Many different definitions of the construct of motivational ambivalence have appeared in the literature on reproductive health. Using a theoretical framework in which motivational ambivalence is defined as an interaction between positive and negative pregnancy desires, we propose two hypotheses. The first is that positive and negative pregnancy desires independently predict the risk of an unplanned pregnancy. The second is that ambivalence and three related constructs that are also based on the interaction between positive and negative desires are each important predictors of pregnancy risk. We use weekly journal data collected from a U.S. sample of 1,003 women aged 18–19 years and conduct hazard model analysis to test our hypotheses. Using both dummy and continuous predictors, we report results that confirm both hypotheses. The proposed interaction framework has demonstrated validity, compares favorably with previously reported alternative approaches, and incorporates a set of constructs that have potential importance for further research directed at the prevention of unplanned pregnancy.
Depression and stress have been linked with poor contraceptive behavior, but whether existing mental health symptoms influence women's subsequent risk of unintended pregnancy is unclear. We prospectively examined the effect of depression and stress symptoms on young women's pregnancy risk over one year. We used panel data from a longitudinal study of 992 U.S. women ages 18-20 years who reported a strong desire to avoid pregnancy. Weekly journal surveys measured relationship, contraceptive use and pregnancy outcomes. We examined 27,572 journal surveys from 940 women over the first study year. Our outcome was self-reported pregnancy. At baseline, we assessed moderate/severe depression (CESD-5) and stress (PSS-4) symptoms. We estimated the effect of baseline mental health symptoms on pregnancy risk with discrete-time, mixed-effects, proportional hazard models using logistic regression. At baseline, 24% and 23% of women reported moderate/severe depression and stress symptoms, respectively. Ten percent of young women not intending pregnancy became pregnant during the study. Rates of pregnancy were higher among women with baseline depression (14% vs. 9%, p=0.04) and stress (15% vs. 9%, p=0.03) compared to women without symptoms. In multivariable models, the risk of pregnancy was 1.6 times higher among women with stress symptoms compared to those without stress (aRR 1.6, CI 1.1,2.7). Women with co-occurring stress and depression symptoms had over twice the risk of pregnancy (aRR 2.1, CI 1.1,3.8) compared to those without symptoms. Among women without a prior pregnancy, having co-occurring stress and depression symptoms was the strongest predictor of subsequent pregnancy (aRR 2.3, CI 1.2,4.3), while stress alone was the strongest predictor among women with a prior pregnancy (aRR 3.0, CI 1.1,8.8). Depression symptoms were not independently associated with young women's pregnancy risk. In conclusion, stress, and especially co-occurring stress and depression symptoms, consistently and adversely influenced these young women's risk of unintended pregnancy over one year.
BackgroundRetrospective reports of lifetime experience with mental disorders greatly underestimate the actual experiences of disorder because recall error biases reporting of earlier life symptoms downward. This fundamental obstacle to accurate reporting has many adverse consequences for the study and treatment of mental disorders. Better tools for accurate retrospective reporting of mental disorder symptoms have the potential for broad scientific benefits.MethodsWe designed a life history calendar (LHC) to support this task, and randomized more than 1000 individuals to each arm of a retrospective diagnostic interview with and without the LHC. We also conducted a careful validation with the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition.ResultsResults demonstrate that—just as with frequent measurement longitudinal studies—use of an LHC in retrospective measurement can more than double reports of lifetime experience of some mental disorders.ConclusionsThe LHC significantly improves retrospective reporting of mental disorders. This tool is practical for application in both large cross-sectional surveys of the general population and clinical intake of new patients.
In this article we describe new research to investigate unintended pregnancies during the transition to adulthood. The Relationship Dynamics and Social Life (RDSL) study begins with a 60-minute in-person interview about family background and current relationship characteristics. At the conclusion of the interview, respondents are enrolled in an ongoing journal, which consists of a 5-minute survey via web or phone and occurs weekly for 2.5 years. We have enrolled over 1,000 young women in the study and have experienced excellent baseline response rates and high journal participation rates. Below we describe the limitations of past research on unintended pregnancy as a background for our study. Then we provide a detailed description of the study and its design strengths and weaknesses.
Introduction We have previously documented the relationships between stress and depression symptoms and adolescent women's nonuse and misuse of condoms and other contraceptive methods and on their unintended pregnancy rates. Aim Here, we examine relationships between mental health symptoms and another understudied adolescent reproductive health behavior - frequency of sexual intercourse. Main Outcome Measure Our outcome was weekly sexual intercourse activity. Methods We used panel data from a longitudinal, population-based cohort study of 992 women ages 18–20. Weekly journals measured sociodemographic, relationship, reproductive, and mental health characteristics, sexual and contraceptive behaviors, and pregnancy. We examined 27,130 surveys from 952 women during the first study year. Predictors of weekly sexual intercourse were moderate/severe stress (PSS-4) and depression (CESD-5) symptoms measured at baseline. Multi-level, mixed-effects logistic regression models estimated the relationships between stress and depression symptoms and the weekly odds of sexual intercourse while adjusting covariate fixed effects and random woman effects. Results Nearly a quarter of the sample had moderate/severe stress (23%) and depression (24%) symptoms at baseline. Women reported sexual intercourse in 36% of weeks. Proportions of sexually active weeks were higher among women with stress (43%) and depression (40%) compared to those without symptoms (35% and 35%, respectively, p-values<0.001). Controlling for covariates, women with baseline stress symptoms had 1.6 times higher weekly odds of sexual intercourse compared to women without stress (aOR 1.6, CI 1.1–2.5, p=0.04). Depression symptoms were not associated with sexual intercourse frequency in adjusted models. Conclusions Stress symptoms were positively associated with sexual intercourse frequency among these young women. Research and practice efforts are needed to identify effective sexual health promotion and risk reduction strategies, including contraceptive education and counseling, in the context of mental health symptoms and unintended pregnancy.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.