Marseille 2007
| Abstract #375 - The Role of Adolescent Psychopathology on the Relationship between Couples Communication and Risky Sexual Behavior Among Adolescents in Psychiatric Care. | ||||
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Session: 26.109: Posters B (Poster) on Tuesday in Chaired by Authors: Presenting Author: Dr Charu Thakral - University of Illinois, United States |
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| Additional Authors: Ms Carla Nappi, Dr Chisina Kapungu, Dr Geri Donenberg, BA Emily Hasselquist, MD Larry Brown, Dr Ralph DiClemente, | ||||
| Aim: Youth with psychiatric illness are at increased risk of HIV infection due to higher rates of sexual activity and unprotected sex than their same aged peers in the general population (Brown et. al, 1997). Mental health disorders may interfere with effective communication especially within the context of a romantic relationship. Specifically, adolescents in psychiatric care may lack the adaptive interpersonal skills required to negotiate safer sex practices/AIDS prevention with their sexual partner (Brown, Danovsky, et al., 1997). Although studies have found that assertive communication has been related to decreased sexual risk taking, fewer partners, and more consistent condom use (Hutchinson & Cooney, 1998), there is a lack of research with youth in psychiatric care. Therefore, the current study examined whether adolescent psychopathology affects the relationship between couples communication and sexual risk behavior. | ||||
| Method / Issue: 164 parent-adolescent dyads from psychiatric treatment programs were recruited to participate in a large-scale multi-site randomized-controlled trial study targeting communication and sexual risk reduction. The sample was limited to sexually active adolescents in romantic relationships. Adolescent psychopathology was assessed using the Computerized Diagnostic Interview Schedule for Children, Fourth Edition (Costello, Edelbrock, Dulcan, Kalas, & Klaric, 1984). Symptom counts were computed for two broad categories: internalizing (MD, PTSD, GAD) and externalizing disorders (CD, ODD, ADHD). Quality of general communication within a romantic relationship was assessed using the Couples Communication Scale (Harper & Grello, in press). Adolescent sexual risk behavior was defined by the frequency of condom use (per adolescent report) on the ARBA (AIDS Risk Behavior Assessment; Donenberg et al., 2001). | ||||
| Results / Comments: Hierarchical multiple regression analyses were used to determine the interaction effects of couples communication and psychopathology on condom use. Separate equations for internalizing and externalizing totals and for both parent and adolescent report were conducted. For parent report, there was a significant interaction between internalizing problems and couples communication (R2 = 0.04, B = 0.02, p = 0.02). Simple effect tests revealed that among low internalizers, adolescents that reported increased communication with sexual partners reported more frequent condom use. Among high internalizers, adolescents that reported greater levels of communication reported less frequent condom use. The interaction term was not significant for parent report of externalizing symptoms. There was a main effect of adolescent report of internalizing symptoms on condom use frequency such that teens with higher levels of symptoms reported less frequent condom use. However, there werent any significant interactions between adolescent report of internalizing and externalizing problems. | ||||
| Discussion: In summary, results indicated effects of couples communication on condom use depended upon level of parent-reported internalizing symptoms. Among adolescents with high internalizing symptoms, higher levels of communication with ones sexual partner was related to riskier sexual behavior. For these teens, psychopathology may impair partner communication, compromising negotiation of safe sex practices. Findings highlight potential interactions between individual (e.g. adolescent mental health issues) and social (e.g., partner relationships) factors in understanding sexual risk behavior. | ||||
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