Lucia F. O’Sullivan

The Developmental Association of Sexual Self-Concept with Sexual Behavior among Adolescent Women.

Developing a sexual self-concept is an important developmental task of adolescence; however, little empirical evidence describes this development, nor how these changes are related to development in sexual behavior. Using longitudinal cohort data from adolescent women, we invoked latent growth curve analysis to: (1) examine reciprocal development in sexual self-concept (sexual openness, sexual esteem and sexual anxiety) over a four year time frame; (2) describe the relationship of these trajectories with changes in sexual behavior. We found significant transactional effects between these dimensions and behavior: sexual self-concept evolved during adolescence in a manner consistent with less reserve, less anxiety and greater personal comfort with sexuality and sexual behavior. Moreover, we found that sexual self-concept results from sexual behavior, as well as regulates future behavior.

In the Absence of Marriage: Long-Term Concurrent Partnerships, Pregnancy, and HIV Risk Dynamics Among South African Young Adults

In KwaZulu/Natal, South Africa, where HIV prevalence is among the world’s highest, a longitudinal qualitative study of partnership dynamics and HIV preventive behaviors was conducted. 47 young adults aged 18–24 participated in in-depth interviews, and 29 were re-interviewed 2 years later. Five analytical domains emerged: primary partnerships, love and romance; secondary partnerships; pregnancy/parenthood; condom use/prevention; and contextual influences, including schooling and future aspirations. Primary relationships were long-lasting, with most men and women in the same relationship at 2-year follow-up. Secondary, casual partnerships were common for men and women, although these were shorter and changed frequently. Love and marriage aspirations were not viewed as incompatible with secondary partners. Condom use increased over time in some primary relationships, but decreased in others, and was nearly universal with non-primary partners. Pregnancy, school drop-out, and economic need strongly influence young people’s lifecourse. These findings suggest the need to focus prevention efforts on the partnership context, including partner reduction, and structural factors that impede or enhance prevention success.

Challenges of providing confidential care to adolescents in urban primary care: Clinician perspectives

PURPOSE Clinician time alone with an adolescent has a major impact on disclosure of risk behavior. This study sought to describe primary care clinicians’ patterns of delivering time alone, decision making about introducing time alone to adolescents and their parents, and experiences delivering confidential services. METHODS We undertook qualitative interviews with 18 primary care clinicians in urban health centers staffed by specialists in pediatrics, family medicine, and adolescent medicine. RESULTS The annual preventive care visit is the primary context for provision of time alone with adolescents; clinicians consider the parent-child dynamic and the nature of the chief complaint for including time alone during visits for other than preventive care. Time constraints are a major barrier to offering time alone more frequently. Clinicians perceive that parental discomfort with time alone is rare. Many clinicians wrestle with internal conflict about providing confidential services to adolescents with serious health threats and regard their role as facilitating adolescent-parent communication. Health systems factors can interfere with delivery of confidential services, such as inconsistent procedures for determining whether unaccompanied youth would be seen. CONCLUSION Despite competing time demands, clinicians report commitment to offering time alone during preventive care visits and infrequently offer it at other times. Experienced clinicians can gain skills in the art of managing complex relationships between adolescents and their parents. Office systems should be developed that enhance the consistency of delivery of confidential services.

Gender Differences in Associations of Sexual and Romantic Stimuli: Do Young Men Really Prefer Sex over Romance?

Theory and research emphasize differences in men’s and women’s sexual and romantic attitudes, concluding that men have stronger preferences for sexual than romantic stimuli as compared to women. However, most of the research on gender differences have relied on self-reports, which are plagued by problems of social desirability bias. The current study assessed young men’s and women’s implicit attitudes toward sexual and romantic stimuli to test whether, in fact, men have a stronger preference for sexual over romantic stimuli compared to women. We also assessed associations between implicit and explicit attitudes, as well as sex role ideology and personality. College students (68 men and 114 women) completed an Implicit Association Test (IAT) that assessed strengths of associations of sexual and romantic stimuli to both pleasant and unpleasant conditions. Results revealed that both men and women more strongly associated romantic images to the pleasant condition than they associated the sexual images to the pleasant condition. However, as predicted, women had a stronger preference toward romantic versus sexual stimuli compared to men. Our study challenges a common assumption that men prefer sexual over romantic stimuli. The findings indicate that measures of implicit attitudes may tap preferences that are not apparent in studies relying on self-reported (explicit) attitudes.

Drawing the Line: The Development of a Comprehensive Assessment of Infidelity Judgments

Infidelity is a leading cause of relationship discord and dissolution, and couples generally report expectations to maintain monogamy. However, a majority of men and women report engaging in some form of infidelity at least once in their lives. Research assessing judgments of the behaviors that constitute infidelity is lacking. The three studies reported here advanced the literature by developing and validating the Definitions of Infidelity Questionnaire (DIQ), a comprehensive measure examining infidelity judgments. Exploratory and confirmatory factor analyses indicated four factors to the scale: sexual/explicit behaviors, technology/online behaviors, emotional/affectionate behaviors, and solitary behaviors. Investigation of the psychometric properties demonstrated the DIQ to be reliable and valid. Participants agreed that sexual/explicit behaviors comprised infidelity to the largest extent, whereas other types of behaviors (technology/online behaviors, emotional/affectionate behaviors, and solitary behaviors) were judged as comprising infidelity to a lesser extent. Men reported more permissive judgments than did women. This study provides insights regarding operationalizing infidelity and identifying areas of ambiguity and consensus. Implications of the findings for educators and practitioners working with individuals in intimate relationships are discussed.

Young Women’s Satisfaction With Sex and Romance, and Emotional Reactions to Sex: Associations With Sexual Entitlement, Efficacy, and Situational Factors

In this study of 364 young women (18–25 years old), self-efficacy theory and social interactionist perspectives were drawn upon to identify personal and situational factors that could account for sexual and romantic satisfaction and positive and negative emotional reactions to sex. As expected, young women were more satisfied and reported more positive emotional reactions and fewer negative reactions to their most recent sexual encounters, when they had elevated psychological sexual health, such as feeling more entitled to desire and reporting greater sexual self-efficacy. Also supporting study hypotheses, multivariate modeling results showed that young women who reported current steady partners and fewer negative influences of alcohol/other drug use on their sexual behavior were more satisfied and had more positive emotional reactions to sex. Condom use and the number of sexual partners were not uniquely associated with satisfaction or emotional reactions to sex in these models.

Passion, connection, and destiny How romantic expectations help predict satisfaction and commitment in young adults’ dating relationships

Romantic beliefs (e.g., love at first sight and soul mates) are common among young people, however, these beliefs are thought to create unrealistic expectations for romantic relationships. The current study assessed the romantic beliefs, romantic expectations, and relationship outcomes (satisfaction and commitment) of 270 young adults (aged 18–28 years) who were involved in dating relationships. Romantic beliefs were associated with greater satisfaction and commitment, whereas unmet romantic expectations were associated with lower satisfaction and commitment. Of note, the endorsement of romantic beliefs was not linked to unmet expectations. Thus, romantic beliefs do not appear to foster false or unobtainable expectations for romantic relationships, and the concerns regarding the endorsement of these beliefs may be misplaced. Individual differences (age, gender, and relationship experience) did not predict romantic beliefs or expectations. The results are discussed with regard to implications for promoting relationship commitment and satisfaction.

Testing Adolescents for Sexually Transmitted Infections in Urban Primary Care Practices: Results From a Baseline Study

Objective: Sexually active urban adolescents experience a high burden of sexually transmitted infections (STI). Adolescents often access medical care through general primary care providers; their time alone with a provider increases the likelihood that youth will disclose risky behavior, which may result in STI testing. Our goals were to assess the association (if any) between the provision of time alone and STI testing, and describe the rates of STI testing among sexually active adolescents in urban primary care. Methods: Youth (aged 12-19 years) presenting for care at 4 urban health centers were invited to complete post-visit surveys of their experience. Sexually transmitted infection screening rates were obtained from the clinical information systems (CIS); CIS data were linked to survey responses. Results: We received 101 surveys. Surveyed youth experienced time alone in 69% of all visits. Time alone varied by age (older teens experienced more time alone), and it occurred more frequently in preventive visits (71%) versus nonpreventive visits (33%). It did not vary by gender. Forty-two of the 46 sexually active youth experienced time alone. Screening rates for sexually active females, either at the index visit or within 6 months prior to the index visit, were 17.9% for human immunodeficiency virus and 32.1% for gonorrhea/Chlamydia. No sexually active surveyed males were tested. Overall screening rates varied widely across practices (human immunodeficiency virus 0%-29%; gonorrhea/Chlamydia 7%-29%). There was no difference in screening rates among youth with and without time alone. Conclusion: STI testing for adolescents is being conducted in this primary care urban population, especially for sexually active females. However, clinicians in this setting are not screening females consistently enough and rarely screen males. We were unable to test our hypothesis that provision of time alone was associated with a higher rate of STI testing. Site differences suggest substantial variation in clinician practices that should be addressed in quality improvement interventions.

Great expectations: Examining unmet romantic expectations and dating relationship outcomes using an investment model framework

Expectations for one’s romantic relationship, and the extent to which these expectations are actually met, are important predictors of relationship outcomes. Themes of romanticism (e.g., idealism, soul mates, love at first sight) emerge from our romantic socialization. But what happens when romantic relationships fall short of these ideals and expectations are unmet? The current study examined the association among unmet romantic expectations and relationship outcomes using an investment model framework. The sample comprised 296 U.S. young adults involved in dating relationships. Participants provided ratings of the romantic characteristics of their current, ideal, and potential alternative relationships. Unmet romantic expectations based on an ideal relationship were associated with lower relationship satisfaction, commitment, and investment. Unmet romantic expectations based on an alternative relationship were associated with lower relationship satisfaction, investment, and commitment and higher quality of alternatives. The results are discussed in terms of implications for researchers and clinicians/counselors.

Distress Severity Following a Romantic Breakup Is Associated With Positive Relationship Memories Among Emerging Adults

Romantic relationship loss is associated with significant psychological distress for emerging adults. Intrusive memories of stressful events are typically associated with symptom severity; however, whether spontaneous positive memories of a relationship breakup may also be related to psychological symptoms has received little attention. We examined links between breakup-specific distress, depressive symptoms, and relationship memories of different valence. Ninety-one emerging adults (M age = 20.13) who had experienced a recent romantic breakup recorded the frequency of positive and negative spontaneous relationship memories in a 4-day online memory diary. Control memories were also recorded. Positive memories were specifically related to breakup distress, whereas negative memories were related to both breakup distress and depression. No such associations were found for the control memories. Experiences of positive memories appear critical for understanding the degree of distress a young person may experience following a breakup. Possible explanations for these findings and similarities with the grief and bereavement literature are discussed.