Archives of Sexual Behavior

, Volume 41, Issue 5, pp 1161–1171 | Cite as

Momentary Affective States Surrounding Sexual Intercourse in Depressed Adolescents and Young Adults

  • Lydia A. ShrierEmail author
  • Henry A. Feldman
  • Shimrit K. Black
  • Courtney Walls
  • Ashley D. Kendall
  • Christopher Lops
  • William R. Beardslee
Original Paper


Depressed young people may have sexual intercourse (sex) to regulate their disordered affective states. This study sought to determine how momentary positive and negative affect relate to subsequent sex events in depressed adolescents and young adults. Fifty-four outpatients (87% female) 15–22 years who reported clinically significant depressive symptoms and having sex at least once a week completed a baseline survey, then reported momentary affective states and the occurrence of sex events on a handheld computer in response to 4–6 random signals per day for 2 weeks. Participants identified 387 unique sex events (median, 3.5/participant/week) on 3,159 reports (median, signal response rate 80%). Most (86–96%) reported low burden of participation on questions asked at study completion. Similar to what has been reported in non-depressed young people, momentary positive and negative affect were both improved beginning approximately 6 h before until approximately 6 h after a sex event. Positive affect was lower in the 24 h before this pericoital period, compared to other times. Negative affect did not significantly differ between before the pericoital period and other times. The findings suggest that depressed youth may have sex to regulate their positive affect and have implications for provision of their mental and physical health care.


Adolescents Young adults Sex behavior Affect Momentary sampling Depression 



This research was supported in part by National Institute of Mental Health grant R21072533 and Maternal Child Health Bureau grant T71MC00009. The authors gratefully acknowledge the assistance of Carl de Moor in study design and of Parul Aneja in data management. The authors also wish to thank the clinicians for aiding in recruitment and the participants for sharing their experiences in the service of this research.


  1. Achenbach, T. M. (1997). Manual for the young adult self-report and young adult behavior checklist. Burlington, VT: University of Vermont, Department of Psychiatry.Google Scholar
  2. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.Google Scholar
  3. Axelson, D. A., Bertocci, M. A., Lewin, D. S., Trubnick, L. S., Birmaher, B., Williamson, D. E., et al. (2003). Measuring mood and complex behavior in natural environments: Use of ecological momentary assessment in pediatric affective disorders. Journal of Child and Adolescent Psychopharmacology, 13, 253–266.PubMedCrossRefGoogle Scholar
  4. Bancroft, J., Janssen, E., Strong, D., Carnes, L., Vukadinovic, Z., & Long, J. (2003). The relation between mood and sexuality in heterosexual men. Archives of Sexual Behavior, 32, 217–230.PubMedCrossRefGoogle Scholar
  5. Beck, A., Steer, R., & Brown, G. (1996). BDI-II manual. San Antonio, TX: The Psychological Corporation, Harcourt Brace & Company.Google Scholar
  6. Clark, M. S., & Isen, A. M. (1982). Toward understanding the relationship between feeling states and social behavior. In A. Hastorf & A. M. Isen (Eds.), Cognitive social psychology (pp. 73–108). New York: Elsevier.Google Scholar
  7. Clark, L. A., & Watson, D. (1991). Tripartite model of anxiety and depression: Psychometric evidence and taxonomic implications. Journal of Abnormal Psychology, 100, 316–336.PubMedCrossRefGoogle Scholar
  8. Cooper, M. L., Agocha, V. B., & Sheldon, M. S. (2000). A motivational perspective on risky behaviors: The role of personality and affect regulatory processes. Journal of Personality, 68, 1059–1088.PubMedCrossRefGoogle Scholar
  9. Cooper, M., Shapiro, C., & Powers, A. (1998). Motivations for sex and risky sexual behavior among adolescents and young adults: A functional perspective. Journal of Personality and Social Psychology, 75, 1528–1558.PubMedCrossRefGoogle Scholar
  10. Craske, M. G. (2009). Cognitive-behavioral therapy. Washington, DC: American Psychological Association.Google Scholar
  11. Crepaz, N., & Marks, G. (2001). Are negative affective states associated with HIV sexual risk behaviors? A meta-analytic review [Comment]. Health Psychology, 20, 291–299.PubMedCrossRefGoogle Scholar
  12. Csikszentmihalyi, M., & Larson, R. (1987). Validity and reliability of the experience-sampling method. Journal of Nervous and Mental Disease, 175, 526–536.PubMedCrossRefGoogle Scholar
  13. Dawson, L. H., Shih, M.-C., de Moor, C., & Shrier, L. A. (2008). Reasons why adolescents and young adults have sex: Associations with psychological characteristics and sexual behavior. Journal of Sex Research, 45, 225–232.PubMedCrossRefGoogle Scholar
  14. Department of Health and Human Services. (2009). Code of Federal Regulations. Title 45 Public Welfare, Part 46 Protection of Human Subjects. Retrieved from
  15. Durrleman, S., & Simon, R. (1989). Flexible regression models with cubic splines. Statistics in Medicine, 8, 551–561.PubMedCrossRefGoogle Scholar
  16. Eysenck, S. B., Easting, G., & Pearson, P. (1984). Age norms for impulsiveness, venturesomeness and empathy in children. Personality and Individual Differences, 5, 315–321.CrossRefGoogle Scholar
  17. Eysenck, S. B., & Eysenck, H. J. (1977). The place of impulsiveness in a dimensional system of personality description. British Journal of Social and Clinical Psychology, 16, 57–68.PubMedCrossRefGoogle Scholar
  18. Eysenck, S. B., Pearson, P. R., Easting, G., & Allsopp, J. (1985). Age norms for impulsiveness, venturesomeness and empathy in adults. Personality and Individual Differences, 6, 613–619.CrossRefGoogle Scholar
  19. Fortenberry, J., Cecil, H., Zimet, G., & Orr, D. (1997). Concordance between self-report questionnaires and coital diaries for sexual behaviors of adolescent women with sexually transmitted infections. In J. Bancroft (Ed.), Researching sexual behavior: Methodological issues (pp. 237–257). Bloomington: Indiana University Press.Google Scholar
  20. Fortenberry, J. D., Temkit, M., Tu, W., Graham, C. A., Katz, B. P., & Orr, D. P. (2005). Daily mood, partner support, sexual interest, and sexual activity among adolescent women. Health Psychology, 24, 252–257.PubMedCrossRefGoogle Scholar
  21. Fredrickson, B. L. (2001). The role of positive emotions in positive psychology: The broaden-and-build theory of positive emotions. American Psychologist, 56, 218–226.PubMedCrossRefGoogle Scholar
  22. Fredrickson, B. L., & Losada, M. F. (2005). Positive affect and the complex dynamics of human flourishing. American Psychologist, 60, 678–686.PubMedCrossRefGoogle Scholar
  23. Freeman, M., Csikszentmihalyi, M., & Larson, R. (1986). Adolescence and its recollection: Toward an interpretive model of development. Merrill-Palmer Quarterly, 32, 167–185.Google Scholar
  24. Furman, W., & Wehner, E. A. (1994). Romantic views: Toward a theory of adolescent romantic relationships. In R. Montemayor, G. R. Adams, & T. P. Gullotta (Eds.), Personal relationships during adolescence (pp. 168–195). Thousand Oaks, CA: Sage Publications.Google Scholar
  25. Greenland, S. (1995). Avoiding power loss associated with categorization and ordinal scores in dose-response and trend analysis. Epidemiology, 6, 450–454.PubMedCrossRefGoogle Scholar
  26. Hektner, J. M., Schmidt, J. A., & Csikszentmihalyi, M. (2007). Experience sampling method: Measuring the quality of everyday life. Thousand Oaks, CA: Sage.Google Scholar
  27. Hufford, M. R., Shields, A. L., Shiffman, S., Paty, J., & Balabanis, M. (2002). Reactivity to ecological momentary assessment: An example using undergraduate problem drinkers. Psychology of Addictive Behaviors, 16, 205–211.PubMedCrossRefGoogle Scholar
  28. Josephson, B. R., Singer, J. A., & Salovey, P. (1996). Mood regulation and memory: Repairing sad moods with happy memories. Cognition & Emotion, 10, 437–444.CrossRefGoogle Scholar
  29. Kahn, J. A., Kaplowitz, R. A., Goodman, E., & Emans, S. J. (2002). The association between impulsiveness and sexual risk behaviors in adolescent and young adult women. Journal of Adolescent Health, 30, 229–232.PubMedCrossRefGoogle Scholar
  30. Kalichman, S. C., & Weinhardt, L. (2001). Negative affect and sexual risk behavior: Comment on Crepaz and Marks (2001). Health Psychology, 20, 300–301.PubMedCrossRefGoogle Scholar
  31. Kelly, J. A., & Kalichman, S. C. (1995). Increased attention to human sexuality can improve HIV-AIDS prevention efforts: Key research issues and directions. Journal of Consulting and Clinical Psychology, 63, 907–918.PubMedCrossRefGoogle Scholar
  32. Khan, M. R., Kaufman, J. S., Pence, B. W., Gaynes, B. N., Adimora, A. A., Weir, S. S., et al. (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.PubMedCrossRefGoogle Scholar
  33. Kirby, D. (2003). Risk and protective factors affecting teen pregnancy and the effectiveness of programs designed to address them. In D. Romer (Ed.), Reducing adolescent risk: Toward an integrated approach (pp. 265–283). Thousand Oaks, CA: Sage Publications, Inc.CrossRefGoogle Scholar
  34. Larson, R. W., Clore, G. L., & Wood, G. A. (1999). The emotions of romantic relationships: Do they wreak havoc on adolescents? In W. Furman, B. B. Brown, & C. Feiring (Eds.), The development of romantic relationships in adolescence (pp. 19–49). Cambridge, UK: Cambridge University Press.Google Scholar
  35. Larson, R., & Csikszentmihalyi, M. (1983). The experience sampling method. In H. Reis (Ed.), Naturalistic approaches to studying social interactions (Vol. 15, pp. 41–56). San Francisco: Jossey-Bass.Google Scholar
  36. 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.PubMedCrossRefGoogle Scholar
  37. Lewinsohn, P. M., Solomon, A., Seeley, J. R., & Zeiss, A. (2000). Clinical implications of “subthreshold” depressive symptoms. Journal of Abnormal Psychology, 109, 345–351.PubMedCrossRefGoogle Scholar
  38. Longmore, M. A., Manning, W. D., Giordano, P. C., & Rudolph, J. L. (2004). Self-esteem, depressive symptoms, and adolescents’ sexual onset. Social Psychology Quarterly, 67, 279–295.CrossRefGoogle Scholar
  39. Mayer, J. (2001). Emotion, intelligence, and emotional intelligence. In J. P. Forgas (Ed.), Handbook of affect and social cognition (pp. 410–431). Mahwah, NJ: Lawrence Erlbaum Associates.Google Scholar
  40. Murray, G. (2007). Diurnal mood variation in depression: A signal of disturbed circadian function? Journal of Affective Disorders, 102, 47–53.PubMedCrossRefGoogle Scholar
  41. Nolen-Hoeksema, S., & Morrow, J. (1991). A prospective study of depression and posttraumatic stress symptoms after a natural disaster: The 1989 Loma Prieta earthquake. Journal of Personality and Social Psychology, 61, 115–121.PubMedCrossRefGoogle Scholar
  42. Nolen-Hoeksema, S., Morrow, J., & Fredrickson, B. L. (1993). Response styles and the duration of episodes of depressed mood. Journal of Abnormal Psychology, 102, 20–28.PubMedCrossRefGoogle Scholar
  43. Riediger, M., Schmiedek, F., Wagner, G. G., & Lindenberger, U. (2009). Seeking pleasure and seeking pain: Differences in prohedonic and contra-hedonic motivation from adolescence to old age. Psychological Science, 20, 1529–1535.PubMedCrossRefGoogle Scholar
  44. Rosenberg, M. (1965). Society and the adolescent self-image. Princeton, NJ: Princeton University Press.Google Scholar
  45. Rostosky, S. S., Regnerus, M. D., & Wright, M. L. (2003). Coital debut: The role of religiosity and sex attitudes in the Add Health Survey. Journal of Sex Research, 40, 358–367.PubMedCrossRefGoogle Scholar
  46. Sewell, K. W. (2005). The experience cycle and the sexual response cycle: Conceptualization and application to sexual dysfunctions. Journal of Constructivist Psychology, 18, 3–13.CrossRefGoogle Scholar
  47. Shiffman, S. (2000). Real-time self-report of momentary states in the natural environment: Computerized ecological momentary assessment. Mahwah, NJ: Lawrence Erlbaum.Google Scholar
  48. Shrier, L. A., Aneja, P., Rice, P. A., Batteiger, B., Braslins, P. B., Orr, D. P., et al. (2009). Depression and STI risk within young, Chlamydia-infected, heterosexual dyads. Journal of Adolescent Health, 45, 63–69.PubMedCrossRefGoogle Scholar
  49. Shrier, L., Harris, S., & Beardslee, W. (2002). Temporal associations between depressive symptoms and self-reported sexually transmitted disease among adolescents. Archives of Pediatrics and Adolescent Medicine, 156, 599–606.PubMedGoogle Scholar
  50. 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.PubMedCrossRefGoogle Scholar
  51. Shrier, L. A., Shih, M.-C., & Beardslee, W. R. (2005). Affect and sexual behavior in adolescents: A review of the literature and comparison of momentary sampling with diary and retrospective self-report methods of measurement. Pediatrics, 115, e573–e581.PubMedCrossRefGoogle Scholar
  52. Shrier, L. A., Shih, M.-C., Hacker, L., & de Moor, C. (2007). A momentary sampling study of the affective experience following coital events in adolescents. Journal of Adolescent Health, 40, 357.e1–357.e8.CrossRefGoogle Scholar
  53. Shrier, L. A., Walls, C., Lops, C., & Feldman, H. A. (2011). Correlates of incorrect condom use among depressed young women: An event-level analysis. Journal of Pediatric and Adolescent Gynecology, 24, 10–14.PubMedCrossRefGoogle Scholar
  54. Spriggs, A. L., & Halpern, C. T. (2008). Sexual debut timing and depressive symptoms in emerging adulthood. Journal of Youth and Adolescence, 37, 1085–1096.PubMedCrossRefGoogle Scholar
  55. van Goozen, S. H., Wiegant, V. M., Endert, E., Helmond, F. A., & van de Poll, N. E. (1997). Psychoendocrinological assessment of the menstrual cycle: The relationship between hormones, sexuality, and mood. Archives of Sexual Behavior, 26, 359–382.PubMedCrossRefGoogle Scholar
  56. Watson, D., Clark, L. A., & 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.PubMedCrossRefGoogle Scholar
  57. Watson, D., & Tellegen, A. (1985). Toward a consensual structure of mood. Psychological Bulletin, 98, 219–235.PubMedCrossRefGoogle Scholar
  58. Weinstein, E., & Rosen, E. (1991). The development of adolescent sexual intimacy: Implications for counseling. Adolescence, 26, 331–339.PubMedGoogle Scholar
  59. Wichers, M. C., Myin-Germeys, I., Jacobs, N., Peeters, F., Kenis, G., Derom, C., et al. (2007). Evidence that moment-to-moment variation in positive emotions buffer genetic risk for depression: A momentary assessment twin study. Acta Psychiatrica Scandinavica, 115, 451–457.PubMedCrossRefGoogle Scholar
  60. Wrosch, C., & Miller, G. E. (2009). Depressive symptoms can be useful: Self-regulatory and emotional benefits of dysphoric mood in adolescence. Journal of Personality and Social Psychology, 96, 1181–1190.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Lydia A. Shrier
    • 1
    Email author
  • Henry A. Feldman
    • 2
  • Shimrit K. Black
    • 3
  • Courtney Walls
    • 2
  • Ashley D. Kendall
    • 1
  • Christopher Lops
    • 1
  • William R. Beardslee
    • 4
  1. 1.Division of Adolescent/Young Adult MedicineChildren’s Hospital BostonBostonUSA
  2. 2.Clinical Research ProgramChildren’s Hospital BostonBostonUSA
  3. 3.Department of PsychologyTemple UniversityPhiladelphiaUSA
  4. 4.Department of PsychiatryChildren’s Hospital BostonBostonUSA

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