Why adolescents conform to high-status peers: Associations among conformity, identity alignment, and self-esteem

This study examined whether conformity to high- but not low-status e-confederates was associated with increases in identification with popular peers and subsequent increases in self-esteem. A sample of 250 adolescents (55.1% male; Mage = 12.70 years; 40.3% White, 28.2% Black, 23.4% Hispanic/Latino, and 7.7% multiracial/other) participated in a well-established experimental chat room paradigm where they were exposed to norms communicated by high- and low-status e-confederates. Results revealed that for boys in the high-status condition only, but not girls, the positive relation between conformity and self-esteem was mediated by greater response alignment with popular peers. These findings bolster prior research by suggesting that conformity to popular peers may be partly motivated by drives for self-esteem and alignment with a valued reference group.

The Role of Feminism and Gender in Endorsement of Hookup Culture among Emerging Adults

Hookup culture has transformed the sexual behavior of emerging adults. Feminism, a movement that has advocated for liberating women from sexual repression, may be associated with hookup endorsement attitudes. This study explores the associations among multiple dimensions of feminism, gender, and hookup culture endorsement. Participants included 318 emerging adults (46% women; Mage = 22.2 years; 51% White, 27% Asian, 5% Hispanic/Latinx, 9% Black, 1% Middle Eastern, 1% American Indian, 6% Multiracial) from five Anglophone countries (62% U.S., 23% United Kingdom, 9% Canada, 5% Australia, 1% New Zealand), who completed the Feminist Beliefs and Behavior Scale and Endorsement of Hookup Culture Index via an anonymous, online survey. Participants were categorized according to their feminist identity label (feminist, non-feminist) and feminist belief system (hold feminist beliefs, hold non-feminist beliefs). A series of ANCOVAs was conducted, revealing that women who identified as feminist and/or held feminist beliefs reported significantly higher endorsement of hookup culture compared to non-feminist women with non-feminist beliefs. Neither dimension of feminism predicted hookup culture endorsement in men. When comparing feminist-identifying women and men, the gender disparity in hookup culture endorsement was eliminated. Together, these findings highlight how social movements, such as feminism, may be associated with young women's attitudes towards hookups, and may ultimately shape their sexual experiences.

The Sociostructural-Intersectional Body Image (SIBI) framework: Understanding the impact of white supremacy in body image research and practice

White supremacy and racial inequities have long pervaded psychological research, including body image scholarship and practice. The experiences of white, heterosexual, able-bodied, cisgender (predominantly college) women from wealthy, Westernized nations have been centered throughout body image research and practice, thereby perpetuating myths of invulnerability among racialized groups and casting white ideals and experiences as the standard by which marginalized bodies are compared. Body image is shaped by multiple axes of oppression that exist within systemic and structural systems, ultimately privileging certain bodies above others. In this position paper, we highlight how white supremacy has shaped body image research and practice. In doing so, we first review the history of body image research and explain how participant sampling, measurement, interpretive frameworks, and dissemination of research have upheld and reinforced white supremacy. Next, grounded in inclusivity and intersectionality, we advance the Sociostructural-Intersectional Body Image (SIBI) framework to more fully understand the body image experiences of those with racialized and minoritized bodies, while challenging and seeking to upend white supremacy in body image research and practice. We encourage other scholars to utilize the SIBI framework to better understand body inequities and the body image experiences of all people, in all bodies.

Testing the minority stress model across gender identity, race, and ethnicity among U.S. gender minority adolescents

Gender minority (GM) youth are at heightened risk for psychopathology, purportedly due to their experiences of GM stressors. However, few studies have examined how GM stressors are associated with depression and anxiety among GM youth. Furthermore, no prior studies have investigated how experiences of GM stressors differ across gender identity and race/ethnicity within a diverse sample of GM youth. A nationwide online cross-sectional survey of 1,943 fourteen- to 18-year-old GM adolescents (66.91% White, 11.73% multiracial, 8.49% Latinx, 7.10% Black, 3.09% Asian, 1.49% American Indian/Alaskan Native) in the United States assessed GM stressors (prejudice events, expectations of rejection, internalized transnegativity, and concealment) and mental health. Structural equation modeling was used to examine how GM stressors and depressive and anxiety symptoms differ across gender identity and race/ethnicity. Higher levels of each GM stressor were related to higher depressive symptoms. Prejudice events, expectations of rejection, and concealment were related to higher anxiety symptoms. Transmasculine and transfeminine youth reported higher levels of GM prejudice events and expectations of rejection, and higher mental health symptoms, than nonbinary youth. Findings were relatively consistent across racial/ethnic identities, with the exception that Black GM adolescents reported fewer GM prejudice events and expectations of rejection and indirectly exhibited lower mental health symptoms as compared to White GM youth. Researchers and clinicians should be attuned to how intersectional identities are related to stress and mental health among diverse GM youth. Recommendations for individual and structural-level interventions are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A longitudinal assessment of adolescents' sexual communication with parents, best friends, and dating partners

Sexual health communication in adolescence is important for sexual well-being. With limited empirical work utilizing longitudinal methodologies, this study aimed to investigate how the frequency of sexual communication with parents, peers, and dating partners changes across adolescence and varies based on sex, race/ethnicity, and sexual orientation. Participants included 886 U.S. adolescents (54.4% females; 45.9% White, 22.6% Hispanic/Latinx, 21.6% Black/African American) surveyed yearly from middle school through 12th grade. Growth curve models were used to estimate trajectories of the frequency in communication. Results showed curvilinear trajectories for adolescents' sexual communication with their parents, best friends, and dating partners over time. Although all three trajectories showed curvilinear patterns, sexual communication with parents and best friends increased earlier in adolescence and leveled off, while sexual communication with dating partners was lower in early adolescence and showed a steep increase across adolescence. Communication trajectories significantly diverged depending on adolescents' sex and race/ethnicity but not their sexual orientation. This study provides the first evidence of developmental changes over time in adolescent sexual communication with parents, best friends, and dating partners. Developmental implications for adolescents' sexual decision making are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Perceived Gender Transition Progress, Gender Congruence, and Mental Health Symptoms Among Transgender Adolescents

PURPOSE

Transgender adolescents (TGAs) have high risk for experiencing mental health problems, but little is known about how aspects of gender identity relate to their mental health symptoms. Evidence from child and adult samples of transgender individuals indicates making progress in gender transition milestones and higher levels of congruence between gender identity and gender expression are related to fewer mental health problems. We examined associations between perceived transition progress, gender congruence, and mental health symptoms in a diverse, nationwide sample of TGAs.

METHODS

TGAs (n = 1,943) participated in a cross-sectional online survey. Perceived gender transition progress, gender congruence, and depressive and anxiety symptoms were assessed. Path analysis was conducted to examine whether transition progress was related to mental health symptoms via higher levels of gender congruence.

RESULTS

Most TGAs had undertaken at least one social transition step (98%), but only 11% had taken medical transition steps. Higher gender congruence was associated with lower mental health symptoms. Greater transition progress was associated with higher gender congruence, and perceived transition progress evidenced negative indirect associations with mental health symptoms. TGAs identifying with binary identities (transmasculine and transfeminine youth) reported lower levels of transition progress and gender congruence compared to other subgroups of TGAs.

DISCUSSION

Higher levels of perceived transition progress and gender congruence are related to lower mental health symptoms among TGAs. Mental health interventions tailored to the unique developmental needs of TGAs are needed given high risk for mental health problems within this population, and interventions addressing transition progress and gender congruence should be examined.

Parents' attitudes towards the content of sex education in the USA: Associations with religiosity and political orientation

While most parents support their adolescents receiving school-based sex education, there is variability in which sex education topics receive the most support from parents. Conservative political orientation and greater religiosity have been independently associated with parents' lack of support for school-based sex education; however, no studies have examined the intersection of these two factors. The three goals of this study were to: 1) identify how specific sexual education topics cluster together to form content areas; 2) examine if religiosity and political orientation are uniquely associated with these content areas; and 3) examine if political orientation moderates the relationship between parents' religiosity and their perceived importance for the specific sex education content areas. Participants were a national sample of 881 US parents. The sex education topics clustered into three content areas: Factual Knowledge (e.g., STI transmission), Practical Skills (e.g., how to access condoms), and Pleasure and Identity (e.g., pleasurable aspects of sex). Politically conservative and more religious parents reported the lowest perceived importance for each content area. Importantly, these main effects were qualified by a significant interaction: parents who reported both political conservativism and high levels of religiosity reported the lowest perceived importance for these three content areas being taught.

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

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

Psychometric properties and factor structure of the appearance-related social media consciousness scale among emerging adults

Appearance-related social media consciousness (ASMC) is the persistent awareness of one's attractiveness on social media. The ASMC Scale, recently developed for use with adolescents (Choukas-Bradley et al., 2020), provides a promising tool for systematically examining ASMC and associations with mental health. The current study examined the psychometric properties of the ASMC Scale among emerging adult men and women. Participants for Study 1 were 428 emerging adults (M age = 21.9) from five Anglophone, industrialized countries (U.S., U.K., Canada, Australia, New Zealand). Results from Study 1 provide evidence that the 13-item ASMC Scale has a unidimensional structure, strong internal consistency, measurement invariance across gender, and convergent validity (i.e., associations with related offline appearance concerns and cognitions) and incremental validity (i.e., associations with depressive symptoms and disordered eating, above and beyond time spent on social media). Participants from Study 2 were 296 U.S. college students (M age = 18.6). Results from Study 2 confirmed the factor structure and further demonstrated the convergent and incremental validity (above and beyond both time spent on social media and offline appearance concerns) of the ASMC Scale. Findings suggest that the ASMC Scale can be used among emerging adults, aiding future research investigating social media experiences and mental health.

Black adolescents' appearance concerns, depressive symptoms, and self-objectification: Exploring the roles of gender and ethnic-racial identity commitment

There is a dearth of research examining Black adolescents' body image, with even less work examining gender differences or the influence of ethnic-racial identity (ERI) commitment. It is critical to understand how culturally relevant aspects of appearance-beyond commonly measured ideals such as thinness and muscularity-are particularly relevant to Black adolescents. The present study of Black youth (n = 252; 55% girls, 45% boys, ages 13-18, M_age = 15.5) explored the roles of gender and ERI commitment in the associations between skin tone, hair, and facial satisfaction and appearance esteem, depressive symptomatology, and self-objectification. With a few exceptions, satisfaction with skin tone, hair, and face were significantly associated with higher appearance esteem and lower self-objectification and depressive symptoms, even when controlling for weight and muscle tone satisfaction. Findings were similar across genders, with some associations stronger among Black girls relative to boys. Among youth with higher ERI commitment, associations were stronger between skin tone, hair, and facial satisfaction and some indicators of wellbeing. Findings elucidate the role of culturally relevant appearance concerns of Black adolescents and the potential benefits of ERI commitment. This work can inform culturally sensitive research practices and therapeutic interventions related to Black youth's body image experiences.

The Perfect Storm: A Developmental-Sociocultural Framework for the Role of Social Media in Adolescent Girls' Body Image Concerns and Mental Health

In this theoretical review paper, we provide a developmental-sociocultural framework for the role of social media (SM) in adolescent girls' body image concerns, and in turn, depressive symptoms and disordered eating. We propose that the features of SM (e.g., idealized images of peers, quantifiable feedback) intersect with adolescent developmental factors (e.g., salience of peer relationships) and sociocultural gender socialization processes (e.g., societal over-emphasis on girls' and women's physical appearance) to create the "perfect storm" for exacerbating girls' body image concerns. We argue that, ultimately, body image concerns may be a key mechanism underlying associations between adolescent girls' SM use and mental health. In the context of proposing this framework, we provide empirical evidence for how SM may increase adolescent girls' body image concerns through heightening their focus on (1) other people's physical appearance (e.g., through exposure to idealized images of peers, celebrities, and SM influencers; quantifiable indicators of approval); and (2) their own appearance (e.g., through appearance-related SM consciousness; exposure to idealized self-images; encouraging over-valuing of appearance; and peer approval of photos/videos). Our framework highlights new avenues for future research on adolescent girls' SM use and mental health, which recognize the central role of body image.

Support over Social Media among Socially Isolated Sexual and Gender Minority Youth in Rural U.S. during the COVID-19 Pandemic: Opportunities for Intervention Research

Sexual and gender minority (SGM) rural adolescents are at risk for higher levels of social isolation, a well-known risk factor for depression and other negative health outcomes. We qualitatively examined how rural SGM youth seek emotional and informational support, which are protective factors for social isolation on social media (SM) regarding their SGM identity, and determined which SM platforms and tools are most effective in providing support. We conducted semistructured online interviews with rural SGM teens who screened positive for social isolation in spring 2020 and used a thematic analysis approach to analyze the data. Sixteen youths participated in interviews. Themes included seeking emotional support through SM groups and communities, seeking emotional support in designated online SGM spaces, using SM feeds for informational support, and disclosing SGM identity differentially across platforms. SM-based interventions could be leveraged to provide emotional and informational support for rural SGM youth across specific SM platforms and consider whether they are providing emotional or information support. Interventions focused on informational support may best be used on content-based platforms. Those designed to combat social isolation and connect marginalized SGM youths to similar others might benefit from community and forum-based platforms.

Sexual Communication between Adolescent Partners: A Scoping Review and Directions for Future Research

Sexual communication between adolescent partners is an important component of sexual health and wellbeing. Over 40 years of research on adolescent sexual communication has yielded rich information, yet there remain gaps in our understanding of the communication process. The purpose of this scoping review was to synthesize the body of research on adolescent sexual communication to identify how communication has been conceptualized, how researchers have measured communication, and what theoretical frameworks have been applied across the literature. We identified 198 assessments of sexual communication across 119 quantitative studies. This work included 127,489 adolescents (M_age = 15.97) from 15 countries (81.5% U.S.-based). Most studies relied on self-reports (93.4%) and surveyed only one member of a couple (97.5%). The definition of sexual communication was highly varied across the literature: in half of assessments (52.0%) sexual communication was operationalized as a behavior-the verbal or nonverbal exchange of messages about sex-whereas the remaining half of assessments captured social-cognitive aspects of communication (e.g., communication self-efficacy, fear/anxiety). There was also a tendency for investigators to create their own idiosyncratic instruments: half of studies (48.9%) used instruments created by the research team with limited or no discussion of reliability/validity. Regarding the topic of communication, a third of assessments (33.8%) focused exclusively on condom communication and another quarter (24.0%) focused on other safer-sex issues (e.g., STDs, abstinence). Notably absent were studies focused on communication surrounding consent or sexual pleasure. Also absent was a guiding conceptual model or theory that could unify this body of work. Overall, results highlight gaps and inconsistencies in how partner sexual communication has been conceptualized, measured, and theorized about in previous work. We provide several recommendations for future theory-building efforts as well as rigorous, multimethod empirical investigations of adolescent sexual communication that would further our understanding of this important aspect of adolescent sexual wellbeing.

Sexual and gender minority (SGM) adolescents' disordered eating: Exploring general and SGM-specific factors

OBJECTIVE

Sexual and gender minority (SGM) adolescents disproportionately report disordered eating, yet have primarily been considered under a larger SGM umbrella. The current study 1) compared disordered eating between sexual minority (SM) and gender minority (GM) adolescents; 2) examined how general psychological factors (self-esteem, depression, and stress) and SGM-specific factors (e.g., feelings about SGM identity, access to SGM resources) were associated with disordered eating; and 3) examined whether associations between these factors differed for SM versus GM adolescents.

METHOD

SGM adolescents in the U.S. (N = 8814; 35.0% GM; 43.7% cisgender girls; 66.9% White; M_age  = 15.6) reported their disordered eating, depressive symptoms, stress, self-esteem, and SGM-related experiences on an anonymous, cross-sectional online survey.

RESULTS

GM adolescents exhibited a higher prevalence of clinical threshold disordered eating than SM adolescents. Self-esteem was associated with lower odds of caloric restriction, purging, and binge eating. Depression was associated with higher odds of caloric restriction, diet pill use, purging, laxatives, and binge eating. Stress was associated with higher odds of purging. Associations were stronger for GM adolescents' caloric restriction. Positive feelings about SGM identity were associated with lower odds of caloric restriction, purging, and binge eating, whereas greater stress of "coming out" was associated with higher odds of caloric restriction, purging, and binge eating.

DISCUSSION

These results suggest that SGM adolescents' disordered eating is associated with both general psychological factors and unique SGM experiences. Results highlight the importance of considering how the unique experiences of SGM youth may leave them vulnerable to disordered eating behaviors.

PUBLIC SIGNIFICANCE STATEMENT

Sexual and gender minority (SGM) youth are disproportionately affected by disordered eating. The current study found that higher depression and stress, and lower self-esteem, were associated with SGM adolescents' disordered eating. Furthermore, unique SGM experiences, such as stress about coming out, were also associated with eating pathology. Results highlight the importance of considering SGM adolescents' perceptions of their identity and social support.

Examining Social Media Experiences and Attitudes Toward Technology-Based Interventions for Reducing Social Isolation Among LGBTQ Youth Living in Rural United States: An Online Qualitative Study

Purpose

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth living in rural areas who feel isolated are at high risk of depression and suicidality. Given the lack of support in their offline communities, many rural-living LGBTQ youth turn to social media for social support. In this qualitative study, we examined rural LGBTQ youth's social media experiences and attitudes toward technology-based interventions for reducing perceived isolation.

Method

In Spring 2020, we conducted online interviews with LGBTQ youth aged 14-19, living in rural areas of the United States, who screened positive for perceived social isolation (n = 20; 11 cisgender sexual minority, 9 transgender). Interviews examined (1) supportive social media experiences, (2) personal strategies to improve social media experiences, and (3) perspective on potential digital intervention delivery modalities. Data were analyzed using thematic analysis.

Findings

Related to supportive content and interactions, themes included (1) positive representation of and connecting with LGBTQ groups on social media are important; (2) content from people with shared experience feels supportive, and (3) lack of feedback to one's experiences is isolating. Regarding personal strategies to improve social media experiences, themes were (1) selecting platforms to connect with different audiences helps make for a more enjoyable social media experience, and (2) several social media platform features can help make for a safer social media experience. Youth discussed advantages and disadvantages of intervention delivery via a mobile app, social media pages or groups, conversational agents (chatbots), and a dedicated website.

Conclusion

Viewing positive representation of and connecting with LGBTQ groups, content from people shared experiences, and utilizing a wide array of platform features to increase the likelihood of positive connections are key to a positive social media experience among this group. Combining delivery modalities is key to engaging rural-living LGBTQ youth in digitally delivered support interventions to reduce perceived isolation. Our results inform future intervention research and conversations about social determinants of health between providers and rural LGBTQ patients.

Incorporating social media and muscular ideal internalization into the tripartite influence model of body image: Towards a modern understanding of adolescent girls' body dissatisfaction

The tripartite influence model stipulates that appearance pressures from three sources (family, peers, traditional media) lead adolescent girls to internalize a thin appearance ideal and engage in social appearance comparisons, resulting in body dissatisfaction (Thompson et al., 1999). Social media is a modern source of appearance pressure and, increasingly, adolescent girls desire an appearance that is both thin and muscular. The current study of U.S. adolescent girls (n = 543, M_age = 15.58, 49.17% Latina, 28.18% White, 8.66% Black, 7.55% Asian, 6.45% multiracial/another race/ethnicity) incorporates social media appearance pressures and muscular ideal internalization into the tripartite influence model using structural equation modeling. Findings provided support for this adapted model: family, peers, traditional media, and social media contributed to body dissatisfaction. All appearance pressure sources were associated with appearance esteem via thin ideal internalization. Peer and social media pressures were both related to greater muscular ideal internalization, which was not significantly associated with appearance esteem. Social media was the only source of pressure associated with appearance esteem through both thin ideal internalization and body comparison. Findings highlight adolescent girls' pressure to look both thin and muscular, as well as the role of social media as a prominent source of appearance socialization.

Reexamining Social Media and Socioemotional Well-Being Among Adolescents Through the Lens of the COVID-19 Pandemic: A Theoretical Review and Directions for Future Research

Social media has rapidly transformed the ways in which adolescents socialize and interact with the world, which has contributed to ongoing public debate about whether social media is helping or harming adolescents. The COVID-19 pandemic has magnified both the challenges and opportunities of adolescents' social-media use, which necessitates revisiting the conversation around teens and social media. In this article, we discuss key aspects of adolescent social-media use and socioemotional well-being and outline how these issues may be amplified in the context of the COVID-19 pandemic. We use this as a springboard to outline key future research directions for the field, with the goal of moving away from reductionist approaches and toward a more nuanced perspective to understand the who, what, and when of social-media use and its impact on adolescent well-being. We conclude with a commentary on how psychological science can inform the translation of research to provide evidence-based recommendations for adolescent social-media use.

Longitudinal associations between appearance-related social media consciousness and adolescents' depressive symptoms

INTRODUCTION

Frequent social media use among adolescents is associated with depressive symptoms, though prior work has overwhelmingly used cross-sectional designs and focused on "screen time." Subjective social media experiences, such as the concern with one's physical appearance on social media, may be more relevant to adolescents' depressive symptoms than mere frequency of use. Appearance-related social media consciousness (ASMC) is the preoccupation with one's physical attractiveness in social media photos and has been associated with depressive symptoms above and beyond frequency of social media use in prior cross-sectional work.

METHODS

In this brief report, we assessed this association longitudinally over 1 year within a diverse sample of highschool adolescents in the Southeastern US (n = 163, M age = 16.19; 55.8% girls; 44.8% White, 23.9% Black, 26.4% Hispanic/Latinx; 49.7% received free or reduced-price lunch).

RESULTS

Baseline ASMC was associated with higher depressive symptoms 1 year later, even when controlling for time spent on social media. Although girls reported higher levels of ASMC, associations were similar for adolescent boys and girls. No evidence was found that heightened depressive symptoms at baseline were associated with higher ASMC 1 year later.

CONCLUSIONS

The findings highlight the importance of physical appearance concerns on social media-above and beyond the frequency of use-in the development of depressive symptoms among adolescents. Implications for future research to examine the role of subjective social media experiences in adolescents' depressive symptoms are discussed.

Picture Perfect During a Pandemic? Body Image Concerns and Depressive Symptoms in U.S. Adolescent Girls During the COVID-19 Lockdown

The stay-at-home orders of the COVID-19 pandemic disrupted U.S. adolescents' lives in numerous ways during the spring of 2020, including substantial changes to in-person routines and increased reliance on digital media. For adolescent girls, stay-at-home practices may have implications for body image concerns. In this research brief, we examine adolescent girls' pandemic-related body image concerns and longitudinal associations with depressive symptoms. The sample included 93 U.S. adolescent girls (M _age = 15.01; 68.8% White), with approximately 2/3 at temperamental risk for depression. Participants self-reported their depressive symptoms and pandemic-related body image concerns via online surveys at three assessments: Time 1 occurred in April/May 2020, approximately one month into stay-at-home orders, followed by two-week and seven-month follow-up assessments. Two pandemic-related body image concerns were assessed: (1) concerns about disrupted appearance-management routines and (2) evaluating one's appearance on video-chat. Both forms of pandemic-related body image concerns predicted depressive symptoms two weeks later, and concerns about disrupted routines also predicted depressive symptoms seven months later. In an era of social distancing, frequent technology-based interactions, and disrupted routines, future work should continue to investigate adolescents' body image concerns and the implications for longer-term mental health outcomes.

A meta-analysis of longitudinal peer influence effects in childhood and adolescence

For decades, psychological research has examined the extent to which children's and adolescents' behavior is influenced by the behavior of their peers (i.e., peer influence effects). This review provides a comprehensive synthesis and meta-analysis of this vast field of psychological science, with a goal to quantify the magnitude of peer influence effects across a broad array of behaviors (externalizing, internalizing, academic). To provide a rigorous test of peer influence effects, only studies that employed longitudinal designs, controlled for youths' baseline behaviors, and used "external informants" (peers' own reports or other external reporters) were included. These criteria yielded a total of 233 effect sizes from 60 independent studies across four different continents. A multilevel meta-analytic approach, allowing the inclusion of multiple dependent effect sizes from the same study, was used to estimate an average cross-lagged regression coefficient, indicating the extent to which peers' behavior predicted changes in youths' own behavior over time. Results revealed a peer influence effect that was small in magnitude (β¯ = .08) but significant and robust. Peer influence effects did not vary as a function of the behavioral outcome, age, or peer relationship type (one close friend vs. multiple friends). Time lag and peer context emerged as significant moderators, suggesting stronger peer influence effects over shorter time periods, and when the assessment of peer relationships was not limited to the classroom context. Results provide the most thorough and comprehensive synthesis of childhood and adolescent peer influence to date, indicating that peer influence occurs similarly across a broad range of behaviors and attitudes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Reexamining Social Media and Socioemotional Well-Being Among Adolescents Through the Lens of the COVID-19 Pandemic: A Theoretical Review and Directions for Future Research

Social media has rapidly transformed the ways in which adolescents socialize and interact with the world, which has contributed to ongoing public debate about whether social media is helping or harming adolescents. The COVID-19 pandemic has magnified both the challenges and opportunities of adolescents' social-media use, which necessitates revisiting the conversation around teens and social media. In this article, we discuss key aspects of adolescent social-media use and socioemotional well-being and outline how these issues may be amplified in the context of the COVID-19 pandemic. We use this as a springboard to outline key future research directions for the field, with the goal of moving away from reductionist approaches and toward a more nuanced perspective to understand the who, what, and when of social-media use and its impact on adolescent well-being. We conclude with a commentary on how psychological science can inform the translation of research to provide evidence-based recommendations for adolescent social-media use.

Selfie Appearance Investment and Peer Feedback Concern: Multi-Method Investigation of Adolescent Selfie Practices and Adjustment

Sharing "selfies" on social media is common among adolescents. The frequency with which adolescents post selfies may be less important than behaviors and cognitions underlying selfie-posting, and these practices may differ by gender. This multi-method study explored selfie practices in a school-based sample of 639 adolescents (M age=17.6; 53.5% female). Participants completed self-report measures of selfie practices, body esteem, depressive symptoms, and peer behaviors. In addition, a subset of participants' social media pages (n = 245) were observationally-coded for numbers of selfies, followers, and likes. Factor analyses revealed two distinct selfie practices: selfie appearance investment and selfie peer feedback concern. Girls posted selfies more frequently, and reported greater levels of appearance investment and concern over peer feedback on selfies compared to boys. Multiple group structural equation models indicated that for boys and girls, selfie appearance investment was associated with depressive symptoms. For girls only, selfie peer feedback concern was associated with excessive reassurance-seeking and lower body esteem. No associations were revealed between observationally-coded measures of selfie-posting frequency and psychosocial outcomes. Overall, findings suggest that frequency of selfie-posting may be less relevant for understanding adolescent adjustment than investment in and concern over the selfie-posting experience.

Examining Sexual Behavior Among U.S. Transgender Adolescents

The health of transgender adolescents (i.e., those identifying with a gender other than their sex assigned at birth) is gaining attention from researchers, yet little work has examined normative sexual behaviors among this population. Self-identified gender minority adolescents, including those identifying as trans boys, trans girls, nonbinary, and questioning their gender identity (age range 14-18, M_age = 16, n = 1,223) from all 50 U.S. states responded to anonymous online surveys. Participants reported on their age of initiation and number of sexual partners for four sexual behaviors ranging in intimacy (i.e., sexual touching, oral sex, vaginal sex, and anal sex). Participants also indicated the gender of their sexual partners and experiences with sexually transmitted infections (STIs), STI tests, and pregnancy. Overall, transgender adolescents' age of initiating sexual behaviors and number of sexual partners are similar to those observed in prior studies of cisgender adolescents. No differences were found between gender identity subgroups on ever engaging, age of initiation, number of partners, and gender of partners across the four sexual behaviors, with some exceptions for anal sex. Participants reported low rates of STIs and pregnancy, but also low rates of STI testing. Implications for sex education and health care are discussed.

Psychosocial correlates of body esteem and disordered eating among sexual minority adolescent girls

The present study examined whether body esteem mediates the associations between psychosocial factors, including peer victimization and parent-adolescent relationship quality, and multiple categories of disordered eating (DE) within a diverse sample of adolescent sexual minority (SM) girls. Participants were 528 girls, aged 14-18 years, recruited as part of a larger online study on LGBTQ + adolescent health. Participants anonymously completed self-report measures of parent-adolescent relationship quality, sexual orientation-based victimization, body esteem, and DE behaviors, including binge eating, purging, and caloric restriction. Parent-adolescent relationship quality was positively associated with SM adolescent girls' body esteem, and some aspects of body esteem subsequently mediated the associations between parent-adolescent relationship quality and DE behaviors. Experiences of sexual orientation-related victimization were also positively related to endorsement of caloric restriction. However, no significant indirect effects were observed between sexual orientation-related victimization and DE via body esteem. These results suggest parents could influence their SM daughters' DE behaviors via body esteem, and SM girls may be engaging in caloric restriction if they experience victimization, regardless of their body esteem.

Values-Alignment Messaging Boosts Adolescents' Motivation to Control Social Media Use

Two preregistered experiments with 2,733 U.S. high school students (age range = 13-19 years) compared the impact of different messages on adolescents' motivation to control social media use (SMU). A traditional message emphasized the benefits of avoiding SMU, whereas a values-alignment message framed controlling SMU as being consistent with autonomy and social justice. Compared to no message or a traditional message, in both studies, a values-alignment message led to greater motivation to control SMU immediately afterward, and in Study 2, awareness of "addictive" social media designs 3 months later. As hypothesized, values-alignment messaging was more motivating for girls than boys. Results offer preliminary support for leveraging adolescents' drives for autonomy and social justice to motivate self-regulation of SMU.

Examining the Link Between Sexual Self-Concept and Sexual Communication among Adolescents

The purpose of this study was to move beyond a sexual risk framework to investigate the possible associations among three sex-positive constructs for adolescents: their sexual self-concept (i.e., their positive/negative feelings about themselves as sexual beings), their sexual communication with romantic/sexual partners, and their sexual communication self-efficacy. We also examined differences in these constructs by sexual intercourse experience and gender. Participants were 171 adolescents who had been in a dating or sexual relationship in the past year (M _age=16.32 years; 64.3% girls). Compared to girls, boys had more positive sexual self-concepts but less self-efficacy to communicate with their partners about sex. Adolescents who reported having had sexual intercourse had more positive sexual self-concepts as well as more frequent partner sexual communication compared to adolescents without sexual intercourse experience. Adolescents with a more positive sexual self-concept had higher sexual communication self-efficacy and reported more frequent sexual communication. In addition, sexual communication self-efficacy partially mediated the relationship between sexual self-concept and sexual communication. Results highlight the connection between sexual self-concept and sexual communication and contribute to a growing body of work on the positive aspects of adolescent sexuality.

Disparities in Childhood Abuse Between Transgender and Cisgender Adolescents

BACKGROUND AND OBJECTIVES

Transgender adolescents (TGAs) exhibit disproportionate levels of mental health problems compared with cisgender adolescents (CGAs), but psychosocial processes underlying mental health disparities among TGAs remain understudied. We examined self-reported childhood abuse among TGAs compared with CGAs and risk for abuse within subgroups of TGAs in a nationwide sample of US adolescents.

METHODS

Adolescents aged 14 to 18 completed a cross-sectional online survey (n = 1836, including 1055 TGAs, 340 heterosexual CGAs, and 433 sexual minority CGAs). Participants reported gender assigned at birth and current gender identity (categorized as the following: cisgender males, cisgender females, transgender males, transgender females, nonbinary adolescents assigned female at birth, nonbinary adolescents assigned male at birth, and questioning gender identity). Lifetime reports of psychological, physical, and sexual abuse were measured.

RESULTS

Seventy-three percent of TGAs reported psychological abuse, 39% reported physical abuse, and 19% reported sexual abuse. Compared with heterosexual CGAs, TGAs had higher odds of psychological abuse (odds ratio [OR] = 1.84), physical abuse (OR = 1.61), and sexual abuse (OR = 2.04). Within separate subgroup analyses, transgender males and nonbinary adolescents assigned female at birth had higher odds of reporting psychological abuse than CGAs.

CONCLUSIONS

In a nationwide online sample of US adolescents, TGAs had elevated rates of psychological, physical, and sexual abuse compared with heterosexual CGAs. Risk for psychological abuse was highest among TGAs assigned female at birth. In the future, researchers should examine how more frequent experiences of abuse during childhood could contribute to disproportionate mental health problems observed within this population.

Disparities in disordered eating between gender minority and cisgender adolescents

OBJECTIVE

Adolescence is a developmental period of increased risk for disordered eating. Gender minority adolescents (GMAs), or those whose gender identity does not align with their sex assigned at birth, may experience body image concerns related to unique gender-related stressors. GMAs may use disordered eating to affirm a feminine, masculine, or nonbinary gender identity. However, little is known about differences in disordered eating between GMAs and cisgender adolescents. Therefore, this study had two primary goals: (a) to compare disordered eating between GMAs and cisgender adolescents by examining the role of gender identity and sex assigned at birth; and (b) within GMAs, to examine associations between gender identity congruence and disordered eating.

METHOD

A large U.S. sample of GMAs and cisgender adolescents (n = 1,191 GMAs; 919 cisgender; M_age = 15.93 years) reported their disordered eating on an anonymous online survey.

RESULTS

A MANOVA revealed a significant interaction between gender identity and sex assigned at birth. Follow-up ANOVAs demonstrated that purging, caloric restriction, excessive exercise, and muscle building differed as a function of gender identity and sex assigned at birth. Among GMAs, a multiple multivariate regression model demonstrated that disordered eating was lower among participants who reported greater gender identity congruence.

DISCUSSION

GMAs should not be considered a homogenous group, as differences in gender identity may lead to the internalization of different appearance ideals and disparate eating disorder symptomatology. Results suggest that clinicians working with GMAs consider the unique body image concerns that could accompany a specific gender identity.

Exploring transgender adolescents' body image concerns and disordered eating: Semi-structured interviews with nine gender minority youth

Transgender adolescents (TGAs) face many of the same sociocultural and biological influences on body dissatisfaction and disordered eating as cisgender peers. Additionally, TGAs experience unique body- and gender-related concerns. The purpose of this study is to explore the nuances of gender identity, gender transitioning, body image, and disordered eating among TGAs. Case summaries and a synthesis of key themes are presented from interviews with nine TGAs aged 16-20 (M_age = 17). All participants reported engaging in at least one behavior to change their weight or shape. Consistent with a theoretical biopsychosociocultural model we proposed, TGAs described body dissatisfaction and disordered eating related to transgender-specific factors (e.g., behaviors aimed at minimizing secondary sex characteristics) and broader developmental and sociocultural factors. Some participants reported improvements in body image and disordered eating following gender transition. The interviews highlight complex associations among gender identity, gender transitioning, body image, and disordered eating during adolescence, suggesting that disentangling transgender-specific factors from other individual factors is difficult. These findings may guide future research on the prevalence and functions of disordered eating among TGAs and point to a unique set of needs for effective detection and treatment of concurrent gender incongruence, body dissatisfaction, and disordered eating.

Associations between adolescents' pornography consumption and self-objectification, body comparison, and body shame

Although prior work indicates an association between idealized media content and adolescents' body-related concerns, such as self-objectification, body comparison, and body shame, few prior studies have examined the role of pornography. Even fewer studies have included adolescent girls, limiting our understanding of potential gender differences. In this brief report, we investigate these associations in a diverse mixed-gender sample of high school students in the Southeastern U.S. (n = 223, ages 15-18, M _age = 16.25, 59 % girls) who completed computerized self-report measures. Controlling for demographic covariates and frequency of social media use, we found an association between frequency of pornography consumption in the past year and higher self-objectification and body comparison, but not body shame. No evidence of differences by gender emerged. Results suggest that both boys and girls may be susceptible to pornography-related body concerns, yet these concerns may not include body shame. Future research should examine both risks and benefits of pornography use among adolescents using longitudinal designs, as well as how body-related concerns can be incorporated into pornography literacy interventions.

Sleep among gender minority adolescents

STUDY OBJECTIVES

Stigmatized youth experience poorer sleep than those who have not experienced stigma. However, no studies have examined the sleep of gender minority adolescents (GMAs). Examining sleep disparities between GMAs and non-GMAs is critical because poor sleep is associated with mental health outcomes experienced disproportionately by GMAs. We examined sleep duration, sleep problems, and sleep quality among our sample and compared these parameters between GMAs and non-GMAs.

METHODS

Adolescents aged 14-18 years (n = 1,027 GMA, n = 329 heterosexual non-GMA, n = 415 sexual minority non-GMA; mean age = 16 years; 83% female sex at birth) completed a cross-sectional online survey, reporting sex assigned at birth and current gender identity, sleep duration, sleep problems (too much/too little sleep and inadequate sleep), sleep quality, and depressive symptoms.

RESULTS

Accounting for demographic covariates, GMAs were more likely to report inadequate sleep and shorter sleep duration and had higher odds of reporting poor sleep quality and getting too little/too much sleep than heterosexual non-GMAs. After also adjusting for depressive symptoms, the finding that GMAs more often reported poor sleep quality remained significant.

CONCLUSIONS

This first large, nationwide survey of sleep among GMAs suggests that GMAs may be more likely to have poor sleep than non-GMAs. The significance of our results was reduced when adjusting for depressive symptoms, suggesting that poorer sleep may occur in the context of depression for GMAs. Future work should include objective measures of sleep, examine the emergence of sleep disparities among GMAs and non-GMAs, and explore pathways that increase risk for poor sleep among GMAs.

Where it Hurts the Most: Peer Interactions on Social Media and in Person are Differentially Associated with Emotional Reactivity and Sustained Affect Among Adolescent Girls

Social media (SM) use has increasingly changed how adolescents interact with their peers, yet it remains unclear how peer interactions on social media differ from in-person peer interactions. The current study evaluated whether the context (social media or in-person) of adolescent girls' worst and best peer interactions influenced their emotional responses to peer interactions and sustained affect in everyday life. In this study, a total of 110 adolescent girls (11-13 years old; mean age = 12.28 years) completed ecological momentary assessment (EMA) for 16 days following an initial baseline visit. Participants reported their worst (i.e., most negative) and best (i.e., most positive) interactions with peers since the last prompt, the context in which it occurred (social media or in-person), emotional reactivity during the interaction, and momentary affect. Multilevel models indicated that negative peer interactions that occurred on social media were more likely to be associated with sustained negative affect, but not negative emotional reactivity during the interaction. Positive interactions on social media were more likely to be associated with both lower positive emotional reactivity and lower sustained positive affect. Findings indicate that peer interactions on social media may differentially impact girls' emotional reactivity and sustained affect, particularly for positive interactions with peers. Findings highlight that social media and in-person peer interactions may impact how girls experience and respond to positive and negative peer interactions, which may have implications for peer relationships and onset of psychopathology during this vulnerable period.

Understanding Adolescents' Attitudes Toward Affirmative Consent

A clear understanding of sexual consent is important for sexual violence prevention. To date, most research has focused on how college students understand and negotiate consent. Although adolescence is a critical period for the development of sexual attitudes, identity, and intimate relationships, the perspectives of high school-aged youth have been largely absent from the consent literature. The current study investigated adolescents' attitudes toward affirmative consent in a sample of 226 high school students (58% female; 46% White, 24% Black, 25% Hispanic) from the southeastern U.S., as well as associations between affirmative consent attitudes and gender, gender role beliefs, and sexual activity status. Additionally, we tested whether gender role beliefs were a mediator between gender and affirmative consent attitudes. Overall, adolescents reported supportive attitudes toward affirmative consent. On average, girls and adolescents with more egalitarian gender role beliefs had more positive attitudes toward affirmative consent than boys and those with less egalitarian gender role beliefs, though no differences by sexual activity status were found. Gender role beliefs mediated the relationship between gender and attitudes toward affirmative consent. The results suggest that adolescents are generally supportive of affirmative consent practices, although some important group differences emerged.

The Gender Minority Youth Study: Overview of Methods and Social Media Recruitment of a Nationwide Sample of U.S. Cisgender and Transgender Adolescents

Recent research has documented significant mental health disparities for transgender adolescents. However, the extant literature is hindered by vague operationalizations of gender identity and limited measurement of trans-specific stressors. In this article, we (1) introduce and describe the Gender Minority Youth (GMY) Study, a large-scale study of transgender youth disparities; and (2) provide evidence of the feasibility of using social media to recruit a diverse sample of U.S. transgender and cisgender youth. Facebook and Instagram advertisements targeted 14-18-year-old adolescents to complete an online survey. Participants (N = 3318) self-reported gender assigned at birth and current gender identity, mental health symptoms, and transgender-specific stressors and milestones. Adolescents included 1369 cisgender (n = 982 cisgender female; n = 387 cisgender male), 1938 transgender (n = 986 transgender male; n = 132 transgender female; n = 639 nonbinary assigned female at birth; n = 84 nonbinary assigned male at birth; n = 84 questioning gender identity assigned female at birth; n = 13 questioning gender identity assigned male at birth), and 11 intersex youth. The GMY Study is the first nationwide sample of U.S. adolescents recruited specifically for a study of mental health disparities between transgender and cisgender youth. We demonstrate the feasibility of using social media advertisements and a waiver of parental permission to recruit a large sample of adolescents, including subsamples of gender minority youth. We remedied limitations in the existing literature by including appropriate measures of gender assigned at birth, current gender identity, and detailed questions about transgender-specific stressors and transition milestones.

The Appearance-Related Social Media Consciousness Scale: Development and validation with adolescents

Appearance-related social media consciousness (ASMC) is defined as the extent to which individuals' thoughts and behaviors reflect ongoing awareness of whether they might look attractive to a social media audience. In this 3-study paper, we report the development and validation of the ASMC Scale for adolescents. In Study 1, we developed 18 items and received input from adolescent focus groups and content experts, resulting in 13 items. In Study 2, we administered these items to a high school sample (N = 1227; 51.8 % girls; M_age = 15.72), completing an exploratory factor analysis and a confirmatory factor analysis on two split halves. Results supported a single-factor solution with configural, metric, and partial scalar gender invariance. In Study 3, we administered the scale to a second high school sample (N = 226; 58.4 % girls; M_age = 16.25). ASMC scores demonstrated strong internal consistency, convergent and incremental validity, and test-retest reliability (measure re-administered for n = 207). Higher ASMC was associated with higher depressive and disordered eating symptoms, controlling for time on social media, gender, race/ethnicity, and body surveillance. Girls reported higher mean scores than boys. Findings support the use of this 13-item scale in reliably assessing adolescents' ASMC, which may have important implications for mental health in the age of social media.

0358 Sleep Among Transgender and Cisgender Adolescents

Introduction

Sleep problems are germane to the majority of adolescents, but stigmatized youth may experience poorer sleep than those who have not experienced stigma. However, no prior studies have examined sleep among transgender adolescents (TGAs). Investigating these sleep disparities is critical, since low sleep duration and poor sleep quality are predictive of depressive symptoms and suicidality among adolescents, two mental health outcomes experienced disproportionately by TGAs. Using a nationwide survey of adolescents, we examined sleep duration, sleep quality, and rates of insufficient sleep among a sample of adolescents, and we compared those parameters between TGAs and cisgender adolescents (CGAs).

Methods

Adolescents (n=1784) ages 14-18 completed an anonymous survey including measures of sleep, sexual and gender identity, depressive symptoms, and demographic variables. Participants were grouped as TGA or CGA. Unadjusted associations between gender identity and sleep outcomes were examined, followed by multivariate regression models examining associations adjusted for demographics and depressive symptoms.

Results

TGAs reported sleeping fewer hours, higher odds of being a ‘poor sleeper’, and lower odds of getting the right amount of sleep and getting ‘enough sleep’ than CGAs. After adjusting for key demographic variables, TGAs were still more likely to report that they were poor sleepers and less likely to report getting enough sleep compared to CGAs. When adding depressive symptoms as a covariate, the finding that TGAs reported they got enough sleep less often than CGAs remained marginally significant.

Conclusion

Transgender adolescents reported receiving poorer sleep than cisgender adolescents. Future studies should focus on longitudinally examining the emergence of sleep problems among TGAs and CGAs, which may also serve to identify specific biopsychosocial pathways that contribute to heightened risk for sleep problems among TGAs. Sleep disparities may be a promising target for prevention and intervention programs to improve health outcomes among stigmatized youth.

Support

This study was funded by the University of Pittsburgh Central Research Development Fund through an award to Drs. Salk, Choukas-Bradley, and Thoma. Dr. Levenson was supported by grant K23HD087433. Dr. Thoma was supported by grants T32MH018951 and K01MH117142, Dr. Salk was supported by grant T32MH018269, and Dr. Hamilton was supported by grant T32HL082610.

Mental health among sexual and gender minority adolescents: Examining interactions with race and ethnicity

OBJECTIVE

Sexual and gender minority (SGM) adolescents report elevated risk for psychopathology. Identifying as a racial/ethnic minority and sexual minority (SM) or gender minority (GM) may lead to greater stress/discrimination and psychopathology. We examined nonsuicidal self-injury, suicide ideation, and suicide attempts (i.e., self-injurious thoughts and behaviors [SITBs]) and depressive symptoms across intersections of sexual orientation, gender, and race/ethnicity.

METHOD

Study participants consisted of a large (n = 2,948; 59% GM) sample of adolescents aged 14-18 who were recruited online to complete a cross-sectional survey. SGM status, race/ethnicity, and their interactions were used to predict depressive symptoms and SITBs. Associations among race/ethnicity and GM-specific psychosocial factors were assessed.

RESULTS

SM (B = 3.75) and GM (B = 8.81) participants reported higher depressive symptoms and SITB histories (odds ratios [ORs] from 1.92 to 2.43 and 2.87 to 5.44, respectively). Asian participants were less likely to report nonsuicidal self-injury (OR = 0.45), and Latinx participants were more likely to report suicide attempts (OR = 1.50). Although omnibus tests of interactions were largely insignificant, exploratory analyses revealed fewer depressive symptoms (B = -8.40) and SITBs (ORs from -0.95 to -2.05) among Black SM participants and, at times, Black GM participants. This protective effect may relate to lower self-reported expectations of rejection due to gender.

CONCLUSIONS

GM participants reported the highest risk for depressive symptoms and SITBs. Contrary to hypotheses, multiple minority identification was not associated with greater psychopathology. Future research, assessing specific sexual and gender identities across diverse samples, is needed to highlight how race affects psychopathology risk across these identities. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Feasibility, Acceptability, and Preliminary Efficacy of a Brief Online Sexual Health Program for Adolescents

This study evaluated the feasibility, acceptability, and preliminary efficacy of a 45-minute interactive, online sexual health program for adolescents, called Health Education and Relationship Training (HEART). The program was originally developed and evaluated among adolescent girls (HEART for Girls); the current project describes and evaluates a new version of the program that was adapted for boys and girls. Participants were 226 high school students (mean age = 16.3; 58% girls; 46% White; 79% heterosexual). Students were randomized to HEART or an attention-matched control and assessed at pre-test and immediate post-test. Overall, the program was feasible to administer in a school setting and youth found the program highly acceptable (83% liked the program, 87% learned new things, and 93% would use program content in the future). At post-test, students who completed HEART demonstrated improvements on every outcome we examined: sexual communication intentions, condom use intentions, HIV/STD knowledge, condom attitudes, condom norms, self-efficacy to practice safer sex, and sexual assertiveness compared to control participants (effect size ds = .23 to 1.27). Interactions by gender and sexual orientation revealed the program was equally acceptable and worked equally well for boys and girls and for heterosexual and sexual minority youth. We propose several avenues to further adapt and tailor HEART given its promise in promoting adolescent sexual health.

Emotional support from social media and face-to-face relationships: Associations with depression risk among young adults

BACKGROUND

Emotional support is highly protective against poor mental health. Though several measures of emotional support exist, none specifically addresses social media (SM) as a source of emotional support. Therefore, the objectives of this study were to determine if SM-based emotional support is an extension of or distinct construct from face-to-face (FTF) emotional support and to assess the independent associations between each domain of emotional support and depression risk among U.S. young adults.

METHODS

In March 2018, we surveyed 2408 18-30 year olds. We assessed perceived FTF emotional support with the brief PROMIS emotional support scale and perceived SM-based emotional support using a new four-item measure. Depression risk was assessed using the PHQ-9. We performed factor analysis (FA) to determine the underlying factor structure of all items and to develop composite scales. Multivariable logistic regression was used to examine the independent association between each resulting emotional support scale and depression risk.

RESULTS

FA revealed two distinct constructs. FTF emotional support was associated with 43% lower odds of depression per 1-unit increase on the 5-point scale (AOR = 0.57, 95% CI = 0.52-0.63). However, SM-based emotional support was significantly associated with 20% greater odds of depression per 1-unit increase on the 5-point scale (AOR = 1.20, 95% CI = 1.09-1.32).

LIMITATIONS

This study utilized a cross-sectional design and self-report data.

CONCLUSIONS

While FTF emotional support was associated with slightly lower odds of depression, SM-based emotional support was associated with slightly greater odds of depression. It may be valuable for clinicians treating individuals with depression to ask about sources of emotional support.

Popular peer norms and adolescent sexting behavior

INTRODUCTION

Adolescents misperceive and are heavily influenced by the behavior of their popular peers, yet research has not yet investigated this phenomenon for a relatively new and potentially risky behavior: adolescent sexting. The present study investigates rates of sexting among popular and non-popular adolescents and the association between adolescents' perceptions of popular peers' sexting behavior and their own sexting behavior.

METHODS

A school-based sample of 626 adolescents from a rural high school in the Southeastern U.S. (M_age = 17.4, 53.5% female) completed surveys indicating whether they had sent a sext in the past year. Participants also reported on perceptions of popular peers' sexting behavior and completed sociometric nominations of peer status.

RESULTS

While 87.4% of adolescents believed the typical popular boy or girl in their class had sent a sext in the past year, only 62.5% of popular adolescents had actually sent a sext. There was no significant difference between rates of sexting among popular and non-popular (54.8%) adolescents. After adjusting for gender and sexual activity status, adolescents who believed that the typical popular peer sent a sext were over ten times more likely to have also sexted in the past year. Among adolescents who believed their popular peers had not sexted, girls were more likely than boys to have sexted themselves; however, this gender difference disappeared among adolescents who believed their popular peers had sexted.

CONCLUSIONS

These results underscore the importance of peer status and perceptions of peer norms in adolescents' sexting.

Developmental patterns of sexual identity, romantic attraction, and sexual behavior among adolescents over three years

INTRODUCTION

Adolescents are heterogeneous in how they define and experience their sexual orientation, which can include specific identity labels, romantic attractions, and other- and/or same-sex sexual behavior. These three components of sexual orientation are not always concordant, and studies suggest adolescents-particularly girls-are fluid in these dimensions of orientation over time. The current study examined: 1) fluidity in adolescent girls' and boys' self-labeled identities and romantic attractions over time, and 2) patterns of adolescent girls' and boys' self-labeled identities and romantic attractions as they coincide with sexual behavior.

METHODS

Surveys were administered to adolescents in three low-income high schools in the rural Southeastern U.S. at three yearly intervals (n = 744; M_age = 15.0; 54.3% girls; 48% White, 24% Hispanic/Latinx, 21% Black/African American). Participants reported their self-labeled sexual identity and romantic attraction at each time point and their lifetime sexual behavior with girls and boys at year 3.

RESULTS

Results revealed 26% of girls and 11% of boys reported fluidity in identity and 31% of girls and 10% of boys reported fluidity in attractions. At each time point, up to 20% of girls and 6% of boys reported a sexual minority identity label with concurrent same-sex attraction; the majority of these participants also reported same-sex behavior. Among heterosexual-identified participants reporting some degree of same-sex attraction at year 3, approximately 66% of girls and 10% of boys reported same-sex behavior.

CONCLUSIONS

The findings suggest that many adolescents are nuanced and dynamic in how they identify and experience their developing sexualities.

Suicidality Disparities Between Transgender and Cisgender Adolescents

BACKGROUND AND OBJECTIVES

Emerging evidence indicates transgender adolescents (TGAs) exhibit elevated rates of suicidal ideation and attempt compared with cisgender adolescents (CGAs). Less is known about risk among subgroups of TGAs because of limited measures of gender identity in previous studies. We examined disparities in suicidality across the full spectrum of suicidality between TGAs and CGAs and examined risk for suicidality within TGA subgroups.

METHODS

Adolescents aged 14 to 18 completed a cross-sectional online survey (N = 2020, including 1148 TGAs). Participants reported gender assigned at birth and current gender identity (categorized as cisgender males, cisgender females, transgender males, transgender females, nonbinary adolescents assigned female at birth, nonbinary adolescents assigned male at birth, and questioning gender identity). Lifetime suicidality (passive death wish, suicidal ideation, suicide plan, suicide attempt, and attempt requiring medical care) and nonsuicidal self-injury were assessed.

RESULTS

Aggregated into 1 group, TGAs had higher odds of all outcomes as compared with CGAs. Within TGA subgroups, transgender males and transgender females had higher odds of suicidal ideation and attempt than CGA groups.

CONCLUSIONS

In this study, we used comprehensive measures of gender assigned at birth and current gender identity within a large nationwide survey of adolescents in the United States to examine suicidality among TGAs and CGAs. TGAs had higher odds of all suicidality outcomes, and transgender males and transgender females had high risk for suicidal ideation and attempt. Authors of future adolescent suicidality research must assess both gender assigned at birth and current gender identity to accurately identify and categorize TGAs.

Assessment of Parent-Based Interventions for Adolescent Sexual Health: A Systematic Review and Meta-analysis

IMPORTANCE

Parent-based sexual health interventions have received considerable attention as one factor that can increase safer sexual behavior among youth; however, to our knowledge, the evidence linking parent-based interventions to youth sexual behaviors has not been empirically synthesized.

OBJECTIVE

To examine the association of parent-based sexual health interventions with 3 primary youth outcomes-delayed sexual activity, condom use, and parent-child sexual communication-as well as several secondary outcomes. We also explored potential moderators of intervention effectiveness.

DATA SOURCES

A systematic search was conducted of studies published through March 2018 using MEDLINE, PsycINFO, Communication Source, and CINAHL databases and relevant review articles.

STUDY SELECTION

Studies were included if they: (1) sampled adolescents (mean age, ≤18 years), (2) included parents in a key intervention component, (3) evaluated program effects with experimental/quasi-experimental designs, (4) included an adolescent-reported behavioral outcome, (5) consisted of a US-based sample, and (6) were published in English.

DATA EXTRACTION AND SYNTHESIS

Standardized mean difference (d) and 95% confidence intervals were computed from studies and meta-analyzed using random-effects models. A secondary analysis evaluated potential moderating variables.

MAIN OUTCOMES AND MEASURES

The primary outcomes were delayed sexual activity, condom use, and sexual communication.

RESULTS

Independent findings from 31 articles reporting on 12 464 adolescents (mean age = 12.3 years) were synthesized. Across studies, there was a significant association of parent-based interventions with improved condom use (d = 0.32; 95% CI, 0.13-0.51; P = .001) and parent-child sexual communication (d = 0.27; 95% CI, 0.19-0.35; P = .001). No significant differences between parent-based interventions and control programs were found for delaying sexual activity (d = -0.06; 95% CI, -0.14 to 0.02; P = .16). The associations for condom use were heterogeneous. Moderation analyses revealed larger associations for interventions that focused on younger, compared with older, adolescents; targeted black or Hispanic youth compared with mixed race/ethnicity samples; targeted parents and teens equally compared with emphasizing parents only; and included a program dose of 10 hours or more compared with a lower dose.

CONCLUSIONS AND RELEVANCE

Parent-based sexual health programs can promote safer sex behavior and cognitions in adolescents, although the findings in this analysis were generally modest. Moderation analyses indicated several areas where future programs could place additional attention to improve potential effectiveness.

Transformation of Adolescent Peer Relations in the Social Media Context: Part 1-A Theoretical Framework and Application to Dyadic Peer Relationships

Investigators have long recognized that adolescents' peer experiences provide a crucial context for the acquisition of developmental competencies, as well as potential risks for a range of adjustment difficulties. However, recent years have seen an exponential increase in adolescents' adoption of social media tools, fundamentally reshaping the landscape of adolescent peer interactions. Although research has begun to examine social media use among adolescents, researchers have lacked a unifying framework for understanding the impact of social media on adolescents' peer experiences. This paper represents Part 1 of a two-part theoretical review, in which we offer a transformation framework to integrate interdisciplinary social media scholarship and guide future work on social media use and peer relations from a theory-driven perspective. We draw on prior conceptualizations of social media as a distinct interpersonal context and apply this understanding to adolescents' peer experiences, outlining features of social media with particular relevance to adolescent peer relations. We argue that social media transforms adolescent peer relationships in five key ways: by changing the frequency or immediacy of experiences, amplifying experiences and demands, altering the qualitative nature of interactions, facilitating new opportunities for compensatory behaviors, and creating entirely novel behaviors. We offer an illustration of the transformation framework applied to adolescents' dyadic friendship processes (i.e., experiences typically occurring between two individuals), reviewing existing evidence and offering theoretical implications. Overall, the transformation framework represents a departure from the prevailing approaches of prior peer relations work and a new model for understanding peer relations in the social media context.

"No messages needed-just pats on the back": Exploring young men's reports of male and female friends' sexual communications

The current study provided an exploratory mixed methods investigation of the messages undergraduate men received about sex and relationships from their male and female friends. Participants included 310 undergraduate men who provided written responses regarding the specific messages they had received from male and female friends. Descriptive codes included: Just Do It, Meaningful Intimacy, Gentlemen, Postpone Sex, Women's Sexual Desire, and Objectification of Women. Reports of sexual communications were typically consistent with the Heterosexual Script and congruent with the friend's gender. Accordingly, reports of male friends' communications often portrayed the accumulation of sexual experiences and partners as necessary and desirable, whereas serious, romantic relationships were often portrayed as hindrances. Reports of female friends' messages, in contrast, primarily focused on the importance of romantic relationships and the idealization of sex within such relationships. Reports of messages that were incongruent with the Heterosexual Script were rare, and were more often found in reports of female friends' communications. For example, female friends were the only source of messages regarding women's sexual needs, desire, and pleasures. By documenting patterns of common and uncommon messages and their sources, the present study contributed insights into how male and female friends similarly and differentially reinforce different dimensions of hegemonic masculinity.

Technology-Based Interventions to Reduce Sexually Transmitted Infections and Unintended Pregnancy Among Youth

PURPOSE

Technology-based interventions to promote sexual health have proliferated in recent years, yet their efficacy among youth has not been meta-analyzed. This study synthesizes the literature on technology-based sexual health interventions among youth.

METHODS

Studies were included if they (1) sampled youth ages 13-24; (2) utilized technology-based platforms; (3) measured condom use or abstinence as outcomes; (4) evaluated program effects with experimental or quasi-experimental designs; and (5) were published in English.

RESULTS

Sixteen studies with 11,525 youth were synthesized. There was a significant weighted mean effect of technology-based interventions on condom use (d = .23, 95% confidence interval [CI] [.12, .34], p < .001) and abstinence (d = .21, 95% CI [.02, .40], p = .027). Effects did not differ by age, gender, country, intervention dose, interactivity, or program tailoring. However, effects were stronger when assessed with short-term (1-5 months) than with longer term (greater than 6 months) follow-ups. Compared with control programs, technology-based interventions were also more effective in increasing sexual health knowledge (d = .40, p < .001) and safer sex norms (d = .15, p = .022) and attitudes (d = .12, p= .016).

CONCLUSIONS

After 15 years of research on youth-focused technology-based interventions, this meta-analysis demonstrates their promise to improve safer sex behavior and cognitions. Future work should adapt interventions to extend their protective effects over time.