Clinical Research Center, Boston Children's Hospital, 300 Longwood Ave., Boston, MA, 02115, USA,
Arch Sex Behav. 2013 Oct;42(7):1209-16. doi: 10.1007/s10508-012-0048-y. Epub 2013 Jan 8.
Depressed adolescents are more likely to engage in sexual risk behaviors than their non-depressed peers. The objectives of this study were (1) to examine whether affective states predicted subsequent condom use, directly or indirectly through contextual factors and (2) to compare results obtained from structural equation models versus non-linear mixed effects models. This study used ecological momentary assessment to collect data on in-the-moment affective states and sexual behavior from 51 depressed adolescents (7 male, 44 female) aged 15-22 years. The association between positive and negative affect and condom use during a subsequent sex event was explored using several structural equation models and non-linear mixed effects models. Potential mediation by substance use before sex, partner type, reason for sex, and who wanted sex was examined. Neither positive nor negative affect was directly associated with condom use in any models; however, negative affect was associated with increased likelihood of sex with a non-main partner, which, in turn, was associated with increased condom use. Both structural equation models and non-linear mixed effects models successfully modeled the relationship between affect and condom use in momentary data while correctly accounting for the correlation of multiple observations from the same individual. The benefit of structural equation modeling was the ability to directly model the mediation of this effect by contextual factors. In this sample of depressed adolescents, negative and positive affect did not appear to be directly predictive of condom use during a subsequent sex event, although may indirectly affect condom use through sex with a non-main partner.
抑郁青少年比非抑郁青少年更有可能发生性行为风险行为。本研究的目的是（1）检验情感状态是否直接或间接地通过情境因素预测随后的 condom 使用，以及（2）比较结构方程模型与非线性混合效应模型的结果。本研究使用生态瞬时评估来从 51 名 15-22 岁的抑郁青少年（7 名男性，44 名女性）中收集关于即时情感状态和性行为的数据。使用几种结构方程模型和非线性混合效应模型来探讨积极和消极情感与随后性行为中 condom 使用之间的关联。检验了性行为前物质使用、伴侣类型、性行为原因和谁想要性行为的潜在中介作用。在任何模型中，积极或消极的情感都与 condom 使用没有直接关联；然而，消极的情感与与非主要伴侣发生性行为的可能性增加有关，而这反过来又与 condom 使用的增加有关。结构方程模型和非线性混合效应模型都成功地对即时数据中情感与 condom 使用之间的关系进行建模，同时正确地考虑了来自同一个体的多个观察值的相关性。结构方程模型的优势是能够直接对这种效应通过情境因素的中介作用进行建模。在这个抑郁青少年样本中，消极和积极的情感似乎并没有直接预测随后性行为中的 condom 使用，尽管可能通过与非主要伴侣发生性行为间接影响 condom 使用。
