A TEST OF WHETHER DIFFICULTIES IN EMOTION REGULATION EXPLAIN THE RELATION OF ATTACHMENT WITH RISKY SEXUAL BEHAVIORS, ATTITUDES, AND SELF-EFFICACY
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The incidence of human immunodeficiency virus (HIV) and other sexually transmitted infections (STI) has increased among adolescents and young adults due to the prevalence of risky sexual behaviors. Adolescents with severe psychopathology may be particularly at risk. Interventions based on decision-making models of risky sexual behaviors have shown inconsistent results. Recent research emphasis on attachment processes and difficulties in emotion regulation suggests these factors may influence risky sexual behaviors, yet the underlying mechanism connecting these variables has not been explored. The primary aim of the present study was to examine whether lower levels of difficulties in emotion regulation would explain the relation of greater attachment security to mother, father, and peers, independently, with fewer risky sexual behaviors among inpatient adolescents. A secondary aim was to examine whether difficulties in emotion regulation explained the relation of attachment with sexual attitudes and self-efficacy. Results showed that attachment to mother and to peers, but not attachment to father, exerted an indirect effect, via difficulties in emotion regulation, on number of sexual partners and alcohol/substance use concurrent with sex. However, the observed indirect effect showed that greater attachment security associated with more sexual partners and alcohol/substance use concurrent with sex. Greater attachment security to mother indirectly associated with greater self-efficacy to negotiate condom use via lower levels of difficulties in emotion regulation. However, no indirect effect was observed upon sexual attitudes or self-efficacy to refuse sex. Findings reflect the development of normative sexual behavior among adolescents, with greater attachment security facilitating fewer difficulties in emotion regulation and more sexual exploration. More research is needed to clarify the functions of attachment and emotion regulation in normative sexual development.