Relationships between Adolescent Stress, Depressive Symptoms, Social Support, Coping and Sexual Risk Behavior in Young Adulthood

Abstract

Objective To describe longitudinal associations among adolescent stressful life events, depressive symptoms, coping skills, social support, and young adult sexual risk behaviors and sexually transmitted infection (STI) in the United States. Design A total of 18,924 participants aged from 12 to 18 at baseline were included in the analysis. The study's design was a secondary analysis of three waves of longitudinal data utilized structural equation modeling (SEM) to test direct and indirect effects of adolescent stressful life events, depressive symptoms, problem-focused coping skills, unhealthy coping strategies, and social support on young adult sexual risk behavior. To examine the hypotheses of this study, three main structural models were evaluated. Model 1 explores the effects of depressive symptoms and stressful life events as the potential mediator of the association between mental health problems and sexual risk behavior, while Model 2 tests mediating effect of unhealthy coping strategies. Lastly, Model 3 examines the indirect effects of problem-focused coping skills and social support on sexual risk behavior. Results As anticipated, direct effects were found for adolescent stressful life events and unhealthy coping strategies on young adult sexual risk behavior. Adolescent stressful life events and unhealthy coping also significantly mediated the relationship between depressive symptoms and young adult sexual risk behavior. Higher social support from family and problem-focused coping strategies were associated with lower depressive symptoms and stressful life events in adolescence. Adolescent social support from family and problem-focused coping skills were shown to influence young adult sexual risk behavior indirectly through reducing stressful life events. Conclusions Given the associations between stressful life events, depressive symptoms, and sexual risk behavior, these findings highlight a need for screening for depression and stressful life events in adolescents. Findings may also be useful to inform interventions for high-risk adolescents facing psychological stressors and suggest that coping skills training and enhancing social support should be specific targets.