A mediated moderation model of negative life events, self-esteem, rumination and parental divorce on depression among Chinese juvenile delinquents

Little attention was paid to the prevalence of depression in Chinese juvenile delinquents who are studied in correctional work-study schools. Hence, the present study aimed to test the unique, mediating and moderating effects of negative life events, self-esteem, rumination and parental divorce on depression among Chinese juvenile delinquents. A total of 236 juvenile delinquents aged between 12 and 17 years old (M = 14.68 SD = 1.30) were recruited to accomplish a battery of self-report questionnaires concerning their negative life events, self-esteem, rumination, depression and demographic profile. The descriptive analysis showed that there was a positive correlation between negative life events and depression in Chinese juvenile delinquents. Moreover, the results from the structural model indicated that self-esteem and rumination played separate and sequential mediating roles between negative life events and depression. In addition, parental divorce had a moderating effect between negative life events and self-esteem in the model. These results suggest that the prevalence of depression among Chinese juvenile delinquents can be reduced through modification of the ruminative way of thinking, improving their self-esteem when they encounter a number of negative life events. Furthermore, more attention should be paid to the juvenile delinquents who experienced parental divorce.

A Latent Class Analysis of Predictors for Engaging in Sex: A Study with Ethnically Diverse High School Students

Sexual activity occurs among a large portion of young adults and adolescents, including high school students. While about 40% of high school students nationwide have engaged in sexual intercourse, more information is needed about how individual characteristics may relate to larger patterns of adolescent sexual behavior. This exploratory study utilized a latent class analysis (LCA) to identify clusters of high school students (N = 801) based on demographic characteristics, sexual refusal skills, healthy relationship skills, sociosexuality, internalizing symptoms, alcohol use, various forms of social support (i.e., parents, friends, teachers), and sexual activity at baseline to predict their sexual behavior at a 6-month follow-up. Four unique latent classes were identified based on these baseline predictors. Distinctions in the profiles of high schoolers varied significantly by internalizing symptoms, race/ethnicity, sexually conservative attitudes, and social support in the prediction of adolescent sexual activity at 6-months. This study contributes to the investigation of demographic, social, psychological, attitudinal, and behavioral factors that may distinguish high school students from one another in terms of their longitudinal rates of sexual activity.

Talking About Sexuality With Youth: A Taboo in Psychiatry?

BACKGROUND

Young people who have psychiatric problems are more likely than their peers to endure difficulties during their sexual and gender identity development.

AIM

This study aims to examine the communication between mental health care providers and their patients about the topics of relations, sexuality and gender identity, including a description of professionals' attitudes toward these topics and the factors that contribute to and inhibit communication.

METHODS

Study participants (n = 242, response rate = 31%) were a representative sample of a large multicenter cohort of 768 mental health care professionals (eg, medical doctors, psychiatrists, psychologists, group counselors, parent counselors) of 7 institutions and 5 solo practices in the Netherlands, who completed a survey on communication about sexuality and gender identity with their young patients (age 12-21 years).

OUTCOMES

Sexuality and gender identity are infrequently discussed by mental health care providers with their young patients or their patients' parents.

RESULTS

Of the study sample, 99.5 % valued sexuality as an important topic to discuss with their patients. However, only 17.1% of the professionals reported that they discussed sexuality-related issues with the majority (>75%) of their patients (adolescents: 19.9%, parents: 14.4%) Additionally, only 2.3 % of the participants discussed gender nonconformity regularly with patients. Information about sexual side effects of prescribed medication was infrequently (20.3%) provided: antidepressants (40.0%), antipsychotics (34.0%), benzodiazepines (5.1%) and stimulants (2.4%). The most frequently cited reasons for not discussing these topics were a lack of awareness, own feelings of discomfort, and the patients' supposed feelings of shame. There was no gender differences observed.

CLINICAL IMPLICATIONS

Recommendations for professionals include to be aware of these topics, initiating age-appropriate conversation and use inclusive language.

STRENGTHS AND LIMITATIONS

The present study included a diverse and representative group of mental health care professionals. Frequency of sexual communication was based on self-report, which brings a risk of bias.

CONCLUSION

Despite a recognized need to engage in age-appropriate communication about sexuality and gender identity in youth mental health care, mental health providers seem to remain hesitant to discuss such topics. Bungener SL, Post L, Berends I, et al. Talking About Sexuality With Youth: A Taboo in Psychiatry?. J Sex Med 2022;19:421-429.

Connectedness, Self-Esteem, and Prosocial Behaviors Protect Adolescent Mental Health Following Social Isolation: A Systematic Review

Societal trends and COVID-19 quarantines have increased the number of adolescents experiencing social isolation, placing them at heightened risk for mental health issues. The aim of this review is to explore protective factors that might mitigate psychological harm in the presence of social isolation. A systematic literature review was conducted using Fink's step-by-step process. Four library databases were searched, and results were reported using PRISMA. Of the 246 studies reviewed, 12 studies were retained following the quality assessment. The sample includes 14,064 participants from USA, Australia, and Europe, ranging from 10-19 years old. Social connectedness (ie., family connectedness, school connectedness, social support), self-esteem, and prosocial behaviors were the most common protective factors to social isolation. Additional factors such as self-efficacy, optimism, and ethnic identity are discussed. Implications for future research are recommended, including the need to explore spiritual, biological, and sociocultural factors influencing social connectedness and mental health in adolescents.

Racial/Ethnic Disparities in Female Sexual Health from Adolescence to Young Adulthood: How Adolescent Characteristics Matter?

STUDY OBJECTIVE

To describe sexual initiation patterns in female adolescents and examine their association with adolescent characteristics and racial disparities in adverse sexual health across adolescence into early adulthood.

DESIGN

A prospective, longitudinal, observational study from adolescence to adulthood.

SETTING

Nationally representative, the National Longitudinal Study of Adolescent to Adult Health data, in the range of 24-32 years old at final assessment.

PARTICIPANTS

Data from 43,577 US women from 1994 to 2008.

INTERVENTIONS AND MAIN OUTCOME MEASURES

Adolescent sex-related characteristics at the individual-, family-, and school peer-level were assessed, and multiple sex partners, sexually transmitted infections (STIs)/HIV, and intimate partner violence (IPV) were longitudinally tracked. The sexual initiation pattern and its longitudinal association with sexual health were analyzed using latent class analysis and mixed effects Poisson regression models.

RESULTS

Of the 43,577 subjects, the sexual initiation patterns were determined as normative (n = 28,712, 65.9%), late (n = 10,799, 24.8%), and early but unempowered (n = 4,066, 9.3%). The highest rate of the early-unempowered group was shown in Hispanic individuals (1,054/7,307 = 14.4%); they were more likely to be depressed, unsatisfied with their bodies, receiving welfare, and have less educated/permissive parents to their sexual initiation than others. The late group had a higher body mass index and greater satisfaction with their bodies. The highest number of STIs/HIV and IPV victimization was shown in non-Hispanic Black (NHB) and Hispanic individuals, respectively. However, NHB females' higher number of STIs/HIV was shown in the late/normative groups, not in the early-unempowered group. Among Hispanic females, adolescent sexual initiation patterns were not directly associated with their frequent IPV victimization.

CONCLUSION

NHB females' higher STI/HIV in late/normative groups and Hispanic females' frequent IPV victimization regardless of their sexual initiation patterns might indicate that racial/ethnic disparities in female sexual health was not directly determined by adolescent risk behaviors.

Associations of Father's Lifetime Cannabis Use Disorder with Child's Initiation of Cannabis Use, Alcohol Use, and Sexual Intercourse by Child Gender

BACKGROUND

Early initiation of alcohol use, cannabis use, and sexual intercourse among adolescents is an important public health concern in the United States. Parents' history of substance use disorder is an important contributing factor for children's problem behaviors.

OBJECTIVES

The associations of fathers' lifetime cannabis use disorder with children's initiation of cannabis use, alcohol use, and sexual intercourse were examined. In addition, child's gender was considered as a moderator of each association.

METHODS

Data from two companion longitudinal studies was utilized, the Rochester Youth Developmental Study and its intergenerational extension, the Rochester Intergenerational Study. Multiple linear regression analyses were conducted to examine the associations of the father's lifetime cannabis use disorder with the child's initiation of cannabis use, alcohol use, and sexual intercourse. To test gender differences in the associations, the study sample was stratified by child's gender.

RESULTS

The average age of first cannabis use (b = -3.71, p < .05), alcohol use (b = -3.65, p < .05), and sexual intercourse (b = -2.94, p < .05) among daughters of fathers with a lifetime cannabis use disorder was lower than that of their counterparts after adjusting for all other control variables, whereas no significant differences were detected in a father-son relationship.

CONCLUSIONS

Homotypic continuity of cannabis use, as well as heterotypic continuity from the father's cannabis use to the child's alcohol use and sexual intercourse existed in a father-daughter relationship. These findings suggest that family-based interventions for female adolescents whose father has suffered from a cannabis use disorder be developed to prevent better adolescents' early substance use and sexual intercourse.

Linking perceived discrimination during adolescence to health during mid-adulthood: Self-esteem and risk-behavior mechanisms

RATIONALE

The literature on the effect of perceived discrimination on health has three gaps. First, the long-term relationship between perceived discrimination and health is underexplored. Second, the mechanisms through which perceived discrimination affects health remain unclear. Third, most studies focus on racial/ethnic discrimination, and other aspects of discrimination are overlooked.

OBJECTIVE

This study aims to fill these gaps by testing a research framework that links the discriminatory experience during adolescence to an individual's health during mid-adulthood via self-esteem and risk behaviors at early adulthood.

METHOD

Structural equation modeling is applied to the National Longitudinal Survey of Youth, 1979 Cohort (N = 6478).

RESULTS

The discriminatory experience during adolescence imposes an adverse impact on health during mid-adulthood even after accounting for other potential covariates, a detrimental effect lasting for over 30 years. In addition, while perceived discrimination reduces self-esteem at early adulthood, it affects only mental health during mid-adulthood, rather than general health. Finally, the discriminatory experience promotes risk behaviors at early adulthood and the risk behaviors subsequently compromise health during mid-adulthood.

CONCLUSIONS

Using a life course perspective, we find that the effect of perceived discrimination is more profound than the literature suggested and that risk behaviors may account for approximately 17% of the total effect of perceived discrimination on health. Our findings highlight the importance of early interventions in coping with perceived discrimination during adolescence.

The Associations of Resilience and HIV Risk Behaviors Among Black Gay, Bisexual, Other Men Who Have Sex with Men (MSM) in the Deep South: The MARI Study

Resilience is an understudied intrapersonal factor that may reduce HIV risk among men who have sex with men (MSM). Multivariable Poisson regression models were used to estimate the prevalence ratio (PR) of sexual risk behaviors, HIV prevalence, and history of sexually transmitted infections (STIs) with resilience scores in a population-based study among 364 black MSM in the Deep South. Participants with higher resilience scores had a lower prevalence of condomless anal sex with casual sexual partners in past 12 months (PR = 0.80, p value = 0.001) and during their last sexual encounter (PR = 0.81; p value = 0.009). Resilience was inversely associated with a lower prevalence of condomless anal sex with main sexual partners, participating in a sex party/orgy and having a STI in the past 12 months. Resilience may have a protective effect on HIV among black MSM, especially in the Deep South, and should be further explored in studies with prospective designs.

Sexual Risk Behavior Among Youth With Bipolar Disorder: Identifying Demographic and Clinical Risk Factors

OBJECTIVE

This study aims to document rates of sexual activity among youth with bipolar spectrum disorder (BD) and to examine demographic and clinical factors associated with first sexual activity and sexual risk behavior during follow-up.

METHOD

The sample was drawn from the Course and Outcome of Bipolar Youth (COBY) study of 413 youth 7 to 17 years at baseline who met criteria for bipolar spectrum disorder according to the Schedule for Affective Disorders and Schizophrenia for School-Aged Children. Psychiatric symptoms during follow-up were assessed using the Adolescent Longitudinal Interview Follow-Up Evaluation (ALIFE). Sexual behavior and level of sexual risk (e.g., unprotected sex, multiple partners, and/or partners with known sexually transmitted infections) were assessed by trained evaluators using the ALIFE Psychosocial Functioning Scale. Analyses were conducted in relation to first sexual behavior during follow-up and then to subsequent sexual behaviors (mean 9.7 years, standard deviation 3.2).

RESULTS

Sexually active COBY youth (n = 292 of 413; 71%) were more likely females, using substances, and not living with both parents. Consistent with findings among healthy youth, earlier first sexual activity in the sample was significantly associated with low socioeconomic status, female sex, comorbid disruptive behavior disorder, and substance use. As with healthy youth, sexual risk behavior during follow-up was significantly associated with non-Caucasian race, low socioeconomic status, substance use, and history of sexual abuse. Of those COBY youth who were sexually active, 11% reported sexual assault or abuse, 36% reported becoming pregnant (or the significant other becoming pregnant), and 15% reported having at least 1 abortion (or the significant other having an abortion) during follow-up. Hypomanic symptoms during follow-up were temporally associated with the greatest risk for sexual risk behavior.

CONCLUSION

Demographic and clinical factors could help identify youth with bipolar spectrum disorder at significantly greatest risk for sexual activity and sexual risk behavior. Attending to sexual risk behaviors in this population is warranted.

Bidirectional Associations Between Adolescents' Sexual Behaviors and Psychological Well-Being

PURPOSE

Assessing bidirectional longitudinal associations between early sexual behaviors (≤16.0 years) and psychological well-being (global self-esteem, physical self-esteem, depression) among 716 adolescents, and the direct and buffering effect of parent-adolescent relationship quality.

METHODS

We used data from Project STARS (Studies on Trajectories of Adolescent Relationships and Sexuality), a longitudinal study on adolescent sexual development in the Netherlands. Participants were 11.0-16.0 years old (mean age at T1 = 13.3 years). Self-reports from four waves of online questionnaires were used. Bidirectional longitudinal associations were assessed by linear mixed-effects models.

RESULTS

At most waves, boys had significantly higher levels of psychological well-being than girls, but genders did not differ in experience with sexual behaviors. Engagement in early sexual behaviors did not predict lower levels of psychological well-being over time, and lower levels of psychological well-being did not predict more engagement in early sexual behaviors over time. Parent-adolescent relationship quality did not moderate these associations in either direction, although we found a significant direct effect, in which a higher-quality parent-adolescent relationship predicted more optimal levels of the three indicators of adolescents' psychological well-being (but not lower levels of early sexual activity) over time.

CONCLUSIONS

Our results show that, among Dutch adolescents, early sexual behaviors and psychological well-being were not interrelated. This may be explained by socio-cultural aspects of the Dutch society, such as more normalization of sexual behaviors during adolescence. As a result, early sexual activity in and of itself was not related to lower psychological well-being over time. Yet, cross-cultural differences in links between adolescents' sexuality and well-being should be further investigated.

A systematic review on identifying risk factors associated with early sexual debut and coerced sex among adolescents and young people in communities

AIMS AND OBJECTIVES

To review literature on identifying the risk factors associated with early sexual coerced debut with the aim to facilitate the healthcare workers' planning of relevant health services to improve intervention strategies for delaying of early coerced sexual debut or forced sexual debut (CSD/FSD) in the communities.

BACKGROUND

Identifying the risk factors associated with coercion at first sex is crucial for developing appropriate sexual and reproductive health information and health promotion in response. However, current knowledge about the risk factors associated with coercion, sexual debut (SD) and delayed SD among young people is limited. Health information programmes are important during adolescence, when young people are developing their values and beliefs about sexual activity and sexual norms. However, little is known about those risk factors on initiation of early sexual debut to plan relevant interventions that can delay SD and prevent CSD/FSD in this population.

DESIGN

A systematic review.

METHODS

An extensive literature search using MEDLINE (PubMed), Nursing Journals (PubMed), Web of Science, PsychINFO and CINAHL.

RESULTS

The search generated 39 published studies that met our inclusion and exclusion criteria. Thirty-two articles passed the quality appraisal and were selected. This review identified six domains of risk factors, categorised as: (1) the individual domain, (2) the family domain, (3) the partner/peer domain, (4) the school domain, (5) the community domain and (6) the cultural domain. These factors highlight the influences on sexual decision-making among adolescents and young people and the timing of their first sexual intercourse.

CONCLUSION

It is important to use the outcome of this review's categorisation of identified risk factors to facilitate the healthcare workers and plan relevant sexual and reproductive health programmes more accessible to adolescents, especially young females and their parents. There is a need to evaluate the impact of these programmes that can delay SD and prevent CSD/FSD in this population.

RELEVANCE TO CLINICAL PRACTICE

The results of this study could provide guidance on the planning of effective interventions for delaying of early CSD/FSD in the communities.

Exploring Psychosocial Mechanisms and Interactions: Links Between Adolescent Emotional Distress, School Connectedness, and Educational Achievement

Internalizing mental health issues are a significant developmental and clinical concern during adolescence, but rarely identified as a problem among school staff. Using data from the National Longitudinal Study of Adolescent Health, this study examined the associations between adolescent emotional distress, school connectedness, and educational achievement by exploring potential mechanistic and interactive roles of perceived school connectedness on the emotion-education association. Emotional distress was negatively associated with adolescents' perceptions of belonging to school, which, in turn, may negatively influence educational achievement. School connectedness also had both additive and multiplicative interaction effects on the emotion-education relationship. Results support previous evidence of school connectedness as a protective factor for adolescents with internalizing mental health concerns, although much of the work to date has focused on externalizing problems. This study informs our understanding of how, why, and for whom emotional problems influence educational outcomes in light of social support in the school context.

The Long-term Effects of Self-Esteem on Depression: The Roles of Alcohol and Substance Uses during Young Adulthood

Using the National Longitudinal Surveys of Youth 1979, this study examines the roles of alcohol and substance use as mediators in the mechanism between self-esteem and depression, and investigates whether the mechanism works for both men and women. Results demonstrate that alcohol and substance use during young adulthood mediates the effect of self-esteem on depression among men. Furthermore, self-esteem during young adulthood remains a determinant of high depression in middle adulthood. However, we did not find evidence to support that same mechanism among women. Our findings provide insight into how self-esteem affects depression over the transition from young to middle adulthood, and elucidate potential gendered responsivity to low self-esteem.

Mother- and Father-Adolescent Relationships and Early Sexual Intercourse

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 (Mean_age@T1 = 12.5 years, SD = 0.61; Mean_age@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.

College Students, Tattoos, and Sexual Activity

This research examined the association of having a tattoo and engaging in premarital sexual intercourse. Data gathered from a convenience sample of 450 college students indicated that tattooed respondents were substantively and significantly more likely to be sexually active than nontattooed college students. Tattooed men became sexually active at a significantly earlier age than nontattooed men but no such difference was found between tattooed and nontattooed college women.

Early Sexual Intercourse: Prospective Associations with Adolescents Physical Activity and Screen Time

OBJECTIVES

To assess the prospective associations of physical activity behaviors and screen time with early sexual intercourse initiation (i.e., before 15 years) in a large sample of adolescents.

METHODS

We used two waves of data from the Rotterdam Youth Monitor, a longitudinal study conducted in the Netherlands. The analysis sample consisted of 2,141 adolescents aged 12 to 14 years (mean age at baseline = 12.2 years, SD = 0.43). Physical activity (e.g., sports outside school), screen time (e.g., computer use), and early sexual intercourse initiation were assessed by means of self-report questionnaires. Logistic regression models were tested to assess the associations of physical activity behaviors and screen time (separately and simultaneously) with early sexual intercourse initiation, controlling for confounders (i.e., socio-demographics and substance use). Interaction effects with gender were tested to assess whether these associations differed significantly between boys and girls.

RESULTS

The only physical activity behavior that was a significant predictor of early sexual intercourse initiation was sports club membership. Adolescent boys and girls who were members of a sports club) were more likely to have had early sex (OR = 2.17; 95% CI = 1.33, 3.56. Significant gender interaction effects indicated that boys who watched TV ≥2 hours/day (OR = 2.00; 95% CI = 1.08, 3.68) and girls who used the computer ≥2 hours/day (OR = 3.92; 95% CI = 1.76, 8.69) were also significantly more likely to have engaged in early sex.

CONCLUSION

These findings have implications for professionals in general pediatric healthcare, sexual health educators, policy makers, and parents, who should be aware of these possible prospective links between sports club membership, TV watching (for boys), and computer use (for girls), and early sexual intercourse initiation. However, continued research on determinants of adolescents' early sexual initiation is needed to further contribute to the strategies for improving adolescents' healthy sexual development and behaviors.

Hooking Up

More than one half of sexually active teens have had sexual partners they are not dating. However, remarkably little is known about the nature of these sexual relationships. Using survey and qualitative data from the Toledo Adolescent Relationships Study the authors contrast the qualities of dating sexual relationships and sexual relationships that occur out-side the dating context. They find that adolescents having sex outside of the dating context are choosing partners who are friends or ex-girlfriends and/or boyfriends. Moreover, one third of these nondating sexual partnerships are associated with hopes or expectations that the relationship will lead to more conventional dating relationships. Boys and girls who experience sex outside of conventional dating relationships often share similar orientations toward their relationship. Results suggest that a more nuanced view is key to understanding adolescent sexual behavior.

Gendered Patterns in Adolescents' School Attachment

A substantial literature documents a gender reversal in many aspects of social psychological functioning during adolescence, in which girls fall below boys in domains in which they once enjoyed advantages. This study elaborates upon recent research from the National Longitudinal Study of Adolescent Health suggesting that this phenomenon may occur in school attachment, an aspect of educational adjustment. Our analysis of grade 7 through 12 students revealed a gender reversal in school attachment only among whites; although gender differences at each grade level were quite small, the larger differences among girls produced the reversal pattern. Self-esteem, depressive symptoms, and relationships with parents appear to be key factors tied to this reversal but ultimately do not account for grade level differences among girls. We also found that the paradoxical coupling of girls' higher achievement with lower attachment in the upper grades resulted from a weaker association between attachment and achievement among girls than among boys, especially in the upper grades.

The Relationship Between Sexual Activity and Depressive Symptoms in Lesbian, Gay, and Bisexual Youth: Effects of Gender and Family Support

There is considerable debate over whether adolescent sexual activity is maladaptive and associated with worse mental health outcomes versus a positive developmental milestone that is associated with better mental health outcomes. Although these perspectives are often pitted against one another, the current study employed a more integrative perspective: adolescent sexual activity may be maladaptive in certain contexts, but healthy in other contexts. We investigated whether family support and gender moderated the relation between sexual activity and mental health outcomes in a diverse sample of 519 lesbian, gay, and bisexual (LGB) youth. Specifically, we examined whether youth who engaged in more sexual activity would have fewer depressive symptoms in the context of a more supportive family environment, but more depressive symptoms in the context of a less supportive family environment and whether this effect was stronger for sexual minority girls. Consistent with the sexual health perspective, we found that among girls with more family support, those who engaged in more frequent same-sex sexual contact had lower levels of depressive symptoms. Unexpectedly, we found that among boys with more family support, those who engaged in more frequent same-sex sexual contact had higher levels of depressive symptoms. In contrast, girls and boys with less family support showed no relation between sexual activity and depressive symptoms. Overall, results suggest that context is critical when determining whether same-sex sexual contact among LGB youth should be considered maladaptive or beneficial.

Sexuality (and Lack Thereof) in Adolescence and Early Adulthood: A Review of the Literature

Youth sexuality has been primarily studied with a focus on its potential public health issues, such as sexually transmitted infections and unwanted pregnancies, and its comorbidity with other risky behaviors. More recently, it has been studied as a normative step in romantic partnerships, either pre- or post-marital, as well as outside the context of romantic involvement. In this paper, we review the extensive literature on sexuality in adolescence and early adulthood both within and outside romantic relationships (i.e., casual sexual relationships and experiences; CSREs). Furthermore, the recent recognition of youth sexuality as a developmental task has led to a renewed interest from scholars in youth who abstain from sexual encounters, whether deliberately or not. A brief overview of the literature on cultural differences in sexuality, and sexual-minority youth sexual development is also provided. This paper concludes by suggesting future directions to bring the field of youth sexuality and romantic relationships forward.

Premarital first births: The influence of the timing of sexual onset versus post-onset risks in the United States

Motivated by long-standing debates between abstinence proponents and sceptics, we examine how socio-economic factors influence premarital first births via: (i) age at first sexual intercourse and (ii) the risk of a premarital first birth following the onset of sexual activity. Factors associated with an earlier age at first intercourse will imply more premarital first births owing to increased exposure to risk, but many of these same factors will also be associated with higher risks of a premarital first birth following onset. Our analyses confirm previous findings that women from disadvantaged backgrounds are younger at first intercourse and have higher premarital first-birth risks than women from more advantaged backgrounds. However, differences in onset timing have a strikingly smaller influence on premarital first-birth probabilities than do differences in post-onset risks. Our findings thus suggest that premarital first births result primarily from differences in post-onset risk behaviours as opposed to differences in onset timing.

The complexities of adolescent dating and sexual relationships: fluidity, meaning(s), and implications for young adults' well-being

The complexity of adolescents' dating and sexual lives is not easily operationalized with simple indicators of dating or sexual activity. While building on prior work that emphasizes the "risky" nature of adolescents' intimate relationships, we assess whether a variety of indicators reflecting the complexity of adolescents' relationships influence early adult well-being (i.e., depressive symptoms, self-esteem, gainful activity, intimate partner violence, and relationship quality). Our analysis of longitudinal data from the Toledo Adolescent Relationships Study showed that the number of adolescent dating and sexual partners does not uniformly influence indicators of young adult well-being, which is at odds with a risk framework. The number of dating partners with whom the individual was sexually active, and not the number of "casual" sex partners, increased the odds of intimate partner violence during young adulthood. Relationship churning and sexual nonexclusivity during adolescence were associated with lower relationship quality during young adulthood. Sexual nonexclusivity during adolescence influenced self-reports of depressive symptoms and lower self-esteem among young adults. Future research should develop more nuanced conceptualizations of adolescent dating and sexual relationships and integrate adolescent dating and sexual experiences into research on early adult well-being.

Unpacking the "Black Box" of Race-Ethnic Variation in Fertility

Race-ethnic differences in a range of childbearing behaviors are long-standing and well-documented, and these differences are attenuated, but not eliminated, when accounting for socioeconomic disparities. The residual differences are often attributed to vague and untested variation across race-ethnic groups in knowledge, attitudes, psychological attributes, normative beliefs, and social context. We use the longitudinal Toledo Adolescent Relationship Study (TARS), which contains a rich set of such factors measured in early adolescence, to assess whether they contribute to race-ethnic differences in having a birth among men and women ages 17-24 (n=1,042). Specifically, we test whether individual attitudes, religiosity, and academic behaviors; knowledge and behaviors regarding sex and dating; peer normative context; and parental communication about sex account for variation in the risk of an early birth. We find that socioeconomic factors attenuate but do not reduce differences between Black, Hispanic, and White respondents. Including adolescent academic performance and early entry into sex reduces the Black-White difference in the odds of early fertility to nonsignificance; however, beyond socioeconomic status, none of the broad range of factors further attenuate Hispanic-White differences, which remain large and statistically significant.

Sexual initiation and emotional/behavioral problems in Taiwanese adolescents: a multivariate response profile analysis

This study aimed to investigate the relations of adolescent sexual experiences (particularly early initiation) to a spectrum of emotional/behavioral problems and to probe possible gender difference in such relationships. The 10th (N = 8,842) and 12th (N = 10,083) grade students, aged 16-19 years, participating in national surveys in 2005 and 2006 in Taiwan were included for this study. A self-administered web-based questionnaire was designed to collect information on sociodemographic characteristics, sexual experience, substance use, and the Youth Self-Report Form. For the sexually experienced adolescents, their sexual initiation was classified as early initiation (<16 years) or non-early initiation (16-19 years). Gender-specific multivariate response profile regression was used to examine the relationship between sexual experience and the behavioral syndromes. Externalizing problems, including Rule-breaking Behavior and Aggressive Behavior, were strongly associated with sexual initiation in adolescence; the magnitude of the association increased for earlier sexual initiation, especially for females. As to internalizing problems, the connection was rather heterogeneous. The scores on some syndromes, such as Somatic Complaints and Anxious/Depressed, were higher only for females with early or non-early sexual initiation whereas the score on Withdrawn, along with Social Problems that is neither internalizing nor externalizing, was lower for the sexually experienced adolescents than for the sexually inexperienced ones. We concluded that earlier sexual initiation was associated with a wider range of behavioral problems in adolescents for both genders, yet the increased risk with emotional problems was predominately found in females.

Social factors associated with readiness for sexual activity in adolescents: a population-based cohort study

Various factors are associated with sexual activity in adolescence and it is important to identify those that promote healthy and adaptive romantic and sexual development. The objectives of this study were to describe rates of early sexual intercourse (before 16 years) and sexual readiness in adolescence and to assess the extent to which these were social patterned. We prospectively studied nearly 5,000 15-year-olds from the Avon Longitudinal Study of Parents and Children, a UK birth cohort. Between 2006 and 2008, female and male participants answered a computer assisted interview about romantic and sexual behaviors in the last year. Predictors of sexual intercourse and readiness for sexual intercourse were examined across a range of sociodemographic measures. Overall, 17.7% (95% CI 16.7%, 18.9%) of participants reported having had sexual intercourse in the last year, with more girls than boys reporting sexual experience (risk ratio 1.30, 95% CI 1.15, 1.47). Of these, one-third of both male and female were classed as unready because they were unwilling, lacking in autonomy, felt regret or had not used contraception. There was strong evidence of social patterning for sexual activity with higher rates for young people from poorer homes, with lower social class, and with younger, less educated mothers. In contrast, among 860 young people who had had sexual intercourse, there was no clear evidence of associations between social factors and sexual readiness. The lack of social patterning in sexual readiness supports the provision of comprehensive education to develop life skills for adolescents across all social groups.

Factors influencing adolescent girls' sexual behavior: a secondary analysis of the 2011 youth risk behavior survey

Adolescence is a tumultuous and challenging time period in life. Sexual risk behavior among adolescents is a widespread topic of interest in the current literature. Two common factors that influence increased sexual risk behavior are symptoms of depression and negative body image. The purpose of this study was to investigate the effect of body image and symptoms of depression upon sexual risk-taking in an adolescent female population. A secondary data analysis of the 2011 Youth Risk Behavior Survey (YRBS) was used to explore girls' sexual activity, body image, and mental health. There were 7,708 high-school girls who participated in this study. Three questions were used to represent the constructs under investigation. There were significant correlations between sexual activity, body image, and symptoms of depression; only symptoms of depression were significant predictors of both sexual activity and condom usage. Body image was a predictor of sexual activity, but not condom use. Our findings support previous studies that suggested that people with depressive symptoms were more likely to engage in risky sexual behaviors. Our study also supports the idea that a negative body image decreases sexual activity; however, other researchers have reported that negative body image leads to an increase in sexual activity.

[Age of puberty and western young women sexuality]

The onset of menarche and age of first sexual experience have both lowered over the past century. Does the age of puberty influence the sexuality of the girl/young occidental woman? If so, to what degree? Besides, is the acquisition of reproductive function, regardless of age, a sign of sufficient maturity to engage in sexual activity? Studies show that early puberty, early sex, unprotected sexual intercourse in adolescence and number of sexual partners in early adulthood are closely related. These early sexual experiences could be stimulated by early drug use as well as by depressive disorders. The age of puberty has a real influence on sexuality but this link will be modulated by a number of social behavioral factors and it is not sustainable. The age of puberty is not a good indicator of maturity for teenage sexuality; early maturation and early sexual activity are usually associated with risky behaviors. However, other studies on the subject are required, including a consideration of the issues associated with delayed puberty, a subject virtually absent from the literature.

Prenatal cocaine exposure and age of sexual initiation: direct and indirect effects

BACKGROUND

Prenatal cocaine exposure (PCE) has been linked to child behavior problems and risky behavior during adolescence such as early substance use. Behavior problems and early substance use are associated with earlier initiation of sexual behavior. The goal of this study was to examine the direct and indirect effects of PCE on sexual initiation in a longitudinal birth cohort, about half of whom were exposed to cocaine in utero.

METHODS

Women were interviewed twice prenatally, at delivery, and 1, 3, 7, 10, 15, and 21 years postpartum. Offspring (52% female, 54% African American) were assessed at delivery and at each follow-up phase with age-appropriate assessments. At age 21, 225 offspring reported on their substance use and sexual behavior.

RESULTS

First trimester cocaine exposure was a significant predictor of earlier age of first intercourse in a survival analysis, after controlling for race, sociodemographic characteristics, caregiver pre- and postnatal substance use, parental supervision, and child's pubertal timing. However, the association between PCE and age of first sexual intercourse was mediated by adolescent marijuana and alcohol use prior to age 15.

CONCLUSIONS

Most of the effect of PCE on age of sexual initiation occurred between the ages of 13-18, when rates of initiation were approximately 10% higher among exposed offspring. This effect was mediated by early adolescent substance use. These results have implications for identification of the exposed offspring at greatest risk of HIV risk behaviors and early, unplanned pregnancy.

Predictors of multiple sexual partners from adolescence through young adulthood

PURPOSE

To examine time-varying associations between predictors of recent multiple sexual partners from middle adolescence through young adulthood.

METHODS

We examined whether the odds of multiple partners in the past year were differentially predicted by substance use and depression over time, using data from a nationally representative longitudinal study (N = 11,963, 52.2% female, 18.3% African-American, 11.9% Hispanic, 3.5% Asian, 2.6% other race, M age at Wave I = 16.1 years, SD = 1.8). Data were analyzed using the time-varying effect model, which estimates associations between predictors and an outcome as a function of near-continuous time.

RESULTS

The proportion of participants having multiple partners increased over time, leveling off at around 30% after age 20. Significant positive associations between substance use and multiple partners were strongest early in adolescence and decreased sharply by around age 18. The significant positive association between depression and sexual behavior weakened with age, remaining significant in young adulthood for women but not men.

CONCLUSIONS

These findings suggest that factors associated with having multiple recent sexual partners change from middle adolescence through young adulthood. The time-varying effect model can be used to identify risk factors that are especially salient at different ages, thus identifying which age periods may hold the greatest promise for intervention.

Age, quality, and context of first sex: associations with sexual difficulties

INTRODUCTION

Research consistently indicates an association between a younger age at first sex and poorer sexual health outcomes. However, research addressing associations between age at first sex and sexual difficulties has produced mixed findings. Moreover, little is known about links between the context and quality of first sex and subsequent sexual difficulties.

AIMS

The aims of this study are to examine whether (i) age and (ii) context and quality at first sex are associated with sexual difficulties; (iii) examine whether age at first sex and context and quality variables are independently associated (after mutual adjustment) with sexual difficulties; and (iv) examine whether age at first sex has an indirect effect on sexual difficulties through an effect on context or quality.

METHODS

Data from 388 questionnaires were gathered from students aged 17-21 living in accommodation halls and by postal invitation to adults aged 25-35.

MAIN OUTCOME MEASURES

The main outcome measure was the Golombok-Rust Inventory of Sexual Satisfaction (GRISS), which assesses sexual difficulties via an overall score and seven subscales.

RESULTS

Appraising first sex as emotionally negative was associated with the majority of sexual difficulties. A less stable relationship at first sex was associated with sexual communication problems and dissatisfaction. Greater enjoyment and using substances were associated with a lower likelihood of anorgasmia for women. Age at first sex was directly associated with reduced sexual frequency only. A younger age at first sex was associated with a greater likelihood of negative appraisal and lower likelihood of a stable relationship and thereby indirectly associated with several sexual difficulties.

CONCLUSIONS

Experiencing first sex as emotionally negative was consistently associated with later sexual difficulties. When attending to sexual difficulties, understanding the quality and context of first sex may be more useful than knowing the age at first sex. This research is limited by the retrospective nature of the reports of first sex.

Predictors of latent growth in sexual risk taking in late adolescence and early adulthood

The goals of this study were to examine latent growth in a composite index of sexual risk taking (defined in terms of number of sexual partners and condom nonuse) on five occasions between ages 14-15 and 22-23 years, and to identify associations between latent growth parameters and covariates. As part of the Children of the National Longitudinal Survey of Youth-1979 (CNLSY-79), 740 adolescents provided data at two-year intervals between 1994 and 2004. Latent growth models revealed quadratic growth in youths' sexual risk taking. High initial levels of risk were attributable to early adolescent family structure, the expectation of teenage parenthood, early autonomy from parents, young age at dating initiation, and delinquency. Linear and quadratic growth terms were explained by early adolescent family structure, perceived academic competence, substance use, and delinquency. These associations persisted when time-varying covariates of other contraceptive use and relationship status were modeled.

Why Do Some Employees Fall into and Fail to Exit a Job-Lock Situation?

Previous studies have paid little attention to the employees' ability to exit a job-lock situation and factors that determine this ability. It remains unclear why some employees who experience job lock are able to exit this state while others remain in job lock. We use longitudinal data to identify employees who have fallen in the state of job lock and their subsequent behavior—exiting or remaining in job lock. By use of a first-order Markov transition models, we analyze the relevance of sociodemographic features, employment, occupational, sectoral, and contextual factors, as well as personality characteristics in explaining the transition or its absence. Overall the results show that both demographic factors and work-related aspects increase the likelihood that an employee enters the long-term job lock state (especially for older, married, full-time employed, those in a craft occupation and governmental sector, and in a region with high unemployment). Mental health problems and personality characteristics (low peak-end self-esteem and decisional procrastination) have a significant effect on the probability to stay in long-term job lock. On the contrary, having a managerial, service, or associate occupation, working in the private sector, and having promotion opportunities increase the chance of an exit from the state of job lock.

Momentary affective states surrounding sexual intercourse in depressed adolescents and young adults

Depressed young people may have sexual intercourse (sex) to regulate their disordered affective states. This study sought to determine how momentary positive and negative affect relate to subsequent sex events in depressed adolescents and young adults. Fifty-four outpatients (87% female) 15-22 years who reported clinically significant depressive symptoms and having sex at least once a week completed a baseline survey, then reported momentary affective states and the occurrence of sex events on a handheld computer in response to 4-6 random signals per day for 2 weeks. Participants identified 387 unique sex events (median, 3.5/participant/week) on 3,159 reports (median, signal response rate 80%). Most (86-96%) reported low burden of participation on questions asked at study completion. Similar to what has been reported in non-depressed young people, momentary positive and negative affect were both improved beginning approximately 6 h before until approximately 6 h after a sex event. Positive affect was lower in the 24 h before this pericoital period, compared to other times. Negative affect did not significantly differ between before the pericoital period and other times. The findings suggest that depressed youth may have sex to regulate their positive affect and have implications for provision of their mental and physical health care.

The Later, the Better? Early, Average, and Late Timing of Sexual Experiences in Adolescence and Psychosocial Adjustment in Young Adulthood

The present article challenges the assumption that later timing of sexual experiences is unequivocally associated with higher psychosocial adjustment. Data from two representative cross-sectional German studies conducted in 1996 and 2005 were analyzed to examine the psychosocial adjustment of young adults (age 20–29) who had their first sexual experiences early (before age 16), at an average age (between age 16 and 18), or late (later than age 18 or not yet). Early timing of sexual experiences was associated with lower educational attainment. Late timing of sexual experiences was associated with poorer social relations. Early and late timing of sexual experiences were associated with lower subjective well-being. Results were replicated across the two studies and controlled for sociodemographic characteristics and (in Study 1) early adversities, parental involvement, and pubertal timing. These findings show that not only early but also late timing of first sexual experiences can be associated with lower psychosocial adjustment in selected domains in young adulthood. Further research is needed to understand maladaptive correlates of late sexual timing.

Pathways to early coital debut for adolescent girls: a recursive partitioning analysis

This study examined pathways to early coital debut among early to middle adolescent girls in the United States. In a two-year longitudinal study of 104 adolescent girls, recursive partitioning (RP) analyses were conducted to examine the specific factors that were related to engaging in first intercourse by the 10th grade among adolescent girls who had not yet engaged in sexual intercourse by the 8th grade. RP analyses identified subsamples of girls who had low, medium, and high likelihoods of engaging in early coital debut based on six variables (i.e., school aspirations, early physical intimacy experiences, depression, body objectification, body image, and relationship inauthenticity). For example, girls in the lowest likelihood group (3% had engaged in sex by the 10th grade) reported no prior experiences with being touched under their clothes, low body objectification, high aspirations to complete graduate education, and low depressive symptoms; girls in the highest likelihood group (75% had engaged in sex by the 10th grade) also reported no prior experiences with being touched under their clothes, but had high levels of body objectification. The implications of these analyses for the development of female adolescent sexuality, as well as for advances in quantitative methods, are discussed.

Short-term prospective study of hooking up among college students

Hook ups are casual sexual encounters (ranging from kissing to intercourse) between two people with no clear mutual expectation of further interactions or a committed relationship. This study utilized a short-term prospective design to examine predictors of hooking up in a sample of young adults (N = 394). Hooking up over the past year, positive reactions to prior hook ups, alcohol use, and loneliness were associated with hooking up over a 4-month period. Alcohol use was a stronger predictor for women than men. Thoughtfulness about relationship transitions and religiosity were significant predictors of hooking up in univariate analyses, but were not significant in multivariate analyses. Young adults who reported more depressive symptoms and feelings of loneliness at Time 1 and subsequently engaged in penetrative hook ups reported fewer depressive symptoms and lower feelings of loneliness at Time 2 as compared to young adults who did not hook up. However, young adults who reported fewer depressive symptoms and were less lonely at Time 1 and engaged in penetrative hook ups over the 4 month period reported more depressive symptoms and greater feelings of loneliness at Time 2 as compared to young adults who did not hook up. Implications for relationship education programs are offered.

Effects of gender and psychosocial factors on "friends with benefits" relationships among young adults

Friends with benefits relationships (FWB) are a blend of friendship and physical intimacy outside of a committed romantic relationship. This study examined young adults' (n = 889) engagement in, and reactions to, a FWB relationship in the past year based on their gender, psychological distress, alcohol use, and relationship attitudes. Men (54.3%) were more likely than women (42.9%) to report at least one FWB relationship and both men and women reported that FWB relationships were associated with more positive emotional reactions than negative ones although this difference was larger for men. Greater alcohol use was related to engaging in a FWB relationship and this relationship was stronger for women. Further, thoughtfulness about relationship decisions moderated the relationship between alcohol use and engaging in FWB relationships, and again this moderation effect was stronger for women than men. Young adults with more psychological distress and who felt constrained in the FWB relationship were more likely to report negative emotional reactions. Implications for psychoeducational programs and future research are offered.

Perceived and observed maternal relationship quality predict sexual debut by age 15

Early sexual behaviors during adolescence have the potential to lead to unhealthy outcomes. This study explored the association between specific dimensions of maternal relationship quality and adolescent sexual debut by age 15. We hypothesized that adolescents who have poor maternal relationships are at greater risk of early sexual debut than those who have a more supportive relationship. These hypotheses were examined using both adolescents' perception of their maternal relationship quality and observed relationship quality. A sample of 268 adolescents (142 girls; 90% European American) were followed longitudinally from age 13 to age 15. The results indicate that adolescents with sexual debut by age 15 report significantly worse relationships with their mothers compared with other adolescents. Furthermore, behavioral observations of lower maternal support and higher observed displays of externalizing affect towards the mother also were related to early sexual debut. The significance of maternal relationship quality remained after controlling for family structure, race, and socioeconomic status. These findings suggest that mothers have a significant role in the timing of their adolescents' sexual debut.

Adolescent sexuality and positive well-being: a group-norms approach

The link between adolescent sexual activity and psychological well-being is a controversial issue in developmental psychology. This cross-sectional study investigated the association between three aspects of teenage sexuality (genital sexual experience, age of sexual onset, and number of sex partners) and positive well-being (hedonic, eudaimonic, and overall) in a sample of 475 high school seniors (48% female; 89% White) from a single school district in a rural upstate New York community. Based on a group-norms perspective, we expected higher well-being in adolescents whose sexual behaviors followed group-normative patterns. As expected, sexually experienced and on-time (at age 16) students reported higher well-being than sexually inexperienced or late-onset (17 or older) students. Contrary to expectations, a high number of sex partners and an early sexual onset (15 or younger) were not related to lower well-being. Early-onset girls reported higher levels of well-being than normative-onset peers. Findings are discussed in relationship to theoretical perspectives and past empirical findings of teenage sexuality as a developmental asset versus risk.

Affairs of the Heart: Qualities of Adolescent Romantic Relationships and Sexual Behavior

We know more about parent and peer influences than about the ways in which specific qualities of adolescent romantic relationships may influence sexual decision-making. Using data from the Toledo Adolescent Relationships Study, we focus on communication processes and emotional feelings, as well as more basic contours of adolescent romantic relationships, including power and influence dynamics. Controlling for traditional predictors and duration of the relationship, results suggest that subjectively experienced relationship qualities matter for understanding teens' sexual behavior choices. Further, findings indicate a similar effect of most relationship qualities on male and female reports of sexual behavior. However, influence and power dynamics within the relationship were not related to the likelihood that boys reported sexual intercourse in a focal relationship. In contrast, girls who perceived a more favorable power balance were less likely to report sexual intercourse than their female counterparts who perceived a less favorable power balance. Recognizing that the results capture reciprocal influence processes, longitudinal and qualitative data are used to further explore the complex nature of these associations.

The relationship between early sexual debut and psychosocial outcomes: a longitudinal study of Dutch adolescents

In a longitudinal dataset of 470 Dutch adolescents, the current study examined the ways in which early sexual initiation was related to subsequent attachment, self-perception, internalizing problems, and externalizing problems. For male adolescents, analyses revealed general attachment to mother and externalizing problems at Wave 1 to predict to early transition at Wave 2. However, there was no differential change in these psychosocial factors over time for early initiators of sexual intercourse and their non-initiating peers. For female adolescents, the model including psychosocial factors at Wave 1 did not predict to sexual initiation at Wave 2. However, univariate repeated measures analyses revealed early initiators to have significantly larger increases in self-concept and externalizing problems than their non-initiating female peers. While the difference between female early initiators and non-initiators were statistically significant, the mean levels of problem behaviors were very low. The findings suggest that, contrary to previous research, early sexual initiation does not seem to be clustered with problem behaviors for this sample of Dutch adolescents.

Individual, familial, friends-related and contextual predictors of early sexual intercourse

This study examined the unique and simultaneous contribution of adolescents' characteristics, parent-child relationship and friends' characteristics on early sexual intercourse, while accounting for family status. A longitudinal multi-sample design was used. The first sample was recruited in a suburban context (n = 265; 62% girls) and the second sample in an urban setting (n = 136; 61% girls). All predictors were measured in Grade 8 and age at first intercourse was assessed yearly for three years. Being in a non-intact family, low parental control, high antisocial behaviors, low self-disclosure, high proportion of other-sex friends and high substance use were associated with earlier sexual intercourse. When all predictors were considered simultaneously, more antisocial behaviors, high proportion of other-sex friends and non-intact family structure significantly discriminated youth reporting first intercourse at age 13 or less from those who reported first intercourse at age 14, at age 15, or were virgins at age 16 among both samples.

The association of socioemotional problems with early sexual initiation

CONTEXT

Research on the association between socioemotional problems and early sexual initiation has not evaluated differences across types of problems, by gender, or by race or ethnicity.

METHODS

Data were analyzed for a sample derived from the Children of the National Longitudinal Surveys of Youth: 1,836 youth who were 10-11 years old at the 1992, 1994 and 1996 waves. Mothers' reports of their child's socioemotional problems at age 10-11 were assessed; sexual initiation before age 15 was assessed using youth self-reports. Logistic regression analyses estimated associations between socioemotional problems and early initiation; predicted probabilities and group differences were calculated using various regression techniques.

RESULTS

Twenty-six percent of youth had had intercourse before turning 15, and their average level of each problem was higher than the level of those who had not. Both internalizing problems (e.g., depression and dependency) and externalizing problems (e.g., hyperactivity and antisocial behavior) were associated with early sexual initiation (odds ratios, 1.1 and 1.2, respectively), but only externalizing problems retained significance when both types were included in the model (1.2). Among specific problems, only hyperactivity and antisocial behavior were associated with early initiation (1.2 for each). Youth with a high level of externalizing problems had a higher predicted probability of having early sex than did those with a low level (0.28 vs. 0.21). Associations between socioemotional problems and early initiation did not differ by gender or by race or ethnicity.

CONCLUSIONS

Interventions should be targeted at youth with externalizing problems, especially those who engage in antisocial or hyperactive behavior, in an effort to promote positive social interactions.

"Hooking up" among college students: demographic and psychosocial correlates

This study investigated 832 college students' experiences with hooking up, a term that refers to a range of physically intimate behavior (e.g., passionate kissing, oral sex, and intercourse) that occurs outside of a committed relationship. Specifically, we examined how five demographic variables (sex, ethnicity, parental income, parental divorce, and religiosity) and six psychosocial factors (e.g., attachment styles, alcohol use, psychological well-being, attitudes about hooking up, and perceptions of the family environment) related to whether individuals had hooked up in the past year. Results showed that similar proportions of men and women had hooked up but students of color were less likely to hook up than Caucasian students. More alcohol use, more favorable attitudes toward hooking up, and higher parental income were associated with a higher likelihood of having hooked up at least once in the past year. Positive, ambivalent, and negative emotional reactions to the hooking up experience(s) were also examined. Women were less likely to report that hooking up was a positive emotional experience than men. Young adults who reported negative and ambivalent emotional reactions to hooking up also reported lower psychological well-being and less favorable attitudes toward hooking up as compared to students who reported a positive hooking up experience. Based on these findings, suggestions for psychoeducational programming are offered. Additionally, directions for future research are provided.

Early adolescent sexual initiation and physical/psychological symptoms: a comparative analysis of five nations

Although most people in developed countries experience sexual initiation during adolescence, little is known about inter-country variability in the psychosocial correlates of early initiation. Population-based samples of 15-year-olds (n = 6,111, 52% female) who participated in the Health Behaviors in School-Aged Children Study (Finland, Scotland, France and Poland, 1997/1998) or the National Longitudinal Study of Adolescent Health (United States, 1996) self-reported sexual intercourse experience and physical (headaches, trouble sleeping) or psychological (unhappiness, loneliness, sadness, moodiness) symptoms. Analyses were conducted stratified by gender. Sexual initiation prevalence and symptoms scores varied significantly across nations. In adjusted models, sexual initiation was not related to symptoms among boys in any nation, but significantly positively related to symptoms among girls in Poland and the US. Results support variability by gender and nation in the relationship between adolescents' sexual initiation and physical/psychological symptoms. Empirically investigating specific features of national contexts that generate these differences should be explored further.

Characteristics associated with sex after periods of abstinence among sexually experienced young women

CONTEXT

Adolescent pregnancy prevention is difficult because adolescent sex is intermittent. Understanding why sexually experienced adolescents have sex after a period of abstinence will help clinicians to tailor counseling.

METHODS

For up to 4.5 years between 1999 and 2006, a sample of 354 adolescent women recruited at urban primary care clinics were interviewed and tested for STDs every three months, and were asked to complete three months of daily diaries twice a year. Survival analyses were used to estimate associations between intrapersonal, relationship and STD-related characteristics and the risk of ending an abstinence period with sex.

RESULTS

Participants reported 9,236 abstinence periods, which averaged 31 days. The risk that an abstinence period ended with sex increased steeply for periods of fewer than 17 days (short), rose less steeply for 17-39-day (intermediate) periods and was fairly steady for longer periods. For short periods, the risk increased with age, sexual interest, positive mood, partner support, relationship quality and history of STD diagnosis more than three months ago (hazard ratios, 1.02-1.2); it decreased as negative mood increased (0.98) and was reduced among adolescents with a recent STD diagnosis (0.9). For intermediate periods, the association with a recent STD diagnosis became positive (1.4). For long periods, sex was associated only with age, sexual interest and relationship quality.

CONCLUSIONS

To provide targeted and timely sexual health counseling, clinicians may want to ask adolescents not only whether they are sexually active but also when they last had sex.