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1.  An experimental study on the effects of peer drinking norms on adolescents’ drinker prototypes 
Addictive behaviors  2013;39(1):85-93.
Adolescents form impressions about the type of peers who drink (i.e., drinker prototypes). The evaluation of, and perceived similarity to these prototypes are related to adolescents’ drinking. Peer drinking norms play an important role in the formation of prototypes. We experimentally examined whether manipulation of peer norms changed the evaluation of and perceived similarity to drinker prototypes and whether these changes were moderated by peers’ popularity.
In a pre-test, we assessed heavy drinker, moderate drinker and abstainer prototypes, drinking behaviors and peer-perceived popularity among 599 adolescents. Additionally, 88 boys from this sample participated in a simulated chat room, in which they interacted with peers from school. These peers were in fact pre-programmed e-confederates, who were either popular or unpopular and who communicated either pro-alcohol or anti-alcohol norms. After the chat room interaction we assessed participants’ drinker prototypes.
Participants exposed to anti-alcohol norms were more negative about, and perceived themselves as less similar to heavy drinker prototypes, than participants exposed to pro-alcohol norms. We found no effects of peer norms on moderate drinker and abstainer prototypes. Effects were not moderated by peers’ popularity. We did find a main effect of popularity on perceived similarity to all prototypes. This indicated that participants rated themselves as more similar to heavy and moderate drinker prototypes and less similar to abstainer prototypes when they interacted with unpopular peers than with popular peers.
Exposure to anti-alcohol norms of peers leads adolescents to form more negative prototypes of the heavy drinker. This could be an important finding for prevention and intervention programs aimed to reduce alcohol consumption among adolescents.
PMCID: PMC4624402  PMID: 24104050
Drinker prototypes; Peer norms; Peer popularity; Adolescents; Peer influence
2.  Adolescent Susceptibility to Peer Influence in Sexual Situations 
One consistent predictor of adolescents’ engagement in sexual risk behavior is their belief that peers are engaging in similar behavior; however, not all youth are equally susceptible to these peer influence effects. Understanding individual differences in susceptibility to peer influence is critical to identifying adolescents at risk for negative health outcomes. The purpose of this project was to identify predictors of susceptibility to peer influence using a novel performance-based measure of sexual risk-taking.
Participants were 300 early adolescents (Mage=12.6; 53% female; 44% Caucasian) who completed 1) a pretest assessment of demographics, sexual attitudes, and hypothetical scenarios measuring the likelihood of engaging in sexual risk behavior, and 2) a subsequent experimental procedure that simulated an internet chat room in which youth believed they were communicating with peers regarding these same hypothetical scenarios. In reality, these “peers” were computer-programmed e-confederates. Changes in responses to the sexual scenarios in the private pretest versus during the public chat room provided a performance-based measure of peer influence susceptibility.
In total, 78% of youth provided more risky responses in the chat room than in pretest. The most robust predictor of this change was gender, with boys significantly more susceptible to peer influence than girls. Significant interactions also were noted, with greater susceptibility among boys with later pubertal development and African American boys.
Results confirm that not all youth are equally susceptible to peer influence. Consistent with sexual script theory, boys evidence greater susceptibility to social pressure regarding sexual behavior than girls.
PMCID: PMC4766019  PMID: 26794431
Sexual Risk-Taking; Sexual Behavior; Peer Influence; Social Norms; Susceptibility; Adolescence
3.  Safe Sext: Adolescents’ Use of Technology to Communicate about Sexual Health with Dating Partners 
This study examined adolescents’ technology-based sexual communication with dating partners, and evaluated associations between technology-based communication and condom use.
Participants were 176 high school students who indicated their use of technology to communicate with partners about condoms, birth control, STIs, HIV/AIDS, pregnancy, and sexual limits. Sexually active youth also reported their frequency of condom use.
Many adolescents (49%) used technology to discuss sexual health with partners, with rates varying by topic. Girls were more likely than boys to discuss HIV, pregnancy, and sexual limits. Ethnic minorities were more likely than Whites to discuss condoms, STIs, HIV, pregnancy, and birth control. Importantly, rates of consistent condom use were three-times higher among youth using technology to discuss condoms and birth control.
Results provide novel preliminary evidence about adolescents’ use of technology to discuss sexual health, and demonstrate links between technology-based communication and condom use among sexually active youth.
PMCID: PMC3999298  PMID: 24512716
adolescent sexual communication; condom use; technology; ehealth
4.  Low Implicit and Explicit Aversion Toward Self-Cutting Stimuli Longitudinally Predict Nonsuicidal Self-Injury 
Journal of abnormal psychology  2014;123(2):463-469.
There is a pressing need to improve the ability to identify individuals at risk for nonsuicidal self-injury (NSSI; e.g., cutting or burning oneself); unfortunately, beyond prior NSSI, there are few powerful longitudinal predictors of NSSI. The present study addressed this limitation by investigating the ability of a novel factor—low aversion to self-cutting stimuli—to longitudinally predict NSSI in 49 individuals with a history of self-cutting. Results revealed that both low implicit and explicit aversion to self-cutting stimuli were significantly associated with future NSSI (rs = .32–.51), and that these associations were unique from several other theoretically important predictors, including prior NSSI, number of NSSI methods, implicit identification with self-cutting, self-prediction of future NSSI, emotion dysregulation, and therapy status. These findings are consistent with the notion that instinctive barriers (e.g., aversion to NSSI stimuli, pain) dissuade most people from engaging in NSSI, and that the erosion of these barriers may facilitate NSSI.
PMCID: PMC4163747  PMID: 24886018
nonsuicidal self-injury; affect; longitudinal; implicit processes; emotion
5.  The Functions of Nonsuicidal Self-Injury: Support for Cognitive–Affective Regulation and Opponent Processes From a Novel Psychophysiological Paradigm 
Journal of abnormal psychology  2010;119(4):850-862.
Although research on the reasons for engaging in nonsuicidal self-injury (NSSI) has increased dramatically in the last few years, there are still many aspects of this pernicious behavior that are not well understood. The purpose of this study was to address these gaps in the literature, with a particular focus on investigating whether NSSI (a) regulates affective valence in addition to affective arousal and (b) serves a cognitive regulation function in addition to an affect regulation function. To elucidate these issues, the present study utilized a sample of 112 participants (33 controls, 39 no pain controls, 16 NSSI individuals, and 24 controls matching the affect dysregulation levels of the NSSI group), employed psychophysiological measures of affective valence (startle-alone reactivity) and quality of information processing (prepulse inhibition), and used experimental methods involving an NSSI-proxy to model the NSSI process. Results largely were consistent with predictions, supporting the hypotheses that NSSI serves to regulate cognitive processing and affective valence. On this latter point, however, the control groups also showed a decrease in negative affective valence after the NSSI-proxy. This unexpected finding is consistent with the hypothesis that opponent processes may contribute to the development of self-injurious behaviors (Joiner, 2005). Overall, the present study represents an important extension of previous laboratory NSSI studies and provides a fertile foundation for future studies aimed at understanding why people engage in NSSI.
PMCID: PMC4163759  PMID: 20939652
nonsuicidal self-injury; NSSI; prepulse inhibition; PPI; affect dysregulation
6.  Relational victimization, friendship, and adolescents’ hypothalamic–pituitary–adrenal axis responses to an in vivo social stressor 
Development and psychopathology  2014;26(3):605-618.
Adolescents’ peer experiences may have significant associations with biological stress-response systems, adding to or reducing allostatic load. This study examined relational victimization as a unique contributor to reactive hypothalamic–pituitary–adrenal (HPA) axis responses as well as friendship quality and behavior as factors that may promote HPA recovery following a stressor. A total of 62 adolescents (ages 12–16; 73% female) presenting with a wide range of life stressors and adjustment difficulties completed survey measures of peer victimization and friendship quality. Cortisol samples were collected before and after a lab-based interpersonally themed social stressor task to provide measures of HPA baseline, reactivity, and recovery. Following the stressor task, adolescents discussed their performance with a close friend; observational coding yielded measures of friends’ responsiveness. Adolescents also reported positive and negative friendship qualities. Results suggested that higher levels of adolescents’ relational victimization were associated with blunted cortisol reactivity, even after controlling for physical forms of victimization and other known predictors of HPA functioning (i.e., life stress or depressive symptoms). Friendship qualities (i.e., low negative qualities) and specific friendship behaviors (i.e., high levels of responsiveness) contributed to greater HPA regulation; however, consistent with theories of rumination, high friend responsiveness in the context of high levels of positive friendship quality contributed to less cortisol recovery. Findings extend prior work on the importance of relational victimization and dyadic peer relations as unique and salient correlates of adaptation in adolescence.
PMCID: PMC4160346  PMID: 25047287
7.  Longitudinal Trajectories and Predictors of Adolescent Suicidal Ideation and Attempts Following Inpatient Hospitalization 
Remarkably little is known regarding the temporal course of adolescent suicidal ideation and behavior, the prediction of suicidal attempts from changes in suicidal ideation, or the prediction of suicidal attempts after accounting for suicidal ideation as a predictor. A sample of 143 adolescents 12–15 years old was assessed during psychiatric inpatient hospitalization and again at 3, 6, 9, 15, and 18 months postdischarge through a series of structured interviews and parent- and adolescent-reported instruments. Symptoms of depression, posttraumatic stress disorder, externalizing psychopathology, hopelessness, and engagement in several forms of self-injurious/suicidal behaviors (i.e., suicide threats/gestures, plans, nonsuicidal self-injury [NSSI]) were assessed. Latent growth curve analyses revealed a period of suicidal ideation remission between baseline and 6 months following discharge, as well as a subtle period of suicidal ideation reemergence between 9 and 18 months postdischarge. Changes in suicidal ideation predicted suicide attempts. After accounting for the effects of suicidal ideation, baseline suicide threats/gestures also predicted future suicide attempts. Higher adolescent-reported depressive symptoms, lower parent-reported externalizing symptoms, and higher frequencies of NSSI predicted weaker suicidal ideation remission slopes. Findings underscore the need for more longitudinal research on the course of adolescent suicidality.
PMCID: PMC3703821  PMID: 18229987
suicidal ideation; suicidal attempts; nonsuicidal self injury; adolescence; longitudinal methods
8.  High Peer Popularity Longitudinally Predicts Adolescent Health Risk Behavior, or Does It?: An Examination of Linear and Quadratic Associations 
Journal of Pediatric Psychology  2011;36(9):980-990.
Objective In contrast to prior work, recent theory suggests that high, not low, levels of adolescent peer popularity may be associated with health risk behavior. This study examined (a) whether popularity may be uniquely associated with cigarette use, marijuana use, and sexual risk behavior, beyond the predictive effects of aggression; (b) whether the longitudinal association between popularity and health risk behavior may be curvilinear; and (c) gender moderation. Methods A total of 336 adolescents, initially in 10–11th grades, reported cigarette use, marijuana use, and number of sexual intercourse partners at two time points 18 months apart. Sociometric peer nominations were used to examine popularity and aggression. Results Longitudinal quadratic effects and gender moderation suggest that both high and low levels of popularity predict some, but not all, health risk behaviors. Conclusions New theoretical models can be useful for understanding the complex manner in which health risk behaviors may be reinforced within the peer context.
PMCID: PMC3621421  PMID: 21852342
adolescents; health-risk behavior; peer relations; sexual behavior; substance use
9.  Susceptibility to Peer Influence: Using a Performance-Based Measure to Identify Adolescent Males at Heightened Risk for Deviant Peer Socialization 
Developmental Psychology  2011;47(4):1167-1172.
A substantial amount of research has suggested that adolescents’ attitudes and behaviors are influenced by peers; however, little is known regarding adolescents’ individual variability, or susceptibility, to peer influence. In this study, a performance-based index from an experimental paradigm was used to directly measure adolescents’ susceptibility to peers. A total of 36 adolescent boys participated in a “chat room” experiment in which they ostensibly were exposed to deviant or risky social norms communicated either by high-peer-status (i.e., popular, well-liked) or low-peer-status (i.e., unpopular, disliked) grade mates who actually were electronic confederates. Changes in adolescents’ responses before and after exposure to peer norms were used as a measure of peer influence susceptibility. These same adolescents completed a questionnaire assessment at the study outset and again 18 months later to assess their actual engagement in deviant behavior and their perceptions of their best friend’s engagement in deviant behavior. Only among adolescents with high levels of susceptibility to high-status peers was a significant longitudinal association revealed between their best friend’s baseline deviant behavior and adolescents’ own deviant behavior 18 months later. Findings support the predictive validity of a performance-based susceptibility measure and suggest that adolescents’ peer influence susceptibility may generalize across peer contexts.
PMCID: PMC3348704  PMID: 21463036
peer influence; deviant/delinquent behavior; susceptibility; adolescents
10.  Friendship Context Matters: Examining the Domain Specificity of Alcohol and Depression Socialization Among Adolescents 
Journal of Abnormal Child Psychology  2012;40(7):1027-1043.
Driven by existing socialization theories, this study describes specific friendship contexts in which peer influence of alcohol misuse and depressive symptoms occurs. In the fall and spring of the school year, surveys were administered to 704 Italian adolescents (53 % male, Mage = 15.53) enrolled in Grades 9, 10 and 11. Different friendship contexts were distinguished based on two dimensions referring to the level (i.e., best friendships and friendship networks) and reciprocity (i.e., unilateral and reciprocal) of the relationships. Social network and dyadic analyses were applied in a complementary manner to estimate peer socialization effects across the different friendship contexts. Results showed that within friendship networks both male and female adolescents’ alcohol misuse was affected by friends’ alcohol misuse, regardless of whether the relationship was reciprocated or not. Conversely, peer socialization of depressive symptoms only emerged within very best friendship dyads of female adolescents. Findings suggest that the effects of peer socialization depend on the friendship context and specific types of behaviors. The theoretical and methodological implications of the findings are discussed.
PMCID: PMC3431470  PMID: 22441645
Peer influence; Friendship; Networks; Dyads; Depressive symptoms; Alcohol misuse
11.  Direct and Indirect Peer Socialization of Adolescent Nonsuicidal Self-Injury 
This study examined direct and indirect forms of peer socialization of non-suicidal self-injury (NSSI) in adolescent friendship networks. Data were collected among 348 adolescents (55% females; Mage = 15.02 years; SD = 0.53) at 4 assessment waves. Stochastic actor-based models revealed no evidence for direct socialization of NSSI: adolescents whose friends reported higher NSSI did not increase their NSSI over time. However, indirect forms of socialization were found. After controlling for direct socialization and selection effects, friends’ depressive symptoms predicted changes in male and female adolescents’ NSSI and friends’ impulsivity predicted changes in male adolescents’ NSSI. Findings highlight the importance of extending peer influence research beyond the classical “modeling” paradigm by providing evidence that peers may indirectly socialize adolescents’ NSSI.
PMCID: PMC4583102  PMID: 26412955
stochastic actor-based models; indirect peer socialization; non-suicidal self-injury (NSSI); depressive symptoms; impulsivity
12.  Similarity in Depressive Symptoms in Adolescents’ Friendship Dyads: Selection or Socialization? 
Developmental Psychology  2011;47(6):1804-1814.
This study examined friendship selection and socialization as mechanisms explaining similarity in depressive symptoms in adolescent same-gender best friend dyads. The sample consisted of 1,752 adolescents (51% male) ages 12–16 years (M = 13.77, SD = 0.73) forming 487 friend dyads and 389 nonfriend dyads (the nonfriend dyads served as a comparison group). To test our hypothesis, we applied a multigroup actor–partner interdependence model to 3 friendship types that started and ended at different time points during the 2 waves of data collection. Results showed that adolescents reported levels of depressive symptoms at follow-up that were similar to those of their best friends. Socialization processes explained the increase in similarity exclusively in female dyads, whereas no evidence for friendship selection emerged for either male or female dyads. Additional analyses revealed that similarity between friends was particularly evident in the actual best friend dyads (i.e., true best friends), in which evidence for socialization processes emerged for both female and male friend dyads. Findings highlight the importance of examining friendship relations as a potential context for the development of depressive symptoms.
PMCID: PMC3349236  PMID: 21639621
homophily; depressive symptoms; selection; socialization; friendships
13.  Temporal Relationship between Substance Use and Delinquent Behavior among Young Psychiatrically Hospitalized Adolescents 
There is considerable evidence linking substance use and delinquent behavior among adolescents. However, the nature and temporal ordering of this relationship remains uncertain, particularly among early adolescents and those with significant psychopathology. This study examined the temporal ordering of substance use and delinquent behavior in a sample of psychiatrically hospitalized early adolescents. Youth (n = 108) between the ages of 12 and 15 years completed three assessments over 18 months following hospitalization. Separate cross-lagged panel models examined the reciprocal relationship between delinquent behavior and two types of substance use (e.g., alcohol and marijuana). Results provided evidence of cross-lagged effects for marijuana: delinquent behavior at 9 months predicted marijuana use at 18 months. No predictive effects were found between alcohol use and delinquent behavior over time. Findings demonstrate the stability of delinquent behavior and substance use among young adolescents with psychiatric concerns. Furthermore, results highlight the value of examining alcohol and marijuana use outcomes separately in order to better understand the complex pathways between substance use and delinquent behavior among early adolescents.
PMCID: PMC3368082  PMID: 22197300
adolescents; alcohol; marijuana; delinquent behavior; cross-lagged panel modeling
14.  Adolescent non-suicidal self-injury: A cross-national study of community samples from Italy, the Netherlands and the United States 
Psychiatry research  2012;197(0):66-72.
This study examined rates and correlates of non-suicidal self-injury (NSSI) across three non-clinical adolescent samples from different countries. Surveys were administered to 1862 adolescents (Mage=15.69, S.D.=0.87) from Italy (n=827), the Netherlands (n=675), and United States (n=360), including measures of NSSI, substance use, internal (i.e., depressive symptoms, loneliness), and interpersonal factors (i.e., peer victimization, peer preference). After controlling for socio-demographic differences, similar prevalence of NSSI was found across the three samples, with approximately 24% of the adolescents reporting at least one NSSI episode within the last year. Multivariate logistic regressions showed that adolescents' victimization and higher levels of depressive symptoms and family-related loneliness were associated concurrently with NSSI comparably in all three samples. However, multi-group analyses indicated that the association between NSSI and substance use varied significantly across samples, indicating that NSSI related more strongly to substance use (i.e., cigarette smoking and frequent marijuana use) in the sample from the United States rather than the samples from the Netherlands and Italy. Findings provide evidence of NSSI and suggest high similarities in rates and correlates across samples from different countries. Future research should further explore NSSI cross-nationally.
PMCID: PMC3666103  PMID: 22436348
Non-suicidal self-injury (NSSI); Adolescence; Cross-national; Correlates
15.  Adolescents’ Conformity to Their Peers’ Pro-Alcohol and Anti-Alcohol Norms: The Power of Popularity 
Research on adolescent development suggests that peer influence may play a key role in explaining adolescents’ willingness to drink, an important predictor of drinking initiation. However, experiments that thoroughly examine these peer influence effects are scarce. This study experimentally examined whether adolescents adapted their willingness to drink when confronted with the pro-alcohol and anti-alcohol norms of peers in a chat room session and whether these effects were moderated by the social status of peers.
We collected survey data on drinking behavior, social status, and willingness to drink among five hundred thirty-two 14- to 15-year-olds. Of this sample, 74 boys participated in a simulated Internet chat room session in which participants were confronted with preprogrammed pro-alcohol or anti-alcohol norms of “grade-mates” which were in fact preprogrammed e-confederates. Accordingly, we tested whether participants adapted their willingness to drink to the norms of these grade-mates. To test whether adaptations in participants’ willingness to drink would depend on grade-mates’ social status, we manipulated their level of popularity.
The results indicated that adolescents adapted their willingness to drink substantially to the pro-alcohol (i.e., more willing to drink) as well as anti-alcohol (i.e., less willing to drink) norms of these peers. Adolescents were more influenced by high-status than low-status peers. Interestingly, the anti-alcohol norms of the popular peers seemed most influential in that adolescents were less willing to drink when they were confronted with the anti-alcohol norms of popular peers. Additionally, the adolescents internalized these anti-alcohol norms.
This study gives more insight into peer influence processes that encourage or discourage alcohol use. These results could be fundamental for the development of prevention and intervention programs to reduce alcohol use among the adolescents.
PMCID: PMC3666104  PMID: 22509937
Peer Influence; Drinking Norms; Adolescents; Popularity
16.  Damaged Self-Esteem is Associated with Internalizing Problems 
Implicit and explicit self-esteem are assumed to be important factors in understanding the onset and maintenance of psychological problems. The current study aims to examine the association between implicit and explicit self-esteem and their interaction with depressive symptoms, suicidal ideation, and loneliness. Specifically, the relationship between the size and the direction of the discrepancy between implicit and explicit self-esteem with depressive symptoms, suicidal ideation, and loneliness were examined. Participants were 95 young female adults (M = 21.2 years, SD = 1.88) enrolled in higher education. We administered the IAT to assess implicit self-esteem, and the Rosenberg self-esteem scale to measure explicit self-esteem while psychological problems were assessed through self-reports. Results showed that discrepancies between implicit and explicit self-esteem were positively associated with depressive symptoms, suicidal ideation, and loneliness. In addition, the direction of the discrepancy was specifically relevant: damaged self-esteem (i.e., high implicit self-esteem and low explicit self-esteem) was consistently associated with increased levels of depressive symptoms, suicidal ideation, and loneliness. In contrast, defensive or fragile self-esteem (i.e., low implicit and high explicit self-esteem) was solely associated with loneliness. These findings provide further support that specifically damaged self-esteem is an important vulnerability marker for depressive symptoms, suicidal ideation, and loneliness.
PMCID: PMC3613594  PMID: 23565101
damaged; implicit cognition; self-esteem; suicidal ideation; depression; loneliness
17.  Psychological, Peer, and Family Influences on Smoking Among an Adolescent Psychiatric Sample 
While much is known about adolescent cigarette use and initiation in community samples, less is known about these factors among adolescents in clinic-referred populations or those with severe psychopathology. Data were collected from 106 adolescents aged 12 to 15 years (M = 13.6; SD = .74) recruited from a psychiatric inpatient facility. Hierarchical logistic regressions assessed the relationship between psychological, peer, and family environment factors and smoking at baseline and 18 months post-hospitalization. Conduct problem symptoms, friends’ cigarette use, and friends’ marijuana use were associated with greater odds of lifetime and current smoking at baseline, but not at follow-up. After accounting for the significant effect of baseline use, greater family conflict predicted decreased odds of having initiated smoking at the 18 month follow-up. The period following inpatient psychiatric hospitalization may represent an important window for smoking cessation and prevention efforts targeting peer and family factors, especially for youth with externalizing problems.
PMCID: PMC3253261  PMID: 21943811
adolescence; smoking; psychiatric comorbidity; peer influence; family environment
18.  Depression Socialization Within Friendship Groups at the Transition to Adolescence: The Roles of Gender and Group Centrality as Moderators of Peer Influence 
Journal of Abnormal Psychology  2011;120(4):857-867.
Tests of interpersonal theories of depression have established that elevated depression levels among peers portend increases in individuals’ own depressive symptoms, a phenomenon known as depression socialization. Susceptibility to this socialization effect may be enhanced during the transition to adolescence as the strength of peer influence rises dramatically. Socialization of depressive symptoms among members of child and adolescent friendship groups was examined over a 1-year period among 648 youth in grades six through eight. Sociometric methods were utilized to identify friendship groups and ascertain the prospective effect of group-level depressive symptoms on youths’ own depressive symptoms. Hierarchical linear modeling results revealed a significant socialization effect and indicated that this effect was most potent for (a) girls and (b) individuals on the periphery of friendship groups. Future studies would benefit from incorporating child and adolescent peer groups as a developmentally salient context for interpersonal models of depression.
PMCID: PMC3353414  PMID: 21842961
depression; socialization; friendship group; peer influence; adolescence
19.  The Interaction Between Pubertal Timing and Peer Popularity for Boys and Girls: An Integration of Biological and Interpersonal Perspectives on Adolescent Depression 
The transition to adolescence marks a time of sharply increased vulnerability to the development of depression, particularly among girls. Past research has examined isolated risk factors from individual theoretical models (e.g., biological, interpersonal, and cognitive) of depression, but few have examined integrative models. This study investigated the conjoint effects of early pubertal timing and popularity in the longitudinal prediction of depressive symptoms. A total of 319 girls and 294 boys (ages 11–14) provided information on their pubertal status, depressive symptoms, and the social status (i.e., popularity) of their peers. Adolescents completed a second measure of depressive symptoms 11 months after the initial time point. Findings supported an integrated biological-interpersonal model in explaining the development of depressive symptoms during adolescence. Early pubertal development was associated with increase in depressive symptoms only when accompanied by low levels of popularity. High levels of popularity buffered the association between early pubertal development and later depressive symptoms. Unexpectedly, these results were significant both for girls and boys. Results are discussed in terms of dynamic systems theories.
PMCID: PMC3066392  PMID: 21061055
Pubertal timing; Depressive symptoms; Peer status
20. Development of a web-based HIV/STD prevention program for adolescent girls emphasizing sexual communication skills 
This article describes the development of, an interactive web-based program designed to improve sexual communication skills and reduce the risk of HIV/STDs among adolescent girls, a population at heightened risk for negative sexual health outcomes (CDC, 2013). Although sexual communication is a critical predictor of safer sex among teens, there are few online interventions that target these skills as a central program component. We developed to fill this gap. Program development involved 1) identifying the target population (ethnically-diverse high school girls); 2) clarifying the theoretical foundation (Reasoned Action Model); 3) conducting formative qualitative research (n=25 girls); 4) drafting initial program content; 5) receiving ongoing feedback from a teen advisory board (n=5 girls); 6) programming online content; and 7) conducting usability testing (n=6 girls). These steps are described along with the final intervention product, which is currently being evaluated in a randomized controlled trial.
PMCID: PMC5257203  PMID: 27710087
eHealth; sexual health communication; HIV/STD intervention; condom use; sex education; safe sex
22.  Social Anxiety Symptoms and Suicidal Ideation in a Clinical Sample of Early Adolescents: Examining Loneliness and Social Support as Longitudinal Mediators 
Recent research has shown that social anxiety may be related to increased risk for suicidal ideation in teens, although this research largely has been cross-sectional and has not examined potential mediators of this relationship. A clinical sample of 144 early adolescents (72 % female; 12–15 years old) was assessed during psychiatric inpatient hospitalization and followed up at 9 and 18 months post-baseline. Symptoms of social anxiety, depression, suicidal ideation, loneliness, and perceived social support were assessed via structured interviews and self-report instruments. Structural equation modeling revealed a significant direct relationship between social anxiety symptoms at baseline and suicidal ideation at 18 months post-baseline, even after controlling for baseline depressive symptoms and ideation. A second multiple mediation model revealed that baseline social anxiety had a significant indirect effect on suicidal ideation at 18 months post-baseline through loneliness at 9 months post-baseline. Social anxiety did not have a significant indirect effect on suicidal ideation through perceived social support from either parents or close friends. Findings suggest that loneliness may be particularly implicated in the relationship between social anxiety and suicidality in teens. Clinicians should assess and address feelings of loneliness when treating socially anxious adolescents.
PMCID: PMC5496444  PMID: 24390470
Adolescents; Social anxiety; Suicidal ideation; Loneliness; Social support
23.  Revealing the form and function of self-injurious thoughts and behaviors: A real-time ecological assessment study among adolescents and young adults 
Journal of abnormal psychology  2009;118(4):816-827.
Self-injurious behaviors are among the leading causes of death worldwide. However, the basic nature of self-injurious thoughts and behaviors (SITBs) is not well-understood because prior studies have relied on long-term, retrospective, aggregate, self-report assessment methods. We used ecological momentary assessment methods to measure suicidal and non-suicidal SITBs as they naturally occur in real-time. Participants were 30 adolescents and young adults with a recent history of self-injury who completed signal- and event-contingent assessments on handheld computers over a 14-day period, resulting in the collection of data on 1262 thought and behavior episodes. Participants reported an average of 5.0 thoughts of nonsuicidal self-injury (NSSI) per week, most often of moderate intensity and short duration (1–30 minutes), and 1.6 episodes of NSSI per week. Suicidal thoughts occurred less frequently (1.1 per week), were of longer duration, and led to self-injurious behavior (i.e., suicide attempts) less often. Details are reported about the contexts in which SITBs most often occur (e.g., what participants were doing, who they were with, and what they were feeling before and after each episode). This study provides a first glimpse of how SITBs are experienced in everyday life and has significant implications for scientific and clinical work on self-injurious behaviors.
PMCID: PMC5258190  PMID: 19899851
24.  Early Adolescent Friendship Selection Based on Externalizing Behavior: the Moderating Role of Pubertal Development. The SNARE Study 
Journal of Abnormal Child Psychology  2016;44(8):1647-1657.
This study examined friendship (de-)selection processes in early adolescence. Pubertal development was examined as a potential moderator. It was expected that pubertal development would be associated with an increased tendency for adolescents to select their friends based on their similarities in externalizing behavior engagement (i.e., delinquency, alcohol use, and tobacco use). Data were used from the first three waves of the SNARE (Social Network Analysis of Risk behavior in Early adolescence) study (N = 1144; 50 % boys; M age = 12.7; SD = 0.47), including students who entered the first year of secondary school. The hypothesis was tested using Stochastic Actor-Based Modeling in SIENA. While taking the network structure into account, and controlling for peer influence effects, the results supported this hypothesis. Early adolescents with higher pubertal development were as likely as their peers to select friends based on similarity in externalizing behavior and especially likely to remain friends with peers who had a similar level of externalizing behavior, and thus break friendship ties with dissimilar friends in this respect. As early adolescents are actively engaged in reorganizing their social context, adolescents with a higher pubertal development are especially likely to lose friendships with peers who do not engage in externalizing behavior, thus losing an important source of adaptive social control (i.e., friends who do not engage in externalizing behavior).
Electronic supplementary material
The online version of this article (doi:10.1007/s10802-016-0134-z) contains supplementary material, which is available to authorized users.
PMCID: PMC5061845  PMID: 26897629
Alcohol use; Delinquency; Pubertal development; Social network analysis; SIENA; Tobacco use
25.  Adolescents Misperceive and Are Influenced By High Status Peers' Health Risk, Deviant, and Adaptive Behavior 
Developmental psychology  2014;50(12):2697-2714.
Most peer influence research examines socialization between adolescents and their best friends. Yet, adolescents also are influenced by popular peers, perhaps due to misperceptions of social norms. This research examined the extent to which out-group and in-group adolescents misperceive the frequencies of peers' deviant, health risk, and adaptive behaviors in different reputation-based peer crowds (Study 1) and the prospective associations between perceptions of high status peers' and adolescents' own substance use over 2.5 years (Study 2). Study 1 examined 235 adolescents' reported deviant (vandalism, theft), health risk (substance use, sexual risk), and adaptive (exercise, studying) behavior, and their perceptions of Jocks', Populars', Burnouts', and Brains' engagement in the same behaviors. Peer nominations identified adolescents in each peer crowd. Jocks and Populars were rated as higher status than Brains and Burnouts. Results indicated that peer crowd stereotypes are caricatures. Misperceptions of high status crowds were dramatic, but for many behaviors, no differences between Populars'/Jocks' and others' actual reported behaviors were revealed. Study 2 assessed 166 adolescents' substance use and their perceptions of popular peers' (i.e., peers high in peer perceived popularity) substance use. Parallel process latent growth analyses revealed that higher perceptions of popular peers' substance use in Grade 9 (intercept) significantly predicted steeper increases in adolescents' own substance use from Grade 9 to 11 (slope). Results from both studies, utilizing different methods, offer evidence to suggest that adolescents misperceive high status peers' risk behaviors, and these misperceptions may predict adolescents' own risk behavior engagement.
PMCID: PMC4480612  PMID: 25365121
health risk behavior; substance use; sexual behavior; delinquency; adolescence; peer relations; popularity; social norms; peer crowds

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