Abstract
Depressed adolescents are more likely to engage in sexual risk behaviors than their non-depressed peers. The objectives of this study were (1) to examine whether affective states predicted subsequent condom use, directly or indirectly through contextual factors and (2) to compare results obtained from structural equation models versus non-linear mixed effects models. This study used ecological momentary assessment to collect data on in-the-moment affective states and sexual behavior from 51 depressed adolescents (7 male, 44 female) aged 15–22 years. The association between positive and negative affect and condom use during a subsequent sex event was explored using several structural equation models and non-linear mixed effects models. Potential mediation by substance use before sex, partner type, reason for sex, and who wanted sex was examined. Neither positive nor negative affect was directly associated with condom use in any models; however, negative affect was associated with increased likelihood of sex with a non-main partner, which, in turn, was associated with increased condom use. Both structural equation models and non-linear mixed effects models successfully modeled the relationship between affect and condom use in momentary data while correctly accounting for the correlation of multiple observations from the same individual. The benefit of structural equation modeling was the ability to directly model the mediation of this effect by contextual factors. In this sample of depressed adolescents, negative and positive affect did not appear to be directly predictive of condom use during a subsequent sex event, although may indirectly affect condom use through sex with a non-main partner.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Beck, A., Steer, R., & Brown, G. (1996). BDI-II Manual. San Antonio, TX: The Psychological Corporation.
Bhushan, D., Blood, E. A., & Shrier, L. A. (2012). Momentary affective states predicting substance use events in depressed youth. Mental Health and Substance Use. doi:10.1080/17523281.2012.708357.
Blood, E. A., & Cheng, D. M. (2012). Non-linear mixed models in the analysis of mediated longitudinal data with binary outcomes. BMC Medical Research Methodology, 12. doi:10.1186/1471-2288-12-5.
Brown, J. L., & Vanable, P. A. (2007). Alcohol use, partner type, and risky sexual behavior among college students: Findings from an event-level study. Addictive Behaviors, 32, 2940–2952.
Cooper, M. L., Frone, M. R., Russell, M., & Mudar, P. (1995). Drinking to regulate positive and negative emotions: A motivational model of alcohol use. Journal of Personality and Social Psychology, 69, 990–1005.
Crepaz, N., & Marks, G. (2001). Are negative affective states associated with HIV sexual risk behaviors? A meta-analytic review. Health Psychology, 20, 291–299.
Eysenck, S. B., Easting, G., & Pearson, P. (1984). Age norms for impulsiveness, venturesomeness and empathy in children. Personality and Individual Differences, 5, 315–321.
Eysenck, S., & Eysenck, H. (1977). The place of impulsiveness in a dimensional system of personality description. British Journal of Social and Clinical Psychology, 16, 57–68.
Eysenck, S. B., Pearson, P., Easting, G., & Allsopp, J. (1985). Age norms of impulsiveness, venturesomeness and empathy in adults. Personality and Individual Differences, 6, 613–619.
Gebhardt, W. A., Kuyper, L., & Dusseldorp, E. (2006). Condom use at first intercourse with a new partner in female adolescents and young adults: The role of cognitive planning and motives for having sex. Archives of Sexual Behavior, 35, 217–223.
Kahn, M. R., Kaufman, J. S., Pence, B. W., Gaynes, B. N., Adimora, A. A., Weir, S. S., & Miller, W. C. (2009). Depression, sexually transmitted infection, and sexual risk behavior among young adults in the United States. Archives of Pediatrics and Adolescent Medicine, 163, 644–652.
LaBrie, J., Earleywine, M., Schiffman, J., Pederson, E., & Marriot, C. (2005). Effects of alcohol, expectancies, and partner type on condom use in college males: Event-level analyses. Journal of Sex Research, 42, 259–266.
Lehrer, J. A., Shrier, L. A., Gortmaker, S., & Buka, S. (2006). Depressive symptoms as a longitudinal predictor of sexual risk behaviors among US middle and high school students. Pediatrics, 118, 189–200.
Leigh, B. C., Vanslyke, J. G., Hoppe, M. J., Rainey, D. T., Morrison, D. M., & Gillmore, M. R. (2008). Drinking and condom use: Results from an event-based daily diary. AIDS and Behavior, 12, 104–112.
Millstein, S. G., & Moscicki, A.-B. (1995). Sexually-transmitted disease in female adolescents: Effects of psychosocial factors and high risk behaviors. Journal of Adolescent Health, 17, 83–90.
Muthen, B. (1984). A general structural equation model with dichotomous, ordered categorical and continuous latent variable indicators. Psychometrika, 49, 115–132.
Schroder, K. E., Johnson, C. J., & Wiebe, J. S. (2009). An event-level analysis of condom use as a function of mood, alcohol use, and safer sex negotiations. Archives of Sexual Behavior, 38, 283–289.
Schwartz, J., & Stone, A. A. (1998). Strategies for analyzing ecological momentary assessment data. Health Psychology, 17, 6–16.
Shrier, L. A., Feldman, H. A., Black, S. K., Walls, C., Kendall, A. D., Lops, C., & Beardslee, W. R. (2012). Momentary affective states surrounding sexual intercourse in depressed adolescents and young adults. Archives of Sexual Behavior, 41, 1161–1171.
Shrier, L. A., Harris, S. K., & Beardlsee, W. R. (2002). Temporal associations between depressive symptoms and self-reported sexually transmitted disease among adolescents. Archives of Pediatrics and Adolescent Medicine, 156, 599–606.
Shrier, L. A., Koren, S., Aneja, P., & de Moor, C. (2010). Affect regulation, social context, and sexual intercourse in adolescents. Archives of Sexual Behavior, 39, 695–705.
Shrier, L. A., Schillinger, J. A., Aneja, P., Rice, P. A., Batteiger, B. E., Braslins, P. G.,… Fortenberry, J. D. (2009). Depressive symptoms and sexual risk behavior in young, chlamydia-infected, heterosexual dyads. Journal of Adolescent Health, 45, 63–69.
Shrier, L. A., Walls, C., Lops, C., Kendall, A. D., & Blood, E. A. (2011). Substance use, sexual intercourse, and condom nonuse among depressed adolescents and young adults. Journal of Adolescent Health, 50, 264–270.
Stone, A. A., & Shiffman, S. (2002). Capturing momentary, self-report data: A proposal for reporting guidelines. Annals of Behavioral Medicine, 24, 236–243.
Stone, A., Shiffman, S., Atienza, A., & Nebeling, L. (2007). The science of real-time data capture: Self-reports in health research. New York: Oxford University Press.
Watson, D., Clark, L., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54, 1063–1070.
Wills, T. A., Sandy, J. M., Shinar, O., & Yaeger, A. (1999). Contributions of positive and negative affect to adolescent substance use: Test of a bidimensional model in a longitudinal study. Psychology of Addictive Behaviors, 13, 327–338.
Acknowledgments
This work was supported by funds from the Aerosmith Endowment Fund, Boston Children’s Hospital.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Blood, E.A., Shrier, L.A. The Temporal Relationship Between Momentary Affective States and Condom Use in Depressed Adolescents. Arch Sex Behav 42, 1209–1216 (2013). https://doi.org/10.1007/s10508-012-0048-y
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10508-012-0048-y