Original studies
Adolescent Girl's Coping With an STD: Not Enough Problem Solving and Too Much Self-Blame

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Abstract

Study Objective: Approximately three million teenagers are infected with an STD each year. The ways in which an adolescent girl copes with an STD may have implications for future risk and for psychological adjustment. The purpose of the current study was to compare whether coping with an STD was similar to coping with other stressors.

Setting: Urban, hospital-based adolescent medicine clinic.

Design and Participants: Sixty-seven girls with a mean age of 15.9 (sexual debut was 13.8) yr completed the KIDCOPE in response to both an STD acquisition and an interpersonal stressor within the previous 6 months.

Results: Problem solving was used less often, and self-blame was used more often, in response to an STD acquisition. Frequency of use of self-blame was not correlated with perceived helpfulness.

Conclusions: These findings suggest that clinicians need to help adolescent girls manage STD acquisition from the perspective of problem solving rather than self-blame.

Introduction

It is estimated that three million teenagers are infected with sexually transmitted diseases (STDs) each year.1 The sequelae of STD acquisition for women and their infants include cervical cancer, neonatal transmission, and involuntary infertility.1 With the advent of noninvasive techniques such as urine-based screening for chlamydia and gonorrhea2 and serological testing for HSV-2,2, 3 health-care providers are in the position to identify adolescents with STDs to an unprecedented extent. The strategies an adolescent uses to cope with the diagnosis may have an impact both on psychological morbidity and on the risk for future acquisition.4 The effectiveness of adolescent girls' coping may be variable. For example, adolescent girls used wishful thinking but did not find it helpful and reported risk-reducing behaviors that they did not actually implement.5, 6 Certainly, repeat STD infections are common among adolescents.7 The impact of the diagnosis may be less related to the type of STD (i.e., bacterial or viral) than characteristics of the girls.8 Therefore, the purpose of this study was to extend previous research by evaluating whether coping strategies used for an STD acquisition are similar to those used for other life stressors. Coping with a stressor associated with a friendship was chosen since these are common in every adolescent's life.

Section snippets

Sample

The subsample for this study was drawn from a sample of 174 girls who were enrolled in a longitudinal study of psychosexual development and STD acquisition.9 The girls were between 12 and 15 yr at the time of recruitment. Participants were interviewed every six months for a total of seven waves of data collection (3 yr). Those girls who were sexually experienced received a medical evaluation for STDs at each visit. For purposes of the current study, analyses were conducted on data collected

Results

There were 67 girls with an STD history. For the first visit at which they reported this history, they had a mean age of 15.9 yr (range 13–18 yr). The girls had a mean age of sexual initiation of 13.8 yr (range 11–17 yr). The racial breakdown of this subsample was 84% African-American and 16% Caucasian. Chlamydia (45%), gonorrhea (28%), and trichomoniasis (22%) were the most common pathogens reported at the visit of interest. With regard to the interpersonal stressor with a friend, most (78%)

Discussion

This study sought to extend previous work by examining adolescent girls' use of coping strategies for STD acquisition in comparison to an interpersonal stressor. The results of this study showed that some of the strategies were used differentially in response to the STD acquisition. In comparison to coping with an interpersonal stressor, adolescents were less likely to report having found something positive in getting an STD (cognitive restructuring), less likely to be able to distract

Acknowledgements

The authors would like to acknowledge the support, in part, by Maternal and Child Health Grant No. MCJ-964; National Institutes of Health Grant No. AI35087, and General Clinical Research Centers Program, National Center for Research Resource, National Institutes of Health; Laura Pace for data management; and Mary Clements for secretarial support.

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