Association of sexual abstinence in adolescence with mental health in adulthood

We examined whether adolescent sexual abstinence predicts better adult mental health. 1,917 adolescents, recruited from middle schools at age 13, were surveyed at ages 13, 18, 23, and 29. In bivariate analyses, adolescent sexual abstinence was associated with better mental health at age 29 for females, but not males; three adolescent factors, educational prospects, family bonding, and unconventionality were investigated as explanatory variables of this relationship. The abstinence-mental health relationship was nonsignificant when educational prospects was included in multivariate models, and marginally significant when family bonding and unconventionality were included; all three explanatory factors accounted for significant proportions of the variance in adult mental health. Girls who are uninvolved in school, have weak family backgrounds, and exhibit unconventionality may have poor adult mental health, whether or not they abstain from sex in adolescence. Interventions that strengthen adolescents' connections to families and schools may reduce risk for long-term mental health problems.     

The Sexual Possible Selves and Strategies of First-Semester College Students: What Do They Hope for and Fear and How Do They Plan to Get There?

The purpose of this study was to expand research on emerging adult sexuality by examining first-semester college students’ (N = 282) possible selves and strategies related to sex, and by considering whether these varied by demographic characteristics. Students were first asked to describe what they expected and feared regarding sex and sexuality in the coming year and were then asked to articulate strategies for achieving goals and avoiding fears. Content analysis of participants’ responses to open-ended questions revealed that expected possible selves commonly discussed included abstinence, interpersonal relationships, physical/sexual health, and exploration. Fears commonly discussed included reputation, risk-taking behaviors, and rape/assault. Categorical comparisons indicated abstinence and interpersonal relationships were the most prominent foci of expected sexual possible selves (SPS) and strategies, and physical/sexual health was the most prominent focus of feared SPS and strategies. Chi-square analyses indicated significant variations in SPS, feared selves, and strategies based on sex, intercourse experience, and relationship type. Binomial logistic regression analyses indicated religiosity differences in the SPS and strategies of abstinence, explore/experiment, physical/sexual health, interpersonal relationship, and risk-taking behaviors. Implications for research and sexual health education for college-based populations are discussed.     

A review of literature: An examination of the correlation between attachment styles and adolescent girls’ sexual behaviors

ABSTRACT

This literature review examines eight studies of parental attachment styles, sexual behavior, and health outcomes among adolescent girls. The review focuses on studies that analyzed the perceived relationships between parents and their adolescent daughters and whether instabilities of life experiences correlated with risky sexual behaviors and if high-risk sexual behaviors were associated with an increase of sexually transmitted infections, unplanned pregnancies, and other poor health outcomes in adolescent girls. Findings show adolescent girls with insecure parental attachment styles were at a higher risk of sexual behaviors, early pregnancies, and transmission of sexually transmitted infections (STI’s). The most common finding in the studies reviewed was the significant association of how higher parental communication and monitoring may prevent risky sexual behaviors at an earlier age. Recommendations for mental and health care providers include the development of treatment programs to address the importance of parent-attachment relationships and multifaceted health needs of adolescents girls. Programs can be strengthened by involving other family members, improving parent-daughter communication and relationships and emphasizing system-level change (policy, procedure, practice). Adding these elements may ultimately lead to sustained improvements over time. Future research on other family social factors (e.g., divorce and separation of attachment figure, poverty, and single-parent homes) associated with attachment and high-risk behaviors is warranted. More research is needed to exam how secure attachments among adolescent girls may prevent earlier sexual encounters, unplanned pregnancies, and STI’s.     

Differences in psychological health and family dysfunction by sexual victimization type in a clinical sample of African American

We examined levels of sexual victimization among a sample of 249 14‐ to 19‐year‐old African American adolescent women. Victimization was common: 32.1% reported having been raped, 33.7% had experienced sexual coercion, and 10.8% reported an attempted rape. Only 23.4% had never been victimized. We investigated whether levels of psychological health and family dysfunction varied as a function of the type of sexual victimization. Girls who had been raped had lower levels of self‐esteem and mastery and higher levels of depression compared to girls who reported no sexual victimization. Significantly higher levels of family cohesion and significantly lower levels of family support were reported by girls who had been raped versus girls who reported no sexual victimization. These findings are a starting point for future studies by providing evidence that levels of mental health and family dysfunction vary by the type of sexual victimization experienced.     

Paths to Intimate Relationship Quality From Parent–Adolescent Relations and Mental Health

Using a developmental systems perspective and public‐use longitudinal data from participants currently in a romantic relationship at Wave 4 of the National Longitudinal Study of Adolescent Health (n = 2,970), the current study explored direct and indirect paths from parent–adolescent relationship quality to young adult intimate relationship quality. Structural equation modeling tested whether mental health (depressive symptoms and self‐esteem) in the transition to adulthood mediated the association between parent–adolescent relations and young adult intimate relations. The results indicated that higher quality parent–adolescent relations predicted higher self‐esteem and lower depressive symptoms during the transition to adulthood as well as higher young adult intimate relationship quality, controlling for adolescent mental health and parent–young adult relationship quality. Higher self‐esteem during the transition to adulthood was associated with greater intimate relationship quality, whereas greater depressive symptomatology predicted reduced intimate relationship quality. One significant indirect path emerged: parent–adolescent relationship quality → self‐esteem → intimate relationship quality.     

Cognitive-behavioral treatment for adolescents who sexually offend and their families: individual and family applications in a collaborative outpatient program

This article describes an outpatient treatment program for adolescent sexual abusers that was established by a mental health agency in collaboration with a specialized probation program in the juvenile court. Individualized treatment is based on a comprehensive clinical assessment with the youth and guardian, for which examples are provided. Given the heterogeneity of this population, we describe several treatment strategies directed to various individual or family clinical targets, including psychiatric disorders, sexual deviance and sexuality, normal adolescent development and adaptive skills, and parent and family relationships. Ongoing collaborative and coordination issues are also reviewed. The integration of mental health and probationary services provides a balanced approach to the community management and treatment of the low-risk, primarily first-time, adolescent sexual offender.     

Adolescents' Need to Talk About Sex and Sexuality in an Urban Mental Health Setting

Summary

For many adults, adolescent sexuality is problematic. For adolescents, it may be problematic, powerfully alluring, or simply a part of becoming an adult. Either way, and irrespective of whether they have ever had sex, young persons seeking mental health counseling in an urban mental health clinic express a strong desire to talk about sex and sexuality. Significant gender and age differences are noted in desire to talk about sexuality and mediated by involvement in sexual risk behaviors. Having experienced forced sex is directly related to desire for counseling about sex and sexuality. The findings presented in this article compel clinicians to engage all adolescents in meaningful dialogue about sex and sexuality.     

Health-Promoting Influences of the Family on Late Adolescent Functioning

This study examined whether potentially modifiable health-promoting family factors during mid-adolescence (age 15) predicted adaptive functioning in late adolescence (age 18) among members of a working-class community cohort. Family factors included feeling valued in the family, cohesion, and social support. Late adolescent outcomes covered developmentally salient areas: academic functioning; mental health; suicidal behavior; and social, psychological, and behavioral functioning. Our findings demonstrate that a positive adolescent family milieu is related to both adaptive outcomes and a reduced likelihood of serious difficulties, including mental and behavior problems. Although each hypothesized health-promoting factor was significantly associated with multiple areas of age 18 functioning, the patterns of association differed by type of family factor. Taken together, results suggest that the family remains an important social context during mid-adolescence and that to be most effective programs designed by practitioners aimed at strengthening families should target multiple features of the family environment.     

The Cognitive Impact of Sexual Abuse and PTSD in Children: A Neuropsychological Study

Sexual abuse is known to have an impact on both child and adult mental health, but the neuropsychological basis of this effect is still largely unknown. This study compared neuropsychological test results from a group of 76 children, 13 of them sexual abuse victims with symptoms of post-traumatic stress disorder, 26 victims of sexual abuse who showed no symptoms post-traumatic stress disorder, and 37 controls. The groups were matched by age, sex, socioeconomic status, and educational level. Child sexual abuse was associated with reduced ability to inhibit automatic responses measured by the Stroop test regardless of post-traumatic stress disorder status. These findings indicate possible attentional inhibition difficulties in child victims of sexual abuse, which may help explain psychopathology associated with the experience.     

Sexual Debut and Mental Health Among South Korean Adolescents

Numerous studies have demonstrated the negative influence of sexual debut during adolescence on mental health outcomes. This article contributes to this literature by investigating whether sexual debut has negative effects on mental health among South Korean adolescents and whether the timing of adolescent sexual debut matters. Drawing on longitudinal data from a nationally representative survey, we first predicted mental health outcomes at one year after high school graduation using first sexual intercourse that had occurred before the outcomes were measured. In a second statistical model, adolescent sexual debut was defined as first coitus that had occurred before high school graduation. Sexual debut was associated with an increase in problematic aggressive behaviors for both genders. In contrast, only girls experienced a rise in depressive symptoms after becoming sexually active. For girls, having sex before high school graduation was correlated with worse mental health outcomes to the extent that sexual debut even enhanced the risk of suicidal ideation. We concluded that the negative effects of sexual activity among South Korean adolescents are attributable mainly to the sexually conservative atmosphere and gendered sexuality in that country.     

Dating Relationship Dynamics,Mental Health,and Dating Victimization: A Longitudinal Path Analysis

The purpose of this study was to assess the longitudinal association between adolescent dating relationship dynamics (measures of intimacy and problem dynamics), mental health, and physical and/or sexual victimization by a dating partner. Gender‐stratified analyses were conducted in a sample of 261 adolescents, ages 10–18 at baseline, interviewed in three annual waves (2013–2015) of the nationally representative Survey on Teen Relationships and Intimate Violence (STRiV). Among male daters, better mental health at baseline was negatively associated with problem dynamics at follow‐up, and aspects of problem dynamics at baseline predicted worse mental health at follow‐up. However, unexpectedly, aspects of relationship intimacy at baseline were also negatively associated with mental health at follow‐up. Male daters’ victimization did not mediate longitudinal measures of mental health or of relationship dynamics, but did predict worse mental health at follow‐up. Among female daters, we found no longitudinal associations between mental health and intimacy or problem relationship dynamics, in either direction. However, victimization mediated aspects of female daters’ reported relationship dynamics. Dating violence prevention efforts should reflect that adolescent females reporting controlling behaviors and feelings of passionate love may be at increased risk for victimization. Positive youth development efforts should attend to the bidirectional associations of mental health and dating relationship dynamics over time, particularly for male adolescents.     

A Noncausal Relation Between Casual Sex in Adolescence and Early Adult Depression and Suicidal Ideation: A Longitudinal Discordant Twin Study

Research on relations between casual sex and mental health is inconclusive; while some studies indicate casual sex may lead to more negative mental health (e.g., depression), other studies report no such relationship. Using a genetically informed approach, this study examined whether earlier casual sex (i.e., ever engaging in casual sex and number of casual sex partners) in adolescence has a causal influence on later mental health in young adulthood (i.e., depressive symptoms and suicidal ideation), as well as the reverse relationship (adolescent negative mental health on young adult casual sex) by exploiting the quasi-experimental nature of discordant-twin models. Multilevel models that measured within-twin and between-twin pair effects of adolescent casual sex were estimated, using 714 twins (357 twin pairs) from the sibling subsample of the National Longitudinal Study of Adolescent Health (Add Health). Results indicated that there was no causal relationship between casual sex in adolescence and higher levels of depressive symptoms or suicidal ideation in young adulthood, and these effects did not differ by gender. There were also no causal relations between adolescent depressive symptoms or suicidal ideation and casual sexual experience in young adulthood. Implications for ways to increase scientific rigor by using different methods (e.g., genetically informed analyses) are discussed.     

Childhood sexual abuse, teenage pregnancy, and partnering with adult men: exploring the relationship

Although the mechanism by which early victimization, specifically sexual abuse, increases the risk of adolescent pregnancy is unclear, a relationship between previous victimization and adolescent pregnancy has been demonstrated. While partnering with an older man may initially offer the means necessary to escape a neglectful or violent family of origin, this protection be accompanied by an imbalance of power and control. Both adolescent mothers partnered with adult men and adolescent mothers partnered with male peers reported sexual abuse perpetrated by family members, family friends, strangers, and peers. Policies developed to protect young people from victimization, including mandatory reporting and statutory rape laws, should be evaluated for their consistent application to all children, regardless of age, race, gender, or pregnancy status.     

The Continued Importance of Quality Parent–Adolescent Relationships During Late Adolescence

The quality of adolescents' relationships with residential parents has been found to predict many different health and behavioral youth outcomes; strong associations have also been found between these outcomes and family processes, and between relationship quality and family processes. Data from Rounds 1–5 of the National Longitudinal Survey of Youth, 1997 were used to examine hypotheses about the influence of the parent–adolescent relationship on subsequent adolescent mental well‐being and delinquency, as mediated by family processes. Using structural equation modeling, we found that the influence of a positive residential parent–adolescent relationship on better mental well‐being and fewer delinquency was entirely mediated by family routines, parental monitoring, and parental supportiveness, net of sociodemographic controls.     

Parent Marital Quality and the Parent–Adolescent Relationship: Effects on Adolescent and Young Adult Health Outcomes

Although a number of studies examined the implications of marital disruption for adolescent well-being, few studied the implications of marital relationship quality on health outcomes for children in married-couple families. The present study examines how parent marital quality among intact families interacts with the quality of parent–adolescent relationships to predict physical health, mental health, and substance use in middle adolescence and early adulthood. The study uses data from the NLSY97 cohort, a nationally representative sample of adolescents who are being followed into adulthood. Predictors include the quality of the parent marital relationship, the quality of the parent–adolescent relationship, marital structure, and a number of contextual covariates and control variables. Combined parent marital quality and parent–adolescent relationship groups were developed using latent class analyses and were used to predict positive and negative health behaviors during the teen and early adult years. Results indicate that adolescents in families experiencing poor marital quality fared worse on physical health, mental health, and substance use outcomes. In addition, adolescents who reported poor relationships with at least one of their parents fared worse on outcomes. Adolescents whose parents have low-quality relationships and also have poor parent–adolescent relationships tended to fare least well across health measures. Adolescents whose parents have a high-quality relationship and who have a good parent–adolescent relationship with both parents consistently had the best outcomes. Overall, poor relationships consistently undermine mental health, physical health, and substance use. Family religious activities also consistently predict better health outcomes.     

Does Adolescent Affect Impact Adult Social Integration? Evidence from the British 1946 Birth Cohort

Using data from the MRC National Survey of Health and Development (the British 1946 birth cohort), we take a life course approach with a sociology of mental health framework to examine the relationship between adolescent affect and adult social integration. The results suggest that being observed as anxious or sad in adolescence has long-term effect on adult social integration. These associations are not explained by adult mental health or socioeconomic status, for the most part. The results demonstrate support for social selection processes between adolescent mental health and adult social outcomes and suggest a disparate effect of type of adolescent affect on adult social outcomes.     

What Pediatric Subspecialists Need to Know About Sexual and Reproductive Health: A Review of the American Board of Pediatrics Content Outlines for Subspecialty Certifying Examinations

ABSTRACT

Many adolescents with complex medical conditions regard their subspecialty providers as an important source of clinical information including sexual and reproductive health information related to their medical condition. Thus, training for pediatric subspecialty providers should include clinically relevant sexual and reproductive content. The purpose of this study is to understand what disease-relevant sexual and reproductive health information is currently included in content outlines for each of the available pediatric subspecialty certifying examinations. The American Board of Pediatrics (ABP) offers 17 subspecialty certifying examinations; 13 content outlines are available on the ABP website which defines the body of knowledge to be tested. Each available outline underwent content analysis for sexual and reproductive health information. A team of adolescent medicine physicians identified seven thematic areas including: 1) puberty; 2) sexual behavior and identity; 3) fertility; 4) contraception; 5) sexually transmitted infections; 6) other genital pathology; 7) pregnancy. Across disciplines, learning objectives related to sexual behavior, sexual identity, fertility, contraception and pregnancy were the most limited. However, content related to puberty, sexually transmitted infections and other genital pathology was better represented. Overall, disease-and treatment-specific sexual and reproductive health information was sparse. Most subspecialty content outlines contain very little disease-specific sexual and reproductive health information despite the growing adolescent and young adult population with complex medical conditions in the care of pediatric subspecialists. Further studies are needed to explore if lack of sexual and reproductive information on board exams relates to the knowledge base and skill set of pediatric subspecialists.     

Does Family Intervention for Adolescent Substance Use Impact Parental Wellbeing? A Longitudinal Evaluation

Adolescent substance abuse is a common problem and family interventions are emerging as a strategy to prevent it and assist family coping. The effectiveness of a prevention‐focussed family intervention was evaluated for its secondary impacts on improving parental mental health and family functioning. Twenty‐four secondary schools in Melbourne Victoria were randomly assigned to either a control condition or an intervention titled Resilient Families. The two intervention levels analysed were: (1) a parenting booklet only and; (2) combining the booklet with face‐to‐face parent education sessions. Parent surveys at baseline were followed up one year and four years later. Repeated‐measures analysis (n = 560) found parents attending parent education demonstrated reductions in mental health symptoms, however this had negative effects on family cohesion and no impact on family conflict. These findings were interpreted in terms of parent education assisting parent mental health by promoting assertive parenting styles that may increase adolescent‐parent tension by encouraging firmer parental boundaries and strategies to reduce adolescent substance use.     

Sexual Communication Between Early Adolescents and Their Dating Partners,Parents, and Best Friends

This study assessed early adolescents’ sexual communication with dating partners, parents, and best friends about six sexual health topics: condoms, birth control, sexually transmitted diseases (STDs), human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), pregnancy, and abstinence/waiting. Using a school-based sample of 603 youth (ages 12 to 15; 57% female; 46% Caucasian), we examined communication differences across demographic and developmental factors, tested whether communication with parents and best friends was associated with greater communication with partners, and examined associations between communication and condom use. More than half of participants had not discussed any sexual topics with their dating partners (54%), and many had not communicated with parents (29%) or best friends (25%). On average, communication was more frequent among adolescents who were female, African American, older, and sexually active, despite some variation in subgroups across partner, parent, and friend communication. Importantly, communication with parents and friends—and the interaction between parent and friend communication—was associated with increased communication with dating partners. Further, among sexually active youth, increased sexual communication with partners was associated with more frequent condom use. Results highlight the importance of understanding the broader family and peer context surrounding adolescent sexual decision making and suggest a possible need to tailor sexual communication interventions.