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

描述（由申请人提供）：很少有条件影响最佳的心理社会发展，以更大的程度比童年虐待。高危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）显然与极高的少女怀孕率有关，因为据估计，受虐待少女的少女怀孕率比全国平均水平高出约4倍。这项研究是一项前瞻性的纵向研究，345虐待和204比较未经生育的青少年女性，年龄在14至18岁，并试图确定怀孕前的因素和随后的怀孕风险定义为：高风险的性行为，青少年怀孕，和青少年母亲的倾向性的前因。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，对先前被证明与随后的妊娠风险相关的假设的孕前机制进行评估。这项拟议的研究将通过以下方式改进过去的研究：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妊娠风险，2）测试发育早期测量的妊娠前机制是否介导了虐待对随后妊娠风险的影响，3）阐明受虐待女性妊娠风险的独特途径，以及4）更好地了解青少年发展中的几个点，即女性特别容易发生随后的高风险性行为、少女怀孕和少女母亲。拟议的研究还将确定虐待特征对结果的不同影响，并探讨可能有助于减轻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风险性行为，青少年怀孕和青少年母亲的途径，包括非洲裔美国人，白人和一个在很大程度上研究不足和服务不足的城市阿巴拉契亚人种族群体。研究结果将为治疗和干预策略的新方向提供信息，这些策略适用于那些特别容易从事高风险性行为、怀孕或成为青少年父母的青少年。

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.