Exploring Condom Use Behaviors Among African American Adolescent Boys in the Deep South.

Risky sexual behaviors among adolescents can increase adverse outcomes including unplanned pregnancy or contraction or transmission of disease. Adolescents who engage in risky sexual activities are at increased risk for adverse health and social outcomes compared to those who do not engage. Despite declines in adolescent pregnancy and birth rates, the diagnosis of sexually transmitted infections (STIs) is steadily increasing among adolescents. Moreover, African American adolescent boys in the United States, specifically in the southeastern region are disproportionally at greater risk for STIs, and STI diagnosis within this population has increased over time, compared to their white counterparts. This study sought to identify factors associated with condom use among adolescent boys in the Deep South. Using data from the Mobile Youth Survey, a longitudinal adolescent community-based survey, this study assessed the relationship between personal, behavioral, and environmental factors and condom use among African American adolescent boys (14-19 years). Younger participants (14-15 and 16-17) were more likely to use a condom during the last sexual intercourse compared to older participants (18-19 years). High positive attachment to boy/girlfriend was associated with increased condom use. The number of sexual partners, age at their first sexual encounter, recent sexual behavior, and having an STI were also associated with increased condom use among participants. The study provides further insights into factors associated with condom use among African American adolescent boys and results can inform the development of sexual health interventions.

A longitudinal study of the impact of school delinquency on self-worth development among Black American adolescents.

Previous research found adolescents with low self-worth often utilize delinquency as a method of "self-enhancing" as proposed by Kaplan, which suggests the effects of delinquency can be both enhancing and damaging to adolescents' later reports of self-worth. We tested Kaplan's self-enhancing thesis to determine the extent to which different levels of self-worth in early adolescents foretell long-term levels of self-worth associated with delinquency among adolescents placed at-risk. Data from a sample of 982 primarily Black American (95%) adolescents living in high-poverty neighborhoods were analyzed using global and behavioral self-worth measures collected annually between the ages of 12-17, with school delinquency as the self-enhancing mechanism. Gender (45% female, 55% male) and baseline self-worth measures were included in the model. We found empirical support for the positive effects of school delinquency consistent with self-enhancing theories, although with younger female participants only. Specifically, engaging in delinquent behaviors at age 12 had a positive effect on a females' behavioral self-worth. There were, however, differential effects for males. Although delinquency increased self-worth among females in the short-term, long-term effects were negative, as greater school delinquency resulted in lower self-worth at age 17. Additional gender results and implications for findings are discussed.

Family Matters: Examining Child Abuse and Neglect as Family Dysfunction for Minority Youth Living in Extreme Poverty.

Two competing models of child abuse and neglect (scapegoat vs. family dysfunction) are used to illustrate how the specification of victims ("index" victim vs. all children in household) from incidents of child abuse and neglect can be used to improve estimates of maltreatment for at-risk minority youth. Child Protection Services records were searched in 2005 for 366 "index" victims who were surveyed for 5 consecutive years (from 1998 to 2002) for the Mobile Youth Survey as well as other siblings in the household. The findings indicate that the baseline estimate of any maltreatment, sexual abuse, physical abuse, and neglect increased by 68%, 26%, 33%, and 74%, respectively, after adjusting for incidents that involved multiple victims (i.e., maltreatment as family dysfunction). In addition, the baseline estimate of more severe (indicated) incidents of physical abuse and neglect increased by 67% and 64%, respectively, after accounting for incidents that involved multiple victims, but there were no incidents of more severe (indicated) sexual abuse that involved multiple victims. Similarly, baseline estimates of age of onset (or chronicity) of maltreatment during childhood and adolescence increased by 62% and 26%, respectively. Baseline estimates for youth with 3 or more years of maltreatment and youth with 3 or more incidents of maltreatment both increased by about 71%. The implications of these findings for policy and practice as well as areas for future research are also discussed.

Bidirectional Relationships Between Parenting Processes and Deviance in a Sample of Inner-City African American Youth.

The current study assessed for bidirectional relationships among supportive parenting (knowledge), negative parenting (permissiveness), and deviance in a sample (N = 5,325) of poor, inner-city African American youth from the Mobile Youth Survey (MYS) over 4 years. Cross-lagged path analysis provided evidence of significant bidirectional paths among parenting processes (knowledge and permissiveness) and deviance over time. Follow-up multigroup tests provided only modest evidence of dissimilar relationships by sex and by developmental periods. The findings improve our understanding of developmental changes between parenting behaviors and deviance during adolescence and extended current research of the bidirectionality of parent and child relationships among inner-city African American youth.

Dimensionality and Genetic Correlates of Problem Behavior in Low-Income African American Adolescents.

Researchers have long observed that problem behaviors tend to cluster together, particularly among adolescents. Epidemiological studies have suggested that this covariation is due, in part, to common genetic influences, and a number of plausible candidates have emerged as targets for investigation. To date, however, genetic association studies of these behaviors have focused mostly on unidimensional models of individual phenotypes within European American samples. Herein, we compared a series of confirmatory factor models to best characterize the structure of problem behavior (alcohol and marijuana use, sexual behavior, and disruptive behavior) within a representative community-based sample of 592 low-income African American adolescents (50.3% female), ages 13 to 18. We further explored the extent to which 3 genes previously implicated for their role in similar behavioral dimensions (CHRM2, GABRA2, and OPRM1) independently accounted for variance within factors specified in the best-fitting model. Supplementary analyses were conducted to derive comparative estimates for the predictive utility of these genes in more traditional unidimensional models. Findings provide initial evidence for a bifactor structure of problem behavior among African American adolescents and highlight novel genetic correlates of specific behavioral dimensions otherwise undetected in an orthogonal syndromal factor. Implications of this approach include increased precision in the assessment of problem behavior, with corresponding increases in the reliability and validity of identified genetic associations. As a corollary, the comparison of primary and supplementary association analyses illustrates the potential for overlooking and/or overinterpreting meaningful genetic effects when failing to adequately account for phenotypic complexity.

Does it really matter which drug you choose? An examination of the influence of type of drug on type of risky sexual behavior.

This study investigates whether certain types of substances are differentially related to certain risky sexual behaviors (RSBs) within the same population and determines whether combination substance use (SU) has additive, redundant or antagonistic effects on RSBs. African-American youth aged 9-19 participated in a large, community-based survey assessing substance use and sexual behaviors. Multilevel modeling was used to predict the differential influence of alcohol, marijuana, and cocaine use on condom use measured in the past 90days and at last intercourse, sex while drunk/high, and number of sexual partners. Tests of the within-participant relations showed that participants increasing their SU over time concurrently increased their RSBs, establishing a strong link between the two behaviors (alcohol: condom ß=-0.045, sex while drunk/high ß=0.138, sex partners ß=0.102; marijuana: condom ß=-0.081, sex while drunk/high ß=0.255, sex partners ß=0.166; cocaine: condom ß=-0.091, sex while drunk/high ß=0.103, sex partners ß=0.031; all p's<0.01). Tests of the between-participant relations showed that, generally, youth reporting less SU across their teenage years were also more likely to report fewer RSBs over this period (alcohol: condom ß=-0.128, sex while drunk/high ß=0.120, sex partners ß=0.169; marijuana: condom ß=-0.170, sex while drunk/high ß=0.638, sex partners ß=0.357; cocaine: condom ß=-0.353; all p's<0.05). Moreover, the combination of some substances has unique redundant or antagonistic effects on RSB. Such findings support the consideration of type of SU, and particular combinations of substances, on RSBs in intervention development.

Genes involved in stress response and alcohol use among high-risk African American youth.

BACKGROUND: Genetic and environmental factors influence substance use behaviors in youth. One of the known environmental risk factors is exposure to life stressors. The aim of this project is to study the interaction between NR3C1 and CRHBP, genes thought to be involved in stress pathways, exposure to stressful life events, and adolescent alcohol use/misuse. METHODS: The sample included 541 African American individuals (ages 13-18) from the Genes, Environment, and Neighborhood Initiative, a subset of the Mobile Youth Survey sample from whom DNA and more extensive phenotypic data were collected. Participants were selected from high-poverty neighborhoods in Mobile, Alabama, with potential exposure to a variety of extreme life stressors. RESULTS: A measure of stressful life events was significantly predictive of alcohol use/misuse. In addition, this association was significantly dependent upon the number of putative risk variants at rs1715749, a single-nucleotide polymorphism (SNP) in CRHBP (P ≤ .006). There was no significant interaction between NR3C1 and stressful life events with respect to alcohol use/misuse, after taking into account multiple testing. CONCLUSIONS: These findings suggest that CRHBP variants are potentially relevant for adolescent alcohol use/misuse among African American youth populations being reared within the context of stressful life events and warrant replication.

Relations among suicidality, recent/frequent alcohol use, and gender in a black american adolescent sample: a longitudinal investigation.

OBJECTIVE: Examine longitudinally select factors that may contribute to suicide ideations and attempts in adolescents. METHOD: Using a multiple cohort research design, surveys were administered to a longitudinal sample of Black American adolescents aged 11-18 years. RESULTS: Two logistic growth models were tested with the probability of a suicide ideation (n = 977) and identified suicide attempt (n = 457) as the outcome variables and the recency and frequency of alcohol use and gender as the predictor variables. The recency and frequency of alcohol use was significantly related to suicide ideations and identified attempts in both females and males. These findings were differentiated based on the age effects for recency and frequency of alcohol use. More recent and frequent alcohol use among younger adolescents exacerbated probabilities of suicide ideations and identified suicide attempts compared to older adolescents. CONCLUSION: Results indicate that early systematic assessment of suicidal behavior and alcohol use in Black American adolescents can inform developmentally and culturally responsive prevention and intervention efforts.

The effects of age, gender, hopelessness, and exposure to violence on sleep disorder symptoms and daytime sleepiness among adolescents in impoverished neighborhoods.

Although sleep problems are associated with negative outcomes among adolescents, studies have not focused on sleep disorder symptoms among adolescents living in impoverished neighborhoods and how sleep problems may be related to two factors common in those environments: hopelessness and exposure to violence. This study used data from the longitudinal Mobile Youth Survey (MYS; N = 11,838, 49% female, 93% African-American) to examine trajectories of sleep problems by age (10-18 years) among impoverished adolescents as a function of gender, feelings of hopelessness, and exposure to violence. The results indicate that sleep problems associated with traumatic stress decline with age, with four notable distinctions. First, the steepest decline occurs during the early adolescent years. Second, the rate of decline is steeper for males than for females. Third, exposure to violence impedes the rate of decline for all adolescents, but more dramatically for females than for males. Fourth, the rate of decline is smallest for adolescents with feelings of hopelessness who also had been exposed to violence. To explore the generalizability of these results to other types of sleep disorders, we analyzed cross-sectional data collected from a subsample of 14- and 15-year-old MYS participants (N = 263, 49% female, 100% African-American) who completed a sleep symptoms questionnaire. Four results from the cross-sectional analysis extend the findings of the longitudinal analysis. First, the cross-sectional results showed that symptoms of apnea, insomnia, nightmares, and restless legs syndrome or periodic limb movement disorder (RLS/PLMD), as well as daytime sleepiness, increase as a function of hopelessness. Second, symptoms of insomnia, RLS, and nightmares, as well as daytime sleepiness, increase as function of exposure to violence. Third, symptoms of insomnia and RLS/PLMD are greater under conditions of combined hopelessness and exposure to violence than for either condition alone. Fourth, symptoms of RLS/PLMD are worst for females who have been exposed to violence and experience hopelessness. Overall, the findings suggest that hopelessness and exposure to violence have negative independent and multiplicative effects on adolescent sleep, particularly for females. Understanding the causal factors associated with inadequate sleep in impoverished adolescents is important for three reasons. First, sleep is an important aspect of adolescent development. Second, inadequate sleep has severe consequences for adolescent morbidity, mortality, and overall quality of life. Third, impoverished adolescents are at the most severe risk for poor outcomes, and improvement in their sleep may produce large gains.

The role of social support and social context on the incidence of attempted suicide among adolescents living in extremely impoverished communities.

PURPOSE: Evaluate the impact of social support and social context on suicide attempt in disadvantaged adolescents, and calculate that longitudinal risk of suicide attempt. METHODS: Seven thousand two hundred ninety-nine adolescents were used to evaluate the effect of social support and context on suicide attempt, and to estimate the overall risk of suicide attempt. RESULTS: Increased peer support reduced the risk of suicide attempt, and increased perceived inevitability of violence led to an increase in risk among 9-year-old children. As children age, the effect of overall peer support remains consistent, while there is a reduction in the effect of inevitability of violence. Approximately 36% of extremely impoverished adolescents attempt suicide by the age of 19. CONCLUSIONS: The current study provides insight into the nature of suicide attempt within a grossly understudied population. Social support and social context have an important impact on suicidal behavior in extremely disadvantaged adolescents.

Associations of adolescent hopelessness and self-worth with pregnancy attempts and pregnancy desire.

OBJECTIVES: We examined the associations of pregnancy desire (ambivalence or happiness about a pregnancy in the next year) and recent pregnancy attempts with hopelessness and self-worth among low-income adolescents. METHODS: To evaluate independent associations among the study variables, we conducted gender-stratified multivariable logistic regression analyses with data derived from 2285 sexually experienced 9- to 18-year-old participants in the Mobile Youth Survey between 2006 and 2009. RESULTS: Fifty-seven percent of youths reported a desire for pregnancy and 9% reported pregnancy attempts. In multivariable analyses, hopelessness was positively associated and self-worth was negatively associated with pregnancy attempts among both female and male youths. Hopelessness was weakly associated (P = .05) with pregnancy desire among female youths. CONCLUSIONS: The negative association of self-worth and the positive association of hopelessness with pregnancy attempts among young men as well as young women and the association of hopelessness with pregnancy desire among young women raise questions about why pregnancy is apparently valued by youths who rate their social and cognitive competence as low and who live in an environment with few options for material success.

SOCIO-ECOLOGICAL PREDICTORS OF INTERCOURSE FREQUENCY AND NUMBER OF SEXUAL PARTNERS AMONG MALE AND FEMALE AFRICAN AMERICAN ADOLESCENTS.

The current study examined 14 waves of data derived from a large, community-based study of the sexual behavior of impoverished youth between 12 and 17 years of age residing in the Deep South. We used multilevel linear modeling to identify ecological predictors of intercourse frequency and number of sexual partners among gender-specific subsamples. Results indicated that predictors of adolescent sexual behavior differed by both type of sexual behavior and gender. For males, age, maternal warmth, parental knowledge, curfew, self-worth, and sense of community predicted intercourse frequency, while age, parental knowledge, curfew, self-worth, friend support, and sense of community were significantly associated with having multiple sexual partners. Among females, age, curfew, and self-worth exerted significant effects on intercourse frequency, while age, parental knowledge, curfew, and self-worth exerted significant effects on having multiple sexual partners. Implications and future directions are discussed.

Change in Age-Specific, Psychosocial Correlates of Risky Sexual Behaviors Among Youth: Longitudinal Findings From a Deep South, High-Risk Sample.

The current study examined psychosocial predictors of change in intercourse frequency and number of sexual partners among youth within a socio-ecological framework and assessed whether these determinants vary by stage of adolescent development. Longitudinal data were derived from a large, community study of adolescent risky behavior among predominantly high-risk, African American youth. Significant predictors of intercourse frequency for early adolescents included age, gender, self-worth, and familial factors; for older youth, age, gender, self-worth, curfews, and sense of community exerted significant effects. Among early adolescents, age, gender, self-worth, familial factors, and sense of community predicted change in the number of sexual partners in the previous year, while age, gender, self-worth, parental knowledge, curfews, and sense of community were predictive of change in the number of sexual partners in the previous year among older youth. Study implications and future directions are discussed.

Specifying the interrelationship between exposure to violence and parental monitoring for younger versus older adolescents: a five year longitudinal test.

Five waves of longitudinal data collected from 349 African American youth living in extreme poverty were used to examine the interrelationship between exposure to violence and parenting during adolescence. Semi-parametric group based modeling was used to identify trajectories of parental monitoring and exposure to violence from T1 to T5. Results from these analyses revealed: (1) a trajectory of declining parental monitoring for 48% of youth; and (2) four distinct trajectories of exposure to violence. Multivariate findings were largely consistent with the ecological-transactional model of community violence. Youth with stable and/or increasing trajectories of exposure to violence were more likely than youth with stable-low exposure to violence to have declining parental monitoring, but additional analyses revealed a similar pattern of findings for younger adolescents (age 9-11 T1), but no evidence of linkages between trajectories of exposure to violence and parental monitoring for older adolescents (age 12-16 T1). The theoretical and policy implications of these findings as well as areas for future research are also discussed.

Sleep disturbance and risk behaviors among inner-city African-American adolescents.

Adolescents tend to experience more problems with sleep loss as a natural consequence of puberty, whereas teens from impoverished urban areas are likely to witness neighborhood violence and/or engage in risk behaviors that may affect sleep. Data from the Mobile Youth Survey, a longitudinal study of impoverished inner-city African-American adolescents (1998-2005; N = 20,716; age range = 9.75-19.25 years), were used to compare paired years of annual surveys elicited by questions about how sleep was affected when bad things happen to friends or family. Using a cross-lagged panel multivariate approach comparing reports for two sequential years and controlling for age/gender plus exposure to traumatic stress and violence, prior sleep disturbance was associated with carrying a knife/gun, brandishing a knife/gun, using a knife/gun, quick temperedness, warmth toward mother, worry, and belief in the neighborhood street code in the latter year. Conversely, seeing someone cut, stabbed, or shot, using alcohol, worry, and internalized anger were associated with sleep disturbance in a latter year. Although a limited measure of sleep disturbance was used, these findings support further research to examine sleep disturbance and risk behaviors among low-income adolescents.

Does parenting shield youth from exposure to violence during adolescence? A 5-year longitudinal test in a high-poverty sample of minority youth.

Five waves of longitudinal data collected from 349 African American youth living in extreme poverty were used to determine if parental monitoring shielded youth from exposure to violence during adolescence. Semiparametric group- based modeling was used to identify trajectories of parental monitoring and exposure to violence from T1 to T5. Results from these analyses revealed (a) about 52% of youth had a trajectory of hypervigilant parental monitoring and (b) two out of the five distinct trajectories of exposure to violence were low and/or declining over the 5-year time period. Multivariate findings indicated that (a) youth with a trajectory of hypervigilant parenting were 109% more likely to have middle-declining exposure to violence, but hypervigilant parenting was unrelated to stable and low exposure to violence T1 to T5. The theoretical and policy implications of these findings as well as areas for future research are also discussed.

Pathways and Predictors of Antisocial Behaviors in African American Adolescents from Poor Neighborhoods.

Antisocial behavior among youth remains a serious personal and social problem in the United States. The purposes of this study were to (1) identify the shape and number of developmental trajectories of antisocial behavior in a sample of poor, inner-city African American youth, and (2) test predictors of group membership and the developmental course of antisocial behaviors. Using growth mixture modeling, we examined predictors of antisocial behavior pathways and the likelihood of arrest in a sample of 566 poor, urban African American adolescents (ages 11 to 16). Three distinct trajectory classes of antisocial behavior were identified over a period of six years: one low-risk group (low steady) and two high-risk groups (incremental and high starter). The conditional probabilities for being arrested during ages 14-16 were 0.18 for the low steady class, 0.68 for the incremental class, and 0.31 for high starter class. Prevention strategies for adolescents at high risk are discussed.

Development and risk behavior among African American, Caucasian, and mixed-race adolescents living in high poverty inner-city neighborhoods.

Youths growing up in low-income inner-city neighborhoods are at substantial risk for initiating substance use, violent behavior, and sexual intercourse at early ages; these risk behaviors continue at comparatively high rates through adolescence. Hopelessness has been implicated as a risk factor for these behaviors. In this paper, we consider how race influences this process. African Americans form a demographic minority within the United States, but they are often the majority within inner-city neighborhoods. For Caucasians, the opposite typically holds. Mixed-race populations form a minority within both contexts. Using longitudinal data, we examine the relationship between race and risk behaviors in several impoverished inner-city neighborhoods where African Americans form the distinct majority and Caucasians and people of mixed racial heritage form a small minority. We also consider how race moderates the relationship between hopelessness and risk behavior. Our findings show that compared to Caucasian or mixed-race adolescents, African American adolescents are less likely to engage in risk behaviors, and that hopelessness has a less important impact on their behaviors.

The origins of hopelessness among inner-city African-American adolescents.

Much has been written in recent years about hopelessness among residents of impoverished inner-city neighborhoods, but little research has been conducted on the origins of hopelessness. The literature on social disorganization and the literature on child development independently suggest two possible causes of hopelessness among adolescents: disruptive events and lack of connectedness to people and institutions. We explore these two factors as predictors of hopelessness for 5895 youths living in impoverished inner-city neighborhoods in Mobile, Alabama. The longitudinal data for this study allow us to explore the development of hopelessness over time, predicted by prior levels of disruption and connectedness. The results show that over time several variables associated with disruption (Change in Mother Figure, Exposure to Violence, Traumatic Stress, Worry) and connectedness (Sense of Community, Warmth Toward Mother, Religiosity) are positively or negatively associated with increased feelings of hopelessness among inner-city adolescents.

Hopelessness and risk behaviour among adolescents living in high-poverty inner-city neighbourhoods.

Ethnographic literature on inner-city life argues that adolescents react to their uncertain futures by abandoning hope, leading them to engage in high levels of risk behaviour. However, few quantitative studies demonstrate this relationship. This study tests this relationship using a survey of 2468 inner-city adolescents, asking them questions about hopelessness, violent and aggressive behaviour, substance use, sexual behaviour, and accidental injury. Nearly 50% of males and 25% of females had moderate or severe feelings of hopelessness. Moreover, hopelessness predicted of each of the risk behaviours considered. These results suggest that effective prevention and intervention programmes aimed at inner-city adolescents should target hopelessness by promoting skills that allow them to overcome the limitations of hopelessness.