Self-esteem, emotional distress and sexual behavior among adolescent females: Inter-relationships and temporal effects

Ethier, Kathleen A.; Kershaw, Trace S.; Lewis, Jessica B.; Milan, Stephanie; Niccolai, Linda M.; Ickovics, Jeannette R.

doi:10.1016/j.jadohealth.2004.12.010

« Previous Next »Journal of Adolescent Health
Volume 38, Issue 3 , Pages 268-274, March 2006

Self-esteem, emotional distress and sexual behavior among adolescent females: Inter-relationships and temporal effects

Kathleen A. Ethier, Ph.D.
- Division of STD Prevention, Behavioral Intervention Research Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Department of Epidemiology and Public Health and Center for Interdisciplinary Research on AIDS, Yale School of Medicine, New Haven, Connecticut, USA
- Address correspondence to: Dr. Kathleen A. Ethier, Behavioral Interventions and Research Branch, Division of STD Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, NE, MS-E44, Atlanta, GA 30329.
Trace S. Kershaw, Ph.D.
- Department of Epidemiology and Public Health and Center for Interdisciplinary Research on AIDS, Yale School of Medicine, New Haven, Connecticut, USA
Jessica B. Lewis, M.A.
- Department of Epidemiology and Public Health and Center for Interdisciplinary Research on AIDS, Yale School of Medicine, New Haven, Connecticut, USA
Stephanie Milan, Ph.D.
- Department of Epidemiology and Public Health and Center for Interdisciplinary Research on AIDS, Yale School of Medicine, New Haven, Connecticut, USA
Linda M. Niccolai, Ph.D.
- Department of Epidemiology and Public Health and Center for Interdisciplinary Research on AIDS, Yale School of Medicine, New Haven, Connecticut, USA
Jeannette R. Ickovics, Ph.D.
- Department of Epidemiology and Public Health and Center for Interdisciplinary Research on AIDS, Yale School of Medicine, New Haven, Connecticut, USA

Received 14 September 2004; accepted 15 December 2004.

Abstract

Purpose

The current analyses attempt to clarify the relationship between psychological factors and sexual behavior. We test a model examining relationships between sexual history (e.g., age at initiation, partner history) and self-esteem and emotional distress (e.g., depression, anxiety, stress, hostility) and their impact on future sexual risk behavior (e.g., unprotected sex, multiple sexual partners).

Methods

The current analyses included 155 sexually active adolescent females, aged 14–19 years, who participated in the first two waves of a longitudinal study of human immunodeficiency virus (HIV)/sexually transmitted disease (STD) and pregnancy risk. The Rosenberg Self-esteem scale, the Perceived Stress Scale, and three subscales of the Brief Symptom Inventory (depression, anxiety, hostility) and a variety of self-report measures of sexual history and sexual behavior were administered. Structural equation modeling using LISREL 8.51 was used to assess the proposed model.

Results

Our model exhibited adequate fit and demonstrated that sexual history reported retrospectively at baseline was related to self-esteem and emotional distress also measured at baseline. These variables predicted sexual risk behavior measured 6 months later. Adolescents who had lower self-esteem at baseline reported initiating sex earlier and having had risky partners. Alternatively, adolescents with more emotional distress at baseline were less likely to have had a previous STD, had more partners per year of sexual activity and a history of risky partners. Self-esteem influenced subsequent unprotected sex and emotional distress influenced subsequent multiple partners.

Conclusions

This model suggests that self-esteem and emotional distress have contrasting relationships with sexual behavior and demonstrates the importance of the temporal nature of these variables. Implications for intervention are discussed.

Keywords: Self-esteem , Emotional distress , Sexual behavior , Adolescents , Sexually transmitted diseases