Bidirectional Linkages between Psychological Symptoms and Sexual Activities among African-American Adolescent Girls in Psychiatric Care

Objective: The current study examines longitudinal associations between light and heavy sexual experiences and psychiatric symptoms in African-American girls receiving mental health care. Research supports bidirectional associations between adolescent romantic and sexual behaviors and depression and other mental health problems, but this finding has not been examined among African-American youth or in clinical samples. African-American girls in psychiatric treatment suffer disparities in HIV/AIDS vulnerability, and understanding the context of girls’ risk-taking (and how psychological symptoms contribute) may aid prevention efforts. Method: 265 African-American girls seeking psychiatric care were assessed for mental health symptoms and light and heavy sexual behaviors. Participants completed a six-month follow-up. Results: Baseline light sexual activity predicted increased internalizing and externalizing symptoms and substance use at follow-up. Internalizing and externalizing symptoms predicted increased heavy sexual behaviors over time, including HIV-risk behaviors. Conclusions: Results support the association between romantic involvement and depression. Psychological symptoms may play a key role in the emergence of risky sexual behaviors among African-American girls in psychiatric care, and should be considered in prevention program development.