Strategies for Coping with Sexually Transmitted Diseases by Adolescent Females
Rosenthal, Susan L., Biro, Frank M., Cohen, Sheila S., Succop, Paul A., Stanberry, Lawrence R., Adolescence
Essentially all sexually active teens are at risk for acquisition of a sexually transmitted disease (STD) due to biological vulnerability and a variety of risk-taking behaviors (Cates, 1991). The acquisition of an STD has potentially serious impacts on the individual both biologically and psychologically (Rosenthal, Cohen, & Biro, 1994). The purpose of this study was to investigate adolescent girls' style of coping in response to the acquisition of an STD. Coping is a transactional event involving the assessment of a stressor, attempts to deal with it, and then behavioral changes that result from the efforts. The nature of the stressor may determine the type of coping used. Research has indicated that both adults and adolescents use more emotion-focused coping with health-related problems (Folkman & Lazarus, 1980; Spirito, Stark, & Williams, 1988). For example, adapting to a disease such as genital herpes requires avoidance of thinking about uncontrollable aspects and taking some responsibility for those which can be controlled (McLarnon & Kaloupek, 1988). In efforts to assess appraisal variables, researchers have incorporated perception of the degree of stress and perceived amount of control (Folkman & Lazarus, 1988; Rosenthal, Schmid, & Black, 1989). A person's coping style may also be affected by moderator variables such as age or gender (Folkman & Lazarus, 19881; Spirito, Stark, Grace, & Stamoulis, 1990).
Little is known about adolescents' style of coping in response to the acquisition of an STD and their subsequent adjustment to the diagnosis. Since coping patterns can have significant implications for future risk behaviors, developmental outcome may be mediated by the success of the coping strategies (Peterson & Hamburg, 1986). For example, if one copes with the diagnosis of an STD by simply wishing it would go away, one may not develop ways to avoid subsequent acquisition. Adolescents with cervical dysplasia report changes in sexual behaviors such as "quitting having sex" or using condoms consistently, but STD rates suggest that they may not actually implement these changes (Biro, Rosenthal, Wildey, & Hillard, 1991). This conclusion is supported by another study indicating that a previous STD did not reduce the likelihood of subsequent STD (Fullilove, Fullilove, Bowser, & Gross, 1990). The degree of impact of an STD diagnosis appears to be related to other psychological symptomatology rather than to the particular STD (Rosenthal & Biro, 1991).
The research on coping with a sexually transmitted disease has focused on adults' coping with the diagnosis of genital herpes in order to determine the degree of psychological distress and the relationship between stress and patterns of coping with recurrences. Psychological distress clearly varies among individuals, and the results of previous research regarding patterns of stress and coping with recurrences have been inconclusive (see VanderPlate & Aral (1987) for a review of the literature). It does appear that it is important to differentiate herpes-specific aspects from general aspects of coping. For example, one study found that the negative aspects of herpes appeared limited to the sexual realm (Shaw & Rosenfeld, 1987); another study found that herpes-specific social support affected the stress-recurrence relationship but general social support did not (Vanderplate, Aral, & Magder, 1988). The relevance of issues specific to herpes demonstrates the need to study coping as it specifically relates to STD.
The current study assessed coping strategies of adolescent girls in response to the acquisition of an STD. The literature on coping with developmental challenges indicates the importance of the context of development and past experiences (Luthar & Zigler, 1991). Thus, coping was examined in the context of past experience with an STD (that is, whether the adolescent was responding to the first or a subsequent episode). …