Christie J. Rizzo

Sexting and Sexual Behavior in At-Risk Adolescents

OBJECTIVES: This study aimed to examine the prevalence of sexting behaviors (sexually explicit messages and/or pictures) among an at-risk sample of early adolescents as well as the associations between sexting behaviors and sexual behaviors, risk-related cognitions, and emotional regulation skills. It also aimed to determine whether differences in risk were associated with text-based versus photo-based sexts. METHODS: Seventh-grade adolescents participating in a sexual risk prevention trial for at-risk early adolescents completed a computer-based survey at baseline regarding sexting behavior (having sent sexually explicit messages and/or pictures), sexual activities, intentions to have sex, perceived approval of sexual activity, and emotional regulation skills. RESULTS: Twenty-two percent of the sample reported having sexted in the past 6 months; sexual messages were endorsed by 17% (n = 71), sexual messages and photos by 5% (n = 21). Pictures were endorsed significantly more often by females (χ2[2] = 7.33, P = .03) and Latinos (χ2[2] = 7.27, P = .03). Sexting of any kind was associated with higher rates of engaging in a variety of sexual behaviors, and sending photos was associated with higher rates of sexual activity than sending text messages only. This was true for a range of behaviors from touching genitals over clothes (odds ratio [OR] = 1.98, P = .03) to oral sex (OR = 2.66, P < .01) to vaginal sex (OR = 2.23, P < .01). CONCLUSIONS: Sexting behavior (both photo and text messages) was not uncommon among middle school youth and co-occurred with sexual behavior. These data suggest that phone behaviors, even flirtatious messages, may be an indicator of risk. Clinicians, parents, and health programs should discuss sexting with early adolescents.

HIV Knowledge and Its Contribution to Sexual Health Behaviors of Low-Income African American Adolescents

OBJECTIVES Although many factors contribute to racial disparities in human immunodeficiency virus (HIV)/AIDS among young African Americans, knowledge is a particularly modifiable factor. However, little information has been published about the current HIV knowledge of African American teens or to what extent knowledge independently contributes to their sexual behavior and health. This study aimed to describe the level of knowledge among this at-risk population and determine whether knowledge contributes to variance in sexual behavior and health beyond that of sociodemographic and psychological factors. METHODS African American adolescents (n = 1658) were recruited in 2 northeastern and 2 southeastern US cities (74% eligible for free or reduced-price school lunch). Analyses utilized data gathered from adolescents using an audio computer-assisted self-interview program. RESULTS On average, participants answered only 50% of HIV knowledge items correctly and were least accurate concerning effective condom use and HIV testing. Controlling tor associated sociodemographic and psychological factors, greater knowledge was associated with sexual experience and, among experienced adolescents, with sexually transmitted infection/HIV testing and--unexpectedly--less condom use. CONCLUSIONS HIV knowledge, which is modifiable, is limited among at-risk African American adolescents and is an important contributor to sexual behavior and health. Findings indicate a need for more comprehensive HIV/AIDS education, particularly with regard to condom use and the benefits of routine sexually transmitted infection/HIV testing. Although knowledge might not be sufficiently protective in and of itself, having accurate information about HIV may benefit sexual health by impacting health-promoting attitudes necessary for successful engagement in health care-seeking behavior.

Associations of the DRD2 TaqIA polymorphism with impulsivity and substance use: preliminary results from a clinical sample of adolescents.

BACKGROUND The A1 allele of the TaqIA polymorphism (rs1800497) in the dopamine D2 receptor gene (DRD2) has been associated with substance use. It is unclear whether this allele is a marker for an underlying propensity for specifically developing a substance use disorder, or more generally to developing an externalizing psychiatric disorder highly correlated with substance use. It is also possible that DRD2 is related to a behavioral phenotype common to externalizing disorders and substance use. METHOD Data was obtained from 104 psychiatrically hospitalized adolescents in a larger assessment study. Adolescents were genotyped for the DRD2 TaqIA site, grouped as carriers of the A1 allele (A1+) or homozygous for the A2 allelle (A1-). Associations of the presence of the A1 allele with externalizing disorders, the intermediate phenotype of impulsivity, and measures of alcohol and drug use were examined. RESULTS A diagnosis of conduct disorder and impulsive behavior were both associated with severity of problem drinking and/or drug use. Further, interaction effects were found between the DRD2 TaqIA polymorphism and conduct disorder (trend level) as well as A1+ status and impulsivity, such that adolescents who were carriers of the A1 allele, and had conduct disorder or impulsive behavior, reported higher levels of problematic alcohol use than those who were non-carriers (A2/A2 or A1-). The same interaction effect between this polymorphism and impulsivity was found for severity of problem drug use. In contrast, no interaction effects were found between the DRD2 allele status and ADHD on severity of problem drinking or drug use. DISCUSSION These results suggest that the well documented relationship between conduct disorder, the behavioral phenotype of impulsivity, and problematic alcohol/drug use among adolescents may be moderated by A1 carrier status of the DRD2 gene.

Gender, Social Support, and Depression in Criminal Justice– Involved Adolescents:

Knowing where criminal justice–involved teens look for support and whether those supports reduce depression has important and possibly gender-specific treatment implications for this vulnerable population. This study examines the relationships between social support and depression in a mixed-gender sample of 198 incarcerated adolescents. Greater support from families and overall and greater satisfaction with supports predicted lower depression for boys and girls. Support from siblings and extended family strongly predicted lower depression; support from parents and from friends was either not related or only weakly related to depression. Girls reported higher levels of depression, more support from friends and extended family, and less support from parents than did boys. Family, sibling, and overall support were stronger predictors of depression for girls than for boys. Results suggest that nonparent family members, especially siblings and extended family, provide important emotional resources for teens in the criminal justice system.

Gender differences in recidivism rates for juvenile justice youth: the impact of sexual abuse.

Young female offenders represent a growing number of young offenders. Studies have shown that youth in the juvenile justice system, particularly young females, report higher rates of lifetime sexual abuse than their nonoffending peers. The aim of this study was to examine gender differences in risk factors for recidivism, including a history of sexual abuse, among a juvenile court clinic sample. Findings suggest that, even after accounting for previously identified risk factors for recidivism such as prior legal involvement and conduct problems, a history of sexual abuse is the most salient predictor of recidivism for young female offenders, but not for males. The development of gender-responsive interventions to reduce juvenile recidivism and continued legal involvement into adulthood may be warranted.

Dating Violence Victimization, Dispositional Aggression, and Nonsuicidal Self‐Injury among Psychiatrically Hospitalized Male and Female Adolescents

The objective of the current study was to characterize the association between dating violence victimization and dispositional aggression in predicting nonsuicidal self-injury (NSSI) among psychiatrically hospitalized male and female adolescents. One hundred fifty-five adolescents (ages 13-17) and their parents completed the Schedule for Affective Disorders and Schizophrenia for School-Age Children clinical interview to assess NSSI and child abuse; adolescents completed self-report measures of aggression and dating violence victimization (verbal, physical, and sexual). Dating violence victimization and NSSI were found to be highly prevalent among both males and females in this psychiatric inpatient sample. Two moderational models were supported, wherein dating violence was associated with NSSI in the context of elevated trait anger in males and indirect aggression in females. Findings suggest that helping victims of dating violence acquire skills to address certain forms of dispositional aggression may attenuate NSSI.

Social-Cognitive Moderators of the Relationship between Peer Victimization and Suicidal Ideation among Psychiatrically Hospitalized Adolescents

Peer victimization among children and adolescents is a major public health concern, given its widespread individual and societal ramifications. Victims of peer aggression often face significant levels of psychological distress and social difficulties, such as depression, suicidal ideation, suicide attempts, and social rejection. The purpose of this study was to examine whether cognitive distortions and perceptions of social support moderate the association between peer victimization and suicidal thoughts among psychiatrically hospitalized adolescents. Participants included 183 psychiatrically hospitalized adolescents (ages 13 to 18). In multiple regression analyses that controlled for gender, social and cognitive factors served as significant resource factors. Cognitive factors also moderated the relationship between peer victimization and suicidal ideation.

Individual and Relationship Characteristics of Adolescent Girls With Histories of Physical Dating Violence

The objective of this article is to examine the individual and relational characteristics of adolescent girls with a history of physical DV, as well as to utilize partner-specific, temporal data to explore links between these factors and recent or ongoing DV experiences. Participants were 109 high school girls (ages 14-17) identified as having a history of DV through a school-based screening procedure. Details regarding the timing of DV and links with specific dating partners were gathered using Timeline Followback (TLFB) interview methodology. At study entry, 30% endorsed clinical levels of depression symptoms and 89% reported delinquent behaviors. Forty-four percent reported vaginal intercourse in their lifetime and of those, 35% reported not using a condom at last sex. During the 90 days prior to study entry, 69% of youth reported having a romantic relationship and 58% of those youth reported physical/sexual violence. Data revealed that more physical/sexual violence was associated with longer relationship length, Wald χ2(2) = 1,142.63, p < .001. Furthermore, depressive symptoms, not delinquency, contributed significantly to recent DV experiences, even when relationship length was controlled. Our findings suggest that prevention programs for this population should teach participants how to quickly recognize unhealthy relationship characteristics, as violence severity increases with relationship length. Programs for adolescent girls should also address depressive symptoms, which are linked to DV severity when other risks are taken into account. Finally, the TLFB calendar method appears useful for gathering the temporal and partner-specific data needed to understand the complexity of dating relationships and violence experiences in this population.

Pilot Investigation of the Katie Brown Educational Program: A School-Community Partnership

BACKGROUND Schools in the United States are increasingly being urged to address the problem of adolescent dating violence (DV) with their students. Given the limited time available to implement prevention programming during the school day, brief programs are needed. The purpose of this study was to test the efficacy of a widely disseminated, brief community-based DV prevention program in partnership with a nonprofit community agency. METHODS We conducted a randomized waitlist control trial of a 5-session DV prevention program (active condition) compared to health class as usual (waitlist control condition). Participants were 225 10th-grade students with a recent dating history in a large public school in New England. Surveys were administered at baseline, end of program, and 3 months postintervention. RESULTS After completing the program, students in the active condition reported significantly lower approval of aggression, healthier dating attitudes, and more DV knowledge. These effects were sustained at 3-month follow-up. In addition, students in the active condition reported significantly less emotional/verbal and total DV perpetration and victimization at 3-month follow-up. CONCLUSIONS These findings suggest that a brief, community-based DV prevention curriculum can promote change in behaviors, attitudes, and knowledge among high school students.