Uncontrolled Anger Research Articles

Exploring Pathways Related to Men’s Violence: A Qualitative Exploration of the Relationship between Violent Men’s Violence and Their Masculinities, Childhood, and Emotions

ABSTRACTThis study explored new ways of finding knowledge about violent men’s pathways toward their status as violent criminals and the mechanisms that underlie their violent behavior. The empirical data were gathered through biographical interviews with 10 men sentenced to therapy against violence and drugs at a Swedish treatment center. The men who had experienced violence and childhood maltreatment tended to bypass shame with uncontrolled anger and violence when reliving childhood traumas. Conversely, men without extreme childhood experiences seemed to exhibit more controlled violence mechanisms. Two men who had experienced brutal physical school bullying might have been expected to bypass shame with immediate violence; however, these men described their violence as controlled, suggesting that they had learnt to take cognitive control over their bypass mechanisms in order to escape the bullying.

Anger and psychological well-being: A correlational study among working adults in Uttarakhand, India

Background: Anger is a completely normal, usually healthy, human emotion. However, when it gets out of control, it can become destructive. Uncontrollable anger can lead to serious problems at work and in personal relationships. A correlational study was conducted on anger and psychological well-being of working adults in a selected institute of Dehradun. Objective: The main aim was to identify the risk population and explore the relationship between anger and psychological well-being of working adults. Materials and Methods: Quantitative survey approach correlational design was used in the study. Quota sampling technique was used to select the study subjects. Data were collected from 210 working adults using sociodemographic performa, clinical anger assessment scale, and General Health Questionnaire (GHQ). Result: The result showed that the mean anger score was 9.02 ± 6.64 and the range was 0-32. More than one-fourth of the study participants (76%) reported minimal clinical anger. The mean GHQ score was 56.6 ± 9.6 and the range was 34–83.The lowest level of general health quality was found in the area of social dysfunction (21.6 ± 3.8).The result shows that anger was negatively correlated with psychological well-being (r = 0.4, P ≤ 0.01). Domain-wise analysis showed that the anger was correlated with somatic symptoms, anxiety, insomnia, and depression. Conclusion: Anger and psychological well-being is negatively correlated. As anger increases, the probability of somatic symptoms, depression, and anxiety increases.

Tracing the Neural Carryover Effects of Interpersonal Anger on Resting-State fMRI in Men and Their Relation to Traumatic Stress Symptoms in a Subsample of Soldiers.

Uncontrolled anger may lead to aggression and is common in various clinical conditions, including post traumatic stress disorder. Emotion regulation strategies may vary with some more adaptive and efficient than others in reducing angry feelings. However, such feelings tend to linger after anger provocation, extending the challenge of coping with anger beyond provocation. Task-independent resting-state (rs) fMRI may be a particularly useful paradigm to reveal neural processes of spontaneous recovery from a preceding negative emotional experience. We aimed to trace the carryover effects of anger on endogenous neural dynamics by applying a data-driven examination of changes in functional connectivity (FC) during rs-fMRI between before and after an interpersonal anger induction (N = 44 men). Anger was induced based on unfair monetary offers in a previously validated decision-making task. We calculated a common measure of global FC (gFC) which captures the level of FC between each region and all other regions in the brain, and examined which brain regions manifested changes in this measure following anger. We next examined the changes in all functional connections of each individuated brain region with all other brain regions to reveal which connections underlie the differences found in the gFC analysis of the previous step. We subsequently examined the relation of the identified neural modulations in the aftermath of anger with state- and trait- like measures associated with anger, including brain structure, and in a subsample of designated infantry soldiers (N = 21), with levels of traumatic stress symptoms (TSS) measured 1 year later following combat-training. The analysis pipeline revealed an increase in right amygdala gFC in the aftermath of anger and specifically with the right inferior frontal gyrus (IFG).We found that the increase in FC between the right amygdala and right IFG following anger was positively associated with smaller right IFG volume, higher trait-anger level and among soldiers with more TSS. Moreover, higher levels of right amygdala gFC at baseline predicted less reported anger during the subsequent anger provocation. The results suggest that increased amygdala-IFG connectivity following anger is associated with maladaptive recovery, and relates to long-term development of stress symptomatology in a subsample of soldiers.

Hashtag Comedy: From Muslim Rage to #Muslimrage

After Newsweek published an article in 2012 entitled “Muslim Rage and the Last Gasp of Islamic Hate,” Twitter proliferated with jokes under the hashtag #MuslimRage. These funny one-liners acted as rebuttals to the negative affect of the Newsweek article by opposing its images of uncontrolled ideological anger with funny quips about the innocuous nature of everyday Muslim life. This analysis argues that #MuslimRage tweets became sensational because of their unique form of argumentation through humor that could only happen through Twitter. Because tweets are iconic and enthymematic, they make arguments that function as a form of individualized, massively resonant counterpropaganda. For Muslims, digital jokes created cognitive space of action that directly combated negative stereotyping and public ridicule.

Driver Anger Scale (DAS) Among Car Drivers: How Serious Are They?

Nowadays, anger while driving on the road is a crucial issue in Malaysia. The anger of driver may lead to traffic crashes. Road accident issue is an important agenda in every country. Driver behaviour and attitude such as impatience, hasty and hot-tempered on the road has become one of the causes in road accidents. Uncontrolled anger will affect the behavior of oneself during driving and could cause an individual to display aggressive attitude. Therefore, this study is aimed to identify contributing factor in anger of drivers and evaluate the Driver Anger Scale (DAS) in Batu Pahat, Johor. In addition, this study also analyzes the relationship between driver anger and the factor of DAS. Cross sectional study method was conducted in this study by distributing 250 questionnaires to car drivers. The data collectied was analyzed by descriptive, chi-square test, correlation and regression analysis using Statistical Package for Social Sciences (SPSS) version 20.0. The findings show that the discourtesy was reported as the most dominant factor contributing to driver anger. As a recommendation, to overcome driver anger issue, the authorities should prepare an action plan, promote and nurture public to practice good driving behaviour. Moreover, curriculum and driver training lesson should be improved to create better attitude among drivers. Drivers also should change their driving attitude by becoming safe drivers and exhibiting defensive driving skills on the road.

Educate: Don’t punish

We all have seen/ experienced incidences of corporal punishment, but most of us don’t see them as something strange/ to question, and yet it makes us feel uncomfortable. In other words; corporal punishment is just one of the wrong ways to discipline a child. In our society, it is a trend that children in school as well as at home are physically punished if they do not conform to the set social behavior. The punishment varies from physical abuse to psychological abuse. A child responds differently to the menace of corporal punishment and the uncontrolled anger of the parent/ teacher, may result in injuries or even death of the child. Children respect and admire adults whether parents/ teachers but these punishments may lead to anger and frustration which diminish the intimacy which the child has towards them and to cope up with the persistent abuse, the child indulges in self-destructive activities like alcohol abuse etc and even suicidal attempts. Chronic abuse of the child leads to a breach of the trust between the child and the parent/ teacher causing effects beyond physical/ mental trauma, there is an erosion of the self-esteem, fear of closeness and illconceived attempts to avoid unpleasant reminders of child abuse. The use of corporal punishment is strongly rooted in our society and is passed on through generations. However, this doesn’t mean that corporal punishment is justified. So, putting an end to corporal punishment is our ethical duty.

Educate: Don’t punish

We all have seen/ experienced incidences of corporal punishment, but most of us don’t see them as something strange/ to question, and yet it makes us feel uncomfortable. In other words; corporal punishment is just one of the wrong ways to discipline a child. In our society, it is a trend that children in school as well as at home are physically punished if they do not conform to the set social behavior. The punishment varies from physical abuse to psychological abuse. A child responds differently to the menace of corporal punishment and the uncontrolled anger of the parent/ teacher, may result in injuries or even death of the child. Children respect and admire adults whether parents/ teachers but these punishments may lead to anger and frustration which diminish the intimacy which the child has towards them and to cope up with the persistent abuse, the child indulges in self-destructive activities like alcohol abuse etc and even suicidal attempts. Chronic abuse of the child leads to a breach of the trust between the child and the parent/ teacher causing effects beyond physical/ mental trauma, there is an erosion of the self-esteem, fear of closeness and ill-conceived attempts to avoid unpleasant reminders of child abuse. The use of corporal punishment is strongly rooted in our society and is passed on through generations. However, this doesn’t mean that corporal punishment is justified. So, putting an end to corporal punishment is our ethical duty.

Effect of anger management education on mental health and aggression of prisoner women

Background and Purpose:“Uncontrolled anger” threats the compatible and health of people as serious risk. The effects of weaknesses and shortcomings in the management of anger, from personal distress and destruction interpersonal relationships beyond and linked to the public health problems, lack of compromises, and aggressive behavior adverse outcomes. This study investigates the effects of anger management education on mental health and aggression of prisoner women in Isfahan.Materials and Methods:The single-group quasi-experimental (pretest, posttest) by prisoner women in the central prison of Isfahan was done. Multi-stage random sampling method was used. Initially, 165 women were selected randomly and completed the Buss and Perry Aggression Questionnaire and the General Health Questionnaire-28, and among these, those with scores >78 (the cut point) in aggression scale was selected and among them 70 were randomly selected. In the next step, interventions in four 90 min training sessions were conducted. Posttest was performed within 1-month after the intervention. Data were analyzed using SPSS-20 software.Results:Data analysis showed that anger management training was effective in reducing aggression (P < 0.001) and also had a positive effect on mental health (P < 0.001).Conclusion:According to the importance of aggression in consistency and individual and collective health and according to findings, presented educational programs on anger management is essential for female prisoners.

Psychoeducative Programme in Anger Management

Chronic uncontrolled anger (often characteristic of dysfunctional families) becomes toxic and produces changes both in the personality traits as well as in the biological substrate. Anger can minimize mental control over behaviour since it interrupts the function of the frontal lobes and detrimentally affects health, family, work-school, financial status, friends, law, personality and values. On the other hand research conducted with fMRI, has shown a close relationship between anger and coronary atherosclerosis, ventricular arrhythmias, morbidity, and mortality. Two main brain targets of chronic anger with obvious changes are amygdala and hippocampus. In this paper we present the results of an anger control psychoeducative programme, based on person centred and group centred principles. It is developed around the hypothesis that anger is an alarm signal indicating an unmet need. Group members learn to bind anger situations with human needs. Among discussed subjects in small groups are personal anger experiences, family influences, physical relaxation methods, inner distorted beliefs, body signs and the psychobiological cycle of anger. Symbolization tools are also used. As a measurement tool we used self administered STPI (State-Trait Personality Inventory), which includes eighty questions designed to measure transitory and dispositional anger, anxiety, curiosity and depression in a four-level Likert scale. This is a twelve months (45 hours) programme divided into two phases (awareness and therapy) It was applied in three groups (Σn=30, 2011-2014). Personality anger traits showed a highly significant difference between the beginning and end of this paired blind trial (p<0.001). Programme and results are presented and discussed.

The Apotheosis of Rage

Recent psychological research on post-traumatic stress disorder (PTSD) has demonstrated that one of the most common symptoms of the disorder is heightened or even uncontrollable anger. In the past decade, various works in biblical studies have assessed the effects of trauma on the ancient Israelites and on the texts of the Hebrew Bible, but these have not fully explored either the connection between anger and PTSD or that between anger in the Hebrew Bible and Israelite trauma. This article seeks to demonstrate the close relationship between trauma and rage, and argues that biblical authors often locate their own traumatized rage in the figure of Yahweh. The emotional response of Yahweh toward the Israelites is frequently presented as one of rage, blame, and contempt – a trio of socially distancing emotions. This depiction of Yahweh results in a “theology of distance” wherein Yahweh’s furious emotionality negates the sympathy of audiences toward the traumatized Israelites.

Levetiracetam-induced rage and suicidality: Two case reports and review of literature.

BackgroundLevetiracetam-induced rage is a rare neurobehavioral adverse effect of levetiracetam that is characterized by seething rage, uncontrollable anger, fits of fury, depression, violence, and suicidal tendencies. It occurs more in patients with prior mood or psychotic disturbances. No such case has been reported in Nigeria.MethodWe report two cases of levetiracetam-induced rage. The first patient was a 29-year-old male with a 14-year history of intractable posttraumatic epilepsy. He was initially placed on sodium valproate and phenobarbitone and later had phenobarbitone replaced with levetiracetam. Within the first week of initiating levetiracetam, he became aggressive, bursted into fits of fury, and attacked his siblings. Levetiracetam was stopped, and the seething rage ceased only to reappear when it was reintroduced; hence, the complete withdrawal of levetiracetam. Naranjo probability score for adverse drug reaction was 8.ResultsThe second patient was a 23-year-old lady who developed seething rage and made several attempts to kill herself with a knife following addition of levetiracetam to the clonazepam and carbamazepine that she was taking for treatment-resistant epilepsy. Withdrawal and reintroduction of levetiracetam by the relatives led to cessation and reemergence, respectively, of the rage and suicidal tendencies. Naranjo score was 8. Levetiracetam was discontinued.ConclusionNeuropsychiatric evaluation for prior mood or psychiatric disorders in those initiating levetiracetam therapy is suggested alongside monitoring for early features of levetiracetam-induced rage by both caregivers and physicians. This will help stem the morbidity and potential mortality associated with this life-threatening adverse drug reaction.

Daily shame and hostile irritability in adolescent girls with borderline personality disorder symptoms.

Recent theoretical and empirical work suggests that adults with borderline personality disorder (BPD) have difficulty regulating both shame and anger, and that these emotions may be functionally related in clinically relevant ways (e.g., Schoenleber & Berenbaum, 2012b). The covariation of shame with anger-related emotions has important clinical implications for interventions targeting shame and uncontrolled anger in BPD. However, no studies have examined shame, anger, and their covariation in adolescents who may be at risk for developing BPD. Therefore, this study focuses on associations between BPD symptoms and patterns of covariation between daily experiences of shame and anger-related affects (i.e., hostile irritability) in a community sample of adolescent girls using ecological momentary assessment. Multilevel models revealed that girls with greater BPD symptoms who reported greater mean levels of shame across the week also tended to report more hostile irritability, even after controlling for guilt. Additionally, examination of within-person variability showed that girls with greater BPD symptoms reported more hostile irritability on occasions when they also reported greater concurrent shame, but this was only the case in girls of average socioeconomic status (i.e., those not receiving public assistance). Unlike shame, guilt was not associated with hostile irritability in girls with greater BPD symptoms. Results suggest that shame may be a key clinical target in the treatment of anger-related difficulties among adolescent girls with BPD symptoms.

Stress Symptoms Among Adolescent: A Study from Islamic Perspective.

Rapid social changes in current times which can be quite abrupt present a challenge to adolescent life. Adolescents who are unable to adapt themselves experience stress which may affect their health. Psychological issues of adolescents require attention because the long-term consequence is worse than the short-term effects, namely, there will be a group of people within society who live under stress. Stressed people show symptoms such as being aggressive, prone to rebel, uncontrollable anger, depression, mental disorders and health problems. Early recognition of adolescent stress symptoms is vital. Pursuant to this, a study is conducted among adolescents in Kajang, Selangor, Malaysia for the purpose of determining whether they experience stress or otherwise, based on stress symptoms in terms of psychology, physiology and social behaviour. An analysis is conducted on 403 respondents who comprise of male and female adolescents aged 16-17years. The required data are gathered through questionnaire and structured interview. Analysis is based on descriptive statistical method and is explained in a table in terms of frequency, percentage and mode. Research results show that adolescents do experience stress and that the majority of them exhibit psychological stress symptoms.

An investigation of differential item functioning across gender of BPD criteria.

Gender differences in prevalence rates of Borderline Personality Disorder (BPD) may reflect true differences between groups or may reflect some form of gender bias in diagnostic criteria. The detection of differential item functioning (DIF) using item response theory methods provides a powerful method of evaluating whether gender differences in prevalence rates of BPD reflect true mean differences or criterion bias. The aim of the current study was to evaluate gender-based DIF in DSM BPD criteria. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) Axis II Personality Disorders (SCID-II: First, Spitzer, Gibbon, Williams, & Benjamin, 1994) was administered to 747 adult inpatients. Results indicated DIF for 2 BPD criteria (impulsivity and uncontrolled anger), such that it was easier for these items to be endorsed for men compared with women at the same level of latent trait. At the level of the test, men were expected to be rated slightly higher than women on the SCID-II at the same level of latent BPD liability. Implications of these results for research and clinical assessment are discussed.

Shenpa and Compassionate Abiding: Mindfulness-Based Practices for Anger and Aggression by Individuals with Schizophrenia

Uncontrolled anger is often expressed as verbal and physical aggression. Some people with schizophrenia engage in verbal and physical aggression when they cannot control their anger either through the use of psychotropic medication or psychosocial interventions. In this study, we taught three individuals with long-standing anger management problems the concept of shenpa—the almost instantaneous reaction of the mind to some internal or external stimulus that hooks them to a negative emotion—and a mindfulness-based practice that helped them to intuit this without attachment or anger. In addition, we taught them the mindfulness-based practice of compassionate abiding for dealing with emotionally arousing feelings that follow shenpa. Using a multiple baseline design, we assessed the effects of the two mindfulness-based practices on anger, verbal aggression and physical aggression. The three individuals were able to decrease their anger, greatly reduce verbal aggression, and virtually eliminate physical aggression.

Ethical Guidelines for Counselors When Working With Clients With Terminal Illness Requesting Physician Aid in Dying

In 2005, the American Counseling Association (ACA) introduced a new ethical standard for counselors working with clients with terminal illness who are considering hastened death options. The authors' purpose is to inform counselors of the Death With Dignity Act and explore relevant ethical guidelines in the ACA Code of Ethics (ACA, 2005). Keywords: death with dignity, ACA Code of Ethics, end of life, physician aid in dying ********** The state of Oregon voted to approve the Oregon Death With Dignity Act (Or. Rev. Star. 127.800 et seq., 1994) in 1994, the first law in the United States establishing individuals' right to hasten their own deaths in the face of a terminal illness. The state of Washington followed suit in November 2008, when voters approved the Washington Death With Dignity Act (Wash. Rev. Code 70.245, 2008). Since these changes in legislation, the National Association of Social Workers (Mackelprang & Mackelprang, 2005), the American Psychological Association (Farberman, 1997), and the American Counseling Association (ACA) have made revisions in their professional codes of ethics to address the role of the counselor in working with these individuals. As right-to-die battles for individuals with terminal illness reach widespread coverage in the media, there has been a growing appreciation for the counselor's role in working with clients facing end-of-life issues. To address some of these deeply personal ethical issues, the ACA Code of Ethics (ACA, 2005) has included a new standard (A.9.) to guide counselors working with individuals with terminal illness who are considering hastened death options. There are several end-of-life concerns currently making headlines in the media. In this article, we focus specifically on adult individuals with terminal illness who request physician aid in dying, ethical guidelines for professional counselors in the ACA Code of Ethics, and the role of the counselor working with this population. TERMINOLOGY According to the organization Compassion & Choices (n.d.), hastened death is a term used when an individual with terminal illness makes a rational decision to take self-directed action and choose when, within the final 6 months of life, death from terminal illness will occur. The term physician aid in dying is also considered apt terminology for discussing the choices of terminal illness in a manner that allows compassion and dignity for individuals facing end-of-life decisions (Tucker, 2008). Suicide or physician-assisted suicide are not considered to be appropriate terms because of distinguishable differences between hastened death factors and suicidal intent as defined under Oregon's Death With Dignity Act. To understand these differences, counselors need to understand the rationale of individuals with terminal illness who request physician aid in dying and to have knowledge of safeguards that have been put in place to protect those who may be experiencing depression. Individuals with terminal illness cite combinations of the following reasons for requesting physician assistance with hastened death: intolerable pain, mind-altering side effects from medications, loss of bodily functions, loss of identity, desire for autonomous control, fears about future quality of life while dying, and negative past experiences with the dying process (Pearlman et al., 2005). According to the American Association of Suicidology (2012), individuals who are suicidal exhibit the following characteristics: a sense of hopelessness, rage or uncontrolled anger, reckless behaviors, increased drug or alcohol use, withdrawal from support systems, unusual anxiety, dramatic mood swings, and thinking there is no reason for living. Individuals who are terminally ill report a desire to live, but also ask to have options to choose a peaceful and dignified death that allows for control and autonomy in the final stages of life (Compassion & Choices, n. …

The Relations Between Traumatic Exposures, Posttraumatic Stress Disorder, and Anger in Male and Female Veterans

Military personnel who have served in Operation Iraqi Freedom and Operation Enduring Freedom have experienced high rates of combat exposure, which is associated with posttraumatic stress disorder. Less is known about the relations between military sexual trauma (sexual harassment, assault, and rape while serving in the military) and posttraumatic stress disorder. Little is known about anger problems in this Operation Enduring Freedom/Operation Iraqi Freedom veteran population, which research from prior conflicts suggests may be a consequence of both traumas and posttraumatic stress disorder. Anger is an emotional state closely related to aggression, hostility, and violence. Veterans who have difficulty controlling anger are at greater risk of interpersonal and employment problems. Uncontrolled anger can lead to aggressive or violent behavior, posing health risks to those around the veteran and increasingly the likelihood that the veteran will come into conflict with the law. This article contributes a review of the literature on what little is known about military sexual trauma and posttraumatic stress disorder as well as reviews literature on anger, which may be associated with high combat exposure or military sexual trauma. Notably, there is almost no research on any of these problems among women veterans. Given that women make up more than 15% of deployed service members in Iraq and Afghanistan, research on these relations in women is imperative.

Surgical resection of hypothalamic hamartomas for severe behavioral symptoms

Hypothalamic hamartomas (HHs) are associated with treatment-resistant epilepsy. Many patients also experience severe and sometimes disabling psychiatric problems. The most common behavioral symptoms consist of paroxysms of uncontrolled anger related to poor frustration tolerance. These can include violence, resulting in disrupted family or school relationships, and legal consequences including incarceration. In a large cohort of patients undergoing surgical resection of HHs for refractory epilepsy, 88% of families described an improvement in overall behavioral functioning [1]. Here, we describe four patients (three males, mean age=11.9years) who underwent surgical resection of HHs largely for behavioral indications. Three patients had relatively well controlled seizures, and one had no history of epilepsy. All patients had striking improvement in their psychiatric comorbidity. HH resection can result in significant improvement in behavioral functioning, even in patients with relatively infrequent seizures. Further investigation under approved human research protocols is warranted.

Teaching kids to cope with anger: Peer education

Anger could be an early warning signal of violent behavior. Early peer education health promotion in relation to anger management could help children before uncontrolled anger becomes a problem in adolescence and adulthood. Peer education has been identified as a viable intervention strategy worldwide with various prevention programs for youth. The purpose of this article is to describe an anger management program (Teaching Kids to Cope with Anger, TKC-A 4th-8th graders) co-led by high school peer educators in an urban school district's summer school enhancement program. A program of five modules will be described. This paper discusses the peer educator implementation and recommendations for future implementation.

The Protective Effect of Family Strengths in Childhood against Adolescent Pregnancy and Its Long-Term Psychosocial Consequences

Few reports have addressed associations between family strengths during childhood and adolescent pregnancy and its consequences. We examined relationships among a number of childhood family strengths and adolescent pregnancy, risk behavior, and psychosocial consequences after adolescent pregnancy. Our retrospective cohort of 4648 women older than 18 years (mean age, 56 years) received primary care in San Diego, CA. Outcomes included adolescent pregnancy and psychosocial consequences compared with number of the following childhood family strengths: family closeness, support, loyalty, protection, love, importance, and responsiveness to health needs. Of the cohort, 3082 participants (66%) reported 6 or 7 categories of childhood family strengths. Teen pregnancy occurred in 39%, 33%, 30%, 25%, 24%, 21%, and 19% of those with 0 or 1, 2, 3, 4, 5, 6, and 7 childhood family strengths, respectively (p for trend < 0.00001). When childhood abuse and household dysfunction were present, adjusted odds ratios (ORs) for adolescent pregnancy demonstrated an increasingly protective effect as numbers of childhood family strengths increased from 0 or 1 to 2 or 3, 4 or 5, and 6 or 7 (1.0 to 0.80), (1.0 to 0.80, 0.60, and 0.54, respectively). These findings were partly explained by progressive delays in initiation of sexual activity as the number of childhood family strengths increased. Adjusted ORs for psychosocial problem occurring decades later decreased as the number of childhood family strengths increased from 0 or 1 to 2 or 3, 4 or 5, and 6 or 7 (job problems, 1.0, 0.8, 0.6, 0.4; family problems, 1.0, 1.1, 0.7, 0.6; financial problems, 1.0, 0.9, 0.9, 0.6; high stress, 1.0, 1.1, 0.9, 0.8; uncontrollable anger, 1.0, 0.7, 0.7, 0.4). Childhood family strengths are strongly protective against adolescent pregnancy, early initiation of sexual activity, and long-term psychosocial consequences.