Romantic and sexual relationships that begin at a relatively young age are associated with an increased risk of maladaptive outcomes [1] and an adverse influence on relationship skills and sexual functioning in later life [2]. In the UK, teenage girls are at high risk of acquiring sexually transmitted infections with various pathological outcomes. More than one in four young adults in the UK now report sexual activity before their 16th birthday [3] with a mean age of sexual debut of 14 years for both boys and girls [4]. In Wales, boys and girls report a mean age of debut of 12 and 13 years respectively [5].

An "integrative model" of predictors of initiation of sexual activity in adolescence concluded that a variety of factors predicted and influenced intention to initiate sexual activity [6]. These included parental involvement in the child's life, supervision and the quality of the parent-child relationship, perceived peer norms and parental attitudes towards sex. Adolescents who experience efficient and effective parental monitoring are less likely to be involved in early sexual activity than those exposed to authoritarian or permissive monitoring [1]. There is also an association between deviant peer relationships and risky sexual activity [2] and there is evidence that risky behaviours cluster together so that individuals develop "health-compromising lifestyles" [3]. Biological factors are also associated with sexual activity with an association betweeen early puberty and early sexual debut [4] and this has been linked to family structure and the presence or otherwise of the father [5]. Adolescents whose families are in lower socio-economic groups are at increased risk of risky sexual behaviour, teenage pregnancy and also sexually transmitted infections[6, 7] However, much of the research from which these conclusions were drawn was undertaken with convenience samples and high risk or clinical groups rather than national cohorts and recommendations have been made for more research using large representative cohorts in order to improve the generalisability of results.

The aim of this study is to examine the relationship between family and social relationships in late childhood and adolescence and both early or otherwise risky sexual activity for both girls and boys in a British population birth cohort.

Methods

Study population

The Avon Longitudinal Study of Parents and Children (ALSPAC: see www.alspac.bris.ac.uk) is a population-based study which has been described in detail elsewhere (Golding, Pembrey, & Jones, 2001). All pregnant women living in one of three Bristol-based health districts (EDD April 1991 - December 1992) were invited to take part in the study; 14,541 mothers enrolled and 13,988 infants were still alive at their first birthday.

Measurement of romantic and sexual behaviour

Romantic and sexual behaviour in the ALSPAC chort has been measured since age 11 using an adapted version of the Adolescent Sexual Activity Index [8]. This measure is administered via a computer assisted interview and asks whether romantic or sexual behaviour has been experienced, whether it was with a same- or opposite sex partner and whether drugs and / or alcohol had been used prior to the event. Each question also includes several items which are designed to assess sexual competence as described by Wellings, 2001 [9] including perceived regret and contraceptive use.

Measurement of parent-child and peer relationships

Parent-child relationships have been measured in a variety of ways across the whole span of the ALSPAC study. Some of these items (measured from infancy onwards through early and middle childhood) fit with concepts of parenting and parent-child relationship which are discussed in the literature eg measures of warmth and support, control and rejection [10] whereas others measure active aspects of the parent-child relationship such separation anxiety (infancy and childhood) and parental monitoring measured from 12 years onwards [11]. Aspects of the parent-child relationship were observed by a third-party during the completion of an interactive task between parent and child using the etch-a-sketch task at 10 and 12 years.

Potential confounders

Family and parent measures: Child age was recorded at the 9-year clinic and mother's age at the birth of the study child has also been recorded. Mother's education level was recorded in the 32-week ante-natal questionnaire and was categorised into none / Certificate of Secondary Education (CSE - a national school exam taken at 16 years), vocational, O level (a national school exam taken at 16 years but higher than CSE), A level (a national school exam taken at 18 years) or degree. Both the mother's occupation and that of her partner were also recorded at this time and these data were used to allocate the family to a social class group (classes I to V with class III split into non-manual and manual) using the 1991 Office for Population Cencuses and Surveys classification. Questions about the early sexual experience of each parent were asked in the 18- and 32-week antenatal questionnaire (mother) and in the 8-month questionnaire (father) and questions about parents' perceptions of their own childhood and the bond they shared with their own parents were asked ante-natally and at 33 months. Items about the quality of the marital relationship including the bond between parents as well as previous marriages and aggression within the relationship have been asked regularly since recrutiment into the cohort together with items about spiritual outlook and religious affiliation. Depression and anxiety have been measured regularly across the life of the cohort using both the Edinburgh post-natal depression scale and the Crown-Crisp Experiential Index. Parental locus of control was also asked at 12 years.

Child behaviour: Measures of child behaviour include the revised Rutter Behaviour Scale [12], the SDQ [13] and the DAWBA [14] - each is measured at least twice giving a choice of measures of social, behavioural and emotional development over time. The Moods and Feelings questionnaire [15] has also been adminsitered regularly from 7 years onwards. Life events have also been measured in data from the study child from 18 months onwards [16] and risky health behaviours including alcohol, tobacco and illicit substance use have been measured from 3 years onwards; anti-social behaviour was first measured at 8 years. Sensation seeking behaviour [17] has also been measured from 11 years onwards.

Biological measures: measures of puberty (Tanner staging) have been measured regularly from 97 months onwards.

Analyses

The opportunity to use data from the ALSPAC cohort to examine the influence of family and social relationships on romantic and sexual activity in adolescence means that both descriptive and inferential analyses can be undertaken to both provide an overview of relationships between all of these factors but we will also be able to start to examine causal relationships - the availability of prospective family data from infancy means that regressional analyses and structural equation modelling can be employed to determine both risk and adaptive factors which influence the development of sexual behaviour in late childhood and adolescence.

References

[1] Rai AA, Stanton B, Wu Y, Li XM, Galbraith J, Cottrell L, et al. Relative influences of perceived parental monitoring and perceived peer involvement on adolescent risk behaviors: An analysis of six cross-sectional data sets. Journal of Adolescent Health. 2003;33:108-18.

[2] Ary DV, Duncan TE, Duncan SC, Hops H. Adolescent problem behaviour: the influence of parents and peers. Behaviour Research and Therapy. 1999;37:217-30.

[3] Jessor R. New Perspectives on Adolescent Risk Behvaiour. Cambridge: Cambridge University Press 1998.

[4] Brooks-Gunn J, Furstenberg Jr FF. Adolescent sexual behaviour. American Psychologist. 1989;44(2):249-57.

[5] O'Connor TG, Dunn J, Jenkins JM, Pickering K, Rasbash J. Family settings and children's adjustment: differential adjustment within and across families. British Journal of Psychiatry. 2001;179:110-5.

[6] Kotchick BA, Shaffer A, Forehand R. Adolescent sexual risk behavior: a multi-system perspective. Clinical Psychology Review. 2001;21(4):493-519.

[7] Teenage Pregnancy. Report. London: Social Exclusion Unit; 1999 June. Report No.: Cm 4342.

[8] Hansen WB, Paskett ED, Carter LJ. The adolescent sexual activity index (ASAI): a standardised strategy for measuring interpersonal heterosexual behaviours among youth. Health Education Research. 1999;14(4):485-90.

[9] Wellings K, Nanchahal K, Macdowall W, McManus S, Erens B, Mercer CH, et al. Sexual behaviour in Britain: Early heterosexual experience. Lancet (North American Edition). 2001;358(9296):1843-50.

[10] Repetti RL, Taylor SE, Seeman TE. Risky families: family social environments and the mental and physical health of offspring. Psychological Bulletin. 2002;128(2):330-66.

[11] Stattin H, Kerr M. Parental monitoring: A reinterpretation. Child Development. 2000 Jun-Aug;71(4):13.

[12] Elander J, Rutter M. Use and development of the Rutter parent's and teachers's scales. International Journal of Methods in Psychiatric Research. 1996;6:63-78.

[13] Goodman R. Psychometric properties of the Strengths and Difficulties Questionnaire. Journal of the American Academy of Child Psychiatry. 2001;40(11):1337-45.

[14] Goodman R, Ford T, Richards H, Gatward R, Meltzer H. The Development and Well-being Assessment: description and initial validation of an integrated assessment of child and adolescent psychopathology. Journal of Child Psychology & Psychiatry. 2000;41:645-55.

[15] Angold A, Costello AJ, Messer SC, Pickles A, Winder F, Silver D. The development of a short questionnaire for use in epidemiological studies of depression in children and adolescents. International Journal of Methods in Psychiatric Research. 1995;5:1-12.

[16] Coddington RD. The significance of life events as etiologic factors in the diseases of children. Journal of Psychosomatic Research. 1972;16:7-18.

[17] Arnett J. Sensation seeking: a new conceptualisation and a new scale. Personality and Individual Differences. 1994;16(2):289-96.