Emotional regulation (ER) skills training lowers the likelihood that young adolescents with mental health symptoms will have vaginal sex.
“The inclusion of ER training in a small-group behavioral intervention reduced sexual risk behaviors among seventh-graders with suspected mental health symptoms over a 2.5-year follow-up beyond that achieved with more traditional health education,” wrote Chistopher Houck, PhD, and his colleagues at Bradley Hasbro Children’s Research Center, Providence, R.I., in Pediatrics. “This was true across a range of behaviors, such as engaging in fewer condom-less sex acts, being less likely to have multiple partners, and being less likely to use substances before sex.”
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Students in the study participated in one of two after school intervention programs, either ER or health promotion (HP). Both programs consisted of 12 twice-weekly, hour-long sessions composed of single-sex groups of 4-8 adolescents. Two follow-up sessions were provided for both groups at 6 and 12 months. Both interventions used identical techniques, such as interactive games, videos, group discussions, and workbook assignments. ER sessions focused more on recognizing feelings, strategies for reducing momentary emotional arousal, and sexual health topics. HP exclusively focused on health topics like sexual risk and substance abuse but did not include emotional education.
During the 30-month study, 63 in the ER group (31%) and 68 students in the HP group (39%) reported having vaginal sex for the first time. This equated to an adjusted hazard ratio that indicated a delay in vaginal sex in the ER group (0.61; 95% confidence interval,0.42-0.89). Overall, students in the ER group were much less likely to endorse risky sexual behaviors than did participants in the HP group: Students in the ER group were less likely to endorse any risky sexual behavior (adjusted odds ratio, 0.52; 95% CI, 0.32-0.84), to support having multiple partners within 6 months (aOR, 0.54; 95% CI, 0.30-0.99), and to support the use of drugs before sex (aOR, 0.42; 95% CI, 0.23-0.75). Students in the ER group also reported fewer condom-less sex acts, compared with students in the HP group (adjusted rate ratio, 0.36; 95% CI, 0.14-0.90).
According to Dr. Houck and his colleagues, this study had several limitations that are common to sexual risk studies. One limitation is the reliance on self-report data, which can be biased. Dr. Houck and his associates utilized computer-assisted self-interviews to minimize biases. Another, and potentially larger, limitation is that the study was powered to assess delay of vaginal sex. Part of the patient sample was not sexually experienced, which provided less power for comparisons to other sexual behaviors.
Dr. Houck and his colleagues also spoke to the potential that ER training has in reducing risky behaviors of adolescents, as well as the issues in implementing it.