Toward a Theory of Adolescent Sexual Decision-Making: A Mixed Methods Approach

1. Toward a Theory of Adolescent Sexual Decision-Making: A Mixed Methods Approach Peter T. Haugen University of Tennessee

2. Sexual Knowledge &Sexual Action • Study of adolescent sexuality attempts to reduce “high risk” behaviors. • Relationship between knowledge and behavior is inconsistent. • Sexual decision-making is a process which might mediate this relationship.

3. Models of Sexual Decision-Making • Models of sexual decision-making: • An act of choosing among a set of possible alternatives (Furby & Beyth-Marom, 1992). • Provide a common structure to describe how individuals make decisions. • Allow comparison. • Suggest ways in which decision-making might be improved.

4. Mixed Evidence for Models • Mixed support for programs which utilize cognitive models of decision-making • A particular model may neglect crucial factors. • A particular model may neglect relational context.

5. Justification • Health-risk model of adolescent sexuality necessarily limit and decontextualize sexuality • More attention should be focused towards the meaning-making of adolescents • Assumptions: • Sexual behavior is a normative process. • Sexual behavior occurs in a dyad and is not solely a property of the individual.

6. Purpose • The main aim of this paper is to first, identify the beliefs, mechanisms, and processes with which adolescent romantic couples construct and negotiate sexual beliefs and behaviors through the use of a hypothetical sexual dilemma, and second, examine how these constellations relate to sexual behaviors including intercourse and use of contraception.

7. Participants • 29 heterosexual dating couples. • 16-20 years of age (mean= 18.3). • Length of dating relationship between four weeks and five years. • 7 couples had not engaged in intercourse. • 22 couples had engaged in intercourse.

8. Hypothetical Sexual Dilemma Conversation Protocol A high school girl’s parents are away for the weekend and she’s alone in the house. Unexpectedly, on Friday evening, her boyfriend comes over. They spend the evening together in the house and after a while they start kissing and touching each other intimately. First, discuss whether you think this situation is right or wrong and whether there are any circumstances that would make it right or wrong? Second, what if the couple had sexual intercourse. Would that be right or wrong? Why? Third, discuss whether there are any circumstances that would make sex right or wrong. Fourth, suppose the girl is less willing than the boy to have sex. The girl thinks sex before marriage is OK for boys but not for girls. Discuss the reasons she might have for thinking this way and talk about whether or not you agree with her about this. Finally, imagine that the girl’s parents return and find that the couple had sex. What should the parents do? (adapted from Gilligan et al., 1971)

9. Consensual Qualitative Research (Hill, Thompson, Nut-Williams, 1997) • Researchers • Primary research team • Auditor • CQR (Hill et al., 1997) • Discovery-oriented, exploratory approach. • Ideal for complicated processes and sequences of behaviors. • Disagreement and consensus is important. • Start-list of 36 domains. • Final list of 17 domains. • Interrater reliability ~.80.

10. Qualitative Findings • 17 domains identified. • 3 thematic clusters. • Attitudes towards sexual behaviors. • Factors that influence attitudes towards sexual behaviors. • Parental responses towards sexual behaviors.

11. Attitudes Towards Sexuality • Intercourse is acceptable in general. • Kissing/Petting (but not Intercourse) are acceptable in general. • Intercourse only acceptable if married. • Intercourse is unacceptable in general. • Intercourse, kissing, and petting is a consequence of insufficient self-control. • Intercourse, kissing, and petting is unacceptable for religious/moral reasons.

12. Criteria that Influence Attitude Towards Sexuality • Self-understanding. • Equality of Sexes and Reputation. • “It’s okay for others.” • Evaluation of the nature of the relationship. • Age/Maturation. • Negative Marital Impact in Future. • Planning/Protection/Responsibility related to Sex/Education.

13. Parental Responses, Stances, or Behaviors Towards Sexuality • Parents should communicate/set rules before teens have sex. • Parents should communicate disapproval/give consequences or punishment after intercourse. • Parents should accept sex is inevitable. • Parents’ support is valued after intercourse.

14. Quantitative Results: Intercourse • 17 domains entered as predictors • Disriminant analyses of couple intercourse • Predicted classification of each couple with 96.6% accuracy (Adjusted R2 = .81).

15. Quantitative Results: Abstained • Couples who have abstained: • “intercourse is acceptable if married”, (F (1, 27) = 4.675, p = .040). • “intercourse will lead to a negative impact on future marriage”, (F (1, 27) = 14.233, p = .001). • “intercourse is unacceptable for religious or moral reasons”, (F (1, 27) = 3.166, p = .086).

16. Quantitative Results: Sexually Active • Couples who have engaged in intercourse • “Evaluation of the nature of the relationship”, (F (1, 27) = 5.331, p = .029). • “Planning, protection, and responsibility”, (F (1, 27) = 3.917, p = .058). • “Age/maturation”, (F (1, 27) = 3.093, p = .090).

17. Quantitative Results: Contraception • Disriminant analyses of consistent vs. inconsistent contraceptive use • Predicted classification of each couple with 100.00% accuracy (Adjusted R2 = .94). • Those couples who used contraception inconsistently, reported: • “Intercourse is unacceptable in general”, (F (1, 20) = 4.664, p = .043).

18. Limitations • Hypothetical dilemma and couples are heterosexual • The trade-off of alienating some at the cost of engaging others most fully • None of the partners report having had STD’s or AIDS. No females report pregnancy • However, 5 males and 14 females report visiting health care clinic for “issues related to sexual activity.”

19. Discussion • Couples’ conversations about sexuality tied to experiences with partners, peers, and parents • ‘Significant others’ often illustrated how not to be. • “Us” vs “them”.

20. Discussion • Hypotheses for polarization: • Couple: • Ensure integrity of relationship through differentiation from others. • Content: • Romantic sexuality is potentially divisive • Relationships as mechanisms for understanding themselves and others

21. Discussion: Abstainers • Intercourse has an inherent meaning: • Premarital sex is morally wrong. • Wrong for religious reasons. • Wrong because it will negatively impact marriage in the future. • Couples often invoke friends who feel differently.

22. Discussion: Sexually Active • Reluctant to assign inherent meaning to intercourse • Age and maturity of an individual • Nature of the relationship • Degree of responsibility shown by an individual and a couple • Couples may selectively interpret and attend to people in their lives in order to emphasize the ‘specialness’ or uniqueness of their romantic relationship.

23. Discussion • Potential for a single message regarding sexuality to be heard by adolescents of different sexual status is compromised. • Sex education programs must take the context of adolescent romantic relationships seriously.