Predicting Korean Adolescents' Sexual Behavior

Abstract

Using data from 370 adolescent males and 390 adolescent females, this study investigates factors associated with Korean adolescents' sexual behavior. The data showed that sixteen percent of the sample reported some type of intimate sexual behavior. The results from regression analyses indicate that alcohol use, dating mood, love for partner, similarity of sexual attitude between partners, and interaction between respondents' attitude on sex and alcohol use were significant predictors of Korean adolescents' sexual behavior with adjusted R² of .61. The factors significant for adolescents' sexual behavior differed by gender. The factors significant for adolescent males and adolescent females accounted for 65% and 61% of the explained variance for adolescent males' and adolescent females' sexual behavior, respectively. In both cases, dating mood was a strong predictor of adolescents' sexual behavior. Contrary to expectations specified, neither parental factors nor sibling influence was significant.     

Including At-Risk Adolescents in Their Own Health and Mental Health Care

Summary

As urban adolescents encounter serious health and mental health risks, they present the allied health professions with important opportunities for health promotion and risk reduction interventions. However, the prevailing emphasis on adolescents' risk behaviors rather than on their vulnerability has limited our capacity to understand and serve them. Further limiting are the widely held myths that adolescents as a whole have few health problems and that they are poor judges of their own needs. This article presents an overview of current theories of adolescent risk and vulnerability and suggests Youth Development as an overarching framework for understanding both. Experience within a comprehensive, adolescent health and mental health center demonstrates how to meaningfully engage adolescents in their own health care from the start.     

Adolescents Seeking Mental Health Services

Summary

Inner-city adolescents receiving mental health services often get inadequate medical care. However, when those who seek counseling are asked about their health concerns, they say they want to discuss them with their therapists. Based on responses to a clinical self-assessment questionnaire (Adquest), adolescent mental health clients reported sleep difficulties, weight and eating concerns, and frequent headaches and stomachaches. Age and gender differences in patterns of vulnerability and willingness to talk were explored.     

A Profile of Adolescent Health

SUMMARY

As the adolescent population living in this country undergoes dramatic demographic changes in the 21st Century, increasing both in numbers and ethnic/racial diversity, practitioners and policy makers need to understand the prevalence of and trends in adolescent risk-taking behaviors, morbidity and mortality. Significant disparities in health status exist by ethnicity/race and gender in areas including: unintentional injury, violence, mental health, substance use, sexual behavior, and disease prevention. The epidemiological profile can help mobilize communities to address adolescent health issues. Developing effective interventions will require an ecological approach that builds on adolescents' assets and takes into account the contexts in which they live.     

Adolescents' Need to Talk About School and Work in Mental Health Treatment

Summary

School-aged adolescents spend much of their time in school. As a result, it is important for mental health practitioners who work with adolescents to address their clients' educational concerns and risks. Based on data “mined” from an adolescent intake questionnaire (Adquest), this study explores how adolescents view their educational life and their need to address educational risks clinically. Likewise, the world of work, also important to adolescents, is discussed. Overall, adolescents are concerned about their educational risk factors, want to be employed, and want to talk about both with clinicians in a mental health context.     

An mHealth Approach to Extend a Brief Intervention for Adolescent Alcohol Use and Suicidal Behavior: Qualitative Analyses of Adolescent and Parent Feedback

Abstract

Mobile health (mHealth) tools that supplement inpatient psychiatric care can maintain and enhance intervention effects following hospitalization. Adolescents hospitalized following a suicidal event represent a vulnerable population who could greatly benefit from such an mHealth intervention. In specific, suicidal adolescents who drink alcohol are in need of robust interventions that address the bidirectional relationship between alcohol use and suicidal thoughts and behaviors, because it puts them at especially high risk for suicide upon discharge. The purpose of this study was to conduct qualitative interviews to gather feedback to improve a brief alcohol intervention provided to suicidal adolescents during psychiatric hospitalization, and to develop a mHealth tool to extend care after discharge. Participants, eight adolescents and their parents, identified the need for a smartphone application to deliver intervention content to adolescents and parents during the posthospitalization period. Adolescents sought support in meeting alcohol- and mood-related goals, while parents desired general resources as well as tips for conversations with their adolescent about mood and alcohol use.     

Theoretical Factors Influencing Adolescent Sexual Behavior: Evidence from a Rural Sample Living in Poverty

ABSTRACT

This study of 414 adolescents who resided in rural Arkansas families receiving AFDC was designed to investigate what theoretical factors predicted frequency of sexual intercourse in the past year prior to the study and number of lifetime sexual partners among males and females. Multivariate analyses indicated that elements of bonding were important to the sexual behavior of females, but not males. On the other hand, feelings of frustration influenced male sexual behavior only. The number of sex partners was increased by associations with sexually active peers for both genders while only females made excuses. The only factor which was associated with both sexual behaviors among both genders was having sex to have a baby to love or to draw a partner closer. The family social work implications of these findings were discussed.     

Gender Differences in the Sexual Well-Being of Mexican Adolescents

Objective: This study examines the associations of gender roles and sexual power with the sexual wellbeing of Mexican adolescents. Particularly we look at the role played by adolescent’s attitudes toward gender roles and sexual power regarding three aspects of their sexual well-being: satisfaction with one’s sex life; consistent condom use; and the refusal of unwanted sexual contact with one’s partner. Methods: we used logistic regression models to analyze possible associations between attitudes toward gender roles, and sexual power, with the sexual well-being of adolescents, using a random and representative sample of 4,738 sexually active teenagers from three Mexican states. Results: egalitarian attitudes are positively associated to high sexual satisfaction for female adolescents, whereas for males they favor the refusal of unwanted sex. Sexual power shows significant associations with consistent condom use for both males and females, and it also significantly increases the likelihood of high sexual satisfaction and refusal of unwanted sex among females. Conclusions: the findings suggest the relevance of overcoming traditional sex roles to achieve adolescent sexual well-being. In this sense, health and population policies should direct more substantial efforts in the promotion of gender equality among the adolescents and in the development of critical attitudes towards traditional gender norms.     

Exploring hope as a mediator between religiosity and depression in adolescents

ABSTRACT

Multiple studies have found an inverse relationship between adolescent religiosity and adolescent depression. However, further research is needed to better understand the complexity of this relationship. One potential mediator that may help to explain this relationship is hope. Prior research has found that adolescent religiosity is predictive of increased adolescent hope and that higher levels of adolescent hope have been associated with multiple positive outcomes, including mental health in adolescents. However, no research has explored the mediational role of hope between religiosity and depressive symptoms in adolescents. Cross-sectional data from 459 adolescents were used to test this mediational or indirect effect. The direct effect between religiosity and depressive symptoms was not significant. However, there was a significant indirect effect whereby higher levels of adolescent religiosity were associated with higher levels of adolescent hope, which in turn were associated with lower levels of adolescent depressive symptoms.     

The State of Sleep Among College Students at a Large Public University

Abstract

Objective: Data about college student sleep were collected and used to develop an education campaign to improve sleep. Participants: On-campus residents at a large state university were surveyed on 4 occasions, October 2005 to April 2007. Sample size was 675 to 1,823 students. Fall 2005 mean age = 18.5 years, SD = 1.03 (range 18–30) years. Initial survey included 935 males and 1,859 females (2005–2006). Matched pairs data (2006–2007) included 91 males and 107 females. Twenty-six males and 22 females participated in interviews. Methods: A survey administered online included the Pittsburgh Sleep Quality Index, along with an 8-question in-person interview. Results: Poor sleep interacted with academics and mental health, and an education campaign positively affected student sleep. Conclusions: Teaching students how to effectively manage sleep can improve their well-being. Sleep may also be a gateway topic for health care professionals to address sensitive health issues such as depression.     

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.     

Unhealthy behavior clustering and mental health status in United States college students

Abstract

Objective: Examine the association of health risk behavior clusters with mental health status among US college students. Participants: 105,781?US college students who completed the Spring 2011 National College Health Assessment. Methods: We utilized the latent class analysis to determine clustering of health risk behaviors (alcohol binge drinking, cigarette/marijuana use, insufficient physical activity, and fruit/vegetable consumption), and chi-square and ANOVA analyses to examine associations between the class membership and mental health (mental health diagnoses, psychological symptoms, and self-injurious thoughts/behaviors). Results: Three classes were identified with differing rates of binge drinking, substance use, and insufficient physical activity but similar rates of insufficient fruit/vegetable consumption. Students classified with the highest rates of binge drinking and cigarette/marijuana use had the highest rates across all mental health variables compared to other classes. Conclusions: Students who reported engaging in multiple health risk behaviors, especially high alcohol and cigarette/marijuana use, were also more likely to report poorer mental health.     

Multiple Risks,Multiple Worries,and Adolescent Coping

Summary

To describe the process that clinicians use to engage vulnerable urban adolescents in mental health counseling, the authors propose a tri-partite model of clinical engagement that takes into account: (1) consumer preference; (2) risk and worry; and (3) youth development (YD) perspectives. These conceptual lenses embody what adolescents want to talk about, their exposure to behavioral and environmental risks, and their coping and strengths. Based on responses given by urban adolescents seeking mental health services to a clinical self-assessment questionnaire (Adquest), this paper uses this tripartite model to summarize patterns of risk that service applicants experience, what they worry about, and how they cope. It explores the substructure of adolescent risk and vulnerability, through factor analysis of relevant items across a broad range of Adquest life areas, to develop a typology of adolescents by risk and worry. Patterns of coping and desire to talk across a range of life areas within this typology are described, as are the practice implications. The authors conclude that even those adolescents who most concern clinicians—because they have high environmental and behavioral risk and low worry-present many different opportunities for engagement.     

Mental health and substance use of sexual minority college athletes

ABSTRACT

Objective: Assess the mental health and substance use of sexual minority collegiate student-athletes in the United States, as compared with heterosexual college students and heterosexual student-athletes. Participants: Undergraduate students (N = 196,872) who completed the American College Health Association's National College Health Assessment (Fall 2008–Fall 2012 administrations). Methods: Written cross-sectional survey. Results: Sexual minority student-athletes had a higher risk of experiencing mental health difficulties than their heterosexual athlete peers. There were no significant differences in mental health between sexual minority male athletes and nonathletes. Sexual minority female athletes appeared to fare better than nonathlete peers. Substance use was greater among sexual minority students (athlete and nonathlete) and was mediated by mental health. Conclusions: Participation in athletics does not appear to be associated with an elevated risk of negative mental health outcomes for sexual minority participants; however, there are disparities in mental health outcomes by sexual orientation regardless of athletics participation.     

Data-Mining Client Concerns in Adolescent Mental Health Services

Summary

Via a practice-based research collaboration, clinicians, supervisors, and managers in an urban adolescent mental health program studied previously collected intake information concerning adolescent risk exposures, behaviors, worries, and self-assessed coping. In addition, desire to talk with a mental health counselor about specific risks and worries was systematically analyzed with the aim of generating practice insights into the clinical challenge of engaging urban adolescents in mental health services. Though provided with research consultation, practitioners were full participants in all aspects of the researchprocess. This organizational development process placed strains on the participants and organization, but many benefits were derived from it. One significant benefit was that mining the expressed concerns of clients gave participants a powerful vehicle for reshaping services. The organization came to see its clients as more than mere service recipients, resulting in a recommitment to Youth Development principles and a renewed effort to increase direct client participation in organizational life.     

Mother-Adolescent Communication in Low-Income,Latino Families during Language Brokering: Examining the Theory of Resilience and Relational Load

ABSTRACT

Low-English proficiency parents often have their bilingual children translate, called language brokering. Brokering can be stressful for low-income, Latino adolescents, who are already at-risk for depression. We tested the theory of resilience and relational load (TRRL) in a new context (in 100 low-income, Latino mother-adolescent dyads who engaged in language brokering) and extended TRRL by proposing security- and threat-based behaviors and appraisals can be represented by interaction goals. We examined mother warmth, mother brokering interaction goals of supporting and monitoring the adolescent, adolescent brokering feelings, and adolescent depressive symptoms. Mothers’ support goal was a protective factor against adolescent depression, but only when adolescents also inferred mothers pursued this goal. Adolescent positive brokering feelings were also a protective factor, as when positive feelings were high, the positive association between negative feelings and depression was not present. Findings supported TRRL propositions about relational maintenance, security-based goals, emotional reserves, and mental health.     

Association of Sexual Abstinence in Adolescence with Mental Health in Adulthood

We examined whether adolescent sexual abstinence predicts better adult mental health. A total of 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 for 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 were included in multivariate models, and was 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.     

Correlates of Mental Health Smartphone Application Use among Patients with Suicidal Ideation

Abstract

Mental health applications (apps) can improve access to evidence-based, mental health strategies. This study evaluated predictors of use for the Virtual Hope Box (VHB), a smartphone app designed to enhance coping among high-risk mental health populations. We also explored the impact of usage on health outcomes. We analyzed data drawn from the treatment arm of a randomized clinical trial of the VHB (n?=?58). Veterans at high risk of suicide used the app over 12 weeks and completed psychosocial assessments throughout the study. We received usage data from each participant’s smartphone. We then used negative binomial regression to evaluate demographic and clinical predictors of usage and generalized estimating equations to explore the longitudinal association between usage and psychosocial outcomes. The most commonly used subcomponents were designed to provide distractions and reminders of sources of meaning.

Lower levels of usage were associated with younger and having a 2-year college degree or higher. Exploratory findings suggested a possible relationship between usage and protective factors. Certain subgroups had lower VHB usage. The findings suggest usage may be associated with changes in health outcomes. Future studies should recruit larger, more diverse samples to further explore relationships between usage and demographic predictors.     

Gender Differences in the Associations Among Body Mass Index,Weight Loss,Exercise, and Drinking Among College Students

Abstract

Objective: To explore gender differences regarding weight management behaviors of college drinkers. Participants: Nationally representative sample of college students from the fall 2008 American College Health Association's National College Health Assessment II (N = 26,062 students). Methods: Structural equation modeling was used to examine potential gender differences in associations among exercise, weight loss behaviors, and alcohol use. Results: Critical ratio tests revealed that associations between exercise and weight loss behaviors were more strongly correlated among females as compared with males. For females, there was a small negative association between exercise and drinking behaviors; in contrast, for males, there was a positive relationship between exercise and alcohol use. Weight loss behaviors were positively associated with drinking for both female and male students; however, the association was significantly stronger for females. Conclusions: This investigation furthers previous research on drunkorexia and also sheds additional light on the gender-based differences in weight management behaviors of drinkers.     

The Effects of Polyvictimization and Quality of Caregiver Attachment on Disclosure of Illegal Sexual Behavior

ABSTRACT

The current study examined the relationship among self-disclosure of illegal sexual behaviors and two conceptually relevant constructs in psychotherapy: childhood polyvictimization (i.e., cumulative types of victimization experienced during childhood) and caregiver attachment. Participants consisted of 63 adolescent males participating in mandated treatment for illegal sexual behavior. Childhood polyvictimization and caregiver attachment were expected to predict self-disclosure of illegal sexual behaviors. Quality of caregiver attachment was also expected to mediate the relationship between polyvictimization and disclosure. Consistent with our main hypothesis, results indicate that quality of caregiver attachment mediated the relationship between childhood polyvictimization and self-disclosure of illegal sexual behaviors in psychotherapy. The current findings highlight the impact of polyvictimization on important therapeutic processes as well as the importance of assessing for multiple types of victimization in adolescents who engage in illegal sexual behavior. Further clinical implications regarding the use of trauma-informed approaches during sex offender treatment are discussed.