A resilience framework: Sexual health trajectories of youth with maltreatment histories

ABSTRACT

There is a wealth of knowledge regarding negative sexual outcomes experienced by youth with childhood maltreatment (CM) histories, yet a dearth of research examines healthy sexual development among these youth. This gap exists despite evidence of resilience highlighting alternative and healthy physical, social, and psychological futures for youth who were abused. This study tested whether trajectories of resilience identified in studies of psychological functioning were applicable to sexual health. Using data from the first four waves of the National Longitudinal Study of Adolescent to Adult Health, latent class growth analysis was conducted among individuals with histories of CM (N = 1,437). On average, participants were 15, 16, 21, and 28 years old, respectively, by waves of data collection. About half of the sample was female (55%), the majority were White (66%), and a sizeable portion had experienced multiple forms of CM prior to Wave I (38%). Controlling for CM severity, three distinct sexual health trajectory classes were identified: resilient, survival, and improving, which were differentiated by age and biological sex. Older participants’ sexual health was more likely to diminish over time, girls were more likely to show gains in sexual health over time, and significant differences in levels of sexual behaviors between the classes were only present during adolescence. Findings support the need for increased attention on the potential for sexual health despite experiences of CM, and highlight the applicability of resilience theory to youth sexuality.

KEYWORDS:

• Adolescent sexuality
• resilience
• childhood maltreatment
• sexual health
• add health

Acknowledgments

This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill. Special acknowledgment is due Ronald R. Rindfuss and Barbara Entwisle for assistance in the original design. Information on how to obtain the Add Health data files is available on the Add Health website (http://www.cpc.unc.edu/addhealth).

Notes

1. chronic: consistently low and/or continuously decreasing levels of sexual health overtime; survival with impairment: initially declining but eventually plateauing levels of sexual health; resilient: stable levels of sexual health consistently located between chronic and thriving classes; and thriving: exhibiting substantial, consistent gains in sexual health overtime.

2. The process for determining biological sex was guided by recommendations from Add Health administrators. There was an error in Add Health’s coding of biological sex from Wave I; therefore, they instruct all users of the data set to use the biological sex variable from Wave II.

3. LCGA models with three waves versus four waves of data converged. Therefore, we present the full and complete models to be transparent while recognizing limitations of secondary data.

Additional information

Funding

No direct support was received from grant P01-HD31921 for this analysis.