GENERAL AND SEXUAL COMMUNICATION BETWEEN PARENTS AND ADOLESCENTS AND BETWEEN ADOLESCENT COUPLES Cami

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GENERAL AND SEXUAL COMMUNICATION BETWEEN PARENTS
AND ADOLESCENTS AND BETWEEN ADOLESCENT COUPLES
Cami K. McBride1, Carla M. Nappi1, Chinmayee
Barve2, Geri R. Donenberg2 Project
STYLE1Rosalind Franklin University of Medicine
and Science, Department of Psychology2University
of Illinois at Chicago, Institute for Juvenile
ResearchFunded by the NIMH Office on AIDS
(MH063008-03) to Larry Brown, M.D.
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INTRODUCTION

• Adolescents with mental health problems face a
  number of challenges to their development.
  Navigating romantic relationships is difficult
  for most youth, and can be especially difficult
  for youth with poor emotional regulation and
  often dysfunctional familial relationships.
  Communication with romantic partners about
  sexuality may be especially problematic, and
  represents an important risk factor, given that
  youth with mental health problems engage in high
  levels of risky sexual behavior.

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BACKGROUND

• Significantly higher rates of HIV risk behavior
  were found in psychiatric inpatient adolescents
  vs. school-based sample (DiClemente Ponton,
  1993).
• 42 of severely emotionally disturbed youth
  reported sexual debut prior to age 13 vs. 6.6 of
  the general sample used in the CDCs Youth Risk
  Behavior Survey (Valois et al, 1997).
• Of 100 adolescents in inpatient psychiatric care,
  71 reported being sexually active and 27
  reported sexual intercourse w/ 5 or more partners
  in past year (Brown et al., 1997).

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BACKGROUND

• Significantly higher rates of HIV risk behavior
  were found in psychiatric inpatient adolescents
  vs. school-based sample (DiClemente Ponton,
  1993).
• 42 of severely emotionally disturbed youth
  reported sexual debut prior to age 13 vs. 6.6 of
  the general sample used in the CDCs Youth Risk
  Behavior Survey (Valois et al, 1997).
• Of 100 adolescents in inpatient psychiatric care,
  71 reported being sexually active and 27
  reported sexual intercourse w/ 5 or more partners
  in past year (Brown et al., 1997).
• Because youth in psychiatric care are at high
  risk for contracting STIs HIV, it is important
  to understand what factors may increase their
  risk or promote health. Prior work with typically
  developing adolescents has found that better
  parent-adolescent communication about sexual
  topics and in general leads to less risky
  behavior (Dutra et al., 1998). However, strained
  familial relationships among youth with mental
  health problems make it unclear whether this
  association will hold in this population.

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BACKGROUND

• Although it has been proposed theoretically, few
  studies have examined how parent-adolescent
  communication influences adolescent couples
  communication. DiClemente et al. (2001) found
  that among African American adolescent girls,
  frequency of communication between parents and
  adolescents was associated with frequency of
  communication about sex with partners. To our
  knowledge, the association between
  parent-adolescent communication with adolescent
  couples communication among youth with mental
  health problems has not been tested.
• It is also not clear how congruent that
  adolescents with mental health problems and
  parents may be in their reports of communication
  about sexual topics (Jaccard, Dittus, Gordon,
  1998). The current study wished to assess the
  associations between parent-adolescent general
  and sexual communication with adolescent couples
  general and sexual communication among a sample
  of multi-ethnic youth with mental health
  problems.

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• HYPOTHESES
• Greater levels of parent-adolescent communication
  about sexual behavior will be associated with
  greater communication between couples about
  sexual behavior.
• Greater levels of parent-adolescent open
  communication will be associated with greater
  open communication between adolescent couples.

• RESEARCH QUESTIONS
• How would each element of communication (process,
  frequency, and openness) relate to the others?
• Would parents and adolescents perceive their
  communication in a similar way?

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PARTICIPANTS AND PROJECT STYLE DESIGN

• Project STYLE is a multi-site, longitudinal,
  3-arm study designed to evaluate an HIV
  prevention intervention program for youth in
  psychiatric care and their families.
• 250 adolescents are being recruited at each of 3
  sites (Chicago, Atlanta, Providence) to complete
  baseline, 3, 6 and 12 month assessments and to
  participate in an intervention workshop at
  baseline and 3 months.
• The current study presents preliminary analyses
  of data obtained from the baseline assessments (N
  158).

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DEMOGRAPHICS

• Only participants that reported currently being
  in a romantic relationship are included in these
  analyses, thus
• N 69 (44 of the Project STYLE sample to date).
  
• Age M 14.91 SD 1.21
• Gender 60.9 Female, 39.1 Male
• Race and Ethnicity 55.1 African American, 30.4
  White, 6 Biracial, 5.7 Did not identify race
  8.7 of the sample is Latino.
• All participants have recently received
  inpatient, day treatment or outpatient
  psychiatric care.

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MEASURES COMPLETED

• Parent-Adolescent Open Communication Scale
  (Barnes Olsen, 1982 alpha .82,.91)
• Sample item I am very satisfied by how my child
  (my parent) and I talk together.
• Process of Sexual Communication between Parents
  and Adolescents (Dutra et al., 1999 alpha .60,
  .85)
• Sample item My teen (my parent) and I talk open
  and freely about topics regarding sex.
• Frequency of Sexual Communication between Parents
  and Adolescents (Dutra et al., 1999)
• Sample item During the past 3 months, how many
  times did you and your teen (parent) talk about
  when it is appropriate to start having sex.
• Welsh Couples Open Communication Scale (2003)
  (alpha .70)
• Sample item I express my feelings to my partner
  when I am upset by him or her.
• Welsh Couples Sexual Communication Scale (2003)
  (alpha .68)
• Sample item I freely discuss sex with my
  partner.

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ANALYSES

• Bivariate correlations were conducted to assess
  the associations between the couples
  communication and communication between parent
  and adolescent (See Table 1).
• Adolescents reported on their communication with
  a romantic partner.
• Both parents and adolescents provided reports on
  communication with one another.

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Table 1 p lt .01, p lt .05, red same
reporter, blue different reporter
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SUMMARY OF RESULTS

• Hypothesized relationships
• Significant positive association between couples
  open communication and the adolescent report of
  the process of sexual communication between
  adolescent and parent (r .26).
• Research Questions - Within Reporter
• Significant positive association between couples
  open communication and couples sexual
  communication (r .71).
• Significant positive associations between process
  and frequency of sexual communication for both
  adolescent and parent reporters (r .50, r
  .54).
• Significant positive associations between process
  of sexual communication and open communication
  for both adolescent and parent reporters (r
  .60, r .49)

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SUMMARY OF RESULTS (contd.)

• Research Questions - Across Reporter
• Significant positive association for process of
  sexual communication between adolescent and
  parent reporters (r .24)
• Significant positive association for frequency of
  sexual communication between adolescent and
  parent reporters (r .38)
• Significant positive association for open
  communication between adolescent and parent
  reporters (r .29)
• Significant positive association for parent
  report of the process of sexual communication and
  adolescent report pf open communication (r .27)

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CONCLUSIONS AND FUTURE DIRECTIONS

• Significant relationship between couples
  communication and parent communication is similar
  to prior work with typically developing youth.
• Convergence between reporters on similar
  constructs suggests similar views of
  communication process.
• Need to determine how general and sexual
  communication relate to actual sexual risk
  behavior.
• Will examine these associations over time to
  determine the direction of the relationships.
• One focus of intervention is improving
  communication between parent and adolescent as
  well as between adolescent partners. How will
  improvements in one impact the other?

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REFERENCES

• Barnes, H. Olson, D. (1982). Parent-Adolescent
  Communication, Family Inventories Inventories
  Used in a National Survey of Families Across the
  Family Life Cycle, eds. D. Olson et al., St.
  Paul, MN Family Social Science, 33-48.
•  Brown, L. K., Kessel, S. M., Lourie, K. J.,
  Ford, H., Lipsitt, L. (1997). The influence of
  sexual abuse on the AIDS-related Journal of the
  American Academy of Child and Adolescent
  Psychiatry, 36, 316-322.
•  DiClemente, R. J., Ponton, L. E. (1993).
  HIV-related risk behaviors among psychiatrically
  hospitalized adolescents and school-based
  adolescents. American Journal of Psychiatry,
  150(2), 324-325.
• DiClemente, R. J., Wingood, G., Crosby, R., Cobb,
  B.K., Harrington, K., Davies, S.L. (2001).
  Parent-adolescent communication and sexual risk
  behaviors among African American adolescent
  females. The Journal of Pediatrics, 139(3),
  407-412.
• Dutra, R., Miller, K.S., Forehand, R. (1999).
  The process and content of sexual communication
  with adolescents in two-parent families
  Associations with sexual risk-taking behavior.
  AIDS and Behavior, 3, 59-66.
• Jaccard,J. Dittus,P.J. Gordon,V.V. (1998).
  Parent-adolescent congruence in reports of
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  about sexual behavior. Child Development, 69,
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• Miller, K.S., Kotchick, B.A., Dorsey, S.,
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• Valois, R. F., Bryant, E. S., Rivard, J. C.,
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  disturbance. Journal of Child and Family Studies,
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• Welsh, D. (2003). Couples Communication Scale.
  Downloaded from the STARR Study of Tennessee
  Adolescent Romantic Relationships Manual at
  http//web.utk.edu/welsh/webstarr.doc