Date of Award

1-5-2009

Document Type

Thesis

Degree Name

Medical Doctor (MD)

First Advisor

Andres Martin

Abstract

This thesis examines psychosocial factors associated with risky sexual behavior in early adolescence with the intention to inform development of adolescent sexual education programs. Through a longitudinal study, data were collected through a self-report survey, the Social and Health Assessment (SAHA), which was administered in three waves between 2001 and 2003 to a cohort of incoming sixth grade students in the public school system (149 classes at 17 middle and high schools, N=1,175) of a small northeastern city in the United States. We first examined whether internalizing and externalizing problems in sixth grade, and the rate of change in these factors during middle school, were predictive of sexual initiation two years later, when most of the sample was in eighth grade. We then assessed whether internalizing and externalizing problems in sixth grade, and the rate of change in these factors during middle school, were predictive of engaging in high risk sexual behavior over the subsequent two years. Externalizing factors are more predictive of sexual risk in early adolescence than are internalizing factors. Specifically, substance use and violent delinquency over the course of middle school were associated with higher, while anxiety with lower, sexual initiation rates during middle school. Additionally, increased substance use over the course of middle school was associated with greater likelihood of engaging in high risk sexual behavior. By identifying particular psychosocial risk factors among young adolescents, the findings of this study support the design of comprehensive youth development programs targeted at highrisk middle school students as a means of preventing health-compromising sexual behavior among young teens.

Comments

This thesis is restricted to Yale network users only. This thesis is permanently embargoed from public release.

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