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Purpose: Early adverse childhood experiences (ACEs) predict early onset of sexual intercourse. However, patterns of ACEs identified using latent class analysis (LCA) and their links to early sexual intercourse have been less examined. In this study, we apply LCA to identify ACEs profiles at age five and to examine whether these profiles differentially predict adolescents' sexual initiation., Methods: We analyzed data obtained from the Future of Families and Child Wellbeing Study for 3,185 participants (male = 1,638; female = 1,547). This included parental/caregivers' reports of 10 types of ACEs when participants were on average at age five and youth self-report data on sexual intercourse before or at age 15. We used LCA to classify the participants into subgroups and multinomial logistic regressions to examine differences in early sexual initiation among the ACEs subgroups., Results: LCA showed evidence of four classes for both genders: low adversity (51.8%), socioeconomic adversity (32.0%), family dysfunction (12.0%), and abuse (4.2%). We found class membership differences in early sexual intercourse in all three adversity classes compared to the low adversity group. Pairwise comparison tests further revealed that adolescents in the family dysfunction class had lesser odds of engaging in early sexual intercourse than their counterparts in the socioeconomic adversity and abuse classes., Discussion: Our findings suggest that LCA could help identify meaningful and distinctive child adversity patterns while accounting for the co-occurrence of ACEs. This is particularly helpful in evaluating who might be at greatest health risk which can further inform more effective and targeted interventions., (Copyright © 2023 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Due to its long-term longitudinal design, the National Longitudinal Study of Adolescent to Adult Health (Add Health) has provided numerous valuable insights into adolescent and young adult sexual behavior. Framed by a conceptual model of sexual behavior and health, I review research using Add Health data to study sexual behavior and health. In this paper, I review research examining both predictors (e.g., neighborhood, family, genetic, individual) and health outcomes (e.g., sexually transmitted infections, mental health) of sexual behavior in adolescents and young adults. Where possible, I focus on long-term longitudinal studies that make use of the unique strengths of the Add Health data. Existing Add Health research has provided considerable information about both the predictors and health consequences of adolescent and young adult sexual behavior. Factors ranging from neighborhoods to genetics predict whether adolescent and young adults engage in sexual behaviors. Findings on long-term outcomes of adolescent sexual behavior suggest that early sexual behavior predicts higher rates of sexually transmitted infections and pregnancy in young adulthood, but not long-term changes to mental health. Unique contributions of Add Health include the ability to examine multidimensional bio-ecological predictors of sexual behavior and to examine long-term effects of sexual behavior and how sexual behaviors and their correlates change across adolescence into adulthood. Future work can leverage these strengths, and in particular the long-term longitudinal nature of the data, to uncover new insights about the developmental course of sexual behavior and health., (Copyright © 2022 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Introduction: This study examined the role of gender and familism support in the associations between parental and adolescent drinking behaviors in a sample of Mexican adolescents., Method: Mexican adolescents (49% girls; N = 724) aged 12-19 completed measures assessing familism support, self-reported drinking behaviors, and perceptions of parental drinking behaviors., Results and Conclusion: Findings suggest that both gender and familism support moderate the relationship between parental drinking behaviors and adolescent drinking behaviors. For instance, the association between mothers' alcohol use frequency and adolescent binge drinking was stronger for girls. In contrast, the association between fathers' amount per drinking day and adolescent binge drinking was stronger for boys. Mother's amount per drinking day was associated with less alcohol use per drinking day among adolescents reporting high familism support. The current study expands our understanding of parental modeling on Mexican adolescent drinking behavior., (© 2022 The Authors. Journal of Adolescence published by Wiley Periodicals LLC on behalf of Foundation for Professionals in Services to Adolescents.)

Introduction: Although early sexual intercourse may be associated with increased depressive symptoms, little research has examined whether first intercourse in late adolescence is associated with changes in mental health., Methods: This paper uses 3 years of longitudinal data from previously sexually abstinent late adolescent students at a large state university in the northeastern United States (N = 144, 53.5% male, M age = 18.5 years old, 47.2% White, 26.4% Asian/Hawaiian/Pacific Islander, 20.1% Hispanic/Latino, 18.1% Black/African American) to examine whether levels of psychological distress changed after first intercourse., Results: Students' distress decreased after first intercourse, although this effect was only significant two or more semesters after first intercourse. There were no gender differences in these associations., Conclusions: Findings suggest first intercourse was, on average, associated with decreased psychological distress for both male and female late adolescents., (Copyright © 2021. Published by Elsevier Ltd.)

Purpose: The objective of the study was to examine whether latent class analysis (LCA) could (1) identify distinct subgroups of youth characterized by multiple risk and protective factors for early sexual initiation and (2) allow for a more nuanced assessment of the effects of a middle school program to prevent teen pregnancy/HIV/sexually transmitted infection., Methods: LCA was applied to data from the baseline (seventh grade) sample of 1,693 sexually inexperienced students participating in a randomized controlled trial of It's Your Game…Keep It Real in Harris County, Texas. Multilevel analysis was applied within subgroups defined by the latent classes to assess for potential differential program effects., Results: LCA identified 3 distinct profiles of youth: family disruption, other language household, and frequent religious attendance. Multilevel analyses found differential effects of the program across these profiles with a significant and substantial reduction (30%) in initiation of vaginal sex by ninth grade for students in the family disruption profile only., Conclusions: Application of LCA may hold promise for conducting more nuanced evaluations and refinements of behavior change interventions for youth., (Copyright © 2018 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Purpose: Sexual minorities experience significant health disparities across a variety of mental, behavioral, and physical health indicators. Yet, an understanding of the etiology and progression of sexual minority health disparities across the lifespan is limited., Methods: We used the U.S. National Epidemiologic Survey of Alcohol and Related Conditions III to evaluate the association between sexual minority status and seven past-year health outcomes (alcohol use disorder, tobacco use disorder, drug use disorder, major depressive episode, generalized anxiety disorder, sexually transmitted infection, and cardiovascular conditions). To do this, we used unadjusted and adjusted logistic regression among our study sample (n = 30,999; aged 18-65 years) and time-varying effect models to evaluate how sexual orientation differences in these outcomes vary across adulthood., Results: Relative to heterosexuals, sexual minorities had elevated odds of past-year alcohol use disorder and drug use disorder across all ages (18-65 years) although the magnitude of the disparity varies by age. Sexual minorities were also more likely to experience major depressive episode, generalized anxiety disorder, tobacco use disorder, sexually transmitted infection, and cardiovascular disease, but only at specific ages., Conclusions: Sexual minority health disparities vary appreciably across the adult lifespan, thus elucidating critical periods for focused prevention efforts., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Background: Although research has documented age differences in substance use, less is known about how prevalence of substance use disorders (SUDs) vary across age and differ by gender and race/ethnicity., Methods: Time-varying effect models (TVEMs) were estimated on data from the National Epidemiologic Survey of Alcohol and Related Conditions-III (NESARC III; N=36,309), a nationally representative survey of the adult population. The sample was 44% male; 53% White, 21% Black, 19% Hispanic/Latino, 6% other race/ethnicity. Prevalence of four SUDs (alcohol, tobacco, cannabis and opioid use disorders) were flexibly estimated across ages 18-90 by gender and race/ethnicity., Results: Estimated SUD prevalences were generally higher for men compared to women at most ages until the 70s. However, disparities by race/ethnicity varied with age, such that for most SUDs, estimated prevalences were higher for White participants at younger ages and Black participants at older ages., Discussion: Results suggest relatively constant disparities by gender across age, and a crossover effect for Black and White participants. Findings demonstrate that Black individuals in midlife may be an important target of intervention programs for some substances., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Guided by theoretical (Brooks-Gunn & Paikoff, 1997) and empirical work (Horne & Zimmer-Gembeck, 2005), this cross-sectional study examined whether sexual well-being (sexual self-acceptance, importance of mutual consent, importance of safe sex) was associated with life satisfaction among Mexican adolescents, and whether these associations were moderated by gender, age, and familism. Mexican adolescents (54% girls, 72% middle schoolers, 30% sexually active) completed surveys. Findings indicated that a greater belief in the importance of safe sex was associated with higher levels of life satisfaction. Greater sexual self-acceptance was associated with life satisfaction, and familism moderated this association. This association was stronger among adolescents who reported low familism. This study contributes to the understanding of sexual adolescent well-being and psychological adjustment in Mexico, an understudied cultural context., (Copyright © 2017 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.)

Purpose: To examine how age of onset of sexual intercourse is associated with past-year and lifetime sexually transmitted infections (STIs) and depression in young adulthood., Methods: We examined how occurrence of a lifetime and past-year STI, lifetime diagnosis of depression, and past-week depressive symptoms differed as a function of age of onset of sexual intercourse using data from the National Longitudinal Study of Adolescent to Adult Health (Add Health; N = 8,938 individuals). Time-varying effect models were used to examine how age of onset, measured as continuous age, was associated with these outcomes in young adulthood, with all analyses stratified to examine gender differences., Results: Individuals who engaged in first intercourse before age 16 reported higher than average rates of all outcomes studied; for example, an estimated 35% of women and 12% of men who initiated at age 14 years reported a lifetime STI, compared with about 5% of those who initiated at age 24 years. Timing of first intercourse past the mid-twenties was associated with lower than average rates of STIs and lifetime depression diagnoses but was associated with a somewhat higher level of past-year depressive symptoms. Patterns were similar by gender, although there was little difference in men's depression diagnoses by age of onset., Conclusions: Results suggest that sexual intercourse before age 16 years may be associated with higher rates of STIs and depression. Findings provide support for comprehensive programs that both promote delay of first intercourse and provide safe sex and psychological support for those who initiate early., (Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Purpose: To examine age-varying prevalence rates and health implications of weapon-related violence exposure (WRVE) from adolescence to young adulthood (ages 14-30) using time-varying effect modeling., Methods: Data were from the Add Health study, a longitudinal study of adolescents in the United States (N = 5,103) followed into young adulthood across four assessment waves from age 14-30., Results: WRVE rates varied with age, peaking during mid-to-late adolescence (ages 16-18). Rates were higher for males (vs. females) and African-American youth (vs. white) across nearly all ages. Rates were higher for Hispanic youth (vs. white) during adolescence. WRVE was positively associated with frequent heavy episodic drinking and negatively associated with self-reported general health; these associations were significant during adolescence and early adulthood (ages 15-24). WRVE was positively associated with depressive symptoms. This association remained stable over age and was stronger for females from ages 16-21. The association between violence exposure and decreased general physical health was stronger for white versus African-American youth from ages 15-17, with no significant association observed for African-American youth at any age., Conclusions: Despite its severity, WRVE is prevalent among U.S. youth during adolescence and young adulthood, particularly among males and African-Americans during mid-to-late adolescence. The associations between WRVE and health were stronger during adolescence and differed by sex and race/ethnicity. This information may assist in the timing and targeting of intervention efforts aimed at interrupting the effects of violence exposure on youth behavioral, mental, and physical health., (Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Background: Substance use and depression often co-occur, complicating treatment of both substance use and depression. Despite research documenting age-related trends in both substance use and depression, little research has examined how the associations between substance use behaviors and depression changes across the lifespan., Methods: This study examines how the associations between substance use behaviors (daily smoking, regular heavy episodic drinking (HED), and marijuana use) and depressive symptoms vary from adolescence into young adulthood (ages 12-31), and how these associations differ by gender. Using data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), we implemented time-varying effect models (TVEM), an analytic approach that estimates how the associations between predictors (e.g., substance use measures) and an outcome (e.g., depressive symptoms) vary across age., Results: Marijuana use and daily smoking were significantly associated with depressive symptoms at most ages from 12 to 31. Regular HED was significantly associated with depressive symptoms during adolescence only. In bivariate analyses, the association with depressive symptoms for each substance use behavior was significantly stronger for females at certain ages; when adjusting for concurrent substance use in a multivariate analysis, no gender differences were observed., Conclusions: While the associations between depressive symptoms and both marijuana and daily smoking were relatively stable across ages 12-31, regular HED was only significantly associated with depressive symptoms during adolescence. Understanding age and gender trends in these associations can help tailor prevention efforts and joint treatment methods in order to maximize public health benefit., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

To broaden our understanding of romance and sexuality during adolescence in Latin American countries, we used a person-oriented approach (latent class analysis) to examine classes marked by different patterns of romantic and sexual behaviors in Mexican adolescents. We found 5 classes: Inactive (8.53%), Early stage (37.8%), Waiting class (27.5%), Physical (8.4%) and Committed (17.9%); but no group dating class. We also explored how these classes were associated with adolescents' mental health and school performance. Middle school adolescents in the Committed class (high in romantic and sexual behaviors) had the highest level of depressive symptoms. Girls in the Inactive class and boys in the Physical class had the lowest level of symptoms. Adolescents in the Committed class also reported less academic motivation and achievement, whereas adolescents in the Inactive class reported higher motivation. This study expands our knowledge of adolescent romantic and sexual development in Mexico., (Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.)

Purpose: The purpose of this study was to describe historical trends in rates of recent substance use and associations between marijuana and other substances, among U.S. high school seniors by race and gender., Methods: Data from Monitoring the Future (1976-2013; N = 599,109) were used to estimate historical trends in alcohol use, heavy episodic drinking (HED), cigarette use, and marijuana use. We used time-varying effect models to flexibly estimate changes in associations of substance use behaviors., Results: Past-month marijuana use rates peaked in the 1970s, declined through 1990, then rose again to reach levels of use of more than 20% for both black and white participants. Recent years show increasing disparities across groups such that males, and in particular black youth, are on a trajectory toward higher use. This rise in marijuana use is particularly concerning among black youth, with rates far exceeding those for cigarette use and HED. The association of marijuana use with both cigarette use and HED is particularly high in recent years among black adolescents., Conclusions: Substance use recently declined among high school seniors, except for marijuana use, particularly among black youth. The increasing association between marijuana and other substances among black adolescents suggests future amplification in critical health disparities., (Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Purpose: To examine time-varying associations between predictors of recent multiple sexual partners from middle adolescence through young adulthood., Methods: We examined whether the odds of multiple partners in the past year were differentially predicted by substance use and depression over time, using data from a nationally representative longitudinal study (N = 11,963, 52.2% female, 18.3% African-American, 11.9% Hispanic, 3.5% Asian, 2.6% other race, M age at Wave I = 16.1 years, SD = 1.8). Data were analyzed using the time-varying effect model, which estimates associations between predictors and an outcome as a function of near-continuous time., Results: The proportion of participants having multiple partners increased over time, leveling off at around 30% after age 20. Significant positive associations between substance use and multiple partners were strongest early in adolescence and decreased sharply by around age 18. The significant positive association between depression and sexual behavior weakened with age, remaining significant in young adulthood for women but not men., Conclusions: These findings suggest that factors associated with having multiple recent sexual partners change from middle adolescence through young adulthood. The time-varying effect model can be used to identify risk factors that are especially salient at different ages, thus identifying which age periods may hold the greatest promise for intervention., (Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Background: To understand the dynamic process of cessation fatigue (i.e., the tiredness of trying to quit smoking) with respect to its average trend, effect on relapse, time-varying relations with craving and negative affect, and differences among genders and treatment groups., Method: Randomized placebo-controlled clinical trial. Participants received either placebo, monotherapy (bupropion SR, nicotine patch, nicotine lozenge), or combined pharmacotherapy (bupropion SR+nicotine lozenge, nicotine patch+nicotine lozenge). Data were collected from 1504 daily smokers who were motivated to quit smoking. The participants completed baseline assessments and ecological momentary assessments for 2 weeks post-quit., Results: Cessation fatigue reduced the likelihood of 6-month post-quit abstinence (OR=0.97, 95% CI (0.95, 0.99)), and was positively associated with craving and negative affect. After controlling for these two factors, average cessation fatigue increased over time. Compared to men, women experienced greater fatigue (t=-10.69, p<0.0001) and a stronger relation between fatigue and craving (t=-8.80, p<0.0001). The relationship between fatigue and negative affect was significantly stronger in men (t=5.73, p<0.0001). Cessation fatigue was significantly reduced by combined pharmacotherapy (t=-13.4, p<0.0001), as well as monotherapy (t=-6.2, p<0.0001)., Conclusions: Cessation fatigue was closely related to craving, negative affect, and cessation outcomes. Women reported greater cessation fatigue than men. Current treatments appeared to reduce fatigue and weaken its relations with craving and negative affect., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

Adolescents who are more religious are less likely to have sex, but the process by which religiosity impacts sexual behavior is not well established. We tested two potential processes, involving: (1) whether religiosity suppressed individuals' motivations to have sex for physical pleasure, and (2) whether individuals internalized their religions' teachings about sex for pleasure. College students (N = 610, 53.8% female, M age = 18.5, 26.1% Hispanic Latino [HL], 14.9% non-HL African American, 23.8% non-HL Asian American/Pacific Islander, 26.3% non-HL European American and 8.9% non-HL multiracial) completed web surveys during their first three semesters. Religiosity did not moderate the association between students' motivations for sex for pleasure and sexual behavior. Motivations mediated the association between religiosity and sexual behavior, suggesting that religion does not override adolescents' existing motivations, but instead, religious adolescents internalize norms about sexual behavior. Testing Two Process Models of Religiosity and Sexual Behavior., (Copyright © 2013 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.)

Sexual behavior is associated with body image, but the directionality of this association is unclear. This study used longitudinal data from a sample of previously abstinent college students (N = 100, 45% female, 49% European American, 26% Latino American, 25% African American) to test whether satisfaction with appearance changed after first intercourse. Male students were more satisfied with their appearance after first intercourse, whereas female students became slightly less satisfied with their appearance. These findings demonstrate that first intercourse can lead to changes in well-being, even if the transition takes places in late adolescence. In addition, they suggest that gendered cultural expectations regarding sexual behavior are associated with differing psychological outcomes for male and female adolescents., (Copyright © 2010 The Association for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.)