Validation of the Sexual Discounting Task for Use in Adolescents.

The Sexual Discounting Task (SDT) was developed to evaluate the effects of delay on decision making as it relates to sexual risk-taking behaviors. Though previously validated with other populations, including urban emerging adults, the current study sought to validate the SDT with adolescents. A sample of adolescents (N = 155; 61% female) between ages 14 and 21 (Mage = 19.5 years) was recruited to complete the SDT (involving choices between immediate unprotected sex and delayed sex with a condom with hypothetical sexual partners) and the Delay Discounting Task (a delay discounting task for money outcomes). Additionally, they completed several self-report measures assessing demographics, sexual behavior, and sexual history. If the condom was readily available, respondents were more likely to use a condom for partners who were judged "most likely to have an STI" and for those that participants were "least likely to have sex with." Moreover, when a condom was not immediately available, greater self-reported sexual risk-taking was related to greater sexual discounting (i.e., greater effects of delay on decreasing condom use). Furthermore, sexual discounting was greater among partners deemed more desirable and those judged "least likely to have an STI." Differences in sexual discounting were significant after controlling for immediately available condom use. Findings from the current study suggest that the SDT is clinically meaningful for adolescents and is sensitive to factors that influence real-world decisions to use condoms. Future treatment and prevention should consider delay discounting as an important variable affecting sexual risk behavior.

A conceptual framework for queer, black womxn sexual assault survivors: an adaptation of the minoritised stress model.

Queer, Black womxn experience sexual assault at an alarming rate in the USA leading to adverse mental and physical health outcomes in survivors. A synthesis of the literature was conducted to understand their unique lived experiences and needs. This article proposes an adapted Meyer's Minoritised Stress framework to understand salient clinical factors impacting Queer, Black womxn sexual assault survivors, including those associated with multiple minoritised identities: Queer-based trauma, race-based trauma, cultural betrayal trauma, and misogynoir. Given the high rates of victimisation, marginalisation and discrimination, psychologists and others working with members of this population should engage with and address these factors to provide culturally responsive, sexually affirming and effective mental health treatment and care.

Sensation seeking, sexual orientation, and drug abuse symptoms in a community sample of emerging adults.

Increased use of drugs is associated with a number of factors including high sensation seeking and sexual minority status (through group-specific minority stress). We sought to examine how personality traits like sensation seeking may influence drug abuse among sexual minority individuals. Participants were 217 emerging adults (Mage = 20.23, SD = 0.85) recruited from Amazon Mechanical Turk (MTurk). Of these participants, 67.7% identified as heterosexual, 9.7% as gay or lesbian, 21.2% as bisexual, and 1.4% indicated other sexual orientations. Sensation seeking and drug abuse were self-reported using the Brief Sensation Seeking Scale and the Drug Abuse Screening Test, respectively. A preliminary multiple analysis of variance indicated no significant mean differences for these variables as a function of sex or sexual orientation. Next, sexual minority status, Brief Sensation Seeking Scale scores, sex and their interactions were entered into a linear regression predicting Drug Abuse Screening Test scores. Results revealed a significant moderation, such that the positive relationship between Brief Sensation Seeking Scale total scores and Drug Abuse Screening Test total scores was stronger for sexual minorities (ß = 0.14, P = 0.00) compared to heterosexuals (ß = 0.04, P = 0.04), controlling for sex. These results demonstrate, while sensation seeking and sexual minority status may selectively indicate risk for drug use, sexual minorities high in sensation seeking may be at especially high risk for problems related to drug abuse. More research examining the addiction etiology of sexual minority individuals would inform targeted interventions for this population.

Correction to: Delay Discounting of Protected Sex: Relationship Type and Sexual Orientation Influence Sexual Risk Behavior.

In the original publication of the article, the corresponding author was processed incorrectly. The corresponding author for this article should be: Woo-Young Ahn.

Delay Discounting of Protected Sex: Relationship Type and Sexual Orientation Influence Sexual Risk Behavior.

Sexual discounting, which describes delay discounting of later protected sex vs. immediate unprotected sex (e.g., sex now without a condom vs. waiting an hour to have sex with a condom), is consistently linked to sexual risk behavior. Estimates suggest that over two-thirds of HIV transmissions occur between individuals in committed relationships, but current sexual discounting tasks examine sexual discounting only with hypothetical strangers, leaving a gap in our understanding of sexual discounting with committed sexual partners. We used the Sexual Discounting Task (SDT) to compare discounting rates between men who have sex with men (MSM; n = 99) and heterosexual men (n = 144) and tested a new SDT condition evaluating sexual discounting with main partners. MSM in committed relationships discounted protected sex with their main partner at higher rates than heterosexual men, and discounting rates correlated with self-report measures of condom use, impulsivity/sensation seeking, and substance use. These findings suggest that sexual discounting is a critical factor potentially related to increased HIV transmission between MSM in committed relationships and may be an important target for intervention and prevention.

In-Clinic Adolescent Peer Group Support for Engagement in Sub-Saharan Africa: A Feasibility and Acceptability Trial.

Holding support groups with the same cohort of adolescents during clinic visits promises to increase engagement in care. Participants (N = 35 patients, aged 12-18, 50% female, from an adolescent HIV clinic in Kumasi, Ghana, were divided into 5 teams. Clinic visits were coordinated for members of each team. Team members participated in group discussions and activities while waiting to meet with their medical team. Teams met quarterly for 1 year. Participants reported benefits from talking with peers about the challenges of managing HIV. Clinic attendance improved from the preceding year (54% versus 84%). There were reductions in perceived internal stigma, perceived external stigma, worries about unintended disclosure from taking antiretroviral therapy (ART), and reduced ART concerns. The program demonstrated the feasibility, safety, and acceptability of facilitating increased interaction among adolescents living with HIV during clinic visits. Improvements in clinic attendance, perceived stigma, and concern about medications suggest that the intervention is a promising candidate for additional study.

The use of technology in the sexual health education especially among minority adolescent girls in the United States.

PURPOSE OF REVIEW: The purpose of this review is to examine current sexual health education technologies for adolescents and identify gaps in knowledge. Disparities in sexual health education are prominent and mainly affect young women of color. As a result, the use of technology to reach these marginalized populations could potentially invoke change. Thus, it is crucial to determine the viability of technology as a mechanism to bridge the knowledge gap regarding sexual health for adolescents that are most at risk of sexually transmitted infections and unwanted pregnancies. RECENT FINDINGS: With a lack of standardized, evidenced-based sexual health education programs in the United States, the future of comprehensive sexual health education is moving toward smartphone apps. Many sexual health technologies exist that target adolescents, most of which have been proven to demonstrate positive effects. Use of mobile apps, especially for vulnerable populations, can be more effective because of privacy and widespread dissemination. SUMMARY: Ultimately, more research needs to be conducted to determine the most effective content for these sexual health apps. Additionally, more research should be conducted on effective sexual health apps for marginalized populations to determine whether technology is a viable solution.

Relationship Between Unsupervised Time and Participation in an Emotion Regulation Intervention and Risk Outcomes.

OBJECTIVE: This study is a secondary analysis of outcomes examining risk behavior in the context of the naturalistic occurrence of parental monitoring and participation in an emotion regulation intervention over a 12-month period. METHOD: Early adolescents with mental health symptoms (N=420), ages 12-14 years, were recruited and randomized into either an Emotional Regulation (ER) or Health Promotion (HP) condition. Assessments included adolescent self-report of unsupervised time, substance use and sexual behavior at baseline, 6-months, and one year post-intervention. Analytic groups were formed by intervention condition (ER or HP) and baseline reports of unsupervised time (≤1× per week or >1× per week of unsupervised time with opposite sex peers) resulting in a total of four groups. Logistic regression and time-to-event analyses were used to test differences in substance use and delay of sexual initiation between the groups. RESULTS: Participation in the ER intervention in the presence of low unsupervised time was superior in reducing both substance use and sexual initiation than either factor alone; and either factor alone was more effective than the absence of both. CONCLUSION: Findings suggest that interventions targeting health risk behaviors, including substance use and sexual risk behavior, among early adolescents with mental health symptoms may be more effective when targeting both internal (e.g., emotional regulation) and external (e.g., unsupervised time spent with peers) protective factors. Limiting unsupervised time spent with peers through parental monitoring may serve to scaffold and reinforce early adolescent acquisition of effective emotion regulation which can be employed during emotionally arousing risk situations.

Drug Use Status in Youth: The Role of Gender and Delay Discounting.

BACKGROUND: Evidence from gender and delay discounting studies suggests these variables may influence drug use in youth. However, no studies to date have examined sexual discounting with regard to drug use in youth. OBJECTIVES: The present study examined gender and delay discounting, both monetary and sexual, with regard to the drug use status of alcohol, tobacco, and marijuana. METHODS: Youth aged 14-21 years (n = 155) provided demographic and drug use information and completed behavioral tasks assessing monetary and sexual discounting in a single laboratory session. Chi-square and analysis of variance were used to assess group differences. RESULTS: Across drug use status, differences in gender and sexual discounting but not monetary discounting were found. Moderate drinkers and smokers were more likely to be male and displayed steeper sexual discounting rates. However, no interaction effect between gender and discounting differences on drug use status was observed. CONCLUSIONS: Findings suggest that drug use may manifest differently by gender and highlight the domain specificity of sexual discounting. These findings further highlight the need to incorporate gender and domain-specific discounting measures when investigating drug use pathology and interventions in youth.

EMOTION REGULATION AS A PREDICTOR OF JUVENILE ARREST.

The current study examines emotion regulation as a novel dynamic factor of juvenile arrest as it compares with known static and dynamic risk factors. Participants included seventh graders at five urban public schools (N = 420, M age = 13, 53% male). The predictive relationship between adolescent self-, parent-, and teacher-report of baseline adolescent emotional competence and arrest at 30-month follow-up was assessed. Stepwise logistic regression analyses revealed that teacher report of emotion regulation strategies, minority status, and lifetime marijuana use were significant predictors of arrest. Findings indicate teacher report of emotion regulation competence in early adolescence may be an important consideration for prevention program development.

Examining weight concern and delay discounting in adolescent females.

OBJECTIVE: Pediatric obesity is a growing public health concern that contributes to high rates of negative long-term physical and mental health outcomes. Research focused on identifying risk for pediatric obesity has linked delay discounting, or an inclination for immediate rewards, as well as weight concern to individuals with greater Body Mass Index (BMI). The current study seeks to fill a void in the literature by examining how these two variables interact to promote higher BMI in female adolescents. METHOD: Adolescent (n=60) females between the ages of 13-19years (mage=17.45, SD=1.74) of age completed the Eating Disorder Examination Questionnaire (EDE-Q) and the Delay Discounting Questionnaire. RESULTS: A mediation model examined whether delay discounting accounted for the relationship between weight concern and BMI. Results indicate that in the current study weight concern was negatively related to delay discounting and delay discounting was negatively related to BMI. The overall model revealed that a partial mediation occurred [b=1.28, t(60)=4.92, p<0.01]. DISCUSSION: These results suggest that while impulsivity is an important factor to consider, other constructs may also be influential in how weight concerns contribute to greater BMI. Nevertheless, the results indicate that prevention and interventions should identify females with high levels of both weight concern and impulsivity as an increased risk for experiencing pediatric obesity and long-term negative health outcomes.

Delay discounting, but not disinhibition or inattention, partially mediates the effects of neuroticism on disordered eating in adolescents.

Adolescence represents an integral developmental period for the prevention and intervention of disordered eating. Individuals with high levels of neuroticism have been shown to respond with greater impulsivity and use of disordered eating as a coping mechanism. However, the exact mechanism through which neuroticism and impulsivity affect disordered eating remains unknown. To understand the effects of personality and impulsivity on disordered eating in adolescence, the present study aimed to investigate whether impulsivity mediated the relationship between neuroticism and disordered eating. Adolescents (N=40) between the ages of 13 and 19 (Mage=18.25years; S.D.=1.30) were queried on eating attitudes and personality, as well as completed behavioral tasks assessing impulsivity (delay discounting, disinhibition and inattention). Mediation analyses revealed that neuroticism was significantly associated with patterns of disordered eating, but delay discounting, and not disinhibition and inattention, appeared to mediate the relationship between neuroticism and disordered eating. These results should guide prospective research exploring the relations between neurotic and impulsive behavior, particularly delay discounting on disordered eating, which will assist in future treatment efforts targeting the development of maladaptive eating behaviors.

The relationship between weight and smoking in a national sample of adolescents: Role of gender.

This study sought to investigate the role of weight status and body mass index percentile in risky smoking behaviors in male and female adolescents. Analyses of the data obtained in the 2011 Youth Risk Behavior Surveillance System were conducted. The national sample size included 15,425 adolescents. Questions addressing weight status and smoking behaviors were used in analyses. Significant effects of perceived weight status, weight change status, and body mass index percentile on smoking behaviors were found for both genders. The current findings indicate the importance of accounting for both gender and weight status when developing prevention and cessation programs targeting smoking behaviors.

Effects of weight and gender on a task of inattention.

OBJECTIVE: Previous studies have established that obese adolescents possess a stronger tendency to behave more impulsively and be more inattentive than healthy-weight children. Additionally, gender difference in inattention and impulsivity has also been substantiated by previous researchers. The current study examined the relationship between gender, body weight, and inattention and impulsivity in adolescents. It was hypothesized that obese males and females would have more inattentive and impulsive responses than their healthy-weight peers. METHOD: Participants were 113 adolescents between the ages of 14 and 19; all participants completed the CPT-II, a measure of inattentive and impulsive response styles. RESULTS: Findings indicated that males who were classified as overweight or obese scored higher on inattention than did obese females, healthy-weight males, and healthy-weight females. Additionally, females committed a greater number of commission errors and were less able to distinguish the target stimuli, suggestive of impulsive responding. CONCLUSION: These findings indicate a gender difference in regard to impulsive responding, and also reveal an interaction of weight status and gender on inattention. Implications for prevention and treatment are discussed.

The relationship between stress and delay discounting: a meta-analytic review.

The objective of the present meta-analytic review was two-fold: (a) to address the mixed findings of previous research by determining the relationship between stress and impulsivity; and (b) to examine age differences in this relationship. A total of 16 articles fulfilled the inclusion criteria for the present meta-analysis for a total sample size of 2189 participants (k=22) ranging in age from 36 months to 71 years. Using the statistical software, Comprehensive Meta-Analysis, Version 2.0 - Hedges's g was computed to estimate the effect size. Results showed that impulsivity was related to stress with a moderate-large effect size (g=0.590). Significant moderating effects were found for the type of stress measure (g=0.592) and the type of discounting measure (g=0.696) used. The current study emphasizes the need for further research on the relationship between stress and discounting as additional findings may aid in improving future prevention and intervention programs for health-risk behaviors.

The role of impulsivity in pediatric obesity and weight status: a meta-analytic review.

Pediatric obesity has reached epidemic proportions over the last two decades; however little research has focused on the behavioral mechanisms that may contribute to the rise of obesity in youth and adolescents. Impulsivity has been examined as a mechanism underlying the displacement of physical activity and the increase in food consumption, however this research is limited. The present meta-analysis aimed to address mixed findings of previous research by determining a relative effect of impulsivity on pediatric obesity. A total of 23 articles met the inclusion criteria for the present meta-analysis for a total sample size of 3898 participants (k=27) aged 2-21years (M=10.99). Using the statistical software, Comprehensive Meta-Analysis, version 2.0-Hedges' g was computed to estimate effect size. Results revealed a moderate effect size, such that impulsivity was greater among overweight/obese children, relative to healthy weight children (g=0.406). Significant moderating effects were found for the type of measure used (g=0.426) and the dimension of impulsivity examined (g=0.402). The current study emphasizes the need for further research on the role of impulsivity in pediatric obesity as additional findings may aid in the enhancement of future prevention and intervention weight management programs.