Sophia Choukas-Bradley

Parent-Adolescent Sexual Communication and Adolescent Safer Sex Behavior: A Meta-Analysis

IMPORTANCE Parent-adolescent sexual communication has received considerable attention as a factor that can positively affect safer sex behavior among youth; however, the evidence linking such communication to youth contraceptive and condom use has not been empirically synthesized. OBJECTIVES To examine the effect of parent-adolescent sexual communication on safer sex behavior among youth and explore potential moderators of this association. DATA SOURCES A systematic search of studies published from database inception through June 30, 2014, using the MEDLINE, PsycINFO, and Communication & Mass Media Complete databases and relevant review articles yielded 5098 studies, of which 52 studies with 25,314 adolescents met the study eligibility criteria. Analysis was conducted from July 1, 2014, to July 27, 2015. STUDY SELECTION Studies were included if they sampled adolescents (mean sample age ≤18 years), included an adolescent report of sexual communication with one or both parents, measured safer sex behavior, and were published in English. DATA EXTRACTION AND SYNTHESIS Correlation coefficients (r) and 95% CIs were computed from studies and meta-analyzed using random-effects models. MAIN OUTCOMES AND MEASURES Safer sex behavior, including use of contraceptives or condoms. RESULTS Fifty-two articles, including 71 independent effects representing more than 3 decades of research on 25,314 adolescents (weighted mean age, 15.2 years) were synthesized. Across studies, there was a significant weighted mean effect (r = 0.10; 95% CI, 0.08-0.13) linking parent-adolescent sexual communication with safer sex behavior, which was statistically heterogeneous (Q = 203.50, P < .001, I2 = 65.60). Moderation analyses revealed larger effects for communication with girls (r = 0.12) than boys (r = 0.04) and among youth who discussed sex with their mothers (r = 0.14) compared with their fathers (r = 0.03). Effects did not differ for contraceptive vs condom use or among longitudinal vs cross-sectional studies, indicating that parent sexual communication had a similar effect across study designs and outcomes. Several methodological issues were identified in the literature; future studies can improve on these issues by measuring parent-adolescent communication with robust, multi-item measures, clearly specifying the target parent, and applying multimethod longitudinal designs. CONCLUSIONS AND RELEVANCE Sexual communication with parents, particularly mothers, plays a small protective role in safer sex behavior among adolescents; this protective effect is more pronounced for girls than boys. We discuss the implications for practice and make suggestions for future research on parent-adolescent sexual communication.

Sexual Communication Between Early Adolescents and Their Dating Partners, Parents, and Best Friends

This study assessed early adolescents’ sexual communication with dating partners, parents, and best friends about six sexual health topics: condoms, birth control, sexually transmitted diseases (STDs), human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), pregnancy, and abstinence/waiting. Using a school-based sample of 603 youth (ages 12 to 15; 57% female; 46% Caucasian), we examined communication differences across demographic and developmental factors, tested whether communication with parents and best friends was associated with greater communication with partners, and examined associations between communication and condom use. More than half of participants had not discussed any sexual topics with their dating partners (54%), and many had not communicated with parents (29%) or best friends (25%). On average, communication was more frequent among adolescents who were female, African American, older, and sexually active, despite some variation in subgroups across partner, parent, and friend communication. Importantly, communication with parents and friends—and the interaction between parent and friend communication—was associated with increased communication with dating partners. Further, among sexually active youth, increased sexual communication with partners was associated with more frequent condom use. Results highlight the importance of understanding the broader family and peer context surrounding adolescent sexual decision making and suggest a possible need to tailor sexual communication interventions.

High Peer Popularity Longitudinally Predicts Adolescent Health Risk Behavior, or Does It?: An Examination of Linear and Quadratic Associations

OBJECTIVE In contrast to prior work, recent theory suggests that high, not low, levels of adolescent peer popularity may be associated with health risk behavior. This study examined (a) whether popularity may be uniquely associated with cigarette use, marijuana use, and sexual risk behavior, beyond the predictive effects of aggression; (b) whether the longitudinal association between popularity and health risk behavior may be curvilinear; and (c) gender moderation. METHODS A total of 336 adolescents, initially in 10-11th grades, reported cigarette use, marijuana use, and number of sexual intercourse partners at two time points 18 months apart. Sociometric peer nominations were used to examine popularity and aggression. RESULTS Longitudinal quadratic effects and gender moderation suggest that both high and low levels of popularity predict some, but not all, health risk behaviors. CONCLUSIONS New theoretical models can be useful for understanding the complex manner in which health risk behaviors may be reinforced within the peer context.

Peer Relationships and the Development of Psychopathology

Merely a half century ago, research examining contextual correlates of youth psychopathology focused almost exclusively on parental factors (Hartup, 1970). Several influential initial studies revealed that children and young adults experiencing significant emotional difficulties could be identified by their troubling experiences with peers earlier in childhood (e.g., Roff, 1961). Soon after, follow-forward studies revealed that children who were disliked by their peers appeared to be at greater risk for a host of later negative outcomes, including delinquent or criminal activity and various symptoms of psychopathology (e.g., Coie, Terry, Lenox, Lochman, & Hyman, 1995). These findings contributed to an emphasis on understanding how children’s peer status, or acceptance/rejection among peers, may be associated with later psychopathology. Over time, researchers began to take interest in developmental antecedents or determinants of children’s peer status and in more broadly understanding the nature of early childhood peer experiences. Soon, an awareness of other types of peer relationships began to dominate researchers’ interest. For instance, studies revealed that youths’ success in dyadic relationships was orthogonal to their status within the overall peer group (Hartup, 1996). Children’s formation, maintenance, and quality of friendships soon became a focus of research; associations among aspects of friendships and adjustment also proliferated.

Heightened activity in social reward networks is associated with adolescents’ risky sexual behaviors

Adolescent sexual risk behavior can lead to serious health consequences, yet few investigations have addressed its neurodevelopmental mechanisms. Social neurocircuitry is postulated to underlie the development of risky sexual behavior, and response to social reward may be especially relevant. Typically developing adolescents (N = 47; 18M, 29F; 16.3 ± 1.4 years; 42.5% sexual intercourse experience) completed a social reward fMRI task and reported their sexual risk behaviors (e.g., lifetime sexual partners) on the Youth Risk Behavior Survey (YRBS). Neural response and functional connectivity to social reward were compared for adolescents with higher- and lower-risk sexual behavior. Adolescents with higher-risk sexual behaviors demonstrated increased activation in the right precuneus and the right temporoparietal junction during receipt of social reward. Adolescents with higher-risk sexual behaviors also demonstrated greater functional connectivity between the precuneus and the temporoparietal junction bilaterally, dorsal medial prefrontal cortex, and left anterior insula/ventrolateral prefrontal cortex. The greater activation and functional connectivity in self-referential, social reward, and affective processing regions among higher sexual risk adolescents underscores the importance of social influence underlying sexual risk behaviors. Furthermore, results suggest an orientation towards and sensitivity to social rewards among youth engaging in higher-risk sexual behavior, perhaps as a consequence of or vulnerability to such behavior.

Intrinsic Religiosity Buffers the Longitudinal Effects of Peer Victimization on Adolescent Depressive Symptoms

Peer victimization is a common and potentially detrimental experience for many adolescents. However, not all youth who are exposed to peer victimization experience maladaptive outcomes, such as depression. Thus, greater attention to potential moderators of peer victimization is particularly important. The current study examined the potential moderating effect of intrinsic religiosity and religious attendance on the longitudinal association between physical and relational victimization and depressive symptoms. A diverse sample of adolescents (N = 313; Mage = 17.13 years; 54% female; 49% Caucasian, 24% African American, 19% Latino, 8% mixed race/other; 80% Christian religious affiliation) were recruited from a rural, low-income setting. Adolescents completed self-report measures of religious attendance and intrinsic religiosity, and two forms of victimization (i.e., physical and relational) were assessed using sociometric procedures in 11th grade. Depressive symptoms were measured in both 11th and 12th grade. Results suggest that relational victimization is associated prospectively with depressive symptoms only under conditions of adolescents’ low intrinsic religiosity. Findings may contribute to efforts aimed at prevention and intervention among adolescents at risk for peer victimization and depression.

Examining moderators of the relation between body consciousness during sexual activity and disordered eating

ABSTRACT Female undergraduates (N = 441) completed questionnaires about body consciousness during sexual activity, weight/shape concern, disordered eating (i.e. dietary restraint), self-objectification, and perfectionistic self-presentation. Controlling for weight/shape concern, body consciousness during sexual activity interacted with self-objectification and perfectionistic self-presentation to identify the level of dietary restraint. In comparing moderator models and including weight/shape concern in interaction with the proposed moderators, weight/shape concern interactions with self-objectification and perfectionistic self-presentation both remained important for dietary restraint. Findings elucidate points of intervention when working with clients exhibiting high levels of body consciousness during sexual activity, self-objectification, or perfectionistic self-presentation. Findings additionally highlight the importance of considering sexual experiences when working with clients exhibiting disordered eating.

Technology-Based Interventions to Reduce Sexually Transmitted Infections and Unintended Pregnancy Among Youth

PURPOSE Technology-based interventions to promote sexual health have proliferated in recent years, yet their efficacy among youth has not been meta-analyzed. This study synthesizes the literature on technology-based sexual health interventions among youth. METHODS Studies were included if they (1) sampled youth ages 13-24; (2) utilized technology-based platforms; (3) measured condom use or abstinence as outcomes; (4) evaluated program effects with experimental or quasi-experimental designs; and (5) were published in English. RESULTS Sixteen studies with 11,525 youth were synthesized. There was a significant weighted mean effect of technology-based interventions on condom use (d = .23, 95% confidence interval [CI] [.12, .34], p < .001) and abstinence (d = .21, 95% CI [.02, .40], p = .027). Effects did not differ by age, gender, country, intervention dose, interactivity, or program tailoring. However, effects were stronger when assessed with short-term (1-5 months) than with longer term (greater than 6 months) follow-ups. Compared with control programs, technology-based interventions were also more effective in increasing sexual health knowledge (d = .40, p < .001) and safer sex norms (d = .15, p = .022) and attitudes (d = .12, p= .016). CONCLUSIONS After 15 years of research on youth-focused technology-based interventions, this meta-analysis demonstrates their promise to improve safer sex behavior and cognitions. Future work should adapt interventions to extend their protective effects over time.

Transformation of Adolescent Peer Relations in the Social Media Context: Part 1—A Theoretical Framework and Application to Dyadic Peer Relationships

Investigators have long recognized that adolescents’ peer experiences provide a crucial context for the acquisition of developmental competencies, as well as potential risks for a range of adjustment difficulties. However, recent years have seen an exponential increase in adolescents’ adoption of social media tools, fundamentally reshaping the landscape of adolescent peer interactions. Although research has begun to examine social media use among adolescents, researchers have lacked a unifying framework for understanding the impact of social media on adolescents’ peer experiences. This paper represents Part 1 of a two-part theoretical review, in which we offer a transformation framework to integrate interdisciplinary social media scholarship and guide future work on social media use and peer relations from a theory-driven perspective. We draw on prior conceptualizations of social media as a distinct interpersonal context and apply this understanding to adolescents’ peer experiences, outlining features of social media with particular relevance to adolescent peer relations. We argue that social media transforms adolescent peer relationships in five key ways: by changing the frequency or immediacy of experiences, amplifying experiences and demands, altering the qualitative nature of interactions, facilitating new opportunities for compensatory behaviors, and creating entirely novel behaviors. We offer an illustration of the transformation framework applied to adolescents’ dyadic friendship processes (i.e., experiences typically occurring between two individuals), reviewing existing evidence and offering theoretical implications. Overall, the transformation framework represents a departure from the prevailing approaches of prior peer relations work and a new model for understanding peer relations in the social media context.

Transformation of Adolescent Peer Relations in the Social Media Context: Part 2—Application to Peer Group Processes and Future Directions for Research

As social media use becomes increasingly widespread among adolescents, research in this area has accumulated rapidly. Researchers have shown a growing interest in the impact of social media on adolescents’ peer experiences, including the ways that the social media context shapes a variety of peer relations constructs. This paper represents Part 2 of a two-part theoretical review. In this review, we offer a new model for understanding the transformative role of social media in adolescents’ peer experiences, with the goal of stimulating future empirical work that is grounded in theory. The transformation framework suggests that the features of the social media context transform adolescents’ peer experiences by changing their frequency or immediacy, amplifying demands, altering their qualitative nature, and/or offering new opportunities for compensatory or novel behaviors. In the current paper, we consider the ways that social media may transform peer relations constructs that often occur at the group level. Our review focuses on three key constructs: peer victimization, peer status, and peer influence. We selectively review and highlight existing evidence for the transformation of these domains through social media. In addition, we discuss methodological considerations and key conceptual principles for future work. The current framework offers a new theoretical perspective through which peer relations researchers may consider adolescent social media use.