父母教養方式發展軌跡與青少年過早初次性行為之關係

Abstract

背景：隨著時代的變遷和性觀念的改變，青少年的過早初次行為是全球公共衛生的重要議題。國內外的許多文獻指出，青少年過早初次性行為會導致未來罹患性傳染病的風險增加、造成非預期懷孕，也會影響青少年未來的行為與發展。父母教養對於青少年的健康及健康行為扮演重要角色，且父母教養方式會隨著不同的生命歷程而有所變化，然而目前針對教養方式與青少年過早初次性行為的研究，缺乏教養方式發展軌跡與青少年過早初次性行為關係的探討。

目的：本研究希望透過次級資料分析，探討父母教養方式，包括：監督與心理控制，在樣本9–15歲時的發展軌跡樣貌，並檢驗不同教養軌跡間的關連性。此外，本研究進一步分析父母教養方式發展軌跡與青少年在16歲時過早初次性行為的關聯性及其中的性別差異。

方法：本研究的資料來源為「兒童與青少年行為之長期發展研究」(Child and Adolescent Behaviors in Long-term Evolution，簡稱CABLE)，取用其2001年就讀小一的第一世代樣本，並使用2003–2010年有完整追蹤的資料進行分析，共2,618名。主要統計分析方法為群組化軌跡模型 (Group-based trajectory modeling) 以及多元邏輯斯迴歸 (Multiple logistic regression)。

結果：根據群組化軌跡模型的結果，父母監督發展軌跡可以分為四種軌跡類型：低緩降組 (18.30%)、先升後持 (25.29%)、高下降組 (33.27%) 和持續高組 (23.41%)；父母心理控制發展軌跡也可以分為四種軌跡類型：低持平組 (36.17%)、中持平組 (48.70%)、高下降組 (5.84%) 和中上升組 (9.28%)。進一步比較父母監督與父母心理控制的關係，發現父母監督軌跡與父母心理控制軌跡呈現負相關。 根據邏輯斯回歸的結果，與父母監督發展軌跡「低緩降組」相比，「先升後持」與「持續高組」的青少年在過早初次性行為的可能性顯著較低，勝算比分別為0.46（95%信賴區間介於0.25至0.85）、0.45（95%信賴區間介於0.22至0.93）。然而，與父母心理控制發展軌跡為「低持平組」者相比，「中持平組」、「高下降組」和「中上升組」的青少年在過早初次性行為的可能性皆沒有統計的顯著差異。此外，本研究發現父母監督發展軌跡與過早初次性行為的關係並無性別差異。最後，在其他因素方面，有性活躍同儕、有飲酒經驗和非雙親的家庭結構，亦是青少年過早初次性行為的危險因子。

結論：本研究發現父母教養方式在孩子9 - 15歲之間會有不同的發展軌跡，此外維持一定程度的父母監督對青少年的過早初次性行為有保護效果，且並不存在性別間的差異。根據本研究結果，建議更多關注青少年過早初次性行為議題。另外，應協助兒童、青少年父母持續給予孩子適當的監督，有助於預防過早初次性行為。

Background: Adolescent early sexual debut (ESD) have been an important public health issue worldwide. Research has shown that adolescent ESD increases the risk of acquiring sexually transmitted diseases, unintended pregnancy, and affect adolescents' behavior development. Parenting practice may change across the different life stages and play an important role in adolescents’ health and health behavior. However, research examining the associations between trajectories of parenting practice and ESD among adolescents remains limited.

Aims: This study aims to identify trajectories of parental monitoring and psychological control among adolescents aged 9–15 years old and examine the interrelationships among different trajectories of parenting practices. In addition, the associations between trajectories of parenting practices and adolescents’ ESD at the age of 16 were investigated as well as the potential sex differences in these associations.

Method: Data were obtained from the Child and Adolescent Behaviors in Long-term Evolution project. Analysis included 2,618 participants from cohort one, spanning the years 2003 to 2010. Group-based trajectory modeling and multiple logistic regression were conducted to test study hypotheses.

Result: Four distinct trajectories of parental monitoring were observed; low-descent group (18.30%), rising-then-maintain group (25.29%), high-descent group (33.27%), and persistent-high group (23.41%). Likewise, four trajectories of parental monitoring were identified: low-stable group (36.17%), moderate-stable group (48.70%), high-descent group (5.84%), and moderate-ascent group (9.28%). Furthermore, parental monitoring was found to be negatively associated with parental psychological control.

The results of multiple logistic regression showed that compared to adolescents in the "low-descent group" of parental monitoring trajectory, those in the "rising-then-maintain group" and "persistent-high group" had significantly lower likelihoods of ESD. No sex differences were found in the observed associations. Unexpectedly, there was no statistically significant association between trajectories of parental psychological control and ESD. Finally, having sexually active peers, drinking experience, and single-parent household were also identified as risk factors of ESD.

Conclusion: This study identified distinct trajectories of parenting practices among children aged 9 – 15. Additionally, parental monitoring emerged as a protective factor of ESD. These findings underscore the importance of addressing the issue of adolescent ESD and emphasize the necessity of assisting parents in maintaining a certain level of monitoring over their children to prevent ESD.