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

描述（由申请人提供）：很少有比童年虐待更能影响最佳心理社会发展的情况了。高风险的性行为和少女怀孕是女性发育中断的最明显表现。不良的童年经历，如虐待（例如，忽视、身体虐待或性虐待）显然与青少年怀孕率异常高有关，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。该研究是一项前瞻性纵向研究，对345名受虐待和204名14至18岁未生育的少女进行比较，旨在确定怀孕前因素和随后怀孕风险的易感性因素，定义为：高风险的性行为、少女怀孕和少女母亲。根据过去的研究，本研究将采用一种全面的、多变量的评估策略，对先前被证明与后续妊娠风险相关的假设的孕前机制进行评估。该研究将在过去的研究基础上进行改进：1)提供坚实的前瞻性证据，证明受虐待的青少年具有极高的怀孕风险；2)检验在发育早期测量的孕前机制是否介导了虐待对随后怀孕风险的影响；3)阐明受虐待女性怀孕风险的独特途径。4)更好地了解女性在青春期发育过程中发生高风险性行为、少女怀孕和少女为人母的风险。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和虐待影响的保护因素。最后，拟议的研究将对比不同种族群体的高危性行为、少女怀孕和少女母亲的途径，包括非洲裔美国人、白人，以及阿巴拉契亚城市中大部分未被充分研究和服务不足的种族群体。研究结果将为那些有高危性行为、怀孕或未成年父母风险的青少年提供治疗和干预策略的新方向。

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.