Parental Social Position, Body Image, and Other Psychosocial Determinants and First Sexual Intercourse among 15- and 16-Year Olds

Valle, Ann-Karin, Roysamb, Espen, Sundby, Johanne, Klepp, Knut Inge, Adolescence

INTRODUCTION

The fact that early first sexual intercourse and sexual and reproductive health risks are associated is well established (Santelli, Lowry, Brener, & Robin, 2000); Valle, Torgersen, Roysamb, Klepp, & Thelle, 2005; Wellings et al., 2001; Wright, Abraham, & Scott, 1998). Early first sexual intercourse is associated with increased risk of teenage pregnancy (Adler & Hendrick, 1991) and sexually transmitted infections (Henderson et al., 2002); Santelli et al., 2000; Santelli, Speizer, Avery, & Kendall, 2006). While a range of social and individual level factors have been shown to be associated with first sexual intercourse (Petersen, Samuelsen, & Wichstrom, 2003; Paul, Fitzjohn, Herbison, & Dickson, 2000b), few studies have investigated its relationship to body image (Goodson, Buhi, & Dunsmore, 2006).

Early to mid-adolescence is a time of rapid growth and development, and increased attention to body image may be expected. Numerous studies have investigated body image in relation to eating disorders; however, the relationship between body image and first sexual intercourse has been studied to a lesser extent (Goodson et al., 2006). Body image is influenced by a multitude of factors (Cash & Prutzinsky, 2002) and constitutes a central part of self development and identity formation. Levine and Smolak found that body image, defined as the perception of physical appearance, including emphasis on weight concerns, was probably the most important component of global self-esteem in adolescents (Levine & Smolak, 2002). Similarities between American youth and Norwegian youth on the relative importance of body-self has also been established (Wichstrom, 1997). Body image has been associated with aspects of psychosocial health, such as depressed moods (Holsen, Kraft, & Roysamb, 2001); Haavet, Dalen, & Straand, 2006; Haavet, Sangstad, & Straand, 2005; Oppedal & Roysamb, 2004; Siegel, Yancey, Aneshensel, & Schuler, 1999), also among Norwegian youth (Holsen et al., 2001; Wichstrom, 1999). Body image is often defined as a mental representation of the body, including perceptions of appearance, feelings, and thoughts about the body. Body image is also modulated by local culture (McArthur, Holbert, & Pena, 2005). Abuse experiences can have a number of negative effects on body image (Fallon & Ackard, 2002; Kearney-Cooke & Ackard, 2000). Body image has also been found to be associated with social support (Cash & Fleming, 2002). A protector of positive body image development is social support from family (Kearney-Cooke, 2002), peers Tantleff-Dunn & Gokee, 2002), and friends (Levine & Smolak, 2002). Parental monitoring has been found to be a protective factor in avoiding sexually risky behavior (Henderson et al., 2002; Valle et al., 2005; Zimmer-Gembeck & Helfand, 2008). Furthermore, studies have demonstrated that social support is associated with first sexual intercourse among youth (Henderson et al., 2002; Paul, Fitzjohn, Herbison, & Dickson, 2000a). However, there is a lack of information regarding first sexual intercourse and body image (Wiederman, 2000). It seems that despite considerable research into factors associated with adolescent sexuality, there are inconclusive findings on first sexual intercourse and associations with body image; more rigorous methodology for future research is recommended (Goodson et al., 2006; Zimmer-Gembeck & Helfand, 2008).

Social position has previously been shown to be associated with future education plans as well as with sexual behavior (Zimmer-Gembeck & Helfand, 2008; Valle et al., 2005). Parental social position and its associations with first sexual intercourse is established in most western countries (Santelli et al., 2000; Valle et al., 2005) while some controversies remain regarding sexual debut (Kraft, 1991; Paul et al., 2000a; Pedersen et al., 2003; Sundet, Magnbus, Kvalem, Samuelsen, & Bakketeig, 1992). There is a need to better understand social context and individual level dynamics as they relate to sexual behavior. Social class variations in body image has also been found (Jackson, 2002; Thompson & van den Berg, 2002), as have ethnic differences (Grogan, 2008; Siegel et al., 1999). In a previous study of youth in Oslo, an interaction between gender, ethnicity, and sexual debut was observed (Valle et al., 2005).

Data on how self-concepts, such as body image and future educational plans, on the one hand, and social support on the other, may mediate variations in first sexual intercourse by the various indicators of parental social position seems to be lacking. Both conceptual and methodological considerations lead to a number of concerns about measurements of social class or parental social position in studies of adolescents (Zimmer-Gembeck & Helfand (2008).

The objective of this study was to investigate associations between first sexual intercourse and body image, future educational plans, depressed moods, as well as the influence of parental education and income on first sexual intercourse. These associations were tested by gender and ethnicity and adjusted for variables likely to affect the findings, as perceived social support, sexual abuse, and age.

METHOD

The Oslo Youth Health Survey was a collaboration between the Norwegian Institute of Public Health, the University of Oslo, and the Municipality of Oslo. The study includes all 10th graders of all schools in Oslo in the years 1999/2000 and 2000/2001. Of the 8,316 eligible students, 7,343 adolescents participated (88.3%; 86.1% for boys; 90.6% for girls) through self-administered questionnaires during school time. Ethical research clearance was obtained for the entire survey from The Norwegian Data Inspectorate as well as the relevant Medical Ethical Committees. In addition, clearance for the linking of youth data and parental register-information was obtained from The Norwegian Data Inspectorate. More detailed information is presented elsewhere (Haavet et al., 2006). Our study excluded those who did not report gender (n = 36) or age (n = 28), as well as those under 15 years of age (n = 20) or over 16 (n = 72). Thus, the sample employed consisted of 7,187 students; 3,544 (49.4%) boys and 3,643 (50.6%) girls.

Dependent Variables

First sexual intercourse. The question was: "Have you ever had sexual intercourse?" The answer categories were (a) "Yes, with one partner," (b) "Yes, with several partners," and (c) "No." The following open-ended question was: "What was your age the first time?" The dependent variable was organized into a dichotomous variable, having had first sexual intercourse, yes or no.

Social Level Independent Variables

Parental education and income. Information on parental education and income was obtained from the Personal Register of Statistics Norway. The student-questionnaire data were linked to the parental data registry, and were encrypted to ensure confidentiality. The parents' total income was included in a five-level classification of net income (Table 1). This classification is based on Statistics Norways' report on family income of 2001. (Currency approximates: I EURO = 8.35 NOK = 1.34100 U.S. dollars 2001 rates.)

Ethnicity

Statistics Norway's definition of ethnicity was used (i.e., ethnic minorities were defined as those with both parents born in non-Western countries. (Among youth with both parents born outside Norway, 4,9% were from Western countries (i.e., other Nordic countries, Western Europe, USA, Canada, Australia, Japan, and New Zealand); 8,9% were from Eastern Europe; 22.8% from North Africa and the Middle East; 10.5% from Sub-Saharan Africa, 10.5% from East Asia and the Pacific, and 42.4% from the Indian Sub-continent, from which Pakistan was the country with the largest proportion of minority youth in Oslo (Kumar, Holmboe-Ottesen, Lien, & Wandel, 2004). For the purposes of this study, the students from Western countries were included …

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Publication information: Article title: Parental Social Position, Body Image, and Other Psychosocial Determinants and First Sexual Intercourse among 15- and 16-Year Olds. Contributors: Valle, Ann-Karin - Author, Roysamb, Espen - Author, Sundby, Johanne - Author, Klepp, Knut Inge - Author. Journal title: Adolescence. Volume: 44. Issue: 174 Publication date: Summer 2009. Page number: 479+. © 1999 Libra Publishers, Inc. COPYRIGHT 2009 Gale Group.

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