Gender Differences in Associations Between Sexual Behavior and Depressive Symptoms from Adolescence to Early Adulthood

ABSTRACT BODY:

Introduction: Sexuality education programs for adolescents often encourage abstinence or delay of sexual behavior, in part because of the potential for negative psychological consequences. Although some research has linked early sexual intercourse and depressive symptoms, particularly for girls, there is little research that pinpoints periods during which sexual behavior may be associated with depressive symptoms and ones during which sexual behavior may be more neutral or positive. A new method, the time-varying effect model (TVEM) can help researchers document the developmental course of sexual behavior and identify periods that are most suitable for intervention. In this study we use TVEM to examine 1) how rates of past year sexual intercourse, condom use and multiple partners change over the course of adolescence and young adulthood, and 2) how these behaviors are differentially associated with depressive symptoms across this age period for male and female adolescents and young adults.

Methods: Data are a subsample of participants (N=11,963, 52% female) from the National Longitudinal Study of Adolescent to Adult Health. Data from 4 waves were used, providing coverage of the age range from 12-32. Only waves when participants were not married were included in the analysis. Participants reported on their sexual behaviors in the past year, and completed a 9-item measure of past-month depressive symptoms adapted from the Center for Epidemiological Studies Depression Scale.  TVEMs were run separately by gender for models with sexual intercourse, contraceptive use and multiple partners as predictors and depressive symptoms as the outcome.

Results: Rates of sexual intercourse in the past year increased sharply from about 10% at age 12 to 70% by age 20, then increased more gradually to 90% at age 30. Among those who were sexually active, rates of contraceptive use and multiple partners were fairly stable over time. For female participants, being sexually active was associated with higher depressive symptoms through age 21. This association was weaker for men, and was only significant between ages 15 and 18. Men who were sexually active were less depressed between ages 23 and 28. Among those who were sexually active, not using contraception and having multiple partners were most strongly associated with depressive symptoms prior to age 16.

Discussion: Findings suggest that although there is an association between sexual behavior and depressive symptoms in adolescence, there is likely no benefit to delaying sexual behavior past the early twenties for mental health reasons. Gender differences suggest the influence of sexual double standards or the greater benefits of romantic relationships for men compared to women.