Abstract
Adolescence and young adulthood are peak periods for risky sexual behaviors (RSB) and borderline personality disorder (BPD) features. RSB is a major public health concern and adolescents with BPD may be particularly vulnerable to RSB, but this is understudied. The aim of this study was to identify distinct RSB profiles in youth and determine whether a specific profile was associated with BPD features. Participants were 220 adolescents and young adults (age 14–21) recruited from the community. To identify groups of adolescents and young adults who engage in similar RSB, a latent profile analysis (LPA) was conducted on sexually active youth (57%). Next ANOVA was used to identify how profiles differed in terms RSB dimensions and BPD features. We identified three distinct RSB profiles: (1) a Low RSB profile that was manifested by the majority (77.7%) of youth; (2) an Unprotected Sex in Relationships profile (13.3%) and; (3) an Impulsive Sex Outside Relationships profile (12%) which was manifested by youth with significantly higher BPD features. The findings shed light on the difficulties youth with BPD manifest around integrating sexuality, intimacy, fidelity, and love. This contrasts with the majority of youth who are sexually active in the context of relationships and engage in little or no RSB. The findings have important clinical implications. Adolescent sexuality is frequently in the blind spot of clinicians. To address the elevated risk of RSB in adolescents with BPD, interventions are needed to help adolescents navigate this period and improve their understanding of the reasons for RSB while addressing difficulties in establishing sexual and attachment relationships.
Highlights
Adolescent risky sexual behavior (RSB) is a major public health concern (Yoon et al, 2018)
To address the gaps in the literature regarding whether distinct risky sexual behaviors (RSB) profiles can be identified, and are associated with borderline personality disorder (BPD), the objectives of the present study were to: (1) examine RSB profiles in adolescents and young adults from a community sample using latent profile analysis (LPA); and (2) investigate whether specific profiles were associated with significantly higher BPD features
The selection was based on the lowest Akaike information criterion (AIC) (Akaike, 1974) and Bayesian information criterion (BIC) (Schwarz, 1978) which assess model fit with varying degrees of consideration for parsimony, the highest entropy which represents the percentage of participants correctly classified by the model (Ramaswamy et al, 1993) and the Lo-Mendell-Rubin adjusted likelihood ratio (LMRT) (Lo et al, 2001) which evaluated whether the model fits the data significantly better than a model with k–1 profiles, that is to say a model with one less profile
Summary
Adolescent risky sexual behavior (RSB) is a major public health concern (Yoon et al, 2018). RSB and BPD changes during the maturation of the reproductive system as well as the hypothalamic-pituitary-gonadal axis (HPG) This is associated with the neurobiological remodeling of cortical and limbic circuits (Sisk and Zehr, 2005). Due to this remodeling, puberty and adolescence are vulnerable periods for extreme stressors as well as the emergence of mental illness (Ge et al, 2001; Andersen, 2003; Grant et al, 2003; Turner and Lloyd, 2004; Kessler et al, 2005; Paus et al, 2008). Findings from other studies suggest that only a subgroup of youth with high rewardrelated ventral striatum reactivity to sexually stimulating material showed elevated levels of RSB and may be at risk (Demos et al, 2012)
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