• Sexual Development and Teen Pregnancy

    Few conditions affect optimal psychosocial development more than childhood maltreatment. Maltreatment (sexual abuse in particular, but including physical abuse and neglect) has been linked to a host of high-risk sexual behaviors: promiscuity, prostitution, early pregnancy, multiple partners and HIV risks, early coitus and compulsive sexual behavior. Sexually abused females, on average, report significantly greater sexual distortions (i.e., they report being more preoccupied with sex and sexual thoughts and display more ambivalent sexual attitudes) than their nonabused adolescent counterparts. This distortion may be indicative of internalized sexual compulsions and / or aversions that develop out of the shame or stigma associated with sexual abuse.

    Adolescence is a period of particular vulnerability for victims; issues that are reminiscent of the abuse, such as sexual boundary violations, dating and other sexualized contexts, become developmentally salient. As demonstrated by our and others’ previous work, teen pregnancy rates for maltreated adolescents are approximately four times higher than the national average. Teen pregnancy is linked with a high chance of negative outcomes for both adolescent mothers and their offspring; findings and initiatives that affect the rate of teen pregnancy could have major public health significance.

    We believe that understanding the unique risks experienced by victims of childhood maltreatment would have significant effect on teen pregnancy.

    Our  previous RO1examined specific pre-pregnancy antecedents associated with teen pregnancy and parenthood. We studied, though annual assessments up to age 18, a racially and economically diverse sample of more than 500 maltreated and nonmaltreated. The study identified differential pathways to teen pregnancy which can lead to new treatment and intervention strategies for adolescents who are at particular risk for high-risk sexual behaviors, becoming pregnant or becoming teenage mothers.

    Our lab developed a multimedia tool for the comprehensive assessment of sexual activities and attitudes. The Sexual Activities & Attitudes Questionnaire (SAAQ) has been translated into three languages and assesses a host of sexual activities including:

    - Age at first intercourse
    - Birth control efficacy
    - Intercourse partners
    - HIV-risk behaviors
    - STDs
    - Pregnancies
    - Sexual behaviors of peers

    The SAAQ also assesses sexual attitudes including:

    - Sexual preoccupation
    - Sexual permissiveness
    - Internal and external pressure to engage in sex
    - Negative attitude toward sex
    - Sexual aversion
    - Sexual ambivalence

    The SAAQ, its codebook and the multimedia assessment tool are described on the link provided and can be obtained by contacting Jennie Noll at 513-636-9922 or Jennie.Noll@cchmc.org.

  • Publications and Funding

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    Noll, JG. A Prospective Confirmation of High Teenage Birthrates for Sexually Abused and Neglected Females. Pediatrics (In Press)

    Noll, JG, Haralson, KJ, Butler, EM & Shenk, CE. Child maltreatment, psychological dysregulation and risky sexual behaviors in female adolescents. Journal of Pediatric Psychology 2011; 36(7):743-752. PMCID: PMC3146756.

    Negriff S, Noll JG, Shenk CE, Putnam FW, Trickett PK. Associations between nonverbal behaviors and subsequent sexual attitudes and behaviors of sexually abused and comparison girls. Child Maltreatment. 15(2) 180-189. 2010.

    Noll JG, Shenk CE, Putnam KT. Childhood sexual abuse and adolescent pregnancy: A meta-analytic update. Journal of Pediatric Psychology. 34(4):366-78. 2009.

    Noll JG. Sexual abuse of children—unique in its effects on development?Child Abuse & Neglect. 32(6):603-5. 2008.

    Noll JG, Trickett PK, Putnam FW. A prospective investigation of the impact of childhood sexual abuse on the development of sexuality. Journal of Consulting and Clinical Psychology. 71(3):575-86. 2003.

    A Prospective Investigation of the Mechanisms Involved in Teen Pregnancy.
    Principal Investigator Noll; NIH/NICHD R01HD052533
    2007-2012

  • Pathways to teen pregnancy.

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