Preventing Teen Pregnancy: Prepregnancy Psychosocial Mechanisms for at-risk Femal

描述(由申请人提供)：很少有条件比童年虐待对最佳心理社会发展的影响更大。高危性行为和青少年怀孕是女性发育障碍的最明显表现之一。儿童时期的不良经历，如虐待(如忽视、身体虐待或性虐待)，显然与极高的青少年怀孕率有关，因为据估计，受虐待青少年的青少年怀孕率约为全国平均水平的4倍。这项拟议的研究是一项前瞻性的纵向研究，对345名受到虐待的14至18岁未分娩的青春期女性和204名对照青春期女性进行研究，试图确定怀孕前的因素和随后怀孕的前置因素-风险定义为：高危性行为、青少年怀孕和青少年为人母。根据过去的研究，这项拟议的研究将采用一种全面的、多变量的评估策略，对先前被证明是随后怀孕风险的重要相关因素的假想怀孕前机制进行评估。拟议的研究将通过以下方式改进过去的研究：1)提供可靠的前瞻性证据，证明受到虐待的青少年具有异常高的怀孕风险；2)测试在发育早期测量的孕前机制是否在虐待对随后的怀孕风险的影响中起中介作用；3)为受到虐待的女性阐明导致怀孕风险的独特途径；以及4)更好地了解青春期发育中女性在随后的高危性行为、青少年怀孕和青少年为母的特别风险中的点。拟议的研究还将确定虐待特征对结果的不同影响，并探索可能有助于缓解虐待影响的保护性因素。最后，这项拟议的研究将对比不同种族群体的高危性行为、青少年怀孕和青少年母亲的路径，包括非裔美国人、白人和在很大程度上未得到充分研究和服务的阿巴拉契亚城市种族群体。结果将为青少年的治疗和干预策略提供新的方向，这些青少年特别容易从事高危性行为、怀孕或成为青少年父母。

DESCRIPTION (provided by applicant): Few conditions affect optimal psychosocial development to a greater degree than childhood abuse. High- risk sexual behaviors and teen pregnancy are among the most tangible manifestations of developmental disruption for females. Adverse childhood experiences such as maltreatment (e.g., neglect, physical abuse, or sexual abuse) are clearly associated with inordinately high rates of teen pregnancy, as the rate of teen pregnancy for maltreated adolescents has been estimated to be approximately 4 times higher than the national average. The proposed study is a prospective longitudinal study of 345 maltreated and 204 comparison nulliparous adolescent females aged 14 through 18 and seeks to identify pre-pregnancy factors and predispositional antecedents of subsequent pregnancy-risk defined as: high-risk sexual behaviors, teen pregnancy, and teen motherhood. Informed by past research, the proposed study will employ a comprehensive, multivariate assessment strategy of hypothesized pre-pregnancy mechanisms previously demonstrated to be important correlates of subsequent pregnancy-risk. The proposed study will improve on past research by 1) providing solid prospective evidence that maltreated adolescents have inordinately high pregnancy-risk, 2) testing whether pre-pregnancy mechanisms measured earlier in development mediate the effect of maltreatment on subsequent pregnancy-risk, 3) illuminating unique pathways to pregnancy-risk for maltreated females, and 4) providing a better understanding of the points in adolescent development when females are at particular risk for subsequent high-risk sexual behaviors, teen pregnancy, and teen motherhood. The proposed study will also identify the differential impact of abuse characteristics on outcome, and explore protective factors that may serve to moderate the effects of maltreatment. Finally, the proposed study will contrast pathways to high-risk sexuality, teen pregnancy, and teen motherhood across diverse ethnic groups including African Americans, Whites, and a largely understudied and underserved ethnic group of urban Appalachians. Results will inform new directions in treatment and intervention strategies for adolescents who are at particular risk for engaging in high-risk sexual behaviors, becoming pregnant, or becoming a teenage parent.