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Background: Adolescent loneliness and poor mental health represent dual public health concerns. Yet, associations between loneliness and mental health, and critically, how these associations vary in school settings are less understood. Aims: Framed by social-ecological theory, we aimed to identify key predictors of adolescent mental health and examine school-level variation in the relationship between loneliness and mental health. Sample: Cross-sectional data on adolescents from the 2018 wave of the Health Behaviour in School-aged Children study (HBSC) in Scotland were used (N = 5286). Methods: Mental health was measured as a composite variable containing items assessing nervousness, irritability, sleep difficulties and feeling low. Loneliness was measured via a single item assessing how often adolescents felt 'left out'. Multilevel models were used to identify social-ecological predictors of mental health, associations with loneliness and between-school variation. Results: Loneliness, as well as demographic, social and school factors, was found to be associated with mental health. Mental health varied across schools, with the between-school difference greater among adolescents with high levels of loneliness. Additionally, the negative effect of loneliness on mental health was stronger in schools with lower average mental health scores. Conclusions: The findings suggest that schools can play an important role in shaping adolescent mental health. Our study uniquely identifies that school-based interventions targeting mental health may be especially necessary among lonely adolescents, and programmes aimed at tackling loneliness may be more beneficial in schools with poorer mental health.

Objective: Due to high prevalence rates of sexual assault among college-aged women and the benefits of disclosure (e.g., emotional well-being), it remains important to consider barriers to disclosure. The current paper aimed to examine if barriers to disclosure may be more salient to sorority women. Participants: We examined differences in rates of hypothetical willingness to formally disclose (N = 693) and actual formal/informal disclosure (N = 584) as well as mental health as a function of Greek-life status among college women. Method: Two separate online surveys were administered (October, 2016; January, 2017), respectively. Results: Findings suggest no significant differences in rates of hypothetical or actual formal/informal disclosure as a function of Greek-life status; however, Greek-life members reported lower mental health. Conclusion: Findings from the current studies suggest that institutional factors (e.g., campus climate) may serve as a barrier to disclosure. Limitations and future directions in this important area are discussed.

Objective: Most studies on agreeing to unwanted sex have assessed sexual encounters between people who have had sex before. Thus, we examined instances of sexual compliance with a novel sexual partner. Participants: A probability sample of college students at a university in the Midwest United States (N = 7,112). Methods: Participants completed an online survey based on measures from the National Survey of Sexual Health and Behavior. Results: Only 2.5% (n = 179) agreed to unwanted sexual activity at their most recent sexual encounter. People who were sexually compliant with a novel sexual partner frequently did so due to their own alcohol intoxication. Further, sexual compliance with novel sexual partners was less frequently associated with affectionate sexual behaviors or orgasm. Conclusions: Our initial findings regarding the effect of sexual precedent on sexual compliance warrant further research on instances when people agree to sex they don't want with novel partners.

Objective: Undergraduate women are more likely to comply with unwanted sexual behavior if they have experienced sexual coercion from their partner. We investigated whether the severity and frequency of sexual coercion was associated with sexual compliance. Participants: A sample of 195 female university students in committed relationships. Methods: Participants completed an online survey about sexually coercive experiences in their relationship and hypothetical sexual compliance. Results: We found that undergraduate women exposed to more frequent mild sexual coercion from their current partner predicted they would be more compliant with hypothetical sexual coercion from that partner--both mild and severe. Conclusion: There may be a precedent for sexual compliance in some sexually coercive relationships; this precedent seems to be gradually set. Prevention programs should emphasize that even the mildest forms of sexual coercion can potentially have negative implications for a relationship.

Objective: College students may not view sexual consent communication while under the influence of substances (i.e., alcohol and drugs) as problematic if media models the co-occurrence of these behaviors. The purpose of this study was to assess the types of consent cues used by characters who are and are not under the influence of substances in mainstream films. Method: Four researchers inductively analyzed popular mainstream films (N = 50). Films were assessed for substance use and consent communication cues. Results: Characters using substances were depicted using implicit verbal and explicit nonverbal consent cues more than characters who had not used substances. Conclusion: Films may perpetuate cultural narratives that substance use can be part of the consent process and that consent is communicated differently when people have used substances. Prevention programs could include media literacy to address misleading messages college students may internalize about substance use and sexual consent communication.

In the USA, universities have recently developed policies and programmes on sexual consent education. But waiting until students enroll in higher education may be too late to begin this work. To examine the extent that K-12 health education standards promote sexual consent education, we conducted a pilot study and found that only two of eighteen states explicitly mentioned sexual consent in their health education standards. Using a small sample (n = 4 states), we then identified four themes as making implicit reference to sexual consent: communication skills, decision making, personal space and interpersonal relationships. Finally, in a robust sample (n = 18 states), we conducted a content analysis of published standards regarding these themes related to sexual consent. Our analysis suggests that sexual consent is likely not discussed in sex education at K-12 schools. We recommend the more explicit inclusion of sexual consent in health education curricula via the identified themes that already exist in most or all standards, emphasising the importance of teaching young people about the nuances of sexual consent and its communication before they become sexually active.

Objective: Our objectives were to measure reporting differences between sexual behavior data from daily diary and retrospective estimates and to assess the utility of using smartphones to collect sexual behavior data from a college student population. Participants: Eighty-six participants (68 women, 18 men) completed the study. Methods: For 30 days during the Spring 2017 semester, participants received prompts to participate in daily diaries about their previous day's sexual behavior on their smartphones. Participants then retrospectively reported their past 30 days of sexual behavior and provided feedback on the process of receiving daily diaries on their smartphones. Results: We found that college students overreported their sexual behavior on the retrospective survey compared to their daily diary reports (ps < 0.001; Cohen's ds = 1.51). Participants provided positive and constructive feedback. Conclusions: Using smartphones to administer daily diaries is a promising technique for obtaining reliable sexual behavior data from college students.

In response to evidence that one in five college women are sexually assaulted, institutions of higher education have started adopting affirmative consent policies. Affirmative consent must be voluntarily and explicitly communicated--verbally or nonverbally. A recently published article highlighted barriers to the success of affirmative consent initiatives at the intrapersonal level. To extend this discussion, we identified barriers at each level of the Social Ecological Model. In our commentary, we discuss social determinants that are particularly relevant for campus sexual assault. There are elements in young people's micro-, meso-, exo-, and macrosystems that hinder their adoption of affirmative consent practices. We focus on gender as an aspect of the macrosystem that is a formidable barrier to the success of affirmative consent initiatives, influencing each of the other levels. Finally, we discuss how sexuality education might begin to address the social determinants of sexual assault.

Alcohol intoxication may influence how bystanders interpret other people's consent and refusal cues. We examined the effects of alcohol intoxication on participants' perceptions of characters' consent and refusal indicators in a fictional vignette depicting an alcohol-involved sexual encounter. Young adults (n = 119, 52% women) participated in an alcohol administration experiment examining the influence of acute intoxication on bystander perceptions during a vignette depicting a character who is intoxicated and declines a sexual advance from another character, who ignores her refusal and continues to pursue sexual activity. Participants were randomly assigned to an alcohol or non-alcohol condition and then guided through a semi-structured interview in which we asked about the characters' consent and refusal cues. Interviews were analyzed using both inductive and deductive coding. Most participants eventually indicated the encounter was nonconsensual, but approximately 9% of participants described the encounter as entirely consensual and another 42% of participants described the interaction as initially consensual and then nonconsensual. Participants discussed nuanced accounts of consent and refusal cues, including indicators related to alcohol consumption. Disregarding intoxication and gender, participants eventually recognized the situation as nonconsensual and thus potentially risky. However, some participants recognized this risk earlier in the encounter than others. Consequently, bystanders who recognize risk later in a situation may have fewer opportunities to intervene before a situation escalates. We recommend sexual assault prevention educators take a more nuanced approach when discussing consent and refusal indicators, emphasizing contextual factors that may indicate risk. [ABSTRACT FROM AUTHOR]

Researchers have demonstrated associations between use of pornography and sexual objectification of women. We examine whether self-reported preference for degrading pornography moderated the relation between use frequency and sexual objectification of others. Participants were 1,342 heterosexual women and men residing in the United States. In women and men, pornography use frequency was associated with the sexual objectification of others, even after controlling for interest in generally explicit content. In men, interest in degrading pornography content significantly predicted sexual objectification of women. Our results suggest greater pornography use is associated with greater sexual objectification of others, across a variety of content categories. [ABSTRACT FROM AUTHOR]