotion Regulation Intervention to Reduce Risk Behaviors Among at-Risk Early Adolescents. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2016; 17:71-82. [PMID: 26297499 DOI: 10.1007/s11121-015-0597-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study aimed to evaluate an intervention designed to enhance early adolescents' emotion regulation skill use and to decrease risk behaviors. Adolescents 12 to 14 years old (N = 420; 53 % male) with mental health symptoms were referred for participation in either an Emotion Regulation (ER) or Health Promotion (HP) intervention consisting of 12 after-school sessions. Participants completed baseline and follow-up questionnaires on laptop computers. Using a generalized analysis of covariance controlling for baseline scores, participants in the ER intervention were less likely to be sexually active and engage in other risk behaviors, such as fighting, at the conclusion of the program. Additionally, participants in the ER intervention reported greater use of emotion regulation strategies and more favorable attitudes toward abstinence. Interventions directly targeting emotion regulation may be useful in addressing health risk behaviors of adolescents with mental health symptoms.
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Affiliation(s)
- Christopher D Houck
- Bradley Hasbro Children's Research Center, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, USA.
- Bradley/Hasbro Children's Research Center, One Hoppin Street, Suite 204, Providence, RI, 02903, USA.
| | - Wendy Hadley
- Bradley Hasbro Children's Research Center, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - David Barker
- Bradley Hasbro Children's Research Center, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Larry K Brown
- Bradley Hasbro Children's Research Center, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Evan Hancock
- Bradley Hasbro Children's Research Center, Rhode Island Hospital, Providence, RI, USA
| | - Brandon Almy
- Bradley Hasbro Children's Research Center, Rhode Island Hospital, Providence, RI, USA
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Thornberry TP, Krohn MD, Freeman-Gallant A. Intergenerational Roots of Early Onset Substance use. JOURNAL OF DRUG ISSUES 2016. [DOI: 10.1177/002204260603600101] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study examines intergenerational continuity in drug use across three generations of respondents in the same family. The data are from the Rochester Intergenerational Study, an ongoing, prospective, multi-generational investigation using a community-based sample. Our findings indicate that there is intergenerational continuity in drug use for Generation 2, or G2 daughters, but not sons, of G1 mothers. Use by G3 is significantly influenced by both G2 mothers and G1 grandmothers. However, for children of G2 fathers, neither prior generation's substance use is significantly related to G3 use. There is some indication that the absence of an effect from G2 fathers to G3 drug use is due to the number of nonresident fathers in the sample.
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Bogart LM, Collins RL, Ellickson PL, Klein DJ. Adolescent Predictors of Generalized Health Risk in Young Adulthood: A 10-Year Longitudinal Assessment. JOURNAL OF DRUG ISSUES 2016. [DOI: 10.1177/002204260603600304] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We conducted a prospective examination of multiple adolescent predictors of generalized health risk in early adulthood. Data were used from 3,392 members of a longitudinal cohort surveyed at ages 13 and 23. A measure of generalized risk was constructed using confirmatory factor analysis to represent shared variance among substance use, sexual risk, and victimization. Multiple regression analysis indicated several robust sociodemographic, behavioral, and environmental early predictors of generalized adult risk, including gender, age, race, not coming from a nuclear family, engaging in smoking and deviant behavior as an adolescent, having poor grades in high school, alcohol and cigarette use by an adult important to the adolescent, and being offered substances as an adolescent. Results support the existence of an underlying risk construct in early adulthood, the importance of early adolescent deviance and substance use exposure in predicting risk, and the use of early comprehensive interventions that prevent several risks simultaneously.
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Crandall A, Magnusson BM, Novilla MLB, Novilla LKB, Dyer WJ. Family Financial Stress and Adolescent Sexual Risk-Taking: The Role of Self-Regulation. J Youth Adolesc 2016; 46:45-62. [PMID: 27460827 DOI: 10.1007/s10964-016-0543-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 07/11/2016] [Indexed: 12/19/2022]
Abstract
The ability to control one's emotions, thoughts, and behaviors is known as self-regulation. Family stress and low adolescent self-regulation have been linked with increased engagement in risky sexual behaviors, which peak in late adolescence and early adulthood. The purpose of this study was to assess whether adolescent self-regulation, measured by parent and adolescent self-report and respiratory sinus arrhythmia, mediates or moderates the relationship between family financial stress and risky sexual behaviors. We assessed these relationships in a 4-year longitudinal sample of 450 adolescents (52 % female; 70 % white) and their parents using structural equation modeling. Results indicated that high family financial stress predicts engagement in risky sexual behaviors as mediated, but not moderated, by adolescent self-regulation. The results suggest that adolescent self-regulatory capacities are a mechanism through which proximal external forces influence adolescent risk-taking. Promoting adolescent self-regulation, especially in the face of external stressors, may be an important method to reduce risk-taking behaviors as adolescents transition to adulthood.
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Affiliation(s)
- AliceAnn Crandall
- Department of Health Science, Brigham Young University, 4103 LSB, Provo, UT, 84602, USA.
| | - Brianna M Magnusson
- Department of Health Science, Brigham Young University, 4103 LSB, Provo, UT, 84602, USA
| | - M Lelinneth B Novilla
- Department of Health Science, Brigham Young University, 4103 LSB, Provo, UT, 84602, USA
| | | | - W Justin Dyer
- Department of Religious Education, Brigham Young University, 270 N JSB, Provo, UT, 84602, USA
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23
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Houck CD, Barker DH, Hadley W, Brown LK, Lansing A, Almy B, Hancock E. The 1-year impact of an emotion regulation intervention on early adolescent health risk behaviors. Health Psychol 2016; 35:1036-45. [PMID: 27175579 DOI: 10.1037/hea0000360] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Sexual activity often begins in early adolescence, and adolescents with mental health symptoms are at greater risk for sexual activity and other health risks. This study aimed to evaluate a developmentally targeted intervention designed to enhance early adolescents' emotion regulation competencies as a strategy for reducing health risk behaviors, including sexual initiation. METHOD Adolescents 12 to 14 years old (N = 420; 53% male) with mental health symptoms participated in either an emotion regulation (ER) or health promotion (HP) intervention consisting of 12 after-school sessions. Participants completed questionnaires on laptop computers at baseline, 2-, 6-, and 12-month follow-ups. RESULTS Time to event analyses were used to compare intervention conditions on rate of initiation to vaginal sex. Results showed that participants in the ER condition were less likely to transition into vaginal sexual activity by 1-year follow-up than were those in the HP condition (adjusted hazard ratio = 0.58, 95% confidence interval [0.36, 0.94], p = .01). However, those who were sexually active did not report differences in sexual risk behaviors (e.g., condomless sex). Participants in the ER condition were significantly less likely to report violence behaviors and showed improvement on a behavioral measure of emotion identification; however, they did not differ from HP participants on self-reports of emotional competence. CONCLUSIONS Emotion regulation strategies can be used to delay sexual initiation among early adolescents with mental health symptoms and may have an important role in health education. (PsycINFO Database Record
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Affiliation(s)
| | | | | | | | - Amy Lansing
- Department of Psychiatry, Geisel School of Medicine
| | - Brandon Almy
- Institute of Child Development, University of Minnesota
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Delaquis SR, Gueye NR, De Moissac DL. [Not Available]. Canadian Journal of Public Health 2016; 106:e489-95. [PMID: 26986909 DOI: 10.17269/cjph.106.4968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 12/23/2015] [Accepted: 09/12/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Risky sexual behaviour associated with sexually transmitted infections (STI) and sexual harassment are important topics in university environments and public health. This article compares these behaviours between student cohorts in 2005 and 2012 from a Western Canadian university. The sexual habits of young adults with multiple partners are also examined. METHODS Researchers conducted a comparative study of sexual behaviour among approximately 400 students per cohort. Estimates of prevalence and adjusted odds for age group and sex were used to analyze associations between the two cohorts and their sexual behaviours. RESULTS Trends in sexual behaviour of young adults are maintained with respect to the proportion of those who are sexually active and their number of partners. A reduction in sexual harassment is observed, especially towards women. The condom remains the most frequently used method of contraception, but its use is erratic, particularly among respondents with multiple sexual partners. Drinking and the use of drugs predisposes to unplanned sexual relations and to non-use of means to prevent STIs and pregnancy, particularly among respondents with multiple sexual partners. CONCLUSIONS The postsecondary student population should be informed of the risks associated with multiple sexual partners and alcohol and drug consumption leading to unplanned sexual acts. A sexual harassment policy contributes to reduction of incidents of harassment within a postsecondary institution.
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Zappe JG, Dell’Aglio DD. Variáveis pessoais e contextuais associadas a comportamentos de risco em adolescentes. JORNAL BRASILEIRO DE PSIQUIATRIA 2016. [DOI: 10.1590/0047-2085000000102] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
RESUMO Objetivo Este estudo investigou o engajamento de adolescentes brasileiros em comportamentos de risco (uso de substâncias, comportamento sexual de risco, comportamento antissocial e comportamento suicida), buscando identificar os fatores de risco e proteção pessoais e contextuais mais associados com esses comportamentos. Métodos Participaram 1.332 adolescentes de 12 a 19 anos (M = 15,68; DP = 1,60), de ambos os sexos. Resultados O engajamento em comportamentos de risco variou em função da idade e do sexo, e o uso de substâncias foi o tipo de comportamento de risco mais prevalente entre os que foram investigados. Os fatores significativamente associados à adoção desses comportamentos foram violência intra- e extrafamiliar, ter amigos próximos ou familiares que usam drogas, eventos estressores e elevado nível de autoeficácia; enquanto os fatores que se mostraram protetores foram elevado nível de autoestima, expectativas positivas quanto ao futuro e percepção de positividade nas relações com família, escola, religião e comunidade. Conclusão O estudo permitiu identificar algumas características da manifestação de comportamentos de risco na adolescência, com destaque para a prevalência mais alta do uso de substâncias e a coocorrência de diferentes tipos de comportamentos de risco. Dentre os fatores de risco mais associados com o engajamento em comportamentos de risco, destacaram-se a presença de eventos estressores ao longo da vida e a proximidade com amigos que usam drogas. A partir disso, sugere-se investir na minimização de fatores de risco e na potencialização de fatores protetivos para a promoção do desenvolvimento saudável durante a adolescência.
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Shek DTL, Leung H. Do Adolescent Sexual Behavior and Intention to Engage in Sexual Behavior Change in High School Years in Hong Kong? J Pediatr Adolesc Gynecol 2016; 29:S49-60. [PMID: 26461531 DOI: 10.1016/j.jpag.2015.10.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
STUDY OBJECTIVE In this study we examined sexual behavior and intention to engage in sexual behavior among Chinese high school students in Hong Kong using 6 waves of data collected over 6 years. We also focused on the related sociodemographic and family correlates. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: A 6-year longitudinal study was conducted. At each wave, a questionnaire was used to collect data on sociodemographic characteristics, positive youth development, and family functioning in the respondents. RESULTS Individual growth curve models showed that adolescent sexual behavior and intention increased over time. Adolescents with higher levels of positive youth development reported lower levels of past sexual behavior. Youths from better-off and higher functioning families increased their sexual behavior at slower rates than did youths from families with economic disadvantage and poor family functioning. Regarding intention to have sex, older adolescents reported higher levels of intention. Youngsters with higher levels of perceived family functioning and positive youth development reported lower levels of initial intention. Adolescent boys increased their intention at a faster rate than did girls. CONCLUSION Findings from the study identified risk factors (ie, age, gender, and economic disadvantage) and protective factors (ie, healthy family functioning, positive youth development) that influence the levels and growth rates of adolescent sexual behavior and intention. Implications for future research and interventions are discussed.
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Affiliation(s)
- D T L Shek
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, P.R. China; Centre for Innovative Programs for Adolescents and Families, The Hong Kong Polytechnic University, Hong Kong, P.R. China; School of Social Development, East China Normal University, Shanghai, P.R. China; Kiang Wu Nursing College of Macau, Macau, P.R. China; University of Kentucky College of Medicine, Lexington, USA.
| | - H Leung
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, P.R. China
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Braje SE, Eddy JM, Hall GCN. A Comparison of Two Models of Risky Sexual Behavior During Late Adolescence. ARCHIVES OF SEXUAL BEHAVIOR 2016; 45:73-83. [PMID: 25925897 DOI: 10.1007/s10508-015-0523-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 09/18/2014] [Accepted: 12/14/2014] [Indexed: 05/16/2023]
Abstract
Two models of risky sexual behavior (RSB) were compared in a community sample of late adolescents (N = 223). For the traumagenic model, early negative sexual experiences were posited to lead to an association between negative affect with sexual relationships. For the cognitive escape model, depressive affect was posited to lead to engagement in RSB as a way to avoid negative emotions. The current study examined whether depression explained the relationship between sexual trauma and RSB, supporting the cognitive escape model, or whether it was sexual trauma that led specifically to RSB, supporting the traumagenic model. Physical trauma experiences were also examined to disentangle the effects of sexual trauma compared to other emotionally distressing events. The study examined whether the results would be moderated by participant sex. For males, support was found for the cognitive escape model but not the traumagenic model. Among males, physical trauma and depression predicted engagement in RSB but sexual trauma did not. For females, support was found for the traumagenic and cognitive escape model. Among females, depression and sexual trauma both uniquely predicted RSB. There was an additional suppressor effect of socioeconomic status in predicting RSB among females. Results suggest that the association of trauma type with RSB depends on participant sex. Implications of the current study for RSB prevention efforts are discussed.
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Affiliation(s)
- Sopagna Eap Braje
- Clinical Psychology Doctoral Program, California School of Professional Psychology-San Diego, Alliant International University, 10455 Pomerado Road, San Diego, CA, 92116, USA.
| | - J Mark Eddy
- Partners for Our Children, School of Social Work, University of Washington, Seattle, WA, USA
- Oregon Social Learning Center, Eugene, OR, USA
| | - Gordon C N Hall
- Department of Psychology, University of Oregon, Eugene, OR, USA
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Mechanisms That Link Parenting Practices to Adolescents’ Risky Sexual Behavior: A Test of Six Competing Theories. J Youth Adolesc 2015; 45:255-70. [DOI: 10.1007/s10964-015-0409-7] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Accepted: 12/17/2015] [Indexed: 11/25/2022]
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Kapadia F, Bub K, Barton S, Stults CB, Halkitis PN. Longitudinal Trends in Sexual Behaviors Without a Condom Among Sexual Minority Youth: The P18 Cohort Study. AIDS Behav 2015; 19:2152-61. [PMID: 26319222 DOI: 10.1007/s10461-015-1175-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Given the heightened risk for HIV and other STIs among young men who have sex with men (YMSM) as well as the racial/ethnic disparities in HIV/STI risk, an understanding of longitudinal trends in sexual behaviors is warranted as YMSM emerge into adulthood. Drawing from an ongoing prospective cohort study, the present analysis employed latent growth curve modeling to examine trends in distinct types of sexual activity without condoms over time in sample of YMSM and examine differences by race/ethnicity and perceived familial socioeconomic status (SES). Overall, White and Mixed race YMSM reported more instances of oral sex without condoms as compared to other racial/ethnic groups with rates of decline over time noted in Black YMSM. White YMSM also reported more receptive and insertive anal sex acts without a condom than Black YMSM. Declines over time in both types of anal sex acts without condoms among Black men were noted when compared to White men, while increases over time were noted for mixed race YMSM for condomless insertive anal sex. The effects for race/ethnicity were attenuated with the inclusion of perceived familial SES in these models. These findings build on previous cross sectional studies showing less frequent sex without condoms among Black YMSM despite higher rates of HIV incidence in emerging adulthood, as well as the importance of considering economic conditions in such models. Efforts to understand racial/ethnic disparities in HIV/STIs among YMSM must move beyond examination of individual-level sexual behaviors and consider both race/ethnicity and socioeconomic conditions in order to evaluate how these factors shape the sexual behaviors of YMSM.
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Affiliation(s)
- Farzana Kapadia
- Center for Health, Identity, Behavior, and Prevention Studies, Steinhardt School of Culture, Education & Human Development, New York University, 411 Lafayette Street, 5th Floor, New York, NY, 10012, USA.
- Department of Population Health, Division of General Internal Medicine, Langone School of Medicine, New York University, New York, NY, USA.
- College of Global Public Health, New York University, New York, NY, USA.
| | - Kristen Bub
- College of Education, University of Illinois, Champaign, IL, USA
| | - Staci Barton
- Center for Health, Identity, Behavior, and Prevention Studies, Steinhardt School of Culture, Education & Human Development, New York University, 411 Lafayette Street, 5th Floor, New York, NY, 10012, USA
| | - Christopher B Stults
- Center for Health, Identity, Behavior, and Prevention Studies, Steinhardt School of Culture, Education & Human Development, New York University, 411 Lafayette Street, 5th Floor, New York, NY, 10012, USA
| | - Perry N Halkitis
- Center for Health, Identity, Behavior, and Prevention Studies, Steinhardt School of Culture, Education & Human Development, New York University, 411 Lafayette Street, 5th Floor, New York, NY, 10012, USA
- Department of Population Health, Division of General Internal Medicine, Langone School of Medicine, New York University, New York, NY, USA
- College of Global Public Health, New York University, New York, NY, USA
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Perceived and experimentally manipulated status moderates the relationship between facial structure and risk-taking. EVOL HUM BEHAV 2015. [DOI: 10.1016/j.evolhumbehav.2015.03.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Kerr DCR, Tiberio SS, Capaldi DM. Contextual risks linking parents' adolescent marijuana use to offspring onset. Drug Alcohol Depend 2015; 154:222-8. [PMID: 26166667 PMCID: PMC4540183 DOI: 10.1016/j.drugalcdep.2015.06.041] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 06/16/2015] [Accepted: 06/25/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVE We studied the extent to which parent marijuana use in adolescence is associated with marijuana use onset in offspring through contextual family and peer risks. METHOD Fathers assessed (n=93) since childhood, their 146 offspring (n=83 girls), and offspring's mothers (n=85) participated in a longitudinal study. Using discrete-time survival analysis, fathers' (prospectively measured) and mothers' (retrospective) adolescent marijuana use was used to predict offspring marijuana use onset through age 19 years. Parental monitoring, child exposure to marijuana use, peer deviance, peer marijuana use, and perceptions of parent disapproval of child use were measured before or concurrent with onset. RESULTS Parents' adolescent marijuana use was significantly associated with less monitoring, offspring alcohol use, the peer behaviors, exposure to adult marijuana use, and perceptions of less parent disapproval. Male gender and the two peer behaviors were positively associated with children's marijuana use onset, controlling for their alcohol use. Parents' adolescent marijuana use had a significant indirect effect on child onset through children's deviant peer affiliations and a composite contextual risk score. CONCLUSIONS Parents' histories of marijuana use may contribute indirectly to children's marijuana use onset through their influence on the social environments children encounter; specifically, those characterized by more liberal use norms, exposure to marijuana use and deviant and marijuana-using peers, and less adult supervision. Given that alcohol use onset was controlled, findings suggest that the contextual factors identified here confer unique risk for child marijuana use onset.
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Affiliation(s)
- David C R Kerr
- School of Psychological Science, Oregon State University, 213 Reed Lodge, Corvallis, OR 97331, USA; Oregon Social Learning Center, 10 Shelton McMurphey Blvd., Eugene, OR 97401, USA.
| | - Stacey S Tiberio
- Oregon Social Learning Center, 10 Shelton McMurphey Blvd., Eugene, OR 97401, USA.
| | - Deborah M Capaldi
- Oregon Social Learning Center, 10 Shelton McMurphey Blvd., Eugene, OR 97401, USA.
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Porche MV, Fortuna LR, Wachholtz A, Stone RT. Distal and Proximal Religiosity as Protective Factors for Adolescent and Emerging Adult Alcohol Use. RELIGIONS 2015; 6:365-384. [PMID: 26146565 PMCID: PMC4486303 DOI: 10.3390/rel6020365] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Data from emerging adults (ages 18-29, N = 900) in the National Comorbidity Survey Replication Study was used to examine the influence of childhood and emerging adult religiosity and religious-based decision-making, and childhood adversity, on alcohol use. Childhood religiosity was protective against early alcohol use and progression to later abuse or dependence, but did not significantly offset the influence of childhood adversity on early patterns of heavy drinking in adjusted logistic regression models. Religiosity in emerging adulthood was negatively associated with alcohol use disorders. Protective associations for religiosity varied by gender, ethnicity and childhood adversity histories. Higher religiosity may be protective against early onset alcohol use and later development of alcohol problems, thus, should be considered in prevention programming for youth, particularly in faith-based settings. Mental health providers should allow for integration of clients' religiosity and spirituality beliefs and practices in treatment settings if clients indicate such interest.
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Affiliation(s)
- Michelle V. Porche
- Wellesley Centers for Women, Wellesley College, 106 Central St., Cheever House, Wellesley, MA 02481, USA
| | - Lisa R. Fortuna
- Boston Medical Center, Dowling Building, 9th Floor, Boston, MA 02118, USA
| | - Amy Wachholtz
- UMASS Memorial Medical Center, Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
| | - Rosalie Torres Stone
- Systems & Psychosocial Advances Research Center, University of Massachusetts Medical School, Department of Psychiatry, 55 Lake Avenue North, Worcester, MA 01655, USA
- Department of Sociology, Clark University, 950 Main Street, Worcester, MA 01610, USA
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Small L, Jackson J, Gopalan G, McKay MM. Meeting the complex needs of urban youth and their families through the 4Rs 2Ss Family Strengthening Program: The "real world" meets evidence-informed care. RESEARCH ON SOCIAL WORK PRACTICE 2015; 25:433-45. [PMID: 26523115 PMCID: PMC4627643 DOI: 10.1177/1049731514537900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Youth living in poverty face compounding familial and environmental challenges in utilizing effective community mental health services. They have ongoing stressors that increase their dropout rate in mental health service use. Difficulties also exist in staying engaged in services when they are involved with the child welfare system. This study examines the 4Rs 2Ss Family Strengthening Program, developed across four broad conceptual categories related to parenting skills and family processes that form a multiple family group service delivery approach. A total of 321 families were enrolled in this randomized intervention study, assigned to either the 4Rs 2Ss Family Strengthening Program or standard care services. Caregivers and their children randomly assigned to the experimental condition received a 16 week multiple family group intervention through their respective outpatient community mental health clinic. Data was collected at baseline, midtest (8 weeks), posttest (16 weeks), and 6 month follow-up. Major findings include high engagement in the 4Rs 2Ss Family Strengthening Program, compared to standard services. Although child welfare status is not related to attendance, family stress and parental depression are also related to participant engagement in this multiple family group intervention. Involvement in the 4Rs 2Ss Family Strengthening Program resulted in improved effects for child behaviors. Lastly, no evidence of moderation effects on family stress, child welfare involvement, or parental needs were found. The 4Rs 2Ss Family Strengthening Program appeared able to engage families with more complex "real world" needs.
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Abstract
Little is known about the influences of peers on the sexual activity of adolescents in sub-Saharan Africa. Better understanding of these issues could lead to more effective sexual and reproductive health interventions. Using two waves of survey data from 1,275 adolescents in two southeastern Ghanaian towns, we examine age, sex, and community differences in peer group characteristics. We also examine prospective associations between peer group characteristics and self-reported sexual initiation and multiple partnerships during a 20-month follow-up period. Sex differences in peer-context variables were small. Affiliation with antisocial peers and perceived peer norms favoring sex increased the odds of transition to first sex. Having more friends increased the odds among younger respondents of acquiring multiple new sexual partners. Among males, perceived peer norms favoring sex increased the odds of acquiring multiple partners. We discuss the implications of these findings for adolescent sexual and reproductive health intervention strategies in sub-Saharan Africa, and conclude that peer-based interventions may be best suited to the needs of at-risk adolescent boys.
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Affiliation(s)
- Jeffrey B Bingenheimer
- Assistant Professor, Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue, NW, Suite 300, Washington, DC 20052.
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Dodge KA, Bierman KL, Coie JD, Greenberg MT, Lochman JE, McMahon RJ, Pinderhughes EE. Impact of early intervention on psychopathology, crime, and well-being at age 25. Am J Psychiatry 2015; 172:59-70. [PMID: 25219348 PMCID: PMC4485380 DOI: 10.1176/appi.ajp.2014.13060786] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This randomized controlled trial tested the efficacy of early intervention to prevent adult psychopathology and improve well-being in early-starting conduct-problem children. METHOD Kindergarteners (N=9,594) in three cohorts (1991-1993) at 55 schools in four communities were screened for conduct problems, yielding 979 early starters. A total of 891 (91%) consented (51% African American, 47% European American; 69% boys). Children were randomly assigned by school cluster to a 10-year intervention or control. The intervention goal was to develop social competencies in children that would carry them throughout life, through social skills training, parent behavior-management training with home visiting, peer coaching, reading tutoring, and classroom social-emotional curricula. Manualization and supervision ensured program fidelity. Ninety-eight percent participated during grade 1, and 80% continued through grade 10. At age 25, arrest records were reviewed (N=817, 92%), and condition-blinded adults psychiatrically interviewed participants (N=702; 81% of living participants) and a peer (N=535) knowledgeable about the participant. RESULTS Intent-to-treat logistic regression analyses indicated that 69% of participants in the control arm displayed at least one externalizing, internalizing, or substance abuse psychiatric problem (based on self- or peer interview) at age 25, in contrast with 59% of those assigned to intervention (odds ratio=0.59, CI=0.43-0.81; number needed to treat=8). This pattern also held for self-interviews, peer interviews, scores using an "and" rule for self- and peer reports, and separate tests for externalizing problems, internalizing problems, and substance abuse problems, as well as for each of three cohorts, four sites, male participants, female participants, African Americans, European Americans, moderate-risk, and high-risk subgroups. Intervention participants also received lower severity-weighted violent (standardized estimate=-0.37) and drug (standardized estimate=-0.43) crime conviction scores, lower risky sexual behavior scores (standardized estimate=-0.24), and higher well-being scores (standardized estimate=0.19). CONCLUSIONS This study provides evidence for the efficacy of early intervention in preventing adult psychopathology among high-risk early-starting conduct-problem children.
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Affiliation(s)
- Kenneth A Dodge
- From Duke University, Durham, N.C.; Pennsylvania State University, University Park; the University of Alabama, Tuscaloosa.; Simon Fraser University, Vancouver, British Columbia, Canada; and Tufts University, Boston
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Lemelin C, Lussier Y, Sabourin S, Brassard A, Naud C. Risky sexual behaviours: The role of substance use, psychopathic traits, and attachment insecurity among adolescents and young adults in Quebec. THE CANADIAN JOURNAL OF HUMAN SEXUALITY 2014. [DOI: 10.3138/cjhs.2625] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The purpose of this study was to examine how substance use, psychopathic traits, and attachment representations explain sexual risk-taking in adolescence. Variables used to define risky sexual behaviours were age at first sexual intercourse and number of lifetime sexual partners. A sample of 1,553 adolescents and young adults completed a battery of questionnaires including measures of substance use, psychopathic traits, attachment representations, and sexual behaviours. Structural equation modelling demonstrated that, in the present sample, risky sexual behaviours were best modelled through both direct effects of avoidant attachment representations and indirect effects of psychopathic traits and abandonment anxiety through increases in substance use. This model was gender-invariant and may represent a contemporary trend toward homogenization of sexual practices among young people in Quebec.
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Affiliation(s)
- Carmen Lemelin
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, QC
| | - Yvan Lussier
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, QC
| | | | - Audrey Brassard
- Department of Psychology, Université de Sherbrooke, Sherbrooke, QC
| | - Christopher Naud
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, QC
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Sarver DE, McCart MR, Sheidow AJ, Letourneau EJ. ADHD and risky sexual behavior in adolescents: conduct problems and substance use as mediators of risk. J Child Psychol Psychiatry 2014; 55:1345-53. [PMID: 24813803 PMCID: PMC4479401 DOI: 10.1111/jcpp.12249] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/31/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Recent studies have linked attention-deficit/hyperactivity disorder (ADHD) to elevated rates of risky sexual behavior (RSB) in adult samples. The current study tested whether ADHD symptoms were associated with RSB among adolescents, and examined comorbid conduct problems and problematic substance use as joint mediators of this association. METHODS ADHD symptoms, conduct problems (oppositional defiant disorder/conduct disorder symptoms), problematic alcohol use (alcohol use disorder symptoms, alcohol use frequency), problematic marijuana use (marijuana use disorder symptoms, marijuana use frequency), and RSB were assessed among an ethnically diverse cross-sectional sample of adolescents (N = 115; mean age = 14.9 years) involved in the juvenile justice system. RESULTS Bootstrapped mediation models revealed an initial association between ADHD symptoms and RSB that was accounted for fully by the influence of problematic alcohol and marijuana use, but not conduct problems. A follow-up multiple groups mediation analysis demonstrated that the relationship between ADHD symptoms and RSB emerged only among youth with clinically elevated conduct problems, and that problematic marijuana use fully accounted for this relationship. Hyperactive/impulsive, but not inattentive, symptoms were related to RSB, although the pattern of indirect effects was consistent with the multiple groups analysis. CONCLUSIONS The association between ADHD and adolescent RSB is restricted to youth with elevated comorbid conduct problems and reflects the contributions of comorbid marijuana use problems, and to a lesser extent alcohol use problems. Early identification and treatment of these comorbid conditions may be important for the prevention of negative sexual health outcomes among youth with ADHD.
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Affiliation(s)
- Dustin E Sarver
- Center to Promote Effective Youth Development (Youth-Nex), University of Virginia, Charlottesville, VA, USA
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Ritchwood TD, Howell RJ, Traylor AC, Church WT, Bolland JM. Change in Age-Specific, Psychosocial Correlates of Risky Sexual Behaviors Among Youth: Longitudinal Findings From a Deep South, High-Risk Sample. JOURNAL OF CHILD AND FAMILY STUDIES 2014; 23:1366-1377. [PMID: 26388682 PMCID: PMC4574299 DOI: 10.1007/s10826-013-9794-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The current study examined psychosocial predictors of change in intercourse frequency and number of sexual partners among youth within a socio-ecological framework and assessed whether these determinants vary by stage of adolescent development. Longitudinal data were derived from a large, community study of adolescent risky behavior among predominantly high-risk, African American youth. Significant predictors of intercourse frequency for early adolescents included age, gender, self-worth, and familial factors; for older youth, age, gender, self-worth, curfews, and sense of community exerted significant effects. Among early adolescents, age, gender, self-worth, familial factors, and sense of community predicted change in the number of sexual partners in the previous year, while age, gender, self-worth, parental knowledge, curfews, and sense of community were predictive of change in the number of sexual partners in the previous year among older youth. Study implications and future directions are discussed.
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Affiliation(s)
- Tiarney D. Ritchwood
- Center for Health Equity Research, University of North Carolina at Chapel Hill, 725 Martin Luther King Jr Blvd, CB#7590, Chapel Hill, NC 27599-7590, USA
| | - Rebecca J. Howell
- Department of Criminal Justice, Charleston Southern University, Charleston, SC 29406, USA
| | - Amy C. Traylor
- School of Social Work, University of Alabama, Tuscaloosa, AL 35487, USA
| | - Wesley T. Church
- School of Social Work, University of Alabama, Tuscaloosa, AL 35487, USA
| | - John M. Bolland
- College of Human Environmental Sciences, University of Alabama, Tuscaloosa, AL 35487, USA
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Caruthers AS, Van Ryzin MJ, Dishion TJ. Preventing high-risk sexual behavior in early adulthood with family interventions in adolescence: outcomes and developmental processes. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2014; 15 Suppl 1:S59-69. [PMID: 23536124 DOI: 10.1007/s11121-013-0383-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Adolescent study participants who engaged in a brief, family-centered intervention (the Family Check-Up, FCU) were later assessed for the intervention's effects on high-risk sexual behavior (HRSB) in early adulthood (age 22). Participants (N = 998 adolescents and their families) were randomly assigned to a family-centered intervention in sixth grade and were offered a gated, multilevel intervention that included (a) a school-based family resource center, (b) the FCU, and (c) more intensive, family-based treatment. All services were voluntary, but high-risk families were actively recruited into the FCU. Approximately 23% of the intervention families engaged in the FCU and approximately 18% engaged in more intensive treatment. Using an intent-to-treat design, we found that the direct effect of the FCU on HRSB was not significant; however, an analysis of the developmental processes indicated that intervention families demonstrated improved family relationship quality when compared to control families, which in turn resulted in lower levels of HRSB in early adulthood. Furthermore, the significant effect of family relationship quality on HRSB was mediated by differences in parental monitoring and early sexual activity, and these effects varied as a function of gender and ethnicity. Indirect effects of the FCU on HRSB were significant via multiple different pathways. The implications of these findings for enhancing the impact of family-centered interventions are discussed.
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Affiliation(s)
- Allison S Caruthers
- Child and Family Center, University of Oregon, 70 Couch Street, Suite 242, Portland, OR, 97209, USA,
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Capaldi DM. Prevention science supplemental issue commentary promoting healthy sexual practices: what we have learned from 100 years of work. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2014; 15 Suppl 1:S78-80. [PMID: 24014107 DOI: 10.1007/s11121-013-0434-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Nijjar R, Ellenbogen MA, Hodgins S. Personality, coping, risky behavior, and mental disorders in the offspring of parents with bipolar disorder: a comprehensive psychosocial assessment. J Affect Disord 2014; 166:315-23. [PMID: 25012447 DOI: 10.1016/j.jad.2014.04.047] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 04/18/2014] [Accepted: 04/19/2014] [Indexed: 01/30/2023]
Abstract
OBJECTIVES It has been proposed that the offspring of parents with bipolar disorder (OBD), through genetic mechanisms and early family interactions, develop a heightened sensitivity to stress, maladaptive coping, and dysregulated behavior, which ultimately increases the risk for affective disorders. The current study tested certain predictions of this model by assessing different psychosocial and health-related outcomes in the OBD, including personality, coping style, smoking, suicidality, high-risk sexual behaviors, criminality, and mental health. METHOD The sample was composed of 74 OBD and 75 control offspring, who were between 14 and 27 years of age (mean: 19.38±3.56). Participants underwent a diagnostic interview and a structured interview to assess high-risk behavior and other maladaptive outcomes, and they completed the Revised NEO Personality Inventory and Coping in Stressful Situations questionnaire. RESULTS The rates of affective (31.1%) and non-affective (56.8%) disorders were elevated in the OBD compared to controls (9.5% and 32.4%). Relative to controls, OBD endorsed fewer task-oriented and more distraction coping strategies [Wilk׳s λ=.83, F(1, 136) =6.92, p<.01], and were more likely to report engaging in high-risk sexual behavior (OR=2.37; Wald=4.13, 1 df, p<05). Importantly, OBD reported elevated high-risk sexual behavior relative to controls, irrespective of affective disorder diagnosis. CONCLUSION The results highlight a potential risk profile for the OBD, consisting of ineffective coping strategies and risky sexual behavior and are discussed in the context of current knowledge of stress and coping in this population. LIMITATIONS The present findings were based on cross-sectional data and relied on offspring self-report. It would be useful to corroborate these findings with biobehavioural and longitudinal measures.
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Affiliation(s)
- Rami Nijjar
- Centre for Research in Human Development, Concordia University, Montreal, Canada
| | - Mark A Ellenbogen
- Centre for Research in Human Development, Concordia University, Montreal, Canada.
| | - Sheilagh Hodgins
- Département de Psychiatrie, Université de Montréal, Montréal, Canada; Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
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Newcomb ME, Mustanski B. Diaries for observation or intervention of health behaviors: factors that predict reactivity in a sexual diary study of men who have sex with men. Ann Behav Med 2014; 47:325-34. [PMID: 24081918 PMCID: PMC3972382 DOI: 10.1007/s12160-013-9549-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Behavioral diaries for observation of health-related behaviors assume absence of reactivity (i.e., change in behavior resulting from observation), while self-monitoring diaries maximize reactivity for behavior change. Little is known about when and for whom behavioral diary studies become self-monitoring interventions. PURPOSE This study evaluated the moderating effects of social cognitive variables on reactivity in sexual risk behavior and risk appraisals in a diary study of men who have sex with men (MSM). METHODS One hundred forty-three MSM completed weekly online sexual diaries for 3 months. Analyses were conducted with hierarchical linear modeling. RESULTS There was no evidence of reactivity for the sample as a whole. Social cognitive variables (e.g., risk reduction motivation, condom use intentions, and social norms) moderated reactivity in study outcomes. For example, more highly motivated MSM experienced declines in serodiscordant unprotected anal intercourse over time. CONCLUSIONS Effectiveness of behavioral self-monitoring strategies may vary depending on social cognitive domains.
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Affiliation(s)
- Michael E Newcomb
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N. Michigan Ave., Suite 2700, Chicago, IL, 60611, USA,
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Barton AL, Snider JB, Vazsonyi AT, Cox JL. Adolescent religiosity as a mediator of the relationship between parental religiosity and adolescent health outcomes. JOURNAL OF RELIGION AND HEALTH 2014; 53:86-94. [PMID: 22528286 DOI: 10.1007/s10943-012-9596-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Studies have demonstrated the positive impacts of both parent and adolescent religiosity on adolescent outcomes; however, the relationships among these variable have not been studied. Our study was conducted to assess whether adolescent religiosity mediates the relationship between parent religiosity and adolescent emotional and behavioral health outcomes. A sample of 491 late adolescents ages 18-22 completed surveys that assessed their parents' religious practices, their own religious practices, deviant behaviors, and internalizing behaviors. Findings suggest that adolescent religiosity mediates the relationship between parents' religiosity and adolescent health outcomes such as drug and alcohol use and depression.
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Affiliation(s)
- Alison L Barton
- Department of Human Development and Learning, East Tennessee State University, Box 70548, Johnson City, TN, 37614-1707, USA,
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McKernan McKay M, Alicea S, Elwyn L, McClain ZRB, Parker G, Small LA, Mellins CA. The development and implementation of theory-driven programs capable of addressing poverty-impacted children's health, mental health, and prevention needs: CHAMP and CHAMP+, evidence-informed, family-based interventions to address HIV risk and care. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2014; 43:428-41. [PMID: 24787707 PMCID: PMC4215567 DOI: 10.1080/15374416.2014.893519] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This article describes a program of prevention and intervention research conducted by the CHAMP (Collaborative HIV prevention and Adolescent Mental health Project; McKay & Paikoff, 2007 ) investigative team. CHAMP refers to a set of theory-driven, evidence-informed, collaboratively designed, family-based approaches meant to address the prevention, health, and mental health needs of poverty-impacted African American and Latino urban youth who are either at risk for HIV exposure or perinatally infected and at high risk for reinfection and possible transmission. CHAMP approaches are informed by theoretical frameworks that incorporate an understanding of the critical influences of multilevel contextual factors on youth risk taking and engagement in protective health behaviors. Highly influential theories include the triadic theory of influence, social action theory, and ecological developmental perspectives. CHAMP program delivery strategies were developed via a highly collaborative process drawing upon community-based participatory research methods in order to enhance cultural and contextual sensitivity of program content and format. The development and preliminary outcomes associated with a family-based intervention for a new population, perinatally HIV-infected youth and their adult caregivers, referred to as CHAMP+, is described to illustrate the integration of theory, existing evidence, and intensive input from consumers and healthcare providers.
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Affiliation(s)
- Mary McKernan McKay
- a Department of Psychiatry and Community Medicine , Mount Sinai School of Medicine
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Davis KC, Stappenbeck CA, Norris J, George WH, Jacques-Tiura AJ, Schraufnagel TJ, Kajumulo KF. Young men's condom use resistance tactics: a latent profile analysis. JOURNAL OF SEX RESEARCH 2014; 51:454-65. [PMID: 23548069 PMCID: PMC3723757 DOI: 10.1080/00224499.2013.776660] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Research suggests that many men have used a variety of tactics to avoid using condoms when having sex with women. Guided by previous work demonstrating that men's use of coercive condom resistance tactics was predicted by negative attitudes toward women, inconsistent condom use, multiple partners, and sexual sensation seeking, the current study used latent profile analysis (LPA) to determine whether similar constructs were associated with a variety of resistance tactics. A community sample of 313 moderate-drinking men participated, of whom 80% reported employing at least one condom use resistance tactic since adolescence. The LPA revealed three classes of men. In general, men with the least negative beliefs about women, low levels of sexual sensation seeking and impulsivity, and positive beliefs about condoms (Condom Positive/Low Hostility) reported less use of resistance tactics than men with moderate sexual sensation seeking and impulsivity, negative beliefs about condoms, and moderate (Condom Negative/Moderate Hostility) or high (Condom Negative/High Hostility) negative attitudes about women. The classes also differed in terms of their sexual behaviors. This study demonstrated that sexual risk behavior interventions should not only address the tactics through which men resist using condoms but also tailor these efforts to men's individual characteristics.
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Affiliation(s)
- Kelly Cue Davis
- School of Social Work, University of Washington, Seattle, WA
| | | | - Jeanette Norris
- Alcohol and Drug Abuse Institute, University of Washington, Seattle, WA
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46
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Thurstone C, Salomonsen-Sautel S, Mikulich-Gilbertson SK, Hartman CA, Sakai JT, Hoffenberg AS, McQueen MB, Min SJ, Crowley TJ, Corley RP, Hewitt JK, Hopfer CJ. Prevalence and predictors of injection drug use and risky sexual behaviors among adolescents in substance treatment. Am J Addict 2013; 22:558-65. [PMID: 24131163 DOI: 10.1111/j.1521-0391.2013.12064.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2011] [Revised: 09/26/2012] [Accepted: 10/08/2012] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The longitudinal risk for human immunodeficiency virus (HIV) infection following adolescent substance treatment is not known. Therefore, it is not known if adolescent substance treatment should include HIV prevention interventions. To address this important research gap, this study evaluates the longitudinal prevalence and predictors of injection drug use (IDU) and sex risk behaviors among adolescents in substance treatment. METHODS Participants were 260 adolescents (13-18 years) in substance treatment and 201 community control adolescents (11-19 years). Participants were assessed at baseline and follow-up (mean time between assessments = 6.9 years for the clinical sample and 5.6 years for the community control sample). Outcomes included self-report lifetime history of IDU, number of lifetime sex partners and frequency of unprotected sexual intercourse. RESULTS At baseline, 7.5% of the clinical sample, compared to 1.0% of the community control sample had a lifetime history of IDU (χ12=10.53, p = .001). At follow-up, 17.4% of the clinical sample compared to 0% of the community control sample had a lifetime history of IDU (χ12=26.61, p = .0005). The number of baseline substance use disorders and onset age of marijuana use significantly predicted the presence of lifetime IDU at follow-up, after adjusting for baseline age, race, and sex. The clinical sample reported more lifetime sex partners and more frequent unprotected sex than the community control sample at baseline and follow-up. CONCLUSIONS Many adolescents in substance treatment develop IDU and report persistent risky sex. Effective risk reduction interventions for adolescents in substance treatment are needed that address both IDU and risky sex.
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Affiliation(s)
- Christian Thurstone
- Denver Health and Hospital Authority, Denver, Colorado; University of Colorado Anschutz Medical Campus, Aurora, Colorado
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47
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Abstract
Adolescent and young adult male health receives little attention, despite the potential for positive effects on adult quality and length of life and reduction of health disparities and social inequalities. Pediatric providers, as the medical home for adolescents, are well positioned to address young men's health needs. This review has 2 primary objectives. The first is to review the literature on young men's health, focusing on morbidity and mortality in key areas of health and well-being. The second is to provide a clinically relevant review of the best practices in young men's health. This review covers male health issues related to health care access and the Centers for Disease Control and Prevention's Healthy 2020 objectives for adolescents and young adults, focusing on the objectives for chronic illness, mortality, unintentional injury and violence, mental health and substance use, and reproductive and sexual health. We focus, in particular, on gender-specific issues, particularly in reproductive and sexual health. The review provides recommendations for the overall care of adolescent and young adult males.
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Affiliation(s)
- David L Bell
- Department of Pediatrics, Department of Population and FamilyHealth, Columbia University Medical Center, New York, NY, USA.
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48
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Mustanski B, Byck GR, Newcomb ME, Henry D, Bolland J, Dick D. HIV information and behavioral skills moderate the effects of relationship type and substance use on HIV risk behaviors among African American youth. AIDS Patient Care STDS 2013; 27:342-51. [PMID: 23701198 DOI: 10.1089/apc.2012.0468] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The HIV/AIDS epidemic is disproportionately impacting young African Americans. Efforts to understand and address risk factors for unprotected sex in this population are critical in improving prevention efforts. Situational risk factors, such as relationship type and substance use before sex, are in need of further study. This study explored how established cognitive predictors of risky sexual behavior moderated the association between situational factors and unprotected sex among low-income, African American adolescents. The largest main effect on the number of unprotected sex acts was classifying the relationship as serious (event rate ratio=10.18); other significant main effects were alcohol use before sex, participant age, behavioral skills, and level of motivation. HIV information moderated the effect of partner age difference, motivation moderated the effects of partner age difference and drug use before sex, and behavioral skills moderated the effects of alcohol and drug use before sex. This novel, partnership-level approach provides insight into the complex interactions of situational and cognitive factors in sexual risk taking.
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Affiliation(s)
- Brian Mustanski
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Gayle R. Byck
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Michael E. Newcomb
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - David Henry
- Institute for Health Research and Policy, School of Public Health and Department of Psychology, University of Illinois at Chicago, Chicago, Illinois
| | - John Bolland
- College of Human Environmental Sciences, University of Alabama, Tuscaloosa, Alabama
| | - Danielle Dick
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University Department of Psychiatry, Richmond, Virginia
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49
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Brown CH, Mohr DC, Gallo CG, Mader C, Palinkas L, Wingood G, Prado G, Kellam SG, Pantin H, Poduska J, Gibbons R, McManus J, Ogihara M, Valente T, Wulczyn F, Czaja S, Sutcliffe G, Villamar J, Jacobs C. A computational future for preventing HIV in minority communities: how advanced technology can improve implementation of effective programs. J Acquir Immune Defic Syndr 2013; 63 Suppl 1:S72-84. [PMID: 23673892 PMCID: PMC3746769 DOI: 10.1097/qai.0b013e31829372bd] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
African Americans and Hispanics in the United States have much higher rates of HIV than non-minorities. There is now strong evidence that a range of behavioral interventions are efficacious in reducing sexual risk behavior in these populations. Although a handful of these programs are just beginning to be disseminated widely, we still have not implemented effective programs to a level that would reduce the population incidence of HIV for minorities. We proposed that innovative approaches involving computational technologies be explored for their use in both developing new interventions and in supporting wide-scale implementation of effective behavioral interventions. Mobile technologies have a place in both of these activities. First, mobile technologies can be used in sensing contexts and interacting to the unique preferences and needs of individuals at times where intervention to reduce risk would be most impactful. Second, mobile technologies can be used to improve the delivery of interventions by facilitators and their agencies. Systems science methods including social network analysis, agent-based models, computational linguistics, intelligent data analysis, and systems and software engineering all have strategic roles that can bring about advances in HIV prevention in minority communities. Using an existing mobile technology for depression and 3 effective HIV prevention programs, we illustrated how 8 areas in the intervention/implementation process can use innovative computational approaches to advance intervention adoption, fidelity, and sustainability.
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Affiliation(s)
- C Hendricks Brown
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Coral Gables, FL 33136, USA.
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50
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Sexual-risk behaviour and HIV testing among Canadian snowbirds who winter in Florida. Can J Aging 2013; 32:145-58. [PMID: 23632072 DOI: 10.1017/s0714980813000123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Rates of HIV (human immunodeficiency virus) and sexual-risk behaviour for those aged 50 and over in the United States are highest and increasing in Florida, where many Canadian "snowbirds" winter. This pilot study examined the sexual-risk behaviour and predictors of HIV testing in a convenience sample of Canadian snowbirds who winter in Florida (n = 265). Multivariate logistic regression analyses revealed that the odds of testing were increased for the unmarried, those aged 50-64, those who had talked to a doctor about sexual-risk behaviour since age 50, and those who agreed that sex was important in their lives. Dating males were more likely to test than non-dating males. Dating females were not more likely to test than non-dating females; and males who dated were 13.6 times more likely to test than females who dated. Further research will improve understanding of Canadian snowbirds' sexual interactions and HIV-testing behaviour.
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