Biomedical subjects
Vaughn I Rickert
Publications and source records attributed to Vaughn I Rickert.
Prevalence and risk factors for LSD use among young women.
STUDY OBJECTIVE: To report the lifetime prevalence of lysergic acid diethylamide (LSD) and to identify unique correlates of using this substance in the last year among a large multiethnic sample of sexually active adolescent and young adult women aged 14 to 26 yrs. DESIGN, SETTING, PARTICIPANTS: A cross-sectional survey, administered at university-based ambulatory reproductive health clinics, was completed by 904 women between April and November of 1997 to identify risk factors associated with their use of LSD within the past 12 months. Subjects who reported lifetime, but not past 12 months', use of marijuana, LSD, or other illicit drugs were excluded, leaving a sample of 368 nonusers and 56 users of LSD. In addition, 231 young women who reported only using marijuana in the last year were used as a comparison group to identify unique factors associated with LSD use. RESULTS: Of the total sample (n=904), 13% (n=119) reported lifetime use of LSD, and 58% (n=536) reported lifetime use of marijuana. Logistic regression analyses controlling for age and race/ethnicity found distinct profiles for those who reported using LSD or only marijuana in the last year when compared to those who reported no substance use. Common to both groups was reporting being drunk at least 10 times during the last year, regular smoking of at least half a pack of cigarettes, and identification as a high-sexual-risk taker. However, LSD users as compared to nonusers were more likely to report white ethnicity (as compared to nonwhite), be less than or equal to 17 years of age (as compared to at least 18 years), report a history of physical abuse, and be categorized as having severe depressive symptomatology. In contrast, those who reported only using marijuana were more likely to report single marital status, young age at first intercourse, having half or more of their friends use marijuana, and poor grades. CONCLUSIONS: The female LSD user presents a distinct profile that might aid clinicians in identifying potential LSD use in this population as well as alerting clinicians to the relationship between LSD use and high-risk sexual behaviors.
Prevalence and patterns of intimate partner violence among adolescent mothers during the postpartum period.
OBJECTIVE: To examine prevalence, frequency, severity, and patterns of intimate partner violence (IPV) during the first 24 months' post partum within a multiethnic cohort of adolescents. DESIGN: A prospective study of adolescent girls followed up for 24 months into the postpartum period. Follow-up surveys were completed at 3, 6, 12, 18, and 24 months' post partum. Overall, 74% completed at least 4 of the 5 follow-up surveys. SETTING: Postpartum unit at a university teaching hospital in Galveston, Tex. PARTICIPANTS: A total of 570 adolescents (18 years or younger; 219 Mexican Americans, 182 African Americans, and 169 European Americans) completed face-to-face interviews within 48 hours of delivery and returned at least 4 of 5 follow-up surveys. MAIN OUTCOME MEASURES: Prevalence of IPV and frequent and severe IPV. RESULTS: Prevalence of IPV was highest at 3 months' post partum (21%) and lowest at 24 months (13%). The percentage of assaulted mothers who experienced severe IPV increased from 40% to 62% across this period. Seventy-five percent of mothers reporting IPV during pregnancy also reported IPV within 24 months following delivery. Of importance, 78% who experienced IPV during the first 3 postpartum months had not reported IPV before delivery. Ethnic differences in IPV were observed at 3, 6, and 18 months' post partum. CONCLUSIONS: Adolescents are at high risk for experiencing IPV during the postpartum period. Frequent screening for IPV by health care practitioners is critical to maximize detection.
Effect of abuse on health: results of a national survey.
HYPOTHESIS: The magnitude of risk would be highest for those reporting both types of abuse compared with those reporting 1 type or none. OBJECTIVE: To examine the independent associations between physical or sexual abuse or both and self-reported health status, mental health, and health-risk behaviors among a national school-based sample of adolescent girls. DESIGN: A secondary data analysis of a cross-sectional survey. SETTING: A nationally representative sample of 3015 girls in grades 5 through 12 from 265 public, private, and parochial schools (with an oversampling of urban schools) completed an anonymous survey conducted by the Commonwealth Fund Adolescent Health Survey. PATIENTS OR OTHER PARTICIPANTS: Girls were eligible for this study if they responded to 2 questions assessing past physical and sexual abuse. RESULTS: Among the respondents, 246 (8%) reported a history of physical abuse; 140 (5%), sexual abuse; and 160 (5%), both. Logistic regression controlling for grade, ethnicity, family structure, and socioeconomic status found that those who reported both types of abuse compared with those who did not report any were significantly more likely to experience moderate to severe depressive symptoms (adjusted odds ratio [AOR], 5.10), moderate to high levels of life stress (AOR, 3.28), regular smoking (AOR, 5.90), regular alcohol consumption (AOR, 3.76), use of other illicit drugs in the past 30 days (AOR, 3.44), and fair to poor health status (AOR, 1.74). Finally, girls who reported both types of abuse were 2.07 times more likely to report moderate to high depressive symptoms compared with those reporting only sexual abuse (95% confidence interval, 1.14-3.74). CONCLUSIONS: The magnitude of risk for adolescents reporting both types of abuse compared with no abuse is much greater than that for either abuse type alone. However, compared with both types, no significant increase in risk was detected in those reporting physical abuse only, and only depressive symptoms increased in those reporting sexual abuse only.
Rave culture and drug rape.
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Physical activity levels among urban adolescent females.
STUDY OBJECTIVE: To examine the proportion of girls engaging in vigorous physical activity in a sample of inner-city adolescent girls and to identify factors associated with this level of exercise. In addition, to report perceived barriers to exercise. DESIGN: Prospective cross-sectional survey. SETTING: Primary care health center. PARTICIPANTS: Females residing in a large northeastern city aged 12-21 yr (n = 305) who presented to a primary care site between September 2000 and May 2001 were consecutively recruited. MAIN OUTCOME MEASURE: In addition to being measured for height and weight, each subject anonymously completed a self-report instrument assessing demographic and reproductive characteristics, weight concerns, number of friends who exercise, medical conditions limiting exercise, and efforts to alter weight status. To compare with other published research, we used standardized measures of vigorous physical activity. We also inquired about parent's weight, exercise, and health status. Finally, each subject was asked about access to physical education classes as well as perceived barriers to exercise. RESULTS: We found that 30.5% (n = 93) of inner-city females reported engaging in regular vigorous exercise in the last week, while 46.6% (n = 142) reported no physical activity. Five factors were significantly associated with regular vigorous exercise including: most or all friends exercised (AOR = 4.72); involved with a sports team (AOR = 3.59); trying to lose weight (AOR = 2.92); believing in the importance of exercise (AOR = 2.37; and being less than 17 years of age (AOR = 2.18). Time constraints and laziness were the most common reasons given for not engaging in physical activity. CONCLUSIONS: Among this sample of primarily minority, inner-city females, engaging in regular vigorous physical activity was much less than has been suggested by other studies. Research efforts to accurately measure physical activity levels among inner-city youth must continue concurrent to the development of health promotion interventions.
The relationship among demographics, reproductive characteristics, and intimate partner violence.
OBJECTIVE: Our purpose was to examine the associations between demographics and reproductive characteristics on the occurrence of intimate partner violence (IPV) in young women. STUDY DESIGN: An anonymous questionnaire was completed by 727 women between 14 and 26 years old who were seen in the family planning clinics in southeast Texas between March 1997 and February 1998 and who reported a current spouse or partner. Subjects completed a standardized measure of violence perpetrated by a partner and provided information on demographics and reproductive characteristics. Separate logistic regression analyses were used to analyze factors associated with physical and verbal violence. RESULTS: Significant and positive associations with physical violence were found for race, employment, and parity (> or =1); risk of verbal abuse included employment, history of sexual abuse, and inconsistent condom and prescription contraceptive use. Protective factors for physical violence included education level, use of hormonal methods of contraception or condoms at last intercourse, and older age at first intercourse and at first childbirth; protection from verbal assault included dual contraceptive use, as well as barrier and hormonal contraception at last intercourse. CONCLUSION: Different patterns of risk emerge between physical and verbal assault among young women seen in a publicly funded family planning clinic. Minority parous women with limited education, early onset of sexual activity, and who report no contraception use at last intercourse appear to be at highest risk for reporting physical violence, whereas history of sexual victimization, early sexual activity, and younger age at first child birth elevates risk for verbal abuse.
Adolescent dating violence and date rape.
PURPOSE OF REVIEW: In this review we intend to examine recent literature on dating violence among female adolescents, including prevalence, risk factors, sequelae, screening practices, and potential interventions. RECENT FINDINGS: Dating violence is perpetrated by both males and females and occurs frequently within heterosexual dating relationships. Attitudes toward physical aggression, including those of peers, and abuse by siblings predict later violence as victim and perpetrator. Victims of childhood or dating violence may be at greater risk of developing eating disorders. New strategies and measures to promote screening are available. SUMMARY: Dating violence occurs among all groups of adolescents with common and unique risk factors for dating violence found across adolescents grouped by race/ethnicity, sex, and prior victimization. Efforts to decrease dating violence should (1) increase the use of screening tools that measure victimization as well as attitudes and contextual parameters that promote dating violence; (2) increase self-efficacy to negotiate safer sex; (3) reduce the use/abuse of alcohol and other drugs that facilitate dating violence; and (4) eliminate the influence of negative peer behavior. Interventions to prevent dating violence will likely also reduce rates of unintended pregnancies, HIV, and sexually transmitted diseases among adolescents.
Is lack of sexual assertiveness among adolescent and young adult women a cause for concern?
CONTEXT: Understanding young women's sexual assertiveness is critical to developing effective interventions to promote sexual health and reduce sexual risk-taking and violence. Young women's perception of their sexual rights may vary according to demographic characteristics, sexual health behaviors and victimization history. METHODS: Data were collected from 904 sexually active 14-26-year-old clients of two family planning clinics in Texas, reflecting their perceptions of their right to communicate expectations about or control aspects of their sexual encounters. Logistic regression analysis was used to assess which characteristics were independently associated with believing that one never has each specified sexual right. RESULTS: Almost 2096 of women believed that they never have the right to make their own decisions about contraception, regardless of their partner's wishes; to tell their partner that they do not want to have intercourse without birth control, that they want to make love differently or that their partner is being too rough; and to stop foreplay at any time, including at the point of intercourse. Poor grades in school, sexual inexperience, inconsistent contraceptive use and minority ethnicity were independently associated with lacking sexual assertiveness. CONCLUSIONS: Many sexually active young women perceive that they do not have the right to communicate about or control aspects of their sexual behavior. Interventions to prevent sexually transmitted diseases, unwanted pregnancy and coercive sexual behaviors should include strategies to evaluate and address these perceptions.