Transitions in body and behavior: a meta-analytic study on the relationship between pubertal development and adolescent sexual behavior

National trends in sexual intercourse and usage of contraception among Korean adolescents

BACKGROUND

The exact influence of the COVID-19 pandemic on sexual intercourse and usage of contraception remains largely uncharted territory. To bridge this gap in knowledge, we conducted a comprehensive, cross-sectional examination of long-term trends in the prevalence of sexual intercourse and usage of contraception among South Korean adolescents from 2006 to 2022.

METHODS

In our research, we drew upon data encompassing 1,138,799 South Korean adolescents aged 12 to 18 years, derived from the Korean Youth Risk Behavior Web-based Survey (KYRBS) over a period spanning from 2006 to 2022. We focused on the prevalence of sexual intercourse, contraception utilization, and the underlying associated factors among this demographic. The KYRBS data was collected using a complex sampling strategy to determine the national prevalence estimates and shifts in prevalence before (2006-2019) and during (2020-2022) the COVID-19 pandemic era.

RESULTS

During the pre-pandemic period, a decrease in adolescent sexual intercourse was observed (6.34% in 2006, 5.53% in 2012, and 5.87% in 2019). However, in the post-pandemic period (2020-2022), there was a surge in sexual intercourse (4.55% in 2020 and 6.20% in 2022). This evident alteration in sexual intercourse trajectory between pre- and post-pandemic periods was statistically significant [βdiff, 0.950; 95% confidence interval (CI), 0.756-1.144]. Regarding contraceptive use among South Korean adolescents, there was an increase in the pre-COVID-19 pandemic phase across all demographic segments (14.61% in 2006, 22.30% in 2012, and 47.69% in 2022) but a notable decline when compared with the pre- and post-pandemic periods (βdiff, - 0.319; 95% CI, - 0.454 to - 0.184). Additionally, during the study period, a decrease in sexual intercourse was observed in the pre-pandemic period (β, - 0.129; 95% CI, - 0.148 to - 0.110), followed by an increase in the post-pandemic period (β, 0.821; 95% CI, 0.627 to 1.014). This shift is highlighted by an effect size of 0.96 [weighted odds ratio (wOR); 95% CI, 0.92 to 1.00], indicating a substantial change in adolescent sexual behaviors across study periods.

CONCLUSIONS

The increase in sexual intercourse and decrease in usage of contraception observed in our study between the pre- and post-COVID-19 periods suggests a potential threat to sexual health among South Korean adolescents. This trend emphasizes the ongoing necessity of raising awareness about adolescent sexual behavior in South Korea.

Associations between externalizing behavior problems and risky sexual behaviors in adolescence: Attachment as a mediator

INTRODUCTION

Risky sexual behaviors in adolescence are associated with negative health and psychological functioning outcomes. Although the association between behavior problems and risky sexual behaviors is well established, addressing these problems requires understanding the mechanisms that help explain this association. Adolescent attachment, while related to risky sexual behavior, has not been extensively explored as an outcome of childhood externalizing problems. The two objectives of this study were to explore the links between parental and peer attachment and risky sexual behaviors and to examine the mediating effect of attachment on the links between behavior problems and risky sexual behaviors.

METHODS

Five hundred and ninety-eight French-Canadian adolescents (46.2% girls), Mage at T1 = 13.23; Mage at T2 = 14.28; Mage at T3 = 17.35) participated in this longitudinal study.

RESULTS

The quality of parental attachment at T2 was significantly and negatively associated with risky sexual behaviors 3 years later, at T3. More specifically, a lower quality parental attachment relationship was associated with having nonexclusive partners as well as with inconsistent condom use. Finally, parental attachment (T2) was a significant mediator between behavior problems (T1) and risky sexual behaviors (T3), but only for younger adolescents.

CONCLUSIONS

Findings suggest that in addition to behavior problems in adolescence, the quality of parental attachment relationships may help in understanding risky sexual behaviors in adolescence.

HIV-Related Knowledge and Sexual Behaviors among Teenagers: Implications for Public Health Interventions

Background: Teenagers are at a turning point in people's physical and psychological maturity and are also in a critical period in reproductive and sexual health. It is reported that the initial age at first sexual behavior is younger than decades ago, which implies that the risky sexual behavior among teenagers may be on the rise. However, it is unclear about the changes of sexual knowledge and behaviors in recent years. Methods: Based on the national sentinel surveillance survey in 2011-2021 among students in Hangzhou, we selected out teenagers aged 10-19 years as our study sample. Demographic characteristics (gender, age, marital status, etc.), knowledge of HIV and sexual behaviors were collected. The sexual knowledge score and sexual behaviors were analyzed, and their influencing factors were explored. Results: In total, 1355 teenagers were incorporated in this study; the awareness rates of sexual knowledge in 2011, 2013, 2014 and 2021 were 74.9%, 71.8%, 89.3% and 95.8%, respectively, which showed an overall upward trend. The results of binary logistic regression showed that the survey year, whether students had received and participated in HIV-related publicity services and whether they had sexual behaviors, had a significant influence on whether the awareness rate ≥ 75%. The survey year and whether the awareness rate ≥ 75% had a significant influence on whether students had sexual behaviors. Conclusions: Both the average scores and awareness rates of teenagers' sexual knowledge showed an overall upward trend from 2011 to 2021. Teenagers' initial sexual behavior was at a low age, and the proportion of teenagers who had fixed, temporary and commercial heterosexual sex was still relatively high despite no significant increasing. Therefore, we should further strengthen health education on the risks of sexual behaviors from schools, families and health-related institutions to ensure teenagers receive HIV-related publicity services.

Does a longer sexual resume affect marriage rates?

Sociologists have proposed numerous theories for declining marriage rates in the United States, often highlighting demographic, economic, and cultural factors. One controversial theory contends that having multiple non-marital sex partners reduces traditional incentives for men to get married and simultaneously undermines their prospects in the marriage market. For women, multiple partners purportedly reduces their desirability as spouses by evoking a gendered double-standard about promiscuity. Though previous studies have shown that having multiple premarital sex partners is negatively associated with marital quality and stability, to date no research has examined whether having multiple non-marital sex partners affects marriage rates. Data from four waves of the National Survey of Family Growth reveal that American women who report more sex partners are less likely to get married by the time of the survey (though so too were virgins). Yet this finding is potentially misleading given the retrospective and cross-sectional nature of the data. Seventeen waves of prospective data from the National Longitudinal Survey of Youth's 1997 mixed-gender cohort that extend through 2015 show the association between non-marital sex partners and marriage rates is temporary: recent sex partners predict lower odds of marriage, but not lifetime non-marital sex partners. Seemingly unrelated bivariate probit models suggest the short-term association likely reflects a causal effect. Our findings ultimately cast doubt on recent scholarship that has implicated the ready availability of casual sex in the retreat from marriage. Rather, the effect of multiple sex partners on marriage rates is "seasonal" for most Americans.

Endocrine Health and Health Care Disparities in the Pediatric and Sexual and Gender Minority Populations: An Endocrine Society Scientific Statement

Endocrine care of pediatric and adult patients continues to be plagued by health and health care disparities that are perpetuated by the basic structures of our health systems and research modalities, as well as policies that impact access to care and social determinants of health. This scientific statement expands the Society's 2012 statement by focusing on endocrine disease disparities in the pediatric population and sexual and gender minority populations. These include pediatric and adult lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA) persons. The writing group focused on highly prevalent conditions-growth disorders, puberty, metabolic bone disease, type 1 (T1D) and type 2 (T2D) diabetes mellitus, prediabetes, and obesity. Several important findings emerged. Compared with females and non-White children, non-Hispanic White males are more likely to come to medical attention for short stature. Racially and ethnically diverse populations and males are underrepresented in studies of pubertal development and attainment of peak bone mass, with current norms based on European populations. Like adults, racial and ethnic minority youth suffer a higher burden of disease from obesity, T1D and T2D, and have less access to diabetes treatment technologies and bariatric surgery. LGBTQIA youth and adults also face discrimination and multiple barriers to endocrine care due to pathologizing sexual orientation and gender identity, lack of culturally competent care providers, and policies. Multilevel interventions to address these disparities are required. Inclusion of racial, ethnic, and LGBTQIA populations in longitudinal life course studies is needed to assess growth, puberty, and attainment of peak bone mass. Growth and development charts may need to be adapted to non-European populations. In addition, extension of these studies will be required to understand the clinical and physiologic consequences of interventions to address abnormal development in these populations. Health policies should be recrafted to remove barriers in care for children with obesity and/or diabetes and for LGBTQIA children and adults to facilitate comprehensive access to care, therapeutics, and technological advances. Public health interventions encompassing collection of accurate demographic and social needs data, including the intersection of social determinants of health with health outcomes, and enactment of population health level interventions will be essential tools.

Impulsivity as a Predictor of Early Dating Initiation in 11-12-Year-Old Youth

As early initiation of dating behaviors is associated with risky sexual behaviors (e.g., higher number of sexual partners, sex with strangers), the current study examined determinants of early dating behaviors, focusing on impulsivity. Participants were 11-12-year-old boys (n = 109) and girls (n = 61) recruited from a psychiatric clinic and ads targeted to the general public. Ordered logistic regression models were used to examine the association between each facet of impulsivity (negative urgency, positive urgency, lack of premeditation, lack of perseverance, and sensation seeking) and dating behaviors. Youth with higher sensation seeking and negative urgency was more likely to initiate dating behaviors at early ages compared to those with lower scores on those measures. Further, we found that female gender and higher parental education were associated with lower risk of initiating dating behaviors at early age. Advanced pubertal development was associated with higher risk for early dating. Our findings can inform prevention efforts, identifying sensation seeking and negative urgency as predictors of youths' early engagement in dating behaviors, which can be a precursor of early sexual debut and risky sexual behaviors.

Identifying causal associations between early sexual intercourse or number of sexual partners and major depressive disorders: A bidirectional two-sample Mendelian randomization analysis

BACKGROUND

Early sexual intercourse and a greater number of sexual partners have been proved associated with depression. However, the causality of these associations is not clear.

METHODS

To unveil the causal associations between sexual factors and major depression disorder (MDD). The bidirectional, two-sample Mendelian randomization (MR) study was conducted, which used genetic variants associated with two sexual factors (age first had sexual intercourse, n = 406,457; lifetime number of sexual partners, n = 378,882) and MDD (n = 500,199) from the largest genome-wide association studies (GWASs) conducted by the UK biobank and the Psychiatric Genomics Consortium. The two-step MR analysis was applied to assess mediation. The Genetic predictors for five risky behaviors were also obtained from the most up-to-date GWAS conducted by the UK Biobank (ever self-harmed: 117,733; ever attempted suicide: 4933; psychoactive substance abuse, alcohol use, and tobacco use: 463,010).

RESULTS

MR analysis indicated a risky causal effect of age first had sexual intercourse (OR = 0.720, 95 % CI: 0.661-0.784, P = 2.45 × 10^-14) and lifetime number of sexual partners (OR = 1.656, 95 % CI: 1.356-2.022, P = 7.46 × 10^-7) on MDD. Mediation analysis showed the effects were mediated by tobacco use, with a proportion of 34.20 % on age first had sexual intercourse and 22.94 % on lifetime number of sexual partners separately.

LIMITATIONS

The overlap of participants in different traits and unclear gender.

CONCLUSIONS

Robust genetic evidence indicated that premature sexual intercourse and more sexual partners were risks for MDD. Risky behaviors, especially the tobacco use, mediated this effect.

Independent and combined associations of urinary arsenic exposure and serum sex steroid hormones among 6-19-year old children and adolescents in NHANES 2013-2016

Arsenic exposure may disrupt sex steroid hormones, causing endocrine disruption. However, human evidence is limited and inconsistent, especially for children and adolescents. To evaluate the independent and combined associations between arsenic exposure and serum sex steroid hormones in children and adolescents, we conducted a cross-sectional analysis of data from 1063 participants aged 6 to 19 years from the 2013-2016 National Health and Nutrition Examination Survey (NHANES). Three urine arsenic metabolites were examined, as well as three serum sex steroid hormones, estradiol (E₂), total testosterone (TT), and sex hormone-binding globulin (SHBG). The ratio of TT to E₂ (TT/E₂) and the free androgen index (FAI) generated by TT/SHBG were also assessed. Linear regression, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) were used to evaluate the associations of individual or arsenic metabolite combinations with sex steroid hormones by gender and age stratification. Positive associations were found between total arsenic and arsenic metabolites with TT, E₂, and FAI. In contrast, negative associations were found between arsenic metabolites and SHBG. Furthermore, there was an interaction after gender-age stratification between DMA and SHBG in female adolescents. Notably, based on the WQS and BKMR model results, the combined association of arsenic and its metabolites was positively associated with TT, E₂, and FAI and negatively associated with SHBG. Moreover, DMA and MMA dominated the highest weights among the arsenic metabolites. Overall, our results indicate that exposure to arsenic, either alone or in mixtures, may alter sex steroid hormone levels in children and adolescents.

Differences in the sexual health information parents/guardians give their adolescent sexual minority sons by outness

Introduction

Parents and guardians are a potentially valuable source of sexual health information for adolescent sexual minority males (ASMM). The current study examines what sexual health topics ASMM report discussing with a parent/guardian and whether topics differ by outness about sexual attraction to other males.

Methods

ASMM (N=154; ages 14-17) in the United States completed the baseline of an online sexual health intervention pilot in 2020. They reported which of twelve sexual health topics they discussed with a parent/guardian and if they had disclosed their sexual attraction to other males. Associations between topics discussed and outness to a parent/guardian were examined with Firth logistic regression.

Results

Eighty-eight (57%) participants reported being out to a parent/guardian. Six sexual health topics were significantly more likely to be discussed if participants were out. The three categories with the largest differences by outness were how to: discuss with a partner what they would not like to do sexually (aOR = 7.0, 95% CI: 2.0-24.6), use condoms (aOR = 5.9, 95% CI: 2.3-15.1), and prevent HIV/AIDS (aOR = 3.5, 95% CI = 1.4-8.7).

Conclusions

Interventions on parental/guardian provision of sexual health information are needed to ensure ASMM receive relevant sexual health knowledge.

An Exploratory Investigation of Childhood Sexual Abuse and Other Theory-Driven Predictors of Sex Work Among Women with and without Childhood ADHD

Limited research has identified prospective risk factors for young-adult sex work or examined overlapping predictors concurrently. We investigated childhood sexual abuse (CSA), along with other theory-driven predictors of sex work, among a well-characterized sample of girls with and without childhood diagnoses of attention/deficit-hyperactivity disorder (ADHD).

METHODS

Participants were a racially and socioeconomically diverse sample of 140 girls with rigorously diagnosed ADHD (47 Inattentive [ADHD-I], 93 Combined [ADHD-C]), and 88 age- and ethnicity-matched comparison girls, all followed longitudinally into adulthood. Self-report data on young-adult occupations revealed a subsample of 7 participants reporting engagement in "sex work" or "prostitution." Logistic regressions tested whether CSA, measured both dichotomously and by discrete age ranges, predicted later sex work, accounting for other risk factors.

RESULTS

A lifetime history of CSA was positively associated with sex work in initial analyses (β = 1.51, p = .045), but not after adjusting for additional risk factors. When examined by age ranges, only CSA occurring between ages 9-15 significantly predicted sex work (β = 2.84, p = .043), even after adjusting for additional risk factors. Childhood ADHD-C also emerged as a significant predictor (β = 4.94, p = .015). ADHD-related medication and years of education were protective factors only when CSA was considered dichotomously.

CONCLUSIONS

Findings from this exploratory study underscore the need for longitudinal research that (a) considers the developmental timing of CSA and (b) accounts for impulsivity and inattention as risk factors for sex work among young-adult women. Implications for clinical practice are briefly discussed.

First Adolescent Romantic and Sexual Experiences in Individuals With Differences of Sex Development/Intersex Conditions

PURPOSE

Adolescence is an important period for sexual development, including sexual debut. The purpose of this study was to assess first romantic and sexual experiences and debut age in individuals with differences of sex development (DSD/intersex) and compare these with age-matched and gender-matched population control values.

METHODS

Questionnaire data on sociodemographic characteristics, romantic and sexual milestones (e.g., masturbation, dating), satisfaction with sexual life and sexual activity at follow-up, self-esteem, and feelings of femininity or masculinity were collected from 976 participants in Europe with a DSD condition. Participants were divided into six diagnostic subgroups based on their diagnostic classification: women with Turner syndrome, congenital adrenal hyperplasia, 46XY-DSD nonvirilized, and 46XY-DSD female partially virilized conditions and men with 46XY-DSD male or Klinefelter syndrome. Age-specific and gender-specific reference values were retrieved from a Dutch population sample.

RESULTS

Individuals with DSD were less likely to reach each of the romantic and sexual milestones compared to their peers without these conditions and they were significantly older when reaching these milestones. Between clinical subgroups, individuals with Klinefelter were significantly older when reaching milestones and in the female groups and individuals with Turner were the least likely to reach milestones. Furthermore, a higher age when reaching several romantic and sexual milestones was correlated with lower self-esteem, lower satisfaction with sexual life, and lower sexual frequency at follow-up.

DISCUSSION

Due to a difference in biopsychosocial context, individuals with DSD often experience a different and/or delayed sexual development during adolescence. Healthcare providers should be aware of these differences in adolescents with DSD and their sexual development to optimize affirmative counseling.

Symptoms of problematic pornography use among help-seeking male adolescents: Latent profile and network analysis

BACKGROUND AND AIMS

Little data exist on exploring the subgroups and characteristics of problematic pornography use (PPU) in help-seeking adolescents. The aims of the study were to classify the subgroups among help-seeking male adolescents, explore their similarities and differences, and uncover their core symptoms.

METHODS

A total of 3,468 Chinese male adolescents (Mage = 16.64 years, SD = 1.24) who were distressed about their pornography use were recruited. The Problematic Pornography Consumption Scale, the Brief Pornography Screen Scale, and Moral Disapproval of Pornography Use were used to classify them. The General Health Questionnaire, the Pornography Craving Questionnaire, and the Sexual Compulsivity Scale were used to investigate participants' negative consequence related to their pornography use; and the Online Sexual Activity Questionnaire (OSAs) and time spent on pornography use every week were considered as quantitative indicators.

RESULTS

Help-seeking male adolescents could be divided into 3 profiles, namely, self-perceived problematic (SP, n = 755), impaired control (IC, n = 1,656), and problematic use groups (PPU, n = 1,057). Frequency of OSAs was important for the identification of SP individuals, while negative consequences were more effective in identifying individuals with objective dysregulated behavior. Salience and mood modification were shared by all groups; however, in addition to this, the SP and PPU groups also showed withdrawal symptoms.

DISCUSSION AND CONCLUSION

This study's results provide support for the presence of different profiles of help-seeking individuals and information on potential intervention targets among adolescents which is lacking in the literature.

The influence of harshness and unpredictability on female sexual development: Addressing gene-environment interplay using a polygenic score

Recent developments in the application life history theory to human development indicate two fundamental dimension of the early environment - harshness and unpredictability - are key regulators life history strategies. Few studies have examined the manner with which these dimensions influence development, though age at menarche (AAM) and age at first sexual intercourse have been proposed as possible mechanisms among women. Data from the Avon Longitudinal Study of Parents and Children (N = 3,645) were used to examine direct and indirect effects of harshness (financial difficulties) and unpredictability (paternal transitions) on lifetime and past year sexual partners during adolescence and young adulthood. Genetic confounding was addressed using an AAM polygenic score (PGS) and potential gene-by-environment interactions were also evaluated using the PGS. Path model results showed only harshness was directly related to AAM. Harshness, unpredictability, and AAM were indirectly related to lifetime and past year sexual partner number via age at first sexual intercourse. The PGS did not account for any of the associations and no significant interactions were detected. Implications of these results for developmental models derived from life history theory are discussed as well as the role of PGSs in gene-environment interplay research.

Why and how does early adversity influence development? Toward an integrated model of dimensions of environmental experience

Two extant frameworks - the harshness-unpredictability model and the threat-deprivation model - attempt to explain which dimensions of adversity have distinct influences on development. These models address, respectively, why, based on a history of natural selection, development operates the way it does across a range of environmental contexts, and how the neural mechanisms that underlie plasticity and learning in response to environmental experiences influence brain development. Building on these frameworks, we advance an integrated model of dimensions of environmental experience, focusing on threat-based forms of harshness, deprivation-based forms of harshness, and environmental unpredictability. This integrated model makes clear that the why and the how of development are inextricable and, together, essential to understanding which dimensions of the environment matter. Core integrative concepts include the directedness of learning, multiple levels of developmental adaptation to the environment, and tradeoffs between adaptive and maladaptive developmental responses to adversity. The integrated model proposes that proximal and distal cues to threat-based and deprivation-based forms of harshness, as well as unpredictability in those cues, calibrate development to both immediate rearing environments and broader ecological contexts, current and future. We highlight actionable directions for research needed to investigate the integrated model and advance understanding of dimensions of environmental experience.

Are victims of bullying primarily social outcasts? Person-group dissimilarities in relational, socio-behavioral, and physical characteristics as predictors of victimization

Existing literature has mostly explained the occurrence of bullying victimization by individual socioemotional maladjustment. Instead, this study tested the person‐group dissimilarity model (Wright et al., Journal of Personality and Social Psychology, 50: 523–536, 1986) by examining whether individuals’ deviation from developmentally important (relational, socio‐behavioral, and physical) descriptive classroom norms predicted victimization. Adolescents (N = 1267, k = 56 classrooms; M_age = 13.2; 48.7% boys; 83.4% Dutch) provided self‐reported and peer‐nomination data throughout one school year (three timepoints). Results from group actor–partner interdependence models indicated that more person‐group dissimilarity in relational characteristics (fewer friendships; incidence rate ratios [IRR]_T2 = 0.28, IRR_T3 = 0.16, fewer social media connections; IRR_T3 = 0.13) and, particularly, lower disruptive behaviors (IRR_T2 = 0.35, IRR_T3 = 0.26) predicted victimization throughout the school year.

Can third-party observers detect attraction in others based on subtle nonverbal cues?

In a series of three studies, we examined whether third-party observers can detect attraction in others based on subtle nonverbal cues. We employed video segments of dates collected from a speed-dating experiment, in which daters went on a brief (approx. 4 min) blind-date and indicated whether they would like to go on another date with their brief interaction partner or not. We asked participants to view these stimuli and indicate whether or not each couple member is attracted to their partner. Our results show that participants could not reliably detect attraction, and this ability was not influenced by the age of the observer, video segment location (beginning or middle of the date), video duration, or general emotion recognition capacity. Contrary to previous research findings, our findings suggest that third-party observers cannot reliably detect attraction in others. However, there was one exception: Recognition rose above chance level when the daters were both interested in their partners compared to when they were not interested.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-022-02927-0.

Talking About Sexuality With Youth: A Taboo in Psychiatry?

BACKGROUND

Young people who have psychiatric problems are more likely than their peers to endure difficulties during their sexual and gender identity development.

AIM

This study aims to examine the communication between mental health care providers and their patients about the topics of relations, sexuality and gender identity, including a description of professionals' attitudes toward these topics and the factors that contribute to and inhibit communication.

METHODS

Study participants (n = 242, response rate = 31%) were a representative sample of a large multicenter cohort of 768 mental health care professionals (eg, medical doctors, psychiatrists, psychologists, group counselors, parent counselors) of 7 institutions and 5 solo practices in the Netherlands, who completed a survey on communication about sexuality and gender identity with their young patients (age 12-21 years).

OUTCOMES

Sexuality and gender identity are infrequently discussed by mental health care providers with their young patients or their patients' parents.

RESULTS

Of the study sample, 99.5 % valued sexuality as an important topic to discuss with their patients. However, only 17.1% of the professionals reported that they discussed sexuality-related issues with the majority (>75%) of their patients (adolescents: 19.9%, parents: 14.4%) Additionally, only 2.3 % of the participants discussed gender nonconformity regularly with patients. Information about sexual side effects of prescribed medication was infrequently (20.3%) provided: antidepressants (40.0%), antipsychotics (34.0%), benzodiazepines (5.1%) and stimulants (2.4%). The most frequently cited reasons for not discussing these topics were a lack of awareness, own feelings of discomfort, and the patients' supposed feelings of shame. There was no gender differences observed.

CLINICAL IMPLICATIONS

Recommendations for professionals include to be aware of these topics, initiating age-appropriate conversation and use inclusive language.

STRENGTHS AND LIMITATIONS

The present study included a diverse and representative group of mental health care professionals. Frequency of sexual communication was based on self-report, which brings a risk of bias.

CONCLUSION

Despite a recognized need to engage in age-appropriate communication about sexuality and gender identity in youth mental health care, mental health providers seem to remain hesitant to discuss such topics. Bungener SL, Post L, Berends I, et al. Talking About Sexuality With Youth: A Taboo in Psychiatry?. J Sex Med 2022;19:421-429.

The Measurement of Female Early Adolescent Sexual Desire

We used the developmental systems model to deduce a definition of female early adolescent sexual desire. We evaluated a measure of this phenomenon with a secondary analysis of data from a randomized group sexual health intervention trial involving low-income, English-speaking, seventh grade Latinas enrolled in a Miami-Dade County public school (n = 542). As part of this study, girls completed a four-item early adolescent sexual desire (EASD) measure. Study findings supported internal consistency (Cronbach's alpha = .81 to .82) and stability over a 1-month period (r = .74). Developmental sensitivity was supported by a decline in stability over 12- (r = .66) and 24-month periods (r = .56). Validity was supported by correlations with puberty changes, sexual intentions, sexting, and sexual behavior, and hypothesized mean differences associated with dating and preference for shoes culturally associated with female sexual attractiveness (p < .01). Research implications include validation work with other ethnic/racial groups and using the EASD as a starting point for a measurement continuum tracking development of sexual desire across adolescence and into adulthood. Directions for future research also include measuring the development of sexual desire in boys and transgendered youth across adolescence and into adulthood.

Longitudinal Associations Between Primary and Secondary Psychopathic Traits, Delinquency, and Current Dating Status in Adolescence

Many have examined the desirability and mate competition tactics of adults higher on psychopathy using cross-sectional data, but few have studied the longitudinal associations between the lower-order factors of psychopathy (e.g., primary and secondary psychopathy) with indices of mating behavior in adolescents. More work is also needed to unravel how psychopathic youth outcompete rivals for mates. Delinquency has long been associated with dating and sexual behavior in adolescents, which may help to explain the competitive success of youth higher in psychopathic traits in vying for mates. We used cross-lagged panel modeling with three waves of data from a randomly drawn sample of 514 Canadian adolescents who provided annual self-reports of primary and secondary psychopathy, delinquency, and dating involvement from Grades 10 to 12 (15-18 years of age). Constructs were temporally stable. Secondary psychopathy and delinquency had positive within-time correlations with current dating status in Grade 10. A cross-lagged pathway from delinquency to dating involvement was supported from Grade 10 to 11, which replicated from Grade 11 to 12. However, this effect was specific to boys and not girls. An indirect effect also emerged whereby secondary psychopathy in Grade 10 increased the likelihood of being in a dating relationship in Grade 12 via heightened delinquency in Grade 11.

Social and Biological Transgenerational Underpinnings of Adolescent Pregnancy

Adolescent pregnancy (occurring < age 20) is considered a public health problem that creates and perpetuates inequities, affecting not only women, but societies as a whole globally. The efficacy of current approaches to reduce its prevalence is limited. Most existing interventions focus on outcomes without identifying or addressing upstream social and biological causes. Current rhetoric revolves around the need to change girls' individual behaviours during adolescence and puberty. Yet, emerging evidence suggests risk for adolescent pregnancy may be influenced by exposures taking place much earlier during development, starting as early as gametogenesis. Furthermore, pregnancy risks are determined by complex interactions between socio-structural and ecological factors including housing and food security, family structure, and gender-based power dynamics. To explore these interactions, we merge three complimentary theoretical frameworks: "Eco-Social", "Life History" and "Developmental Origins of Health and Disease". We use our new lens to discuss social and biological determinants of two key developmental milestones associated with age at first birth: age at girls' first menstrual bleed (menarche) and age at first sexual intercourse (coitarche). Our review of the literature suggests that promoting stable and safe environments starting at conception (including improving economic and social equity, in addition to gender-based power dynamics) is paramount to effectively curbing adolescent pregnancy rates. Adolescent pregnancy exacerbates and perpetuates social inequities within and across generations. As such, reducing it should be considered a key priority for public health and social change agenda.

The Self-Identification, LGBTQ+ Identity Development, and Attraction and Behavior of Asexual Youth: Potential Implications for Sexual Health and Internet-Based Service Provision

While often included in the spectrum of sexual minority identities, asexuality receives comparatively little attention. Awareness and understanding remains limited, and knowledge has been generated primarily from adult populations. This paper employs a sample of 711 self-identified asexual youth (aged 14-24, M = 17.43 years) who identified as members of the LGBTQ+ community to consider the implications of a number of different areas for service provision. Two-thirds (66.8%) of participants identified as gender minorities within the spectrum of transgender and non-binary identities. Findings include aspects of participants' LGBTQ+ developmental processes, including that only 14.3% had disclosed their LGBTQ+ status to everyone in their lives. However, just 2.4% had disclosed to no one. Their attraction and sexual activity were also explored, with 27.1% having never experienced any kind of romantic or sexual attraction and 20.6% having ever been sexually active. Findings regarding participants' accessing of LGBTQ+ health information and engagement in a range of offline and online LGBTQ+ community activities are also provided. Participants acquired more health information online than offline-including sexual health information. Recommendations for service provision, particularly implications for sexual health and Internet-based services, are discussed.

Heterozygosity of the major histocompatibility complex predicts later self-reported pubertal maturation in men

Individual variation in the age of pubertal onset is linked to physical and mental health, yet the factors underlying this variation are poorly understood. Life history theory predicts that individuals at higher risk of mortality due to extrinsic causes such as infectious disease should sexually mature and reproduce earlier, whereas those at lower risk can delay puberty and continue to invest resources in somatic growth. We examined relationships between a genetic predictor of infectious disease resistance, heterozygosity of the major histocompatibility complex (MHC), referred to as the human leukocyte antigen (HLA) gene in humans, and self-reported pubertal timing. In a combined sample of men from Canada (n = 137) and the United States (n = 43), MHC heterozygosity predicted later self-reported pubertal development. These findings suggest a genetic trade-off between immunocompetence and sexual maturation in human males.

Association between pubertal development and elevated blood pressure in children

Blood pressure (BP) increased with age and height development, but little was known about the effect of pubertal development on blood pressure in children. A cross‐sectional study was performed among 4146 children aged 7–12 years old in China. Pubertal development was assessed based on breast stages and testicular volume. The associations of pubertal development with BP levels and the rate of elevated blood pressure (EBP) were quantified using multiple linear and logistic regressions. We found that pubertal developmental level was positively correlated with BP, and children who experienced puberty onset and early pubertal timing had higher BP levels and prevalence of EBP. After adjusting for covariates, children experienced puberty onset had 3.84 and 2.24 mmHg increase in systolic blood pressure and diastolic blood pressure, and 70%, 53%, and 62% increased odds of EBP, ESBP, and EDBP, respectively, compared with those without puberty onset. Similar results were observed for children who had early pubertal timing. The change of BP in puberty is greater and the association between pubertal development and BP is stronger in girls than boys. These findings suggested that pubertal development could be an important independent factor and one critical period for the EBP progress. Monitoring and management of pubertal development are necessary particularly among girls.

Longitudinal Associations of Pubertal Timing and Tempo With Adolescent Mental Health and Risk Behavior Initiation in Urban South Africa

PURPOSE

In high-income countries, early and rapid pubertal development is consistently associated with poor adjustment and increased risk behavior in adolescence. This study contributes to the meager knowledge of these associations in lower income countries.

METHODS

We used longitudinal data from 1,784 urban black South Africans in the Birth to Twenty Plus cohort. We used regression analyses to assess associations between age at menarche and latent classes of pubertal timing and tempo and adolescent internalizing and externalizing emotional and behavioral problems, eating attitudes, and patterns of health risk behavior initiation.

RESULTS

Relatively earlier and faster pubertal timing and tempo were associated with increased health risk behavior initiation (e.g., adjusted odds ratio [95% confidence interval] high- vs. low-risk pattern = 5.7 [1.7, 19.06] for male genital development; adjusted odds ratio = 3.45 [1.13, 10.49] for female breast development). Among males, earlier and faster pubertal timing and tempo were associated with increased externalizing problems in early adolescence and increased oppositional defiant problems in midadolescence, whereas later and slower pubertal timing and tempo were associated with decreases. Among females, earlier and faster pubertal timing and tempo were associated with increased internalizing and externalizing problems in midadolescence and increased dieting behaviors in early and late adolescence (β [95% confidence interval] = 2.51 [.87, 4.15] for pubic hair development), whereas later and slower pubertal timing and tempo were associated with decreases.

CONCLUSIONS

In this urban South African cohort, relatively earlier and faster pubertal development was detrimental to mental health and risk behavior activity, whereas later and slower maturation was somewhat protective.

Effects of a randomized controlled trial of a brief, student-nurse led, parent-based sexual health intervention on parental protective factors and HPV vaccination uptake

BACKGROUND

Parents play a pivotal role in adolescent sexual health and Human Papillomavirus (HPV) vaccination. Nurses are on the frontlines of healthcare and play a critical role in promoting HPV vaccination and parent-child sexual health communication. We enhanced the Families Talking Together (FTT) parent-based sexual health curriculum to include adolescent vaccinations herein, FTT + HPV, and trained student nurses to provide a strong HPV vaccination and parent-child sexual health communication endorsement.

METHODS

Using a randomized attention-controlled trial design, we examined the efficacy of FTT + HPV among 519 parents and their 11-14 year old youth recruited from medically underserved communities between 2015 and 2018. Participants were recruited from 22 after-school programs (e.g., Boys and Girls Clubs) and 19 charter schools. For parents, we examined protective factors including parent-child sexual health communication and parental involvement. For youth, we examined sexual health knowledge, parent-child sexual health communication, and parent-child connectedness. To assess HPV vaccination initiation and completion, we searched IMMTRAC immunization registry records for 85% of youth and used parental report for youth without registry records. Group differences were calculated using the estimated mean difference at one- and six months post-intervention with significance set at the p < 0.05 level.

RESULTS

Baseline rates of HPV vaccination were low at 55.7%. No significant difference between the groups was seen in vaccination initiation or completion rates by one-month post-intervention. However, by six-months post intervention, there was a significant difference between the groups with 70.3% of the intervention group initiating the HPV vaccination series vs. 60.6% for the control group (p = 0.02). No difference between the groups was found for HPV series completion at six-months. There were significant differences in condom knowledge (p = 0.04), parent-child connectedness (p = 0.04), and communication frequency (p = 0.001) with greater improvement in the intervention vs. the control group. Rates of sexual activity remained low in both groups throughout the six-month follow-up period.

CONCLUSION

A brief parent-based adolescent sexual health and HPV vaccination intervention delivered by student nurses can improve sexual health outcomes including protective parental factors, adolescent sexual health knowledge, and HPV vaccination initiation rates.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT02600884 . Prospectively registered September 1, 2015.

Investigating the emergence of sex differences in jealousy responses in a large community sample from an evolutionary perspective

Sex differences in jealousy responses to sexual and emotional infidelity are robust in samples of heterosexual adults, especially in more gender egalitarian nations. However, investigations of when and how these differences develop have been scant. We applied two forced choice infidelity scenarios in a large community sample of high school students (age 16–19, N = 1266). In line with previous findings on adults using the forced choice paradigm, adolescent males found the sexual aspect of imagined infidelity more distressing than adolescent females did. Nevertheless, there was no effect of age on the jealousy responses, and age did not moderate the sex difference. There were neither any effects of three covariates (having had first sexual intercourse, being in a committed romantic relationship, and sociosexuality), neither as markers of pubertal maturation nor as psychosocial environmental stimuli. Future research needs to investigate even younger samples in order to specify at what age the sex difference in jealousy responses emerges.

Age- and Sex-Related Differences in Morbidities of Sexually Transmitted Diseases in Children

Sexually transmitted diseases (STDs) are causes of public health burden globally. The purpose of this study is to document age-specific and sex-related changes in the morbidity of four representative STDs in children. Japanese national surveillance data from 1999 to 2017 on morbidities of the following four STDs were analyzed by age and sex: Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), condylomata acuminate (CA), and genital herpes simplex virus (GHSV). The morbidities of males and females in each age group were compared through the male-to-female morbidity (MFM) ratios. The MFM ratios were not different from one in infants, less than one in children, and greater than one after puberty in all four STDs. The reversal of MFM ratio less than 1 to greater than 1 for NG infection was observed between 10–14 and 15–19 year of age, i.e., during the puberty, while that for GHSV infection was observed between 35–39 and 40–44 year of age, i.e., during adulthood. In conclusion, the morbidities of the four STDs were similar between the sexes in infants, and were higher in female children than in male children, while the morbidities in all four diseases were higher in men after puberty.

A polygenic score for age-at-first-birth predicts disinhibition

BACKGROUND

A recent genome-wide association study identified molecular-genetic associations with age-at-first-birth. However, the meaning of these genetic discoveries is unclear. Drawing on evidence linking early pregnancy with disinhibitory behavior, we tested the hypothesis that genetic discoveries for age-at-first-birth predict disinhibition.

METHODS

We included participants with genotype data from the two-decade-long Environmental Risk (E-Risk) Study (N = 1,999) and the four-decade-long Dunedin Study (N = 918). We calculated a genome-wide polygenic score for age-at-first-birth and tested whether it was associated with a range of disinhibitory outcomes across the life course, including low childhood self-control; risk for externalizing psychopathology; officially recorded criminal offending; substance dependence; informant reports of disinhibitory problems; and number of lifetime sexual partners. We further tested whether associations were attributable to accelerated pubertal maturation.

RESULTS

In both cohorts, the age-at-first-birth polygenic score predicted low childhood self-control, externalizing psychopathology, officially recorded criminal offending, substance dependence, and number of sexual partners. Associations were modest, but robust across replication. Childhood disinhibition partly mediated associations between the polygenic score and reproductive behaviors. In contrast, associations were not attributable to accelerated pubertal timing.

CONCLUSIONS

Genomic discoveries for age-at-first-birth are about more than reproductive biology: They provide insight into the disinhibitory traits and behaviors that accompany early parenthood. Age-at-first-birth is a useful proxy phenotype for researchers interested in disinhibition. Further, interventions that improve self-regulation abilities may benefit young parents and their children.

Developmental Trajectories of Adolescent Girls' Borderline Personality Symptoms and Sexual Risk Behaviors

Adolescence is a developmental period during which youth tend to initiate sexual behavior, which may include sexual risk behavior. Symptoms of borderline personality disorder (BPD) are associated with increased rates of risky behaviors. However, little is known about longitudinal associations between BPD symptoms and sexual risk behaviors during adolescence. This study examines developmental trajectories of adolescent girls' BPD symptoms and sexual risk behaviors in a community sample of Black and White girls from the Pittsburgh Girls Study (n = 1620). Dual trajectory modeling provided insights into the temporal precedence and co-development of BPD symptoms and sexual risk behaviors from ages 14 to 18. In order to examine the unique association between BPD symptoms and sexual risk behaviors, analyses controlled for symptoms of depression and conduct disorder, as well as race, sexual orientation, and pubertal development. Girls with more BPD symptoms at age 14 showed steeper growth over time in sexual risk behaviors from ages 14 to 18. Additionally, adolescents who showed steeper increases in BPD symptoms over time also showed steeper increases in sexual risk behaviors across adolescence. Notably, however, sexual risk behavior at age 14 was not significantly associated with longitudinal trajectories of BPD symptoms. Results suggest that adolescent girls with early symptoms of BPD are at heightened risk for the development of sexual risk behaviors during adolescence, while the reverse association does not hold. Implications for adolescent development and sexual risk behavior are discussed.

The interaction between pubertal timing and childhood maltreatment on the risk of human papillomavirus infection among adolescent girls and young women

PURPOSE

The goal of this study was to evaluate the effect of pubertal timing, and its interaction with prior childhood maltreatment, on the risk of cervical human papillomavirus (HPV) among sexually active adolescent minority female adolescents and young adults.

METHODS

This cross-sectional study includes 842 adolescent girls and young women (aged 12 to 20 years; predominately Black and Hispanic) enrolled in an HPV vaccine surveillance study at a large adolescent health clinic in New York City between 2007 and 2016. Pubertal timing was assessed by self-reported age at menarche at baseline, with "early" and "late" defined as one standard deviation below (<11 years) or above (>13 years) the mean. Childhood exposure to abuse (sexual, physical and emotional) and neglect (physical and emotional) was assessed using the Childhood Trauma Questionnaire. Over 40 types of HPV infection were detected using the polymerase chain reaction in cervical Pap specimens.

RESULTS

Results from multivariable logistic regression showed that early and late pubertal timing were marginally associated with a higher risk of HPV infection, adjusting for demographic and health covariates. Childhood maltreatment moderated the association between early pubertal timing and HPV infection: early pubertal timing was associated with a higher risk for HPV infection among maltreated girls (OR = 3.32, 95%CI:1.61-6.85), but not among non-maltreated girls (OR = 0.96, 95%CI:0.61-1.50; p-interaction<0.01).

CONCLUSIONS

Variation in the timing of puberty and history of childhood maltreatment may have implications for adolescent sexual and reproductive health. Findings suggest that clinicians need to assess the biological and psychosocial risks in caring for youth.

The Impact of Sexual Initiation Timing and Sexual Experience on Depressive Symptoms in South Korean Adolescents: Gender Differences in a Nationwide Cross-Sectional Study

PURPOSE

This study utilized data from the Korea Youth Risk Behavior Survey to examine gender differences in the impact of sexual initiation, and age at sexual initiation, on depressive symptoms among Korean adolescents.

DESIGN AND METHODS

This study performed a secondary analysis of cross-sectional data from the 14th Korea Youth Risk Behavior Survey (2018). Data from 60,040 adolescents aged 12-18 were included in this study. The relationship between sexual experience, age at initiation, and depressive symptoms was analyzed with complex sample multiple logistic regression.

RESULTS

Overall, 5.7% of participants declared having had sexual experience. Sexual initiation tended to occur from grade 7 and above. In addition, 33.6% of girls and 21.1% of boys reported having depressive symptoms. Depressive symptoms were associated with sexual initiation experience, but depression symptoms were not associated with the timing of sexual initiation.

CONCLUSIONS

This study provides preliminary evidence of a relationship between sexual experience and depressive symptoms among adolescents; however, this relationship appeared independent of the timing of sexual initiation. These findings suggest that sexually active adolescents should be screened for depressive symptoms, regardless of gender.

PRACTICE IMPLICATIONS

This is the first study to examine the impact of sexual initiation and its timing on depressive symptoms among Korean adolescents. Sexual behaviors of Korean adolescents should be accounted for during the development of mental health policies aimed at young people. In addition, sexually active adolescents should be screened and monitored for depressive symptoms.

Oral Sex Knowledge and Experience of Transgender Youth: An Opportunity for Dental Education

Recent evidence suggests that, when compared to their cisgender counterparts, transgender youth exhibit more unsafe sexual behavior that may elevate their risk for sexually transmitted infections. The aim of this study was to better understand what transgender youth know about oral sex, related consequences, and mechanisms of protection and where they obtained this information. The findings can be helpful in preparing oral health providers to play a role in meeting this public health need. The study took place at a U.S. academic pediatric medical center in 2017. Participants were recruited at a Transgender Research Day and during Transgender Clinic sessions. English-speaking transgender adolescents ages 14 to 24 were invited to participate in a previously validated survey about their knowledge and behaviors related to oral sex. Of the 138 transgender youth invited to participate, 57 completed the surveys, for a 41% response rate. Most respondents reported feeling they understood the necessity of protection and consequences of oral sex but did not use protection. Over half of the participants (58%) said they had not had a physician, dentist, or parent speak to them about oral sex. Given the lack of standardized, evidence-based sex education, it is imperative that adolescents, particularly in highly vulnerable populations like transgender youth, receive accurate information about oral sexual contact. Dental schools should prepare future practitioners to address these issues with youth using a culturally competent, evidence-based approach.

Pubertal Timing, Parenting Style, and Trajectories of Pornography Use in Adolescence: Peer Pornography Use as the Mediator

This study examined the effect of pubertal timing, parenting style, and peer behaviors on the trajectories of pornography use among adolescents. Data consisted of 1272 boys and 1210 girls, who completed at least three waves of pornography use questions from 7th to 12th grade (the year 2007 to 2012). Group-based trajectory modeling was applied to identify the trajectories of pornography use. Multinomial logistic regression and the Z-mediation method were conducted to examine the influences of pubertal timing, parenting style, and peer behaviors on the trajectories and the mediating effect. The results showed that early puberty was associated with earlier exposure to pornography and more frequent exposure later. Parental monitoring protected adolescents from pornography use, whereas psychological control increased the chance of more exposure. Peer pornography use mediated the relationship between adolescent pornography use, pubertal timing, and parental style. This mediating effect was stronger among boys versus girls. These findings provide insight into the mechanism of pubertal timing, parental style, and peer influence on the trajectory of pornography use in adolescence.

Old-for-Grade Status and Suicide Risk in U.S. High School Students

Health-risk behaviors associated with increased risk of suicide are more prevalent in old-for-grade students compared to age-appropriate-for-grade peers; however, the association between old-for-grade status and suicidal behavior is largely unknown. This study investigated sex-specific differences in suicidal ideation, planning, attempts, and other risk behaviors by old-for-grade status. Secondary analyses utilizing bivariate and logistic regression methods for complex samples were conducted using data from the 2011, 2013, and 2015 National Youth Risk Behavior Survey for 16,579 female and 17,282 male high school students in grades 9 through 11. Among both males and females, students considered old-for-grade reported increased drug use, feeling sad/hopeless, violence, sexual activity, and limited/no seatbelt use compared with their peers. Old-for-grade students were also more likely to report a suicide attempt with increased suicidal ideation and planning observed only in old-for-grade males. Associations between old-for-grade status and suicide risk-related outcomes were attenuated in both sexes after adjusting for demographic characteristics and other health-risk behaviors. Findings suggest that common risk factors (e.g., sadness, substance use) may explain increased rates of suicidal behaviors in old-for-grade students.

Sexual risk-taking and subcortical brain volume in adolescence

Background

The developmental period of adolescence marks the initiation of new socioemotional and physical behaviors, including sexual intercourse. However, little is known about neurodevelopmental influences on adolescent sexual decision-making.

Purpose

We sought to determine how subcortical brain volume correlated with condom use, and whether those associations differed by gender and pubertal development.

Methods

We used FreeSurfer to extract subcortical volume among N = 169 sexually experienced youth (mean age 16.07 years; 31.95% female). We conducted multiple linear regressions to examine the relationship between frequency of condom use and subcortical volume, and whether these associations would be moderated by gender and pubertal development.

Results

We found that the relationship between brain volume and condom use was better accounted for by pubertal development than by gender, and moderated the association between limbic brain volume and condom use. No significant relationships were observed in reward areas (e.g., nucleus accumbens) or prefrontal cortical control areas.

Conclusions

These data highlight the potential relevance of subcortical socioemotional processing structures in adolescents' sexual decision-making.

Effects of the Timing of Sex-Steroid Exposure in Adolescence on Adult Health Outcomes

CONTEXT

Variation in pubertal timing is associated with a wide range of adult risks and outcomes, but it is unclear whether these associations are causal, and it is largely unknown whether these associations can be modified by treatment.

EVIDENCE ACQUISITION

We conducted PubMed searches to identify Mendelian randomization (MR) studies on the influence of pubertal timing on adult health and studies on sex-steroid treatment of the following conditions associated with reduced reproductive endocrine function in adolescence: constitutional delay, Turner syndrome, and Klinefelter syndrome.

EVIDENCE SYNTHESIS

Results of MR studies suggest that earlier pubertal timing increases body mass index; increases risk for breast, ovarian, endometrial, and prostate cancers; elevates fasting glucose levels and blood pressure; impairs lung capacity and increases risk for asthma; leads to earlier sexual intercourse and first birth; decreases time spent in education; and increases depressive symptoms in adolescence. Later pubertal timing appears to lower bone mineral density (BMD). Although studies of constitutional delay have not shown that sex-steroid treatment alters adult height or BMD, studies of girls with Turner syndrome and boys with Klinefelter syndrome suggest that earlier initiation of sex-steroid treatment improves physical and neurocognitive outcomes.

CONCLUSIONS

Despite having some limitations, MR studies suggest that pubertal timing causally influences many adult conditions and disease risks. Studies of Turner syndrome and Klinefelter syndrome suggest that earlier sex-steroid exposure may have short- and long-term benefits. The mechanisms underlying these findings and the effects of trends and treatments affecting pubertal timing remain to be determined.

Assessment of Parent-Based Interventions for Adolescent Sexual Health: A Systematic Review and Meta-analysis

IMPORTANCE

Parent-based sexual health interventions have received considerable attention as one factor that can increase safer sexual behavior among youth; however, to our knowledge, the evidence linking parent-based interventions to youth sexual behaviors has not been empirically synthesized.

OBJECTIVE

To examine the association of parent-based sexual health interventions with 3 primary youth outcomes-delayed sexual activity, condom use, and parent-child sexual communication-as well as several secondary outcomes. We also explored potential moderators of intervention effectiveness.

DATA SOURCES

A systematic search was conducted of studies published through March 2018 using MEDLINE, PsycINFO, Communication Source, and CINAHL databases and relevant review articles.

STUDY SELECTION

Studies were included if they: (1) sampled adolescents (mean age, ≤18 years), (2) included parents in a key intervention component, (3) evaluated program effects with experimental/quasi-experimental designs, (4) included an adolescent-reported behavioral outcome, (5) consisted of a US-based sample, and (6) were published in English.

DATA EXTRACTION AND SYNTHESIS

Standardized mean difference (d) and 95% confidence intervals were computed from studies and meta-analyzed using random-effects models. A secondary analysis evaluated potential moderating variables.

MAIN OUTCOMES AND MEASURES

The primary outcomes were delayed sexual activity, condom use, and sexual communication.

RESULTS

Independent findings from 31 articles reporting on 12 464 adolescents (mean age = 12.3 years) were synthesized. Across studies, there was a significant association of parent-based interventions with improved condom use (d = 0.32; 95% CI, 0.13-0.51; P = .001) and parent-child sexual communication (d = 0.27; 95% CI, 0.19-0.35; P = .001). No significant differences between parent-based interventions and control programs were found for delaying sexual activity (d = -0.06; 95% CI, -0.14 to 0.02; P = .16). The associations for condom use were heterogeneous. Moderation analyses revealed larger associations for interventions that focused on younger, compared with older, adolescents; targeted black or Hispanic youth compared with mixed race/ethnicity samples; targeted parents and teens equally compared with emphasizing parents only; and included a program dose of 10 hours or more compared with a lower dose.

CONCLUSIONS AND RELEVANCE

Parent-based sexual health programs can promote safer sex behavior and cognitions in adolescents, although the findings in this analysis were generally modest. Moderation analyses indicated several areas where future programs could place additional attention to improve potential effectiveness.

Associations between adolescents' use of sexually explicit material and risky sexual behavior: A longitudinal assessment

The unprecedented accessibility and affordability of online sexually explicit material (SEM) has facilitated widespread use among adolescents and growing concerns over adverse reproductive health outcomes. Although SEM-induced risky sexual behavior is among key concerns, there is a paucity of longitudinal research addressing this issue. This study aimed to assess the longitudinal association between frequency of SEM use and risky sexual behavior among adolescents in two independent 5-wave panel samples of Croatian adolescents (n = 368; n = 247). The indicators of risky sexual behavior were: (1) not using a condom at most recent sexual intercourse, and (2) reporting two or more sexual partners. Multilevel logistic regression analysis with a lagged component was used to explore the associations of interest. Controlling for sociodemographic characteristics, pubertal timing and sensation seeking, frequency of SEM use was not associated with the two indicators of sexual risk taking. This study’s findings are relevant for health and educational experts, but also for concerned parents.

Developmental Trajectories of Executive Functioning and Puberty in Boys and Girls

There are substantial changes in executive functioning during adolescence that may correspond with the onset and progression of puberty. The current study examines associations between pubertal development (timing and tempo) and changes in specific executive functioning skills (i.e., attention and self-control) across the transition from childhood to adolescence (ages 9.5-15.5) using data from the Study of Early Child Care and Youth Development (1099 youth; 52% female, 81% White, 83% above the poverty line). The findings indicated that early maturation was associated with faster increases in attention skills over adolescence for both boys and girls. Further, early maturation predicted worse self-control among girls but not boys. This study provides new insights on executive functioning during the transition to adolescence-a period of both vulnerability and opportunity.

Developmental Adaptation to Stress: An Evolutionary Perspective

The assumption that early stress leads to dysregulation and impairment is widespread in developmental science and informs prevailing models (e.g., toxic stress). An alternative evolutionary–developmental approach, which complements the standard emphasis on dysregulation, proposes that early stress may prompt the development of costly but adaptive strategies that promote survival and reproduction under adverse conditions. In this review, we survey this growing theoretical and empirical literature, highlighting recent developments and outstanding questions. We review concepts of adaptive plasticity and conditional adaptation, introduce the life history framework and the adaptive calibration model, and consider how physiological stress response systems and related neuroendocrine processes may function as plasticity mechanisms. We then address the evolution of individual differences in susceptibility to the environment, which engenders systematic person–environment interactions in the effects of stress on development. Finally, we discuss stress-mediated regulation of pubertal development as a case study of how an evolutionary–developmental approach can foster theoretical integration.

Caregiving Disruptions Affect Growth and Pubertal Development in Early Adolescence in Institutionalized and Fostered Romanian Children: A Randomized Clinical Trial

OBJECTIVES

To determine the effects of foster care vs institutional care, as well as disruptions in the caregiving environment on physical development through early adolescence.

STUDY DESIGN

This was a randomized controlled trial of 114 institutionalized, though otherwise healthy, children from 6 orphanages and 51 never institutionalized control children living in birth families (family care group) in Bucharest, Romania. Children were followed from baseline (21 months, range 5-31) through age 12 years for caregiving disruptions and growth trajectories and through age 14 years for pubertal development.

RESULTS

Children randomized to the foster care group showed greater rates of growth in height, weight, and body mass index (BMI) through age 12 years than institutionalized group. Tanner development was delayed in institutionalized group boys compared with foster care group and family care group boys at 12 but not 14 years. There were no differences in Tanner development and age of menarche among foster care group, institutionalized group, and family care group girls at ages 12 and 14 years. More disruptions in caregiving between 30 months and 12 years moderated decreases in growth rates of height in foster care group and weight in foster care group and institutionalized group across age. institutionalized group boys with ≥2 disruptions showed lower Tanner scores at age 12 vs institutionalized group and foster care group boys with <2 disruptions. foster care group girls with ≥2 disruptions had higher Tanner scores at age 14 vs foster care group girls with <2 disruptions. Age of menarche was not affected by caregiving disruptions.

CONCLUSIONS

For children who experienced early institutionalization, stable placement within family care is essential to ensuring the best outcomes for physical developmental.

TRIAL REGISTRATION

clinicaltrials.gov: NCT00747396.

Early pubertal timing and adult adjustment outcomes: Persistence, attenuation, or accentuation?

Early pubertal timing is associated with internalizing and externalizing problems during adolescence. However, few studies explicitly test whether early puberty is especially problematic for those with pre-existing problems (i.e., accentuation) and little is known about whether the negative correlates of early pubertal timing persist past young adulthood. We address these questions using longitudinal data from up to 451 participants in the Iowa Youth and Families project (e.g., Ge, Conger, & Elder, 1996, 2001). We replicated and extended previous results reported for this sample during adolescence (e.g., early maturing boys and girls reported more substance use) and found some evidence for accentuation in adolescence for psychological distress and substance use. However, correlations between early puberty and adult outcomes assessed up to two decades later were largely indistinguishable from zero including attenuation effects. These results suggest that any negative correlates of early pubertal timing are attenuated by the fourth decade of life.

Our Buddies, Ourselves: The Role of Sexual Homophily in Adolescent Friendship Networks

The present study tests the assumption that peers wield sufficient influence to induce sexual homophily (i.e., similarities in sexual experiences). Because girls face greater stigma for their sexual experiences than do boys, sexual homophily may be greater in girls' friendship networks than in boys'. Stochastic actor-based models were used to analyze network data (n = 2,566; ages 14-18) from two high schools in the National Longitudinal Study of Adolescent to Adult Health. Sexual homophily was present in friendship networks. Girls and boys were equally susceptible to their friends' influence, but the former exhibited a stronger preference for befriending same sexual debut status peers than the latter. The findings suggest that adolescents-particularly girls-"curate" their networks to minimize peer ostracism.

Implications of Pubertal Timing for Romantic Relationship Quality Among Heterosexual and Sexual Minority Young Adults

PURPOSE

Relative to on-time or late-maturing peers, girls who begin puberty early typically begin romantic and sexual experiences earlier; however, advanced pubertal status does not necessarily coincide with commensurate interpersonal skills necessary for healthy romantic relationships. Research is limited on the long-term implications of early puberty for relationship quality, and virtually nothing is known about the social implications of early timing for sexual minority females.

METHODS

Using linear regression, we examine longitudinal associations between two measures of girls' pubertal timing (self-perceived timing and menarcheal age) and romantic relationship quality in young adulthood, stratified by sexual orientation, among 5,568 females in waves I and IV of the National Longitudinal Study of Adolescent to Adult Health. We also examine whether identified associations are mediated by parent-adolescent relationship quality.

RESULTS

Among sexual minorities, early self-perceived pubertal timing was associated with lower adult romantic relationship quality compared with on-time maturers (β = -2.32; standard error = 1.44; p = .05); this association was mediated by parent-adolescent relationship quality. Among heterosexuals, girls experiencing menarche before age 12 (early maturers) reported lower adult relationship quality compared to on-time maturers (β = -.43; standard error = .22; p = .03); parent-adolescent relationship quality did not mediate this association.

CONCLUSIONS

Early maturation is associated with lower romantic relationship quality in young adulthood. However, evidence of the association varies by measure of pubertal timing, and the processes by which pubertal timing is linked to later relationship quality may be different for sexual minority and heterosexual females. Potential explanations and public health implications are discussed.

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±1.4years; 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.