Adolescent Perceived Costs and Benefits Scale for Sexual Intercourse

Abstract

The Adolescent Perceived Costs and Benefits Scale for Sexual Intercourse is an influential psychometric instrument developed by Stephen A. Small, Susan B. Silverberg, and Don Kerns (1993) to assess subjective cognitive appraisals regarding nonmarital adolescent sexual activity. Grounded in subjective expected utility theory, social cognitive theory, and adolescent decision-making models, the instrument operationalizes youth not as passive agents driven solely by biological impulses or peer pressure, but as rational cognitive decision-makers who weigh anticipated positive and negative consequences. The assessment comprises two independent, psychometrically robust subscales of 10 items each: the Perceived Costs Subscale (measuring anticipated deterrents including pregnancy, sexually transmitted infections, parental disapproval, moral conflict, and compromised educational aspirations) and the Perceived Benefits Subscale (measuring anticipated rewards including physical pleasure, emotional validation, peer conformity, perceived maturity, and affect regulation).

Each item is rated on a 4-point Likert-type scale (ranging from 0 to 3), generating separate composite scores from 0 to 30 for each dimension. Psychometric evaluations across diverse adolescent samples (including a primary validation cohort of N = 2,444 secondary school students) demonstrate excellent internal consistency, with Cronbach’s alpha reaching .86 for both the Perceived Costs and Perceived Benefits subscales. Test-retest reliability across a two-week interval yielded coefficients of .70 for perceived costs and .65 for perceived benefits in a sample of 124 adolescents. The scale displays strong criterion-related and construct validity, differentiating sexually active adolescents from their non-active peers, predicting contraceptive regularity, and capturing developmental shifts and gender differences across adolescence.

Keywords

Adolescent sexual behavior, perceived costs, perceived benefits, subjective expected utility, adolescent decision making, sexual debut, psychometrics, risk perception, health-compromising behavior, contraceptive consistency

Authors

The scale was conceptualized, developed, and empirically validated by:

• Stephen A. Small, Ph.D. — Professor Emeritus of Human Development and Family Studies, School of Human Ecology, University of Wisconsin–Madison, and Family Relations Specialist, University of Wisconsin–Extension. Contact: Department of Human Development and Family Studies, University of Wisconsin–Madison, 1430 Linden Drive, Madison, WI 53706; E-mail: [email protected].
• Susan B. Silverberg, Ph.D. — Associate Professor, Department of Family Studies and Human Development, University of Arizona (previously collaborating at the University of Wisconsin–Madison).
• Don Kerns, M.S. — Researcher in Child and Family Studies, University of Wisconsin–Madison.

Purpose

During the early 1990s, public health, developmental psychology, and sociomedical research frequently framed adolescent sexual activity through deficit-oriented and pathology-focused paradigms. Early sexual debut was primarily analyzed as a manifestation of delinquency, inadequate impulse control, deviant peer contagion, or broken family dynamics. While these perspectives identified critical sociological correlates, they frequently neglected the internal cognitive calculus and subjective agency of the adolescent. Stephen A. Small and colleagues developed the Adolescent Perceived Costs and Benefits Scale for Sexual Intercourse to address this conceptual omission, offering researchers and clinicians a standardized methodology to investigate adolescent sexual onset through an expectancy-value decision framework.

The central purpose of the scale is to quantify the subjective valence and cognitive importance that youth attach to the prospective outcomes of sexual intercourse. Rather than assuming that all adolescents harbor identical perceptions of risk or pursue uniform psychological incentives, the instrument recognizes that an individual’s behavioral trajectory is governed by their personal ratio of anticipated losses versus anticipated gains. The assessment has multiple core purposes across diverse contexts:

• Etiological Investigation: Delineating the precise motivational mechanisms that distinguish sexually active teenagers from abstinent peers, including how perceived costs function as cognitive barriers and perceived benefits operate as behavioral catalysts.
• Preventive Intervention Design: Enabling public health educators, school counselors, and sex education curriculum developers to tailor interventions to the empirical beliefs held by specific youth cohorts. For instance, interventions can directly target misplaced benefit beliefs (e.g., that sexual intercourse resolves emotional distress or guarantees relationship longevity) or reinforce salient cost evaluations (e.g., long-term vocational disruption).
• Contraceptive and Health Behavior Analysis: Providing a cognitive metric that correlates not only with sexual initiation itself but also with the regularity and diligence of contraceptive and barrier-method use among sexually active adolescents.
• Developmental and Demographic Mapping: Tracking longitudinal shifts in risk-reward calculations across early, middle, and late adolescence, illuminating how gender role socialization, parental monitoring, and academic aspirations recalibrate cost-benefit perceptions over time.

Psychological Construct

The scale operationalizes two primary, quasi-orthogonal cognitive dimensions: Perceived Costs and Perceived Benefits. Rather than viewing costs and benefits as polar ends of a single continuum, the theoretical architecture assumes that an individual can concurrently endorse high costs and high benefits, or conversely perceive low costs alongside low benefits. Each subscale captures an intricate constellation of psychosocial, interpersonal, emotional, and pragmatic considerations.

1. Perceived Costs Dimension

The Perceived Costs subscale measures the extent to which an adolescent believes that engaging in sexual intercourse will produce negative physical, psychological, social, or developmental outcomes. The ten items within this subscale encompass several distinct thematic domains:

• Physical and Biomedical Hazards: Direct recognition of somatic vulnerabilities, specifically the acquisition of sexually transmitted infections (STIs), human immunodeficiency virus (HIV/AIDS), or unplanned pregnancy (e.g., Item 2: “Teenagers don’t have sex because they don’t want to get a sexually transmitted disease (STD) or a disease like AIDS”; Item 6: “Teenagers don’t have sex because they or their partner might get pregnant”).
• Teleological and Educational Disruption: Cognitive appraisal of the long-term opportunity costs of sexual activity, notably the derailment of higher education, career aspirations, and life ambitions triggered by premature parenthood (e.g., Item 10: “Teenagers don’t have sex because they or their partner might get pregnant which might mess up their future plans for college, school or a career”).
• Interpersonal Disapproval: Sensitivity to social sanctions from significant attachment figures, particularly parents and friendship networks (e.g., Item 3: “Teenagers don’t have sex because their parent(s) don’t approve”; Item 5: “Teenagers don’t have sex because their friends won’t approve”).
• Internalized Moral and Affective Distress: Moral, ethical, or spiritual incongruence and anticipated negative affective states such as shame or guilt (e.g., Item 1: “Teenagers don’t have sex because they think it is morally wrong or against their religion”; Item 9: “Teenagers don’t have sex because they would feel guilty”).
• Developmental Incompetence and Emotional Autonomy: Subjective recognition of psychological unreadiness or an autonomous evaluation that sexual activity is non-essential for current subjective well-being (e.g., Item 4: “Teenagers don’t have sex because they don’t feel old enough to handle it”; Item 8: “Teenagers don’t have sex because they don’t need it to make them happy”).

2. Perceived Benefits Dimension

The Perceived Benefits subscale assesses the perceived positive reinforcements, functional utilities, and psychosocial rewards that youth associate with sexual intercourse. The ten items span the following affective, developmental, and relational functions:

• Hedonic and Affective Gratification: Direct somatic pleasure and positive emotional states (e.g., Item 5: “Teenagers have sex because it makes them feel good”).
• Coping and Avoidant Escapism: The utilization of sexual activity as a maladaptive or palliative emotional regulation strategy to suppress stress or escape personal difficulties (e.g., Item 1: “Teenagers have sex because it helps them forget their problems”).
• Developmental Maturation and Self-Efficacy: The perception of sexual debut as a rite of passage marking adult status, maturity, and heightened personal confidence (e.g., Item 2: “Teenagers have sex because it makes them feel grown up”; Item 9: “Teenagers have sex because it makes them feel more confident and sure of themselves”).
• Relational Securitization and Intimacy: Using sex to foster, authenticate, or preserve romantic bonds and experience interpersonal love (e.g., Item 4: “Teenagers have sex as a way to get or keep a boyfriend or girlfriend”; Item 6: “Teenagers have sex because it makes them feel loved”).
• Social Conformity and Peer Prestige: Striving to meet normative peer expectations, emulate admired social models, or elevate status within the adolescent peer hierarchy (e.g., Item 7: “Teenagers have sex because they want to fit in with their friends”; Item 10: “Teenagers have sex because people they admire or look up to make it seem like a ‘cool’ thing to do”).
• Curiosity and Exploration: Developmental novelty-seeking and experiential experimentation (e.g., Item 8: “Teenagers have sex because they want to see what it’s like”).
• Procreative Intentions: Explicit desires to achieve pregnancy or transition into parenthood (e.g., Item 3: “Teenagers have sex because they want to get pregnant or become a parent”).

Theoretical Framework

The structural design of the Adolescent Perceived Costs and Benefits Scale rests at the intersection of several landmark theoretical models in cognitive psychology, behavioral economics, and developmental psychopathology.

1. Subjective Expected Utility (SEU) Theory

Rooted in neoclassical decision science (Edwards, 1954; Feather, 1982), Subjective Expected Utility Theory posits that when individuals are confronted with behavioral alternatives, they choose the course of action that maximizes subjective expected utility. Mathematically, this utility is a product of the subjective probability that an outcome will occur multiplied by the subjective value (valence) of that outcome. Small, Silverberg, and Kerns (1993) adapted this paradigm to adolescent developmental science, asserting that adolescents evaluate sexual initiation through an internal comparison of potential costs and benefits. When perceived benefits outweigh perceived costs, the cognitive probability of behavioral initiation escalates sharply.

2. The Health Belief Model (HBM)

Originally formulated by Rosenstock (1974) and expanded by Becker (1974), the Health Belief Model posits that health-compromising or health-protective actions are governed by perceptions of susceptibility to harm, the perceived severity of consequences, perceived benefits of preventative actions, and perceived barriers. The Perceived Costs subscale directly measures perceived severity and susceptibility regarding STIs, pregnancy, and educational derailment. Concurrently, the Perceived Benefits subscale measures the competing subjective payoffs that act as barriers to adopting abstinent or health-protective behaviors.

3. Bandura’s Social Cognitive Theory

Under Albert Bandura’s (1986) Social Cognitive Theory, human agency operates through triadic reciprocal causation among cognitive factors, behavioral patterns, and environmental influences. A cornerstone of this theory is outcome expectancies: beliefs concerning the probable consequences that behavior will yield. Outcome expectancies are divided into physical outcomes (sensory pleasure or disease), social outcomes (peer acceptance or parental disapproval), and self-evaluative outcomes (self-satisfaction or guilt). The 20 items of Small and colleagues’ scale map directly onto Bandura’s tripartite classification of outcome expectancies.

4. Jessor’s Problem Behavior Theory (PBT)

Richard Jessor and Shirley Jessor’s (1977) Problem Behavior Theory articulates that youth behaviors are driven by the dynamic balance between instigations (incentives, perceived value of nonconventionality) and controls (internalized personal beliefs, conventional values, and social controls). The perceived benefits subscale mirrors Jessor’s behavioral instigators, whereas the perceived costs subscale mirrors personal and social controls that maintain conventional behavior.

Validity

Empirical evaluations provide robust psychometric evidence for the construct, criterion-related, convergent, and discriminant validity of both subscales across multiple demographic cohorts (Small, 1991; Small et al., 1993; Small, 1996).

Criterion-Related and Known-Groups Validity

The scale effectively distinguishes adolescents based on their reported sexual intercourse status. In the primary validation study of 2,444 adolescents (Small, Silverberg, & Kerns, 1993):

• Sexual Activity Status and Perceived Costs: Non-sexually active adolescents endorsed significantly higher perceived costs for engaging in sexual intercourse compared to sexually active peers. The point-biserial correlation between sexual intercourse status and the Perceived Costs subscale was r = .32 (p < .001).
• Sexual Activity Status and Perceived Benefits: Sexually active adolescents perceived significantly greater benefits than non-sexually active adolescents, although the correlation was more modest (r = .11, p < .001). This finding aligns with theoretical predictions that perceived costs operate as primary cognitive deterrents to behavioral initiation, whereas perceived benefits alone may not induce behavior without an accompanying reduction in perceived costs.

Gender Differences in Valuation

In congruence with developmental and evolutionary psychological models, marked gender differences emerged across both dimensions:

• Perceived Costs: Adolescent females reported significantly higher perceived costs (M = 17.30, SD = 6.42) than adolescent males (M = 14.80, SD = 6.18; p < .001). This divergence reflects heightened structural and biological vulnerabilities borne by young women regarding unplanned pregnancy, childbearing, single parenthood, and gender-asymmetric social stigmatization.
• Perceived Benefits: Adolescent males perceived significantly more benefits (M = 18.22, SD = 5.81) than adolescent females (M = 17.68, SD = 5.75; p < .05), reflecting gendered peer norms that confer higher social status and masculine validation upon early sexual conquest.

Developmental Divergence and Cognitive Recalibration

Cross-sectional analyses across grade levels revealed a complex interaction between age and sexual experience. For non-sexually active adolescents, perceived benefit scores remained stable across secondary school grades. However, among sexually active adolescents, perceived benefit scores declined significantly after the 9th grade. Small et al. (1993) proposed two explanations for this pattern:

1. Experiential Disillusionment: Upon initiating sexual intercourse, adolescents discover that idealized expectations (e.g., that sex dissolves emotional stress, provides unyielding confidence, or guarantees peer admiration) do not materialize, leading to cognitive recalibration.
2. Normative Threshold Shifts: At younger ages (early adolescence), when sexual activity violates normative developmental expectations, adolescents must perceive extraordinarily high benefits to justify cross-boundary behavior. At older ages, as sexual activity becomes normative within peer groups, high anticipated benefits are no longer cognitively necessary to motivate initiation.

Contraceptive Consistency and Relational Validity

In subsequent analyses using the Teen Assessment Project (TAP) data, Small (1996) investigated the behavioral correlates of the scale among sexually active teens:

• Contraceptive Diligence: Regularity of birth control use among sexually active adolescents was significantly and positively correlated with the Perceived Costs subscale (r = .24, p < .001), but showed no correlation with the Perceived Benefits subscale. Adolescents who recognize the personal costs of STIs and pregnancy engage in more protective self-regulation during intercourse.
• Parent-Adolescent Relationship Quality: Adolescents reporting high parental warmth, open communication, and supportive relationships perceived significantly greater costs to sexual intercourse than peers reporting alienated or conflictual parent-child relations.
• Educational Aspirations: Small (1991) documented that adolescents aspiring to attend college were significantly more likely than non-college-bound peers to identify pregnancy and the disruption of future academic goals as primary deterrents.

Reliability

The psychometric evaluation of the Adolescent Perceived Costs and Benefits Scale demonstrates sound internal consistency and temporal stability across diverse adolescent demographics.

Internal Consistency

In the primary empirical validation study involving a multi-county sample of 2,444 middle and high school students (Small, Silverberg, & Kerns, 1993), internal reliability was calculated using Cronbach’s coefficient alpha:

• Perceived Costs Subscale (10 items): α = .86
• Perceived Benefits Subscale (10 items): α = .86

These coefficients exceed the standard .80 benchmark for psychometric adequacy in behavioral research, indicating high internal coherence among the constituent items without excessive redundancy.

Test-Retest Stability

Temporal stability was evaluated across a two-week test-retest interval in a subsample of 124 male and female secondary school students:

• Perceived Costs Subscale: r = .70 (p < .001)
• Perceived Benefits Subscale: r = .65 (p < .001)

These stability coefficients indicate reliable longitudinal measurement while preserving sensitivity to developmental shifts, environmental interventions, and changing relationship statuses.

Factor Analysis

The empirical development of the scale included multi-stage qualitative item derivation followed by exploratory and confirmatory factor analytic procedures. Extensive interviews with diverse cohorts of adolescents generated the initial pool of behavioral rationales. Pilot testing and subsequent exploratory factor analyses (EFA) demonstrated that perceived costs and perceived benefits do not load as opposing poles of a single bipolar construct, but instead emerge as two distinct, quasi-orthogonal latent dimensions.

A two-factor solution provided optimal theoretical and empirical fit:

• Factor 1: Perceived Costs: Items addressing pregnancy risks, disease vulnerability, moral guilt, parental censure, peer rejection, and academic derailment loaded heavily onto this factor (factor loadings > .50). Cross-loadings onto the benefits factor were negligible (< .15).
• Factor 2: Perceived Benefits: Items measuring physical pleasure, emotional security, coping/escapism, adult status, and peer conformity loaded cleanly onto this factor (factor loadings > .45).

The low inter-factor correlation between the two subscales (typically ranging between r = -.08 and r = .05 depending on sample demographics) confirms their orthogonality. This factorial independence demonstrates that adolescent cost-benefit appraisals are dual-process cognitive evaluations: an adolescent may simultaneously recognize extreme risks while anticipating substantial rewards.

Instrument / Measurement Tool

• Instrument Name: Adolescent Perceived Costs and Benefits Scale for Sexual Intercourse
• Authors: Stephen A. Small, Ph.D., Susan B. Silverberg, Ph.D., and Don Kerns, M.S.
• Publication Year: 1993
• Target Population: Adolescents and youth aged approximately 12 to 19 years (grades 7 through 12).
• Administration Type: Self-administered paper-and-pencil questionnaire or digital computer-assisted survey.
• Completion Time: Approximately 3 to 5 minutes per subscale (6 to 10 minutes for the full 20-item instrument).
• Scale Structure: 20 items organized into two 10-item subscales:
  • Perceived Costs Subscale: 10 items assessing reasons teenagers choose not to have sexual intercourse.
  • Perceived Benefits Subscale: 10 items assessing reasons teenagers choose to have sexual intercourse.
• Response Format: 4-point Likert-type scale scored as:
  • 0 = Strongly Disagree
  • 1 = Disagree
  • 2 = Agree
  • 3 = Strongly Agree

  (Note: When administered on machine-scorable forms, items may be presented with reverse code labels; scoring should be aligned so that higher numerical values consistently denote higher perceived costs or higher perceived benefits).

• Scoring Procedures:
  • Each subscale is scored independently by summing the 10 corresponding item responses.
  • Perceived Costs Score: Sum of Items 1 through 10 of the Costs subscale (Range: 0 to 30). Higher scores indicate greater perceived costs and stronger cognitive deterrents against intercourse.
  • Perceived Benefits Score: Sum of Items 1 through 10 of the Benefits subscale (Range: 0 to 30). Higher scores reflect greater perceived benefits and stronger cognitive incentives favoring intercourse.
  • No global composite score is calculated; costs and benefits are interpreted as distinct behavioral determinants.
  • Individual item profiling can be conducted to identify the modal reasons for sexual decision-making in specific demographic cohorts.

Permissions & Fee and Test Year

The Adolescent Perceived Costs and Benefits Scale for Sexual Intercourse was developed in 1993 as part of the University of Wisconsin–Madison Teen Assessment Project (TAP). The instrument was published in the peer-reviewed literature in the Journal of Youth and Adolescence (Small, Silverberg, & Kerns, 1993). The scale is made accessible for academic, clinical, non-profit, and public health research without commercial licensing fees, provided appropriate scholarly attribution and citation are maintained.

Researchers intending to adapt, translate, or incorporate the instrument into large-scale institutional assessments may correspond with the lead author:

Dr. Stephen A. Small
Department of Human Development and Family Studies
School of Human Ecology, University of Wisconsin–Madison
1430 Linden Drive, Madison, WI 53706, USA
Email: [email protected]

References

• Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50(2), 179–211. https://doi.org/10.1016/0749-5978(91)90020-T
• Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Prentice-Hall.
• Becker, M. H. (1974). The health belief model and personal health behavior. Health Education Monographs, 2(4), 324–473. https://doi.org/10.1177/109019817400200401
• Edwards, W. (1954). The theory of decision making. Psychological Bulletin, 51(4), 380–417. https://doi.org/10.1037/h0053870
• Feather, N. T. (Ed.). (1982). Expectations and actions: Expectancy-value models in psychology. Lawrence Erlbaum Associates.
• Jessor, R., & Jessor, S. L. (1977). Problem behavior and psychosocial development: A longitudinal study of youth. Academic Press.
• Philipp, M. (1993). From the adolescent’s perspective: Understanding the costs and benefits of using alcohol [Unpublished doctoral dissertation]. University of Wisconsin–Madison.
• Rosenstock, I. M. (1974). Historical origins of the health belief model. Health Education Monographs, 2(4), 328–335. https://doi.org/10.1177/109019817400200403
• Small, S. A. (1991, October). Understanding the reasons underlying adolescent sexual activity [Paper presentation]. Symposium on Teen Sexuality Challenge: Bridging the Gap between Research and Action, University of Wisconsin–Green Bay, Green Bay, WI, United States.
• Small, S. A. (1996). Teen Assessment Project findings [Unpublished data]. Department of Child and Family Studies, University of Wisconsin–Madison.
• Small, S. A., Silverberg, S. B., & Kerns, D. (1993). Adolescents’ perceptions of the costs and benefits of engaging in health-compromising behaviors. Journal of Youth and Adolescence, 22(1), 73–87. https://doi.org/10.1007/BF01537734

13. Items of the Scale (Questionnaire)