The Temporal Relationship Between Momentary Affective States and Condom Use in Depressed Adolescents
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Depressed adolescents are more likely to engage in sexual risk behaviors than their non-depressed peers. The objectives of this study were (1) to examine whether affective states predicted subsequent condom use, directly or indirectly through contextual factors and (2) to compare results obtained from structural equation models versus non-linear mixed effects models. This study used ecological momentary assessment to collect data on in-the-moment affective states and sexual behavior from 51 depressed adolescents (7 male, 44 female) aged 15–22 years. The association between positive and negative affect and condom use during a subsequent sex event was explored using several structural equation models and non-linear mixed effects models. Potential mediation by substance use before sex, partner type, reason for sex, and who wanted sex was examined. Neither positive nor negative affect was directly associated with condom use in any models; however, negative affect was associated with increased likelihood of sex with a non-main partner, which, in turn, was associated with increased condom use. Both structural equation models and non-linear mixed effects models successfully modeled the relationship between affect and condom use in momentary data while correctly accounting for the correlation of multiple observations from the same individual. The benefit of structural equation modeling was the ability to directly model the mediation of this effect by contextual factors. In this sample of depressed adolescents, negative and positive affect did not appear to be directly predictive of condom use during a subsequent sex event, although may indirectly affect condom use through sex with a non-main partner.
Keywords:Affective state Condom use Structural equation modeling Non-linear mixed effects model
This work was supported by funds from the Aerosmith Endowment Fund, Boston Children’s Hospital.
- Beck, A., Steer, R., & Brown, G. (1996). BDI-II Manual. San Antonio, TX: The Psychological Corporation.Google Scholar
- Bhushan, D., Blood, E. A., & Shrier, L. A. (2012). Momentary affective states predicting substance use events in depressed youth. Mental Health and Substance Use. doi: 10.1080/17523281.2012.708357.
- Blood, E. A., & Cheng, D. M. (2012). Non-linear mixed models in the analysis of mediated longitudinal data with binary outcomes. BMC Medical Research Methodology, 12. doi: 10.1186/1471-2288-12-5.
- Kahn, M. R., Kaufman, J. S., Pence, B. W., Gaynes, B. N., Adimora, A. A., Weir, S. S., & Miller, W. C. (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.Google Scholar
- Shrier, L. A., Feldman, H. A., Black, S. K., Walls, C., Kendall, A. D., Lops, C., & Beardslee, W. R. (2012). Momentary affective states surrounding sexual intercourse in depressed adolescents and young adults. Archives of Sexual Behavior, 41, 1161–1171.Google Scholar
- Shrier, L. A., Schillinger, J. A., Aneja, P., Rice, P. A., Batteiger, B. E., Braslins, P. G.,… Fortenberry, J. D. (2009). Depressive symptoms and sexual risk behavior in young, chlamydia-infected, heterosexual dyads. Journal of Adolescent Health, 45, 63–69.Google Scholar
- Stone, A., Shiffman, S., Atienza, A., & Nebeling, L. (2007). The science of real-time data capture: Self-reports in health research. New York: Oxford University Press.Google Scholar