Does Sexual Force/Coercion Mediate the Relationship Between Early Age at Sexual Initiation and Depression?

Background: A great deal of research and public policy has advised that there is a link between early sexual initiation and poor psychological outcomes, such as depression. Hypothesized explanations for this association often allude to a lack of developmental readiness. Strikingly lacking throughout the early sexual initiation literature, however, is an in-depth consideration of sexual force/coercion.  Prevalence rates of forced sex for adolescents who have sex earlier than their peers are 2 to 3 times higher than those for adolescents who have sex later (Kaplan et al., 2013), and previous research has shown that, due to the realities of child development, non-voluntary sex is more common than voluntary sex at younger ages (Abma, Driscoll, & Moore, 1998). Given that sexual force/coercion is widely accepted as a significant predictor of depression, the present study theorizes that the younger youth are when they first have sex, the less likely it is that they are meaningfully able to choose whether or not they participate in that sex, and the more likely it is that subsequent depressive symptoms develop due to the forced/coerced sexual experience, rather than due to a direct effect of age at first sex. The study aims to evaluate this theory by analyzing the extent to which force/coercion mediates the relationship between age at sexual initiation and depression.

Method: The analyzed sample consisted of 4,164 participants from the 1994-2008 National Longitudinal Study of Adolescent Health (Add Health), a nationally representative study of youth who were interviewed at 4 separate intervals, beginning in their 7-12^th grades and ending when participants were between 24 and 32 years old. Path analysis was conducted to investigate the relationships among age at sexual initiation, sexual force/coercion, and later depressive symptomology. Sobel’s test was then applied to measure the significance of mediation.

Results: As expected, younger ages at sexual initiation significantly increased the likelihood of sexual force/coercion, and age at sexual initiation and sexual force/coercion separately significantly predicted subsequent depression outcomes while controlling for demographic variables (sex, highest parental education level, age at interview, and race/ethnicity). When input into the hypothesized path model together, however, sexual force/coercion significantly mediated the relationship between one’s age at sexual initiation and depressive symptomology in young adulthood (p < .0001).

Conclusion: This study found that age at sexual initiation’s effect on subsequent depression outcomes is significantly explained by sexual force/coercion. Findings emphasize the need for further consideration of youths’ capacity to choose when addressing their sexual experiences in research, practice, and policy. Implications of this study for policies that seek to prevent later depression in youth are supportive of redirecting emphasis of prevention and treatment efforts towards the concerns of sexual force/coercion in childhood and adolescence rather than on youths’ timing of sexual initiation by choice.