"It's On Me": Perspectives of College Students Without Complex Medical Needs Learning to Manage Their Healthcare

Objective

Most of the transition literature examines adolescents and young adults with special healthcare needs, though many youth will eventually transition to adult healthcare providers, regardless of medical complexity. This study addresses this gap by examining transition needs and experiences specifically within a college student sample of emerging adults without complex medical needs.

Methods

108 college students (Mage=20.93 years, SD=1.14) completed interviews and questionnaires regarding transition. The most difficult and easiest aspects of healthcare self-management were thematically coded. Differences in questionnaires were assessed across sources of transition education.

Results

52% of college students reported receiving education about managing healthcare from medical providers versus 95% from caregivers. Notably, 57% desired more support. Those receiving medical provider education reported higher responsibility. Students reported most difficulty managing health insurance. Results were similar across racial and ethnic groups and genders.

Conclusions

Gaps in transition preparation include low rates of medical provider education and support regarding health insurance. College students receiving education from medical providers reported greater healthcare responsibility. Provider-led transition education is needed for college students without complex medical needs.

Implications for Impact Statement

This study suggests that college students without complex medical conditions experience gaps in transition preparation. Although half reported talking to their medical provider about transition to adult care, many desired more support, with the greatest difficulty reported in learning to manage health insurance.

Mental and Physical Health, Psychosocial Maturity, and Desistance in Young Adulthood

Recent theoretical and empirical work has drawn increased attention to the role that mental and physical health can play in promoting life-course success and desistance from crime. This study integrates literature on youth development with the health-based desistance framework to investigate a key developmental pathway through which health influences desistance among system-involved youth. Using multiple waves of data from the Pathways to Desistance Study, the current study uses generalized structural equation modeling to examine whether and to what extent mental and physical health influence offending and substance use directly and indirectly through psychosocial maturity. Findings indicate that both depression and poor health stall the development of psychosocial maturity, and that those with higher psychosocial maturity are less likely to engage in offending and substance use. The model provides general support for the health-based desistance framework, finding an indirect process linking better health states to normative developmental desistance processes. Results hold important implications for the development of age-graded policies and programs geared toward promoting desistance among serious adolescent offenders both within correctional and community settings.

Profiles of Adoptee Adjustment in Young Adulthood

The developmental stage of young adulthood, the period from one's late twenties through thirties, has grown in attention and research focus among general populations. However, little is known about the adjustment of adopted individuals during this phase. The present study sought to expand our understanding of the various patterns of adoptee adjustment in young adulthood. Latent profile analysis was used to identify profiles across eight domains of functioning spanning physical and mental health to relationships, achievement, and engagement. Three profiles were identified, demonstrating varying levels of adult functioning. Adoption related and non-adoption related variables were explored using a series of multinomial logistic regressions to determine which factors differentiated between profiles. It appears that, although some adoption related variables remain significant in young adulthood, non-adoption related variables are more strongly linked to adoptee adjustment at this developmental stage. Implications and future directions for clinical care and research are discussed.

Psychosexual Development and Sexual Functioning in Young Adult Survivors of Childhood Cancer

BACKGROUND

Childhood cancer and its treatment can impair survivors' development throughout life, particularly psychosexual development, which can be affected in complex ways and is crucial for survivors' well-being. Yet, research is scarce.

AIM

This study assessed psychosexual development (milestone attainment, age at attainment, perceived timing) in young adult survivors of childhood cancer. It further examined sexual satisfaction and sexual functioning, and whether survivors' perceived timing of sexual debut was related to satisfaction or functioning.

METHODS

A registry-based nationwide survey was completed by N = 492 German survivors of childhood cancer (age 21-26 years, 6-26 years postdiagnosis). They completed standardized measures of psychosexual milestones (eg, first kiss, sexual debut), sexual satisfaction, and sexual functioning. Psychosexual development was compared to normative data (N = 1,533).

OUTCOMES

Psychosexual development, sexual satisfaction, and sexual functioning were the primary outcome measures. Psychosexual development was characterized in three ways: milestone attainment (yes/no), age at attainment, perceived timing ("right" time, too early/late).

RESULTS

Milestone attainment was comparable to normative data, except for sexual debut: Survivors were less often experienced (82.5% vs 88%; P = .002) and older at sexual debut (17.4 vs 16.2 years; g = 0.55), but most survivors (58.3%) perceived their timing as "right." Survivors of brain tumors were least likely to have had their sexual debut, but if experienced age at sexual debut was similar to other survivors. Female survivors were somewhat more experienced than males (eg, first kiss, first relationship; <10% difference), but they were somewhat older when they first kissed (g = 0.26). Age at diagnosis was unrelated to milestone attainment. Perceived early/late sexual debut was related to lower satisfaction in female survivors (P = .026), but unrelated to sexual dysfunction. Instead, partnered men reported particularly low dysfunction whereas women reported similar levels of sexual dysfunction irrespective of their relationship status (P = .049). Overall, sexual functioning was favorable (60.2%: not/barely problematic).

CLINICAL IMPLICATIONS

Most survivors reported favorable sexual satisfaction and functioning, but a minority of survivors may need supportive services.

STRENGTHS & LIMITATIONS

This project represents one of few large-scale studies on psychosexual development in childhood cancer survivors relative to normative data, and is the first to link development to sexual satisfaction/functioning. Assessing satisfaction/functioning with validated, but brief measures limits detailed insights, but was inclusive of any sexual orientation. Medical background information based on registry data was limited.

CONCLUSION

Results showed normative psychosexual development (except for sexual debut) in most survivors. A self-determined attitude toward sexuality (ie, engaging in sexual activities at the "right" time) may generally determine positive sexual experiences.

Body Dissatisfaction, Distorted Body Image and Disordered Eating Behaviors in University Students: An Analysis from 2017-2022

University students, as young adults, are at risk for Body Dissatisfaction (BD) and Distorted Body Image (DBI), which are related to Disordered Eating Behaviors (DEBs). This study aimed to assess changes in the prevalence of these three conditions over six years; and the associations between them. Data was collected through an annual online survey from 2017 to 2022 at a private university in Mexico City. Students between 18-30 years old were invited to participate. Body image-related variables were assessed by the Stunkard's Silhouettes and Body Mass Index, by self-reported height and weight. Disordered Eating Behaviors were measured by the Brief Disordered Eating Behaviors Questionnaire. A median of 250 students participated per year, with a median age of 21 years old. The prevalence was 63.5-71.7% for BD, 40.4-49.1% for DBI, and 25-38.3% for DEBs. DEBs and BD showed associations during the whole period (OR from 3.6 to 15.9, p ≤ 0.001); as well as DBI with DEBs (OR from 1.9 to 3.3, p < 0.05). Alterations in Body Image and eating behaviors are common conditions, mainly in women and in the young population. Therefore, it is important to promote screening for these conditions, as they usually remain undiagnosed, their prevalence is increasing worldwide, and their impact on physical and mental health has already been acknowledged.

Beers with Peers: Childhood ADHD and Risk for Correlated Change in Perceived Peer and Personal Alcohol Use Across Young Adulthood

BACKGROUND

ADHD poses risk for problematic alcohol use through adulthood. Perceived peer alcohol use, one of the strongest correlates of individuals' own alcohol use, is especially salient for adolescents with ADHD. The extent to which this risk extends into young adulthood is unknown, as well as how change in these constructs is associated throughout young adulthood.

METHODS

In the Pittsburgh ADHD Longitudinal Study, 358 individuals with childhood-diagnosed ADHD and 239 without were prospectively followed from ages 18 to 29. Piecewise, bivariate longitudinal growth modeling was used to examine the change in both peer alcohol use and individuals' heavy drinking (binge-drinking frequency), their between-person associations, and differences by ADHD group. The addition of structured residuals probed within-person year-to-year change in peer and personal alcohol use and their prospective associations.

RESULTS

Perceived peer alcohol use and individuals' heavy drinking frequencies changed together over time concurrently-from ages 18 to 21 (piece 1) and 21 to 29 (piece 2). Prospectively, individuals who increased the most in heavy drinking from ages 18 to 21 reported more friends using alcohol at age 29, regardless of ADHD history. Within-person increases in personal alcohol use likewise predicted increased perceived peer use the subsequent year within each age group (piece), regardless of ADHD history. However, while decreasing perceived peer use from ages 21 to 29 was related to more frequent heavy drinking at age 29 for those without ADHD, increasing perceived peer use from ages 18 to 21 predicted more frequent heavy drinking at age 29 for those with ADHD.

CONCLUSIONS

Young adult heavy drinking changes in tandem with perceived peer alcohol use across individuals and predicts selection of alcohol-using peers from year to year within individuals, further into adulthood than previously documented. Findings suggest the centrality of relationships with alcohol-consuming friends in relation to one's heavy drinking, especially for young adults with ADHD histories, through the twenties.

Heavy Episodic Drinking in Early Adulthood: How Parents' Education Contextualizes the Effects of College Status

Young adults who transition to college are at particular risk of heavy episodic drinking (HED), as they consume more alcohol than their same-aged peers who do not attend college. Yet the link between college attendance and HED during young adulthood may vary depending on social class origins. Building on life course and socio-structural perspectives that suggest that status characteristics give meaning to role transitions in ways that shape young adults' drinking behavior, this study situates the risk of HED within the sociological context of educational attainment, and examines how parents' education conditions the relationship between young adults' college status and HED. We suggest that the odds of HED are higher when a young adult's college status is "off-diagonal"-incongruent with her/his parents' educational attainment. Using data from Waves I and III of the National Longitudinal Study of Adolescent to Adult Health for a sample of 13,526 young adults, stratified by sex, results indicate that being off-diagonal increases the odds of HED, but not for everyone. Females whose parents have higher levels of education but who themselves do not attend college, and those whose parents have low levels of education but who themselves attend four-year colleges, have higher odds of HED. The results for males show no significant interactions between parents' education and own college status. For both females and males, there are pronounced racial/ethnic differences in HED odds, after controlling for educational mismatch. Findings suggest that HED policies targeting the archetypal four-year-college attending male should be expanded to other groups.

Weight Gain Trajectory and Pain Interference in Young Adulthood: Evidence from a Longitudinal Birth Cohort Study

OBJECTIVE

Obesity is associated with chronic pain, but the contribution of body mass index (BMI) trajectories over the life course to the onset of pain problems remains unclear. We retrospectively analyzed how BMI trajectories during the transition to adulthood were associated with a measure of pain interference obtained at age 29 in a longitudinal birth cohort study.

METHODS

Data from the National Longitudinal Survey of Youth, 1997 Cohort (follow-up from 1997 to 2015), were used to determine BMI trajectories from age 14 to 29 via group trajectory modeling. At age 29, respondents described whether pain interfered with their work inside and outside the home over the past four weeks (not at all, a little, or a lot). Multivariable ordinal logistic regression was used to evaluate pain interference according to BMI trajectory and study covariates.

RESULTS

Among 7,875 respondents, 11% reported "a little" and 4% reported "a lot" of pain interference at age 29. Four BMI trajectory groups were identified, varying in starting BMI and rate of weight gain. The "obese" group (8% of respondents) had a starting BMI of 30 kg/m2 and gained an average of 0.7 kg/m2/y. On multivariable analysis, this group was the most likely to have greater pain interference, compared with "high normal weight" (odds ratio [OR] = 1.47, 95% confidence interval [CI] = 1.14-1.88), "low normal weight" (OR = 1.45, 95% CI = 1.13-1.87), and "overweight" trajectories (OR = 1.33, 95% CI = 1.02-1.73).

CONCLUSIONS

Obesity and rapid weight gain during the transition to adulthood were associated with higher risk of pain interference among young adults.

Understanding the effects of emotional reactivity on depression and suicidal thoughts and behaviors: Moderating effects of childhood adversity and resilience

BACKGROUND

Early adulthood is a period of increased risk for depression and suicide. Emotional reactivity (a tendency to react to stress with increases in negative affect and maladaptive interpretations of events) is an important risk factor for these outcomes that has been under-studied. We hypothesized that elevated emotional reactivity would be associated with higher levels of depressive symptoms and suicidal thoughts and behaviors. Further, we hypothesized that experiences of childhood maltreatment would amplify this relationship, whereas the presence of resilience would act as a buffer.

METHODS

1703 young adults (Mean Age = 19.56 years), 71% female) completed well-validated self-report questionnaires at a single time point.

RESULTS

Higher emotional reactivity was directly associated with higher levels of depressive symptoms and suicidal thoughts and behaviors. Further, resilience levels significantly moderated the relationships between emotional reactivity and depressive symptoms and suicidal thoughts and behaviors. Finally, childhood trauma significantly moderated the relationship between emotional reactivity and suicidal thoughts and behaviors only.

LIMITATIONS

This study was cross-sectional in design and relied upon self-report measures only.

CONCLUSIONS

The current study demonstrates an association between emotional reactivity, depressive symptoms, and suicidal thoughts and behaviors during emerging adulthood. Whereas a history of childhood maltreatment may amplify the relationship between emotional reactivity, depression, and suicidal thoughts and behaviors, certain qualities associated with resilience may buffer against the effects of emotional reactivity. Future studies can identify the resilience-promoting factors that are most protective and develop and test interventions that can potentially augment those factors.

Social Support Networks among Delinquent Youth: An 8-Year Follow-up Study

Supportive social networks are key to the successful transition to young adulthood. Yet, we know little about networks of delinquent youth, a population at risk for disrupted social connections. This study describes the structure and function of social support networks among delinquent youth eight years after detention; median age 24 years. Nearly one-fifth of participants had no one that they could count on, and one-third had only one person in their support network. Participants tended to have very dense networks composed almost entirely of family. Findings underscore the importance of expanding social supports for delinquent youth as they age.

Longitudinal Course and Correlates of Parents' Differential Treatment of Siblings in Mexican-Origin Families

Parents' differential treatment (PDT) is a common family dynamic that has been linked to youth development and well-being, including adjustment problems and poor sibling relationships. Much less is known, however, about the developmental course of PDT and the conditions under which parents treat their children differently in adolescence and young adulthood. This study examined longitudinal changes in mothers' and fathers' differential warmth and conflict with their two offspring from early adolescence through young adulthood and examined parents' experiences of individual stress (depressive symptoms and role overload) and marital difficulties as time-varying correlates of (changes in) PDT. We also tested crossover effects to determine whether mothers' experiences of individual stress and marital difficulties were linked to fathers' differential treatment, and vice versa. Participants were mothers, fathers, and two siblings from 246 Mexican-origin families who were interviewed in their homes on three occasions over 8 years. Multilevel models revealed that mothers' and fathers' differential conflict with their two children increased until middle adolescence and then declined into young adulthood, but there were no changes over time for parents' differential warmth. In general, both mothers' and fathers' levels of differential treatment were exacerbated by their own experiences of individual stress and marital difficulties and also by the experiences of their spouses. However, in some cases, greater stress than usual was linked to less differential treatment than usual.

Poly-victimization and trajectories of binge drinking from adolescence to young adulthood among serious juvenile offenders

BACKGROUND

Justice involved youth exposed to multiple forms of victimization (i.e., poly-victimization) may be at risk for long term substance use problems and difficulty in self-regulation, placing them at higher risk of long-term problematic behaviors. This study empirically identifies victimization classifications in a sample of justice involved youth and how long-term binge drinking is related to victimization experiences. We further sought to understand how self-regulatory abilities such as impulse control and emotion regulation effect emergent profiles and binge drinking trajectories.

METHODS

Based on a sample of 1354 justice involved youth from 15 to 25 years old, classes of victimization were extracted. Emergent classes were examined in relationship to their binge drinking trajectories using latent growth models. Finally, self-regulation was examined as a predictor of binge drinking trajectories across emergent classes.

RESULTS

The analyses indicated three classes of victimization: poly-victimized, indirectly victimized, and lowly victimized. Latent growth models revealed that the poly-victimized class had significantly steeper growth in binge drinking as compared to the indirect and low victimized patterns. Impulse and emotional regulation both significantly decelerated binge drinking only for the indirect victimization group.

CONCLUSIONS

Findings highlight the need to focus on poly-victimization in understanding binge drinking trajectories as well as the role impulse control and emotional regulation play among justice involved youth. Findings are discussed through the lens of adolescent development, coping strategies, and early traumatic experiences.

Competitive sports participation in high school and subsequent substance use in young adulthood: Assessing differences based on level of contact

The objective of this analysis is to examine how participation in different types of competitive sports (based on level of contact) during high school is associated with substance use 1 to 4 years after the 12^th grade. The analysis uses nationally representative samples of 12^th graders from the Monitoring the Future Study who were followed 1 to 4 years after the 12^th grade. The longitudinal sample consisted of 970 12^th graders from six recent cohorts (2006-2011). The analyses found that respondents who participated in at least one competitive sport during the 12^th grade had greater odds of binge drinking during the past two weeks (AOR = 2.04; 95% CI = 1.43, 2.90) 1 to 4 years after the 12^th grade, when compared to their peers who did not participate in sports during their 12^th grade year. Moreover, respondents who participated in high-contact sports (i.e., football, ice hockey, lacrosse, and wrestling) had greater odds of binge drinking (AOR = 1.80; 95% CI = 1.18, 2.72) and engaging in marijuana use during the past 30 days (AOR = 1.81; 95% CI = 1.12, 2.93) 1 to 4 years after the 12^th grade when compared to their peers who did not participate in these types of sports during their 12^th grade year. Accordingly, the findings indicate important distinctions in sport participation experiences on long-term substance use risk that can help inform potential interventions among young athletes.

Alcohol use initiation is associated with changes in personality trait trajectories from early adolescence to young adulthood

BACKGROUND

Recent work has demonstrated the codevelopment of personality traits and alcohol use characteristics from early adolescence to young adulthood. Few studies, however, have tested whether alcohol use initiation impacts trajectories of personality over this time period. We examined the effect of alcohol use initiation on personality development from early adolescence to young adulthood.

METHODS

Participants were male (nmen = 2,350) and female (nwomen = 2,618) twins and adoptees from 3 community-based longitudinal studies conducted at the Minnesota Center for Twin and Family Research. Data on personality traits of Positive Emotionality (PEM; Well-being), Negative Emotionality (NEM; Stress Reaction, Alienation, and Aggression), and Constraint (CON; Control and Harm Avoidance)-assessed via the Multidimensional Personality Questionnaire (MPQ)-and age of first drink were collected for up to 4 waves spanning ages 10 to 32.

RESULTS

Alcohol use initiation was associated with significant decreases in levels of Well-being and CON traits, most notably Control; and significant increases in levels of all NEM traits, particularly Aggression. In general, the effects of alcohol use initiation on personality traits were moderated by gender and enhanced among those with earlier age of first drink.

CONCLUSIONS

From early adolescence to young adulthood, alcohol use initiation predicts deviations from normative patterns of personality maturation. Such findings offer a potential mechanism underlying the codevelopment of personality traits and alcohol use characteristics during this formative period of development.

Integrating Social-Contextual and Intrapersonal Mechanisms of "Maturing Out": Joint Influences of Familial-Role Transitions and Personality Maturation on Problem-Drinking Reductions

BACKGROUND

"Maturing out" of problem drinking is associated with both role transitions (e.g., getting married) and personality development. However, little is known concerning how these 2 mechanisms jointly influence problem-drinking desistance. This study investigated whether salutary effects of role transitions and personality occur at different points in young-adult development and whether they mediate one another's effects.

METHODS

Participants were initially recruited as first-year undergraduates, with family history of alcoholism overrepresented by design (N = 489). Using 4 waves of data at roughly ages 21, 25, 29, and 34, cross-lagged panel models estimated prospective relations among familial-role transitions (marriage or parenthood), personality (disinhibition, conscientiousness, and neuroticism), and problem drinking.

RESULTS

Mixed support was found for the prediction of roles being more strongly associated with earlier maturing out of problem drinking and personality being more strongly associated with later maturing out. Regarding mediation, no evidence was found for the expectation that role effects would be mediated by personality. However, results did support mediation of personality effects by role transitions. Specifically, lower disinhibition and higher conscientiousness in emerging adulthood predicted role adoption, which, in turn, predicted later problem-drinking reductions. Family history of alcoholism also distally influenced these mediation processes.

CONCLUSIONS

The differential timing of role and personality effects is consistent with the notion of decreasing contextual influences and increasing intrapersonal influences across development. In light of role incompatibility theory, results suggest that, over the course of development, the association of familial roles with problem drinking may increasingly reflect problem-drinking effects on role entry (i.e., role selection) and decreasingly reflect role entry effects on problem drinking (i.e., role socialization). As emerging-adult disinhibition and conscientiousness were associated with an apparent developmental cascade of both direct and indirect effects, findings highlight their potential importance as etiologic mechanisms and intervention targets.

Longitudinal associations among parental acceptance, familism values, and sibling intimacy in Mexican-origin families

Prospective associations among parent-adolescent acceptance and familism values in early and middle adolescence and sibling intimacy in late adolescence and young adulthood were assessed in 246 Mexican-origin families. Older sibling gender and sibling gender constellation were investigated as moderators of these associations. Sibling intimacy was stable over time and younger siblings with older sisters reported higher levels of sibling intimacy than those with older brothers. As predicted, stronger familism values were associated with greater sibling intimacy, but this link was evident only for older sisters and for girl-girl dyads. The links from mother- and father-acceptance to sibling intimacy also depended on the gender constellation of the sibling dyad: Higher levels of maternal warmth were associated with greater sibling intimacy for older sisters and girl-girl sibling pairs but higher levels of paternal warmth were linked to greater sibling intimacy only for older siblings in mixed-gender sibling dyads. Findings are consistent with prior research on the role of gender in family relationships but extend this work to encompass the effects of both parents' and siblings' gender, as well as the role of sociocultural values in parents' socialization influences.

Role transitions and young adult maturing out of heavy drinking: evidence for larger effects of marriage among more severe premarriage problem drinkers

BACKGROUND

Research has shown a developmental process of "maturing out" of problem drinking beginning in young adulthood. Perhaps surprisingly, past studies suggest that young adult drinking reductions may be particularly pronounced among those exhibiting relatively severe forms of problem drinking earlier in emerging adulthood. This may occur because more severe problem drinkers experience stronger ameliorative effects of normative young adult role transitions like marriage.

METHODS

The hypothesis of stronger marriage effects among more severe problem drinkers was tested using 3 waves of data from a large ongoing study of familial alcohol disorder (N = 844; 51% children of alcoholics).

RESULTS

Longitudinal growth models characterized (i) the curvilinear trajectory of drinking quantity from ages 17 to 40, (ii) effects of marriage on altering this age-related trajectory, and (iii) moderation of this effect by premarriage problem drinking levels (alcohol consequences and dependence symptoms). Results confirmed the hypothesis that protective marriage effects on drinking quantity trajectories would be stronger among more severe premarriage problem drinkers. Supplemental analyses showed that results were robust to alternative construct operationalizations and modeling approaches.

CONCLUSIONS

Consistent with role incompatibility theory, findings support the view of role conflict as a key mechanism of role-driven behavior change, as greater problem drinking likely conflicts more with demands of roles like marriage. This is also consistent with the developmental psychopathology view of transitions and turning points. Role transitions among already low-severity drinkers may merely represent developmental continuity of a low-risk trajectory, whereas role transitions among higher-severity problem drinkers may represent developmentally discontinuous "turning points" that divert individuals from a higher- to a lower-risk trajectory. Practically, findings support the clinical relevance of role-related "maturing out processes" by suggesting that they often reflect natural recovery from clinically significant problem drinking. Thus, understanding these processes could help clarify the nature of pathological drinking and inform interventions.

Impact of pubertal stage at first drink on adult drinking behavior

BACKGROUND

Early alcohol use is one of the strongest predictors of later alcohol use disorders, with early use usually taking place during puberty. Many researchers have suggested drinking during puberty as a potential biological basis of the age at first drink (AFD) effect. However, the influence of the pubertal phase at alcohol use initiation on subsequent drinking in later life has not been examined so far.

METHODS

Pubertal stage at first drink (PSFD) was determined in N = 283 young adults (131 males, 152 females) from an epidemiological cohort study. At ages 19, 22, and 23 years, drinking behavior (number of drinking days, amount of alcohol consumed, hazardous drinking) was assessed using interview and questionnaire methods. Additionally, an animal study examined the effects of pubertal or adult ethanol (EtOH) exposure on voluntary EtOH consumption in later life in 20 male Wistar rats.

RESULTS

PSFD predicted drinking behavior in humans in early adulthood, indicating that individuals who had their first drink during puberty displayed elevated drinking levels compared to those with postpubertal drinking onset. These findings were corroborated by the animal study, in which rats that received free access to alcohol during the pubertal period were found to consume more alcohol as adults, compared to the control animals that first came into contact with alcohol during adulthood.

CONCLUSIONS

The results point to a significant role of stage of pubertal development at first contact with alcohol for the development of later drinking habits. Possible biological mechanisms and implications for prevention are discussed.

YOUNG ADULT DATING RELATIONSHIPS AND THE MANAGEMENT OF SEXUAL RISK

Young adult involvement in sexual behavior typically occurs within a relationship context, but we know little about the ways in which specific features of romantic relationships influence sexual decision-making. Prior work on sexual risk taking focuses attention on health issues rather than relationship dynamics. We draw on data from the Toledo Adolescent Relationships Study (TARS) (n = 475) to examine the association between qualities and dynamics of current/most recent romantic relationships such as communication and emotional processes, conflict, demographic asymmetries, and duration and the management of sexual risk. We conceptualize 'risk management' as encompassing multiple domains, including (1) questioning the partner about previous sexual behaviors/risks, (2) using condoms consistently, and (3) maintaining sexual exclusivity within the relationship. We identify distinct patterns of risk management among dating young adults and find that specific qualities and dynamics of these relationships are linked to variations in risk management. Results from this paper suggest the need to consider relational dynamics in efforts to target and influence young adult sexual risk-taking and reduce STIs, including HIV.

The Role of Religion in Adolescence for Family Formation in Young Adulthood

This paper examines the role of religion in adolescence for shaping subsequent family formation. Data were drawn from the National Longitudinal Study of Adolescent Health (n=13,895). We explored the role of three dimensions of religious life-affiliation, attendance, and religious fervor, both singly and in combination for the transition to either marriage or cohabitation. Although each dimension predicted subsequent union formation, it was the particular combination of these dimensions that was important for understanding the likelihood of cohabiting. We also found evidence that patterns of religious identity, attendance, and fervor in adolescence were associated with the length of cohabitation, the likelihood of the cohabitation ending in marriage, and beliefs about the purpose of cohabitation.