A meta-analytic review of the relationship between adolescent risky sexual behavior and impulsivity across gender, age, and race

Background: Impulsivity is frequently included as a risk factor in models of adolescent sexual risk-taking; however, findings on the magnitude of association between impulsivity and risky sexual behavior are variable across studies. The aims of the current meta-analysis were to examine (1) how specific impulsivity traits relate to specific risky sexual behaviors in adolescents, and (2) how the impulsivity-risky sex relationship might differ across gender, age, and race. Method: Eighty-one studies were meta-analyzed using a random effects model to examine the overall impulsivity-risky sex relationship and relationships among specific impulsivity traits and risky sexual behaviors. Results: Overall, results revealed a significant, yet small, association between impulsivity and adolescent risky sexual behavior (r = 0.19, p < 0.001) that did not differ across impulsivity trait. A pattern of stronger effects was associated with risky sexual behaviors as compared to negative outcomes related to these behaviors. Gender moderated the overall relationship (beta = 0.22, p = 0.04), such that effect sizes were significantly larger in samples with more females. Age, race, study design, and sample type did not moderate the relationship, although there was a pattern suggesting smaller effects for adolescents in juvenile detention settings. Conclusions: Adolescent samples with more females showed a larger impulsivity-risky sex relationship, suggesting that impulsivity may be a more important risk factor for risky sex among adolescent females. Research and treatment should consider gender differences when investigating the role of impulsivity in adolescent sexual risk-taking. (C) 2014 Elsevier Ltd. All rights reserved.