Promoting healthy sexuality: guidelines for the school-age child and adolescent

The purpose of this article is to provide the clinician with practical information to promote the healthy sexuality of the school-age child through adolescence. Much of the current literature related to sexuality is problem-focused; this article focuses on sexuality from a health promotion viewpoint. The development of a healthy sexuality is a life-long process with different issues and problems pertaining to each age group. Issues common to the school-age child and adolescent include changing physical characteristics and body image concerns. A set of guidelines has been developed that can be used in the clinical setting. In order to follow a holistic approach to health promotion with these age groups, the clinician must address sexuality. These guidelines will provide the information the clinician will need to initiate a discussion about sexuality. Patient education guidelines are also presented that will help the parent, child, and adolescent in sexual issues and understanding. Suggested reading materials about sexuality are also presented.     

Adolescent sexual risk-taking behavior in single-parent ethnic minority families.

Relationships of maternal sexual behavior, mother-adolescent communication about sex, and maternal attitudes about adolescent sexuality to adolescent sexual risk-taking behavior were examined in a sample of 397 Black and Hispanic families headed by single mothers. Some support emerged for a positive relationship between maternal sexual risk-taking behavior and adolescent risk-taking behavior; however, when considered in the context of communication about sex and maternal attitudes about adolescent sexuality, the relationship was no longer significant. When the process of sexual communication between a mother and an adolescent was open and receptive, less adolescent risk-taking behavior was reported. The role of single mothers in influencing their adolescents' sexual behavior is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social contagion, adolescent sexual behavior, and pregnancy: a nonlinear dynamic EMOSA model

Nonlinear dynamic modeling has useful developmental applications. The authors introduce this class of models and contrast them with traditional linear models. Epidemic models of the onset of social activities (EMOSA models) are a special case, motivated by J. L. Rodgers and D. C. Rowe's (1993) social contagion theory, which predict the spread of adolescent behaviors like smoking, drinking, delinquency, and sexuality. In this article, a biological outcome, pregnancy, is added to an earlier EMOSA sexuality model. Parameters quantify likelihood of pregnancy for girls of different sexuality statuses. Five different sexuality/pregnancy models compete to explain variance in national prevalence curves. One finding was that, in the context of the authors' simplified model, adolescent girls have an approximately constant probability of pregnancy across age and time since virginity.     

Violence and associated high-risk health behavior in adolescents. Substance abuse, sexually transmitted diseases, and pregnancy of adolescents

The intricate relationship between the social and health behaviors of persons of all ages has long been described. In adolescent health care, the risk-taking behaviors that are recognized in the areas of sexuality, drug and alcohol abuse, and violence need to be addressed. This article discusses adolescent risk behaviors and their relationships to violence. Health care providers need to consider these risk behaviors as they care for adolescents.     

Cultural suppression of female sexuality.

Four theories about cultural suppression of female sexuality are evaluated. Data are reviewed on cross-cultural differences in power and sex ratios, reactions to the sexual revolution, direct restraining influences on adolescent and adult female sexuality, double standard patterns of sexual morality, female genital surgery, legal and religious restrictions on sex, prostitution and pornography, and sexual deception. The view that men suppress female sexuality received hardly any support and is flatly contradicted by some findings. Instead, the evidence favors the view that women have worked to stifle each other's sexuality because sex is a limited resource that women use to negotiate with men, and scarcity gives women an advantage. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gender differences in adolescent sexual attitudes: the influence of individual and family factors

The present study, continuing a recent trend, examined multiple influences on adolescent sexuality, focusing on sexual attitudes because of their influence on sexual behavior. Empirical analyses were based on a nonrandom availability sample of 1,587 public high school students and 1,372 parents. Multiple regression analyses were conducted in three phases to elaborate models for adolescent attitudes about premarital sexual intercourse; separate models were developed for females and males. First, a regression model was developed that featured individual adolescent characteristics (e.g., age, gender, locus of control, self-esteem, and religious participation) as predictor variables. A second regression model was developed that included family characteristics (e.g., number of siblings, number of parents in home, communication with mother and father, family strengths, parent contribution to sexuality education, parental discussion of sexual values, and the sexual attitudes of mother and father). In the final step, multiple regression was conducted on both individual and family factors. Results indicated that (1) the integrated model had more explanatory power than either separate model, and (2) females were influenced by more family factors and males were influenced by more individual factors.     

Discussion of media influences and other selected issues in adolescent psychology texts.

Analyzed the content of 10 adolescent psychology textbooks published 1983–1985 and 15 published 1975–1982. Major issues were found to be sexuality, identity, and drug or alcohol use. Only 12 of the 25 textbooks studied discussed the effects of music and the media on adolescents. It is suggested that music and media influence on adolescents has been and continues to be an issue largely neglected or ignored in basic adolescent psychology texts. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social contagion and adolescent sexual behavior: A developmental EMOSA model.

Epidemic Models of the Onset of Social Activities (EMOSA models) describe the spread of adolescent transition behaviors (e.g., sexuality, smoking, drinking) through an interacting adolescent network. A theory of social contagion is defined to explain how social influence affects sexual development. Contacts within a network can, with some transition rate or probability, result in an increase in level of sexual experience. Five stages of sexual development are posited. One submodel proposes a systematic progression through these stages; a competing submodel treats each as an independent process. These models are represented in sets of dynamically interacting recursive equations, which are fit to empirical prevalence data to estimate parameters. Model adjustments are substantively interpretable and can be used to test for and better understand social interaction processes that affect adolescent sexual behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Daily Mood, Partner Support, Sexual Interest, and Sexual Activity Among Adolescent Women.

The main objective of this study was to examine day-to-day associations of coitus, sexual interest, partner emotional support, negative mood, and positive mood among adolescent women. Diaries assessed partner interactions, sexual activity, substance use, and mood. Participants were 146 adolescent women who provided 28,376 diary days. Correlates of coitus on a given day included age, increased coital frequency in previous week, coitus on the previous day, partner support, increased same-day sexual interest, and decreased same-day negative mood. The data demonstrate complex associations of sexual interest, mood, partner interactions, and sexual activity. The findings extend understanding of the sexuality of adolescent women and have implications for a variety of interventions to reduce sexually transmitted infections and unplanned pregnancies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adolescent sexual and reproductive behavior: a review of the evidence from India

Despite the fact that adolescents represent almost one quarter of the Indian population, their reproductive health needs are poorly understood and ill served. This paper documents the existing research on sexual and reproductive health, explores the knowledge and attitudes among this population in India, and highlights limitations of methodologies currently employed in research on adolescent reproductive health in India. One serious limitation is the lack of attention in almost every dimension of their reproductive health, including sexuality, reproductive morbidity, abortion-seeking and reproductive choice. What is needed is more behavioral research that explores the levels, patterns, and sociocultural factors underlying adolescents' reproductive health; assesses adolescent reproductive health needs and ways in which health and information services can be structured to respond to these needs in light of the social, cultural and economic constraints that adolescents face; and explores appropriate methodological alternatives, recognizing the need for community-based research, as well as the difficulties of conducting such research under the sociocultural constraints prevailing in India. At the same time, this review argues for far more attention within programs to address adolescent reproductive health service and information needs.     

Comment on "Social contagion, adolescent sexual behavior, and pregnancy: A nonlinear dynamic EMOSA model."

The epidemic model of the onset of social activities (EMOSA model) for adolescent sexuality by J. L. Rodgers, D. C. Rowe, and M. Buster (1998) is examined. Strengths of the model include the nonlinear dynamic specification that seems reasonably realistic and the potential when used as a theoretical tool to generate new hypotheses for further testing at the individual level. Limitations include the lack of a well-developed statistical framework, the inability to include a variety of predictors to capture both social contagion and individual differences in the same model, and the focus on aggregate-level data. The EMOSA model for sexuality can be reparameterized to a hazard rate or an event history model that eliminates these shortcomings. Growth curve analysis represents another analytic alternative for the EMOSA model that also does not have these limitations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The birds and the bees: an analysis of advice given to parents through the popular press

There is a growing need for parents to communicate with their adolescents about sexuality, as teenage pregnancies and sexually transmitted diseases are on the rise. Many parents indicate that they lack information and feel uncomfortable communicating with their children about sex. The popular press regularly publishes articles on parenting issues, including how to discuss sex. In this study, 26 articles from 1984 to 1993 were reviewed, and the tone, quality of information, and advice given to parents on how to communicate were analyzed. The articles reflected current research regarding parent-child sexual communication and provided much more detailed advice about how best to approach the topic with an adolescent. However, readership seemed to be primarily white and mothers in traditional families, and little advice was offered on how to handle more difficult issues, such as contraception and AIDS. The findings suggest that the popular press could serve as an informational vehicle for educating both youth and parents about sexuality and how to have productive discussions regarding this issue.     

How Latino American and European American adolescents discuss conflicts, sexuality, and AIDS with their mothers.

The authors examined how the structure of mother–adolescent conversations differs by ethnic group, age, and dyadic and individual factors. Mother–adolescent dyads of European or Latino descent participated in conversations and reported on their relationship and AIDS knowledge. Latina American mothers dominated conversations more than European American mothers, independent of socioeconomic status. Mothers dominated conversations about sexuality and AIDS more than conversations about conflicts. Mothers of older adolescents reacted more negatively, and older adolescents reported less satisfaction, less openness, and more sexual discussions with persons other than their mothers. Latino American adolescents whose mothers dominated conversations more reported fewer sexual discussions. Latina American mothers who dominated conversations more reported more openness and satisfaction. When mothers dominated conversations more, adolescents had lower AIDS knowledge. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Calcium-activated transient membrane currents are carried mainly by chloride ions in isolated atrial, ventricular and Purkinje cells of rabbit heart

This article aims to show how the period now known as adolescence came into being and how it was shaped by international economic, institutional, and social influences. It considers premodern societies and argues that traditional culture has shaped contemporary adolescence even more than has global society. Explanations are offered for the enormous differences across the world in adolescent sexuality, reproduction, and marriage. The data are drawn mainly from research programs in Nigeria, Sri Lanka, India, and Bangladesh, and comparisons are made with other countries.     

Knowledge and attitudes toward sexuality in adolescents and their association with the family and other factors

Family structure and function and their association with knowledge and attitudes toward sexuality, contraception, and sexually transmitted diseases (STD) were studied in 918 students and 312 adolescents working in factories. Unmarried workers reported higher rates of sexual activity than did students (30.9% vs. 21.8%, p = .04 for males; 12.9% vs. 6.0%, p = .005 for females). Among sexually active males, 33.3% of students and 30.7% of workers used contraception, compared with 27.5% of female students and 9.5% of female workers. Workers were from larger families than students, and the male and female workers had lower scores for knowledge on sexuality, contraception, and STD than did students. Multiple stepwise regression showed that age and schooling of the parents were associated with knowledge and attitudes in the students. In workers, the position of the child in the family was a negative regressor for attitudes and knowledge on sexuality in males, and for knowledge on contraception and STD in females. In regard to family function, the significant factors were compromise between the parents, positive affective response, communication within the family, problem solution, and control of behavior. It was concluded that female workers are at higher risk for unwanted pregnancies and STD. The factors associated with knowledge and attitudes were age, schooling of the parents, mother working out of home, position of the adolescent in the family, and the diverse aspects of family function.     

Adolescent decision making: a broadly based theory and its application to the prevention of early pregnancy

The purpose of this paper is to present a broadly based theory of adolescent decision making including all the necessary components of the subject: cognitive development, social and psychological factors, and, perhaps most importantly, cultural and societal influences. Previous theories and applications have often focused on only one or two aspects. This theory is then applied to the problem of prevention of early pregnancy at an inner-city high school. Use of this theory, combined with an open-ended data-gathering format made possible some of the unexpected findings of this study: most of the young women at this school desire their pregnancies; many of them prefer single parenthood to traditional family structure; and low academic skills and poverty often result in pregnancy, rather than pregnancy causing high school dropouts and a life of poverty. Prevention programs will necessarily differ for sexually active adolescents who do and do not want pregnancy and for younger versus older adolescents. In designing such programs, we need to focus on pregnancy as the problem rather than on adolescent sexuality.     

Impediments to identity formation in female adolescents.

Summarizes and explores from a psychoanalytic perspective important aspects of female psychology, including parenting arrangements, the impact of cultural and social forces, and female sexuality. The normative psychological changes that occur in adolescence and their relevance for adolescent females are discussed. Cultural, social, and psychological factors attenuate female identity formation and the development of ego strengths throughout girlhood. Females tend to experience greater increases in anxiety, conflict, shame, self-doubt when faced with choice, and the lack of differentiation from the family and culture at large. Ego weaknesses and cultural pressures render females' identity formation process more difficult and attained identity more tenuous. For adolescent females cultural pressures and internal dissonance cultivate a diffuse sense of identity, with failure to do so resulting in a marginalized existence without significant social support. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Développement du jugement moral chez l'adolescente en rééducation.

The cognitive-developmental approach of L. Kohlberg (1958) and his collaborators has not been extensively used in the study of adolescent female delinquents. The purpose of the present research was to employ this approach to establish the level of moral judgment in Ss at the beginning and end of a reeducation process; Ss were 29 adolescent girls. Results indicate that (a) Ss at the beginning of this process were functioning at the preconventional level, whereas those at the end of the process were functioning at the conventional level; and (b) although the reeducation process had a positive effect on the global moral judgment functioning level, in certain areas such as the parent–child relationship and sexuality, all Ss remained at the preconventional level. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A successful attempt with a consulting service for boys

As adolescence is a critical period of development, and as boys are less inclined than girls to approach the school facility for adolescent counselling, segregated consulting hours were introduced for boys to attract those with problems. The frequency of consultations by boys increased by 25 per cent, and 70 per cent of the boys reported a preference for the segregated consulting hours; 75 per cent appreciated the absence of girls from the waiting room; and of the 42 per cent with special preferences regarding the gender of the staff encountered, half reported preferring a man. Most of the boys presented with defined problems, though many revealed other problems, often relating to sexuality, in the course of consultation. The availability of segregated consulting hours for boys with adolescent problems is important, and often the only way to reach young boys who need help.