Preventive research related to adolescent risk behaviors is a public health priority. To rigorously assess the impact of primary prevention interventions, youth must be followed longitudinally. To be successful, longitudinal research on adolescents' risky behaviors requires that adolescents trust the researchers. Youth are unlikely to trust and disclose intimate information without the assurance of confidentiality, for fear parents or others will learn of their behavior, disapprove, and enact punitive measures. Informed consent is achieved only when study confidentiality requirements are clearly articulated, well understood, and assented to by both the parent and child. Consent forms must also state contingencies that would necessitate a breech in confidentiality. While there is general agreement that reports of abuse constitute imminent harm, and thus legitimize a break in confidentiality, there is less consensus and more ambiguity relative to whether other disclosures, such as drinking and driving, unprotected sex, and thoughts of suicide present the threat of imminent harm. Longitudinal study designs that ensure adolescent anonymity rather than confidentiality allow researchers to avoid the responsibility of breeching confidentiality, but may be unfeasible or problematic in other ways. These issues are discussed within the context of an adolescent alcohol/HIV prevention study. Concern over youth responses to a question on suicidal thoughts led investigators into a murky area where ethics, confidentiality, and research intersect. Unless confidential, longitudinal research can be conducted, efforts to understand the antecedents of risk behaviors and evaluate preventive interventions will be severely stymied.
Learning Objectives: Identify key ethical, logistical, and scientific issues related to imminent risk associated with adolescent self-disclosure. Critically evaluate the pros and cons when determining disclosure procedures related to imminent risk.
Keywords: Ethics, Adolescent Health
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Research funded by a grant from the National Institute on Alcohol Abuse and Alcoholism and conducted by the Laboratory of Health Behavior Assessment and Intervention, Department of Public and Community Health, University of Maryland at College Park
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Research Grant and Employment