The Decline in Adult Activities Among U.S. Adolescents, 1976–2016

Reasons for alcohol use from 1976 to 2020 in the United States among individuals aged 18 to 30: Historical changes and mediation of cohort effects in binge drinking

BACKGROUND

Alcohol use is declining among US adolescents/early young adults and increasing among other adults, with increases in adult binge drinking more concentrated in females than males. Reasons for drinking are historically patterned by age and sex, and if historically variant, could suggest that changes over time could in part explain age- and sex-differential cohort effects.

METHODS

We analyzed longitudinal Monitoring the Future data for individuals born from 1958 to 1990. These individuals were aged 29/30 from 1987 to 2020, and first surveyed at age 18 from 1976 to 2008 (N = 14,190). Five reasons for drinking were analyzed (social, enhancement, avoid problems, relax, boredom). Drinking for social reasons and to relax were most prevalent. Total effects of birth cohort predicting past-2-week binge drinking were estimated with polynomial regression models by age; indirect effects through mediators were estimated.

RESULTS

Drinking reasons exhibited dynamic time trends across birth cohort and sex. Notable increases were observed in social reasons: among women aged 29/30, social reasons increased from 53% to 87% from 1987 to 2020. Social reasons to drink had prominent positive indirect effects at adult ages (age 23/24 and above among men; age 19 and above among women), indicating that binge drinking would have increased less were it not for the increase in social reasons for drinking. Social reasons also mediated adult male/female differences, indicating that part of the reason sex differences are diminishing is the more rapid increases in social reasons for drinking among women. Indirect effects were also observed for drinking to relax and for boredom, and limited indirect effects were observed for enhancement and to avoid problems.

CONCLUSION

Changing endorsement of drinking reasons, especially social reasons, among US adult drinkers mediate cohort effects in binge drinking in the US adult population and explain in part why binge drinking is converging by sex.

An integrative literature review of birth cohort and time period trends in adolescent depression in the United States

PURPOSE

The aim of this literature review is to examine evidence of time trends and birth cohort effects in depressive disorders and symptoms among US adolescents in peer-reviewed articles from January 2004 to April 2022.

METHODS

We conducted an integrative systematic literature review. Three reviewers participated at different stages of article review. Of the 2234 articles identified in three databases (Pubmed, ProQuest Central, Ebscohost), 10 met inclusion criteria (i.e., adolescent aged United States populations, included information about birth cohort and survey year, focused on depressive symptoms/disorders).

RESULTS

All 10 articles observed increases in depressive symptoms and disorders in adolescents across recent survey years with increases observed between 1991 and 2020. Of the 3 articles that assessed birth cohort trends, birth cohort trends were less prominent than time period trends. Proposed explanations for increases included social media, economic-related reasons, changes in mental health screening and diagnosis, declining mental health stigma, increased treatment, and, in more recent years, the COVID-19 pandemic.

CONCLUSIONS

Multiple cross-sectional surveys and cohort studies documented rising prevalence of depressive symptoms and disorder among adolescents from 1991 to 2020. Mechanisms driving this increase are still unknown. Research to identify these mechanisms is needed to inform depression screening and intervention efforts for adolescents.

Annual Research Review: Sex, gender, and internalizing conditions among adolescents in the 21st century - trends, causes, consequences

Internalizing conditions of psychopathology include depressive and anxiety disorders; they most often onset in adolescence, are relatively common, and contribute to significant population morbidity and mortality. In this research review, we present the evidence that internalizing conditions, including depression and anxiety, as well as psychological distress, suicidal thoughts and self-harm, and fatal suicide, are considerably increasing in adolescent populations across many countries. Evidence indicates that increases are currently greatest in female adolescents. We present an epidemiological framework for evaluating the causes of these increases, and synthesize research on whether several established risk factors (e.g., age of pubertal transition and stressful life events) and novel risk factors (e.g., digital technology and social media) meet conditions necessary to be plausible causes of increases in adolescent internalizing conditions. We conclude that there are a multitude of potential causes of increases in adolescent internalizing conditions, outline evidence gaps including the lack of research on nonbinary and gender nonconforming populations, and recommend necessary prevention and intervention foci from a clinical and public health perspective.

Poverty and birth cohort effects of experiencing the 2007-2009 Great Recession during adolescence on major depressive episodes and mental health treatment of young adults in the United States

PURPOSE

Household economic adversity during adolescence is hypothesized to be a risk factor for poor mental health later in life. To test this hypothesis, we conducted a quasi-experimental analysis of an economic shock, the Great Recession of 2007-2009. We tested if going through adolescence during the Great Recession was associated with increased risk of major depressive episodes (MDE) and mental health treatment in young adulthood with potential moderation by household poverty to explore differences by economic adversity.

METHODS

We analyzed data on young adults age 18-29 years from the 2005-2019 National Survey on Drug Use and Health (N = 145,394). We compared participants who were adolescents during the recession to those followed-up prior to the recession. Regression analysis tested effect modification by household poverty status.

RESULTS

Adolescent exposure to the Great Recession was associated with higher likelihood of MDE during young adulthood (aOR = 1.30, 95% CI = 1.23, 1.37); there was no relationship with mental health treatment. Effects on MDE were stronger among those in households with higher incomes compared to those living in poverty.

CONCLUSION

Findings support the hypothesis that exposure to the Great Recession during adolescence may have increased risk for MDE, but raise questions about whether the mechanism of this association is economic distress.

Psychosocial correlates of drinking transitions: A longitudinal study among adolescents in Sweden

INTRODUCTION

Non-drinkers have been shown in older studies to have poorer mental health and social life compared to their alcohol-using counterparts. Given the profound decline in adolescent drinking observed in most high-income countries, this pattern may have changed. This study explores drinking transitions and examines psychosocial factors among adolescents by longitudinal drinking status.

METHODS

Data were based on two waves of a prospective longitudinal nationwide study (n = 4018). The first wave (T1) of data was collected in 2017 (age 15/16) and the second wave (T2) was in 2019 (age 17/18). Respondents were asked about their past year drinking status, general health, psychosomatic problems, psychiatric medication, school enjoyment, emotional symptoms, peer relationship problems, prosocial ability, friendships satisfaction and satisfaction with relation to mother/father. Comparisons by mean values were assessed and multinomial logistic regressions were used to examine associations.

RESULTS

Abstainers and later drinkers differed significantly from early drinkers on 9/10 factors respectively at T1. Fewer psychosomatic problems, less psychiatric medication, higher school enjoyment, more emotional symptoms, higher parental relationship satisfaction, more peer problems and lower friendships satisfaction at T1 were associated with abstaining and/or later drinking. All factors were more strongly associated with abstaining. School enjoyment predicted abstaining but not later drinking.

DISCUSSION AND CONCLUSIONS

Longitudinal drinking status relates to small to moderate systematic psychosocial differences. Adolescents with better mental health, more content relationships with parents and lower friendships satisfaction are more often abstainers. Those generally worse off are more likely early drinkers but they also have better friendships.

Time-varying associations between parental closeness, self-esteem, and sexual behavior across adolescence and emerging adulthood

This study applied the time-varying effect model (TVEM) to data from the National Longitudinal Study of Adolescent to Adult Health to explore how self-esteem mediated age-varying associations of closeness to mother and father and their child's sexual behavior through adolescence and emerging adulthood. Paternal closeness is associated with lesser odds of sexual behaviors for both female and male adolescents until age 20, whereas maternal closeness only predicts for female adolescents between ages 13 and 15. Self-esteem mediated the association between mother closeness and multiple partners in male adolescents between ages 14.5 and 16.5. Fathers have an impact on adolescent sexual behavior across adolescence and emerging adulthood, while mothers' roles are more important for female adolescents in early adolescence.

Lifetime use of alcohol and cannabis among U.S. adolescents across age: Exploring differential patterns by sex and race/ethnicity using the 2019 NSDUH data

Background

Early use of alcohol and cannabis is associated with health and social problems. It is unclear how lifetime use changes for each additional year of age during adolescence, and whether this change varies by sex and race/ethnicity. This study characterized lifetime rates of alcohol and cannabis use by age among 12- to 17-year-old American youth and explored differential patterns by sex and race/ethnicity.

Methods

Data were obtained from the 2019 National Survey on Drug Use and Health. Analyses were restricted to 12-17-year-olds who were non-Hispanic White, non-Hispanic Black, or Hispanic/Latino (n = 11,830). We estimated the increase in lifetime use of alcohol and cannabis by age for the full sample and stratified by sex and race/ethnicity. Slopes of the regression lines were compared to assess differential patterns across groups.

Results

In these cross-sectional analyses, reported lifetime use increased substantially from age 12 to 17 for alcohol (6.4 % to 53.2 %) and cannabis (1.3 % to 35.9 %). The increase in lifetime alcohol use was slightly, but not significantly, steeper among girls than boys (F1,8 = 3.40, p = 0.09). White and Latino youth showed similar rates of increase in lifetime alcohol use, which was significantly flatter among Black youth (F2,12=21.26, p<0.0001). Latino youth had a slightly, but not significantly, steeper increase in lifetime cannabis use than White and Black youth (F2,12=3.17, p = 0.07).

Conclusions

Reports of lifetime alcohol and cannabis use substantially increase from age 12 to 17 and the rates are different according to sex and race/ethnicity, highlighting the need for early and tailored substance use prevention in adolescents.

Sexual pleasure during college students' most recent partnered sexual experiences

ObjectiveWe explored college students' sexual pleasure using a new self-report measure, the Body, Emotions, Sensations, Touch/Trust (B.E.S.T.) Scale of Sexual Pleasure. Participants: Data were from 3997 randomly sampled students with a partnered sexual experience. Methods: Students completed an online survey about their most recent partnered sexual experience. Data was collected in January 2020. Results: Students find the nonphysical aspects of partnered sex (e.g., emotions, trust, connection with partners) as pleasurable as physical aspects (e.g., behaviors engaged and received, bodily sensations). Self-reported arousal, wantedness, and emotional intimacy were the strongest correlates of male, female, and transgender/gender non-binary students' sexual pleasure. Few sexual behaviors were associated with sexual pleasure and only one - cuddling for women - was associated with greater sexual pleasure. Conclusions: Students find their partnered sexual experiences pleasurable. Students' sex may be more pleasurable when they feel ready for sex, desire sex, and feel close to their partners.

A multicenter study of the relationship between the compulsory time spent at home and sexual functioning

OBJECTIVE

To investigate how sexual life is affected by the increase in the amount of time spent at home due to the restrictions of the coronavirus disease 2019 (COVID-19) pandemic, and the relationships among depression, anxiety, amount of stress, and sexuality.

METHODS

This cross-sectional study was conducted in two cities, Istanbul (metropolitan city) and Rize (city in a rural area). All data were collected face to face in the gynecology outpatient clinics from patients who came in for benign gynecologic reasons or a check-up. The questionnaire comprised a sociodemographic form, the Arizona Sexual Experience Scale (ASEX) Scale, and the Depression Anxiety Stress Scale.

RESULTS

A total of 459 participants took part in the study. Around half of the participants were living in an urban area. There was a statistically significant increase in weekly sexual intercourse frequency for both groups. Sexual desire and arousal scores were significantly higher in the rural groups. There was a significant decrease in sexual pleasure within urban groups. Depression, anxiety, and stress scores were significantly higher in urban groups. There was no statistically significant difference in ASEX total scores between groups.

CONCLUSIONS

This study suggests that even though the rate of COVID-19 and restrictions did not differ between the compared areas, the lockdown may have had a greater effect on the sexual pleasure of women in urban areas.

Decreasing alcohol use among young adults presenting for service in the U.S. Air Force: An epidemiological surveillance study

U.S. surveys demonstrate recent decreases in the prevalence of alcohol use and binge drinking among young adults. The current study aims to determine whether similar trends are evident in a similarly aged cohort of service members in the US Air Force to inform ongoing prevention efforts. Participants were 103,240 Air Force personnel in entry-level training between 2016 and 2019. Participants anonymously completed the AUDIT (Alcohol Use Disorder Identification Test) regarding their pre-service drinking. Logistic regression analyses and the Cochran-Armitage test were conducted to measure population trends over the study duration with stratification by age (<21 vs. ≥21) and evaluation of specific alcohol behaviors. Between 2016 and 2019, the proportion of young service members endorsing any alcohol use significantly decreased for both the <21 group (i.e. from 38.9% to 32.6%) and the ≥21 group (i.e. from 80.6% to 77.5%). Among those who endorsed drinking, a decrease over time in binge use was also observed from 46.6% to 37.8% for the <21 group and from 34.2% to 27.5% for the ≥21 group. Responses to other specific alcohol risk items and total AUDIT scores also demonstrated decreases. Binge use and risky drinking remained disproportionately common among those under the legal drinking age. It is encouraging to observe a shift toward abstinence and decreased binge use among this population of young military recruits. However, given the risk for many adverse health and legal consequences in this population, more work is needed to prevent problematic drinking, especially among those under the legal drinking age.

Changes in sexually transmitted infections-related sexual risk-taking among young Croatian adults: a 2005-2021 three-wave population-based study

AIM

To assess the prevalence and dynamics of risky sexual behaviors among Croatian emerging adults in the 2005-2021 period.

METHODS

Three surveys were conducted on large-scale national samples of young adults aged 18-24 in 2005 (N=1092) and 18-25 in 2010 and 2021 (N=1005 and N=1210, respectively). The 2005 and 2010 studies were conducted with face-to-face interviews on stratified probabilistic samples. The 2021 study was conducted by computer-assisted web-interviewing on a quota-based random sample from the largest national online panel.

RESULTS

Compared with 2005 and 2010, the age at coital debut increased for both genders in 2021 (by a median of one year, to 18 years, and by a mean of half a year, to 17.5 years, in men and to 17.9 in women). In the 2005-2021 period, condom use increased by about 15% both at first intercourse (to 80%) and in consistent use (to 40% in women and 50% in men). When we controlled for basic socio-demographics, Cox and logistic regressions indicated that, for both genders, in 2005 and 2010 compared with 2021, the risks/odds were significantly higher for reporting an earlier sexual debut (adjusted hazard ratio 1.25-1.37), multiple sexual partners (adjusted odds ratio [AOR] 1.62-3.31), and concurrent relationships (AOR 3.36-4.64), while the odds were lower for condom use at first sexual intercourse (AOR 0.24-0.46) and consistently (AOR 0.51-0.64).

CONCLUSION

Risky sexual behaviors decreased in the 2021 survey compared with the previous two waves, in both genders. Nonetheless, sexual risk-taking is still frequent among young Croatian adults. The introduction of sexuality education and other national-level public health interventions to reduce sexual risk-taking thus remains a public health imperative.

Adolescence as the Context for Understanding Young Mothers' Engagement with Health Promotion: A Phenomenological Exploration

BACKGROUND

The current social construction of young mothers is generally negative, pointing to a lack of engagement with universal services and poor outcomes for their infants and children. However, qualitative studies offer an alternative, more positive construct of young motherhood. Understanding the context of young motherhood can improve the relevance and efficacy of health promotion directed to this group of high-risk mothers.

AIM

To explore the lived experience of young women transitioning to motherhood to better understand their experiences and perspective; and what influences their engagement with health promotion aimed to support safer parenting practices and whether their behaviour changes over time with exposure to parenting health promotion.

METHOD

Longitudinal Interpretative Phenomenological Analysis (IPA) was used with five first-time mothers identified with characteristics known to influence poorer outcomes for infants and children such as low educational achievement and economic disadvantage. Participants aged 16 to 19 years were recruited antenatally. Serial in-depth interviews were conducted at three time points during the ante- and post-natal periods. Interviews were transcribed and data were analysed inductively following the prescribed method of double hermeneutic analysis for IPA.

FINDING

Three themes were identified from the full study: Transition, Information, and Fractured application; the focus of this paper is Transition. Transition revealed that becoming mothers impacted key adolescent developmental tasks; their identity and relationships were significantly affected, both positively and negatively and adolescent brain development influenced behaviour and decision making capability. Adolescence influenced how these young mothers engaged with and interpreted parenting health promotion messages.

CONCLUSIONS

Young mothers in this study operate within the context of adolescence. Adolescence impacts participants' decision making activity and early parenting behaviours which informs the debate on why young mothers may fail to reduce risks for their infants. This insight can contribute to the development of more effective health promotion/educational strategies, and support professionals to better engage with this high-risk group to improve early parenting behaviour and subsequently improve outcomes for their infants and children.

iGen or shyGen? Generational Differences in Shyness

Generation Z (1997-2012) has been characterized in the popular media as more socially inhibited, cautious, and risk averse than prior generations, but are these differences found between generations on an empirical level? And, if so, are these differences observable within generations in response to acute events such as the COVID-19 pandemic? Using a simplified time-lagged design to control for age effects, we examined between-group differences in self-reported shyness in young adult participants (N = 806, age: 17-25 years) at the same developmental age and university from the millennial generation (tested: 1999-2001; n = 266, M_age = 19.67 years, 72.9% female) and Generation Z (tested: 2018-2020), the latter generation stratified into prepandemic (n = 263, M = 18.86 years, 82.4% female) and midpandemic (n = 277, M_age = 18.67 years, 79.6% female) groups. After first establishing measurement invariance to ensure trustworthy group comparisons, we found significantly higher mean levels of shyness across each successive cohort, starting with millennials, through Generation Z before the pandemic, to Generation Z during the pandemic.

Decline in youth drinking in high-income settings: Implications for public health in low-income countries

Declining drinking among youth in many high-income countries has attracted scholarly attention and debates. Still, researchers are yet to globalize such research or examine its public health implications for low-resource settings. This commentary has two interrelated purposes. First, using evidence from Nigeria, it highlights how declining youth drinking in high-income countries may impact public health in low-income countries. Second, it highlights the necessity for research to examine youth drinking behaviours simultaneously worldwide. The declining drinking trends among young people in high-income countries have occurred simultaneously with global alcohol corporations being more aggressive in low-income countries like Nigeria. Relatedly, alcohol corporations may employ evidence regarding declines in drinking to argue against implementing stringent policies or other effective interventions in Nigeria (and other low-income settings), claiming their apparent success in the falling drinking trends in high-income settings. The article argues that research on the drinking decline among young people should be globalized because without commensurate attempts to examine their drinking behaviours/trends worldwide simultaneously, public and/or global health may be harmed for the reasons explored in this article.

The Generation Gap Revisited: Generational Differences in Mental Health, Maladaptive Coping Behaviors, and Pandemic-Related Concerns During the Initial COVID-19 Pandemic

The purpose of this study was to assess differences in mental health symptoms, pandemic-related concerns, and maladaptive coping behaviors among adults in the United States across generations during the initial period of the COVID-19 pandemic. A social media campaign was used to recruit 2696 U.S. individuals to participate in an online survey in April 2020, assessing various validated psychosocial factors, including major depressive disorder, generalized anxiety disorder (GAD), perceived stress, loneliness, quality of life, and fatigue, along with pandemic-specific concerns and changes in alcohol use and substance use. Participants were grouped based on generation status (Gen Z, Millennial, Gen X, and Baby Boomer) and statistical comparisons were conducted based on demographics, psychosocial factors, pandemic-related concerns, and substance use. During the initial period of the COVID-19 pandemic, the younger cohorts (Gen Z and Millennials) rated significantly worse on mental health indices, including major depression, GAD, perceived stress, loneliness, quality of life, and fatigue. Further, the participants in the Gen Z and Millennial generational groups exhibited greater increase in maladaptive coping with substance use, specifically alcohol use and increased use of sleep aids. Our results indicate that during the initial period of the COVID-19 pandemic, members of the Gen Z and Millennial generational cohorts were considered a psychologically vulnerable population due to their mental health and maladaptive coping behaviors. Improving access to mental health resources during early stages of a pandemic is an emerging public health concern.

Ambivalence in Adolescents’ Alcohol Expectancies: A Longitudinal Mixed Methods Study Among 12-to-18-Year-Olds

Drawing on the framework of alcohol expectancies and their importance for drinking behaviors, this longitudinal mixed-methods study examined changes and continuities in development of alcohol expectancies during adolescence. Quantitative and qualitative data were prospectively collected at four time points between 2015 and 2020 from nationwide, socio-economic, and gender-balanced samples of Norwegian adolescents aged 12–18. Quantitative data ( n = 3425) were analyzed using linear mixed-effects models, and qualitative data ( nT1 = 118) using thematic analysis. Quantitative and qualitative results were juxtaposed in the discussion. Quantitative results indicated an increase in social facilitation and tension reduction expectancies from age 13 to 18, and a simultaneous decrease in negative emotional expectancies. This development could partly be explained by experience with alcohol use in adolescence. Similarly, qualitative findings showed adolescents’ expectancies of alcohol evolving with age; from one-sided negative expectancies of aggression and harm to increased positive expectancies of fun, sociability, and relaxation. Both analyses showed that negative expectances remained high throughout the study period, but by late adolescence, many participants held positive and negative expectations simultaneously. The qualitative data illustrated how adolescents’ alcohol expectancies became increasingly ambivalent and complex with age, as alcohol use became more common. Prevention strategies aiming to reduce underage alcohol use should acknowledge this complexity.

Exploration of Emerging Adult Virgins' Difficulties

Social clock theory posits that off-time transitions, such as virginity loss, are often socially reproached and stigmatized. Research suggests, however, that reasons for virginity in adulthood are heterogeneous and that some emerging adult virgins (EAVs) are struggling socially. To guide the development of interventions tailored to this population, it is important to understand their difficulties. Through individual semi-structured interviews, this study explores the difficulties and disagreeable emotions experienced by 29 heterosexual virgins aged between 20 and 29. The data were analyzed using thematic analysis. Three main themes were identified: (a) difficulties related to society, (b) difficulties related to interpersonal relationships, and (c) disagreeable emotions experienced relative to late virginity. These results reveal that difficulties expressed by EAVs are intertwined and surprisingly, the most salient difficulty was related to lack of intimacy, rather than virginity per se. Theoretical and clinical implications are discussed, along with recommendations for future research.

Positive and negative risk-taking: Age patterns and relations to domain-specific risk-taking

People take risks at all ages to achieve certain goals. Although these goals may be achieved through negative risks (e.g., adolescent drinking to impress their friends), people also take positive risks. Positive risks are theorized to help individuals achieve goals in developmentally appropriate and socially acceptable ways, such as initiating a new friendship as an adolescent, applying for a promotion as a young adult, or exploring a new hobby as a retiree. To test the hypothesis that people endorse different patterns of risk-taking across life, we examined age patterns in positive and negative risk-taking with a sample of individuals ranging in age from 12 to 71 years. In adults aged 19-71, we also examined to what extent positive and negative risk-taking are associated with domain-specific risk-taking and risk-taking propensity. Results indicated that positive risk-taking varied with age in the form of an inverted-U shape and peaked in middle adulthood. Negative antisocial risk-taking varied with age in the form of a U shape and was highest in adolescence. Negative health risk-taking varied with age in the form of an inverted-U shape and peaked in middle adulthood. In adults, greater positive risk-taking was associated with greater risk-taking in the social domain and greater risk-taking propensity. Greater negative risk-taking was associated with greater risk-taking in ethical and health/safety domains, and with greater risk-taking propensity. Altogether, this study is the first to demonstrate age patterns in positive and negative risk-taking across adolescence and adulthood. It also contributes to the validity of positive risk-taking as a construct distinct from negative risk-taking.

How Covid-19 restrictions affected young people's well-being and drinking practices: Analyzing interviews with a socio-material approach

BACKGROUND

The Covid-19 restrictions - as they made young people's practices in their everyday life visible for reflection and reformation - provide a productive opportunity to study how changing conditions affected young people's well-being and drinking practices.

METHODS

The data is based on qualitative interviews with 18- to 24-year-old Swedes (n=33) collected in the Autumn 2021. By drawing on the socio-material approach, the paper traces actants, assemblages and trajectories that moved the participants towards increased or decreased well-being during the lockdown.

RESULTS

The Covid-19 restrictions made the participants reorganize their everyday life practices emphatically around the home and communication technologies. The restrictions gave rise to both worsened and improved well-being trajectories. In the worsened well-being trajectories, the pandemic restrictions moved the participants towards loneliness, loss of routines, passivity, physical barriers, self-centered thoughts, negative effects of digital technology, sleep deficit, identity crisis, anxiety, depression, and stress. In the improved well-being trajectories, the Covid-19 restrictions brought about freedom to study from a distance, more time for significant others, oneself and for one's own hobbies, new productive practices at home and a better understanding of what kind of person one is. Both worsened and improved well-being trajectories were related to the aim to perform well, and in them drinking practices either diminished or increased the participants' capacities and competencies for well-being.

CONCLUSIONS

The results suggest that material domestic spaces, communication technologies and performance are important actants both for alcohol consumption and well-being among young people. These actants may increase or decrease young people's drinking and well-being depending on what kinds of relations become assembled.

Declines in Pregnancies among U.S. Adolescents from 2007 to 2017: Behavioral Contributors to the Trend

STUDY OBJECTIVES

Adolescent pregnancies and births in the United States have undergone dramatic declines in recent decades. We aimed to estimate the contribution of changes in 3 proximal behaviors to these declines among 14- to 18-year-olds for 2007-2017: 1) delays in age at first sexual intercourse, 2) declines in number of sexual partners, and 3) changes in contraceptive use, particularly uptake of long-acting reversible contraception (LARC).

DESIGN

We adapted an existing iterative dynamic population model and parameterized it using 6 waves of the Centers for Disease Control and Prevention's Youth Risk Behavior Survey. We compared pregnancies from observed behavioral trends with counterfactual scenarios that assumed constant behaviors over the decade. We calculated outcomes by cause, year, and age.

RESULTS

We found that changes in these behaviors could explain pregnancy reductions of 496,200, 78,500, and 40,700 over the decade, respectively, with total medical and societal cost savings of $9.71 billion, $1.54 billion, and $796 million. LARC adoption, particularly among 18-year-olds, could explain much of the improvement from contraception use. The 3 factors together did not fully explain observed birth declines; adding a 50% decline in sex acts per partner did.

CONCLUSIONS

Delays in first sexual intercourse contributed the most to declining births over this decade, although all behaviors considered had major effects. Differences from earlier models could result from differences in years and ages covered. Evidence-based teen pregnancy prevention programs, including comprehensive sex education, youth-friendly reproductive health services, and parental and community support, can continue to address these drivers and reduce teen pregnancy.

Sexual Behavior and Health From Adolescence to Adulthood: Illustrative Examples of 25 Years of Research From Add Health

Due to its long-term longitudinal design, the National Longitudinal Study of Adolescent to Adult Health (Add Health) has provided numerous valuable insights into adolescent and young adult sexual behavior. Framed by a conceptual model of sexual behavior and health, I review research using Add Health data to study sexual behavior and health. In this paper, I review research examining both predictors (e.g., neighborhood, family, genetic, individual) and health outcomes (e.g., sexually transmitted infections, mental health) of sexual behavior in adolescents and young adults. Where possible, I focus on long-term longitudinal studies that make use of the unique strengths of the Add Health data. Existing Add Health research has provided considerable information about both the predictors and health consequences of adolescent and young adult sexual behavior. Factors ranging from neighborhoods to genetics predict whether adolescent and young adults engage in sexual behaviors. Findings on long-term outcomes of adolescent sexual behavior suggest that early sexual behavior predicts higher rates of sexually transmitted infections and pregnancy in young adulthood, but not long-term changes to mental health. Unique contributions of Add Health include the ability to examine multidimensional bio-ecological predictors of sexual behavior and to examine long-term effects of sexual behavior and how sexual behaviors and their correlates change across adolescence into adulthood. Future work can leverage these strengths, and in particular the long-term longitudinal nature of the data, to uncover new insights about the developmental course of sexual behavior and health.

Temporal Trends and Differences in Sexuality among Depressed and Non-Depressed Adults in the United States

This study aimed to examine temporal trends and differences in sexuality between depressed and non-depressed adults aged 18-59 in the United States from 2005 to 2016. A total of 21,437 people (5432 with depression) were enrolled in this cross-sectional study. From 2005-2008 to 2013-2016, the average age at first sexual intercourse decreased, while the proportion of normal frequency of sexual activity and heterosexual sexual orientation increased among all the participants. Some differences in sexuality were found between the depressed and non-depressed groups. The average age at first sexual intercourse (p < 0.001), the proportion of normal frequency of sexual activity (p < 0.001), and heterosexual sexual orientation (p < 0.001) were lower in depressed participants, and the differences did not change over time (p_{for trend} = 0.926 of average age at first sexual intercourse, p_{for trend} = 0.823 of normal frequency of sexual activity, p_{for trend} = 0.926 of heterosexual sexual orientation). Moreover, these differences were associated with marital status (p_{for interaction} < 0.001 by average age at first sexual intercourse), employment status (p_{for interaction} < 0.001 by average age at first sexual intercourse), education status (p_{for interaction} = 0.023 by heterosexual sexual orientation) and family income status (p_{for interaction} = 0.013 by average age at first sexual intercourse and p_{for interaction} = 0.017 by normal frequency of sexual activity). In conclusion, the study found that the age at first sexual intercourse decreased and the frequency of sexual intercourse increased in all the participants, and differences in sexuality between depressed and non-depressed participants were present; however, these differences had no further increase or decrease during the 12-year period. These differences were associated with marital status, employment status, education status, and family income status. These findings show differences in sexuality between depressed and non-depressed patients but are somewhat different from previous studies; the results may provide directions for future research and social work.

Experiences of the Ukrainian adolescents during the Russia-Ukraine 2022 War

Purpose

The study aims to explore the current experiences of Ukrainian adolescents affected by the Russia-Ukraine war. The study focused on the changes in adolescents’ lives caused by the war, adolescents’ emotional reactions to the disruptions caused by the war, coping strategies employed by adolescents in dealing with disruptions and the role of information technology in supporting new realities and coping strategies of adolescents.

Design/methodology/approach

This study relied on semi-structured interviews conducted on Zoom with 27 Ukrainian adolescents ages 10-18. Participants were recruited using the snowball sample and came from various regions of Ukraine. The interview notes and partial transcripts were analyzed using thematic analysis to identify the common and unique patterns in participant responses.

Findings

The interview data revealed the signs of traumatic experiences and various stages and methods of coping with them. Participants’ resilience was supported by external factors, including families, communities, continuous schooling, ability to talk to friends, information technology, as well as internal skills, including social competence, problem-solving, critical consciousness, autonomy and a sense of purpose. Participants shared specific recommendations for improving information platforms and online content, e.g. making them more accessible and affordable for Ukrainian users, improving content curation and personalization, creating and promoting Ukrainian content and others.

Research limitations/implications

Research relied on convenience sample of participants who had access to information communication technology (ICT), were aware and had an ability to participate. Field work is needed to reach out to participants without access to ICT.

Practical implications

This study contains broad recommendations for improving information technologies for the use of Ukrainian adolescents.

Social implications

This research offers three timely account of the first-hand experiences of Ukrainian adolescents affected by the Russia-Ukraine war and can inform future work aimed at improving life conditions for teen population.

Originality/value

This study relied on first-hand reports of Ukrainian adolescents’ experiences, feelings and coping strategies during the first three months of Russia-Ukraine war. The study applied war trauma and resilience frameworks to interpret the findings and translate some of the findings into practical recommendations for the information science community.

Adolescents' Use of Free Time and Associations with Substance Use from 1991 to 2019

Background: Understanding time trends in risk factors for substance use may contextualize and explain differing time trends in substance use. Methods: We examined data (N = 536,291; grades 8/10/12) from Monitoring the Future, years 1991-2019. Using Latent Profile Analyses, we identified six time use patterns: one for those working at a paid job and the other five defined by levels of socialization (low/high) and engagement in structured activities like sports (engaged/disengaged), with the high social/engaged group split further by levels of unsupervised social activities. We tested associations between time use profiles and past two-week binge drinking as well as past-month alcohol use, cigarette use, cannabis use, other substance use, and vaping. We examined trends and group differences overall and by decade (or for vaping outcomes, year). Results: Prevalence of most substance use outcomes decreased over time among all groups. Cannabis use increased, with the largest increase in the group engaged in paid employment. Vaping substantially increased, with the highest nicotine vaping increase in the high social/engaged group with less supervision and the highest cannabis vaping increase in the highly social but otherwise disengaged group. Substance use was lowest in the low social groups, highest in the high social and employed groups. Conclusions: While alcohol, cigarette, and other substance use have declined for all groups, use remained elevated given high levels of social time, especially with low engagement in structured activities or low supervision, or paid employment. Cannabis use and vaping are increasing across groups, suggesting the need for enhanced public health measures.

Time use and associations with internalizing symptoms from 1991 to 2019 among US adolescents

Introduction

Adolescent time use in recent cohorts is distinguished by large-scale changes, including shifts in parental monitoring, supervision, and adolescent activity patterns, that together may provide a more complete perspective on changing patterns of mental health than can be captured by single risk factors.

Methods

To determine whether patterns of adolescent time use explain recent increases in depressive and other internalizing symptoms, we first conducted latent profile analyses of 465,839 adolescents, grades 8/10, from annual, cross-sectional Monitoring the Future surveys, years:1991-2019, using twenty-one variables (e.g., frequency of attending parties) to identify groups based on patterns of time use. Most of the sample was female (51.0%), non-Hispanic white (58.8%), and in grade 8 (52.2%); mean age: 14.60 years (95% CI: 14.57, 14.64). We subsequently examined differences in depressive and other internalizing symptoms between these time use groups over time with survey-weighted logistic regressions producing odds ratios.

Results

Analyses derived six groups: part time workers, full time workers, and four groups based on levels of social activities (Low, medium, and high levels, with "High Social" split between those engaged in sports, academics, and community service and those who were not). Internalizing symptoms were predicted by lower socialization, low engagement in activities like sports, academics, and community service, and time spent at a paid job. Adolescents decreasingly engaged in social activities over time, though shifts in time use patterns did not account for much of the overall increase in depressive symptoms.

Conclusion

Shifts in adolescent time use do not explain increases in depressive and other internalizing symptoms, which increased across different patterns of time use. Levels of internalizing symptoms were highest among those with low socialization, low recreational engagement, and those working substantial hours. Encouraging socialization, engagement in recreational activities, and providing mental health resources for isolated adolescents may reduce internalizing symptom trends.

Benefits of Bullying? A Test of the Evolutionary Hypothesis in Three Cohorts

Recent work on bullying perpetration includes the hypothesis that bullying carries an evolutionary advantage for perpetrators in terms of health and reproductive success. We tested this hypothesis in the National Child Development Study (n = 4998 male, n = 4831 female), British Cohort Study 1970 (n = 4261 male, n = 4432 female), and TRacking Adolescents' Individual Lives Survey (n = 486 male, n = 521 female), where bullying was assessed in adolescence (NCDS, BCS70: age 16, TRAILS: age 14) and outcomes in adulthood. Partial support for the evolutionary hypothesis was found as bullies had more children in NCDS and engaged in sexual intercourse earlier in TRAILS. In contrast, bullies reported worse health in NCDS and BCS70.

Associations between screen time and internalizing disorder diagnoses among 9- to 10-year-olds

BACKGROUND

Children and adolescents spend an increasing amount of time with screen media. Identifying correlates of youth mental disorders has become more urgent with rates of depression, self-harm, suicide attempts, and suicide deaths rising sharply among U.S. children and adolescents after 2012. This study examined the relationship between screen time and internalizing disorders in preadolescent children between the ages of 9 and 10.

METHODS

Participants were 9- and 10-year-old youth (n = 11,780) in the baseline of the multi-site Adolescent Brain and Cognitive Development Study (ABCD). Youth reported the number of hours a day they spent watching TV shows or movies, watching videos online, playing video games, texting, using social media, and video chatting. Youth responded to an abbreviated version of the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS-5), a semi-structured clinical interview measuring current and past symptoms of internalizing disorders using DSM-5 criteria.

RESULTS

Youth spending 2 or more hours (vs. less than 2) a day with screen media were more likely to fit criteria for depressive disorders, self-harm, and suicidal ideation or attempts, even after adjustment for demographic covariates. For anxiety disorders, associations with digital media use (social media, texting, gaming, and online videos) were stronger than with screen time generally.

LIMITATIONS

This is a cross-sectional study utilizing retrospective screen time reports, which limits our ability to determine causality and the accuracy of the reports.

CONCLUSIONS

Preadolescents who spend more time using screens, especially digital media, are more likely to fit DSM-5 criteria for internalizing disorders.

Motivations for Maintaining Virginity Among US Adolescents

PURPOSE

This study describes trends in virginity and the motivations for maintaining virginity between 2006 and 2019 among 15- to 19-year-old adolescents in the United States.

METHODS

We used logistic regression and the margins command in Stata to estimate the proportion reporting virginity and the primary motivation for virginity during each survey period and the lincom command to facilitate statistical comparisons across time.

RESULTS

The proportion of males reporting virginity increased (from 56% to 61%), and the distribution of reasons for maintaining virginity shifted over time. Most females and males reported not having "found the right person" (16%-25% for females; 26%-35% for males), and a small percentage of females reported religion and morality (39%-27%) as motivations for abstinence.

DISCUSSION

The calculus of adolescents' sexual decision-making is changing, pointing to a need for new, longitudinal data aimed at clarifying the role of sexual (in)activity in teens' lives.

African Americans and the COVID-19 pandemic: A qualitative inquiry of preparedness, challenges, and strategies on how we can move forward

RATIONALE

The COVID-19 pandemic has disproportionately impacted Black Americans. Inequities in systems and social determinants of health along with racial health disparities impact degree of pandemic preparedness.

OBJECTIVE

In early pandemic stages, we aimed to explore: 1) state of pandemic preparedness; 2) effects of socio-ecological factors on preparedness; and 3) multi-level strategies to increase preparedness among uniquely, vulnerable Black American subgroups.

METHODS

We conducted 62 in-depth interviews with Black American community members representing parents, individuals with underlying medical conditions, essential workers, and young adults. Based on the McLeroy's Model Ecological for Health Promotion, an inductive-deductive content analysis approach was used to analyze the interview data around the factors influencing preparedness on individual, interpersonal processes and primary groups, community/institutional, and public policy.

RESULTS

Majority (56.5%) of the participants stated they were somewhat or very prepared. We identified four themes: 1) Lived Experiences during the COVID-19 Pandemic; 2) Challenges experienced during the COVID-19 Pandemic; 3) I would do this differently they say; 4) Changes Needed to Survive the Pandemic relate to Public Policy, Community/institutional factors, and Interpersonal processes and primary group(s). All participants described their adjustments to live in the new norm. Participants identified perceived challenges and solutions on multi-levels, driven by subgroup.

CONCLUSIONS

Pandemic response plans should use targeted strategies across multi-levels to enhance the preparedness of Black Americans, especially those in vulnerable groups. This could reduce the disproportionate COVID-19 disease burden exhibited by Black Americans and better prepare for future pandemics.

Analysis of AUDIT Domains in Freshman Students in Spain: Three Cross-Sectional Surveys (2005, 2012 and 2016)

Purpose: We aimed to evaluate changes in the frequency of drinking, alcohol dependence and alcohol-related harm in freshman college students from 2005, 2012 and 2016, and identify risk-associated factors. Method: A cross-sectional study involving 5009 freshman students was carried out in Spain in 2005, 2012 and 2016. The Dimensions of Alcohol Use Disorders Identification Test (frequency of drinking, symptoms of dependence and alcohol-related harm) was analysed. Adjusted relative risks (RRs) and their 95% confidence intervals were estimated using negative binomial regression. Results: Place of residence, positive expectancies and early onset of alcohol consumption continue to be crucial conditions for developing patterns of risky consumption, alcohol dependence and harm. Women and men were more vulnerable to alcohol harm and dependence when living away from home, having higher economic status and positive alcohol expectancies. Cohorts from 2012 and 2016 were at lower risk of risky alcohol consumption. Men belonging to the 2012 and 2016 cohorts were at lower risk of alcohol negative consequences compared with the 2005 cohort. However, women remained vulnerable over time to alcohol dependence and harm. Starting drinking after 16 protects them both from alcohol dependence and harm. Conclusions: Women are more vulnerable to alcohol dependence and harm in recent cohorts of freshmen. Limiting access to alcohol at a younger age and working on false positive expectancies could benefit freshmen by avoiding alcohol damage and alcohol dependence.

The kids are alright: adolescents’ experiences during COVID-19 disruption

Purpose

This study aimed to understand adolescents’ experiences, negative feelings and coping mechanisms associated with the major disruption caused by the COVID-19 pandemic. The purpose of this study was to develop a baseline for understanding adolescents and their environment to assist future developments of technological and other solutions to mitigate adolescents’ loneliness, improve their wellbeing and strengthen their resilience.

Design/methodology/approach

The data about adolescents’ experiences during the COVID-19 pandemic was collected through virtual interviews conducted via Zoom. A total of 39 adolescents (aged 12 through 18 years) primarily from the North East of the USA participated in the study. The transcripts of the interviews were analyzed using thematic analysis.

Findings

This study found evidence of negative disruptions to adolescents’ social, learning and emotional routines. This study also found that in dealing with the effects of COVID-19 disruption, most of the participants exhibited five key attributes of individual resilience, including social competence, problem-solving, critical consciousness, autonomy and a sense of purpose. External factors supporting resilience were also mentioned, including technology resources, family, school and broader community.

Originality/value

This study relied on first-hand adolescents’ reports of their experiences, feelings and coping strategies during the pandemic. This study applied a resilience framework to interpret the findings and translate them into recommendations for further development of support systems for adolescents.

Declining drinking among adolescents: Are we seeing a denormalisation of drinking and a normalisation of non-drinking?

BACKGROUND

In the early 2000s, alcohol use among young people began to decline in many western countries, especially among adolescents (ages between 12-17 years old). These declines have continued steadily over the past two decades, against the backdrop of much smaller declines among the general population.

ARGUMENT

Hypotheses examining individual factors fail adequately to provide the necessary 'big picture' thinking needed to understand declines in adolescent drinking. We use the normalisation thesis to argue that there is strong international evidence for both processes of denormalisation of drinking and normalisation of non-drinking occurring for adolescents in many western countries.

CONCLUSIONS

Research on declining adolescent drinking provides evidence of both denormalisation of alcohol consumption and normalisation of non-drinking. This has implications for enabling policy environments more amenable to regulation and increasing the acceptability of non-drinking in social contexts. Normalisation theory (and its various interpretations) provides a useful multi-dimensional tool for understanding declines in adolescent drinking.

Structure and trends of externalizing and internalizing psychiatric symptoms and gender differences among adolescents in the US from 1991 to 2018

PURPOSE

We aimed to estimate the structure of internalizing and externalizing symptoms and potential time dynamics in their association. This is understudied among adolescents, despite increasing internalizing and decreasing externalizing symptoms in recent years.

METHODS

We analyzed data from US Monitoring the Future cross-sectional surveys (1991-2018) representative of school-attending adolescents (N = 304,542). Exploratory factor analysis using maximum likelihood estimation method and promax rotation resulted in a two-factor solution (factor correlation r = 0.24) that differentiated eight internalizing and seven conduct-related externalizing symptoms. Time-varying effect modification linear regression models estimated the association between standardized internalizing and externalizing symptoms factor scores over time overall and by gender.

RESULTS

In 2012, trends in average factor scores diverged for internalizing and externalizing factors. The average standardized internalizing factor score increased from - 0.03 in 2012 to 0.06 in 2013 and the average externalizing factor score decreased from - 0.06 in 2011 to - 0.13 in 2012. We found that for every one-unit increase in standardized internalizing factor score, standardized externalizing factor score increased by 0.224 units in 2010 (95% CI: 0.215, 0.233); the magnitude of this increase was 22.3% lower in 2018 (i.e., 0.174 units; 95% CI: 0.160, 0.188). Decoupling of internalizing and externalizing symptoms began earlier among boys (~ 1995) than among girls (~ 2010).

CONCLUSION

The decoupling of internalizing and externalizing symptoms among adolescents suggests that changes in the prevalence of shared risk factors for adolescent psychiatric symptoms affect these dimensions in opposing directions, raising the importance of considering symptoms and their risk factors together in prevention and intervention efforts.

Youth drinking in decline: What are the implications for public health, public policy and public debate?

Youth drinking has declined across most high-income countries in the last 20 years. Although researchers and commentators have explored the nature and drivers of decline, they have paid less attention to its implications. This matters because of the potential impact on contemporary and future public health, as well as on alcohol policy-making. This commentary therefore considers how youth drinking trends may develop in future, what this would mean for public health, and what it might mean for alcohol policy and debate. We argue that the decline in youth drinking is well-established and unlikely to reverse, despite smaller declines and stabilising trends in recent years. Young people also appear to be carrying their lighter drinking into adulthood in at least some countries. This suggests we should expect large short- and long-term public health benefits. The latter may however be obscured in population-level data by increased harm arising from earlier, heavier drinking generations moving through the highest risk points in the life course. The likely impact of the decline in youth drinking on public and policy debate is less clear. We explore the possibilities using two model scenarios, the reinforcement and withdrawal models. In the reinforcement model, a 'virtuous' circle of falling alcohol consumption, increasing public support for alcohol control policies and apparent policy successes facilitates progressive strengthening of policy, akin to that seen in the tobacco experience. In the withdrawal model, policy-makers turn their attention to other problems, public health advocates struggle to justify proposed interventions and existing policies erode over time as industry actors reassert and strengthen their partnerships with government around alcohol policy. We argue that disconnects between the tobacco experience and the reinforcement model make the withdrawal model a more plausible scenario. We conclude by suggesting some tentative ways forward for public health actors working in this space.

Becoming Safe, Legal, Mature, Moderate, and Self-Reflexive: Trajectories of Drinking and Abstinence among Young People

In recent years, a vast body of research has investigated trends of declining alcohol consumption among youths. However, the extent to which restrictive-youth approaches towards drinking are maintained into adulthood is unclear. The aim of this study is to explore how young people's relation to alcohol changes over time. Our data are based on longitudinal qualitative in-depth interviews with 28 participants aged 15 to 23 conducted over the course of three years (2017-2019). The study draws on assemblage thinking by analysing to what kinds of heterogeneous elements young people's drinking and abstinence are related and what kinds of transformations they undergo when they get older. Five trajectories were identified as influential. Alcohol was transformed from unsafe to safe assemblages, from illegal to legal drinking assemblages, from performance-orientated to enjoyment-orientated assemblages, and from immature to mature assemblages. These trajectories moved alcohol consumption towards moderate drinking. Moreover, abstinence was transformed from authoritarian assemblages into self-reflexive assemblages. Self-control, responsibility, and performance orientation were important mediators in all five trajectories. As the sober generation grows older, they will likely start to drink at more moderate levels than previous generations.

Cohort differences in the development of civic engagement during adolescence

Investigating whether changing societal circumstances have altered the development of civic engagement, this study compared developmental changes from mid- to late adolescence (i.e., age 15-18) across two cohorts of representative Swiss samples (born in1991, N = 1258, M_{age T1}  = 15.30, 54% female, 33% migration background representing diverse ethnicities; born in 2000, N = 930, M_{age T1}  = 15.32, 51% female; 33% migration background). Findings from latent multigroup models revealed similar levels in attitudes about social justice in both cohorts, remaining stable over time. Adolescents reported lower levels of political efficacy and informal helping in the cohort born in 2000. Both aspects slightly increased during adolescence. Informal helping had a steeper increase in the 1991 compared to the 2000 cohort, suggesting developmental differences between cohorts.

17 Is the New 15: Changing Alcohol Consumption among Swedish Youth

To examine and compare trends in drinking prevalence in nationally representative samples of Swedish 9th and 11th grade students between 2000 and 2018. A further aim is to compare drinking behaviours in the two age groups during years with similar drinking prevalence. Data were drawn from annual surveys of a nationally representative sample of students in year 9 (15-16 years old) and year 11 (17-18 years old). The data covered 19 years for year 9 and 16 years for year 11. Two reference years where the prevalence of drinking was similar were extracted for further comparison, 2018 for year 11 (n = 4878) and 2005 for year 9 (n = 5423). The reference years were compared with regard to the volume of drinking, heavy episodic drinking, having had an accident and quarrelling while drunk. The prevalence of drinking declined in both age groups during the study period. The rate of decline was somewhat higher among year 9 students. In 2018, the prevalence of drinking was the same for year 11 students as it was for year 9 students in 2005. The volume of drinking was lower among year 11 students in 2018 than year 9 students in 2005. No differences were observed for heavy episodic drinking. The decline in drinking has caused a displacement of consumption so that today's 17-18-year-olds have a similar drinking behaviour to what 15-16-year-olds had in 2005.

The Role of Parental Control and Support in Declining Adolescent Drinking: A Multi-Level Study Across 30 European Countries

BACKGROUND

Adolescent drinking has declined in many high-income countries since the early 2000s. It has been suggested that changing parenting practices may have contributed to the decline. However, previous studies investigating parenting have focused on single countries and have provided conflicting evidence. This study tested the association between changes in individual- and population-level parental control and parental support and changes in past month adolescent drinking.

METHODS

A total of 271,823 adolescents aged 15-16 years, from 30 European countries between 2003 and 2015 were included in this study. Our key independent variables were adolescent reports of parental control and parental support. Our outcome measure was a dichotomous measure of any alcohol use in the 30 days before the survey, referred as past month drinking. Aggregated measures of parenting variables were used to estimate between-country and within-country effects of parenting on adolescent drinking. Data were analysed using three-level hierarchical linear probability methods.

RESULTS

At the individual-level, we found a negative association between the two parental measures, i.e. parental control (β = -0.003 and 95% CI = -0.021 to 0.017) and parental support (β = -0.008 and 95% CI = -0.010 to 0.006) and past month drinking. This suggests adolescents whose parents exert higher control and provide more support tend to drink less. At a population level, we did not find any evidence of association on between-country and within-country parenting changes and past month drinking.

CONCLUSIONS

It is unlikely that changes in parental control or support at the population-level have contributed to the decline in drinking among adolescents in 30 European countries.

Alcohol and Cigarette Use among Adolescents and Young Adults in Austria from 2004-2020: Patterns of Change and Associations with Socioeconomic Variables

Background: Adolescents and young adults are a crucial target group for preventing harm related to substance use. Recently, declining alcohol and tobacco consumption in young people has been observed in many countries. Based on survey data from 2004 to 2020, we describe time trends for several subgroups of adolescents and young adults (based on consumption levels and socioeconomic variables) and analyze associations between the level of alcohol per capita consumption or daily smoking and socioeconomic variables. Methods: Time trends for males and females are analyzed by a two-way ANOVA and predictors of use by using multivariate regression and logistic regression. Results: Alcohol per capita consumption decreased significantly for both sexes in the 16-year period, with male and female consumption levels converging. Daily smoking was equally prevalent for young males and females and decreased to a similar degree for both sexes. Being male and living in rural areas are associated with a higher level of alcohol consumption. Daily smoking is associated with a low level of education and is more prevalent among young adults who have already started to work. Conclusions: The decline in alcohol use and daily smoking among adolescents and young adults is taking place simultaneously. However, higher levels of alcohol consumption and daily smoking occur in different groups of adolescents and young adults, which should be considered in prevention strategies.

Negotiating Emerging Adulthood With Master and Counter Narratives: Alcohol-Related Identity Trajectories Among Emerging Adults in Performance-Oriented Neoliberal Society

This study analyzes how emerging adults negotiate their relation to alcohol in the context of declining youth drinking and how this relationship changes over time. The sample consists of longitudinal qualitative interview data ( N = 28) with 9 boys and 19 girls aged 15 to 21. The participants were recruited through schools, social media and non-governmental organizations from mainly the Stockholm region and smaller towns in central Sweden to reach a heterogeneous sample in terms of sociodemographic factors and drinking practices. We interviewed the participants in-depth three times between 2017 and 2019. Thematic coding of the whole data with NVivo helped us select four cases for more detailed analysis, as they represented the typical trajectories and showed the variation in the material. We used the master narrative framework and Bamberg’s narrative positioning analysis to examine the data. The analysis demonstrates what kinds of narrative alignments in identity development encourage heavy drinking, moderate alcohol consumption, and fuel abstinence. The results suggest that the decline in youth drinking is produced by a co-effect of multiple master narratives that intersect and guide the identity development away from heavy drinking.

U.S. Trends in Adolescent Substance Use and Conduct Problems and Their Relation to Trends in Unstructured In-Person Socializing With Peers

PURPOSE

This study examined whether national trends in unstructured in-person socializing with peers (i.e., socializing without goals or supervision) among adolescents could help explain recent declines in adolescent risk behaviors (e.g., substance use, fighting, theft).

METHODS

The sample contained of 44,842 U.S. 12th-grade students (aged 17-18 years) from the Monitoring the Future survey (years 1999-2017). Analyses examined (1) prevalence trends, (2) latent factor structure of risk behaviors and unstructured in-person socializing, and (3) whether trends in the unstructured in-person socializing factor accounted for the relationship between time (i.e., survey year) and the risk behavior factor.

RESULTS

Adolescent risk behaviors and unstructured in-person socializing declined by approximately 30% in the U.S., and both formed coherent latent factors. After adjusting for sociodemographics, declines in unstructured in-person socializing accounted for approximately 86% of declines in risk behaviors.

CONCLUSIONS

The prevalence of risk behaviors and unstructured in-person socializing behaviors declined among U.S. 12th graders from 1999 to 2017. It is unknown whether such effects are directly causal and/or influenced by unmeasured variables. However, the results provide evidence that national declines in unstructured in-person socializing are a likely component of the explanation for national declines in adolescent risk behaviors.

Impacts of Changing Sexual Behavior on Chlamydia and Gonorrhea Burden Among US High School Students, 2007 to 2017

BACKGROUND

Rates of adolescent sexual activity have long been declining in the United States. We sought to estimate the number of cases of gonorrhea and chlamydia averted over 1 decade associated with these declines and associated costs saved.

METHODS

We analyzed data from the Centers for Disease Control and Prevention's Youth Risk Behavior Survey of US high school students from 2007 to 2017 and combined it with epidemiological estimates drawn from the literature to parameterize a dynamic population transmission model. We compared transmissions from observed behavioral trends with a counterfactual scenario that assumed sexual behaviors from 2007 remained constant for 10 years. We calculated outcomes by age and for 3 racial/ethnic groups (Hispanic, non-Hispanic Black, and non-Hispanic White adolescents) who vary on underlying burden and amount of behavioral change.

RESULTS

We estimated 1,118,483 cases of chlamydia and 214,762 cases of gonorrhea were averted (19.5% of burden across all ages). This yielded $474 million (2017 dollars) savings in medical costs over the decade. The largest number of averted cases (767,543) was among Black adolescents, but the largest proportion (28.7%) was among Hispanic adolescents.

CONCLUSIONS

Whatever its origins, changing sexual behavior among adolescents results in large estimated reductions in STI burden and medical costs relative to previous cohorts. Although diagnoses among adolescents have not declined at this rate, multiple explanations could make these apparently divergent trends consistent. Efforts to continue supporting effective sex education in and out of school along with STI screening for adolescents should reinforce these gains.

Virgins at age 26: who are they?

Background Studies on virgins remain scarce. This study explores the characteristics of virgin young adults, the reasons for remaining virgin, and its potential social and health implications.

METHODS

Data were drawn from the 2017 Swiss study on sexual health and behaviour among young adults. A total of 5175 participants (mean age 26 years ± 0.01) were divided into virgins and non-virgins. Virginity was defined as never having had a sexual partner, defined as a person with whom the participant has had sexual contact with or without penetration.

RESULTS

A total of 275 (5.3% (95% CI: 4.7-6.0), 58% males) were virgins. Virgins had higher odds of being male (aOR: 2.27 (95% CI: 1.62-3.17)) and reporting poorer health (1.43 (1.07-1.92)). They had lower odds of living on their own (0.24 (0.18-0.32)), being satisfied with their social life (0.78 (0.72-0.85)), having experimented with substances (e.g. drunkenness, 0.27 (0.19-0.67)) and having used online dating (0.52 (0.26-1.12)) or pornography (0.67 (0.42-0.94)). The main reason for remaining virgin was 'I have not found the right person' for females, and 'I have not had the occasion' for males.

CONCLUSIONS

Among young adults, 1 in 20 is a virgin. Virgins do not seem to have gone through the usual experimentations of adolescence, are less socially driven and reported more health challenges. The main reason for remaining a virgin reveals gender-stereotyped responses. Sexual inactivity among young adults should be considered by health professionals to ensure the absence of distress and open discussion for potential questions.

Does the millennial generation of women experience more mental illness than their mothers?

BACKGROUND

There is concern that rates of mental disorders may be increasing although findings disagree. Using an innovative design with a daughter-mother data set we assess whether there has been a generational increase in lifetime ever rates of major depressive disorder, generalised anxiety disorder, panic disorder, and post-traumatic stress disorder (PTSD) experienced prior to 30 years of age.

METHODS

Pregnant women were recruited during 1981-1983 and administered the Composite International Diagnostic Interview (CIDI) at the 27-year follow-up (2008-11). Offspring were administered the CIDI at the 30-year follow-up (2010-2014). Comparisons for onset of diagnosis are restricted to daughter and mother dyads up to 30 years of age. To address recall bias, disorders were stratified into more (≥12 months duration) and less persistent episodes (< 12 months duration) for the purposes of comparison. Sensitivity analyses with inflation were used to account for possible maternal failure to differentially recall past episodes.

RESULTS

When comparing life time ever diagnoses before 30 years, daughters had higher rates of persistent generalised anxiety disorder, and less persistent major depressive disorder, generalised anxiety disorder and PTSD.

CONCLUSIONS

In the context of conflicting findings concerning generational changes in mental disorders we find an increase in generational rates of persistent generalised anxiety disorders and a range of less persistent disorders. It is not clear whether this finding reflects actual changes in symptom levels over a generation or whether there has been a generational change in recognition of and willingness to report symptoms of mental illness.