Kathryn Harker Tillman

Sexual Orientation and Substance Use Among Adolescents and Young Adults

OBJECTIVES We examined interrelationships among the 3 dimensions of sexual orientation-self-identity, sexual attraction, and sexual experience-and their associations with substance use among adolescents and young adults. METHODS To estimate total and net associations of sexual identity, attraction, and experience with use of tobacco, drugs, and alcohol, we applied logistic regression to cross-sectional data from the National Survey of Family Growth Cycle 6. RESULTS We found a lack of concordance among the different dimensions of sexual orientation. More youths reported same-gender sexual attraction and same-gender sexual experiences than identified as lesbian, gay, or bisexual. Estimates of substance use prevalence differed significantly by gender and across dimensions of sexual orientation. Sexual experience was the most consistent predictor of substance use. Women and men with no sexual experience had the lowest odds of all forms of substance use; those reporting sexual experience with partners of both genders had the highest odds. CONCLUSIONS Our findings indicate that sexual identity was less strongly associated with substance use than sexual experience and attraction were, pointing to the need for more nuanced indicators of sexual orientation in public health studies.

Trajectories of depressive symptoms, dopamine D2 and D4 receptors, family socioeconomic status and social support in adolescence and young adulthood.

Objectives The purpose of this study is two-fold. First, we tested the association between dopamine D2 and D4 receptors and a trajectory of depressive symptoms in adolescence and young adulthood. Second, we reestimated the association between the dopamine receptors and depression after taking into account the effects of socioeconomic disparity and child–parent ties and social support. Methods The study uses the DNA sample of approximately 2500 individuals in the National Longitudinal Study of Adolescent Health (Add Health). Each individual was measured three times in 1994, 1996, and 2002. Results This study has yielded robust associations of the DRD2 and DRD4 variants with depressive symptoms among male adolescents and young adults. The DRD2*304/178 genotype is associated with a level of depressive symptoms 0.04–0.07 points (3–5% of the mean) higher than the DRD2*178/178 genotype. Relative to the other more common DRD4 variants, the DRD4*379/379 genotype raises the level of depression by about 0.25 points (about 17% of the mean). These findings hold after adjusting for the effects of socioeconomic status (family structure, parental education, family income, mothers employment status, and whether attending public school) and child–parent ties/social support (conflict with parent(s), closeness to parent(s), parental availability, and social support). Although the gene–sex interaction is clearly present, the tests of gene-lifecourse interaction did not yield any significant results. Conclusion Our findings emphasize the importance of joint influences of genetic propensities and social environment on depressive symptoms.

Risky sexual behaviors among Hispanic young adults in South Florida: nativity, age at immigration and gender differences.

CONTEXT U.S. Hispanics are disadvantaged compared with whites in regard to sexual health, particularly early sexual initiation and contraceptive use. It is unclear whether differences in nativity and immigration are associated with risky sexual behaviors. METHODS Data collected between 1998 and 2000 from a community sample in South Florida were analyzed to examine sexual behaviors among 709 Hispanic individuals aged 18-23. Associations between nativity and age at immigration and sexual behaviors were assessed separately by gender using chi-square tests and analyses of covariance. RESULTS Smaller proportions of sexually experienced women who had immigrated to the United States before age six than of similar U.S.-born women reported having had vaginal sex (83% vs. 91%) and oral sex (71% vs. 86%) in the past year. Compared with U.S.-born women, those who had immigrated at age six or older reported lower levels of oral sex (66% vs. 86% of those with sexual experience) and drug use in conjunction with sex in the past year (mean score, 1.2 vs. 1.6 on a scale of 1-5), and a lower average lifetime number of sexual partners (2.0 vs. 3.7 in the sample overall). Immigrant men were no less likely than U.S.-born men to engage in risky sexual behavior. CONCLUSIONS Given the diversity of nativity and immigration histories among Hispanics in the United States, it is important that research examine both factors. An understanding of their joint association with sexual activity, plus the conditioning effects of gender, could help professionals to develop effective education and prevention programs for young people who are at risk for engaging in potentially dangerous sexual behavior.

Coresident Sibling Composition and the Academic Ability, Expectations, and Performance of Youth:

This study examines the effects of living with “nontraditional” siblings (i.e., step- and/or half-siblings) on the verbal ability scores, grade point averages (GPAs), and college expectations of adolescents and whether sibling composition effects are moderated by family structure. On average, youth who live with step- or half-siblings report significantly poorer outcomes than youth who do not. The sibling composition effects on verbal ability scores and grades are similar in direction and magnitude across family types. The association between nontraditional siblings and the college expectations of youth, however, appear to be conditioned by family structure, such that youth living with two biological parents or single mothers are negatively affected by the presence of half-siblings and the expectations of youth living in stepfather families are negatively affected by the presence of step-siblings. The mechanisms underlying sibling composition effects on academic-related outcomes also vary by family structure.

Childhood Family Structure and Romantic Relationships During the Transition to Adulthood

We use the National Longitudinal Study of Adolescent Health (Add Health) to examine whether childhood family structure experiences influence the development of romantic relationships during adolescence and whether adolescent relationships, in turn, help to shape long-term relationship trajectories. Young people who live in “nontraditional” families during their childhood are more likely than their peers to engage in romantic relationships during adolescence. Family-related mechanisms are significant mediators of this association. Individuals who were raised in stepparent and single-parent families are also more likely to cohabit during adulthood, and those who were raised in single-parent families are less likely to have ever married. Childhood family structure is not associated with serious relationship conflict during adolescence or adulthood, however. Moreover, although adolescent relationship experiences have long-term effects on relationship trajectories, they do not significantly mediate the associations between childhood family structure and relationship outcomes in adulthood.

Protective Influences on the Negative Consequences of Drinking Among Youth

The prevention of underage drinking and related outcomes focuses on strengthening protective factors. Using data from the National Longitudinal Study of Adolescent Health ( N = 3,862), the authors examine the effects of protective factors from three domains of adolescents’ lives (individual, familial, and extrafamilial) on experiencing negative consequences of alcohol use, while controlling for relevant risk factors, among youth who have already started drinking. Results showed that protective factors had relatively little influence on not experiencing negative alcohol-related consequences, regardless of social context. One individual protective factor, strategic decision making, was related to negative drinking outcomes in cross-sectional models. In longitudinal models, maternal attachment reduced the likelihood of experiencing negative outcomes over time. The effects of the risk factors remained strong in all models. Findings suggest “mixed-methods” preventive approaches, attending to risk factors, and including strategies to strengthen protective factors across multiple domains of adolescents’ lives when striving to affect negative drinking-related outcomes.

Binge Drinking in Young Adulthood: The Influence of Age at First Intercourse and Rate of Sex Partner Accumulation

There has been growing attention to the influence of youths’ sexual experiences on alcohol use and other health-risk behaviors. Yet, because of the cross-sectional nature of many studies, as well as the likelihood of alcohol use and sexual behaviors to co-occur, the question of whether initiation of sexual activity tends to precede engagement in other behaviors, like binge drinking, remains largely unanswered. Using data from 4726 respondents who participated in Waves I through IV of the National Longitudinal Study of Adolescent to Adult Health (Add Health), we examined the association between age at first intercourse and frequent binge drinking during one’s mid-twenties and early thirties. We further explored whether this relationship was mediated or moderated by the rate at which individuals accumulated sex partners during the transition to adulthood. Findings showed for women and men, later ages at first intercourse were associated with lower odds of frequent binge drinking in young adulthood. While rate of sex partner accumulation partially mediated this association, it did not moderate it. Furthermore, rate of partner accumulation was positively associated with binge drinking, particularly among women, with a quicker accumulation of sex partners associated with a higher likelihood of engaging in frequent binge drinking. Our findings underscore the importance of considering multiple dimensions of a single behavior and their relation to subsequent health-related behaviors.

Timing of Sexual Initiation and Relationship Satisfaction in Young Adult Marital and Cohabiting Unions

Using the National Longitudinal Study of Adolescent to Adult Health, this research examines the association between timing of oral sex initiation and marital and cohabiting relationship satisfaction among young adults. Findings indicate that women who transition to oral sex “late” or who have no oral sex experience report higher levels of relationship satisfaction in their current coresidential unions than do women who transition at a “normative” age. Higher levels of relationship satisfaction among women who transition “late,” however, appear to be explained by their lower likelihood of experiencing forced sexual relations and sexually transmitted infections. We find no evidence of any association between timing of oral sex initiation and relationship satisfaction among men. To best promote healthy relationships, researchers, practitioners, and educators need to better understand the various types of sexual activities in which young people engage.