Adolescents' pornography viewing frequency and its relationship with condom attitudes.

Background This study examined adolescent pornography viewing and its' relationship with condom attitudes. Methods Data were from 457 adolescents aged 13-18years old who completed an online survey assessing pornography viewing frequency and condom attitudes. Results Many adolescents in our sample had viewed pornography in the past year (n =188, 41%), with pornography viewing frequency being higher among older adolescents (P =0.02), those who have had sex in the past year (P =0.001), and those who identified as White (P =0.01), LGB+ (P =0.05), and male (P =0.001). Adolescents who viewed pornography more frequently had more negative condom attitudes (r =-0.18, P Conclusions A substantial proportion of adolescents in our sample viewed pornography and those who view more frequently had more negative condom attitudes. Results indicate a need for experimental studies examining this relationship and interventions addressing pornography literacy among adolescents.

Longitudinal Change in Appearance-Related Social Media Consciousness and Depressive Symptoms: A Within-Person Analysis during Early-to-Middle Adolescence.

Online appearance preoccupation may put adolescents at risk of developing mental health challenges, perhaps especially during early-to-middle adolescence. A random intercept cross-lagged panel model assessed within-person associations between appearance-related social media consciousness and depressive symptoms over three time-points with three months between waves. The sample (n = 1594) included U.S. adolescents aged 11-15 (Mage = 13; 47% girls, 46% boys, 7% another gender; 37% Latine, 33% White, 18% Black, 7% Asian). Within-person increases in appearance-related social media consciousness were associated with subsequent increases in depressive symptoms, but not vice versa. There was no evidence of gender differences and results were robust to controlling for both time on social media and offline self-objectification. Thus, online appearance concerns precede mental health challenges during early and middle adolescence.

Evaluation of a Brief Online Sexual Health Program for Adolescents: A Randomized Controlled Trial.

Adolescents are at increased risk of acquiring sexually transmitted infections (STIs) and experiencing unintended pregnancy. In particular, adolescents from marginalized communities experience significant sexual health disparities compared to their more advantaged peers. Digital sexual health programs, such as HEART (Health Education and Relationship Training), may be effective in reducing these risks and addressing these disparities. HEART is a web-based intervention focused on the promotion of positive sexual health outcomes, such as sexual decision-making skills, sexual communication skills, sexual health knowledge, and sexual norms and attitudes. The current study evaluates the efficacy of HEART, and examines whether effects were moderated by gender, socioeconomic status (SES), race, English as a second language, and sexual orientation to ensure the program is effective for diverse groups of adolescents. Participants were 457 high school students (Meanage=15.06, 59% girls, 35% White, 78% heterosexual, 54% receive free or reduced-price lunch). Students were randomized to HEART or an attention matched control and assessed at pretest and immediate posttest. HEART was effective in increasing sexual assertiveness, sexual communication intentions, HIV/STI knowledge, condom attitudes, and safer sex self-efficacy compared to the control condition. There were no significant interactions by gender, SES, race, English as a second language, or sexual orientation, suggesting the program worked equally well for all groups of youth. The findings of this study suggest that HEART may be a promising avenue for the promotion of positive sexual health outcomes for diverse groups of youth.

Validated HIV Knowledge Scales for Use with Adults and Adolescents: A Systematic Review.

HIV knowledge - the information a person possesses about HIV - is essential for the prevention and management of HIV. Therefore, the accurate measurement of HIV knowledge is important for both science and practice. This systematic review identifies extant HIV knowledge scales that have been validated with adolescent and adult populations and summarizes the state of this research. We searched seven electronic databases, which resulted in 6,525 articles. After title/abstract and full-text review, 27 studies remained and underwent qualitative review of reported scale psychometric properties. Many studies were conducted in the last decade (n = 12), reflecting advances in scientific knowledge of HIV. Five were exclusively adolescent-based studies (sample age ≤ 18). Most studies reported reliability (n = 25) or at least one form of validity (n = 21). Future studies should develop or refine HIV knowledge scales so that they reflect recent scientific developments, use rigorous psychometric testing, and target samples that include those persons at highest risk for HIV.

How Emotional Shifts Effect Youth Perceptions of Opioid Risk and Efficacy: Testing a Know the Truth Campaign Narrative.

Integrating the extended parallel process model (EPPM) and the emotional flow hypothesis, we tested the persuasive effect of emotional shifts during exposure to a Know the Truth anti-opioid campaign narrative in a sample of middle-school students (n = 480). Testing two emotional flow sequences (threat to efficacy and efficacy to threat) of the Know the Truth narrative against a static (threat-only) emotional condition, we found that youth exposed to any emotional flow narrative reported higher levels of hope and lower levels of fear than those exposed to a threat-only narrative. We also found that a threat to efficacy narrative elicited higher levels of self-efficacy than an efficacy to threat emotional flow condition, suggesting that the emotional sequence influences self-efficacy, a well-established predictor of health behavior change. We conclude that the traditional threat to efficacy emotional flow may be superior to its inverse (efficacy to threat) when communicating with young people about opioid addiction. Implications for message design are discussed.

Longitudinal associations between appearance-related social media consciousness and adolescents' depressive symptoms.

INTRODUCTION: Frequent social media use among adolescents is associated with depressive symptoms, though prior work has overwhelmingly used cross-sectional designs and focused on "screen time." Subjective social media experiences, such as the concern with one's physical appearance on social media, may be more relevant to adolescents' depressive symptoms than mere frequency of use. Appearance-related social media consciousness (ASMC) is the preoccupation with one's physical attractiveness in social media photos and has been associated with depressive symptoms above and beyond frequency of social media use in prior cross-sectional work. METHODS: In this brief report, we assessed this association longitudinally over 1 year within a diverse sample of highschool adolescents in the Southeastern US (n = 163, M age = 16.19; 55.8% girls; 44.8% White, 23.9% Black, 26.4% Hispanic/Latinx; 49.7% received free or reduced-price lunch). RESULTS: Baseline ASMC was associated with higher depressive symptoms 1 year later, even when controlling for time spent on social media. Although girls reported higher levels of ASMC, associations were similar for adolescent boys and girls. No evidence was found that heightened depressive symptoms at baseline were associated with higher ASMC 1 year later. CONCLUSIONS: The findings highlight the importance of physical appearance concerns on social media-above and beyond the frequency of use-in the development of depressive symptoms among adolescents. Implications for future research to examine the role of subjective social media experiences in adolescents' depressive symptoms are discussed.

Social self-efficacy and sexual communication among adolescents in the United States: a cross-sectional study.

Background Sexual communication between partners is associated with safer sex behaviours, including condom use among adolescents. Several studies have found a relationship between negative psychological constructs (e.g. depression, anxiety) and poor sexual communication; however, scant research exists regarding positive psychological constructs and their potential to promote effective sexual communication among adolescents. This study examined the association between a positive construct, social self-efficacy - a person's belief in their ability to successfully manage social relationships - and three components of sexual communication: sexual assertiveness, self-efficacy for communication, and frequency of sexual communication with dating partners. METHODS: Data were collected in a cross-sectional survey from 222 high school girls in a rural school district in the south-eastern United States (Mage = 15.2; 38% White, 29% Latina, 24% Black; 50% were in a dating relationship in the past 3 months). Variables were measured with Likert-type scales. Bivariate correlation and regression analyses were conducted. RESULTS: Social self-efficacy was significantly positively associated with sexual assertiveness and sexual communication self-efficacy for all girls, and there was a positive trend in the relationship between social self-efficacy and communication frequency among the subsample of girls who had a dating partner. The significant relationship with sexual assertiveness (ß = 0.22, s.e. = 0.07, P = 0.001) and sexual communication self-efficacy (ß = 0.17, s.e. = 0.04, P = 0.013) remained when controlling for sexual activity status. CONCLUSIONS: Strengthening social self-efficacy may enhance girls' sexual communication and assertiveness skills. Future studies are needed to confirm the causal and temporal nature of these associations.

Randomized Trial of a Single-Session Growth Mind-Set Intervention for Rural Adolescents' Internalizing and Externalizing Problems.

Adolescents living in rural regions of the United States face substantial barriers to accessing mental health services, creating needs for more accessible, nonstigmatizing, briefer interventions. Research suggests that single-session "growth mind-set" interventions (GM-SSIs)-which teach the belief that personal traits are malleable through effort-may reduce internalizing and externalizing problems in adolescents. However, GM-SSIs have not been evaluated among rural youth, and their effects on internalizing and externalizing problems have not been assessed within a single trial, rendering their relative benefits for different problem types unclear. We examined whether a computerized GM-SSI could reduce depressive symptoms, social anxiety symptoms, and conduct problems in female adolescents from rural areas of the United States. Tenth-grade female adolescents (N = 222, M age = 15.2, 38% White, 25% Black, 29% Hispanic) from 4 rural, low-income high schools in the southeastern United States were randomized to receive a 45-min GM-SSI or a computer-based active control program, teaching healthy sexual behaviors. Young women self-reported depression symptoms, social anxiety symptoms, and conduct problem behaviors at baseline and 4-month follow-up. Relative to the female students in the control group, the students receiving the GM-SSI reported modest but significantly greater reductions in depressive symptoms (d= .23) and likelihood of reporting elevated depressive symptoms (d= .29) from baseline to follow-up. GM-SSI effects were nonsignificant for social anxiety symptoms, although a small effect size emerged in the hypothesized direction (d= .21), and nonsignificant for change in conduct problems (d= .01). A free-of-charge 45-min GM-SSI may help reduce internalizing distress, especially depression-but not conduct problems-in rural female adolescents.

Preliminary Evaluation of a Prescription Opioid Misuse Prevention Program Among Rural Middle School Students.

Adolescent opioid misuse, addiction, and overdose have emerged as national health crises. Nearly 17% of high school students have misused prescription opioids. The purpose of this study was to evaluate the reach and acceptability of a widely-used prescription opioid misuse prevention program, This Is (Not) About Drugs© (TINAD), and its preliminary efficacy at improving opioid misuse knowledge, opioid misuse attitudes, self-efficacy to avoid opioid misuse, and intentions to misuse opioids. Participants were 576 7th grade students (Mage = 11.8; 51% boys; 39% Hispanic, 31% White, 20% Black) from a rural county in the southeastern U.S. All participants received the TINAD program and completed pretest and immediate posttest assessments. The program was school-based and implemented in collaboration with school teachers and administrators. Over 91% of all eligible students in the school district participated in the TINAD program. Most participants found the program acceptable-over 83% of students liked the program. Approximately 9% of participants reported prior misuse of prescription opioids. After participating in TINAD, students self-reported higher knowledge and self-efficacy as well as safer attitudes. However, there was no change in intentions to misuse opioids in the future. Effects of the program were consistent across gender, socioeconomic status, race/ethnicity, and previous opioid misuse. TINAD is acceptable and shows promise for improving opioid-related cognitions. However, more rigorous experimental and longitudinal research is needed to understand whether TINAD reduces opioid misuse over time. Given the limited research on adolescent opioid misuse prevention, this study lays the ground work for future randomized control trials.

Popular peer norms and adolescent sexting behavior.

INTRODUCTION: Adolescents misperceive and are heavily influenced by the behavior of their popular peers, yet research has not yet investigated this phenomenon for a relatively new and potentially risky behavior: adolescent sexting. The present study investigates rates of sexting among popular and non-popular adolescents and the association between adolescents' perceptions of popular peers' sexting behavior and their own sexting behavior. METHODS: A school-based sample of 626 adolescents from a rural high school in the Southeastern U.S. (Mage = 17.4, 53.5% female) completed surveys indicating whether they had sent a sext in the past year. Participants also reported on perceptions of popular peers' sexting behavior and completed sociometric nominations of peer status. RESULTS: While 87.4% of adolescents believed the typical popular boy or girl in their class had sent a sext in the past year, only 62.5% of popular adolescents had actually sent a sext. There was no significant difference between rates of sexting among popular and non-popular (54.8%) adolescents. After adjusting for gender and sexual activity status, adolescents who believed that the typical popular peer sent a sext were over ten times more likely to have also sexted in the past year. Among adolescents who believed their popular peers had not sexted, girls were more likely than boys to have sexted themselves; however, this gender difference disappeared among adolescents who believed their popular peers had sexted. CONCLUSIONS: These results underscore the importance of peer status and perceptions of peer norms in adolescents' sexting.

Applying a Multifactorial Communication Framework to Better Understand Differences between Father-daughter and Mother-daughter Sexual Health Discussions.

While the literature on parent-child sexual communication among adolescent girls is robust overall, research that is specifically focused on communication between fathers and daughters is more limited. Further, there have been calls for work on parent-child sexual communication to be situated within a multi-factorial conceptual framework that distinguishes between different communication components, such as the communication source, content, frequency, quality, and timing. Using such a framework, this study examined aspects of father-daughter sexual communication as they compare to mother-daughter communication in a diverse sample of 193 girls (Mage = 15.62). Results highlighted several gaps between father-daughter and mother-daughter communication. Girls reported covering less content and communicating less frequently about sexual topics with their fathers compared to their mothers. Girls also reported being less comfortable communicating and found their discussions to be less helpful with fathers than mothers. Girls were also less likely to report communicating with fathers about sexual topics before their sexual debut than with mothers. No significant differences were found in communication style (i.e., conversational or like a lecture) between fathers or mothers. Results highlight the importance of understanding the multifaceted process of parent-child communication and signal the need for targeted intervention efforts to improve upon father-daughter communication.

Developmental patterns of sexual identity, romantic attraction, and sexual behavior among adolescents over three years.

INTRODUCTION: Adolescents are heterogeneous in how they define and experience their sexual orientation, which can include specific identity labels, romantic attractions, and other- and/or same-sex sexual behavior. These three components of sexual orientation are not always concordant, and studies suggest adolescents-particularly girls-are fluid in these dimensions of orientation over time. The current study examined: 1) fluidity in adolescent girls' and boys' self-labeled identities and romantic attractions over time, and 2) patterns of adolescent girls' and boys' self-labeled identities and romantic attractions as they coincide with sexual behavior. METHODS: Surveys were administered to adolescents in three low-income high schools in the rural Southeastern U.S. at three yearly intervals (n = 744; Mage = 15.0; 54.3% girls; 48% White, 24% Hispanic/Latinx, 21% Black/African American). Participants reported their self-labeled sexual identity and romantic attraction at each time point and their lifetime sexual behavior with girls and boys at year 3. RESULTS: Results revealed 26% of girls and 11% of boys reported fluidity in identity and 31% of girls and 10% of boys reported fluidity in attractions. At each time point, up to 20% of girls and 6% of boys reported a sexual minority identity label with concurrent same-sex attraction; the majority of these participants also reported same-sex behavior. Among heterosexual-identified participants reporting some degree of same-sex attraction at year 3, approximately 66% of girls and 10% of boys reported same-sex behavior. CONCLUSIONS: The findings suggest that many adolescents are nuanced and dynamic in how they identify and experience their developing sexualities.

Sexual Assertiveness Skills and Sexual Decision-Making in Adolescent Girls: Randomized Controlled Trial of an Online Program.

OBJECTIVES: To evaluate the efficacy of an interactive, Web-based sexual health program (Health Education and Relationship Training [HEART]) for developing sexual assertiveness skills and enhancing sexual decision-making in adolescent girls. METHODS: Participants were 222 tenth-grade girls (mean age = 15.2; 38% White, 29% Hispanic, 25% Black) in the Southeastern United States who were randomized in fall 2015 to the HEART intervention or an attention-matched control. We assessed participants at pretest, immediate posttest, and 4-month follow-up. RESULTS: Both groups had similar demographic and sexual behavior characteristics at pretest. At immediate posttest, girls who completed the HEART program demonstrated better sexual assertiveness skills measured with a behavioral task, higher self-reported assertiveness, intentions to communicate about sexual health, knowledge regarding HIV and other sexually transmitted diseases (STDs), safer sex norms and attitudes, and condom self-efficacy compared with the control condition. At 4-month follow-up, group differences remained in knowledge regarding HIV and other STDs, condom attitudes, and condom self-efficacy. CONCLUSIONS: This brief online sexual health program can improve short-term outcomes among adolescent girls and offers an exciting new option in the growing array of digital health interventions available to youths. TRIAL REGISTRATION NUMBER: NCT02579135.

Technology-Based Communication and the Development of Interpersonal Competencies Within Adolescent Romantic Relationships: A Preliminary Investigation.

This study investigated longitudinal associations between adolescents' technology-based communication and the development of interpersonal competencies within romantic relationships. A school-based sample of 487 adolescents (58% girls; Mage  = 14.1) participated at two time points, one year apart. Participants reported (1) proportions of daily communication with romantic partners via traditional modes (in person, on the phone) versus technological modes (text messaging, social networking sites) and (2) competence in the romantic relationship skill domains of negative assertion and conflict management. Results of cross-lagged panel models indicated that adolescents who engaged in greater proportions of technology-based communication with romantic partners reported lower levels of interpersonal competencies one year later, but not vice versa; associations were particularly strong for boys.

Emergency contraception: Sources of information and perceptions of access among young adults.

Emergency contraception (EC) can prevent pregnancy for up to 5 days after unprotected sex. Although EC has become increasingly available, little is known about perceptions of young adults regarding access to EC or whether information sources about EC relate to perceived access among young adults. Over a 1-week period in November 2013, a self-report survey was administered to 352 college students (67% women) at the student union of a large, public university in the southeastern United States. The survey assessed three aspects of EC: perceived access, information sources, and prior use. Twenty-one percent of participants had used EC. Participants reported relatively high perceptions of access to EC, with females reporting higher perceptions of access than males. Prior to the study, 7.4% of students had never heard of EC; the remaining students had heard of EC from an average of four sources. Among women, hearing of EC from media, interpersonal, or health education sources was significantly associated with greater perceived access (ps < .05). Among men, no specific information sources were associated with perceived access (ps > .10). Future EC awareness efforts for women should leverage all three of these sources, while future research should examine specific sources to focus on the content, quality, and frequency of messages.

Perceptions of a campus-wide condom distribution programme: An exploratory study.

OBJECTIVE: Condom distribution programmes are an important means of preventing sexually transmitted infections (STIs); yet little research has examined their perceived and actual impact on college campuses. DESIGN: Quantitative, cross-sectional study. SETTING: Large public university in the Southeastern USA. METHOD: Approximately 2 months after a campus-wide condom distribution programme began, we utilised intercept surveys with 355 students (68% women; 43% racial/ethnic minorities) to examine their perceptions of the availability, accessibility and acceptability of condoms, and their perceptions and use of the newly installed condom dispensers. RESULTS: Students perceived condoms to be available and accessible on campus after implementation of the condom dispensers. Students had heard about the dispensers from other people (36%), through social media (18%) and the campus newspaper (15%). Most students (71%) had seen the dispensers. Almost one in four students (23%) had taken a condom from the dispensers; among those who were sexually active during the 2months that the dispensers were available, 33% had used them. More than one-third of students (37%) - and 53% of sexually active students - indicated intentions to use the dispensers in the next 6months. Multiple regression analysis controlling for age, gender and race revealed that prior condom use, attitudes about the dispensers and comfort with the dispensers were significant predictors of sexually active students' intentions to use the dispensers (p<.001). CONCLUSION: Overall, results indicate that over a short time period, this condom distribution programme was successful in reaching students and providing free condoms. Implications for implementing condom distribution programmes on college campuses as well as future directions for research are discussed.

Demographic and developmental differences in the content and sequence of adolescents' ideal romantic relationship behaviors.

This study utilizes data from 18,392 respondents (aged 12-19) in Wave 1 of the National Longitudinal Study of Adolescent to Adult Health (Add Health) to provide a detailed descriptive analysis of U.S. adolescents' desired behaviors in their ideal romantic relationships. Age, gender, and ethnic group differences in the desire for--and preferred sequence of--a set of activities that could occur in a hypothetical romantic relationship were explored within subsets of heterosexual (n = 17,274) and sexual minority adolescents (n = 1118). Non-sexual behaviors were more commonly desired compared to sexual behaviors. The typical desired behavioral sequence was: holding hands, going out alone, telling others they were a couple, kissing, saying "I love you," sexual touching, and finally having sex. Overall, more similarities than differences emerged across groups, with some notable differences in the percentages who desired sexual behaviors. Results provide a nuanced picture of adolescent relationship scripts, with implications for education and prevention.

Sexual narcissism and infidelity in early marriage.

There is theoretical reason to believe that narcissism is associated with infidelity. Yet, studies that have examined this association have yielded inconsistent results. Given that these inconsistencies may have emerged because prior studies used global assessments of narcissism that do not capture the extent to which the components of narcissism are activated in the sexual domain, the current research drew from two longitudinal studies of 123 married couples to examine the extent to which sexual narcissism predicted marital infidelity. Consistent with the idea that narcissism predicts sexual behavior when activated in the sexual domain, own sexual narcissism was positively associated with infidelity, controlling for own marital and sexual satisfaction, own globally-assessed narcissism, partner globally-assessed narcissism, and partner sexual narcissism. Helping to explain why this association emerged, further analyses demonstrated that it was driven by all four facets of sexual narcissism-sexual exploitation, grandiose sense of sexual skill, sexual entitlement (Study 1 only), and lack of sexual empathy (husbands only). Additionally, although partner sexual narcissism was unrelated to infidelity on average, partners' grandiose sense of sexual skill and partners' sexual entitlement (Study 2 only) were positively associated with infidelity, and partners' lack of sexual empathy was negatively associated with infidelity (Study 2 only). These findings highlight the benefits of using domain-specific measures of sexual narcissism in research on sexual behavior and the benefits of using domain-specific measures of personality more generally.

Adolescent Barriers to Sexual Communication with Their Parents: Differences by Sexual and Gender Identity.

Parent-adolescent sexual communication has important health benefits for adolescents, yet not all families openly communicate about sex. In particular, adolescents often report various barriers to engaging in sexual communication with their parents. The purpose of this study was to address gaps in past research by examining barriers to communication with both mothers and fathers, separately, as well as to explore the unique barriers to communication among queer and trans adolescents. Participants were recruited via Instagram (n = 566; Mage = 16.0; 57.6% cisgender girls; 41.4% heterosexual). The most endorsed barrier to communicating with mothers was the adolescent believing they already knew enough about sexual topics. The most endorsed barrier for communicating with fathers was embarrassment. The least endorsed barriers included mother's lack of knowledge, and perceptions of anger from fathers when discussing sexuality. Several differences emerged by sexual and gender identity: cisgender girls and trans adolescents tended to agree more with barriers to communication with parents compared to cisgender boys. Additionally, queer adolescents tended to agree more with barriers to communication with parents than their heterosexual peers, although group differences depended on the particular barrier. These findings highlight specific barriers to parent-adolescent sexual communication faced by various groups of youth.