ABSTRACT
PURPOSE: To test the hypothesis that ego development would predict contraceptive use. Problems in ego development were defined in terms of three factors: (1) realism, (2) complexity, and (3) discontinuity. METHODS: Forty-one respondents aged 14-17 years were selected from a group of 233 adolescents who were administered a projective pregnancy scenario and participated in a 12-month follow-up. Twenty of these adolescents were randomly selected from the group determined to be effective contraceptive users, while 21 were randomly selected from the group of poor contraceptors. RESULTS: Chi-square test revealed a significant association (p < .0005) between the composite ego maturity (EM) measure and contraceptive outcome (chi 2 = 13.82, with df-1). Low scores on the ego maturity measure predicted poor contraceptive use. EM was unrelated to age but was associated with race (chi 2 = 7.535, .025 < p < .05). However, EM predicted contraceptive use when controlling for the effects of race. CONCLUSIONS: A simple, time-efficient projective pregnancy scenario is an effective way of determining adolescent females at risk for poor contraceptive effectiveness and, therefore, untimely pregnancy. These stories are analyzed using factors related to the ego development of the adolescent. Subjects who scored lower on this measure have poor contraceptive effectiveness while subjects with higher levels demonstrated effective contraception use, at 1-year follow-up.
PIP: The hypothesis that ego development predicts adolescent contraceptive use was investigated in 41 females 14-17 years of age. These 41 subjects were recruited from a broader group of 233 adolescents attending teen clinics in San Francisco, California, who completed a projective pregnancy scenario and were followed for up to 12 months; 20 subjects were randomly selected from the subgroup determined to be effective contraceptive users, while 21 were drawn from the subgroup of poor contraceptors. An ego maturity index was developed for each teen based on an assessment of three dimensions of the adolescents' projective stories: 1) realism, idealism, or cynicism; 2) complexity, concreteness, or overelaboration; and 3) continuity, mild discontinuity, or abrupt discontinuity. The 25 adolescents whose stories were realistic, continuous, and articulately told were rated high in ego maturity, and 18 of these young women were effective contraceptors (defined as always or almost always using at least 1 moderately or very effective method) at the 1-year follow-up. In contrast, only 2 of the 16 participants with low ego maturity were effective contraceptors. Chi-square test revealed a significant association (p 0.0005) between the composite ego maturity measure and contraceptive outcome. This association remained significant (p 0.01) even after controlling for race. These findings suggest the feasibility of targeting sexually active adolescents with signs of lower ego development for early intervention.
