Adolescent sexual activity and pregnancy: Socioenvironmental problems,physical health,and mental health

This paper examines the association between adolescent pregnancy and socioenvironmental, physical, and mental health problems in 1590 inner-city females aged 13–18 who use health clinics. Adolescents who have become pregnant, those who are sexually active but never have been pregnant, and those who are sexually inactive are compared. The sexually active youngsters come from more psychosocially disadvantaged backgrounds than their sexually inactive peers; the sexually active girls who become pregnant come from more psychosocially disadvantaged backgrounds than those who have never been pregnant. Despite this, the youths who have become pregnant do not have more current relationship problems, more stressful life events, or worse physical health than the never-pregnant sexually active youths. Although sexually inactive youths have the lowest rates of mental health problems, adolescents who have been pregnant have lower rates of anxiety and conduct disorder symptoms than those who are sexually active but never pregnant.Supported by the Robert Wood Johnson Foundation. Fieldwork conducted by Survey Research Associates.Research interests include adolescents and children, parenting, and families.Research interests include epidemiology of child and adolescent psychiatric disorder.Research interests include psychiatric epidemiology/deviant behavior.Research interests include mental health and statistical issues.Research interests include health behavior and mental health issues.     

Sexually active but not pregnant: A comparison of teens who risk and teens who plan

Previous studies have compared contraceptive users with nonusers, and pregnant teens with nonpregnant ones. This paper reports the findings of a study of a sample of 119 women aged 21 and under who visited the Young Adult Clinic at Columbia-Presbyterian Medical Center in New York City during 1981. All of these women had been sexually active for a year or longer, but had never been pregnant. The expectation that such a sample would include mainly consistent users of contraception was unwarranted; within this special population were found young women who had never used contraception or who had only been sporadic users, as well as the consistent users. Moreover, there are many more similarities than differences among these groups, and their stated motivations for not becoming pregnant are the same. The consistent contraceptors were more likely to live with their mothers, to have mothers who worked, to indicate that their parents would help them have an abortion, and to indicate they would have an abortion should they become pregnant. The similarities between these young women are very important for programs, which often rely heavily on stated motivation or even on a clinic visit as evidence that a young woman intends to use a birth control method. There is nothing here to support this simple view. Instead the notion is substantiated that many adolescents may lack cognitive consistency on this subject or may lack the future orientation to be effective contraceptive users.     

Contraceptive behavior in adolescence: A decision-making perspective

The contraceptive behavior of adolescent girls was viewed from a decision-making perspective. A semistructured interview protocol was used in interviewing 120 girls aged 12–19 in three clinics (Teen Family Planning, Prenatal, Pediatric Acute Care) at Michael Reese Hospital and Medical Center on (1) demographic in formation; (2) sexual and obstetric history; (3) contraceptive and sexual knowledge, attitudes, and practices; (4) environmental pressures; (5) personality factors; and (6) decision-making style. We found that the girls were generally poor contraceptors. They viewed the costs of contraception (in terms of safety) to be high; and they positively valued physical intimacy, opportunities for which come up unexpectedly and sporadically. These factors, along with their ambivalent views toward pregnancy and childbearing seemed to encourage their risk-taking behavior. Once pregnancy occurred, it was carried to term because of the strong internal and external pressures they felt to have and keep the baby. The peer-led intervention program that we are developing based on the survey findings will focus on (1) the teenagers' lack of accurate and complete knowledge about birth control and conception, (2) their limited sense of options concerning birth control and pregnancy outcomes, and (3) their poor understanding of and lack of insight into what motivates their behavior.This study is part of the investigation being conducted by the YADMAC (Young Adult and Adolescent Decision Making About Contraception) Project at Michael Reese Hospital and Medical Center, 2959 South Cottage Grove, Chicago, Illinois 60616. The authors are all members of the YADMAC research team.Received Ph.D. from the University of Chicago. Current interests are human sexuality and reproductive behavior. Currently at Department of Psychology, St. Xavier College.Received M.D. from the University of Michigan. Current interests are liaison child psychiatry and adolescent sexuality.Received Ph.D. from the University of Chicago. Current interests are early adolescent development issues.Current interests are puberty and sex differences.B. A. candidate in social work, Roosevelt University. Current interests are adolescent sexuality and contraceptive behavior.     

Family life education for young inner-city teens: Identifying needs

Sexual decision making, perceptions of responsibility for birth control and pregnancy, and knowledge of contraception and the consequences of teenage pregnancy were assessed among 251 high-risk seventh- and eighth-grade black, inner-city adolescents to determine these young peoples' need for information. Survey results indicated that these adolescents were aware of contraceptive methods, but lacked practical information about requirements for obtaining them or method effectiveness. Many students were uninformed about the circumstances under which pregnancy can occur. Males indicated a willingness to have intercourse, regardless of the contraceptives used, if any, and believed responsibility for use of a birth control method belonged to females. Females believed themselves to be responsible for contraceptive utilization and preferred intercourse with adequate protection. Both genders endorsed the notion of mutual responsibility for an unplanned pregnancy and related decisions. Implications for school-based family life education programs for young adolescents are discussed.This research was supported by grants from the Illinois Department of Children and Family Services and the Pittway Charitable Trust, to the Center for Health Services and Policy Research of Northwestern University; the project was administered by the Ounce of Prevention Fund. Portions of this paper were presented at the 112th annual meeting of the American Public Health Association at Anaheim, California, November 1984. Conclusions or opinions expressed in this article are those of the authors and do not necessarily reflect the views of the Center for Population Options, Northwestern University, or the State University of New York at Buffalo.Received Ph.D. from Loyola University of Chicago. Major interests include policy analysis and maternal and child health care.Received Ph.D. from the State University of New York at Buffalo. Major interests include evaluation of the effectiveness of maternal and child health services.     

Pregnancy in early and late adolescence

The degree to which adolescent pregnancy is viewed as a social problem varies with the age of the adolescent: the younger the adolescent, the greater the perceived risks and costs. The young adolescent has been found to be at greater risk medically; both the young adolescent and her infant are subject more frequently to prenatal and postpartum complications. A sample of 130 pregnant adolescents and adolescent mothers was surveyed to determine the factors that discriminate between girls who become pregnant in early years versus late adolescence. The younger group had begun dating and particularly steady dating at a significantly earlier age than the older group. The age discrepancy between the groups is even greater for the average age at which subjects began steady dating, that is, dating 1 boyfriend exclusively. While ages at which the adolescent began dating and particularly steady dating were found to be significantly related to early pregnancy, this vulnerability was increased by the subjects' lack of knowledge and use of birth control. Subjects in both groups reported that prior to pregnancy they desired quite frequently to leave their parents' home and be on their own. Early pregnancy appeared instead to have increased the adolescents' dependence upon her parents, especially the mother. The findings point to a need for instruction in reproduction and birth control to begin at an earlier age. Opportunity is needed for guided discussion among peers about their feelings regarding the costs and benefits of relationships and how one might deal with potential problems.     

Family life education for young adolescents: A quasi-experiment

The impact of a family life education program for inner-city, minority elementary-school students was investigated. Two randomly assigned groups of seventh and eighth graders (balanced for gender) completed a self-administered survey, both before and after program implementation. In comparison to the control group, program participants displayed (a) improved knowledge about contraception, reproductive physiology, and adolescent pregnancy outcomes; (b) increased awareness of the existence of specific birth control methods; (c) among seventh graders, more conservative attitudes toward circumstances under which sexual intercourse was viewed as personally acceptable, and among eighth graders, a shift toward more liberal attitudes; and (d) a greater tendency to acknowledge mutual responsibility for contraception. The impact of this intervention and school-based sex education programs in general is discussed within the broader context of the young adolescent's social environment.This research was supported by grants from the Illinois Department of Children and Family Services and the Pittway Charitable Trust, and administered by the Ounce of Prevention Fund.Received Ph.D. from Loyola University Chicago.Received Ph.D. from the University of Michigan.Received Ph.D. from the State University of New York at Buffalo.     

The Influences of Family and Place on Rural Adolescents’ Educational Aspirations and Post-secondary Enrollment

Despite the large contingent of students living in rural areas, existing research on the processes that precede the college enrollment of rural adolescents is limited. With a particular focus on gender, this study investigated rural adolescents’ perceptions of family and place and how these perceptions related to their educational aspirations and subsequent college enrollment using a nationwide sample of rural adolescents (N?=?3456; 52.5% female). Female adolescents reported higher academic achievement, educational aspirations, parental expectations, and family responsibility and enrolled in two-year and four-year institutions at greater rates compared to male adolescents, who reported significantly higher rural identity and perceptions of job opportunities in the rural community. Utilizing a multiple group moderated mediation approach, the results provided evidence that adolescents’ increased perceptions of their parents’ educational expectations were associated with increased educational aspirations and college enrollment and that adolescents’ increased perceptions of job opportunities in their rural community were associated with decreased educational aspirations. In addition, the results showed that gender moderated the relation between perceptions of job opportunities in the rural community and postsecondary enrollment. These findings highlight how the developmental resources of family and place relate to adolescents’ educational aspirations and subsequent postsecondary enrollment.     

Pregnancy in the single adolescent girl: The role of cognitive functions

Interviews were conducted with 211 single adolescent girls, free of known psychiatric disturbance, who had undergone an elective abortion at a metropolitan municipal hospital. Besides providing help for the possible emotional stress connected with their situation, it was learned to what extent they were acquainted with birth control methods and had actually attempted to avoid their pregnancy. Similar data relating to birth control were obtained in interviews with a group of 200 single adolescents pregnant for the first time, and from 50 girls serving as controls who had effectively practiced birth control for at least 6 months. The great majority of the girls came from the same socioeconomic background, close to the subsistence level. The results indicate that about three-fourths of the pregnancies were unintended. Besides the implied external difficulty involved in finding a congenial low-cost birth control clinic, three psychological cognitive mechanisms were uncovered which virtually block the conversion of birth control knowledge into its successful practice. This finding suggests that adolescent out-of-wedlock pregnancies do not exclusively arise from motivational factors.Received M.A. and Ph.D. in sociology from Columbia University, New York. Associated with René A. Spitz, M.D. (Denver), for many years. Collaborated on latter's book,The First Year of Life, International Universities Press, New York, 1965. Current interests are in psychology of adolescence and infancy; prenatal psychological phenomena.     

Gender differences in patterns of adolescent sexual behavior

The findings of a questionnaire survey of sexual attitudes and behavior of a large nationwide sample of Israeli adolescents (N=5410) show clear gender differences in patterns of sexual behavior even among kibbutz adolescents who express very permissive attitudes toward premarital coitus and live under conditions which provide easy access to potential sexual partners. Permissive conditions increase rates of coitus among female adolescents, but this sexual experience occurs within the framework of an emotionally involving relationship. Kibbutz girls who report coital rates equal to those of kibbutz and nonkibbutz boys (about 40%) have their first coital relationship with a steady boyfriend with whom they are in love and continue having sexual relations with the same partner. This pattern is similar to that of nonkibbutz females, who report much lower rates of coitus (14%). Males do not necessarily have sexual relations in the context of an emotional relationship. The findings are interpreted in terms of pattern of sex-role socialization.This study was supported by the Israel Center for Demographic Studies and by the Ministry of Health.Research interests are socialization, parent-child interaction, and cross-cultural research.Presently working on Ph.D. in public health at University of California, Berkeley.Research interests are child development and personality.Research interests are clinical obstetrics and gynecology, contraception, sex education, and family planning.Research interests are chronic disease epidemiology and research methodology.     

A comparative study of pregnant teenagers' parenting attitudes and knowledge of sexuality and child development

A survey was taken to determine pregnant teenagers' knowledge of sexuality and child development and their parenting attitudes relative to comparison groups. The results indicate that the knowledge and attitude base of pregnant teenagers is almost identical to that of never-pregnant teenagers. However, adult mothers scored slightly but significantly higher than the teenagers on a measure of child development knowledge and considerably lower than the teenagers on a measure of knowledge of sexuality. The results illustrate the importance of using comparison groups in studies of pregnant teenagers. The implications for sex education programs include focusing on factors beyond sexual knowledge or lack of it as an explanation for teenage pregnancy. Further research is needed on teenage values, handling of sexual information, and perception of contraceptive availability.     

Contextual Stress and Health Risk Behaviors Among African American Adolescents

This study examined the longitudinal association between contextual stress and health risk behaviors and the role of protective factors in a community epidemiologically-defined sample of urban African American adolescents (N = 500; 46.4% female). Structural equation modeling was used to create a latent variable measuring contextual stress (community violence, neighborhood disorder, and experiences with racial discrimination). Contextual stress in 8th grade was associated with aggressive behavior and substance use 2 years later for boys. For girls, contextual stress predicted later substance use, but not aggressive behavior. High academic competence and self-worth reduced the impact of contextual stress on substance use for boys. Implications for intervention and directions for future research on health risk behaviors among African American adolescents are discussed.     

Factors related to cigarette smoking during adolescent pregnancy

Previous research suggests that maternal smoking during pregnancy remains prevalent, particularly among adolescents. However, little is known about the factors related to smoking during adolescent pregnancy. The goal of the present study is to identify intrapersonal, familial, and peer factors that are related to smoking during adolescent pregnancy, and to determine the relative degree to which they affect this behavior. Interviews were conducted with 241 unmarried pregnant adolescents who planned to carry their pregnancies to term. Consistent with previous studies, 27% of the respondents reported daily smoking during pregnancy, and whites reported higher rates of use than members of other racial groups. Smoking during adolescent pregnancy was related to intrapersonal, familial, and peer factors. The results of a regression analysis suggest that perceived parental disapproval of smoking during pregnancy, friends' cigarette use, and race play a particularly important role in this behavior. The implications of these findings for preventive programs are discussed.Research reported here and the preparation of this report were supported by Grant DA-05208 from the National Institute on Drug Abuse.Received M.A. in sociology from the University of Washington. Research interests include health behaviors, and the relationship between social stratification and health.Received Ph.D. in social welfare from the University of Washington. Research interests are in adolescent development, gender issues in adolescent development, and health promotion and problem prevention with children and adolescents. Received Ph.D. in sociology from the University of Washington. Research interests are adolescent problem behaviors, and particularly adolescent sexual decision making.Received M.S. in educational psychology from the University of Wisconsin—Madison. Research interests: adolescent substance use, pregnancy and parenthood, and peer relations.     

Sexual Activity,Pregnancy, and Deviance in a Representative Urban Sample of African American Girls

The primary goal of this paper is to investigate the interrelationship between sexual activity, pregnancy, and deviance among a cohort of urban African American adolescent girls and compare the risk factors that predict these behaviors. The data are drawn from the Rochester Youth Development Study (RYDS), a multiwave panel study designed to examine the causes and correlates of delinquent behavior and drug use in a representative urban sample. This study relies on data from the 196 African American girls in the panel. Results indicate that girls who engage in early sexual activity and those who become pregnant are more likely to be involved in substance use and status offenses than girls who are not sexually active and who do not become pregnant. Additionally, sexual behavior and pregnancy are both influenced by socioeconomic disadvantage, unlike the other kinds of deviance examined. However, the proximal predictors of early sexual activity and pregnancy differ, with the profile of sexually active girls being more similar to the profile of girls involved in substance use and status offenses.     

Timing of first sexual intercourse: the role of social control,social learning,and problem behavior

Prior research has pointed to several distinct processes that may affect the timing of first intercourse among adolescents. In the present study, the role of six hypothesized processes was assessed in a sample of 289 rural adolescent boys and girls. Results support the importance of family socialization and problem-behavior for both sexes, the role of biological factors for boys, and the role of social control processes for girls. Two other hypothesized influences—social class and poor psychosocial adjustment—were not supported in either gender. These results indicate that multiple processes influence the timing of first intercourse; thus, they underscore the need for eclectic predictive models that incorporate the multiplicity of influences.Received Ph.D. in Human Development from the University of Chicago. Current research interests include adolescent psychosocial development and risk behaviors.Received Ph.D. in Human Development and Family Studies from the Pennsylvania State University. Current research interests include adolescent sexuality and health-related behaviors.Received Ph.D. in Health Education from The Pennsylvania State University. Current research interests include adolescent health.Received Ph.D. in Education from The Pennsylvania State University. Current interests include adolescent substance abuse and pregnancy, as well as community health interventions.     

Effect of Major Depression on the Self-Image of Adolescent Boys and Girls

We investigated the specific impact of major depressive disorder (MDD) on the self-image of adolescent boys and girls seeking outpatient treatment. We used the Offer Self-Image Questionnaire (OSIQ) to compare 68 adolescents with MDD and 39 adolescents with no diagnosis of psychiatric illness according to the Structural Clinical Interview for DSM-III-R (SCID). Self-image among MDD patients was in general poorer than in the comparison group and was particularly expressed as dissatisfaction with life and an impaired mastery of the environment. Logistic regression analysis showed S2 (Emotional Tone) to be an independent factor associated with MDD (OR 1.15). In girls S2 was also independently associated with MDD (OR 1.14). The effect of MDD on self-image was more negative in girls than in boys and the self-image pattern differed between the sexes.     

Mothers’ and Fathers’ Autonomy-Relevant Parenting: Longitudinal Links with Adolescents’ Externalizing and Internalizing Behavior

The goal of this study was to advance the understanding of separate and joint effects of mothers’ and fathers’ autonomy-relevant parenting during early and middle adolescence. In a sample of 518 families, adolescents (49 % female; 83 % European American, 16 % African American, 1 % other ethnic groups) reported on their mothers’ and fathers’ psychological control and knowledge about adolescents’ whereabouts, friends, and activities at ages 13 and 16. Mothers and adolescents reported on adolescents’ externalizing and internalizing behaviors at ages 12, 14, 15, and 17. Adolescents perceived their mothers as using more psychological control and having more knowledge than their fathers, but there was moderate concordance between adolescents’ perceptions of their mothers and fathers. More parental psychological control predicted increases in boys’ and girls’ internalizing problems and girls’ externalizing problems. More parental knowledge predicted decreases in boys’ externalizing and internalizing problems. The perceived levels of behavior of mothers and fathers did not interact with one another in predicting adolescent adjustment. The results generalize across early and late adolescence and across mothers’ and adolescents’ reports of behavior problems. Autonomy-relevant mothering and fathering predict changes in behavior problems during early and late adolescence, but only autonomy-relevant fathering accounts for unique variance in adolescent behavior problems.     

Adolescents' Willingness to Seek Psychological Help: Promoting and Preventing Factors

Although a relatively high percentage of Australian adolescents experience mental health problems, many disturbed adolescents do not receive the help they require, and only a small proportion of adolescents seek professional psychological help. The present study examined adolescents' willingness to seek help and investigated factors that promote and prevent adolescents from seeking help for a mental illness from both formal and informal sources. Secondary school students (254 in number) from schools in Brisbane, Australia completed a questionnaire that examined the relationship between demographic and psychological variables, attitudes toward mental illness, and willingness to seek help for a mental illness. Results suggest that adolescents with greater adaptive functioning, fewer perceived barriers to help seeking, and higher psychological distress were more willing to seek help from formal and informal sources for a mental illness. Greater social support also predicted willingness to seek help from informal sources. Although attitudes toward mental illness did not influence willingness to seek help, less stigmatising attitudes were related to higher knowledge of mental illness, being female, and higher levels of social support. Implications for the present study focus on enhancing the ability of mental health interventions to increase adolescents' willingness to seek psychological help.Received PhD from The University of Queensland     

“A Defeat not to Be Ultra-Fit”: Expectations and Experiences Related to Pregnancy and Employment in Contemporary Norway

Managing work while pregnant has long been a challenge for women in both paid and unpaid work. With Norway as the case in point, the aim of this study was to explore expectations and experiences among women relating to work-life and pregnancy health. Employing the constant comparison method, we drew on interviews, Internet discussions, newspapers, and health information booklets. The findings revealed strong discourses on pregnancy as health, and high expectations among pregnant women to be healthy, fit, and maintain their working capacity throughout pregnancy. Women who needed to slow down failed to fulfil these normative expectations and commonly experienced this as a personal defeat. Despite policies and regulations protecting women's pregnancy-related needs vis-à-vis their employer, some women hesitated to claim their eligibility to special rights. Many pregnant women overstretched, compromising their own health. This, we argue, reflects the ambiguity in policy and in the public debate. Ideas about pregnant women as a vulnerable group needing special protection on the one hand, and the expectations to perform as usual throughout pregnancy on the other, are discussed here in view of a gender-difference versus a gender-neutral discourse, the latter being foundational to the public debate on gender in contemporary Norway.