Prevalence and factors associated to sexual behavior in Puerto Rican adolescents

Sexual relations with intercourse (ASR-I) and high prevalence of teen pregnancies (19.2%, in 2002) among adolescents in Puerto Rico constitute a serious biopsychosocial problem. Studying the consequences and correlates of ASR-I in community and mental health samples of adolescents is important in designing and implementing sexual health programs. Randomized representative cross-sectional samples of male and female adolescents from 11-18 years old (N = 994 from the general community, N = 550 receiving mental health services) who had engaged in ASR-I were the subjects of this study. Demographic, family, and sexual data and the DISC-IV were collected from individual interviews. Logistic regression models, bivariate odds ratios, Chi-squares, and t tests were used in the statistical analysis. The mental health sample showed higher rates of ASR-I, lifetime reports of pregnancy and lower age of ASR-I onset for females. No gender difference in the prevalence of ASR-I was observed in both samples. Older adolescents from the community sample meeting psychiatric diagnosis criteria, and with lower parental monitoring, were more likely to engage in ASR-I, whereas in the mental health sample, adolescents with lower parental monitoring and parental involvement reported significantly more ASR-I. Prevalence of ASR-I and Risky Sexual Behavior (RSB) were almost identical. Adolescents with mental health disorders initiate and engage in ASR-I earlier and more frequently regardless of gender. Older adolescents are more likely to engage in ASR-I and parent-child relationships emerged as a highly relevant predictor of adolescent sexual behavior. The high correspondence between ASR-I and RSB has important clinical implications.

Test-retest reliability of the Spanish version of the Diagnostic Interview Schedule for Children (DISC-IV).

The test-retest reliability of the Spanish Diagnostic Interview Schedule for Children (DISC-IV) is presented. This version was developed in Puerto Rico in consultation with an international bilingual committee, sponsored by NIMH. The sample (N = 146) consisted of children recruited from outpatient mental health clinics and a drug residential treatment facility. Two different pairs of nonclinicians administered the DISC twice to the parent and child respondents. Results indicated fair to moderate agreement for parent reports on most diagnoses. Relatively similar agreement levels were observed for last month and last year time frames. Surprisingly, the inclusion of impairment as a criterion for diagnosis did not substantially change the pattern of results for specific disorders. Parents were more reliable when reporting on diagnoses of younger (4-10) than older children. Children 11-17 years old were reliable informants on disruptive and substance abuse/dependence disorders, but unreliable for anxiety and depressive disorders. Hence, parents were more reliable when reporting about anxiety and depressive disorders whereas children were more reliable than their parents when reporting about disruptive and substance disorders.

Dissociation, psychopathology, and abusive experiences in a nonclinical Latino university student group.

A variety of clinical and experimental data suggest that many individuals who report abusive and traumatic experiences also report a wide array of dissociative and other psychopathological symptoms. In this study, 198 Puerto Rican undergraduate students participated in a study to examine the possible relationship between different types of traumatic experiences and the self-report of dissociative experiences, depressive symptoms, and general psychopathology. Another aspect of this study was the examination of the psychometric properties of the Dissociative Experiences Scale (DES) in a Latino sample. Results supported the hypothesis that those individuals who reported frequent and severe traumatic experiences were also the most likely to experience psychological malaise and scored higher on the DES. Of interest was the finding that the psychometric characteristics of the DES are consistent with those reported in the United States and other countries. The authors conclude that individuals with a marked history of trauma and abuse are more likely to use dissociative defenses as a coping response.

Repressed memories: some clinical data contributing toward its elucidation.

This article offers two case reports that strongly support the clinical notion that under certain circumstances some persons can dissociate from their executive ego traumatic memories of sexual abuse. The patients had absolutely no conscious memory of their childhood abusive experiences and in both cases I obtained definite and clear-cut independent corroboration of the realities of the abuse. I think that a series of several well-documented case reports, like the ones reported in this article, could represent persuasive preliminary evidence for the existence of dissociative memories, at least in some specific cases. I hope that the publication of these two cases will stimulate other clinicians or researchers to report, in as much detail as possible, other similar experiences. Only through the publication of clear-cut cases can the debate about repressed memories be settled in an empirical way.