Childhood behavior problems and age at first sexual intercourse: a prospective birth cohort study

Specifying the timescale of early life unpredictability helps explain the development of internalising and externalising behaviours

Early life unpredictability is associated with both physical and mental health outcomes throughout the life course. Here, we classified adverse experiences based on the timescale on which they are likely to introduce variability in children's environments: variations unfolding over short time scales (e.g., hours, days, weeks) and labelled Stochasticity vs variations unfolding over longer time scales (e.g., months, years) and labelled Volatility and explored how they contribute to the development of problem behaviours. Results indicate that externalising behaviours at age 9 and 15 and internalising behaviours at age 15 were better accounted for by models that separated Stochasticity and Volatility measured at ages 3 to 5. Both externalising and internalising behaviours were specifically associated with Volatility, with larger effects for externalising behaviours. These findings are interpreted in light of evolutionary-developmental models of psychopathology and reinforcement learning models of learning under uncertainty.

Effect of women's fertility and sexual development on epigenetic clock: Mendelian randomization study

BACKGROUND AND OBJECTIVES

In observational studies, women's fertility and sexual development traits may have implications for DNA methylation patterns, and pregnancy-related risk factors can also affect maternal DNA methylation patterns. The aim of our study is to disentangle any potential causal associations between women's fertility and sexual development traits and epigenetic clocks, as well as to search for probable mediators by using the Mendelian randomization (MR) method.

METHODS

Instrumental variables for exposures, mediators, and outcomes were adopted from genome-wide association studies data of European ancestry individuals. The potential causal relationship between women's fertility and sexual development traits and four epigenetic clocks were evaluated by inverse variance weighted method and verified by other two methods. Furthermore, we employed multivariable MR (MVMR) adjusting for hypertension, hyperglycemia, BMI changes, and insomnia. Then, combining the MVMR results and previous research, we performed two-step MR to explore the mediating effects of BMI, AFS, and AFB. Multiple sensitivity analyses were further performed to verify the robustness of our findings.

RESULTS

Leveraging two-sample MR analysis, we observed statistically significant associations between earlier age at first birth (AFB) with a higher HannumAge, PhenoAge and GrimAge acceleration(β = - 0.429, 95% CI [- 0.781 to - 0.077], p = 0.017 for HannumAge; β = - 0.571, 95% CI [- 1.006 to - 0.136], p = 0.010 for PhenoAge, and β = - 1.136, 95% CI [- 1.508 to - 0.765], p = 2.03E-09 for GrimAge respectively) and age at first sexual intercourse (AFS) with a higher HannumAge and GrimAge acceleration(β = - 0.175, 95% CI [- 0.336 to - 0.014], p = 0.033 for HannumAge; β = - 0.210, 95% CI [- 0.350 to - 0.070], p = 0.003 for GrimAge, respectively). Further analyses indicated that BMI, AFB and AFS played mediator roles in the path from women's fertility and sexual development traits to epigenetic aging.

CONCLUSIONS

Our study suggested that AFS and AFB are associated with epigenetic aging. These findings may prove valuable in informing the development of prevention strategies and interventions targeted towards women's fertility and sexual development experiences and their relationship with epigenetic aging-related diseases.

Risk Factors for Early Sexual Intercourse in Adolescence: A Systematic Review of Cohort Studies

This systematic review provides a comprehensive assessment of risk factors related to early sexual intercourse (ESI) among adolescents. We used PRISMA guidelines to identify eligible cohort studies published between January 1999 and December 2020. We searched on three databases: PubMed, Embase and LILACS. Studies were screened for quality and eligibility. Of 2787 identified studies, seven met our inclusion criteria. The studies examined a range of factors, which were organized into four dimensions - individual, family, social and environmental, and sociodemographic. Risk factors with strong associations for ESI were: adolescent and parental substance use, aggression and conduct disorders, family attachment, school achievement, family living situation, and maternal education. Three studies were birth cohorts. This review demonstrates the important roles of substance use, family attachment and academic factors in shaping adolescents' sexual behavior. A strength of this review is its focus on longitudinal studies, enabling exploration of exposures collected before initiation of sexual intercourse.

Perhaps It Was Too Soon: College Students' Reflections on the Timing of Their Sexual Debut

Early sexual debut has been a focus of social scientific research due to its association with adverse circumstances and negative outcomes. However, there has been a recent shift to considering not only chronological age, but also the degree to which the event is viewed to be optimally timed (i.e., the perception that it occurred at the "right time" versus too soon). The purpose of this study was to assess how individual/family background variables and contextual aspects of the experience (including partner and relationship aspects) are associated with both the actual age at sexual debut and the perceived acceptability of the timing of the event. Using data collected from students at a U.S. university between 1990 and 2019 (N = 6,430), several factors (in addition to chronological age) were associated with the perceived acceptability of the timing of sexual debut. Strong gender differences were found - women perceived their timing to be less acceptable, even though they did not differ from men in actual age at sexual debut. Other robust predictors of perceived acceptability included (lower) religious involvement and recalling desire (for the experience), pleasure, and lower guilt at the time. Only slight changes occurred over the 30-year period in age at sexual debut and perceived acceptability of the timing. Suggestions for future research are provided and implications for sex education/sexual health interventions are discussed.

Mental health and behavioural factors involved in road traffic crashes by young adults: analysis of the Raine Study

BACKGROUND

Road traffic crashes (RTC) are a leading cause of mortality and morbidity in young people. Severe mental health and behavioural conditions increase the likelihood of RTC, as do a range of driving-risk activities.

METHOD

We used data from the Raine Study, a prebirth cohort from Perth, Australia, to assess the relationship between measures of common mental health or behavioural conditions (Child Behavior Checklist Internalising and Externalising scores) at age 17 and subsequent RTC by 27 years, controlling for substance use and driving-risk activities.

RESULTS

By 27 years of age, of 937 participants, 386 (41.2%) reported zero crashes and 551 (58.8%) reported ≥1 crashes. In the baseline Poisson model, increased Externalising scores (eg, aggression and delinquency) were associated with increased RTC (incidence rate ratio (IRR)=1.02, 95% CI 1.01 to 1.02): increased Internalising scores (eg, anxiety and depression) were associated with fewer RTC (IRR=0.99, 95% CI 0.98 to 1.00). In the fully adjusted model, the mental health measures were not significant (Externalising IRR=1.01, 95% CI 0.99 to 1.02: Internalising IRR=0.99, 95% CI 0.99 to 1.00). Risky driver activities, such as falling asleep while driving (IRR=1.34), more frequent use of a hands-free telephone (IRR=1.35) and more frequent hostility towards other drivers (IRR=1.30) increased the rate of RTC.

CONCLUSION

Measures of mental health scores at age 17 were not predictive of subsequent RTC, after adjusting for measures of driving-risk activities. We need to better understand the determinants of externalising and risky driving behaviours if we are to address the increased risk of RTC.

Risky sexual behaviour among Russian adolescents: association with internalizing and externalizing symptoms

BACKGROUND

Risky sexual behaviour (RSB) is regarded as a major health problem during adolescence. Russia has one of the highest rates of teenage pregnancy, abortion and newly diagnosed HIV infections in the world, but research on RSB in Russian youth has been limited. To address this deficit, this study examined the role of several factors, including internalizing and externalizing symptoms, in RSB among Russian adolescents.

METHODS

Self-reported data were collected from 2573 Russian adolescents aged 13-17 years old (59.4 % girls; Mean age = 14.89) regarding RSB (unprotected sex, early pregnancy, multiple sexual partners and substance use during sexual encounters). Information was also obtained on externalizing (conduct problems and delinquent behaviour) and internalizing (depression, anxiety and posttraumatic stress) symptoms, as well as interpersonal risk and protective factors (affiliation with delinquent peers, parental involvement and teacher support). Hierarchical multiple binary logistic regression analysis was used to examine the associations between these variables and RSB.

RESULTS

Boys reported engaging in more RSB than girls. Externalizing symptoms and affiliation with delinquent peers were most strongly associated with RSB, whereas symptoms of anxiety were negatively associated with RSB. There was an interaction effect for sex and affiliation with delinquent peers on RSB with boys reporting RSB when having more delinquent peers. Neither parental involvement nor teacher support were protective against RSB.

CONCLUSIONS

Early detection of and interventions for RSB and associated externalizing symptoms may be important for adolescent physical and mental wellbeing. Affiliation with delinquent peers should, especially among boys, be regarded as a risk marker for RSB.

Factors associated with risk behaviors in adolescence: a systematic review

OBJECTIVE

Understanding the distal (≤ 6 years of age) and proximal (between 6 years of age and early adolescence) factors in adolescent risk behavior is important for preventing and reducing morbidity and mortality in this population. This study sought to investigate the factors associated with the following adolescent risk behaviors: i) aggressiveness and violence, ii) tobacco, alcohol, and illicit substance use, iii) depressive behavior and self-harm (including suicidal ideation and attempts), iv) sexual risk behavior, and v) multiple risk behavior.

METHODS

A systematic review was conducted to identify longitudinal studies that examined factors associated with adolescent risk behaviors. The PubMed, PsycINFO, and LILACS databases were searched.

RESULTS

Of the 249 included studies, 23% reported distal risk factors, while the remaining reported proximal risk factors. Risk factors were related to sociodemographic characteristics (neighborhood, school, and peers), family patterns, and the presence of other adolescent risk behaviors.

CONCLUSION

Distal and proximal factors in adolescent risk behavior that are not exclusively socioeconomic, familial, environmental, or social should be explored more thoroughly.

Prenatal environmental exposures and associations with teen births

BACKGROUND

Children's prenatal exposure to multiple environmental chemicals may contribute to subsequent deficits in impulse control, predisposing them to risk-taking.

OBJECTIVE

Our goal was to investigate associations between prenatal exposure mixtures and risk of teen birth, a manifestation of high-risk sexual activity, among 5865 girls (1st generation) born in southeast Massachusetts from 1992-1998.

METHODS

Exposures included prenatal modeled polychlorinated biphenyls (PCBs), ρ,ρ'-dichlorodiphenyl dichloroethylene (DDE), hexachlorobenzene (HCB), lead (Pb), and mercury (Hg). We fit adjusted generalized additive models with multivariable smooths of exposure mixtures, 1st generation infant's birth year, and maternal age at 1st generation birth. Predicted odds ratios (ORs) for teen birth were mapped as a function of joint exposures. We also conducted sensitivity analyses among 1st generation girls with measured exposure biomarkers (n = 371).

RESULTS

The highest teen birth risk was associated with a mixture of high prenatal HCB, Hg, Pb, and PCB, but low DDE exposure, with similar associations in sensitivity analyses. The highest OR predicted for girls born in 1995 to mothers of median age (26 years) was at the 95th percentile of the HCB and PCB exposure distributions (OR = 3.09; 95% confidence interval: 0.29, 32.4). Additionally, girls born earlier in the study period or to teen mothers were at increased risk of teen birth.

SIGNIFICANCE

Prenatal environmental chemical exposures and sociodemographic characteristics may interact to substantially increase risk of teen births.

Assessing the relation of chemical and non-chemical stressors with risk-taking related behavior and adaptive individual attributes among adolescents living near the New Bedford Harbor Superfund site

BACKGROUND

Early life exposure to neurotoxicants and non-chemical psychosocial stressors can impede development of prefrontal cortical functions that promote behavioral regulation and thereby may predispose to adolescent risk-taking related behaviors (e.g., substance use or high-risk sexual activity). This is particularly concerning for communities exposed to multiple stressors.

METHODS

This study examined the relation of exposure to mixtures of chemical stressors, non-chemical psychosocial stressors, and other risk factors with neuropsychological correlates of risk-taking. Specifically, we assessed psychometric measures of both adverse behavioral regulation and adaptive attributes among adolescents (age ∼ 15 years) in the New Bedford Cohort (NBC), a sociodemographically diverse cohort of 788 children born 1993-1998 to mothers residing near the New Bedford Harbor Superfund site. The NBC includes biomarkers of prenatal exposure to organochlorines and metals; sociodemographic, parental and home characteristics; and periodic neurodevelopmental assessments. We modelled exposure mixtures using multi-dimensional smooths within generalized additive models.

RESULTS

Children of younger mothers with lower IQ who were exposed prenatally to higher polychlorinated biphenyls and lead had poorer anger control. This pattern was not apparent for children of older mothers with higher IQs. Direction of associations between increased hyperactivity and prenatal levels of organochlorine mixtures differed by maternal age and depression symptoms. Higher cord blood Pb levels, in conjunction with poorer HOME scores, were associated with poorer self-esteem when mothers had fewer depression symptoms.

CONCLUSIONS

Analyses suggest that prenatal chemical exposures and non-chemical factors interact to contribute to neuropsychological correlates of risk-taking behaviors in adolescence. By simultaneously considering multiple factors associated with adverse behavioral regulation, we identified potential high-risk combinations that reflect both chemical and psychosocial stressors amenable to intervention.

Prospective cohort study of childhood behaviour problems and adolescent sexual risk-taking: gender matters

Background Externalising (delinquent, aggressive) and internalising (anxious/depressed, withdrawn) behaviour problems are prevalent in childhood. Few studies have prospectively measured relationships between childhood behaviour problems and adolescent health risk behaviour, a major predictor of morbidity and mortality. This study sought to determine relationships, by gender, between childhood behaviour problems and adolescent risky sexual behaviours and substance use.

METHODS

In a population-based birth cohort [The Western Australian Pregnancy Cohort (Raine) Study], total, externalising and internalising behaviour problems (domain-specific T≥60) were calculated from parent-reported Child Behavior Checklist at ages 2, 5, 8, 10 and 14 years. At age 17 years, 1200 (49% male) participants reported sexual and substance use activity Results: For both genders, those with earlier externalising behaviour problems were more likely to be sexually active (oral sex or sexual intercourse) by age 17 years. Males with childhood externalising behaviour problems were more likely to have multiple sexual partners by age 17 years than those without such problems [adjusted odds ratio (aOR) 2.96, 95% confidence interval (CI) 1.49-5.86]. Females with childhood externalising behaviour problems were more likely to have had unwanted sex (aOR 1.91, 95% CI 1.04-3.53). Externalising behaviour problems were associated with substance use for both genders. No association was found between internalising behaviour problems and risky behaviour.

CONCLUSIONS

Externalising behaviour problems from as early as 5 years old in boys and 8 years old in girls predict a range of risky sexual behaviour in adolescence, which has important implications for targeting interventions in adolescence.

Paternal Incarceration and Early Sexual Onset among Adolescents

Despite a growing literature documenting deleterious intergenerational consequences of incarceration, relatively little is known about how exposure to paternal incarceration is associated with risk behaviors in adolescence. In this article, we use data from the Fragile Families and Child Wellbeing Study (N = 3,405)-a cohort of urban children born around the turn of the 21st century and followed for 15 years-to examine the relationship between paternal incarceration and one indicator of adolescent risk behavior, early sexual onset. Results from adjusted logistic regression models show that paternal incarceration is associated with a greater likelihood of initiating sexual activity before age 15, in part resulting from externalizing problems that follow paternal incarceration. We also find that these associations are concentrated among boys living with their fathers prior to his incarceration. Given that paternal incarceration is a stressor concentrated among already vulnerable children, paternal incarceration may exacerbate inequalities in adolescent sexual risk behavior.

Perceptions of Physical Sexual Health Among Young Men Who Have Sex with Men with a Previous History of Childhood Sexual Abuse

Childhood sexual abuse (CSA) has been reported to be disproportionately higher among young men who have sex with men (YMSM) than among heterosexual men. Most research and public health programs among YMSM CSA survivors have been mainly infectious disease-based, and research on the physical sexual health among this group is limited. This study sought to further understand components of physical sexual health among YMSM with CSA histories. Sixteen participants were recruited, and through a phenomenological approach, semi-structured interviews were conducted. Four themes were found, participants (1) reported a one-dimensional definition of sexual health; (2) had limitations in health insurance hindering preventative care; (3) described reoccurring anal pain during sexual intercourse; and (4) conveyed a positive perception of sexual satisfaction. These findings indicate a need for healthcare providers, health educators, and researchers to increase awareness about the comprehensive needs of YMSM with CSA histories.

Associations of parental alcohol use disorders and parental separation with offspring initiation of alcohol, cigarette and cannabis use and sexual debut in high-risk families

BACKGROUND AND AIMS

Parental alcohol use disorders (AUDs) and parental separation are associated with increased risk for early use of alcohol in offspring, but whether they increase risks for early use of other substances and for early sexual debut is under-studied. We focused on associations of parental AUDs and parental separation with substance initiation and sexual debut to (1) test the strength of the associations of parental AUDs and parental separation with time to initiation (age in years) of alcohol, tobacco and cannabis use and sexual debut and (2) compare the strength of association of parental AUD and parental separation with initiation.

DESIGN

Prospective adolescent and young adult cohort of a high-risk family study, the Collaborative Study on the Genetics of Alcoholism (COGA).

SETTING

Six sites in the United States.

PARTICIPANTS

A total of 3257 offspring (aged 14-33 years) first assessed in 2004 and sought for interview approximately every 2 years thereafter; 1945 (59.7%) offspring had a parent with an AUD.

MEASUREMENTS

Diagnostic interview data on offspring substance use and sexual debut were based on first report of these experiences. Parental life-time AUD was based on their own self-report when parents were interviewed (1991-2005) for most parents, or on offspring and other family member reports for parents who were not interviewed. Parental separation was based on offspring reports of not living with both biological parents most of the time between ages 12 and 17 years.

FINDINGS

Parental AUDs were associated with increased hazards for all outcomes, with cumulative hazards ranging from 1.19 to 2.71. Parental separation was also an independent and consistent predictor of early substance use and sexual debut, with hazards ranging from 1.19 to 2.34. The strength of association of parental separation with substance initiation was equal to that of having two AUD-affected parents, and its association with sexual debut was stronger than the association of parental AUD in one or both parents.

CONCLUSIONS

Parental alcohol use disorders (AUDs) and parental separation are independent and consistent predictors of increased risk for early alcohol, tobacco and cannabis use and sexual debut in offspring from families with a high risk of parental AUDs.

Parental Time of Returning Home From Work and Child Mental Health Among First-Year Primary School Students in Japan: Result From A-CHILD Study

Introduction: Child mental health is known to be influenced by parental work hours. Although literature suggests that parent-child interaction mediates the association, few studies have directly measured the parental time of returning home from work. We analyzed data from a school-based survey to examine the association between parental time of returning home from work and child mental health. Methods: We used a sample of 2,987 first-year primary school students derived from the Adachi Child Health Impact of Living Difficulty (A-CHILD) study that examined the impact of family environment and lifestyle on child health in Adachi City, Tokyo, Japan. We analyzed the associations between reported parental time of returning home and the continuous Strengths and Difficulties Questionnaire (SDQ) scores using multivariable regression modeling. Results: Children whose parents both returned home late (later than 6 p.m. for the mother and later than 8 p.m. for the father), or at irregular times, had higher scores in total difficulties (β = 1.20, 95% CI: 0.55 to 1.85), the "conduct problems" subscale (β = 0.37, 95% CI: 0.13 to 0.60), and the hyperactivity/inattention subscale (β = 0.53, 95% CI: 0.24 to 0.82) compared with children whose parents both returned home earlier. Mediation analyses indicated that the percentage of the total association between parental time of returning home and the SDQ scores, which was mediated by parent-child interaction, was 20% (95% CI: 10 to 46) for total difficulties, 17% (95% CI: 7 to 49) for conduct problems, and 23% (95% CI: 11 to 52) for hyperactivity/inattention. Conclusions: Late or irregular returning home times for both parents had an adverse effect on child mental health, and the relationship was partly mediated by reduced frequency of parent-child interaction.

Seeking sexual health information? Professionals' novel experiences of the barriers that prevent female adolescents seeking sexual health information

Objective Sexual health professionals are key stakeholders in implementing sexual health intervention programmes, yet their views are largely absent from the literature. Sexual health professionals provide a unique perspective on teen sexual health issues as they engage in confidential discussions with a wide range of teenagers. This study aimed to provide an in-depth exploration of professionals' perceptions of teenagers' sexual health information seeking practices and barriers. Furthermore, the research provided a unique re-examination of key predictors of risky sexual behaviours, which have been highlighted by previous research. Methods Nine semi-structured interviews were undertaken with sexual health professionals to explore their perceptions of teenagers' sexual health information seeking practises and barriers. Subsequently the professionals rank ordered the 57 factors identified in previous research in terms of their perceived importance in predicting risky sexual behaviours. Results Four themes emerged: "society and media"; "environment and family"; "peer influences"; and "the self". The rank order task confirmed that 33 of the 57 factors were perceived as highly important by sexual health professionals. Conclusion Society, peers, environment and family are perceived as barriers to teenagers seeking reliable sexual health information, but these are dependent on the individual person. An individual with higher self-esteem is more confident in seeking sexual health information and applying this knowledge appropriately. Self-esteem was also identified as a key perceived predictor of risky sexual behaviours. Therefore, there is scope for intervention programmes targeting self-esteem and knowledge, so teenagers have the confidence to seek out sexual health information and to make their own informed sexual health decisions.

The physiology of adolescent sexual behaviour: A systematic review

Objectives: To examine physiological influences of adolescent sexual behaviour, including associated psychosocial factors. Methods: Systematic review. Results: Thirteen studies met the inclusion criteria relating to adolescents, physiology and sexual behaviour. We excluded studies relating to abnormal development. Findings highlighted hormonal and gender differences. Females appear to be more influenced by psychosocial aspects, including the effects of peers, than males. Males may be more inclined to engage in unprotected sex with a greater number of partners. Early maturing adolescents are more likely to be sexually active at an early age. Conclusions: Hormonal, psychosocial context, and sexual preference need to be acknowledged in intervention development. Stage of readiness to receive information may differ according to gender and physiological maturity.

Early sexual debut in Norwegian youth with epilepsy: A population-based study

OBJECTIVES

In comparison with controls, youth with epilepsy (YWE) have greater psychosocial problems. However, information about their sexual behavior is sparse. We have performed a large, population-based questionnaire study to examine differences in sexual behavior between YWE and controls.

METHODS

A randomly chosen cohort of youth (13-19 years) from Akershus county, Norway (n=19,995) was asked to complete a questionnaire anonymously with questions on epilepsy and sexual activity.

RESULTS

The response rate was 85%. Two hundred forty-seven participants reported having or having had epilepsy, i.e., a lifetime epilepsy prevalence of 1.2%. Compared with controls, a higher proportion of YWE reported having had sexual intercourse (43.6% vs. 35.3%, p=0.009). The mean age at sexual debut was significantly lower in YWE than in controls (14.0 years vs. 15.0 years, p<0.001), and this was particularly marked among boys. A higher proportion of YWE reported not having used contraceptives at their last sexual intercourse compared with controls (31.6% vs. 22.3%, p=0.03). Ten percent of YWE, compared with 2% of the controls, reported that they had been forced into their first sexual intercourse.

CONCLUSION

In YWE, some aspects of sexual behavior differ from those of their peers, with earlier sexual debut and less frequent use of contraceptives. More attention should be directed toward this subject, aiming at avoiding unwanted pregnancies and potential emotional traumas in this already vulnerable patient group.

Effects of prenatal cocaine exposure on early sexual behavior: Gender difference in externalizing behavior as a mediator

BACKGROUND

Prenatal cocaine exposure (PCE) is associated with increased risk for externalizing behavior problems; childhood externalizing behavior problems are linked with subsequent early sexual behavior. The present study examined the effects of PCE on early sexual initiation (sexual intercourse prior to age 15) and whether externalizing behavior in preadolescence mediated the relationship.

METHODS

Three hundred fifty-four (180 PCE and 174 non-cocaine exposed; 192 girls, 142 boys), primarily African-American, low socioeconomic status, 15-year-old adolescents participated in a prospective longitudinal study. Adolescents' sexual behavior was assessed at 15 years using the Youth Risk Behavior Surveillance System. Externalizing behavior was assessed at 12 years using the Youth Self-Report.

RESULTS

Logistic regression models indicated that adolescents with PCE (n=69, 38%) were 2.2 times more likely (95% CI=1.2-4.1, p<.01) to engage in early sexual intercourse than non-exposed peers (n=49, 28%) controlling for covariates. This relationship was fully mediated by self-reported externalizing behavior in girls but not in boys, suggesting childhood externalizing behavior as a gender moderated mediator. Blood lead level during preschool years was also related to a greater likelihood of early sexual intercourse (OR=2.6, 95% CI=1.4-4.7, p<.002). Greater parental monitoring decreased the likelihood of early sexual intercourse, while violence exposure increased the risk.

CONCLUSIONS

PCE is related to early sexual intercourse, and externalizing behavior problems mediate PCE effects in female adolescents. Interventions targeting externalizing behavior may reduce early sexual initiation and thereby reduce HIV risk behaviors and early, unplanned pregnancy in girls with PCE.