Archives of Sexual Behavior

, Volume 39, Issue 3, pp 724–734 | Cite as

Relationship Between Mental Disorders/Suicidality and Three Sexual Behaviors: Results from the National Comorbidity Survey Replication

  • Natalie P. Mota
  • Brian J. Cox
  • Laurence Y. Katz
  • Jitender Sareen
ORIGINAL PAPER

Abstract

The present study examined the relationship between sexual behaviors and mental disorders and suicidality in the National Comorbidity Survey Replication, a representative sample of adults ages 18 years and older (N = 5,692). The World Health Organization Composite International Diagnostic Interview was used to make DSM-IV based disorder diagnoses. Participants were also asked about suicidality and sexual behaviors. Multiple logistic regression analyses adjusted for sociodemographic variables were used to examine the relationships of three sexual behaviors (age of first intercourse, number of past year partners, and past year condom use) with 15 mental disorders (clustered into any mood, anxiety, substance use, and disruptive behavior groups) and suicidality (ideation and attempts). Compared to ages 15–17, those with age of first intercourse between 12 and 14 had increased rates of lifetime disruptive behavior, substance use, and any mental disorder, and suicidal ideation and attempts (adjusted odds ratio (AOR) range, 1.46–2.01). Those with age of first intercourse between ages 18–25 and 26–35 were at decreased likelihood of several lifetime disorder groups (AOR range, 0.19–0.81). Individuals who had two or more sexual partners in the past year had increased rates of all past year disorder groups examined (AOR range, 1.44–5.01). Never married participants who rarely/never used condoms were more likely than those who always used condoms to experience any mood, substance use, and any mental disorder, and suicide attempts (AOR range, 1.77–8.13). Future research should longitudinally examine these associations and account better for possible familial and personality confounders.

Keywords

Sexual behaviors Age of first intercourse Depression Anxiety Substance use 

References

  1. Abma, J. C., Martinez, G. M., Mosher, W. D., & Dawson, B. S. (2004). Teenagers in the United States: Sexual activity, contraceptive use, and childbearing, 2002. Vital and Health Statistics, 23, 1–48.Google Scholar
  2. Afifi, T. O., Macmillan, H., Cox, B. J., Asmundson, G. J., Stein, M. B., & Sareen, J. (2008). Mental health correlates of intimate partner violence in marital relationships in a nationally representative sample of males and females. Journal of Interpersonal Violence, [Epub ahead of print].Google Scholar
  3. Anderson, J. E., Mosher, W. D., & Chandra, A. (2006). Measuring HIV risk in the U.S. population aged 15–44: Results from Cycle 6 of the National Survey of Family Growth. Advanced Data, 23, 1–27.Google Scholar
  4. Apostolopoulos, Y., Sonmez, S., & Yu, C. H. (2002). HIV-risk behaviours of American spring break vacationers: A case of situational disinhibition? International Journal of STD & AIDS, 13, 733–743.CrossRefGoogle Scholar
  5. Boden, J. M., & Horwood, L. J. (2006). Self-esteem, risky sexual behavior, and pregnancy in a New Zealand birth cohort. Archives of Sexual Behavior, 35, 549–560.CrossRefPubMedGoogle Scholar
  6. Brener, N., Kann, L., Lowry, R., Wechsler, H., & Romero, L. (2006). Trends in human immunodeficiency virus-related risk behaviors among high school students-United States, 1991–2005. Journal of School Health, 76, 521–524.CrossRefPubMedGoogle Scholar
  7. Brook, D. W., Brook, J. S., Pahl, T., & Montoya, I. (2002). The longitudinal relationship between drug use and risky sexual behaviors among Columbian adolescents. Archives of Pediatrics & Adolescent Medicine, 156, 1101–1107.Google Scholar
  8. Burge, V., Felts, M., Chenier, T., & Parrillo, A. V. (1995). Drug use, sexual activity, and suicidal behavior in U.S. high school students. Journal of School Health, 65, 222–227.CrossRefPubMedGoogle Scholar
  9. Carey, M. P., Carey, K. B., Maisto, S. A., Gordon, C. M., & Vanable, P. A. (2001). Prevalence and correlates of sexual activity and HIV-related risk behavior among psychiatric outpatients. Journal of Consulting and Clinical Psychology, 69, 846–850.CrossRefPubMedGoogle Scholar
  10. Carey, M. P., Carey, K. B., Maisto, S. A., Schroder, K. E., Vanable, P. A., & Gordon, C. M. (2004). HIV risk behavior among psychiatric outpatients: Association with psychiatric disorder, substance use disorder, and gender. Journal of Nervous and Mental Disease, 192, 289–296.CrossRefPubMedGoogle Scholar
  11. Cauffman, E., & Steinberg, L. (2000). (Im)maturity of judgment in adolescence: Why adolescents may be less culpable than adults. Behavioral Sciences & the Law, 18, 741–760.CrossRefGoogle Scholar
  12. Colorado, R. A., Shumake, J., Conejo, N. M., Gonzalez-Pardo, H., & Lima, F. G. (2006). Effects of maternal separation, early handling, and standard facility rearing on orienting and impulsive behavior of adolescent rats. Behavioural Processes, 71, 51–58.CrossRefPubMedGoogle Scholar
  13. de Visser, R. O., Smith, A. M. A., Richters, J., & Rissel, C. E. (2007). Associations between religiosity and sexuality in a representative sample of Australian adults. Archives of Sexual Behavior, 36, 33–46.CrossRefPubMedGoogle Scholar
  14. Devieux, J., Malow, R., Stein, J. A., Jennings, T. E., Lucenko, B. A., Averhart, C., et al. (2002). Impulsivity and HIV risk among adjudicated alcohol- and other drug-abusing adolescent offenders. AIDS Education and Prevention, 14, 24–35.CrossRefPubMedGoogle Scholar
  15. Durant, L. E., & Carey, M. P. (2000). Self-administered questionnaires versus face-to-face interviews in assessing sexual behavior in young women. Archives of Sexual Behavior, 29, 309–322.CrossRefPubMedGoogle Scholar
  16. Durant, L. E., & Carey, M. P. (2002). Reliability of retrospective self-reports of sexual and nonsexual health behaviors among women. Journal of Sex & Marital Therapy, 28, 331–338.CrossRefGoogle Scholar
  17. Evans, J., Heron, J., Lewis, G., Araya, R., Wolke, D., & ALSPAC Study Team. (2005). Negative self-schemas and the onset of depression in women: Longitudinal study. British Journal of Psychiatry, 186, 302–307.CrossRefPubMedGoogle Scholar
  18. Fenton, K. A., Korovessis, C., Johnson, A. M., McCadden, A., McManus, S., Wellings, K., et al. (2001). Sexual behaviour in Britain: Reported sexually transmitted infections and prevalent genital Chlamydia trachomatis infection. Lancet, 358, 1851–1854.CrossRefPubMedGoogle Scholar
  19. Fergus, S., Zimmerman, M. A., & Caldwell, C. H. (2007). Growth trajectories of sexual risk behavior in adolescence and young adulthood. American Journal of Public Health, 97, 1096–1101.CrossRefPubMedGoogle Scholar
  20. Fergusson, D. M., & Woodward, L. J. (2000). Educational, psychosocial, and sexual outcomes of girls with conduct problems in early adolescence. Journal of Child Psychology and Psychiatry, 41, 779–792.CrossRefPubMedGoogle Scholar
  21. Grunseit, A. C., & Richters, J. (2000). Age at first intercourse in an Australian national sample of technical college students. Australian and New Zealand Journal of Public Health, 24, 11–16.CrossRefPubMedGoogle Scholar
  22. Hallfors, D. D., Waller, M. W., Bauer, D., Ford, C. A., & Halpern, C. T. (2005). Which comes first in adolescence-sex and drugs or depression? American Journal of Preventive Medicine, 29, 163–170.CrossRefPubMedGoogle Scholar
  23. Hallfors, D. D., Waller, M. W., Ford, C. A., Halpern, C. T., Brodish, P. H., & Iratini, B. (2004). Adolescent depression and suicide risk: Association with sex and drug behavior. American Journal of Preventive Medicine, 27, 224–231.PubMedGoogle Scholar
  24. Haro, J. M., Arbabzadeh-Bouchez, S., Brugha, T. S., de Girolamo, G., Guyer, M. E., Jin, R., et al. (2006). Concordance of the Composite International Diagnostic Interview Version 3.0 (CIDI 3.0) with standardized clinical assessments in the WHO World Mental Health Surveys. International Journal of Methods in Psychiatric Research, 15, 167–180.Google Scholar
  25. Hayaki, J., Anderson, B., & Stein, M. (2006). Sexual risk behaviors among substance users: Relationship to impulsivity. Psychology of Addictive Behavior, 20, 328–332.CrossRefGoogle Scholar
  26. Heath, A. C., Bucholz, K. K., Madden, P. A. F., Dinwiddie, S. H., Slutske, W. S., Bierut, L. J., et al. (1997). Genetic and environmental contributions to alcohol dependence risk in a national twin sample: Consistency of findings in women and men. Psychological Medicine, 27, 1381–1396.CrossRefPubMedGoogle Scholar
  27. Kaestle, C. E., Halpern, C. T., Miller, W. C., & Ford, C. A. (2005). Young age at first sexual intercourse and sexually transmitted infections in adolescents and young adults. American Journal of Epidemiology, 161, 774–780.CrossRefPubMedGoogle Scholar
  28. Kessler, R. C., Berglund, P., Chiu, W. T., Demler, O., Heeringa, S., Hiripi, E., et al. (2004). The U.S. National Comorbidity Survey Replication (NCS-R): Design and field procedures. International Journal of Methods in Psychiatric Research, 13, 69–92.CrossRefPubMedGoogle Scholar
  29. Kessler, R. C., Berglund, P. A., Demler, O., Jin, R., & Walters, E. E. (2005a). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 593–602.CrossRefPubMedGoogle Scholar
  30. Kessler, R. C., Berglund, P. A., Foster, C. L., Saunders, W. B., Stang, P. E., & Walters, E. E. (1997). Social consequences of psychiatric disorders, II: Teenage parenthood. American Journal of Psychiatry, 154, 1405–1411.PubMedGoogle Scholar
  31. Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005b). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 617–627.CrossRefPubMedGoogle Scholar
  32. Kessler, R. C., & Ustun, T. B. (2004). The World Mental Health (WMH) survey initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). International Journal of Methods in Psychiatric Research, 13, 93–121.CrossRefPubMedGoogle Scholar
  33. King, R. A., Schwab Stone, M., Flisher, A. J., Greenwald, S., Kramer, R. A., Goodman, S. H., et al. (2001). Psychosocial and risk behavior correlates of youth suicide attempts and suicidal ideation. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 837–846.CrossRefPubMedGoogle Scholar
  34. Klein, H., Elifson, K. W., & Sterk, C. E. (2007). Childhood neglect and adulthood involvement in HIV-related risk behaviors. Child Abuse & Neglect, 31, 39–53.CrossRefGoogle Scholar
  35. Langstrom, N., & Hanson, R. K. (2006). High rates of sexual behavior in the general population: Correlates and predictors. Archives of Sexual Behavior, 35, 37–52.CrossRefPubMedGoogle Scholar
  36. Lavan, H., & Johnson, J. G. (2002). The association between axis I and II psychiatric symptoms and high-risk sexual behavior during adolescence. Journal of Personality Disorders, 16, 73–94.CrossRefPubMedGoogle Scholar
  37. 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.CrossRefPubMedGoogle Scholar
  38. Leigh, B. C., Morrison, D. M., Trocki, K., & Temple, M. T. (1994). Sexual behavior of American adolescents: Results from a U.S. national survey. Journal of Adolescent Health, 15, 117–125.CrossRefPubMedGoogle Scholar
  39. Leigh, B. C., Temple, M. T., & Trocki, K. (1993). The sexual behavior of U.S. adults: Results from a National survey. American Journal of Public Health, 83, 1400–1408.CrossRefPubMedGoogle Scholar
  40. Lejuez, C. W., Simmons, B. L., Aklin, W. M., Daughters, S. B., & Dvir, S. (2004). Risk-taking propensity and risky sexual behavior of individuals in residential substance use treatment. Addictive Behaviors, 29, 1643–1647.CrossRefPubMedGoogle Scholar
  41. Meade, C. S., & Sikkema, K. J. (2007). Psychiatric and psychosocial correlates of sexual risk behavior among adults with severe mental illness. Community Mental Health Journal, 43, 153–169.CrossRefPubMedGoogle Scholar
  42. Nelson, E. C., Heath, A. C., Madden, P. A. F., Cooper, M. L., Dinwiddie, S. H., Bucholz, K. K., et al. (2002). Association between self-reported childhood sexual abuse and adverse psychosocial outcomes. Archives of General Psychiatry, 59, 139–145.CrossRefPubMedGoogle Scholar
  43. Ogletree, R. J., Dinger, M. K., & Vesely, S. (2001). Associations between number of lifetime partners and other health behaviors. American Journal of Health Behavior, 25, 537–544.PubMedGoogle Scholar
  44. Ramrakha, S., Caspi, A., Dickson, N., Moffitt, T. E., & Paul, C. (2000). Psychiatric disorders and risky sexual behaviour in young adulthood: Cross sectional study in birth cohort. British Medical Journal, 321, 263–266.CrossRefPubMedGoogle Scholar
  45. Research Triangle Institute. (2000). Software for the statistical analysis of correlated data (SUDAAN), Release 7.5. Research Triangle Park, NC: Author.Google Scholar
  46. Santelli, J. S., Brener, N. D., Lowry, R., Bhatt, A., & Zabin, L. S. (1998). Multiple sexual partners among U.S. adolescents and young adults. Family Planning Perspectives, 30, 271–275.CrossRefPubMedGoogle Scholar
  47. Santelli, J. S., Lindberg, L. D., Abma, J., McNeely, C. S., & Resnick, M. (2000). Adolescent sexual behavior: Estimates and trends from four nationally representative surveys. Family Planning Perspectives, 32, 156–165, 194.Google Scholar
  48. Schrimshaw, E. W., Rosario, M., Meyer-Bahlburg, H. F. L., & Scharf-Matlick, A. A. (2006). Test-retest reliability of self-reported sexual behavior, sexual orientation, and psychosexual milestones among gay, lesbian, and bisexual youths. Archives of Sexual Behavior, 35, 225–234.CrossRefPubMedGoogle Scholar
  49. Staton, M., Leukefeld, C., Logan, T. K., Zimmerman, R., Lynam, D., Milich, R., et al. (1999). Risky sex behavior and substance use among young adults. Health and Social Work, 24, 147–154.PubMedGoogle Scholar
  50. Sterk, C. E., Klein, H., & Elifson, K. W. (2004). Self-esteem and “at risk” women: Determinants and Relevance to sexual and HIV-related risk behaviors. Women and Health, 40, 75–92.Google Scholar
  51. Thatcher, W. G., Reininger, B. M., & Drane, J. W. (2002). Using path analysis to examine adolescent suicide attempts, life satisfaction, and health risk behavior. Journal of School Health, 72, 71–77.CrossRefPubMedGoogle Scholar
  52. Tubman, J. G., Andres, G. G., & Wagner, E. F. (2003). Patterns of sexual risk behaviors and psychiatric disorders in a community sample of young adults. Journal of Behavioral Medicine, 26, 473–499.CrossRefPubMedGoogle Scholar
  53. Waller, M. W., Hallfors, D. D., Halpern, C. T., Iritani, B. J., Ford, C. A., & Guo, G. (2006). Gender differences in associations between depressive symptoms and patterns of substance use and risky sexual behavior among a nationally representative sample of U.S. adolescents. Archives of Women’s Mental Health, 9, 139–150.CrossRefPubMedGoogle Scholar
  54. Wild, L. G., Flisher, A. J., & Loombard, C. (2004). Suicidal ideation and attempts in adolescents: Associations with depression and six domains of self-esteem. Journal of Adolescents, 27, 611–624.CrossRefGoogle Scholar
  55. Williams, C. T., & Latkin, C. A. (2005). The role of depressive symptoms in predicting sex with multiple and high-risk partners. Journal of Acquired Immune Deficiency Syndromes, 38, 69–73.CrossRefPubMedGoogle Scholar
  56. Wilson, H. W., & Widom, C. S. (2008). An examination of risky sexual behavior and HIV in victims of child abuse and neglect: A 30-year follow-up. Health Psychology, 27, 149–158.CrossRefPubMedGoogle Scholar
  57. Yang, X., Latkin, C., Celentano, D., & Luo, H. (2006). Prevalence and correlates of HIV risk behaviors among drug users in China. AIDS and Behavior, 10, 71–81.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Natalie P. Mota
    • 1
    • 3
  • Brian J. Cox
    • 1
    • 2
    • 3
  • Laurence Y. Katz
    • 3
  • Jitender Sareen
    • 1
    • 2
    • 3
  1. 1.Department of PsychologyUniversity of ManitobaWinnipegCanada
  2. 2.Department of Community Health SciencesUniversity of ManitobaWinnipegCanada
  3. 3.Department of PsychiatryUniversity of ManitobaWinnipegCanada

Personalised recommendations