PEDIATRICS Vol. 109 No. 4 April 2002, pp. 581-584
Self-Esteem as a Predictor of Initiation of Coitus in Early Adolescents
* Hamilton Center Section of Adolescent Medicine, Indianapolis, Indiana
Indiana University School of Medicine, Section of Adolescent Medicine, Indianapolis, Indiana
 |
ABSTRACT |
|---|
 TOP ABSTRACT INTRODUCTIONMETHODSRESULTSDISCUSSIONREFERENCES |
|---|
Objective. To examine the role of self-esteem in predicting coitus initiation in a population of early adolescents.
Methods. Questionnaires assessing coital status, self-esteem, and pubertal maturation were collected from 188 participants who had not engaged in coitus by enrollment. Data were collected longitudinally while the participants were in the seventh and ninth grade. Ages ranged from 12 to 14 (mean: 12.50; standard deviation: 0.57) at Time 1 and from 14 to 16 (mean: 14.30; standard deviation: 0.49) at Time 2.
Results. Boys with higher self-esteem ratings at Time 1 were more likely to initiate intercourse by Time 2. Girls with higher self-esteem at Time 1 were more likely to remain virgins than girls with lower self-esteem. Pubertal status was unrelated to initiation of coitus in this sample.
Conclusions. Self-esteem, regardless of pubertal status, predicted coitus transition differentially in boys and girls. Results from this longitudinal study seem to fit within traditional problem behavior theory.
Key Words: coitus initiation • adolescents • self-esteem • longitudinal
Abbreviations: RSES, Rosenberg Self-Esteem Scale • SD, standard deviation
|
INTRODUCTION |
|---|
|
TOPABSTRACTINTRODUCTIONMETHODSRESULTSDISCUSSIONREFERENCES |
|---|
The relationship of self-esteem to initiation of intercourse in early adolescents has been discussed often but has received relatively little attention in the research literature. The few studies that have focused on self-esteem have been limited to cross-sectional designs or have used older adolescent and young adult samples.
A cross-sectional study of self-esteem using early and middle adolescents age 12 to 16 found that self-esteem scores for nonvirginal girls were significantly lower than those of virginal girls, with no relationship between self-esteem scores and coital status for boys.1 A second cross-sectional study of adolescents found no relationship among gender, self-esteem, and coital status.2 The conflicting results from these studies and the cross-sectional designs make interpretation of the findings difficult.
The only longitudinal study of self-esteem and transition to nonvirginity3 found no significant correlation between preexisting self-esteem and initiation of coitus for girls. However, higher levels of preexisting self-esteem were predictive of transition to coitus for boys. Research participants for this study, however, were older adolescents and young adults, who may have been influenced by different factors than young adolescents.
In this study, we report on a longitudinal study designed to investigate gender differences in self-esteem as predictors of subsequent initiation of coitus in early adolescents. Based on previous research, our hypotheses are as follows: 1) lower self-esteem will predict subsequent initiation of coitus among girls, and 2) higher self-esteem will predict subsequent initiation of coitus among boys.
|
METHODS |
|---|
|
TOPABSTRACTINTRODUCTIONMETHODSRESULTSDISCUSSIONREFERENCES |
|---|
Participants and Procedures
Seventh-grade students attending 2 junior high schools were followed over a 2-year period. The schools were located in working-class neighborhoods with urban students being bused into the district. Students in each school completed the questionnaire each year on a single day during a mandatory class. Students and parents had been informed in writing that participation was optional and all information was confidential. The school administration and Indiana University Committee for the Protection of Human Subjects waived written parental permission.
Five hundred twenty-one seventh-graders at Time 1 completed questionnaires, with 12 (2%) parents requesting that their adolescents not participate in the study. Of this sample, 46 (8.8%) students did not answer the coital status question and were eliminated, leaving 475 participants with complete data at Time 1. Because the research question addressed factors related to the initiation of intercourse, students were then screened by coital status at Time 1. This resulted in 290 (61%) virgins and 185 (39%) nonvirgins. Only the virgins were retained for this study sample.
At Time 2 (22 months after Time 1), when the questionnaires were readministered to the students in ninth grade, 98 (33%) of the 290 virginal participants were lost to follow-up. An additional 4 participants did not answer the coital status question at Time 2, leaving a final total of 188 participants with complete data for both years. At the second testing session, no parents requested that their children be excluded from participation.
Students provided standard sociodemographic information and completed a questionnaire containing the Rosenberg Self-Esteem Scale (RSES), questions about pubertal maturation, and a single question concerning coital status (virginal or nonvirginal).
The RSES
The RSES4 is a 10-item self-report scale designed to measure global self-esteem among adolescents. The scale contains 10 items with 4 response choices ranging from strongly agree to strongly disagree. Scores range from 10 to 40, with higher scores indicating higher levels of self-esteem. The RSES has been found to be a psychometrically sound instrument5 with adequate internal consistency (
= 0.74–0.78)6 and good test-retest reliability with correlations of 0.82 to 0.85.7
Coital Status
Coital status was determined with 1 item. Respondents were instructed to answer yes or no to the single item ("I have had sexual intercourse/gone all the way").
Pubertal Maturation
Pubertal maturation was measured with a self-report questionnaire recalling the timing of particular pubertal events.8 Boys were classified as early maturers if they reported genital growth or pubic hair at age 10, average maturers if these changes occurred between the ages of 11 and 12, and late maturers if they reported no development by age 13. Early maturing girls were those who reported the appearance of pubic hair or breast growth by age 9 or menarche by age 10. Average maturers reported pubic hair or breast growth at the ages of 10 and 11 and menarche at 11 and 12. Late-maturing girls were those who indicated that pubic hair or breast growth had not appeared by age 12 or menarche by age 13. Pubertal maturation was categorized as early, average, or late relative to peers, rather than in the clinical sense of precocious or delayed.
Analysis
Previous research has found that adolescents who begin puberty early are likely to initiate sexual activity earlier than their less developed peers.9,10 Because the primary interest for this study is in the effect of gender differences in self-esteem on initiation of intercourse, rather than the effects of pubertal timing on initiation of intercourse, pubertal timing was chosen as a covariate. Therefore, a 2x2 analysis of covariance was conducted for gender (male, female) and coital status (virgin, nonvirgin) on self-esteem, with pubertal timing as the covariate. Statistical significance was accepted at P < .05.
|
RESULTS |
|---|
|
TOPABSTRACTINTRODUCTIONMETHODSRESULTSDISCUSSIONREFERENCES |
|---|
Sample Characteristics
Of the 188 seventh-graders, 43% were boys, 57% were girls, 84% were white, and 16% were black. Ages ranged from 12 to 14 (mean: 12.50; standard deviation [SD]: 0.57) at Time 1 and from 14 to 16 (mean: 14.30; SD: 0.49) at Time 2. Twenty-nine students (15.4%) were classified as early pubertal maturers (59% girls, 41% boys). One hundred twenty-five students (66.5%) were average (60% girls and 40% boys) and 34 (18.1%) were late pubertal maturers (47% girls, 53% boys), in relation to their peers. Scores on the RSES ranged from 12 to 40, with higher scores indicating higher self-esteem. Means for gender were nearly identical at 30.41 (SD: 4.20) for girls and 30.12 (SD: 5.00) for boys. Remembering that all participants were virgins at Time 1, in seventh grade, 40% of boys and 31% of girls reported initiation of coitus by Time 2, in the ninth grade.
Comparisons With Excluded Subgroups
Of the 521 seventh-graders who returned Time 1 questionnaires, 475 responded to the coital status question, whereas 46 did not respond and were eliminated from additional analyses. Comparisons between these 2 groups of participants indicated no significant differences in pubertal status, self-esteem scores, or distribution of gender.
Of the 475 participants, only those who indicated at Time 1 that they had not had coitus (N = 290) were retained for this study. Comparisons of these participants with the excluded nonvirgin group (N = 185) indicated no significant difference in self-esteem scores. However, the nonvirgin group reported earlier pubertal maturation (mean: 1.85; SD: 0.65) than those who had not yet had coitus (mean: 2.03; SD: 0.57): t = 3.16, P < .002. In addition, a greater proportion of males (55.4%) compared with females (20.5%) were eliminated because of reports of coitus at Time 1.
Of the 290 seventh-graders with useable data at Time 1, 98 were lost to follow-up and 4 failed to respond to the coital status question at Time 2, resulting in a final sample of 188 participants with complete data for both time periods. Participants who were lost to follow-up did not differ on Time 1 self-esteem scores, gender, or pubertal maturation from those who remained in the study.
Analysis of Covariance
The analysis revealed no significant main effects for gender (F[1,183] = 0.30; P < .59) or coital status (F[1,183] = 0.16; P < .69), meaning that self-esteem did not vary by gender or by coital status. The covariate, pubertal status, also was not statistically significant, indicating that it was not associated with coital status or gender (F[1,183] = 0.78; P < .38). However, a significant gender by coital status interaction for self-esteem was found (F[1,183] = 9.91; P < .01). The precise nature of the interaction effect (Fig 1) was examined by using logistic regression analyses to analyze self-esteem separately for boys and girls across coital status. For these analyses, self-esteem scores were dichotomized using a median split. Results indicated that boys with high self-esteem at Time 1 (RSES >30) were 2.4 times more likely to initiate intercourse than boys with low self-esteem (RSES 
30). Conversely, girls with high self-esteem at Time 1 (RSES >30) were 3 times more likely to remain virgins than those girls with low self-esteem (RSES 30). Self-esteem mean and standard deviations for boys and girls are found in Table 1.
|
|
Self-Esteem at Time 2
Self-esteem at Time 2 was also examined to determine whether there were gender differences in self-esteem occurring after initiation of intercourse. Interestingly, scores after initiation (M = 30.8) were not significantly different from self-esteem scores preceding initiation (M = 30.5); t = -0.80; P < .42. In addition, the scores were moderately stable over the 2-year period of the study (r = .54). The analyses were repeated with the ninth grade self-esteem scores as the dependent measure and gender and coital status as the independent measures. As in the Time 1 analysis, there were no significant main effects for gender or coital status. In contrast to the previous analysis, however, the gender by coital status interaction was not significant (F = 3.05; P < .08).
|
DISCUSSION |
|---|
|
TOPABSTRACTINTRODUCTIONMETHODSRESULTSDISCUSSIONREFERENCES |
|---|
Concern about negative consequences of early sexual debut in young adolescents prompted us to investigate factors influencing the transition to first coitus. Most of the research published to date has been cross-sectional in nature. Previous cross-sectional research has noted gender differences in self-esteem for nonvirginal adolescents. However, because of the cross-sectional design of these studies, it is not possible to evaluate the temporal relationship of self-esteem with the transition to coitus. In this study, we analyzed longitudinal data, allowing us to test the hypothesis that low self-esteem in girls and high self-esteem in boys precede and predict early initiation of coitus. The findings from this longitudinal study indicate that differences in self-esteem precede the initiation of intercourse in early adolescence. Hence, a temporal association is evident in our data.
Our results suggest that self-esteem may differentially influence adolescent transition to nonvirginity. Girls who scored low on the self-esteem measure were 3 times more likely to subsequently initiate sexual intercourse. Conversely, boys who scored high on the self-esteem measure were 2.4 times more likely to initiate coitus during the subsequent 22 month period. The occurrence of gender differences may, in part, reflect a societally-based double standard for sexual activity, in which early sexual intercourse for boys is not considered as deviant as early coitus for girls. Problem behavior theory3 suggests that higher self-esteem in girls may be a protective personality characteristic, enabling these girls to avoid some of the negative outcomes associated with early initiation of coitus. Girls with low self-esteem are without this protection and are more likely to transgress to problem behaviors. Problem behaviors are functional and purposeful.3 Therefore, girls with low self-esteem may initiate coitus to feel better about themselves, to provide themselves with intimacy, a sense of maturity, or to rebel against conventional norms concerning early sexual activity.
In contrast, early sexual initiation for boys may be seen as a badge of honor that is celebrated within the peer culture. Thus, those boys who have higher self-esteem and are more self-confident may be more likely to find willing partners than boys with low self-esteem who remain virgins.
Problem behavior theory suggests that higher self-esteem is one of several protective factors for avoidance of problem behaviors. Although this seems to hold true for the girls in our study, it also seems that this factor does not provide the same protection for boys when applied to the problem behavior of early sexual intercourse.
Because early initiation of coitus is associated with negative outcomes for adolescents, prevention programs aimed at delaying the age of first intercourse are of use. However, these programs might be more effective if issues around self-esteem are addressed. Obviously, we do not want to lower boys’ self-esteem to delay intercourse, but prevention programs that include raising self-esteem for girls might be helpful.
Limitations
Contrary to many previous studies, this study found no effect for pubertal timing. The explanation for these results is clearly seen in the analysis of participant selection. Participants who had already had sex at the time of initial data collection were removed from the sample. The number of excluded but sexually experienced subjects who were also early pubertal maturers was statistically significant. This indicates that if the excluded subjects had been recruited at an earlier age, before their sexual debut, early pubertal maturation would likely have been found to be significant for initiation of coitus. Therefore, a limitation of this study is that the full range of subjects from this population was not available. Future studies need samples younger than age 12 to include those adolescents who initiation coitus at very young ages.
The participants in this study represented a convenience sample of relatively high-risk adolescents from a single geographical area. Data analysis was limited to those adolescents who had not initiated coitus by Time 1 and were available for the follow-up assessment at Time 2, resulting in the elimination of a large proportion of the original sample. Because of these factors, caution must be exercised in interpreting the results, which may not be generalizable to other groups of adolescents. In addition, evaluation of initiation of coitus was necessarily based on participant self-report, which is potentially subject to overreporting or underreporting biases. For example, the relatively high rates for very early initiation of coitus (before the seventh grade assessment), especially among boys, raises the question of possible overreporting by boys.
We also relied on self-report to determine relative timing of puberty, rather than physician ratings. However, most research examining the relationships between pubertal development and behavior in larger populations have used self-report measures of pubertal status, ie, participants were asked to compare their level of physical development to line drawings or pictures. Several investigators have shown that self-assessment is correlated with physician assessment.11,12 It has been suggested that young adolescents tend to overestimate their development early in puberty, and to underestimate development in later pubertal stages during self-reports when looking at pictures.13 Therefore, this study used an alternative method of self-assessment that has been documented in previous work, hopefully avoiding this potential for bias.8
Early initiation of unprotected coitus can have serious consequences for the very young adolescent. Therefore, it is important to understand what factors affect sexual debut. Problem behavior theory suggests that there are a number of factors that play a role in transition-proneness to these behaviors, including self-esteem. However, almost no longitudinal literature exists that specifically examines the relationship of self-esteem to sexual debut, and there is none existing for this question for the very early adolescent. This study confirms the significance of preexisting levels of self-esteem in the problem behavior of initiation of intercourse for this young age group.
|
ACKNOWLEDGMENTS |
|---|
This research was supported, in part, by grants from the National Institutes of Health/National Institute of Allergy and Infectious Diseases (U19 AI43924) and the Maternal and Child Health Bureau (T71 MC 00008).
|
FOOTNOTES |
|---|
Received for publication Mar 26, 2001; Accepted Oct 29, 2001.
Reprint requests to (G.D.Z.) Section of Adolescent Medicine, Indiana University School of Medicine, 575 N West Dr, Rm 070, Indianapolis, IN 46202. E-mail: gzimet{at}iupui.edu
|
REFERENCES |
|---|
|
TOPABSTRACTINTRODUCTIONMETHODSRESULTSDISCUSSIONREFERENCES |
|---|
- Orr D, Wilbrandt M, Brack C, Rauch S, Ingersoll G. Reported sexual behaviors and self-esteem among young adolescents. Am J Dis Child.1989; 143 :86 –90[Medline]
- Robinson RB, Frank D. The relation between self-esteem, sexual activity, and pregnancy. Adolescence.1994; 29 :27 –35[Medline]
- Jessor S, Jessor R. Transition from virginity to nonvirginity: a social-psychological study over time. Dev Psychol.1975; 11 :473 –484
- Rosenberg M. Society and the Adolescent Self-image. Princeton, NJ: Princeton University Press;1965
- Blascovich J, Tomaka J. Measures of self-esteem. In: Robinson JP, Shaver JR, Wrightsman LS, eds. Measures of Personality and Social Psychological Attitudes. San Diego, CA: Academic Press;1991 :115 –160
- Hoge DR, McCarthy JD. Issues of validity and reliability in the use of real-ideal discrepancy scores to measure self-regard. J Person Soc Psychol.1983; 44 :1048 –1055
- Fleming JS, Courtney BE. The dimensionality of self-esteem II. Hierarchical facet model for revised measurement scales. J Person Soc Psychol.1984; 46 :404 –421
- Orr D, Ingersoll G. The contribution of level of cognitive complexity and pubertal timing to behavioral risk in young adolescents. Pediatrics.1995; 95 :528 –533[Abstract]
- Brooks-Gunn J, Furstenberg FF. Adolescent sexual behavior. Am Psychol.1989; 44 :249 –257[Medline]
- Smith EA, Udry JR, Morris NM. Pubertal development and friends: a biosocial explanation of adolescent sexual behavior. J Health Soc Behav.1985; 26 :183 –192[Medline]
- Morris NM, Udry JR. Validation of a self-administered instrument to assess stage of adolescent development. J Youth Adolesc.1980; 9 :271 –280
- Duke P, Litt I, Gross R. Adolescent’s self-assessment of sexual maturation. Pediatrics.1980; 66 :918 –920[Abstract]
- Schlossberger N, Turner R, Irwin C. Validity of self-report of pubertal maturation in early adolescents. J Adolesc Health.1992; 13 :109 –113[Medline]
PEDIATRICS (ISSN 1098-4275). ©2002 by the American Academy of Pediatrics
CiteULike 
Connotea 
Del.icio.us 
Digg 
Facebook 
Reddit 
Technorati 
Twitter What's this?
This article has been cited by other articles:
|
|
 |
|
  R. J. DiClemente, C. P. Crittenden, E. Rose, J. M. Sales, G. M. Wingood, R. A. Crosby, and L. F. Salazar Psychosocial Predictors of HIV-Associated Sexual Behaviors and the Efficacy of Prevention Interventions in Adolescents at-Risk for HIV Infection: What Works and What Doesn't Work? Psychosom Med, June 1, 2008; 70(5): 598 - 605. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Brendgen, B. Wanner, and F. Vitaro Peer and Teacher Effects on the Early Onset of Sexual Intercourse Am J Public Health, November 1, 2007; 97(11): 2070 - 2075. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. H. Eaves and M. Robertson-Smith The Relationship Between Self-Worth and Marital Infidelity: A Pilot Study The Family Journal, October 1, 2007; 15(4): 382 - 386. [Abstract] [PDF]
|
|
|
|
 |
|
 R. J. DiClemente, L. F. Salazar, and R. A. Crosby A Review of STD/HIV Preventive Interventions for Adolescents: Sustaining Effects Using an Ecological Approach J. Pediatr. Psychol., September 1, 2007; 32(8): 888 - 906. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. E. Cornwell, M. J Law Smith, L. G Boothroyd, F. R Moore, H. P Davis, M. Stirrat, B. Tiddeman, and D. I Perrett Reproductive strategy, sexual development and attraction to facial characteristics Phil Trans R Soc B, December 29, 2006; 361(1476): 2143 - 2154. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. F. Salazar, R. A. Crosby, R. J. DiClemente, G. M. Wingood, C. M. Lescano, L. K. Brown, K. Harrington, and S. Davies Self-Esteem and Theoretical Mediators of Safer Sex Among African American Female Adolescents: Implications for Sexual Risk Reduction Interventions Health Educ Behav, June 1, 2005; 32(3): 413 - 427. [Abstract] [PDF]
|
|
|
|
 |
|
 L. Kelly, J. Sheeder, and C. Stevens-Simon Teen Home Pregnancy Test Takers: More Worried or More Wishful? Pediatrics, March 1, 2004; 113(3): 581 - 584. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Self-Esteem and Sexual Activity in Early Adolescence Journal Watch Pediatrics and Adolescent Medicine, May 13, 2002; 2002(513): 9 - 9. [Full Text]
|
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
