{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T17:40:55Z","timestamp":1791999655298,"version":"4.4.0"},"reference-count":41,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2001,11,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objective.<\/jats:title>\n                  <jats:p>The purpose of the study was to examine the association between adolescents' psychological distress and their sexually transmitted disease\/human immunodeficiency virus (STD\/HIV)-associated sexual behaviors and attitudes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Method.<\/jats:title>\n                  <jats:p>Sexually active black adolescent females (N = 522) completed, at baseline and again 6 months later, a self-administered questionnaire that assessed sexual health attitudes and emotional distress symptoms (using standardized measures, \u03b1 = .84), a structured interview that assessed STD\/HIV-associated sexual risk behaviors, and a urine screen for pregnancy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results.<\/jats:title>\n                  <jats:p>In multivariate analyses, controlling for observed covariates, adolescents with significant distress at baseline were more likely than their peers, after 6 months, to be pregnant (adjusted odds ratio [AOR]: = 2.0), have had unprotected vaginal sex (AOR = 2.1), have nonmonogamous sex partners (AOR = 1.7), and not use any form of contraception (AOR = 1.5). Additionally, they were also more likely to: perceive barriers to condom use (AOR = 2.2), be fearful of the adverse consequences of negotiating condom use (AOR = 2.0), perceive less control in their relationship (AOR = 2.0), have experienced dating violence (AOR = 2.4), feel less efficacious in negotiating condom use with a new sex partner (AOR = 1.6), and have norms nonsupportive of a healthy sexual relationship (AOR = 1.7).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion.<\/jats:title>\n                  <jats:p>The findings suggest that psychological distress is predictive over a 6-month period of a spectrum of STD\/HIV-associated sexual behaviors and high-risk attitudes. Brief screening to detect distress or depressive symptoms among adolescent females can alert the clinician to the need to conduct a sexual health history, initiate STD\/HIV-preventive counseling, and refer for comprehensive psychological assessment and appropriate treatment. Among adolescents receiving STD treatment, those with even moderate emotional distress may be at heightened risk for further unhealthy outcomes. STD\/HIV interventions should also consider psychological distress as one potential risk factor that may impact program efficacy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.108.5.e85","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:55:51Z","timestamp":1092441351000},"page":"e85-e85","source":"Crossref","is-referenced-by-count":163,"title":["A Prospective Study of Psychological Distress and Sexual Risk Behavior Among Black Adolescent Females"],"prefix":"10.1542","volume":"108","author":[{"given":"Ralph J.","family":"DiClemente","sequence":"first","affiliation":[{"name":"From Emory University, Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Atlanta, Georgia;"},{"name":"Emory University School of Medicine, Department of Pediatrics, Division of Infectious Diseases, Epidemiology and Immunology, Atlanta, Georgia;"},{"name":"Emory\/Atlanta Center for AIDS Research, Behavioral and Social Sciences Core, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gina M.","family":"Wingood","sequence":"additional","affiliation":[{"name":"From Emory University, Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Atlanta, Georgia;"},{"name":"Emory\/Atlanta Center for AIDS Research, Behavioral and Social Sciences Core, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A.","family":"Crosby","sequence":"additional","affiliation":[{"name":"From Emory University, Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Atlanta, Georgia;"},{"name":"Emory\/Atlanta Center for AIDS Research, Behavioral and Social Sciences Core, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catlainn","family":"Sionean","sequence":"additional","affiliation":[{"name":"From Emory University, Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larry K.","family":"Brown","sequence":"additional","affiliation":[{"name":"Brown University School of Medicine, Department of Psychiatry and Human Behavior, Providence, Rhode Island;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Rothbaum","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elana","family":"Zimand","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda K.","family":"Cobb","sequence":"additional","affiliation":[{"name":"Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy","family":"Harrington","sequence":"additional","affiliation":[{"name":"School of Public Health, Department of Health Behavior, University of Alabama, Birmingham, Birmingham, Alabama."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Davies","sequence":"additional","affiliation":[{"name":"School of Public Health, Department of Health Behavior, University of Alabama, Birmingham, Birmingham, Alabama."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2001,11,1]]},"reference":[{"key":"2021121003541998400_B1","doi-asserted-by":"crossref","first-page":"1894","DOI":"10.1001\/jama.279.23.1894","article-title":"Trends in HIV incidence among young adults in the United States.","volume":"279","author":"Rosenberg","year":"1998","journal-title":"JAMA"},{"key":"2021121003541998400_B2"},{"key":"2021121003541998400_B3"},{"key":"2021121003541998400_B4"},{"key":"2021121003541998400_B5","first-page":"67","article-title":"HIV infection in disadvantaged out-of-school youth: prevalence for U.S. Job Corps entrants, 1990 through 1996.","volume":"19","author":"Valleroy","year":"1998","journal-title":"JAIDS."},{"key":"2021121003541998400_B6"},{"key":"2021121003541998400_B7"},{"key":"2021121003541998400_B8"},{"key":"2021121003541998400_B9"},{"key":"2021121003541998400_B10"},{"key":"2021121003541998400_B11","first-page":"1609","article-title":"Adolescents with psychiatric disorders and risk of HIV.","volume":"36","author":"Brown","year":"1997","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"2021121003541998400_B12","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1176\/ajp.150.2.324","article-title":"Prevalence of HIV-related risk behaviors among psychiatrically hospitalized adolescents: comparison with a referent adolescent population.","volume":"150","author":"DiClemente","year":"1993","journal-title":"Am J Psychiatry"},{"key":"2021121003541998400_B13","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1017\/S0954579499001960","article-title":"Motherhood during the teen years: a developmental perspective on risk factors for childbearing.","volume":"11","author":"Miller-Johnson","year":"1999","journal-title":"J Dev Psychopathol."},{"key":"2021121003541998400_B14","first-page":"230","article-title":"Depressive symptoms and risk factors for HIV acquisition among Black women attending urban health centers in Baltimore.","volume":"6","author":"Orr","year":"1994","journal-title":"AIDS Educ Prev"},{"key":"2021121003541998400_B15","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1136\/bmj.321.7256.263","article-title":"Psychiatric disorders and risky sexual behaviour in young adulthood: cross sectional study in a birth cohort.","volume":"321","author":"Ramrakha","year":"2000","journal-title":"BMJ"},{"key":"2021121003541998400_B16","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1097\/00005053-199205000-00005","article-title":"The influence of mental health problems on AIDS-related risk behaviors in young adults.","volume":"180","author":"Stiffman","year":"1992","journal-title":"J Nerv Ment Dis"},{"key":"2021121003541998400_B17","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1001\/archpsyc.57.1.21","article-title":"Adolescent onset of the gender difference in lifetime rates of major depression.","volume":"57","author":"Cyranowski","year":"2000","journal-title":"Arch Gen Psychiatry"},{"key":"2021121003541998400_B18","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1037\/0003-066X.48.2.155","article-title":"Depression in adolescence.","volume":"48","author":"Petersen","year":"1993","journal-title":"Am Psychol"},{"key":"2021121003541998400_B19","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1177\/0013164493053004024","article-title":"A short depression index for women.","volume":"53","author":"Melchior","year":"1993","journal-title":"Educ Psychol Measurement."},{"key":"2021121003541998400_B20","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/BF01537606","article-title":"The use of the Center for Epidemiological Studies Depression Scale in adolescents and young adults [Special issue: The emergence of depressive symptoms during adolescence].","volume":"20","author":"Radloff","year":"1991","journal-title":"J Youth Adolesc"},{"key":"2021121003541998400_B21","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1177\/014662167700100306","article-title":"The CES-D scale: a self-report depression scale for research in the general population.","volume":"1","author":"Radloff","year":"1977","journal-title":"Appl Psychol Measure"},{"key":"2021121003541998400_B22"},{"key":"2021121003541998400_B23","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1176\/ajp.140.1.41","article-title":"The Center for Epidemiologic Studies Depression Scale: its use in a community sample.","volume":"140","author":"Roberts","year":"1983","journal-title":"Am J Psychiatry"},{"key":"2021121003541998400_B24","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/0165-1781(85)90079-4","article-title":"Depressive symptoms, major depression, and generalized anxiety: a comparison of self-reports on CES-D and results from diagnostic interviews.","volume":"15","author":"Breslau","year":"1985","journal-title":"Psychiatry Res"},{"key":"2021121003541998400_B25","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1097\/00004583-199101000-00009","article-title":"Screening for adolescent depression: a comparison of depression scales.","volume":"30","author":"Roberts","year":"1991","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"2021121003541998400_B26","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1001\/archfami.6.6.567","article-title":"Can case-finding instruments be used to improve physician detection of depression in primary care?","volume":"6","author":"Klinkman","year":"1997","journal-title":"Arch Fam Med"},{"key":"2021121003541998400_B27"},{"key":"2021121003541998400_B28","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1177\/109019810002700502","article-title":"Applying a theoretical framework of gender and power to understand the exposures and risk factors for HIV among women.","volume":"27","author":"Wingood","year":"2000","journal-title":"Health Educ Behav"},{"key":"2021121003541998400_B29","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1097\/00007435-199905000-00003","article-title":"Racial\/ethnic group differences in the prevalence of sexually transmitted diseases in the United States: a network explanation.","volume":"26","author":"Laumann","year":"1999","journal-title":"Sex Transm Dis"},{"key":"2021121003541998400_B30","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1097\/00007435-199905000-00004","article-title":"Sexual network patterns as determinants of STD rates: paradigm shift in the behavioral epidemiology of STDs made visible.","volume":"26","author":"Aral","year":"1999","journal-title":"Sex Transm Dis"},{"key":"2021121003541998400_B31","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1097\/00007435-199902000-00002","article-title":"The geography of sexual partnerships in Baltimore: applications of core theory dynamics using a geographical information system.","volume":"26","author":"Zenilman","year":"1999","journal-title":"Sex Transm Dis"},{"key":"2021121003541998400_B32","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1046\/j.1360-0443.1998.93343311.x","article-title":"The relationship between depressive symptoms and cigarette smoking in US adolescents.","volume":"93","author":"Escobedo","year":"1998","journal-title":"Addiction"},{"key":"2021121003541998400_B33","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1097\/00004714-199908000-00015","article-title":"Long-term codeine use is associated with depressive symptoms.","volume":"19","author":"Romeach","year":"1999","journal-title":"J Clin Psychopharmacol"},{"key":"2021121003541998400_B34","first-page":"150","article-title":"Adolescent psychiatric inpatients: alcohol use and HIV risk-taking behavior.","volume":"17","author":"Aruffo","year":"1994","journal-title":"Psychosoc Rehabil J"},{"key":"2021121003541998400_B35","doi-asserted-by":"crossref","first-page":"129","DOI":"10.3109\/10826089209068734","article-title":"Alcohol, drugs, and adolescent sexual behavior.","volume":"27","author":"Strunin","year":"1992","journal-title":"Int J Addict"},{"key":"2021121003541998400_B36","doi-asserted-by":"crossref","first-page":"128","DOI":"10.2307\/2135701","article-title":"Linkages between sexual activity and alcohol and drug use among American adolescents.","volume":"20","author":"Mott","year":"1988","journal-title":"Fam Plann Perspect"},{"key":"2021121003541998400_B37","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1097\/00004583-199511000-00020","article-title":"Continuity of psychopathology in a community sample of adolescents.","volume":"34","author":"Orvaschel","year":"1995","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"2021121003541998400_B38","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1176\/ajp.156.1.133","article-title":"Adolescent depressive symptoms as predictors of adult depression: moodiness or mood disorder.","volume":"156","author":"Pine","year":"1999","journal-title":"Am J Psychiatry"},{"key":"2021121003541998400_B39","first-page":"729","article-title":"Development of an HIV prevention program for psychiatrically-hospitalized adolescents.","volume":"30","author":"Ponton","year":"1991","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"2021121003541998400_B40","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1176\/appi.ajp.157.9.1413","article-title":"The impact of sexual abuse on the sexual risk behavior of adolescents in intensive psychiatric treatment.","volume":"157","author":"Brown","year":"2000","journal-title":"Am J Psychiatry"},{"key":"2021121003541998400_B41"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/108\/5\/e85\/892614\/pe11010000n1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/108\/5\/e85\/892614\/pe11010000n1.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T11:24:11Z","timestamp":1639135451000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/108\/5\/e85\/63728\/A-Prospective-Study-of-Psychological-Distress-and"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,11,1]]},"references-count":41,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2001,11,1]]},"published-print":{"date-parts":[[2001,11,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.108.5.e85","relation":{},"ISSN":["1098-4275","0031-4005"],"issn-type":[{"value":"1098-4275","type":"electronic"},{"value":"0031-4005","type":"print"}],"subject":[],"published":{"date-parts":[[2001,11,1]]}}}