Contextual Mediators between Adolescent Sexuality and Negative Outcomes
These three papers form an argument that youths? sexual behavior and sexual-minority orientation are associated with negative outcomes of alcohol use, depression, and suicide via negative changes in perceived contextual support. They employ data from the first two waves of the National Longitudinal Survey of Adolescent Health (collected 1995 & 1996, Wave I N = 18,924, Wave II N = 13,570, http://www.cpc.unc.edu/projects/addhealth). The first paper demonstrates reciprocal effects over one year between adolescent sexual activity and shared activities with opposite-sex parents, closeness with same-sex parents, and more problem-focused interactions with both parents. The second paper finds that initiating or continuing sexual activity predicts reduced integration with the school environment, increased number of close friends who use alcohol, and increased problem-focused interactions with parents. It is additionally associated with lower personal religiousness for young women only. The second paper finds further that ceasing sexual activity did not forestall negative changes in contextual supports, as the first paper?s results implied, but rather that negative changes continued. The second paper also finds that levels of context factors significantly mediate the relationship between sexual activity and each of depression, suicidality, and alcohol use. The third paper, using only Wave I data, applies the first two papers? contextual mediation concept to explain mental health risks associated with same-sex, both sex, and opposite-sex romantic attraction, dating, and sexual behavior. After testing every combination of subject?s gender, object?s gender, and domain of expression for associations with depression and suicidality, the third paper finds several patterns ? sexually/romantically active female, sexual-minority, and non-virgin ? consistently associated with depression and suicidality. These patterns are suggested to be associated with risk because they impart stigmatized status to youth that impedes their access to needed social supports. A theoretical model is advanced asserting that stigmatization of youth sexuality leads to both mental health risk and greater likelihood of risk behavior, the latter of which leads to even greater stigmatization and even greater likelihood of risk behavior. This model suggests that increasing support for non-virgin and sexual-minority youth and decreasing stigmatization of them would be most helpful approach for their health.
dissertation or thesis