Loneliness in older parents: marital transitions, family and social connections, and separate bedrooms for sleep.

OBJECTIVES: This research innovatively analyzed the marital transitions (i.e., divorce and widowhood) of older Taiwanese parents, their sleep problems and spousal specific characteristics (i.e., separate bedrooms for sleep and marital relationships) as well as their social and family connections, all of which were simultaneously reflected in emotional and social domains of loneliness. METHODS: Data are from 1645 older parents from Northern Taiwan. Loneliness was assessed by a De Jong-Gierveld short scale with emotional and social domains. We conducted multivariate logistic regression to examine the associations of marital transitions and family/social connections regarding sleep problems and psychological well-being with loneliness in social and emotional domains. Besides sleep problems and individual socioeconomic status, we included data on couples' sleeping arrangements and marital relationships. RESULTS: Social loneliness was significantly associated with being divorced (AOR = 1.80, 95% CI 1.13-2.86) and living alone (AOR = 1.50, 95% CI 1.02-2.23). In contrast, strong family cohesion and frequent weekly contact with friends were associated with lower social loneliness. Married parents who slept in separate bedrooms were more likely than bed-sharing couples to feel emotional and social loneliness, despite adjusting for their sleep problems. Furthermore, satisfactory spousal relationships significantly decreased the magnitude of associations in the social domain. DISCUSSION: Our findings support significant associations between loneliness in later life and major marital transitions, family and social connections and sleep problems which differ in social and emotional domains. Independent of relationship satisfaction, separate bedrooms relate to higher risks of emotional loneliness in older adults.

Exposure to sexually explicit media in early adolescence is related to risky sexual behavior in emerging adulthood.

BACKGROUND: Sexually explicit media exposure during early adolescence has been found to be associated with risky sexual behavior. However, previous study suffered from methodological issue, such as selection bias. Furthermore, little is known about the effect of multi-modality sexually explicit media exposure on risky sexual behavior, and how this relationship can be applied to non-western societies. OBJECTIVES: This study aimed to improve upon previous studies by using instrumental variable estimation. In addition, this study also included multi-modality of sexually explicit media and three risky sexual behavior measure from a sample of Taiwanese adolescents. METHODS: Participants were recruited from a prospective longitudinal study (Taiwan Youth Project). All were in 7th grade (mean age = 13.3) when the study was initiated in 2000. Sexually explicit media exposure, including ever-exposure and number of modalities exposed to, was measured in wave 2 (8th grade). Risky sexual behavior was measured in waves 8 (mean age = 20.3) and 10 (mean age = 24.3). A two-stage least squares regression was employed, with pubertal timing as the instrumental variable. RESULTS: About 50% of participants had been exposed to sexual media content by 8th grade, from an average of one modality. Sexually explicit media exposure predicted early sexual debut, unsafe sex, and multiple sexual partners (all: p < .05). Furthermore, exposure to more media modalities increased the likelihood of risky sexual behaviors. However, only the effect on early sexual debut was gender invariant. CONCLUSIONS: Exposure to sexually explicit media in early adolescence had a substantive relationship with risky sexual behavior in the emerging adulthood. Knowledge of this causal like effect provides a basis for building better preventive programs in early adolescence. One prominent way is early education on media literacy, and physicians themselves may need to be familiar with such content to initiate it.

"Happiness in the air?" the effects of air pollution on adolescent happiness.

BACKGROUND: We aimed to examine the effect of ambient air pollution at the district level on adolescents' happiness and their change in happiness over time in a cohort sample from Taiwan. METHOD: A cohort from the Taiwan Youth Project was evaluated. The adolescents (n = 2571) were in the 7th grade (mean age = 14.3 years) when the study was initiated and resided in 40 districts in three cities and counties in northern Taiwan. We examined the effects of the concentration level of air pollution, including PM2.5, PM10, and NO2, at the district level on adolescents' happiness and their change in happiness over time (7th to 9th grade). Due to the high correlations of the three pollutants, we examined each separately with similar covariates. The analyses were based on both multilevel modeling and latent growth curve modeling. RESULTS: Higher concentration levels of each of the three air pollutants measured were associated with adolescent happiness such that a higher level of concentration was related to lower levels of adolescents' happiness. These results were observed after controlling for important individual- and district-level covariates. However, further analyses did not reveal that the concentration level of air pollution was associated with the change in happiness in the study period (after 3 years). Some sensitivity checks (e.g., adjusting district size) did not change the substantive results. CONCLUSION: Many previous studies have shown the influence of air pollution on physical health and negative emotions, but only a few using adult samples have shown that air pollution is inversely related to positive wellbeing. This study may be the first to examine the effects of air pollution on adolescents' positive affect. Our results echo recent research on the consequent health burden of air pollution. Given that positive affect has been linked to future adult health, the results of the current study provide empirical grounds for early intervention concerning environmental factors.

Loneliness in young adulthood: Its intersecting forms and its association with psychological well-being and family characteristics in Northern Taiwan.

OBJECTIVES: Most researchers have examined forms of loneliness as discrete and emotional distress. The approach proposed in this study captures the reality that many persons experience more than one dimension of loneliness-varying degrees coupled with their psychological well-being in a family context. This study explores the latent structure of loneliness during young adulthood and its association with psychological well-being, as well as how these are related to their family characteristics in adolescence. METHODS: Data are from 2,748 young people, a cohort sample from the Taiwan Youth Project (TYP). Loneliness was assessed by a 6-item de Jong-Gierveld short scale with emotional and social loneliness domains. We describe the clustering between loneliness domains and psychological well-being, namely depressive symptoms, self-esteem, suicidal thoughts, and alcohol use using latent class cluster analysis. In addition to incorporating the Taiwanese family context, multivariate multinomial logistic regression models included data on family cohesion and parental guan (parental control) in adolescence. This might be associated with choices in partnership and childbearing, and influence loneliness in young adulthood. RESULTS: Our results demonstrate a three-cluster model of loneliness involving emotional loners, serious emotional loners, and severe emotional/social loners. We also found that a feeling of serious emotional loneliness and severe emotional/social loneliness were significantly associated with psychological well-being, even adjusting for individual characteristics. Among young adults who had a partner, the married adults were significantly less likely to feel serious emotional loneliness than those who were living alone. Furthermore, young adults with stronger family cohesion during early adolescence were less likely to suffer from serious emotional loneliness (Relative risk ratios [RRR] 0.77, 95% CI 0.65-0.91) and severe emotional/social loneliness (RRR 0.54, 95% CI 0.34-0.85) in young adulthood. DISCUSSION: This measurement strategy provides a foundation for future research into how experts can address loneliness clusters in order to better understand psychological well-being during young adulthood and family context in adolescence. This is important because our results suggest that the various loneliness domains do not occur independently, but rather are embedded in patterns and are associated with family characteristics.

Educational Tracking and Juvenile Deviance in Taiwan: Direct Effect, Indirect Effect, or Both.

Educational tracking in Chinese society is quite different from that in Western society, in that the allocation to either the vocational or academic track is based on a national entrance examination, which happens at ninth grade (age 14-15). Hence, students in many Asian countries (e.g., China and Taiwan) have to face academic tracking in early adolescence. Because of cultural emphasis on education in Taiwan, the impact of tracking on deviance is profound and can be seen as a crucial life-event. With this concept in mind, we examine how educational tracking influences adolescent deviance during high school. In addition, we also examine how educational tracking may indirectly influence deviance through other life domains, including depression, delinquent peer association, and school attachment. By using longitudinal data (the Taiwan Youth Project), we find that educational tracking increases deviance not only directly but also indirectly through delinquent peers and low school attachment. Some implications and limitations are also discussed.

Unhealthy sleep practices, conduct problems, and daytime functioning during adolescence.

Although sleep has been linked to activities in various domains of life, one under-studied link is the relationship between unhealthy sleep practices and conduct problems among adolescents. The present study investigates the influence of adolescents' unhealthy sleep practices-short sleep (e.g., less than 6 h a day), inconsistent sleep schedule (e.g., social jetlag), and sleep problems-on conduct problems (e.g., substance use, fighting, and skipping class). In addition, this study examines unhealthy sleep practices in relationship to adolescent emotional well-being, defiant attitudes, and academic performance, as well as these three domains as possible mediators of the longitudinal association between sleep practices and conduct problems. Three waves of the Taiwan Youth Project (n = 2,472) were used in this study. At the first time-point examined in this study, youth (51% male) were aged 13-17 (M = 13.3). The results indicated that all three measures of unhealthy sleep practices were related to conduct problems, such that short sleep, greater social jetlag, and more serious sleep problems were concurrently associated with greater conduct problems. In addition, short sleep and sleep problems predicted conduct problems one year later. Furthermore, these three unhealthy sleep practices were differently related to poor academic performance, low levels of emotional well-being, and defiant attitudes, and some significant indirect effects on later conduct problems through these three attributes were found. Cultural differences and suggestions for prevention are discussed.

Adolescent internet use and its relationship to cigarette smoking and alcohol use: a prospective cohort study.

The present study aims to investigate the longitudinal impact of situational Internet use on future cigarette smoking and alcohol use among male and female adolescents. A Northern Taiwanese cohort sample of adolescents with no prior use of cigarettes (n=1445) or alcohol (n=1468) was surveyed at age 16 and again 4 years later. Information regarding where, why, and length of time spent using the Internet was gathered from the 16-year-old participants. Outcome information regarding cigarette/alcohol use was gathered via a follow-up questionnaire at age 20. Multivariate regressions were used to incorporate peer, individual and family characteristics as measured at age 16 and create models of future cigarette and alcohol use at age 20. The analyses demonstrated that adolescent Internet use, particularly where such use took place, has a significant impact on future cigarette smoking and alcohol use, adjusted for conventional factors, and its relationship differs significantly by gender. Female adolescents with Internet café use appear to be especially likely to develop these two risky behaviors. The why of Internet use is also a predictor of future cigarette smoking. Finally, time spent using the Internet is significantly related to alcohol use; greater use of the Internet is associated with higher levels of drinking. The results revealed that different risky behaviors are differentially influenced by separate components of adolescent Internet use. These findings suggest that programs aimed at promoting adolescent health could potentially benefit Taiwanese adolescents by including components related to situational Internet use and taking gender into consideration.

Exploring the relationship between premarital sex and cigarette/alcohol use among college students in Taiwan: a cohort study.

BACKGROUND: Cigarette/alcohol use and premarital sex, and their subsequent consequences on the well-being of college students, are international health promotion issues. However, little is known about the temporal relationship of these risk behaviors among Taiwanese college students. METHODS: This study utilizes data from the Taiwan Youth Project, a cohort sample of 20-year-olds (N = 2,119) with a 2-year follow-up, to explore the relationship between adolescent cigarette/alcohol use, and subsequent premarital sex. To incorporate the Taiwanese context where the normative value of abstinence until marriage remains strong, multivariate logistic regression models included data on premarital sex attitudes, stressful life events, peer influence, as well as family and individual factors which might influence this relationship. RESULTS: The sample consists of 49% male and 51% female college students. About 16% of the sample report having had premarital sex by age 20. After excluding sexually active youth, 20% of males and 13% of females report engaging in premarital sex in the 2-year follow-up interview. Multivariate logistic regression analyses reveal adolescent alcohol use is significantly associated with a higher likelihood of engaging in premarital sex for both genders; adolescent smoking is significantly associated with premarital sexual activity among males, but not females. Our results indicate liberal premarital sexual attitudes and stressful personal events are also significantly associated with premarital sexual activity. CONCLUSIONS: These findings suggest health promotion programs for college students need to take developmental and gender perspectives into account. Future research to incorporate a broader, multi-cultural context into risk reduction materials is recommended.

Community effects on pregnancy intention among cohabiting women in the Philippines: implications for maternal and child health.

Unintended pregnancy impacts both maternal and child health. International studies continue to emphasize the importance of reproductive health in the context of community. Only a few researchers have explored the impact of community factors on pregnancy intention using population-based surveys. This issue is of particular importance for women of low socioeconomic status in developing countries, where unintended fertility rates remain relatively high. Using the 1998 (n = 6,849) and 2003 (n = 6,773) Demographic and Health Surveys in the Philippines, we employed multilevel logistic models to explore whether community factors are associated with pregnancy intention among these women. The results showed community social capital, comprised of community-related variables, significantly predicted women's pregnancy intention, even after controlling for women's socioeconomic status, individual background factors, and spousal characteristics. The relationship between pregnancy intention and selected variables associated with community social capital, however, was not consistent across the two surveys. Community context, in general, has a significant influence on women's pregnancy intention. Specific components of the community context vary in their associations with pregnancy intention over time. In addition, differences in pregnancy intention may explain individual-level social disparities between communities. These findings suggest population health policies designed to promote maternal and child health must be context-specific.

Adolescent premarital sex and health outcomes among Taiwanese youth: perception of best friends' sexual behavior and the contextual effect.

This study explores premarital sex among adolescents and its health outcomes in a typical East Asian society, Taiwan. As a collective society in terms of cultural heritage, a particular target of this study was perceived peer pressure and its contextual influence. The data were taken from the Taiwan Youth Project, 2004 and 2007, and never married youth aged 20 years constituted our sample (N=3530). Best friends' sexual behavior and other context-related factors, such as school attendance and community participation, are presumed to influence adolescent premarital sex as well as their health status. Logistic regression models show a positive and significant association between the perception of friends' sexual behavior and the likelihood of adolescent premarital sex engagement, after adjusting for the youth's own sex-related experience and attitudes, individual characteristics, and family background. The analysis also confirms that school attendance and community participation are significantly associated with a lower likelihood of having premarital sex. Furthermore, adolescent premarital sex was found to be linked to the perceived health status of the youth (self-rated health, smoking, and drinking), as expected. These findings demonstrate the importance of peers and social context, which suggests that HIV prevention and health promotion programs for youth need to take friendship networks and social context into consideration.