Clea McNeely

Public and private domains of religiosity and adolescent health risk behaviors: evidence from the National Longitudinal Study of Adolescent Health

The purpose of this study was to examine the association of public and private domains of religiosity and adolescent health-related outcomes using data from the National Longitudinal Study of Adolescent Health (Add Health), a nationally representative sample of American adolescents in grades 7-12. The public religiosity variable combines two items measuring frequency of attendance at religious services and frequency of participation in religious youth group activities. The private religiosity variable combines two items measuring frequency of prayer and importance of religion. Our results support previous evidence that religiosity is protective for a number of adolescent health-related outcomes. In general, both public and private religiosity was protective against cigarettes, alcohol, and marijuana use. On closer examination it appeared that private religiosity was more protective against experimental substance use, while public religiosity had a larger association with regular use, and in particular with regular cigarette use. Both public and private religiosity was associated with a lower probability of having ever had sexual intercourse. Only public religiosity had a significant effect on effective birth control at first sexual intercourse and, for females, for having ever been pregnant. However, neither dimension of religiosity was associated with birth control use at first or most recent sex. Public religiosity was associated with lower emotional distress while private religiosity was not. Only private religiosity was significantly associated with a lower probability of having had suicidal thoughts or having attempted suicide. Both public and private religiosity was associated with a lower probability of having engaged in violence in the last year. Our results suggest that further work is warranted to explore the causal mechanisms by which religiosity is protective for adolescents. Needed is both theoretical work that identifies mechanisms that could explain the different patterns of empirical results and surveys that collect data specific to the hypothesized mechanisms.

Feeling disrespected by parents: Refining the measurement and understanding of psychological control

This study investigated parental psychological control of adolescents when construed as disrespect of individuality. First, 120 adolescents from 5 cultures were interviewed and asked to identify specific parental behaviors that communicated to them that they were disrespected as individuals. The interview data were coded and 8 new survey items were constructed to reflect key content. These items were then administered to 2100 adolescents in the same cultures along with a traditional measure of psychological control (PCS). Confirmatory factor analyses indicated that model fit was better when the two scales were kept separate, across culture and sex of parent. In structural equation models, the new scale - labeled Psychological Control - Disrespect - accounted for all and more of the variance in youth depression and antisocial behavior than the PCS did. The discussion centers on the validation the study makes of the construct and offers several suggestions for future research.

Too Many Friends: Social Integration, Network Cohesion and Adolescent Depressive Symptoms

Using a nationally representative sample of adolescents, we examine associations among social integration (network size), network cohesion (alter-density), perceptions of social relationships (e.g., social support) and adolescent depressive symptoms. We find that adolescents with either too large or too small a network have higher levels of depressive symptoms. Among girls, however, the ill effects of over-integration only occur at low levels of network cohesion. For boys, in contrast, the ill effects of over-integration only occur at high levels of network cohesion. Large social networks tend not to compromise positive perceptions of friend support or belonging; whereas, small networks are associated with low perceptions of friend support and belonging. Hence, perceptions of social relationships mediate the ill effects of under-integration, but not over-integration, on depressive symptoms.

Reliability of self-reported contraceptive use and sexual behaviors among adolescent girls.

This study examines two issues relevant to adolescents’ self‐reported sexual and contraceptive use behaviors: reliability of partner‐referent reports versus 3‐ and 6‐month reports, and test‐retest reliability of reports completed over a 2‐week period. Data are from 196 13‐ to 18‐year‐old girls recruited into this study while they sought reproductive care from health clinics in a metropolitan area. All participants reported having had sexual intercourse during the past 6 months. Twice over a 2‐week interval, participants completed the same paper‐and‐pencil surveys. The survey presented questions about sexual behavior and contraceptive use using 3 sequential frames of reference: within the past 6 months, within the past 3 months, and by specific sexual partners in the past 6 months. Findings demonstrate that adolescent girls can reliably report sexual behavior and contraceptive use over a 6‐month interval. Study findings have implications for future research utilizing adolescents’ self‐reported sexual and contraceptive use behaviors.

How Do Parents Make Adolescents Feel Loved? Perspectives on Supportive Parenting From Adolescents in 12 Cultures

The conceptualization and measurement of parental support is predominately the work of adult researchers from the West. This mixed-method study reports the parental behaviors that adolescents themselves perceive as supportive. Data come from the Cross-National Adolescent Project, a survey of adolescents in 12 nations or ethnic groups in Africa, Asia, Australia, the Americas, the Balkans, Europe, and the Middle East. The authors find that adolescents in all 12 settings validated the substantive content of existing survey measures of parental supportive behaviors. Adolescents in all settings also expanded the list of supportive behaviors. When parents provide a rare and valued commodity, it is perceived as love. The specific commodities, which include quality time, basic necessities, and support for education, vary across culture. In the discussion the authors describe how parenting strategies that have been interpreted previously as reinforcing distinct cultural purposes may, in fact, serve the same purpose.

The Role of Structure Versus Individual Agency in Churches’ Responses to HIV/AIDS: A Case Study of Baltimore City Churches

This paper examines the activities of churches in Baltimore, Maryland, concerning the issues of sexuality, whether they potentially stigmatize persons with or at risk for HIV/AIDS, and to what extent individual agency versus institutional forces influence churches in this regard. In-depth interviews were conducted with 20 leaders from 16 churches and analyzed using a grounded theory methodology. Although many churches were involved in HIV/AIDS-related activities, the content of such initiatives was sometimes limited due to organizational constraints. Church leaders varied, however, in the extent to which they responded in accordance with or resisted these constraints, highlighting the importance of individual agency influencing churches’ responses to HIV/AIDS.

Sexual Abuse History, Risk Behavior, and Sexually Transmitted Diseases: The Impact of Age at Abuse

Objective: The objective of this study was to examine the relationship between age at onset of sexual abuse, risk behaviors, and a diagnosis of sexually transmitted disease (STD) in a clinic-attending adolescent population. Methods: Bivariate analyses were used to test association among age at onset of sexual abuse, risk behaviors, and STD diagnosis (n = 2175). Relationship between sexual abuse and STD acquisition was assessed by regression analysis. Results: More females than males reported sexual abuse, 26.75% and 5.4%, respectively. Abuse at or before 10 years of age was associated with more lifetime and recent partners. History of abuse was associated with higher rates of STD tests. In regression analysis, for males and females, the odds of having an STD were 2.5 times greater if abuse occurred at 10 years or younger. Conclusion: Sexual abuse at a younger age is associated with more sexual risk behaviors and is a risk factor for STDs.

A rose by any other name? Objective knowledge, perceived knowledge, and adolescent male condom use

Objective. To investigate the role of objective and perceived knowledge about condoms in adolescent males’ condom use at first intercourse. Methods. A longitudinal analysis was conducted of data from a nationally representative sample of 404 virgin male adolescents who were aged 15 to 17 years at wave 1 and reported becoming sexually experienced at the second wave of data collection. Objective knowledge was measured as a 5-item knowledge test about condoms. Perceived knowledge was measured as a 5-item scale regarding participants’ confidence about their answers on the objective knowledge test. Condom use was assessed by self-report. Results. Objective and perceived knowledge were moderately correlated with each other. Male adolescents with low objective but high perceived knowledge were identified as being at particular risk for not using a condom in that they were nearly 3 times less likely to report using a condom at first intercourse (odds ratio: 0.35) than those with other levels of objective and perceived knowledge. Conclusions. Previous evidence suggests that knowledge about sex does not accurately predict sexual behavior. This lack of predictive accuracy may be because studies have focused only on objective knowledge. Our results suggest that both objective and perceived knowledge serve as antecedents to male condom use at first intercourse. However, those with higher perceived knowledge, particularly in the context of low objective knowledge, may be at greater risk for not using condoms. Addressing not only objective but also perceived knowledge may increase the effectiveness of interventions that are designed to increase rates of condom use among male adolescents.

Human insecurity, chronic economic constraints and health in the occupied Palestinian territory.

Research on the effects of political conflict has focused predominantly on the association between violence exposure and psychological trauma. This paper expands that focus. We broaden the assessment of health beyond the conventional spotlight on trauma-related stress to include culturally derived measures of health, and we assess the association between a broad array of political and economic conditions and health. Household interviews were conducted in 2011 with a representative sample of 508 30–40 year olds in the occupied Palestinian territory (oPt; response rate = 97%). The four dependent variables were limits on functioning due to health, feeling broken or destroyed (both culturally derived measures of health), feelings of depression and trauma-related stress. Twenty-four predictor variables assessed multiple dimensions of political conflict and background characteristics. All four measures of health and suffering were associated with human insecurity and resource adequacy. Exposure to political violence was associated only with trauma-related stress. These findings support the increasing recognition that human insecurity and chronic economic constraints in the oPt broadly threaten health, perhaps more so than direct exposure to violence. Ultimately, a political solution is required, but in the meantime, efforts to reduce insecurity and improve economic conditions may improve health and reduce suffering in the oPt.

Politics drives human functioning, dignity, and quality of life.

Too little is known about human functioning amidst chronic adversity. We addressed that need by studying adult Palestinians in the occupied Palestinian territories (oPt), a population that has experienced longstanding economic and political hardships. Fourteen group interviews were conducted in February, 2010 in Arabic by local fieldworkers with 68 participants representing the main stratifications of Palestinian society: gender, region, refugee status, and political affiliation. Interview tasks included each participant: describing someone doing well and not well, free listing domains of functioning, and prioritizing domains to the three most important. Thematic analyses highlighted the dominating role of the political domain of functioning (e.g., political structures, constraints, effects, identity, and activism) and the degree to which political conditions impacted all other realms of functioning (economic, education, family, psychological, etc.). The discussion links the findings to relevant theory and empirical work that has called attention to the need to include the political in frameworks of quality of life. It also emphasized that values, such as justice, rights, dignity and self-determination, that underlie political structures and policies, are key elements of human functioning. This is the case not only in the oPt, but in any society where power imbalances marginalize segments of the population.