Parental Alcohol Communication and Student Drinking: Examining Potential Differences between Underage and Legal Drinking Age Students.

BACKGROUND: We explored associations between parental alcohol communication (PCA) and student drinking behavior and protective behavioral strategies (PBS) use. METHODS: College students in the United States, who had talked about alcohol with parents, (N = 251) completed an anonymous online survey in Fall 2021. Participants reported frequency of discussing 14 alcohol-related topics with parents, past 30-day drinking behaviors, and PBS use. RESULTS: We identified two forms of PCA: general alcohol information and alcohol risk information, with alcohol risk information being more common than general alcohol information. PCA was not significantly associated with drinking behavior but was associated with two types of PBS. Specifically, general alcohol information was associated with greater use of serious harm reduction and stopping or limiting drinking strategies. Additionally, legal drinking age status moderated the associations between both forms of PCA and the use of stopping or limiting drinking strategies. In general, underage students stopping or limiting drinking strategies benefited from general alcohol information but not alcohol risk information. Legal drinking age students stopping or limiting drinking strategies benefited from alcohol risk information. CONCLUSIONS: Among these students, PCA appears to have a greater impact on PBS use rather than drinking behavior. This may reflect a shift in students' beliefs about parental authority over alcohol and parents' acceptance of alcohol use by their children.

Sex and Relationships Pre- and Early- COVID-19 Pandemic: Findings from a Probability Sample of U.S. Undergraduate Students.

In the wake of the COVID-19 pandemic, most U.S. colleges closed their campuses-including residence halls-causing significant disruption to students' lives. Two waves of data were collected from undergraduate students enrolled at a large U.S. Midwestern university: Wave 1 was a confidential online survey of 4989 randomly sampled undergraduate students collected in January/February 2020; Wave 2 was collected in April/May 2020 following campus closure. Our research aimed to: (1) assess how the COVID-19 related campus closure affected college students' romantic/sexual relationships, (2) examine students' past month sexual behaviors prior to the pandemic in comparison with their sexual behaviors during campus closure, and (3) compare participants' pre-pandemic event-level sexual behaviors with those occurring during campus closure. Of 2137 participants who completed both waves (49.8% women, mean age = 20.9), 2.6% were living at home in Wave 1 compared to 71.0% at Wave 2. Of those in relationships, 14.5% experienced a breakup and 25.3% stayed in their relationship but returned home to different cities. There were no statistically significant differences in participants' prior month reports of solo masturbation or sending/receiving nude/sexy images between Waves 1 and 2; however, participation in oral, vaginal, and anal sex significantly decreased across waves. Examining participants' most recent sexual events, Wave 2 sex more often occurred with a cohabiting or relationship partner and was rated as more wanted, emotionally intimate, and orgasmic. Implications for sexual health professionals are discussed.

Family Structure Diversity and Youth Health Care Access and Interactions With Health Care Providers.

Using data from the 2019 National Survey of Children's Health, we evaluated family structure differences in youth health care access and experiences. We found youth living with their married biological/adoptive parents generally had greater health care access than youth living in structurally diverse families. Differences, however, varied based on which aspect of health care access was examined and the specific types of structurally diverse families youth were living in. Youth living in single-father and other relative-headed families showed the most consistent differences in health care access from youth living with their married biological/adoptive parents. In terms of health care experiences, youth living in several structurally diverse families were more likely to have had time alone with health care providers. Furthermore, there were differences in family-centered care, but the effect size and magnitude of the differences were small.

Diverse Sexual Behaviors in Undergraduate Students: Findings From a Campus Probability Survey.

BACKGROUND: Probability-based surveys of college students typically assess sexual behaviors such as oral, vaginal, and anal sex. Little is known about the broader range of sexual behaviors in which students engage. AIMS: In a random sample survey of undergraduate students, we aimed to: (1) describe how recently participants had engaged in solo and partnered sexual behaviors, (2) examine how frequently participants enacted certain rough sex sexual behaviors (e.g., light spanking, hard spanking, choking, slapping, and others), (3) assess participants' frequency of experiencing certain rough sex behaviors, (4) describe participants' frequency of threesome/group sex, (5) assess the characteristics of participants' experiences with choking during sex; and (6) examine choking and face slapping in regard to consent. METHODS: A confidential, online cross-sectional survey of 4,989 randomly sampled undergraduate students at a large U.S. university. OUTCOMES: Participants reported having engaged in a broad range of solo and partnered sexual activities, including rough sex behaviors. RESULTS: The most prevalent general sexual behaviors were solo masturbation (88.6%), oral sex (79.4% received, 78.4% performed), penile-vaginal intercourse (73.5%), and partnered masturbation (71.1%). Anal intercourse was the least prevalent of these behaviors (16.8% received, 25.3% performed). Among those with any partnered sexual experience, 43.0% had choked a partner, 47.3% had been choked, 59.1% had been lightly spanked and 12.1% had been slapped on the face during sex. CLINICAL TRANSLATION: College health clinicians and educators need to be aware of the diverse and evolving range of solo and partnered sexual behaviors reported by students. In addition to counseling students about pregnancy and sexually transmitted infection risk, clinicians might assess patients' engagement in diverse sexual behaviors, such as choking/strangulation during sex, given the risk for serious outcomes including death. STRENGTHS AND LIMITATIONS: Strengths of our research include the large sample size, use of random sampling, high response rate for college populations, broad range of behaviors assessed, and novel data on choking during sex. Among our limitations, we did not assess to what extent the experiences were wanted, pleasurable, or appealing to participants. Except for in relation to choking and slapping, we also did not assess issues of consent. CONCLUSION: Participants reported engaging in diverse sexual behaviors, some of which have important clinical implications, are understudied, and warrant further research. Herbenick D, Patterson C, Beckmeyer J, et al. Diverse Sexual Behaviors in Undergraduate Students: Findings From a Campus Probability Survey. J Sex Med 2021;18:1024-1041.

The Prevalence of Using Pornography for Information About How to Have Sex: Findings from a Nationally Representative Survey of U.S. Adolescents and Young Adults.

We analyzed cross-sectional data collected from a U.S. nationally representative survey of individuals ages 14-24 years old on what sources of information from the past year they considered to be the most helpful about how to have sex (n = 600 adolescents ages 14-17 years old, and n = 666 young adults ages 18-24 years old). Among the 324 adolescents who indicated that they had been helped by at least one source of information, helpful information was most likely to have come from parents (31.0%) and friends (21.6%). Only 8.4% of adolescents said pornography was helpful. However, for those in the 18-24-year-old age group, pornography was the most commonly endorsed helpful source (24.5%), as compared to other possible options such as sexual partners, friends, media, and health care professionals. Multivariable regression analyses revealed that indicating that pornography was the most helpful source of information about how to have sex, compared to the other sources, was inversely associated with being female (OR = 0.32, p = .001), inversely associated with identifying as bisexual compared to heterosexual (OR = 0.15, p = .038), positively associated with being Black compared to being white non-Hispanic (OR = 4.26, p = .021), inversely associated with reporting a household income of either $25 K to $49,999 (OR = 0.31, p = .010) or $50 K to $74,999 (OR = 0.36, p = .019) compared to more than $75 K, and positively associated with having masturbated (OR = 13.20, p = .005). Subsequent research should investigate the role of pornography in both adolescent and adult sexual development, including why one-quarter of U.S. young adults say that pornography is a helpful source of information about how to have sex and what they think that they are learning from it.

Pleasure During Adolescents' Most Recent Partnered Sexual Experience: Findings from a U.S. Probability Survey.

Compared to studies on sexually transmitted infections and pregnancy prevention, sexual pleasure has received limited attention in the adolescent sexual development literature. In the present study, we used data from 157 adolescents (66 females; 14 to 17 years old), with a partnered sexual experience in the past 12 months to explore adolescents' sexual pleasure. First, we examined adolescents' perceptions of pleasure during their most recent partnered sexual experience. We then used information about those sexual experiences to identify correlates of sexual pleasure. Adolescents' reports of sexual pleasure were mixed. Although 17.8% reported their sexual experience was extremely pleasurable and 36.5% reported it was quite pleasurable, 26.6% indicated moderate pleasure, 13.1% a little pleasure, and 3.3% reported no pleasure. Sexual pleasure was primarily associated with aspects of sexual experiences that reflected socioemotional intimacy and desire. Specifically, cuddling with partners, emotional intimacy, and wantedness were all associated with greater sexual pleasure. Additionally, adolescents found sex more pleasurable when it occurred with a friend, but less pleasurable when it involved genital rubbing. Most sexual behaviors, having experienced orgasm, and the situational context of sexual experiences were not associated with sexual pleasure. Thus, specific sexual behaviors and orgasm may have less impact on sexual pleasure than feelings of emotional intimacy and desire. The diversity of perceived sexual pleasure and its associations with intimacy and desire suggest that, during adolescence, partnered sexual experiences are not primarily motivated by anticipated physical pleasure.

What Is Rough Sex, Who Does It, and Who Likes It? Findings from a Probability Sample of U.S. Undergraduate Students.

Using data from an undergraduate probability sample, we aimed to: (1) describe the prevalence and demographic characteristics of students who reported having engaged in rough sex with their current partner; (2) assess which sexual behaviors students consider to be rough sex; (3) describe the frequency with which participants report engaging in rough sex as well as their reports of initiating and liking rough sex, in relation to gender and sexual identity; and (4) examine predictors of rough sex frequency. Participants were 4998 students randomly sampled from a large Midwestern university who completed a confidential Internet-based survey (2453 women, 2445 men, 41 gender non-binary, 36 transgender or other gender non-conforming identities). Within these, 1795 individuals who reported a romantic/sexual partner of at least 3 months responded to questions about engaging, liking, and initiating rough sex. The most common behaviors participants considered to be rough sex were choking, hair pulling, and spanking. Transgender and gender non-binary students more often endorsed behaviors as rough sex. Also, rough sex was conceptualized as multidimensional, with one cluster being more consistent with earlier conceptualizations of rough sex (e.g., hair pulling, spanking) and the second cluster including behaviors such as choking, slapping, punching, and making someone have sex. About 80% of those with a current sexual or romantic partner engaged in rough sex with them and most who engaged it liked it. Bisexual women reported greater rough sex frequency and enjoyment (54.1% indicated enjoying it "very much"). Implications for sexuality research and education are discussed.

Exploring the associations between middle adolescent romantic activity and positive youth development.

INTRODUCTION: Although prior research has demonstrated romantic involvement can negatively impact adolescent well-being, it may also provide a context for developing characteristics of positive youth development (PYD). The present study explored the associations between adolescent romantic involvement and PYD. Study aim-1 determined if participation in different romantic activities was associated with PYD. Study aim-2 specifically focused on adolescents in romantic relationships, testing if relationship quality was associated with PYD. METHODS: The study was a secondary analysis of cross-sectional data from the age-15 assessment of the NICHD Study of Early Child Care and Youth Development. Study aim-1 used data from 826 15-year-olds (50% female) who reported their romantic socializing, dating, and relationship involvement. Study aim-2 used data from 190 15-year-olds (52% female) in romantic relationships who reported positive and negative interactions in their relationships. For both study aims, PYD was assessed as psychosocial maturity, peer competence, and school bonding. RESULTS: Based on hierarchical regression models, romantic socializing was positively associated with psychosocial maturity, peer competence, and school bonding; dating was positively associated with peer competence and school bonding; and relationship involvement was negatively associated with psychosocial maturity and school bonding. In terms of relationship quality, only one significant association emerged such that positive interactions were positively associated with peer competence. CONCLUSIONS: Overall, results supported the expectation that romantic involvement is associated with PYD during middle adolescence. However, the potential benefits of romantic involvement may be limited to the on-time romantic activities of romantic socializing and dating.

A Salient Belief Elicitation Examining Adolescents' Meditation Beliefs Using the Reasoned Action Approach.

The purpose of this study was to identify adolescents' consequence, referent, and circumstance beliefs about trying to meditate at least twice in the next week in order to inform subsequent meditation intervention design. A survey based on reasoned action approach (RAA) constructs was developed and pilot-tested. Thereafter, adolescents (N = 129), recruited from a northeastern U.S. high school, responded to open-ended survey questions eliciting beliefs underlying intention to try meditating. Thematic analysis was executed to examine beliefs and frequencies of beliefs. Five types of salient meditation beliefs were identified: advantages (e.g., reduces stress, increases relaxation, improves focus), disadvantages (e.g., slows everything down), supporters and disapprovers (e.g., family and friends), and facilitating circumstances (e.g., more time, fewer distractions). Adolescents recognize meditation as having health benefits but as also taking time. They further viewed meditation as socially acceptable but need sufficient time and a conducive environment to try it. To be effective, interventions designed to promote adolescents' self-regulation through meditation should address identified salient beliefs.

Considerations in the Measurement and Reporting of Withdrawal: Findings from the 2018 National Survey of Sexual Health and Behavior.

INTRODUCTION: Although withdrawal use is routinely measured as part of contraceptive surveillance in the United States, its assessment may be prone to underreporting and measurement errors. Additionally, at the population level, little is known about subjective experiences of withdrawal. AIM: To measure respondents' frequency of and reasons for engaging in extra-vaginal ejaculation in the past year, and to compare contraceptive withdrawal vs extra-vaginal/anal ejaculation during the most recent sexual event. METHODS: The 2018 National Survey of Sexual Health and Behavior is a U.S. nationally representative probability survey of adolescents and adults. This study was administered in February-March 2018 via GfK Research's KnowledgePanel. Respondents who reported consensual penile-vaginal intercourse in the past year were included in the analysis. Logistic regression was used to assess factors associated with finding extra-vaginal ejaculation sexy/arousing. MAIN OUTCOME MEASURES: Main outcomes were the frequency of and reasons for extra-vaginal ejaculation in the past year, as well as reported contraceptive withdrawal use and the location of ejaculation at the most recent penile-vaginal intercourse. RESULTS: In the past year, approximately 60% of respondents reported engaging in any extra-vaginal ejaculation; pregnancy prevention and sexual pleasure were given as common reasons. Those who were men, white, or aged 25-29 were more likely to find extra-vaginal ejaculation sexy or arousing; no gender differences were observed in their partner's perception of this act. Prevalence of selecting withdrawal on the contraceptive inventory was 12.2% (95% CI 10.6-14.0) at last sexual event, whereas extra-vaginal/anal ejaculation was reported by 20.8% (95% CI 18.7-23.0). This lack of concordance in differing measures was observed consistently across all age groups, and approximately 12% to 14% of individuals reported an ejaculation location that did not correspond to their withdrawal use. CLINICAL IMPLICATIONS: The results of this study have implications for how healthcare providers discuss withdrawal with their patients and counsel them on using extra-vaginal ejaculation as part of their contraceptive use or part of their sexual repertoire. STRENGTHS & LIMITATIONS: This is the first nationally representative study to directly compare contraceptive withdrawal to extra-vaginal ejaculation. Limited data were collected at event level regarding motivations for extra-vaginal ejaculation, pregnancy attitudes, perceptions of condoms and sexually transmitted infection prevention, or exposure to erotic media, thus limiting further assessment of relationships between various factors and extra-vaginal/anal ejaculation. CONCLUSION: We found that reporting of withdrawal as a contraceptive method vs extra-vaginal/anal ejaculation was inconsistent and that extra-vaginal/anal ejaculation was commonly used for reasons other than pregnancy prevention; future research should use more precise measures of "withdrawal." Fu TC, Hensel DJ, Beckmeyer JJ, et al. Considerations in the Measurement and Reporting of Withdrawal: Findings from the 2018 National Survey of Sexual Health and Behavior. J Sex Med 2019;16:1170-1177.

Characteristics of Adolescent Sexting: Results from the 2015 National Survey of Sexual Health and Behavior.

Using data from 78 sexting-experienced adolescents from the 2015 National Survey of Sexual Health and Behavior, we describe sexting frequency, sexting partners, sexual relationships with such partners, and characteristics associated with sexting. Most (59.2%) respondents sexted at most monthly, usually with romantic partners (62.0%). About 41% of sexting-experienced adolescents did not usually have sexual relationships with sexting partners, 36.6% usually sexted after starting a sexual relationship, and 16.8% reported that their sexting typically preceded sexual relationships. Younger adolescents sexted more frequently. Those without vaginal sex/anal sex experience, or prior romantic experience, were more likely to have sexted a non-romantic/sexual partner.

With a little help from my friends? A longitudinal look at the role of peers versus friends on adolescent alcohol use.

INTRODUCTION: Alcohol is the most commonly used substance by South African adolescents. Social norms play a key role in alcohol use, although distinctions are not always made between descriptive and injunctive norms and peer proximity. Additionally, little research identifies factors attenuating social norms, peer proximity, and alcohol use, such as one's ability to resist peer influence. METHODS: The current study investigates the relationship between adolescent alcohol use in 9th Grade and descriptive peer and injunctive friend norms in 8th grade, the moderating role of resistance to peer influence, and sex differences. Data were from South African students (N = 3592; Mage = 14) participating in the HealthWise South Africa implementation quality trial. RESULTS: Path model results indicated injunctive friend norms, but not peer norms, influenced alcohol use. Resistance to peer influence did not moderate relationships and group comparisons found no sex differences. CONCLUSION: Findings suggest social proximity shapes influences of alcohol use. Despite a differing cultural context, findings were consistent with those from the United States, indicating social proximity is relevant cross-culturally.

Family-Centered Care and Positive Developmental Outcomes for Youth With Special Health Care Needs: Variations Across Family Structures.

Drawing on a social determinants of health framework, we evaluated associations between perceived family-centered care (FCC) and positive developmental outcomes for youth with special health care needs across six different family structures (married biological families, cohabiting biological families, married stepfamilies, cohabiting stepfamilies, divorced/separated single-mother families, and never-married single-mother families). Using data from the 2011-2012 National Survey of Children's Health, we found that married biological families perceive greater FCC than do other family structures. Perceived FCC was positively associated with all three positive youth outcomes evaluated (children's health, participation in extracurricular activities, and flourishing) in married biological families, and two of the three outcomes (children's health and flourishing) in married stepfamilies and divorced/separated single-mother families. Implications for health care provision and future research with structurally diverse families are discussed.

Non-intercourse and intercourse hookup intentions, drinking expectancies, and college students' heavy drinking.

BACKGROUND: The current study tested the associations between college students' intentions to hookup (i.e., specifically intending to go out and engage in sexual behavior with a non-romantic partner) and self-reported heavy drinking. Further, social and sexual enhancement drinking expectancies were tested as moderators of those associations. METHODS: College students (N = 235) reported (a) if they had specifically intended to hookup (reported separately for non-intercourse and intercourse hookup intentions) in the past 6 months; (b) social and sexual enhancement drinking expectancies; and (c) heavy drinking (a composite of past-30-day drinking frequency, typical amount consumed per drinking occasion, and how many times they got drunk). Data were analyzed using a hierarchical multiple regression (HMR), controlling for demographic variables. RESULTS: Non-intercourse hookup intentions were positively associated with heavy drinking, but intercourse hookup intentions were not. Sexual but not social enhancement drinking expectancies moderated the associations between both types of hookup intentions and heavy drinking. Among those who had intended a non-intercourse hookup, heavy drinking was greater when they also reported high (+1 SD) sexual enhancement drinking expectancies. For intercourse hookup intentions, higher (+1 SD) sexual enhancement drinking expectancies were associated with less heavy drinking. CONCLUSIONS: Pursuing non-intercourse hookups appears to be associated with heavy drinking, but intercourse hookup intention is not. Sexual enhancement drinking expectancies moderated those associations. Thus, an interest in some types of casual sexual experiences may promote heavy drinking among college students.

Moving Beyond Drinking to Have a Good Time: a Person-Centered Approach to Identifying Reason Typologies in Legal-Aged College Student Drinkers.

Alcohol use, reasons for use, and consequences of use continue to be a major concern in college student populations. This is especially true for students of legal drinking age who may experience different reasons for and greater negative consequences of alcohol use than students under 21 years old. Although multiple studies have used person-centered approaches to understand motivations for and ultimately prevent alcohol use, few have identified multiple typologies of reasons for alcohol use. The current study used latent class analysis to identify homogeneous subtypes of reasons for alcohol use and how classification was associated with alcohol-related consequences in college students aged 21 years old and older (N = 2300) from the 2013 Indiana College Substance Use Survey. Four profiles of reasons for alcohol use emerged across males and females: social drinkers, feel good drinkers, relaxed escaping drinkers, and emotion coping drinkers. Although the likelihood of consequences differed across gender, the emotion coping drinkers were more likely to experience all negative consequences, suggesting that it was a high-risk class. In general, this pattern of risk continued with the feel good drinkers and female relaxed escaping drinkers. These results can help optimize college substance use prevention and intervention efforts to (1) identify and understand characteristics of high- and low-risk student drinkers and (2) tailor the content of interventions to those specific profiles resulting in more effective approaches to reducing alcohol use.

Perceptions of alcohol use by friends compared to peers: Associations with middle adolescents' own use.

BACKGROUND: In this study, the authors (a) distinguished between adolescents' perceptions of their peers' and friends' alcohol use to examine the unique associations these perceptions have on adolescents' own alcohol use and (b) tested if the ability to resist peer influence moderated those associations. METHODS: Data were from the Study of Early Child Care and Youth Development (N = 876, all aged 15). Adolescents reported (a) perceptions of alcohol use by their peers, (b) perceptions of alcohol use by their friends, (c) their own alcohol use in the last year, and (d) a measure of their ability to resist peer influence. Data were analyzed with hierarchical logistic regression (HLR), controlling for demographic variables and parental knowledge. RESULTS: Three HLR models were computed: 1 for the full sample, 1 for only males, and 1 for only females. In all models, perceptions of alcohol use by friends (odds ratios [ORs]: ORFull = 10.17, ORFemale = 15.51, ORMale = 7.25) were associated with a greater likelihood of adolescents using alcohol themselves. Perceptions of alcohol use by peers (ORFull = 1.13, ORFemale = 1.11, ORMale = 1.14) were not significantly associated with adolescents' own alcohol use. The ability to resist peer influence did not moderate any of those associations. CONCLUSIONS: It appears that when adolescents perceive more of their friends, but not their peers, consume alcohol, they themselves are at greater risk for alcohol use, and those associations do not depend upon their ability to resist peer influence.

Comparing the associations between three types of adolescents' romantic involvement and their engagement in substance use.

Using data on 838 middle adolescents, the current study compared the associations between three types of romantic involvement and alcohol, tobacco, and marijuana use. Off-time (i.e., serious romantic relationships) but not on-time (i.e., romantic socializing and dating) types of involvement were expected to be associated with increased odds of using each substance. Participating in romantic socializing was unrelated to substance use and dating was only positively associated with alcohol use. Participation in serious romantic relationships, however, was associated with an increased likelihood of having used each substance. Associations did not differ between males and females. Based on these results some but not all forms of romantic involvement may place middle adolescents at risk for substance use. Implications for parents and relationship education are discussed.

Correlates of college student use of protective behavioral strategies when drinking alcohol.

Objective: The present study identified student characteristics associated with using protective behavioral strategies (PBS) to reduce harms when consuming alcohol. Participants: 224 college students who drink alcohol (66.5% female, 89.7% White non-Hispanic, Mage = 21.04) completed an anonymous study survey. Methods: Participants reported use of three PBSs: serious harm reduction; stopping or limiting drinking; and manner of drinking. They also reported sensation seeking, romantic involvement, parent-student alcohol communication, and attitudes toward alcohol in college life. Results: Attitudes toward alcohol in college life, Greek life participation, and sensation seeking were the variables most consistently associated with PBS use. Perceiving alcohol as an important part of college and sensation seeking were associated with less PBS use, but Greek life participation was associated with greater PBS use. Conclusions: Specific resources may be needed to encourage PBS use among high sensation seeking students and those who believe alcohol is a part of college life.

Long-distance romantic relationships among college students: Prevalence, correlates, and dynamics in a campus probability survey.

OBJECTIVE: To determine the prevalence of long-distance relationships (LDRs) among college students and explore how relationship dynamics differed between LDRs and geographically close relationships (GCRs). PARTICIPANTS: Data were from romantically involved students (N = 2075) who participated in the 2020 College Sexual Health Survey. METHODS: Students completed an online survey in which they reported their current romantic relationship status, if they were in a long-distance relationship, and relationship dynamics (happiness, commitment, and conflict). RESULTS: Overall, 34.2% of romantically involved students were in LDRs, which were more common for first-year students, students in longer duration relationships, dating relationships, and Hispanic, Asian, and multiracial students. LDRs were less common for older students. Based on χ2 tests, relationship happiness, commitment, and conflict did not differ based on LDR status. CONCLUSIONS: As LDRs are common, providing students with resources focused on navigating LDRs may help them manage their romantic relationships.