Love hurts (in more ways than one): Specificity of psychological symptoms as predictors and consequences of romantic activity among early adolescent girls.

The emergence of romantic relationships in adolescence is a developmentally normative occurrence and an important context for the acquisition of relationship skills. However, evidence indicates that romantic involvement might have deleterious trade-offs. Romantic relationships might challenge adolescents’ coping resources and might expose them to stressors that require significant emotion regulation skills, thereby increasing the likelihood that romantic activities will be associated with negative affect (see Davila, 2008). Indeed, numerous studies have demonstrated a positive association between adolescent romance and depressive symptoms. Specifically, research consistently demonstrates that greater involvement in adolescent romantic activities (including both dating experiences, such as going on dates or being in a relationship, as well as sexual experiences, including intercourse and nonintercourse behaviors) (a) is concurrently associated with reports of greater depressive symptoms, (b) predicts increases in depressive symptoms over time, and (c) is predicted by prior depressive symptoms (e.g., Compian, Gowen, & Hayward, 2004; Davila, 2008; Davila, Steinberg, Kachadourian, Cobb, & Fincham, 2004; Davila, Stroud et al., 2009; Joyner & Udry, 2000). The association between early adolescent romantic activities and depression has been interpreted as evidence that romantic experiences are particularly, and perhaps uniquely, linked to depression (see Davila, 2008). It is unclear if this is actually the case, however, because the specificity of this association has never been tested, a critical limitation of the literature. Diagnostic specificity refers to the extent to which a variable’s association with a syndrome cannot be better accounted for by a co-occurring symptom or diagnosis. If an association is not diagnostically specific, it is instead spurious, meaning that other factors more precisely account for its existence (see Joiner, Metalsky, Katz, & Beach, 1999). Compared with research on depression, considerably less research has examined the relation between adolescent romantic experiences and other types of psychological symptoms, and existing studies have generally not controlled for symptoms of co-occurring disorders. There are several compelling reasons to examine adolescent romantic activity in relation to a range of psychological symptoms. First, depressive symptoms rarely occur in isolation. Over 70% of adolescents with a depressive disorder have an additional Axis I disorder (Karlsson et al., 2006), with depression showing pronounced co-occurrence with a broad range of clinical disorders and subthreshold symptoms (Essau, Conradt, & Petermann, 1999; Karlsson et al.; Sanford, Szatmari, Spinner, & Munroe-Blum, 1995; Wittchen, Stein, & Kessler, 1999). Comorbidity might produce spurious associations between depression and romantic experiences, as their relation might be more precisely accounted for by symptoms of a co-occurring disorder. Likewise, the relation between other types of symptoms and romantic experiences might be best accounted for by co-occurring depressive symptoms, and thus analyses should control for depression. In the current study, we do so by examining associations among romantic experiences, depressive symptoms, and symptoms of anxiety, externalizing, and eating disorders. Determining specificity and nonspuriousness is an important component of evaluating risk factors for (and consequences of) psychopathology (Garber & Hollon, 1991; Hollon, Kendall, & Lumry, 1986). In addition, exploring romantic activities within a broader context of psychological symptoms might more accurately reflect interrelated associations. Along similar lines, Jessor and colleagues (Donovan & Jessor, 1985; Donovan, Jessor, & Costa, 1988, 1991; Jessor, 1992, 1993; Jessor & Jessor, 1977; Jessor et al., 2003) delineated a model of problem behaviors in adolescence to explain why adolescent oppositional behaviors, substance abuse, and risky health decisions tend to co-occur, suggesting that interrelated risk factors, such as low self-esteem and poor familial and social environments, provoke a wide range of problem behaviors. In turn, these behaviors lead to common negative outcomes, such as depression and early sexual activity. As a result, disparate problem behaviors tend to cluster together in adolescence, comprising a single, multifaceted syndrome. In the context of this model, it is possible that romantic experiences, rather than being uniquely associated with depressive symptoms, fit within a wider net of experiences linked to several types of psychological problems through a shared set of pathways. As such, examining several types of symptoms at once, rather than focusing exclusively on depressive symptoms, might provide a fuller view of how these processes unfold. The current state of the literature does not clearly identify which types of adolescent psychopathology, in addition to depressive symptoms, are linked to romantic involvement. As explained below, several types of psychological symptoms are conceptually likely to relate to adolescent romantic experiences. Here, we examine three types of symptoms, in addition to depressive symptoms: anxiety, externalizing symptoms, and eating disorder symptoms.