SEXUAL BEHAVIOR DURING THE EMERGING ADULT YEARS: ATTACHMENT
AND SOCIAL SUPPORT PERSPECTIVES
Nicole D. Stillo, M.S.
Dissertation Prepared for the Degree of
DOCTOR OF PHILOSOPHY
UNIVERSITY OF NORTH TEXAS
August 2014
APPROVED:
Vicki L. Campbell, Major Professor and Chair of the Department of Psychology Shelley Riggs, Committee Member Timothy Lane, Committee Member Heidemarie Blumenthal, Committee Member Mark Wardell, Dean of the Toulouse Graduate School Stillo, Nicole D. Sexual Behavior during the Emerging Adult Years: Attachment and Social
Support Perspectives. Doctor of Philosophy (Counseling Psychology), August 2014, 143 pp., 10 tables, 9 figures, references, 128 titles.
The purpose of this study was to better understand sexual development during the transition to adulthood. Previous research was extended by testing models that examined direct effects of romantic attachment and social support on emerging adults’ sexual outcomes, as well as models that examined the mediating role of sexual motivations in those associations.
Undergraduate students (n = 290, 66% female) completed questionnaires that assessed romantic attachment, social support, sexual motives, risky sexual behaviors, and health- promoting sexual beliefs. Results indicated romantic attachment strongly predicted sexual functioning, such that higher levels of attachment insecurity were associated with fewer health- promoting sexual beliefs and more risky sexual behaviors. Attachment anxiety was most closely associated with sexual outcomes for females, while attachment avoidance was a stronger predictor of sexual outcomes for males. Furthermore, coping but not intimacy motivations were found to partially mediate the link between attachment anxiety and health-promoting sexual beliefs for females. Although overall relationships between social support and sexual outcomes were not significant as hypothesized, links between specific support sources and sexual outcomes emerged during further analysis. Conclusions underscore the usefulness of attachment theory as a framework for understanding sexual behavior and provide further support for the importance of considering gender differences when examining the interplay between the attachment and sexual systems. Practical implications for sexual health prevention and intervention efforts are discussed.
Copyright 2014
by
Nicole D. Stillo
ii ACKNOWLEDGEMENTS
As I reflect on the journey of this dissertation, I am eternally grateful for the support,
guidance, and encouragement from my committee members, friends, and family.
I would like to express my deepest appreciation to my advisor and committee chair, Dr.
Vicki Campbell, for providing me with a consistent, “secure” base from which I felt safe to
explore the world of research. I am thankful for her guidance, commitment to our weekly
meetings, and perfectly timed pep-talks. I would like to thank Dr. Shelley Riggs for her
contributions and encouragement to take this research further, as well as her formative role in
my clinical training as a family therapist. I would also like to acknowledge Dr. Timothy Lane and
Dr. Heidemarie Blumenthal for their insightful comments and thoughtful questions that helped
guide this project.
I’m grateful for my fellow graduate students in the Families and Futures Lab for their
continuous support and willingness to offer ideas and a helping hand. I am also appreciative of the undergraduate research assistants who helped to recruit participants and collect data. This project would not have been possible without their help.
I would also like to thank my family for their patience and unrelenting encouragement.
They have inspired my interest in studying protective family processes, which I have most
certainly benefited from throughout my work on this dissertation. Last, but certainly not least, I
would like to thank my partner and close friends for always lending an ear and providing helpful
distractions when I needed it most.
iii TABLE OF CONTENTS
Page
ACKNOWLEDGEMENTS…………………………………………………………………………………………………………..…iii
LIST OF TABLES……………………………………………………………………………………..…………………..………….……v
LIST OF FIGURES…………………………………….……………………………………………………………………..…….…….vi
Chapter
I. INTRODUCTION………………………….……………………………………………………………………….1
II. LITERATURE REVIEW…………………………………………………………………………..………………5
III. METHOD…………………………………………………………………………………………………………..38
IV. RESULTS……………………………………………………………………………………………………………47
V. DISCUSSION………………………………………………………………………………………………………68
APPENDICES…………………………………………………………………………………………………………………………..114
REFERENCES…………………………………………………………………………………………………………………………..125
iv LIST OF TABLES
Page
1. Frequencies for General Demographics …………………………………………………………………………….89
2. Frequencies for Romantic and Sexual History Demographics – All Participants……..…………..92
3. Frequencies for Sexually Active Participant Demographics……………………………………..………...94
4. Means, Standard Deviations, Ranges for All Variables……………………………………………….……….96
5. Means, Standard Deviations, Ranges for Recoded Sexual Risk Survey…………………………..…...98
6. Correlations for Key Variables and Scales’ Alpha Coefficients…………………………………….……...99
7. Correlations for Key Variables: Females Only…………………………………………………………..……..100
8. Correlations for Key Variables: Males Only……………………………………………………………………..101
9. Indices of Fit for Direct Effects Models…………………………………………………………………………….102
10. Indices of Fit for Indirect Effects Models……………………………………………………………...... 103
v LIST OF FIGURES
Page 1. Path model of the direct effects of attachment on sexual outcomes for men and women (Model 1)…………………………………………………………………………………….………..……..105
2. Path model of the direct effects of parental support on sexual outcomes for men and women in full sample (Model 2a)……………………………………….…….……..………………..106
3. Path model of the direct effects of parental and partner support on sexual outcomes for men and women in partial sample (Model 2b)…………………………………………………………...107
4. Path model of risky sexual behavior as a function of attachment specified to occur through sexual motives (Model 3)………………………………………………………………….…………...…..108
5. Path model of health promoting sexual beliefs as a function of attachment specified to occur through sexual motives (Model 4)…………………………………………………………..………….109
6. Path model of risky sexual behavior as a function of parental support specified to occur through sexual motives in full sample (Model 5a)…………………………………………………..110
7. Path model of risky sexual behavior as a function of parental and partner support specified to occur through sexual motives in partial sample (Model 5b)………………………....111
8. Path model of health-promoting sexual beliefs as a function of parental support specified to occur through sexual motives in full sample (Model 6a)……………………………….112
9. Path model of health-promoting sexual beliefs as a function of parental and partner support specified to occur through sexual motives in partial sample (Model 6b)…………....113
vi CHAPTER I
INTRODUCTION
Within the United States and other industrialized nations, the transition to adulthood
has undergone substantial change during the past several decades. While this time period was
once comprised of a relatively consistent collection of developmental tasks, increases in the
pursuit of post-secondary education and delays in marriage and parenthood have resulted in a
much longer transition from childhood to adulthood than in previous generations. Arnett
(2000) describes this unique developmental period as “emerging adulthood.” He notes that
emerging adults are a heterogeneous group comprised of individuals in their late teens through
mid-twenties who have exited adolescence but not fully entered young adulthood. Several
distinct features characterize this life stage, including greater opportunities for identity
exploration and self-focus, increases in personal freedom, and a sense of optimism about future possibilities (Arnett, 2006).
Additionally, many emerging adults describe a feeling of “in between.” While they no longer consider themselves to be adolescents, they often report that they do not consider themselves to be adults either (Arnett, 2000). During this transitional period, perceived support remains an important predictor of physical and psychological functioning (Moak &
Agrawal, 2009). Supportive relationships during emerging adulthood have been linked with a variety of positive developmental outcomes, including higher levels of social competence, life satisfaction, trust and tolerance of others, trust of authority, and civic action and engagement
(O’Connor et al., 2011). Romantic relationships, in particular, appear to be primary sources of emotional support and intimacy for emerging adults (Weiss, 1974).
1 However, this developmental period is also a time of increased vulnerability. Emerging
adults face considerable instability, with frequent changes in work, residence, and relationships
common during this life stage. Many emerging adults are confronted with the task of initiating
new roles, and separation from families and old friends often necessitates the development of
new social networks (Arnett, 2005; Schulenberg & Maggs, 2002). Such transitional periods
offer tremendous opportunities for personal growth and self-exploration, but for many, these
changes also contribute to feelings of anxiety and sadness. It has been suggested that
psychological responses to stressors play an important role in predicting emerging adults’
engagement in risky behaviors (Arnett, 2005). The normative decrease in parental monitoring
and freedom from role responsibilities, such as parenting, also appear to set the stage for
increased opportunities to experiment with risky behaviors.
In fact, emerging adults consistently demonstrate higher levels of risk behavior
compared with any other developmental period. Rates of illicit drug use, binge drinking, and
other high risk behaviors, such as driving under the influence of drugs and alcohol, are highest
during this life stage (Substance Abuse and Mental Health Services Administration [SAMHSA],
2005). Moreover, sexual activity on college campuses appears to be a normative occurrence,
with most studies suggesting that approximately 70% or more of college students are sexually
active (American College Health Association, 2008; Stillo, 2011). Although this statistic alone is not inherently problematic, emerging adults evidence alarmingly high rates of risky sexual
behaviors. Of those who are sexually active, a large number report that they have had multiple
sexual partners, have engaged in casual sex, and have used contraceptives inconsistently
(Centers for Disease Control [CDC], 2009; Grello, Welsh, & Harper, 2006; Lewis, Miguez-
2 Burbano, & Malow, 2009; Paul, McManus, & Hayes, 2000; Stillo, 2011). The link between these
behaviors and problematic sexual outcomes are difficult to deny. Women in this age group
report the highest rates of unintended pregnancy (Finer & Henshaw, 2006). Additionally, levels
of sexually transmitted infections have been shown to peak during this developmental period
(CDC, 2009). Studies suggest that individuals aged 15 to 24 account for approximately half of
the 19 million sexually transmitted infections that occur each year (Weinstock, Berman, &
Cates, 2004). In 1999, the National Institutes of Health recognized the serious health
implications disproportionately impacting our youth, as well as the complexities involved in
reducing risky behavior, and called for further research to aid sexual health prevention and
intervention efforts (National Institutes of Health [NIH], 1999).
Although research investigating influences on adolescent sexual risk behavior abounds,
significantly less is known about these associations during the transition to adulthood when risk
behavior often reaches its highest points. The unique features of emerging adulthood,
increases in sexual experimentation, and the high incidence of sexually transmitted infections
and unintended pregnancy in this group underscore the need for a better understanding of the
factors that influence sexuality during this life stage. Such information would be useful in the
design of effective programs aiming to prevent or reduce problematic sexual outcomes and
encourage healthy sexual development in emerging adults.
The goal of the present study is to better understand sexual development during the
transition to adulthood. In particular, this review examines the available literature regarding romantic development, attachment theory, and social support and the empirical research that links these factors with sexual development in adolescence and emerging adulthood. A variety
3 of sexual outcomes are considered, including sexual motivations, risky sexual behavior, and health-promoting sexual beliefs.
4 CHAPTER II
LITERATURE REVIEW
Arnett (2000) describes “emerging adulthood” as the developmental period in which adolescence has concluded, but adulthood has not fully been reached according to the dominant culture. This life stage is characterized by relative freedom from social expectations, as roles and developmental tasks are not clearly defined. Successful negotiation of adult roles is undoubtedly a complex and challenging process. Unfortunately, our understanding of the conditions that promote positive development during this life stage is insufficient at present
(Masten et al., 2004). For many, emerging adulthood is a time of significant identity exploration that involves experimentation with different life possibilities and consideration of many possible outcomes for one’s future. It is hypothesized that experimenting with risky behaviors is one avenue through which emerging adults explore various aspects of their identity (Arnett, 2000).
Although adolescents are often the group most frequently associated with identity development, recent research suggests that the bulk of identity exploration occurs during the emerging adult years (Kroger, Martinussen, & Marcia, 2010). Contemporary research on romantic development is consistent with this perspective. Experimentation with romantic partners often begins early on, with nearly two-thirds of adolescents reporting at least some romantic involvement (Meier & Allen, 2009). However, only in recent decades have initial romantic experiences been recognized as having important implications for children’s development (Collins, 2003). Adolescent romantic relationships have been linked with
5 numerous developmental outcomes, including identity formations, relationships with family
members and peers, sexual development, and career development (Furman & Shaffer, 2003).
Theories of romantic love typically embrace a normative developmental perspective.
One such model of romantic development is the behavioral systems approach (Furman &
Wehner, 1994). According to this model, romantic relationships established in early
adolescence serve different functions from those in late adolescence and emerging adulthood.
Furman and Wehner (1994) suggest that adolescent romantic relationships primarily fulfill needs for companionship, reciprocity, and physical intimacy. On the other hand, emerging adults’ romantic relationships are thought to serve more intimate attachment and care giving functions, nurturing feelings of love, security, and mutual support.
Other theorists (Brown, 1999; Connolly & Goldberg, 1999) emphasize phase-based approaches in understanding romantic development, which identify four stages of romantic relationships: initiation, affiliation, intimate, and committed. According to this model, the earliest romantic relationships that emerge during the initiation phase are characterized by attraction, though partners have relatively little contact with one another. In the affiliation phase, individuals begin to mingle in groups where they meet partners and begin to experiment with cross-gender interactions. Relationships begin to form and couples start initiating distance from peer groups during the intimate stage. Eventually, during the committed phase, partners experience physical intimacy and begin to serve attachment and care giving functions.
Although these two approaches offer different perspectives on romantic development, they are not necessarily mutually exclusive.
6 Overall, theories of romantic development depict a pattern in which romantic
relationships become lengthier and increasingly intimate. Initial exploration of romantic
relationships often emerges during adolescence, and these early romantic interests are no
longer dismissed as trivial or unimportant (Collins, 2003). Late adolescents and emerging
adults, on the other hand, typically form more intimate bonds with their romantic partners and
may grapple with more serious questions about their romantic and sexual identities, such as
the qualities they wish for in a long-term partner and the type of romantic relationship they
envision for themselves.
Most theories of romantic development acknowledge that romantic relationships offer unique contexts for sexual experimentation and include physical expressions of intimacy.
Furman and Shaffer (2003) note:
We believe that one’s romantic relationships are likely to be one of the primary, if not the primary context, for learning about most facets of sexuality. Romantic relationships provide a testing ground for not only the how of sexual behavior but also for the what and when. They provide a context in which adolescents discover what is attractive and arousing. Adolescents learn what they like in their partners and what partners tend to like. They learn to reconcile their sexual desires, their moral values, and their partners’ desires. (p. 12).
It is ironic, then, that the body of literature investigating sexual behavior is largely independent from studies of romantic love. In contrast to the normative perspective that dominates research on romantic development, studies of sexual development tend to adopt a
“problematic” focus (Kotchick, Shafer, & Forehand, 2001). Rather than delineating the
processes by which adolescents become healthy sexual adults, a majority of the literature in
this area focuses on aspects of sexual intercourse, contraception, and other “risky” behaviors.
Given the high rates of unintended pregnancy and sexually transmitted infections for
7 adolescents and emerging adults, this research certainly is warranted. However, the dearth of empirical studies attending to health-promoting sexual behaviors has led to gaps in our understanding of developmentally appropriate and healthy expressions of sexual exploration.
Researchers have described several components of a healthy sexual identity, including learning about intimacy, understanding interpersonal roles, becoming aware of and comfortable with feelings of sexual attraction, understanding socially acceptable standards of sexual expression, and learning about the reproductive process (Bukowski, Sippola, & Brender, 1993).
Additionally, changes in romantic relationship status are relatively common occurrences during adolescence and emerging adulthood. Despite the positive developmental outcomes associated with romantic involvement, the dissolution of romantic relationships presents adolescents and emerging adults at increased risk for problematic outcomes. In fact, romantic relationship break-ups have been identified as the most frequent trigger for first episodes of major depression for adolescent boys and girls (Monroe, Rohde, Seeley, & Lewinsohn, 1999).
Furthermore, frequent changes in romantic partners and the dissolution of romantic relationships during emerging adulthood have been linked with increases in heavy drinking, marijuana use, and cigarette smoking (Fleming, White, Oesterle, Haggerty, Catalano, 2010).
Results of the study by Fleming and colleagues (2010) suggest that changes in psychological health (e.g. depression) may partially account for the increases in substance use following changes in relationship status. Ultimately, these studies seem to suggest a complex relationship between romantic development, psychological health, and problematic outcomes.
8 Attachment Theory
Attachment theory (Bowlby, 1973, 1982, 1988) provides a useful framework for
understanding emerging adults’ functioning and behavior in intimate relationships. According
to this theory, primary caregivers who are generally nurturing and responsive to their child’s needs are conceptualized as providing a secure base from which their children can safely explore their surroundings without significant anxiety (Ainsworth, 1978). Long standing, positive patterns of interaction with primary caregivers are hypothesized to contribute to the development of secure “internal working models,” through which positive beliefs about the self and expectations of others are internalized (Bowlby, 1988). On the other hand, if a child’s primary caregiver is either inconsistently available or consistently unavailable, he or she is likely to develop an insecure attachment style reflective of negative beliefs about the self and/or others. Experiencing one’s relationship with his or her primary caregiver as generally safe and secure has been linked with a variety of positive outcomes, including greater self-confidence, acquiring healthy coping skills, and encouraging self-exploration and discovery (Ainsworth,
1991).
Attachment and romantic relationships. While preliminary research on attachment behavior attended to the relationship between infant and primary caregiver, the theory has since been expanded and applied to intimate relationships in adulthood (Hazan & Shaver, 1987;
Feeney & Noller, 1990; Tracy, Shaver, Albino, & Cooper, 2003). As previously described, romantic relationships are theorized to begin fulfilling attachment and caregiving functions as individuals reach late adolescence and emerging adulthood (Hazan & Shaver, 1987; Furman &
Wehner, 1994). Furthermore, links between parent-child bonds and support in romantic
9 relationships have been found to strengthen as individuals progress through adolescence,
lending support for the idea that attachment processes may become increasingly relevant during the later stages of romantic development (Furman, Simon, Shaffer, & Bouchey, 2002).
Overall, the literature on romantic attachment reflects positive associations between
secure attachment and favorable romantic development outcomes. Securely attached adults
report greater relationship satisfaction (Feeney, Noller, & Patty, 1993), and they are more likely
to become involved in romantic relationships characterized as trusting, friendly, and happy
(Hazan & Shaver, 1987). Their relationships are more likely to be stable and high in mutual
communication and intimacy (Tracy et al., 2003). In addition, secure individuals tend to utilize
active support seeking strategies, hold positive expectations of their partners’ ability to provide
support, and offer support and comfort to their romantic partners effectively (Mikulincer &
Shaver, 2007).
In contrast, attachment dimensions reflective of insecure attachment styles (e.g.
avoidance and anxiety) have been linked with less desirable processes in romantic
relationships. Individuals high in attachment avoidance tend to report less interest in long-term
romantic relationships (Shaver & Brennan, 1992), are less likely to fall in love (Tracey et al.,
2003), and experience greater discomfort with intimacy (Levy & Davis, 1988). Additionally,
attachment avoidance has been negatively linked with relationship satisfaction, connectedness
between romantic partners, as well as general support (Li & Chan, 2012). Higher levels of
attachment anxiety have also been linked with difficulties in romantic relationships. Those who
are anxiously attached often report intense fears of rejection and abandonment by one’s
partner (Tracey et al., 2003), are more likely to perpetrate psychological and physical
10 aggression in romantic relationships (Miga, Hare, Allen, & Manning, 2010), and report greater
conflict in relationships (Li & Chan, 2012).
Attachment and sexual outcomes. Shaver, Hazan, and Bradshaw (1988) argued that romantic love is a complex process comprised of three behavioral systems: attachment, caregiving, and sexuality. Comparatively, the literature on the sexual behavior system has received significantly less empirical attention, and most empirical studies of attachment and
sexuality rarely integrate the various systems (Dewitte, 2012). Nonetheless, important
associations between attachment style and sexual outcomes have arisen, with most notable
links emerging between broad attachment dimensions and risky sexual behaviors.
Dewitte (2012) suggests that individuals who are securely attached often experience a
“balance” between sex and love. As opposed to engaging in sexual activity to fulfill attachment needs, research suggests that they strive for mutually satisfying sexual experiences, are comfortable with and enjoy physical intimacy, and are responsive to their partner’s sexual needs (Brennan, Wu, & Loev, 1998). Furthermore, securely attached individuals are less likely to engage in casual sex experiences or “hook ups” (Paul et al., 2000), use alcohol or drugs in sexual situations, be victims or perpetrators of sexual aggression, or experience negative emotions during sexual intercourse (Tracy et al., 2003). It is important to note, however, that research also suggests that securely attached adolescents are frequently engaged in sexual behavior (Tracy et al., 2003). In other words, while they may be less likely to engage in risky sexual behaviors, such as casual sex encounters, securely attached individuals are often quite open to sexual exploration and may enjoy sex as a means of expressing love for their partner.
Interestingly, given that the majority of research studies have tended to focus on links between
11 insecure attachment styles and “problematic” sexual outcomes, significantly less is known
about the sexual behavior of securely attached individuals in comparison to those with insecure
attachments.
The associations between attachment anxiety and sexual outcomes have been
described as a “fusion between sex and love” (Dewitte, 2012, p. 110). The strong desire to be
accepted and loved by one’s partner may predispose individuals high in attachment anxiety to
falling in love rapidly and quickly engaging in physical intimacy (Feeney et al., 1993). They may
engage in sexual activity to decrease feelings of insecurity and increase feelings of closeness with their partner (Schachner & Shaver, 2004). Attachment anxiety has been negatively associated with a variety of health-promoting sexual beliefs (Stillo, 2011), as well as confidence in one’s ability to use condoms (Feeney, Kelly, Gallois, Peterson, & Terry, 1999; Kershaw et al.,
2007). Furthermore, empirical studies suggest that anxiously attached individuals are at increased risk for engaging in consensual, but unwanted acts of sexual intimacy (Gentzler &
Kerns, 2004). For those high in attachment anxiety, it is possible that refusing sexual activity or advocating for protective sexual behaviors, such as contraceptive use, may tap fears about potentially damaging relationships that are already perceived as fragile. Ultimately, the literature in this area suggests an inclination for individuals high in attachment anxiety to use sexual activity as a means of becoming closer with their partner, as well as coping with feelings of insecurity and negative self-views.
Given that the avoidance dimension of attachment is reflective of preferences for distance in interpersonal relationships and discomfort with intimacy, it is not surprising that those processes have implications for sexual behaviors. Researchers have suggested that
12 individuals high in attachment avoidance often experience love and sex as relatively
independent processes (Dewitte, 2012). Instead of engaging in sexual behavior as a means for
expressing affection and love, individuals high in attachment avoidance may engage in sexual
behavior as a means of physical gratification. Supporting this hypothesis, a recent study found
that higher levels of attachment avoidance significantly predicted stronger instrumentality
attitudes about sex (i.e. biological, utilitarian attitudes towards sex as a means of experiencing
physical pleasure), more permissive attitudes about sex, and fewer idealistic beliefs about sex
(Stillo, 2011). High levels of attachment avoidance have been linked with more frequent
engagement in casual sex or “hookups” (Feeney et al., 1993; Gentzler & Kerns, 2004; Stillo,
2011), increased use of drugs and alcohol prior to engaging in sexual activity (Tracy et al., 2003),
as well as more impulsive sexual behaviors and greater intent to engage in risky sexual
behaviors (Stillo, 2011). Researchers also have suggested that some individuals high in
attachment avoidance may limit intimacy by evading sexual experiences altogether. For
instance, results of one study found that adults with high levels of attachment avoidance
reported less frequent sexual activity with their partners, more attempts to avoid sexual activity
with their partner, and less enjoyment during sexual intercourse (Brassard, Shaver, & Lussier,
2007).
For individuals high in attachment avoidance, motivations to engage in sexual behavior
more often reflect inclinations to engage sexual activity in effort to reduce psychological
distress (Davis, Shaver, & Vernon, 2004), desires to “fit in” with their peer group (Cooper et al.,
2006), and attempts to increase their self-esteem (Davis et al., 2006). It is interesting to note that while individuals high in attachment avoidance may be more likely to engage in sexual
13 activity outside the context of romantic relationships, they report greater confidence in their ability to refuse intercourse and use contraception than those high in anxiety (Feeney et al.,
2000; Stillo, 2011). Perhaps preferences for interpersonal distance and less emotional intimacy with sexual partners may lessen concerns that refusing sexual activity and advocating for contraceptive use may potentially offend or upset their partners. However, recent research does suggest that higher levels of attachment avoidance may decrease the likelihood of questioning potential partners about their sexual history (Stillo, 2011). Such conversations may be avoided because they may cause discomfort, as the content may be perceived as intimate in nature. Qualitative studies with emerging adults suggest that having dialogues about sexual history and condom use, especially with casual partners, may be perceived as more intimate than the act of intercourse itself (Hammarlund, Lundgren, & Nystrom, 2008).
Although attachment theory itself does not suggest gender differences, there is quite a bit of evidence to suggest that socialization and evolutionary factors differentially impact men and women’s expressions of sexual behavior. In general, the body of research that has investigated gender differences in how attachment dynamics are expressed in relation to sexual behavior has revealed the strongest links between anxious attachment and sexual behavior in females and between avoidant attachment and sexual behavior in males (Cooper et al., 2006).
Regrettably, many studies have failed to account for gender differences in the sex-attachment link.
Unfortunately, the present body of literature examining attachment and sexual behavior is limited by several factors. First, a majority of studies have specifically focused on the impact of attachment style on sexual behavior, and relatively few studies have considered a possible
14 dyadic relationship between the two systems. In fact, some have suggested that certain sexual behaviors may protect romantic relationships from the effects of insecure attachment styles
(Karney & Bradbury, 1995). For instance, results of a recent study by Little, McNulty, & Russell
(2010) revealed that romantic relationships with more frequent sexual activity appear to be shielded from the negative impact of attachment avoidance on marital satisfaction. These findings underscore the possibility that some sexual behaviors may serve protective functions in moderating the links between insecure attachment styles and non-optimal outcomes in romantic relationships. Another limitation of the present body of research is that the vast majority of studies examine hypothesized direct associations between dimensions of attachment and sexual outcomes, and potential variables that may explain or modify those relationships have rarely been examined. As a result, empirical research currently provides an insufficient understanding of the pathways that may explain the interplay between the attachment and sexual systems and largely ignore questions about how the sexual system may also influence attachment perspectives (Dewitte, 2012).
Attachment and social support. Researchers have suggested attachment theory is useful in understanding processes of perceived support, support seeking, and support provision
(Mikulincer & Shaver, 2009; Sarason, Pierce, & Sarason, 1990). In fact, such links trace back to
Bowlby (1982), who described support seeking as the “primary strategy” of the attachment system. He noted that the main goal of support seeking is to facilitate one’s experience of the world as safe and secure, that the others can be relied upon if needed, and that exploring the world is ultimately rewarding.
15 Attachment theory describes three types of social support that individuals seek during times of need throughout the lifespan (Ainsworth, 1991; Mikulincer & Shaver, 2009). First, attachment figures may provide support and reassurance through physical or psychological closeness, while separation or loss of attachment figures may result in feelings of anxiety and worry. Second, attachment figures may provide instrumental and emotional support when an individual is faced with hardship or presented with obstacles. Third, attachment figures often serve as “secure bases” (Bowlby, 1988) that encourage autonomy and healthy exploration of one’s environment and are conducive to personal growth. Ultimately, attachment theory asserts that individuals “seek a haven of safety when the world seems dangerous, and they seek encouragement of and support for autonomy and self-expansion when the world offers interesting challenges that might facilitate the development of knowledge and skills”
(Mikulincer & Shaver, 2009, p. 9).
Differences in attachment figures and support seeking strategies across developmental periods have been observed. For example, primary caregivers, typically parents, are most likely to fulfill the role of attachment figures during infancy and childhood (Ainsworth et al., 1978).
During infancy, support seeking strategies most often appear in the form of nonverbal behaviors, such as smiling, reaching, or clinging. However, as individuals progress through adolescence and emerging adulthood, peers and romantic partners often begin assuming attachment roles (Ainsworth, 1991). For adolescents and adults, support seeking is often sought through verbal requests, behaviors (e.g. sending a text message), or mental representations of attachment figures.
16 According to attachment theory, individual differences in support seeking emerge following each individual’s unique pattern of interaction with his or her primary caregiver that results in an “internal working model” of self and others (Bowlby, 1973). Secure relationships with parents reinforce beliefs that others are reliable and dependable sources of support.
However, longstanding patterns of inconsistent or unavailable support from attachment figures are likely to foster doubts about others’ ability to provide support when needed. In those nonoptimal situations, individuals’ reliance on social support is often replaced with
“hyperactive” or “deactivated” support seeking strategies (Mikulincer & Shaver, 2009).
Mikulincer and Shaver (2009) note that hyperactive support seeking strategies include anxious or controlling attempts to gain a caregiver or partner’s support. In the latter strategy, individuals are described as dismissing their needs for support from others and appearing
“compulsively self-reliant” (Bowlby, 1973).
Empirical studies of attachment theory reveal that an attachment style (e.g. secure or insecure) may influence perceptions of available support. In one such study, Collins and Feeney
(2004) found that individuals with insecure attachment were more likely to interpret and recall their partner’s behavior as less supportive, particularly in ambiguous situations, than those with a secure attachment style. On the other hand, there is some research to suggest that individuals with insecure attachment styles may be more likely to become involved with partners who are not supportive and behave in ways that make it less likely for partners to provide support (Rholes, Simpson, Campbell, & Grich, 2001).
Attachment theory and the function of support-seeking also provide useful frameworks for understanding the emergence of risk behavior and problematic outcomes in emerging
17 adulthood. Given that a history of supportive interactions with primary caregivers facilitates
positive beliefs about oneself and others’ ability to provide support, individuals who perceive
their parents as supportive are likely to have acquired self-confidence and skills to manage stressors and cope effectively with challenge (Sarason, Pierce, & Sarason, 1990). In other words, secure attachment and perceived social support are hypothesized to offer protective effects against engagement in risky behavior through increases in self-efficacy and expanded coping resources.
Social Support
Given the theoretical importance of perceived support in increasing an individual’s sense of autonomy and self-efficacy, empirical investigations examining specific pathways of influence may provide a better understanding of the construct and its impact during the transition to adulthood. Findings from previous research demonstrate that social support is associated with many physical health benefits, including cardiovascular, neuroendocrine, and immune functioning (Chida & Steptoe, 2010; Dickerson & Kemeny, 2004; Kiecolt-Glaser,
McGuire, Robles, & Glaser, 2002); however, the psychological mechanisms responsible for such associations are unclear at present (Uchino, Bowen, Carlisle, & Birmingham, 2012). In addition to improved physical health outcomes, supportive relationships appear to serve added protective functions that extend into adulthood. In fact, the availability of perceived social support is one of the most commonly identified predictors of adaptive outcomes and resiliency
(Masten & Coatsworth, 1998). Overall, research suggests an inverse relationship between social support and engagement in problematic behaviors during adolescence and young adulthood. A majority of the literature in this area has considered the association between risk
18 behaviors and overall levels of perceived social support, as well as support directly from parents and peers.
Social support and sexual outcomes. As previously introduced, sexual activity is a normative experience for the majority of emerging adults. Research investigating links between social support and sexual outcomes may bear important insights regarding the processes that are involved in the development of a healthy sexual identity. Such investigations
may be particularly useful in the design of prevention and intervention efforts in attempt to
reduce problematic outcomes, such as sexually transmitted infections and unintended
pregnancy, and encourage protective sexual behaviors during the transition to adulthood.
The role of parental support has been extensively studied in relation to risky sexual
behaviors in adolescence, with studies typically reporting negative relationships between
parental support and engagement in risky sex. Studies have revealed that adolescents with
lower levels of parental support are more likely to report having multiple partners and using
condoms inconsistently (Luster & Small, 1994; Mosack, Gore-Felton, Chartier, & McGarvey,
2007), as well as greater overall sexual risk (Boyer, Tschann, & Shafer, 1999). Additionally, high
levels parent-adolescent connectedness have been associated with reduced involvement in
pregnancy (Scaramella, Conger, Simons, and Whitbeck, 1998), later sexual debuts (Miller,
Norton, Fan, & Christopherson, 1998), and safer sexual decisions (Perrino, Gonzalez-Soldevilla,
Pantin, & Szopacznik, 2000). Although a majority of studies in this area reveal associations
between parental support and risky sexual behavior, others have not. For example, one study
of 158 African American adolescents found that perceived social support was unrelated to
engagement in risky sexual behavior (Bachanas et al., 2002). Similarly, Perkins, Luster,
19 Villarruel, and Small (1998) found family support to be unrelated to sexual activity during
adolescence.
While some studies do not reveal direct links between parental support and sexual
outcomes, they do suggest links with healthy sexual behaviors. For instance, in their study of
209 male and female adolescents, Somers and Ali (2011) found that perceived levels of parental support did not predict adolescents’ intentions to avoid pregnancy, plans for sexual intercourse debut, or plans for continuing sexual intercourse if already sexually active. However, higher levels of family support were associated with greater self-efficacy to resist risky sexual
situations. A recent study utilizing a sample of 327 emerging adults noted similar results. Stillo
(2011) found that quality of relationships with parents was unrelated to overall engagement in
risky sexual behavior. However, higher quality parent-emerging adult relationships predicted
greater self-efficacy for engaging in protective sexual behaviors and fewer permissive attitudes
about sex. Overall, studies examining links between social support and sexual development
tend to focus more extensively on problematic sexual outcomes. As such, much less is
understood about the role of social support as it relates to the prediction of health-promoting
sexual behaviors.
There is some evidence to suggest that the link between perceived support and risky
sexual behavior may be stronger for younger adolescents than for emerging adults. One study
of 403 females found that those who reported higher levels of sexual risk taking, such as
inconsistent condom use, multiple sexual partners, and history of sexually transmitted
infections, reported lower levels of social support (Mazzaferro et al., 2006). Notably, however,
the magnitude of the association between perceived social support and sexual outcomes was
20 significantly stronger for females aged 14 to 19 than those aged 20 to 25. Similarly, results of a
study by Deptula, Henry, and Schoeny (2010) revealed that parenting factors, such as parent-
child relationship quality, better predicted condom nonuse in adolescents 16 and younger.
While perceived support appears to remain an important correlate of risky sexual behaviors during the transition to adulthood, it is likely that the construct functions differently than in
adolescence. Unfortunately, the available research that investigates the influence of social
support on sexual behaviors largely concentrates on adolescent populations, and studies
distinguishing the two developmental periods are rare. Thus, significantly less is known about
the role of perceived support during emerging adulthood.
In addition, there seem to be important distinctions between males and females when considering associations between social support and sexual outcomes. For example, one study
investigating relationships between family and peer variables and risky sexual behavior in 1,008
at-risk male and female adolescents found that higher levels of perceived emotional support
from one’s family was associated with fewer sexual partners for females yet more sexual partners for males (Mosack et al., 2007). The authors suggest that one possible explanation could be that parents may be knowledgeable about their sons’ engagement in risky sexual behavior and may be “reaching out to them” to promote healthier behavior. Alternatively, the items tapping emotional support may actually be reflect permissive parenting styles, which have been linked with behavioral problems in childhood (Akhter, Hanif, Tariq, & Atta, 2011;
Cohen & Rice, 1997; Donenberg, Emerson, & Mackesy-Amiti, 2011).
The function of parental support may also differ based on cultural and racial considerations. Despite the elevated risk of sexually transmitted infections for racial and ethnic
21 minority groups, relatively few studies include comparisons of different racial groups. Using a
multi-ethnic sample of 10,131 adolescents who participated in the National Longitudinal Study
of Adolescent Health, Gillmore, Chen, Haas, Kopak, and Robillard (2011) investigated the
influence of family and parenting factors on condom use. Results of this study revealed that
family support predicted increased condom use for the overall sample and for the white
sample, but similar relationships did not emerge when considering African American, Mexican
American, and Chinese American groups. Additional research is warranted to further explicate the role of parental support in predicting the sexual behaviors of racial and ethnic minorities.
Sexual minority adolescents and emerging adults present unique considerations. Gay,
lesbian, and bisexual emerging adults report significantly lower levels of parental support than
heterosexual men and women (Needham & Austin, 2010), which may partially explain why they are at increased risk for negative health outcomes (Savin-Williams, 1994). Similar results emerged in a study that compared perceptions of social support in sexual minority and sexual majority females (Corliss, Austin, Roberts, & Molnar, 2009). Findings from this study indicated
that sexual minority females reported significantly less social support from family and friends.
Additionally, differences in perceived support partially mediated relationships between sexual orientation and sexual risk. Further research is needed to better understand links between sexual minority groups and sexual outcomes.
A limitation of the existing literature regarding parental support and problematic outcomes is the failure to distinguish between sources of parental support. Studies often fail to delineate support specifically from mothers and fathers. Even worse is the frequency with which the construct of paternal support is neglected altogether. As a result, little is understood
22 regarding fathers’ influence on adolescent and emerging adult development. This is
unfortunate, given the existing evidence that supportive relationships with fathers provide
unique and positive influences on their child’s outcomes. For instance, higher quality
relationships with fathers have been associated with reduced likelihood of having acquired a sexually transmitted infection by emerging adulthood (Stillo, 2011). Others have also noted positive relationships between supportive father-child relationships and protective sexual behaviors, such as condom use. These researchers suggest that fathers are just as important as
mothers in promoting adaptive outcomes in their children, and we should no longer disregard
the role of fathers in prevention and intervention efforts (Pingel et al., 2012; Wilson, Dalberth,
& Koo, 2010). Furthermore, findings from previous research suggest that family processes
likely effect sons and daughters in unique ways, and pathways of influence seem to vary for each dyad (e.g. mother-son; father-daughter) (Stillo, 2011). Taken together, these studies emphasize the need for more fine-tuned models in order to better understand associations between parental support and emerging adult outcomes.
As noted by Hazan and Shaver (1994), the transition to adulthood is characterized by a gradual shift in attachment functions. While parents remain important attachment figures throughout the lifespan, peer relationships become increasingly central in fulfilling needs for emotional support, companionship, guidance, and advice during the transition to adulthood.
Thus, supportive peer relationships are also believed to play an important role in understanding adolescent and emerging adult behavior. The presence of supportive peer relationships has been linked with a variety of favorable sexual outcomes, including fewer sexual partners
23 (Mosack et al., 2007; Rotheram-Borus, Reid, & Rosario, 1994) and more responsible attitudes about birth control (Stillo, 2012).
Studies examining multiple sources of perceived support (e.g. from parents and from peers) seem to indicate that only examining only one support source provides an insufficient
understanding of social influences on sexual outcomes. Instead, investigations that consider
interactive effects of parent and peer relationships may provide a more effective and powerful
way to understand the overall effects of the supportive functions of various attachment
relationships. Results of a study by Henrich, Brookmeyer, Shrier, and Shahar (2006) accentuate
the need for more integrated models. In their study of 2,655 sexually active adolescents who
participated in the National Longitudinal Study of Adolescent Health (Add Health), Henrich and
colleagues found that supportive relationships with parents and peers interact to predict
reduced engagement in risky sexual behaviors. Specifically, higher levels of parental support were associated with reduced engagement in risky sexual behaviors for adolescents who reported stable and supportive friendships. Thus, while peer support may not directly predict sexual outcomes, it may play a more indirect role by enhancing protective effects stemming from the parent-child relationship.
Still, other studies investigate overall levels of perceived support without attending to the source of support. Overall levels of social support, though more general in nature, may provide a broad understanding about an individual’s supportive resources. One such study investigated overall social support as a predictor of African-American adolescents’ sexual
outcomes (St. Lawrence, Brasfield, Jefferson, Allyene, & Shirley, 1994). In this study,
adolescents who reported lower levels of overall support knew less about sexually transmitted
24 infections, held more negative views toward condoms, were at greater risk for engaging in casual sex, were more frequently pressured into unwanted sexual activity, and were more likely to have acquired a sexually transmitted infection. Notably, results of this study indicate that males with low social support demonstrated the greatest risk for engaging in sexual behaviors.
Limitations of existing social support research. Careful examination of empirical studies that seek to examine the influence of supportive relationships on sexual outcomes reveals several important limitations. First, although the construct of social support is popular and its protective benefits are widely recognized, its measurement is limited. Many studies include single-item instruments and questions not based on established measures, which potentially limits interpretations of the findings. Additionally, researchers have conceptualized social support in a variety of ways and emphasize various dimensions the construct spanning from structural characteristics to potential functions of support, such as emotional support or securing of instrumental aid. The lack of consistent definitions presents challenges when drawing conclusions across studies and limits understanding of the underlying protective mechanisms. Such variability across studies, at least in part, likely contributes to some inconsistencies in findings. Furthermore, the influence of different sources of support during the transition to adulthood is unclear. Significantly more is known regarding the influence of maternal support, and the role of fathers is less understood. Additionally, although peers and romantic partners are theoretically recognized as gaining attachment significance during this developmental period, relatively little is known about the functions of these supportive relationships on emerging adults’ sexual outcomes.
25 Sexual Values and Motivations for Sexual Behavior
In order to provide a more comprehensive understanding of sexual behavior, this
section focuses on the available empirical research that examines the relationship between
sexual values and motivations for sexual behaviors and sexual outcomes during emerging
adulthood. Though values and motivations are considered to be the guiding forces of the
sexual system, relatively little is understood and agreed upon concerning their links with sexual
behavior. While some studies have examined the links between values and motivations in relation to adolescent sexual behavior, it is currently unclear whether these associations maintain during the transition to adulthood.
Although several qualities of the family environment have been directly linked with value development in adolescence, recent studies suggest a more indirect relationship exists with regard to value transmission in emerging adults (Walker, 2010). Perceived parent disapproval of sex and parents’ actual values for their child to avoid pregnancy through delays in intercourse or via contraceptive use are two of the strongest predictors of sexual behavior in
adolescence, and studies suggest that sexual values are most effectively transmitted in the
context of a close and supportive parent-child relationship (Deptula et al., 2010; Miller, 2002).
Sexual values have been shown to have important moderating effects when considering the
influence of family environment qualities, such as parent-child communication, on adolescent
sexual behavior (Miller et al., 1998). While parents certainly communicate their value systems
to their children through verbal communication, adolescents also gauge their parents’ attitudes
and values through observations of behavior.
26 It appears that sexual values continue to be an important influence on emerging adult sexual behaviors. Wetherill, Neal, and Fromme (2008) examined the role of parent, peers, and sexual values during the transition from high school to college. Results of their study indicated
that sexual values significantly predicted risky sexual behavior while in college, such that men
and women with more conservative sexual values reported safer sexual behavior and fewer
sexual partners compared to those with more liberal sexual values. However, their results were
more complicated when considering the added influence of parental and peer support.
Although higher levels of parent and peer support were associated with less sexual risk
behavior, college students who reported liberal sexual values in combination with high levels of
parent and peer support were at greatest risk for engaging in unsafe sexual behavior and
having multiple partners.
One critique of the relatively limited literature in this area is the narrow focus and
definition of sexual values (Morgan & Zurbriggen, 2012). For example, previous studies
examining college students’ sexual values have asked participants to indicate which sexual
value system most frequently guided their behavior: absolutism (strict moral codes dictating
what is right and wrong), relativism (context determines the appropriateness of behavior), or
hedonism (doing what feels good as long as others are not hurt) (Knox, Zusman, & Cooper,
2001). Results of the study by Knox and colleagues (2001) suggest that younger students are
more likely to endorse absolutist sexual values, those in romantic relationships were more likely
to identify as relativistic, while men, older students, and students who casually dated held more
hedonistic values. Although this research provides a starting point for the investigation of
sexual values, the vast majority of students identify as “relativistic.” Thus, even though these
27 values offer a starting point for research linking values to sexual behavior, the narrow focus seems to limit broader examination of sexual values and presents difficulties in considering individual differences.
Recently Morgan and Zurbriggen (2012) utilized a qualitative approach that allowed participants to freely describe their values in effort to broaden understanding of emerging adult sexual values. According to their findings, seven themes emerged including: casual sex values, respect, intimacy, trust, physical pleasure, consent, and physical safety. Interestingly, this study was a longitudinal design and allowed for the examination of changes in values during the first and second year of college. According to the authors, the one significant change from Time 1 to
Time 2 was the higher percentage of college students who acknowledged casual sex values.
These results provide preliminary support for the notion that changes in values occur as individuals progress through emerging adulthood. Future research in this area is warranted to identify potential sources of values and the processes that influence value transmission during this life stage.
According to the functional perspective of behavior, individuals often engage in sexual behavior in effort to achieve certain purposes. Although individuals are often motivated to act in accordance with their values, it is likely that different desires, such as attachment needs, play an important role in shaping behavior. Thus, understanding motivations for engaging in sexual behavior may help to identify potential avenues for prevention and intervention (Cooper,
Shapiro, & Powers, 1998). At present, there appears to be little understood and agreed upon regarding the sexual motivations of college students, and very few studies have empirically examined the links between attachment style and sexual motives (Gillath & Schachner, 2006).
28 Cooper and colleagues (1998) identify two underlying motivational dimensions that combine to influence sexual behaviors. The first dimension is one of approach-avoidance. In other words, they suggest some individuals engage in sexual behavior to experience desirable effects (i.e. physical pleasure), while others engage in sexual behavior in effort to evade negative outcomes (i.e. rejection or abandonment). The second dimension delineates a self- other focus. Those who engage in sexual behavior with a self-focus may be more likely to use sex as a means of assuring one’s sense of self-worth or cope with negative affect. On the other hand, individuals who tend to adopt focus on others may be more likely to engage in sexual behavior in effort to increase an emotional connection or gain their partner’s approval.
Drawing upon this framework, Cooper and colleagues (1998) identified four broad categories of sexual motivations: intimacy motives, coping and affirmation motives, partner approval, and enhancement motives. Intimacy motives for engaging in sexual behavior involve the use of sex as a means of creating an emotional bond and fostering intimacy with one’s partner. There is some evidence to suggest that individuals who report high levels of intimacy sexual motives are less likely to engage in sexual intercourse outside the context of a committed relationship (Cooper et al., 1998). Coping and affirmation motives are considered to be similar in that they both refer to using sexual behavior in effort to evade uncomfortable psychological states. While the former refers mostly to using sex to avoid negative affective states, the latter refers to the tendency for individuals to engage in sexual behavior in effort to assuage negative beliefs about the self. Even though they are alike, the two motives appear to be uniquely related to sexual behaviors. For instance, high levels of coping motives have been linked with increases in casual sex relationships, more sexual partners, and more consistent
29 contraceptive use (Cooper et al., 1998). As the name implies, partner approval sexual motives involve goals for sexual behavior such as avoiding social rejection, while enhancement motives refer to the desire to engage in sexual behavior for physical gratification.
Theoretically, researchers have drawn connections between these sexual motives and attachment needs. For instance, it has been suggested that individuals who are securely attached may report engaging in sexual behavior to experience interpersonal closeness, those high in anxiety may use sex as way to maintain approval from their partner, and those high in avoidance may be more motivated to engage in sexual behavior for coping reasons (Cooper et al., 1998; Cooper et al., 2006). Furthermore, sexual motivations and goals for sexual behavior are most often cited as likely contributors to the observed links between the attachment and sexual systems (Gentzler & Kerns, 2004).
Empirical research linking attachment needs and sexual motives, however, is scarce.
Schachner and Shaver (2004) were of the first to consider sexual motives in relation to attachment and sexual outcomes. Results of their research largely supported hypotheses founded in attachment theory. Specifically, individuals who reported higher levels of attachment avoidance were more likely to have sex to gain social status, while those high in attachment anxiety were more likely to have sex in order to feel valued by their partner and assuage fears of abandonment. Additional empirical research examining the role of sexual motivations as potential mediators between attachment styles and sexual outcomes may help to elucidate the specific pathways of influence. Although these pathways are grounded in attachment theory, rarely have empirical studies directly tested these explanatory pathways
(Cooper et al., 2006). Of the investigations that have examined the possible mediating
30 influence of sexual motives in the relationship between attachment and sexual outcomes, nearly all have focused on problematic sexual outcomes. Furthermore, no known studies have considered the potential mediating influence of sexual motives on the link between attachment and protective sexual beliefs, such as one’s belief in their ability to refuse sex.
Recently, an alternative perspective to understanding sexual motivations has emerged wherein researchers have acknowledged that it may be just as important to consider adolescents and emerging adults’ reasons for not engaging in sexual behavior. Patrick, Maggs,
Cooper, and Lee (2011) explained that understanding reasons to avoid risky sexual behaviors or sexual activity altogether may be especially useful for prevention efforts that aim to promote health-promoting beliefs and attitudes. They describe moral or ethical obligations to not engage in sex (values), protecting one’s health, and emotional readiness as potential reasons individuals avoid sexual behavior. Results of the study conducted by Patrick and colleagues
(2011) revealed that motivations to engage in sex and motivations to avoid sex are not mutually exclusive, highlighting the need for future research to consider the constructs separately.
Although motivations to avoid sex were linked with reduced sexual activity, they were not linked with emerging adults’ contraceptive use.
Rationale
While it is an exciting time for personal growth and exploration, emerging adulthood is also a challenging developmental period marked with uncertainty. The normative decrease in parental monitoring, relatively few role responsibilities, and increase in personal freedom set the stage for greater experimentation with risky behaviors. In fact, the highest incidence of risk behavior is associated with this developmental period (Arnett, 2000; Nelson & Barry, 2005).
31 Rates of alcohol-related problems (Johnston, O’Malley, Bachman, & Schulenberg, 2008), illicit drug use (SAMHSA, 2005), and sexually transmitted infections (CDC, 2009) peak during the emerging adult years.
Unfortunately, the majority of the literature that examines risky behavior has predominantly focused on adolescent populations. Given the high incidence of problematic outcomes and the unique features of this life stage, it is important to better understand the processes which influence risk behavior during the transition to adulthood. Since a majority of emerging adults attend college at some point and over two-thirds of high school students enroll in postsecondary education immediately following graduation (Aud et al., 2012), college students are a relevant population from which to study emerging adult development. The present study aims to further examine risky sexual behaviors in a college student population with an age restriction of 18-25, the years commonly associated with emerging adulthood.
Although research on sexual behavior has burgeoned in recent decades, much of the overall literature has been limited by a narrow focus on virginity status, age of first sexual intercourse, and whether or not an individual is sexually active. Although those outcomes are certainly relevant during adolescence, they may not be as applicable for emerging adult populations where sexual behavior is relatively common. Furthermore, the literature examining risky sexual behavior has been limited by investigations that only consider one dimension of sexual risk, such as number of previous partners or acquisition of a sexually transmitted infection. The present study addresses this limitation by utilizing the Sexual Risk
Survey (Turchik & Garske, 2009), an instrument that assesses several domains of risky sexual
32 outcomes, including sex with uncommitted partners, unprotected sexual behavior, impulsive
sexual behaviors, and intent to engage in risky sexual behavior.
Another limitation of the literature examining sexual development has been the near exclusive focus on risky sexual behavior. This tendency to focus on “problematic” sexual outcomes has led to an incomplete understanding of sexual development that largely ignores factors that may promote healthy sexual behaviors (Kotchick et al., 2001). Studies that examine health-promoting behaviors, such as consistent condom use, healthy attitudes towards sex, and confidence for engaging in protective sexual behaviors, would allow for a more complete understanding of normative sexual development. This research may be especially useful in the design of outreach and prevention programs aimed at promoting healthy sexual development.
Additionally, previous research suggests that risky sexual behaviors and health-promoting sexual behaviors are not mutually exclusive constructs, emphasizing the need for researchers to investigate the two outcomes as distinct constructs (Stillo, 2011). Therefore, the present study utilizes the Self-Efficacy Instrument for Protective Sexual Behaviors (Cecil & Pinkerton, 1998), in an effort to further examine processes that may influence emerging adults’ beliefs about their ability to engage in health-promoting behaviors, such as questioning potential partners, refusing sex, and using condoms.
Another overall limitation of the existing literature on sexual behavior during adolescence and emerging adulthood is the lack of consistent theory guiding the research.
Thus, a major contribution of this study is the grounding in attachment theory. The attachment and sexual behavior systems have been theoretically linked for decades (Hazan & Shaver,
1987). However, even though contemporary researchers argue that attachment theory holds
33 “the greatest explanatory power for understanding sexual interactions” (Dewitte, 2012, p. 105),
empirical literature integrating the two systems is limited. Of the investigations that have
examined the interplay between attachment and sexual behavior, most have established
general links between attachment processes and specific sexual outcomes. Only a small
number of studies have examined underlying mechanisms that may influence relationships
between attachment behavior and sexual outcomes. Even fewer have investigated these pathways during the transition to adulthood. A major goal of the present study is to follow-up on the results of a recent study by Stillo (2011) that found several novel links between the attachment and sexual systems by 1) replicating those findings in a new sample of emerging adults and 2) adding to the body of literature that explains the relationship between the attachment and sexual behavioral systems.
Although researchers have theorized that motivations to engage in sexual behavior play an important explanatory role in the relationship between the attachment and sexual system, only within the past decade have such pathways been empirically investigated (Cooper et al.,
2006). Preliminary research in this area largely supports the idea that attachment-related needs and desires prime certain motivations to engage in or avoid sexual behavior (Davis,
Shaver, & Vernon, 2003; Davis et al., 2004; Gillath & Schachner, 2006; Shachner & Shaver,
2004). Intimacy motives, such as having sex to make an emotional connection, and coping motives, such as having sex to suppress negative affect, were included in the models, as these motives were hypothesized to most closely reflect the interplay between the attachment and sexual systems based on previous studies (Cooper et al., 1998; Patrick et al., 2011).
34 Furthermore, no known studies have directly assessed possible explanatory pathways of sexual motives in the link between patterns of romantic attachment and protective sexual behaviors.
Perceptions of available social support may also contribute to emerging adults’ sexual development. An area of controversy in the literature is the relative importance of different support sources during the transition to adulthood. The majority of studies investigating parental support has either failed to distinguish between sources of maternal and paternal support, or alternatively has focused on maternal support and neglected paternal support altogether. Furthermore, while some theorists maintain that the influence of parental support persists during the emerging adult years, others argue that support from romantic partners becomes more salient during this developmental period. Although rarely empirically examined, perceived support from romantic partners is expected to directly influence sexual behavior.
Thus, the present study aims to expand the understanding of links between source-specific social support and various sexual outcomes by utilizing three source-specific versions (Mother,
Father, Romantic Partner) of the Social Provision Scale (SPS; Cutrona & Russell, 1987). It is expected that perceived support from partners would be an especially important predictor of sexual outcomes for romantically involved emerging adults.
An additional goal of this study was to test a model that may explain the interplay between social support and sexual outcomes through examination of sexual motivations. It is expected that perceiving low levels of support may increase the likelihood that individuals will be motivated to use sexual behavior as a means of coping or satisfying needs not attained in other relationships. In so doing, these emerging adults may be more likely to encounter less desirable sexual health outcomes. We also predicted that greater perceived support would be
35 associated with more positive sexual health outcomes by increasing motivations to engage in sexual behavior to foster an intimate connection with their partner. Should these expectations be supported, it would highlight the importance of enhancing social support in sexual health prevention and intervention efforts for emerging adults.
Research Questions and Hypotheses
The current study aimed to address several of the aforementioned limitations by examining several models that investigated the links between attachment and social support on sexual outcomes. Multiple-group path analysis was utilized to allow for investigation of gender differences, as we expected men and women to differ in their sexual expressions of attachment and support-related needs and desires due to cultural and societal norms. Thus, models were tested to explore fit to the data, examine mediational pathways, and assess for moderation by gender.
Three models examined the link between the attachment and sexual behavior systems for men and women. The first investigated the direct effects of attachment on sexual outcomes, and two indirect effects models examined the mediation effects of intimacy and coping sexual motives on the relationship between attachment and sexual outcomes (risky and
health-promoting). It was expected that higher levels of attachment insecurity would be linked with more risky sexual behaviors and fewer health-promoting sexual beliefs. That is, discomfort
with closeness (attachment avoidance) or preoccupation with concerns about relationships
(attachment anxiety) were expected to influence sexual outcomes through a direct impact on
motivations for engaging in sexual behavior.
36 This study also examined several models that tested associations between social support and sexual outcomes. Two path models investigated the direct effects of source- specific social support on sexual outcomes. The first of the direct effects models examined parental support for the entire sample, while the second direct effects model also considered the role of partner support for romantically involved participants. It was expected that higher levels of support would lessen engagement in risky sexual behaviors and increase health- promoting sexual beliefs in each of the models, with partner support most strongly related to sexual outcomes in the latter model. The final set of models examined the mediation effects of intimacy and coping sexual motives on the relationship between source-specific social support and sexual outcomes. We anticipated that higher levels of support would decrease the likelihood that individuals would be motivated to use sexual behavior as a means of coping or satisfying needs not attained in other relationships and increase the likelihood of engaging in sex to increase closeness with their partner, which would in turn directly impact sexual outcomes.
37 CHAPTER II
METHOD
Participants and Procedures
Participants were 290 undergraduate students from the University of North Texas.
Participants’ ages were restricted to the 18-25 year range in effort to collect data from individuals mostly likely to comprise the “emerging adult” period of development. The sample had an average age of 20.74 (SD = 1.80), with 66.2% (n = 192) reported as female and 33.4% (n
= 97) reported as male. To control for variation unrelated to the research questions, only unmarried participants were asked to participate. In terms of relational status, 53.8% (n = 156) were in a romantic relationship and 46.2% (n = 134) were single. Additional demographic characteristics of the sample are summarized in Table 1. With regard to race/ethnic background, 42.6% (n = 123) were Caucasian, 21.7% (n = 63) African American, 20.4% (n = 59)
Latino/a, 8.5% (n = 25) Multiracial, and 6.6% (n = 19) Asian. The majority (88.3%) of participants identified as straight (n = 256), while approximately 10% (n = 29) identified as sexual minority.
Data was collected during the summer semester of 2013. Students were recruited from the University of North Texas psychology department subject pool via the SONA system.
Participants were voluntarily recruited and offered SONA credit for their participation. All procedures were approved through the University of North Texas Institutional Review Board for the Protection of Human Subjects. Students completed questionnaire packets in group administrations. The participants were asked to provide demographic data and complete the self-report measures concerning perceptions of their social support network, romantic attachment, and a variety of sexual outcomes, including sexual motivations, risky sexual
38 behaviors, and health-promoting sexual beliefs. The packets included the measures described below. The total completion time was approximately one hour. In order to protect the confidentiality of all participants, data from each participant was assigned a code number and stored separately from the participant’s name in a locked room.
Instrumentation
Demographic information. A demographics questionnaire (Appendix D) was included to obtain descriptive information about the sample to allow for a more comprehensive understanding of the sample’s background. Information concerning the participants’ age, gender, ethnicity, spiritual affiliation, parents’ marital status, parental education level, and place of residence (e.g., living with parents or outside of the home) were assessed. Participants were asked to provide information concerning their current and past romantic relationships and sexual history for additional descriptive purposes.
Romantic attachment: Experiences in Close Relationships Scale (ECR). The experiences in Close Relationships Scale (ECR; Brennan et al., 1998) was included to assess participants’ romantic attachment. The ECR is a self-report measure comprised of 36 items. Responses are recorded using a 7-point Likert scale with endpoints ranging from 1 (disagree strongly) to 7
(agree strongly). Although the earlier literature most frequently conceptualized attachment in terms of distinct types or categories (Bartholomew & Horowitz, 1991), many contemporary attachment researchers investigate attachment in terms of the two underlying dimensions of anxiety and avoidance (Brennan et al., 1998; Feeney & Noller, 1996). In this study, the ECR will be utilized to provide two continuous scores for the anxiety and avoidance dimensions of romantic attachment. The anxiety scale measures fears of interpersonal rejection and needs
39 for reassurance, while the avoidance scale measures discomfort with closeness and fear of dependence on others.
Psychometric properties of the ECR are strong. Brennan et al. (1998) report high internal consistency for the anxiety and avoidance scales, with Cronbach alpha’s of .91 and .94, respectively, consistent with other recent studies (Stillo, 2011; Alonso-Arbiol, Balluerka, Shaver,
& Gallath, 2008). The ECR demonstrated high internal consistency with the current sample (α =
.93 for both scales). Previous researchers have documented adequate test-retest reliability
(Lopez & Gormley, 2002). The validity of the instrument has also been established through
studies that have found attachment and avoidance to be positively linked with a variety of
constructs, including negative affect (Wei, Russell, Mallinckrodt, & Zakalik, 2004) and
depressive symptoms (Zakalik & Wei, 2006), and inversely related to measures of self-efficacy
(Mallinckrodt & Wei, 2005).
Social support: Social Provisions Scale (SPS). The SPS is a 24-item self-report measure
that examines overall perceptions of social support developed by Cutrona and Russell (1987).
In addition to completing the original SPS in its entirety, the present study included a source-
specific version of the SPS (Cutrona, 1989) in which participants were asked to rate their
perceptions of social support specifically from their mother, father, and current (or most
recent) romantic partner. Responses to the items were recorded on a 4-point Likert scale with
endpoints ranging from 1 (strongly disagree) to 4 (strongly agree). In addition to computing a
global support scale, total scores were also calculated for each of the specific support sources.
Total scores for the global and specific scales ranged from 24 to 96, with higher scores
indicating higher levels of perceived support.
40 Cronbach alpha reliability coefficients of the total score have been found to range from
.84 to .92 (Cutrona & Russell, 1987), and research with this instrument has supported the validity of the Social Provisions Scale in a variety of populations. Specifically, predictive validity of the instrument has been established through research on loneliness (Cutrona, 1982), post- partum depression (Cutrona, 1984), and health status (Russell, Altmaier, & Van Velzen, 1987).
Studies have also established convergent, divergent, and construct validity of the instrument
(for review see Cutrona & Russell, 1987). High internal reliability was observed in the present study, with Cronbach alpha coefficients of .90, .93, .94, and .93 for the global support, mother support, father support, and partner support scales, respectively.
Sexual functioning: Sexual Risk Survey (SRS). The Sexual Risk Survey (SRS) is a 23-item self-report measure that assesses the frequency of risky sexual behaviors in the past six months in individuals with or without sexual experience (Turchik & Garske, 2009). The 23 items can be used to compute a total score of risky sexual behavior, which was used in the primary analyses of this study. In addition, the instrument also reflects five subscales: sexual risk taking with uncommitted partners, risky sex acts, impulsive sexual behaviors, intent to engage in risky sexual behaviors, and risky anal sex acts. Given that the data is expected to be significantly negatively skewed, Turchik and Garske (2009) recommend that frequencies be recoded to reflect five ordinal categories using the following guidelines: 0 = 0, 1 = 40% of responses, 2 =
30% of responses, 3 = 20% of responses, and 4 = 10% of responses. After recoding, possible total scores on the SRS range from 0 to 92, with higher scores indicating higher levels of sexual risk.
41 The SRS total score has demonstrated good reliability (.88-.89) in previous studies (Stillo,
2011; Turchik & Garske, 2009; Turchick, Garske, Probst, & Irvin, 2010). Consistent with this, the present study yielded a Cronbach’s alpha of .87 for the SRS total score. Previous studies also
support good test-retest reliability (.93) for the total scale (Turchik & Garske, 2009; Turchik et
al., 2010). Furthermore, the SRS has been shown to have good content, concurrent, and
convergent validity, and is especially appropriate for use with college students (Turchik &
Garske, 2009).
Self-Efficacy Instrument for Protective Sexual Behaviors. To assess participants’
confidence for engaging in health-promoting sexual behaviors, the Self-Efficacy Instrument for
Protective Sexual Behaviors (SEI; Cecil & Pinkerton, 1998) was used. The SEI is a 22-item self-
report measure that assesses participants’ self-efficacy in three domains of protective sexual
behavior: 1) ability to refuse sexual intercourse, 2) question potential sexual partners, and 3)
use condoms. The instrument asks participants to rate their confidence to engage in a
particular behavior on a 5-point Likert scale with endpoints ranging from 1 (not at all) to 5 (very
sure). Total scores are calculated by summing item scores, such that greater scores indicate
higher levels of self-efficacy.
Cecil and Pinkerton (1998) report good internal consistency with Cronbach alphas of .85
(refusing intercourse), .80 (questioning partners), and .81 (condom use). The present study
yielded similar findings, with Cronbach’s alphas of .85, .83, .83 for the subscales, respectively,
and .86 for the total score. Previous studies have demonstrated adequate convergent and
discriminant validity (Cecil & Pinkerton, 1998).
42 Sexual motivations. To assess participants’ motivations for engaging in sexual behavior,
the Sexual Motives Scale (SMS), a 29 item self-report measure developed by Cooper and
colleagues (1998), was used. This instrument asks participants to rate their reasons for
engaging in sexual behavior on a 5-point Likert scale ranging from 1 (not at all important) to 5
(very important). The measure identifies six motivations for sexual behavior, including Intimacy motivations (e.g. “make an emotional connection”), Enhancement motivations (e.g. “satisfy sexual needs”), Coping motivations (e.g. “feel better when low”), Self-Affirmation (e.g. “feel better about self”), Partner Affirmation (e.g. “afraid partner will leave if don’t have sex”), and
Peer Approval (e.g. “Because friends are having sex”).
Previous studies have reported adequate convergent and divergent validity, as well as good reliabilities for the sex motive scales. Cooper et al. (1998) reported Cronbach’s alphas for the Enhancement, Intimacy, Coping, Self-Affirmation, Partner Approval, and Peer Approval scales to be .87, .90, .82, .87, .84, and .87, respectively. Similar internal reliabilities were observed in the present study, with Cronbach’s alphas of .91, .94, .84, .83, and .85, respectively.
It is important to note that previous studies have reflected some concern about the high inter- correlations of some of the scales. In the present study, the Coping and Self-Affirmation scales were most correlated (r = .67). Given their hypothesized theoretical relevance, the Coping and
Intimacy scales will be used in the primary hypotheses of the present study. The scales have been shown to demonstrate adequate convergent and divergent validity (Cooper et al., 1998).
Data Analytic Strategy
Preliminary analyses checked for missing data, out-of-range variables, fit between
distributions, and whether assumptions were met for the primary hypotheses. Data were also
43 examined to identify problems with multicollinearity and assess the normality of the
distributions. In addition, the scales were examined to test associations with demographic
variables.
This study employed multiple-group path analysis (Bollen, 1989; Arbuckle & Wothke,
1999) using full information maximum likelihood estimation to examine the primary
hypotheses. This design was selected to allow for the simultaneous assessment of multiple
mediators and evaluation of comparative strengths of the direct and indirect effects of
variables (Olobatuyi, 2006). Although path analysis allows for “causal modeling,” the
correlational design of the current study tests directional hypotheses based on existing
literature but cannot empirically support the direction of causality.
Specifically, the present study evaluated 1) the unique contributions of romantic
attachment and source-specific social support in predicting sexual outcomes, 2) sex differences
in these relationships, 3) sexual motives as potential mediators of those relationships, and 4)
whether or not these relationships differed between men and women (moderated mediation).
Three sets of theoretical models were identified and are depicted in Figures 1-9. The statistical
program Analysis of Moment Structures Version 22.0 (Amos; Arbuckle, 2013) was used to
examine the proposed models. Consistent with recommendations for the sample size and
design of the current study, single indicators were used for all variables. Each set of models
was run using two different sexual outcomes as dependent variables: risky sexual behavior
(SRS total score) and health-promoting sexual beliefs (SEPSB total score). Various indices were consulted to evaluate fit for each model, including chi-square model of fit, comparative fit index
44 (CFI), root mean square of approximation (RMSEA), normed fit index (NFI), and incremental fit
index (IFI).
Model Hypotheses
Each of the theoretical models denotes a group of several specific hypotheses. The first set of multi-group models tested the direct effects of romantic attachment and source-specific
social support on sexual outcomes. Specifically, Model 1 predicted that attachment avoidance
would be positively related to risky sexual behaviors and inversely related to health-promoting
sexual beliefs, and attachment anxiety would be positively related to risky sexual behaviors and
inversely related to health-promoting sexual beliefs. Strengths of these associations are
expected to vary for males and females. Models 2a and 2b tested the direct effects of source-
specific social support on sexual outcomes. Specifically, Model 2a utilized the full sample and
predicted that higher levels of perceived parental support would be inversely related to risky
sexual behavior and positively related to health-promoting sexual beliefs for males and
females. Model 2b investigated the effects of support from parents and romantic partners for
those participants who reported current involvement in a romantic relationship. This model
predicted that higher levels of perceived support from mothers, fathers, and romantic partners
would be inversely related to risky sexual behavior and positively related to health-promoting
sexual beliefs for both males and females.
The second set of models tested associations between romantic attachment and sexual
outcomes, specified to occur through coping and intimacy motives. Specifically, Model 3
predicted that higher levels of attachment avoidance would be negatively related to intimacy
motives and positively related to coping motives, attachment anxiety would be positively
45 related to intimacy and coping motives, and intimacy and sexual motives would mediate the relationship between attachment dimensions and risky sexual behavior. The hypothesized pathways proposed in Model 4 are similar, but include health-promoting sexual beliefs as the dependent variable of interest.
The third set of models tested associations between source-specific social support and sexual outcomes, specified to occur through coping and intimacy motives for men and women.
Specifically, Model 5a utilized the full sample and predicted that higher levels of parental support would be positively related to intimacy motives and negatively related to coping motives, and intimacy and coping motives would mediate the relationship between parental support and risky behaviors. Model 5b was similar, but predicted that sexual motives would mediate links between parental and partner support in the subset of the sample that reported current involvement in a romantic relationship. The hypothesized pathways proposed in
Models 6a and 6b are similar to the previous two models, but include health-promoting sexual beliefs as the dependent variable of interest.
46 CHAPTER III
RESULTS
Description of the Sample
A description of the sample characteristics are presented in Table 1. The sample consisted of 192 female and 97 male students. The participants had a mean age of 20.74 years
(SD = 1.81). The sample was predominantly Caucasian (42.6%), followed by African-American
(21.7%), Latino/Latina (20.4%), Multiracial (8.6%), and Asian (6.6%) which is similar to the overall university population. Students with a senior class standing represented 33.8% of the sample, followed by juniors (24.1%), freshmen (20.0%), sophomores (18.3%), and other (2.8%).
A little more than half of the participants reported their parents were married and living together (55.2%). When asked about their parents’ level of education, most participants reported their parents having had at least some college education or higher, with participants reporting slightly higher numbers for their mothers (71.8%) having had at least some college compared to their fathers (63.3%). A large majority of participants reported their relationships with their parents either stayed the same or improved since beginning college. More than half of the sample reported their relationship with their mother had improved (53.1%), and almost half reported their relationship with their father had improved (49.6%). Only 7.2% and 10.3% of the sample reported declines in their relationships with their mothers and fathers, respectively.
In addition, 37.4% of the participants were first-generation college students. Of these individuals, 72.2% were female and 27.8% were male. The mean age of first-generation
47 students was 20.63 years (SD = 1.83). The majority were Caucasian (35.2%), followed by
Latino/Latina (32.4%), African American (19.4%), Multi-racial (9.3%), and Asian (3.7%).
Demographic information relating to participants’ romantic and sexual histories was also assessed and is presented in Table 2. A little more than half of the sample reported current involvement in a romantic relationship (53.8%), with the majority of these relationships having lasted at least one year (55.0%). Most participants indicated they had only been involved in one romantic relationship during the past year (53.8%), followed by zero (21.0%), two (16.6%), three (3.1%), and four or more relationships (5.2%). With regards to sexual orientation, a majority of the sample identified as straight (88.3%), followed by gay/lesbian
(4.1%), bisexual (4.1%), other (1.0%), and prefer not to answer (0.3%).
A large majority of the sample was sexually active (79.3%). Approximately half of these participants reported previously visiting a health care professional for issues or testing related to sexual activity (50.1%). A smaller number of this sample reported having been pregnant or caused pregnancy (9.6%) and/or diagnosed with a sexually transmitted disease (7.7%).
Among sexually active participants, most reported their first sexual intercourse occurred before age 18 (65%) and was unplanned (56.4%). The majority indicated their first partner was a boyfriend/girlfriend (71.4%), and they used contraceptives during their first sexual experience
(68.8%). When asked about the change in relationship after first intercourse, participants most commonly reported they became closer with their partner (59.8%). However, some indicated they grew apart from their partner (18.6%), lost respect for themselves (8.6%), lost respect for their partner (3.8%), or believed their partner lost respect for them (1.4%).
48 Approximately half of sexually active participants reported having one sexual partner
within the past year (51.9%), with others reporting two (21.7%), three (7.5%), and four or more
(13.2%) sexual partners during that time. It is interesting to note these percentages appear similar to the number of relationships within the past year. The mean number of lifetime sexual partners was 7.29 (SD = 15.17) and ranged from 0 to 150. Additionally, the majority of the sexually active sample indicated they had previously engaged in sexual intercourse outside the context of an exclusive romantic relationship (67.5%). Of those, most reported four or more casual sex partners (40.1%).
Preliminary Analyses
Preliminary analyses were conducted to determine whether scales were performing as expected, based on recent literature, and to identify any potential measurement problems.
Means, standard deviations, and ranges of the scales are presented in Table 4. Of note, based on the recommendations by the authors, raw items of the Sexual Risk Survey (SRS; Turchik &
Garske, 2009) were recoded into an ordinal series to reduce variability in raw score totals.
Means, standard deviations, and ranges for the recoded SRS scales are presented in Table 5.
Analyses were also conducted to assess the influence of demographic variables (age, gender, relational status, racial/ethnic identity, sexual orientation, first-generation status) on
primary variables of interest (attachment anxiety and avoidance, social support, sexual
motivations, risky sexual behavior, and health-promoting sexual beliefs) to determine whether they needed to be accounted for in the models. Pearson correlations indicated that age of the participants was not significantly related to either attachment dimension or perceived support from fathers or romantic partners. However, age was negatively correlated with mother
49 support (r = -.12, p = .047), suggesting as individuals age they report less perceived support
from maternal figures. Although age did not correlate with coping motivations to engage in
sexual behavior, a positive relationship did emerge between age and intimacy motivations (r =
.15, p = .01). As might be expected, older students reported more frequent engagement in
risky sexual behavior (r = .20, p = .000). Unfortunately, older students also reported fewer health-promoting sexual beliefs (r = -.12, p = .045).
A series of t-tests were conducted to examine gender differences among the primary
variables. While there was no significant difference in scores for females and males in ratings
of attachment avoidance, females reported greater attachment anxiety (M = 69.05, SD = 21.55)
than males (M = 62.20, SD = 21.39; t [286] = 2.55, p = .01); however, the magnitude of the mean difference was small (η2 = .02). Participants’ gender was not significantly associated with perceptions of support from mothers, fathers, or romantic partners. While no significant gender differences emerged when considering intimacy motivations for engaging in sexual behavior, t-tests demonstrated that males reported greater motivations to engage in sexual behavior for coping reasons (t = 2.74, p < .01, η2 = .02). There were no significant gender differences in participants’ reports of risky sexual behavior in the past six months. However, t-
tests revealed a significant gender difference in health-promoting sexual beliefs, such that
female participants reported greater overall self-efficacy for engaging in protective sexual
behaviors (M = 81.68, SD = 12.76) than male participants (M = 74.07, SD = 12.83; t [281] = 4.73, p < .001, η2 = .07).
A series of t-tests were conducted to examine differences in relationship status among the primary variables. While there was no significant difference in ratings of attachment
50 anxiety between the groups, romantically attached participants reported less attachment avoidance (M = 45.91, SD = 16.76) than those who were single (M = 57.71, SD = 19.51; t [286] =
-5.52, p < .001). The magnitude of the differences in the means was moderate (η2 = .09).
Participants’ relational status was not significantly associated with perceptions of support from
mothers or fathers. However, as expected, romantically involved participants reported greater
perceived support from current or most recent romantic partners (M = 80.99; SD = 7.87) than
those who were single (M = 65.51; SD = 15.73; t [261] = 10.46, p < .001). It is important to note that approximately 9% of the sample reported never having been involved in a relationship; thus, these participants were excluded from the latter analysis. In addition, while there were
no significant differences between the groups when considering coping motivations for sexual
behavior, t-tests demonstrated that those in a relationship reported greater motivations to
engage in sexual behavior for intimacy reasons (M = 19.20, SD = 5.07) than those who were single (M = 17.88, SD = 4.19; t = [286] = 2.11, p = .04); however, the magnitude of the differences in the means was small (η2 = .02). There were no significant differences in relational
status with regard to participants’ reports of risky sexual behavior in the past six months or
health-promoting sexual beliefs.
A series of t-tests were also conducted to examine the effects of parents’ marital status
on the primary variables. Parents’ marital status was collapsed into “intact” and “non-intact,”
which separated participants whose parents were currently married (58.3%) from those whose
parents were divorced, deceased, or never married (41.7%). Of note, those from an intact
family reported significantly less engagement in risky sexual behavior (t [288] = -3.66, p = .01, η2
=.02), as well as greater perceived support from mothers (t [283] = 1.97, p = .05, η2 =.01) and
51 fathers (t [280] = 5.681, p = .000, η2 =.10), as compared with those participants whose parents
were no longer married. There were no significant differences in parents’ marital status with
regard to attachment dimensions, partner support, health-promoting sexual beliefs, or sexual
motivations.
Using analysis of variance (ANOVA) tests, participants’ ethnicity was examined to
elucidate potential relationships between ethnicity and the primary variables. Results revealed
that ethnicity was not significantly related to key study variables when examined individually
nor when ethnicity was collapsed into “Caucasian” and “non-Caucasian” groups. To ascertain
any differences related to participants’ first generation status, t-tests were conducted. No
significant relationships emerged between first generation status and the key variables in this
study. Finally, sexual orientation was collapsed into “straight” and “non-straight” given the
small sexual minority distribution, and t-tests were conducted to evaluate relationships with
sexual orientation and primary variables. Several significant differences emerged during these
analyses, such that sexual minority participants reported higher levels of attachment anxiety (t
[282] = -4.24, p = .000, η2 = .06), less perceived support from mothers (t [278] = 3.11, p = .002,
η2 = .03) and fathers (t [275] = 1.47, p = .025, η2 = .02), and greater engagement in risky sexual
behaviors (t [283] = -2.39, p = .02, η2 =.02). Aside from the medium effect observed for attachment anxiety, the actual differences in mean scores between the other groups were small. Thus, we did not find reason to include these variables in the primary analyses.
For exploratory purposes, analysis of variance (ANOVA) tests examined potential links between engagement in casual sex and the primary variables utilizing the subsample of sexually active participants (n = 230). The ANOVAs for health-promoting sexual beliefs (F[4, 220] = 7.42,
52 p < .001, η2 =.12), risky sexual behavior (F[4, 225] = 16.70, p < .001, η2 =.22), and coping motives
(F[4, 224] = 3.54, p < .01, η2 =.06) were significant. Post-hoc pairwise comparisons revealed that participants who have engaged in several (four or more) casual sex encounters reported significantly fewer health-promoting sexual beliefs, more risky sexual behaviors, and greater coping sexual motives than did participants who have not engaged in casual sex.
Path Analysis
Preliminary analyses were conducted to evaluate the data for statistical assumptions of path analysis, including linearity of relationships between variables, independence of exogenous variables, and multivariate normality. First, path analysis assumes linear relationships among variables. Curve estimations for all relationships in the models were conducted, and it was determined that relationships were sufficiently linear. Next, exogenous variables were reviewed to determine independence from one another. As shown in Table 6, significant correlations emerged between several scales, which was expected given that many of the variables examined related constructs. In path analysis, a correlation of .80 or greater typically is recognized as the cutoff for violating the assumption of independence. Therefore, although several correlations reached statistical significance, the assumption of independence was not violated.
To assess for normality, Shapiro-Wilk’s tests of normality were performed on the individual scales, and several variables were found to be non-normal at the .05 level.
Multivariate normality was also evaluated for each of the models using the Amos statistical software. Results similarly revealed that several of the models were found to be non-normal at the .05 level (Cox & Small, 1978). To address issues of non-normality, non-parametric
53 bootstrap approaches were utilized with maximum likelihood estimations. Data transformations, often utilized in other multivariate analyses, were considered. However, several potential drawbacks for transforming variables in path analysis have been identified.
Among these limitations is that results of statistical analyses run using transformed variables yield different interpretations than analyses using original scales (Kline, 2011).
Assessment of Model Fit
The first step in path analysis is the evaluation of fit with the data compared to a specified model. Overall, there is wide disagreement on which indexes to report; thus, researchers recommend presenting multiple values to reflect diverse criteria (Jaccard & Want,
1996). In the present study, model fit was determined by examining several indices, including the chi-square test of model fit, the comparative fit index (CFI), the root mean square residual
(RMSEA), the normed fit index (NFI), and the incremental fit index (IFI) (Kline, 2011).
Adequate fit as measured by the chi-square test of model fit requires a p-value greater than .05 (Barrett, 2007). In the present study, the Bollen-Stine bootstrap modification of model chi-square was utilized to adjust for lack of multivariate normality and test model fit. Using this approach, if p-values are less than .05, the model is rejected. Demonstrating adequate fit for
CFI requires a value of greater than .90 to accept the model, which indicates that 90% of the covariation in the data can be reproduced by the model. Adequate fit as demonstrated by use of the RMSEA requires value of .06 or less, while values between .05 and .08 indicate a fair fit, and values spanning .08 to .10 are mediocre fit. The Amos statistical software package reports a 90% confidence interval around this value. NFI values above .95 indicate good fit, and IFI values close to 1 indicate a very good fit. Martens (2005) cautions against exclusive use of the
54 goodness-of-fit index (GFI) and NFI statistics, as they tend to be substantially affected by
sample size and number of indicators and have been shown to not generalize well across
samples. As such, they recommend including CFI and RMSEA as primary goodness of fit statistics.
Direct Effects Models
Two direct effect models were examined for adequate fit between the data and the specified models. The first direct effects model (Model 1) examined risky and health-promoting sexual outcomes as a function of romantic attachment in a multiple group model simultaneously estimated separately for men and women. It was predicted that a positive relationship would emerge between attachment dimensions and sexual risk taking behaviors, as well as an inverse relationship between attachment dimensions and health-promoting sexual beliefs. When evaluating model fit, covariances among attachment subscales were constrained to equality across gender to avoid a completely saturated model, which allowed for examination of model fit. In other words, forcing this parameter to derive equal estimates across genders simplified the analysis because only one coefficient was needed rather than two, thus freeing up a degree of freedom (Kline, 2011). Disturbance correlations were included to reflect the assumption that the sexual outcome variables share at least one common unmeasured cause. Fit indices are presented in Table 9 and provided reasonably good fit, given that the chi-square was approaching significance, χ2 (1) = 3.58, p = .059; Bollen-Stine bootstrap
p = .074; CFI = .960; RMSEA = .095; NFI = .953; IFI = .966. Figure 1 presents the standardized
path coefficients for men and women included in Model 1.
55 We tested the hypothesis that males and females would differ by conducting a multiple-
group moderation analysis. Constraining the structural parameters in Model 1 to be equal
across the groups resulted in a statistically significant worsening of overall model fit (Δχ2=
24.12, Δ df = 4; p < .001), rejecting the null hypothesis that the paths (as a whole) are the same across the genders. Thus, significant differences between specific pathways were evaluated through tests of critical ratios differences. Results supported the hypothesis that gender
moderates the relations between attachment subscales and each of the sexual outcomes. That
is, there was a statistically significant difference between males and females on the paths
leading from a) attachment avoidance to sexual risk (p < .01), b) attachment avoidance to
health-promoting sexual beliefs (p < .05), c) attachment anxiety to sexual risk (p < .01), and d)
attachment anxiety to health-promoting sexual beliefs (p < .01).
Examination of the parameter estimates by gender provides further information. As
males reported higher levels of attachment avoidance, they also reported fewer health-
promoting beliefs and greater engagement in risky sexual behavior. In other words, a
significant inverse relationship between males’ attachment avoidance and health-promoting
sexual beliefs (β = -.22, p = .03) emerged as anticipated, as did a significant positive relationship
between attachment avoidance and risky sexual behaviors (β = .28, p = .01). Notably,
hypothesized parameters between attachment avoidance and sexual outcomes for females
were not significant as expected in this model.
In contrast, examination of the direct effects of attachment anxiety on sexual outcomes
yielded several significant findings for females, but not for males. As females reported higher
levels of attachment anxiety, they also reported fewer health-promoting sexual beliefs and
56 more frequent engagement in risky sexual behavior. Specifically, hypothesized parameters
between females’ ratings of attachment anxiety and health-promoting sexual beliefs
demonstrated a significant negative relationship as anticipated (β = -.28, p < .001). A significant
positive relationship between females’ attachment anxiety and risky sexual behaviors also
emerged as anticipated (β = .24, p < .001). No significant association between male attachment
anxiety and either sexual outcome was observed. Therefore, for both males and females
insecure attachment was associated with problematic sexual outcomes, although attachment
avoidance was the strongest predictor for males and attachment anxiety was the strongest
predictor for females.
The second model (Model 2a) examined the direct effects of perceived social support from mothers and fathers on risky and health-promoting sexual outcomes for the entire sample. A multi-group model was used to simultaneously estimate the effects separately for men and women. It was predicted that perceived support from mothers and fathers would be positively related to health-promoting sexual beliefs and inversely related to risky sexual behavior. Covariances of the support scales were constrained across genders to evaluate model fit, and disturbance correlations were included to reflect the assumption that the sexual outcome variables share at least one common unmeasured cause. The resulting model provided good fit to the data, χ2 (1) = .01, p = .91; Bollen-Stine bootstrap p = .908; CFI = 1.000;
RMSEA = .000; NFI = 1.001; IFI = 1.010. Figure 2 presents the standardized path coefficients for
men and women included in Model 2a.
We tested the hypothesis that males and females would differ from one another on
each of the relations in the path model by conducting a multiple-group moderation analysis.
57 Constraining the structural parameters in Model 2a to be equal across the groups did not result
in a statistically significant worsening of overall model fit (Δχ2= 9.01, Δ df = 4; p = .06), which
failed to reject the null hypothesis that the paths (as a whole) are the same across the genders.
That is, results did not support the hypothesis that gender moderates the relations between
parental support and sexual outcomes. Although the findings above support a fit between the
data and the specified model, hypothesized parameters between support sources and sexual
outcomes were not significant. Therefore, hypotheses that parental support would be related
to sexual outcomes were not significant for the overall sample of emerging adults.
The third model (Model 2b) examined the direct effects of perceived social support from
mothers, fathers, and romantic partners on risky and health-promoting sexual outcomes for
those participants who reported current involvement in a romantic relationship (n = 156). It is
important to note that power was negatively affected by the smaller sample size included in
this model. A multi-group model was used to simultaneously estimate the effects separately
for men and women. It was predicted that perceived support from mothers, fathers, and
romantic partners would be positively related to health-promoting sexual beliefs and inversely
related to risky sexual behavior. We hypothesized that the strength of the effect would be
stronger for romantic partners than for parental support. Covariances of the support scales
were constrained across genders to evaluate model fit, and disturbance correlations were
included to reflect the assumption that the sexual outcome variables share at least one
common unmeasured cause. The resulting model provided good fit to the data, χ2 (3) = 3.17, p
= .37; Bollen-Stine bootstrap p = .56; CFI = .997; RMSEA = .019; NFI = .963; IFI = .998. Figure 3 presents the standardized path coefficients for men and women included in Model 2b.
58 We tested the hypothesis that males and females would differ from one another on the
path model by conducting a multiple-group moderation analysis. Constraining the structural
parameters in Model 2b to be equal across genders resulted in a statistically significant worsening of overall model fit (Δχ2= 17.26, Δ df = 6; p = .01), rejecting the null hypothesis that
the paths (as a whole) are the same across the genders. Thus, significant differences between
specific pathways were evaluated through tests of critical ratios differences. Results of this
analysis supported the hypothesis that gender moderates the relationship between mother
support and health-promoting sexual beliefs (p < .01).
Examination of the parameter estimates by gender provides further information. For
men, the hypothesized pathway between mother support and health-promoting sexual beliefs
was significant, but in the opposite direction anticipated (β = -.43, p < .01). That is, as males
reported higher levels of maternal support, they also reported fewer health-promoting sexual
beliefs. Hypothesized pathways between perceived support from fathers and romantic
partners and males’ health-promoting sexual beliefs were not significant. None of the
hypothesized pathways between support sources and risky sexual behavior were supported for
males in this model.
While results for females also revealed a significant pathway between mother support and health-promoting sexual beliefs, it was in the positive direction as anticipated (β = .24, p =
.02). In other words, as females reported higher levels of perceived support from their mothers, they also reported more health-promoting sexual beliefs. Similar to the findings for males, neither the pathway between father support and health-promoting sexual beliefs nor
the pathway between partner support and health-promoting sexual beliefs was significant in
59 this model. The hypothesized pathways between support sources and risky sexual behavior were also not supported for females in this model.
Indirect Effects Models
Romantic attachment models. Two romantic attachment indirect effects models were examined for adequate fit between the data and the specified models. The first (Model 3) examined risky behavior as a function of romantic attachment specified to occur through sexual motives. The second (Model 4) was similar, but included health-promoting sexual beliefs as the outcome variable of interest. Each evaluated variables in a multiple group model, simultaneously estimated separately for men and women, and included intimacy and coping motives as indirect paths. It was predicted that attachment avoidance would be inversely related to intimacy motives and positively related to coping motives, attachment anxiety would be positively related to intimacy and coping motives, and the sexual motives would mediate the relationship between attachment dimensions and the sexual outcomes.
When evaluating fit to the data for each model, covariances among attachment subscales were constrained to equality across genders to avoid completely saturated models, and disturbance correlations among endogenous mediators were included to reflect the assumption that the sexual motivation variables shared at least one common unmeasured cause. Path coefficients between attachment dimensions and motives and between motives and sexual outcomes were free to vary across gender. Fit indices are presented in Table 10 and provided reasonably good fit to the data for Model 3, given that the chi-square was approaching significance, χ2 (1) = 3.58, p = .06; Bollen-Stine p = .07; CFI = .984; RMSEA = .095;
NFI = .980; IFI = .985, and Model 4, χ2 (1) = 3.58, p = .06; CFI = .983; RMSEA = .095; NFI = .980; IFI
60 = .985. Figures 4 and 5 present the standardized path coefficients for men and women included the models.
We tested the hypothesis that males and females would differ by conducting a multiple-
group moderation analysis. Constraining the structural parameters in Model 3 to be equal
across the groups resulted in a statistically significant worsening of overall model fit (Δχ2=
31.66, Δ df = 8; p < .001), rejecting the null hypothesis that the paths (as a whole) are the same
across the genders. Similarly, constraining the structural parameters in Model 4 to be equal
across the groups also resulted in statistically significant worsening in overall model fit (Δχ2=
22.89, Δ df = 8; p < .01), rejecting the null hypothesis that the paths (as a whole) are the same across the genders. Thus, significant differences between specific pathways were evaluated
through tests of critical ratios differences for each of the models. In addition to the significant
gender differences observed in the direct effects models between the attachment scales and
sexual outcomes, results also supported hypotheses that gender moderates the relations
between attachment anxiety and coping motivations (p < .01) and between coping motivations
and sexual risk (p < .01).
Examination of the parameter estimates by gender provides further information about the results for each model. For males in both models, hypothesized parameters between
attachment avoidance and intimacy motives demonstrated a significant inverse relationship as
anticipated (β = -.47, p < .001), showing that males who reported higher levels of attachment avoidance reported fewer intimacy sexual motives, whereas no significant association between attachment avoidance and coping motives was observed. Further, significant paths between
attachment anxiety and intimacy motives were found in the positive direction as anticipated in
61 both models (β = .24, p < .01), showing that males who reported higher levels of attachment
anxiety reported greater intimacy sexual motives, whereas no significant association between
attachment anxiety and coping motives was observed. For males in Model 3, although the path between intimacy motives and risky sexual behavior was not significant, the parameter estimate between coping motives and sexual risk demonstrated a significant positive relationship as predicted (β = .30, p = .001). In other words, men with higher levels of coping sexual motives reported more engagement in risky sexual behavior. For males in Model 4, although the path between intimacy motives and health-promoting sexual beliefs was not significant, the parameter estimate between coping motives and health-promoting sexual beliefs demonstrated a significant inverse relationship as predicted (β = -.25, p = .01). That is,
men with fewer coping sexual motives reported more health-promoting sexual beliefs. When
indirect effects were examined for males in Models 3 and 4, results did not support hypotheses
that sexual motivations would mediate the relationship between attachment dimensions and
sexual outcomes.
For females in both models, hypothesized parameters between attachment avoidance
and intimacy motives demonstrated a significant inverse relationship as anticipated (β = -.46, p
< .001), showing that females who reported higher levels of attachment avoidance also
reported fewer intimacy sexual motives, whereas no significant association between
attachment avoidance and coping motives was observed. Further, significant paths between
attachment anxiety and intimacy motives (β = .26, p < .001) and between attachment anxiety
and coping motives (β = .41, p < .001) were observed in the positive direction as anticipated in
both models. Therefore, females with higher levels of attachment anxiety reported more
62 intimacy and coping motivations for sexual behavior. For females in Model 3, parameter
estimates between sexual motives and risk sexual behavior were not significant as anticipated.
Thus, the hypothesized relationships between attachment avoidance and sexual risk through
sexual motives were not supported. For females in Model 4, although the path between
intimacy motives and health-promoting sexual beliefs was not significant, the parameter
estimate between coping motives and health-promoting sexual beliefs demonstrated a
significant inverse relationship as predicted (β = -.19, p = .01). In other words, females with
fewer coping sexual motivations reported more health-promoting sexual beliefs. When indirect
effects were examined for females in Model 4, data supported a relationship between
attachment anxiety and health-promoting sexual beliefs through coping motives (β = -.07, p <
.05). Results indicated that coping motivations partially mediates the effect of attachment
anxiety on females’ health-promoting sexual beliefs. The hypothesized relationship between
attachment anxiety and health-promoting sexual beliefs through intimacy was not supported.
Results also did not support hypotheses that sexual motives would mediate the relationship
between attachment avoidance and health-promoting sexual beliefs.
Social support models. Two sets of social support indirect effects models were
examined for adequate fit between the data and the specified models. The first set of social
support indirect models (Model 5a and Model 6a) examined sexual outcomes as a function of
parental social support specified to occur through sexual motives for the entire sample. Model
5a examined risky sexual behavior as the dependent variable of interest, while Model 6a
included health-promoting sexual beliefs as the sexual outcome. Each evaluated variables in a multiple group model, simultaneously estimated separately for men and women, and included
63 intimacy and coping motives as indirect paths. It was predicted that higher levels of perceived
parental support would be positively related to intimacy motives and inversely related to
coping motives, and the sexual motives would mediate the relations between parental support
and sexual outcomes.
When evaluating fit to the data for each model, covariances among social support subscales were constrained to equality across genders, and disturbance correlations among endogenous mediators were included to reflect the assumption that the sexual motivation variables shared at least one common unmeasured cause. Path coefficients between social support sources and motives and between motives and sexual outcomes were free to vary
across gender. Fit indices are presented in Table 10 and provided good fit to the data for Model
5a, χ2 (1) = .01, p = .91; Bollen-Stine p = .91; CFI = 1.000; RMSEA = .000; NFI = 1.000; IFI = 1.011, and good fit to the data for Model 6a, χ2 (1) = .01, p = .91; Bollen-Stine p = .908; CFI = 1.000;
RMSEA = .000; NFI = 1.000; IFI = 1.010. Figures 6 and 8 present the standardized path
coefficients for men and women included in Model 5a and Model 6a, respectively.
We tested the hypothesis that males and females would differ by conducting a multiple-
group moderation analysis. Constraining the structural parameters in Model 5a to be equal
across the groups resulted in a statistically significant worsening of overall model fit (Δχ2=
19.03, Δ df = 8; p = .01), rejecting the null hypothesis that the paths (as a whole) are the same
across the genders. Similarly, constraining the structural parameters in Model 6a to be equal
across the groups also resulted in statistically significant worsening in overall model fit (Δχ2=
17.77, Δ df = 8; p = .02), rejecting the null hypothesis that the paths (as a whole) are the same across genders. Thus, significant differences between specific pathways were evaluated
64 through tests of critical ratios differences for each of the models. Results revealed a significant difference between males and females on the pathway between coping motives and risky sexual behavior (p < .01), as well as other pathways that approached significance (p < .10), including the associations between maternal support and intimacy motives, father support and coping motives, mother support and health-promoting sexual beliefs, and intimacy motives and health-promoting sexual beliefs.
Examination of the parameter estimates by gender provides further information about the results for each model. For males, hypothesized parameters between parental support and sexual motives were not significant in either model. When indirect effects were examined for men in Models 5a and 6a, results did not support hypotheses that sexual motivations would mediate relationships between parental support and sexual outcomes.
For females in both models, hypothesized parameters between father support and coping motives demonstrated a significant inverse relationship as anticipated (β = -.17, p = .02), showing that females with greater paternal support reported fewer motivations to engage in sexual behavior to regulate negative affect. No significant associations between father support and intimacy motives emerged, nor did they occur between maternal support and either sexual motive. For females in Model 5a, parameter estimates between sexual motives and risk sexual behavior were not significant as anticipated. Thus, the hypothesized relationships between attachment avoidance and sexual risk through sexual motives were not supported. When indirect effects were examined for females in Model 6a, data showed a relationship between paternal support and health-promoting sexual beliefs through coping motives (β = .03, p = .04).
65 Results did not support hypotheses that intimacy motivations would mediate relationships
between support and health-promoting sexual beliefs for females in this model.
The second set of social support models (Model 5b and Model 6b) examined sexual outcomes as a function of maternal, paternal, and romantic partner support specified to occur through sexual motives for the subset of romantically involved participants (n = 156).
Specifically, Model 5b examined risky sexual behavior as the dependent variable of interest, while Model 6b included health-promoting sexual beliefs as the sexual outcome. Each evaluated variables in a multiple group model, simultaneously estimated separately for men and women, and included intimacy and coping motives as indirect paths. It was predicted that greater perceived support would be positively related to intimacy motives and inversely related to coping motives, and the sexual motives would mediate the relations between support and sexual outcomes. We anticipated that the parameters between partner support and the endogenous variables would be more strongly related, relative to the parental support scales.
When evaluating fit to the data for each model, covariances among social support subscales were constrained to equality across genders, and disturbance correlations among endogenous mediators were included to reflect the assumption that the sexual motivation variables shared at least one common unmeasured cause. Path coefficients between social support sources and motives and between motives and sexual outcomes were free to vary across gender. Fit indices are presented in Table 10 and provided good fit to the data for Model
5b, χ2 (3) = 3.17, p = .37; Bollen-Stine p = .561; CFI = 1.000; RMSEA = .019; NFI = .972; IFI = .998,
as well as Model 6b, χ2 (3) = 3.17, p = .37; Bollen-Stine p = .561; CFI = .998; RMSEA = .019; NFI =
66 .974; IFI = .999. Figures 7 and 9 present the standardized path coefficients for men and women included in Model 5b and Model 6b, respectively.
We tested the hypothesis that males and females would differ by conducting a multiple-
group moderation analysis. Constraining the structural parameters in Model 5b to be equal
across the groups did not result in a statistically significant worsening of overall model fit (Δχ2=
9.33, Δ df = 11; p = .59), which failed to reject the null hypothesis that the paths (as a whole) are the same across the genders. Similarly, constraining the structural parameters in Model 6b to be equal across the groups did not result in a statistically significant worsening of overall model fit (Δχ2= 6.01, Δ df = 6; p = .42), which also failed to reject the null hypothesis that the paths (as a whole) are the same across genders. That is, results did not support the hypothesis that gender moderates the relations between support and sexual outcomes in Model 5b or Model
6b.
Examination of the parameter estimates showed a significant path between partner support and intimacy motives in the positive direction as anticipated for males (β = .31, p = .04) and females (β = .24, p = .02). For participants who were currently involved in a relationship, higher perceived support from their romantic partner was linked greater motivation to engage in sex to enhance intimacy regardless of gender. Hypothesized pathways between support and coping motives were not significant. When indirect effects were examined, results did not support hypotheses that sexual motivations would mediate relationships between support and sexual outcomes for romantically involved emerging adults.
67 CHAPTER IV
DISCUSSION
The purpose of this study was to better understand the influence of romantic attachment and social support on the sexual development of emerging adults. Previous research was extended by investigating comprehensive models which examined sexual motivations as potential underlying mechanisms that may explain the effects of romantic attachment and social support on sexual outcomes during the transition to adulthood. An additional contribution of the present study was expansion of the construct of sexuality to include both risky and health-promoting elements to promote a more inclusive understanding of sexuality for emerging adults, as well as the various processes that may influence prevention and intervention efforts.
Support was found for the path models and several of hypothesized pathways in the present study. Examination of the attachment models revealed support for the direct relationships between attachment and sexual outcomes. As predicted, gender was found to moderate these relations, such that attachment avoidance was more closely associated with males’ sexual outcomes, while attachment anxiety was most linked with females’ sexual outcomes. A partial mediation effect was found from attachment anxiety through coping motives to health-promoting sexual beliefs for females. However, the expected mediating effect of intimacy motives was not supported in any of the attachment models.
Relative to the attachment models, less support was found for hypotheses regarding the pathways in the social support models. While direct relationships between parental support and sexual outcomes were not significant for the overall sample, pathways between maternal
68 support and health-promoting sexual beliefs did emerge in the sample of romantically involved emerging adults. An indirect effect was found from father support through coping motives to health-promoting sexual beliefs for females in the overall sample. However, similar to the attachment models, findings did not support the hypothesized mediating effect of intimacy motives in any of the social support models.
Several important findings emerged from the current study. Some results support conclusions from previous research, while others introduce new ideas. First, findings highlight the importance of studying a variety of sexual outcomes in emerging adulthood, given the normative engagement in sexual behavior and unique processes present during this developmental period. Second, results from this study provide further backing for the idea that attachment theory provides an important framework for understanding sexual development.
Specific contributions to the literature on attachment and sexual behavior included further investigation of gender differences in the expression of attachment-related needs as it relates to sexuality, as well as consideration of intimacy and coping motives as potential explanatory pathways for links between the attachment and sexual systems. Third, overall findings indicated that perceived support was not shown to be as related to sexual outcomes as anticipated. Nonetheless, when considering gender and relationship context unique relationships between specific support sources and outcomes did emerge and will be discussed further. Finally, practical implications, limitations, and directions for future research will be addressed.
69 Sexuality in Emerging Adulthood
Emerging adulthood is a developmental period associated with a number of distinct
characteristics, such as normative declines in parental monitoring, few role responsibilities, and greater personal freedom (Arnett, 2000). The unique processes that affect this life stage have been associated with a number of outcomes, including a peak in risky behavior during the transition to adulthood (Arnett, 2005). It is expected, then, that emerging adults’ sexual behavior is also differentially impacted by the combination of those developmental processes.
However, relative to the literature on adolescent sexual behavior, it appears less is understood about emerging adults’ sexual development. Results of the current study highlight the importance of studying sexual behaviors during the transition to adulthood.
First, findings support the idea that sexual behavior is developmentally and statistically normative during this life stage. A large majority (79%) of the overall sample was sexually active, most of whom (84%) reported reaching their sexual debut on or before age 18, rates consistent with other recent studies (Abma et al., 2004; Stillo, 2011). These results challenge researchers to look beyond a “problematic” perspective of sexual behavior narrowly focused on harmful outcomes and instead adopt a normative lens that also acknowledges processes relevant as individuals develop into healthy sexual adults.
Further, results of the present study accentuate the relatively common occurrence of casual sex or “hook-up” encounters during this life stage. Nearly two-thirds of sexually active emerging adults reported at least one past sexual encounter with someone whom they were not romantically involved with. Implications of this observation are numerous, given that previous research has linked sexual behavior occurring outside of a romantic relationship with a
70 variety of problematic outcomes, including depression, substance use, and poor academic performance (Collins, Welsh, & Furman, 2009). In the present study, those participants who reported engaging in casual sex within the past six months reported significantly fewer health- promoting sexual beliefs and more frequent engagement in a number of risky sexual behaviors.
It is important to note, however, that examination of the risky sexual behavior dimension revealed that participants’ engagement in risky sexual behaviors was positively skewed. In other words, most emerging adults reported infrequent involvement across many of the risky sexual behaviors assessed. Even so, concerning health implications were associated with sexual behavior in this age group. Approximately 8% of the sexually active sample reported previously testing positive for a sexually transmitted infection, and 10% of the sample endorsed having previously been pregnant or caused a pregnancy. Although these events were not linked with overall engagement in risky sexual behavior, those participants who reported a previously diagnosed sexually transmitted infection did report significantly higher rates of risky sex acts (e.g. unprotected sexual intercourse and sexual intercourse under the influence of substances) and anal sex. It is likely that more significant associations with the STI and pregnancy outcomes did not emerge, at least in part, due to the relatively small number of affected participants. Review of the health-promoting sexual dimension revealed a normal distribution, which indicates greater variability in emerging adults’ reports of their confidence to engage in protective sexual behaviors. Overall, the above findings give emphasis to the importance of studying correlates of risky and health-promoting sexual outcomes throughout the transition to adulthood.
71 There is some evidence to suggest that specific groups of emerging adults may be especially at risk for negative health outcomes associated with sexual activity. Older emerging adults may be one such group, as the present study found increasing age to be significantly correlated with higher rates of risky sexual behavior and fewer health-promoting sexual beliefs.
Further, males more frequently reported engaging in sexual behavior as a coping mechanism and less confidence in their ability to engage in protective sexual behaviors, relative to their female counterparts. Emerging adults from intact families may also experience protective benefits, as they were found to report significantly fewer risky sexual behaviors and higher levels of perceived parental support. Finally, results indicate that sexual minority participants may be at elevated risk for negative health outcomes. Consistent with past research (e.g.
Corliss et al., 2009), emerging adults who identified as a sexual minority reported significantly less perceived support from their parents, as well as higher levels of attachment anxiety and more frequent engagement in risky sexual behavior. Given the small percentage of the present sample that identified as sexual minority (9.5%), it is recommended that future research continue to examine these relationships within a larger sample.
Emerging adults with prior involvement in casual sexual encounters also appear to be at elevated risk. When compared with sexually active emerging adults who have only engaged in romantic sex, emerging adults who have had sex with several (four or more) casual partners reported significantly less confidence in their ability to engage in health-promoting sexual behaviors, more frequent engagement in risky sexual behavior, and were more likely to have sex for coping reasons. Perhaps not surprisingly, engagement in sexual behavior with uncommitted partners was also associated with greater levels of attachment avoidance, fewer
72 intimacy sexual motives, and significantly less perceived support from current or most recent
romantic partners. These results, taken together with previous research that has linked
involvement in casual sex with other problematic health outcomes, such as depression (Grello
et al., 2006; Stillo, 2011), highlight the need for continued research on emerging adult sexuality
to take into account the context of sexual behavior (casual or romantic).
Many previous investigations of sexual development have been limited by a
predominant focus on risky sexual behaviors, operating on the assumption that risky and
health-promoting sexual behaviors are mutually exclusive. More recently, researchers have
argued these outcomes should be measured as two distinct constructs since it is possible for
individuals to engage in both risky and health promoting sexual behaviors (Stillo, 2011). Results
of the present study revealed a significant negative correlation between the two variables. This suggests a relationship between the two sexual outcomes, such that as men and women report higher levels of health-promoting beliefs, they also report less involvement in risky sexual
behaviors. The connection between these constructs is intriguing and may suggest a pathway
important to the design of sexual health prevention programs. Future investigation employing
longitudinal designs is warranted to clarify the direction of the relationship (i.e. whether
increasing emerging adults’ confidence in their ability to engage in health-promoting sexual
behaviors does, in fact, reduce engagement in risky sexual behavior). In addition, findings
provide further support for the idea that the constructs should be examined separately, as
many of the pathways that predicted positive aspects of sexuality were different from those
that predicted risky sexual outcomes.
73 Romantic Attachment and Emerging Adult Sexual Behavior
Overall, findings strongly validated attachment theory as a useful framework for understanding how beliefs about self and others may impact emerging adults’ sexual development. In support of previous research, both the direct and indirect effects models revealed several significant pathways in the expected directions between attachment dimensions and sexual motivations, beliefs, and behaviors in the expected directions.
Extending prior findings, the multiple group design revealed important sex differences in understanding links between attachment and sexual outcomes. As previous authors have noted (Cooper et al., 2006; Schachner & Shaver, 2004), while attachment theory does not assert sex-specific motivational dynamics, past research does suggest gender differences in expressions of sexual behavior for evolutionary and cultural reasons. Thus, results of the present study underscore the importance of considering the role of gender in understanding links between the attachment and sexual behavioral systems.
Examination of the direct effects model (Model 1) revealed that the attachment dimension which tapped avoidance, or discomfort with closeness, was particularly related to males’ sexual outcomes. That is, men who reported higher levels of attachment avoidance acknowledged significantly greater engagement in risky sexual behavior and fewer health- promoting sexual beliefs. Consistent with assertions of attachment theory, these results suggest that discomfort with closeness may increase the likelihood that males would engage in sexual behavior in ways that would limit intimacy, such as having sex impulsively or with uncommitted partners. Additionally, males high in attachment avoidance may be reluctant to engage in certain health-promoting sexual behaviors (i.e. questioning potential sexual partners
74 about their sexual backgrounds) because they are perceived as intimate in nature and may prime fears that those conversations would foster feelings of closeness that would result in feelings of discomfort. In understanding the non-significant links between attachment avoidance and sexual outcomes for females, some have suggested that societal gender roles that support caring, warmth, and nurturing may lessen the negative effects of attachment avoidance on sexual behavior among women (Cooper et al., 2006).
On the other hand, the attachment dimension of anxiety was found to be an especially important predictor of sexual outcomes for females. Specifically, those who endorsed higher levels of anxiety in relationships also reported significantly greater involvement in risky sexual behavior and less confidence in their ability to engage in protective sexual behaviors. These patterns support notions rooted in attachment theory which suggest that, particularly for females, concerns about being unloved or abandoned may increase the likelihood of engaging in risky sexual behaviors to meet seemingly endless demands for greater closeness and decrease the likelihood of advocating for safer sex practices, as it could potentially disrupt relationships already perceived as fragile. Although the size of affected participants was small, results indicated that females with a history of sexually transmitted disease reported significantly higher levels of attachment anxiety. The same finding did not emerge for males.
Ultimately, this provides further support for the idea that attachment anxiety may place females at greater risk for unintended negative consequences associated with sexual behavior.
Interestingly, although the pathway between attachment anxiety and risky sexual behavior in males was not supported in the direct effects model, it became significant in the indirect effects model – but in the opposite direction predicted. In other words, males who
75 reported higher levels of attachment anxiety reported engaging in significantly fewer risky
sexual behaviors. In their 2006 study, Cooper and colleagues similarly found that while
attachment anxiety was associated with riskier sexual outcomes for women, it may actually
serve a protective function for males. They argued sex-role expectations for males that emphasize independence and control may lessen the influence of attachment anxiety on males’ sexual behavior. Others assert this gender difference may be due, at least in part, to the observation that anxious men are less likely to view sex as an indicator of relationship quality than anxious women (Birnbaum et al., 2006). Future research investigating the potentially protective effects of attachment anxiety on risky sexual behavior in men is warranted.
As a major goal of the present study was to further understand the interplay between attachment and sexual systems, two indirect effects models examined the potential explanatory role of motivations for sexual behavior. The first mediator examined intimacy motives, which assesses desires to engage in sexual behavior to establish an emotional connection. Indeed, overall findings strongly support links between attachment dimensions and intimacy motives. As expected, higher levels of attachment avoidance was associated with significantly fewer intimacy motivations for males and females. This finding supports notions rooted in attachment theory which suggest that individuals high in avoidance are motivated to limit intimacy in sexual encounters and likely engage in sexual behavior for other reasons, such as coping or as a means of physical gratification. Also consistent with our predictions, higher levels of attachment anxiety were associated with greater intimacy motivations regardless of gender. Despite the strong associations with romantic attachment, intimacy motives were neither linked with engagement in risky sexual behavior nor health-promoting sexual beliefs.
76 Thus, contrary to expectation, hypotheses that these motivations would explain links between attachment and sexual behavior were not supported for either gender.
It is important to consider explanations for why intimacy motives were not linked with sexual outcomes as was predicted, given that previous studies have found intimacy motives to be related to less risky behavior (Cooper, Shapiro, & Powers, 1998). Perhaps individuals who report greater motivations for sex to establish an emotional connection are more likely to be involved in a romantic relationship. As those engaged in romantic sex often report significantly more frequent engagement in sexual behavior and higher incidences of unprotected sex (Stillo,
2011), it is possible that our measure of risky sexual behavior which tapped a variety of risky sexual behaviors did not reflect this. Additionally, these findings may be further complicated since the attachment indirect effects models did not account for individuals’ relational status.
This may be important to consider in future research, as romantically involved emerging adults reported significantly higher levels of intimacy motivations.
The indirect effects models also assessed the extent to which sexual behavior as a coping mechanism mediates the relations between attachment dimensions and sexual outcomes among emerging adults. Overall, findings indicate that links between attachment dimensions and coping motivations were less apparent: only higher attachment anxiety in females was linked with engaging in sexual behavior to cope with and manage negative affect.
Although these results seem to point to an important gender difference, they are somewhat inconsistent with previous research that has also suggested positive links between attachment avoidance and coping motivations (Davis, Shaver, & Vernon, 2004), as well as an inverse relationship between attachment anxiety and coping motivations in males (Cooper et al., 2006).
77 In contrast, expected links between coping motivations and sexual outcomes were
largely supported. Specifically, men who reported greater motivations to engage in sex to cope with unpleasant emotions reported more frequent engagement in risky sexual behaviors.
Overall, these results are consistent with past studies that have revealed positive associations
between coping sexual motives and risky sexual behaviors, including number of sexual partners
and having sex outside the context of a committed relationship (Cooper et al., 1998; Cooper et
al., 2006). Previous research was extended by establishing links between coping motives and
health-promoting sexual outcomes. Specifically, men and women who reported fewer
motivations to engage in sex to cope with unpleasant emotions were more likely to report
confidence in their ability to engage in protective sexual behaviors. Such findings seem to point
to the expansion of coping mechanisms as a potential objective to target in sexual health
prevention and intervention efforts.
Notably, investigation of the indirect effects models examining coping motivations as a
potential explanatory pathway yielded an important finding: for females, the association
between attachment anxiety and health-promoting sexual beliefs was partially mediated by
coping motives. This suggests that women who are highly anxious have less confidence in their
ability to engage in protective sexual behaviors, at least in part, because they are more likely to
have sex for coping reasons. Thus, the finding that attachment anxiety-related effects are
partially mediated by motives increases the likelihood that motive-based prevention efforts
may help increase protective sexual beliefs among female emerging adults.
78 Social Support and Emerging Adult Sexual Behavior
Attachment theory also provides a useful framework for understanding how support from important figures, such as parents and romantic partners, may be linked with the development of certain beliefs and patterns of behavior. While much attention has been given to the influence of the quality of the parent-child relationship on adolescents’ sexual
development (e.g. Miller et al., 1998; Perrino et al., 2000; Scaramella et al., 1998), comparatively less research has examined the impact of parental relationships on sexuality
during the transition to adulthood. Therefore, one goal of the present study was to determine
whether elements of the family system that have been linked with adolescent sexual behavior
similarly effect emerging adults’ sexuality. In particular, we sought to further understand the
influence of parental support on sexual behavior during this developmental period. Previous
research was extended by distinguishing maternal and paternal support and considering gender differences. Other advances include examination of the role of support from romantic partners, as it has been suggested that this support source becomes more salient during emerging adulthood.
Emerging adulthood is a period of transition during which the longing to become autonomous, independent, and self-reliant is countered with a desire to maintain close, but more equal parent-child relationships. Consistent with this idea, the current study found that
50% and 53% of participants reported improvements in relationships with their fathers and mothers, respectively, since entering emerging adulthood. Relationships with parents rarely worsened during this period, with 10% and 7% of participants reporting negative changes with their fathers and mothers, respectively. These findings support conclusions reached in a recent
79 qualitative study (Lefkowitz, 2005). Further supporting this developmental hypothesis, results
revealed a significant negative correlation between age and maternal support. In other words,
older emerging adults reported less perceived support from their mothers as compared with
younger emerging adults. Taken together, these results appear to suggest that despite
normative declines in support, relationships between emerging adults and their parents often
improve during the transition to adulthood.
Overall, findings suggest that parental support differently impacts sexual development
in adolescence and emerging adulthood. Given the many studies that report links between
parental support and adolescent sexual behavior (e.g. Boyer et al., 1999; Luster & Small, 1994;
Mosack et al., 2006; Somers & Ali, 2011), it was expected that parental support would remain
important predictors of risky and health-promoting sexual outcomes during emerging
adulthood. In actuality, when these links were examined in the overall sample, neither maternal nor paternal support was found to directly predict either sexual outcome. These
results seem to provide further backing for the idea that links between perceived support and sexual outcomes are likely stronger for younger adolescents than for emerging adults
(Mazzaferro et al., 2006; Deptula et al., 2010).
When considering the context of sexual behavior, however, important associations between parental support and sexual outcomes did emerge for romantically involved emerging adults. Specifically, maternal support was found to be a significant predictor of males and females’ report of health-promoting sexual beliefs for this group. For females, the relationship was in the expected direction, such that as perceptions of available maternal support increased so did confidence in their ability to engage in protective sexual behavior. Ultimately, this
80 finding supports the hypothesis that maternal support may serve a protective function,
particularly for female emerging adults engaging in romantic sex. Additional variables that
were not accounted for in the present model may further explicate this relationship, such as
whether and how mothers and daughters communicate about relationships or healthy sexual
behaviors. It is possible that entry into a committed romantic relationship in emerging adulthood may serve as a catalyst for having these discussions, as previous longitudinal research has found support for the idea that parents are likely to initiate communication about sexual behavior only after they begin to suspect their child is sexually active (Levin & Robertson,
2002; Miller et al., 1998; Miller et al., 2001).
It is notable, however, that for males the pathway between maternal support and health-promoting sexual beliefs was significant in the opposite direction anticipated. In other words, males who reported higher perceived support from their mothers also reported less confidence in their ability to engage in protective sexual behaviors. Exploratory analyses were conducted to further understand links between maternal support and the specific dimensions of healthy sexual behavior (i.e. self-efficacy to refuse sex, question potential partners, or use condoms). When considering the various dimensions of health-promoting sexual beliefs, only one subscale was found to be significantly negatively related to maternal support: self-efficacy to refuse sexual behavior. That is, as romantically involved males reported greater perceived support from their mothers, they also reported less confidence in their ability to refuse sex from their partners. While this runs counter to the anticipated relationship, it is important to consider potential explanations for this finding. Perhaps males would not classify refusal of sexual behavior as “health-promoting” in the same way the construct is viewed for females. It
81 is possible that males who experience sexual behavior within a romantic relationship may hold
different views about refusing sex from their partner than do females or males engaging in casual sex encounters. This finding points to a limitation in the overall sexual development literature, as general research investigating refusal of sexual behavior in males is scarce. Given that refusal of sexual behavior in males was negatively associated with several risky sexual outcomes including unprotected sex acts and intent to engage in risky sexual behavior, future research is needed to further understand the interplay between maternal support and self- efficacy for refusing sex in romantically involved males.
Further examination of the models that investigated the direct effects of parental and partner support on romantically involved male and females’ sexual outcomes revealed several pathways that closely approached significance, such as the pathway between support from romantic partners and sexual risk for males and the pathway between paternal support and sexual risk for females – both of which were observed in the negative direction as anticipated.
It is likely the above pathways were non-significant, at least in part, due to lack of power and small sample size in these groups. It is recommended that future research continue to examine these pathways in larger samples of romantically involved males and females.
As an additional aim was to further understand the interplay between social support and sexual systems, the present study examined the potential explanatory role of motivations for sexual behavior. When considering links between parental support and sexual motivations in the overall sample, the only significant pathway to emerge was the indirect association between father support and health-promoting sexual beliefs through coping motives for females. This suggests that women who report less support from their fathers have less
82 confidence in their ability to engage in protective sexual behaviors, at least in part, because
they are more likely to engage in sexual behavior for coping reasons. Unfortunately, until
recently the role of fathers on emerging adults’ sexuality has been largely overlooked by both
practitioners and researchers (Pingel et al, 2012; Wilson et al., 2010; Wyckoff et al., 2008).
Taken together with previous research, which has revealed links between quality of father-
daughter relationships during the transition to adulthood and problematic sexual outcomes
such as sexually transmitted infections (Stillo, 2011), findings point to the importance of
including fathers in continued sexual health research and prevention efforts. Interestingly, this
pathway did not remain significant in the indirect model that examined only romantically
involved males and females. This finding may suggest that father support serves a protective
function particularly for females who engage in sexual behavior outside of a committed
romantic relationship. Perhaps, as females become romantically involved, support from
romantic partners may become more important in a manner consistent with developmental
hypotheses.
Consistent with the idea that the transition to adulthood is characterized by gradual
shift toward romantic partners in fulfilling attachment needs and emotional support (Hazan &
Shaver, 1994), the present study revealed that higher levels of perceived support from romantic
partners predicted greater motivations for engaging in sexual behavior to create an emotional
connection. Parental support, on the other hand, did not significantly predict romantically involved emerging adults’ motivations to engage in sexual behavior to experience interpersonal closeness. This finding has important implications, as intimacy sexual motives have been linked with both secure attachment and less engagement in casual sex (Cooper et al., 1998; Cooper et
83 al., 2006). However, as previously mentioned, intimacy motives were neither associated with engagement in risky sexual behavior nor protective sexual beliefs in the present study.
Therefore, hypotheses that intimacy motivations may explain links between support and sexual behavior were not supported for either gender.
Practical Implications, Limitations, and Future Directions
The present study was an important next step in understanding the nature of emerging adults’ sexual development. In fact, results suggest that both individual (i.e. attachment) and interpersonal (i.e. social support) factors influence sexual motivations, beliefs, and behaviors during the transition to adulthood. Such findings have important implications for parents, health care professionals, health care organizations and institutions (e.g. hospitals, university health centers, and clinics), and others important in the lives of emerging adults.
First, the high prevalence of risky sexual behaviors and sizable minority of participants who reported past consequences associated with sexual activity, including unintended pregnancy and sexually transmitted infections, hold important implications for prevention and intervention efforts. Up to now, sexual health has received less attention from colleges and universities than appears warranted (Jaworski & Carey, 2001). Results of the present study, however, suggest university health and counseling centers would be appropriate sponsors of such programming and a setting relevant to the dissemination of sexual specific information.
Sexual health programs targeting specific demographic groups may be especially useful given observed links with less desirable sexual outcomes. Specifically findings suggest that emerging adults who are older, engaging in casual sex, from non-intact families, and/or identify as sexual minority may benefit from targeted prevention and intervention efforts.
84 Another notable outcome of the present study relates to the important role of
attachment in understanding sexual development. In fact, numerous significant relationships
emerged between attachment dimensions and protective sexual beliefs, risky sexual outcomes,
and motivations to engage in sexual behavior. Such findings suggest assessment of individuals’
attachment security may be especially useful in identifying those who may most benefit from
sexual health initiatives. The present study offers implications for clinical intervention.
Psychotherapy aimed at promoting secure attachment may be useful in reducing less desirable sexual outcomes. Results also underscore the utility of considering the effects of gender when examining and potentially altering the link between attachment and expressions of sexual behavior. Treatment efforts are especially encouraged to address and explore sexual manifestations of attachment anxiety in females and attachment avoidance in males. A specific implication for psychotherapy proposes that interventions aimed at developing distress tolerance and affect regulation skills may be especially useful in providing a protective buffer from the effects of attachment anxiety on females’ health-promoting sexual beliefs.
Even though social support was not as linked with sexual outcomes as was hypothesized, results of the present study nonetheless suggest some potentially important associations for specific groups of emerging adults. One such observation revealed that maternal support was linked with protective sexual outcomes for romantically involved emerging adults, though the association differed for males and females. In particular, prevention efforts aimed at increasing support between females and their mothers could be an important component in promoting protective sexual behaviors for those in a committed relationship.
85 There was also some evidence to suggest that perceived support from fathers may indirectly effect females’ confidence in their ability to engage in health-promoting sexual behaviors through a direct effect on coping sexual motivations. Unfortunately, up to now, the father-daughter relationship has been largely ignored by both practitioners and researchers.
Results of this study imply that both sexual health prevention efforts and family therapy aimed toward enhancing fathers’ efforts to establish supportive relationships with their daughters may have continue to have important implications for sexual development during the transition to adulthood.
While findings from this study add significantly to the literature on emerging adults’ sexual development, several limitations were inherent and should be noted for future research.
First, participants were predominantly college students enrolled in psychology courses receiving extra credit for their participation in the study. The sample had a large number of females
(66%), most self-identified as straight (88%), and 43% were Caucasian. While ethnic diversity was a relative strength in the overall sample, the smaller numbers of sexual minorities limit further examination of these group differences in the present study. A larger sample with even greater diversity may reveal important differences and allow for better generalizability between groups. It is also important to note that participants were volunteers and, as such, may be different from the overall emerging adult population in important ways. For instance, they may differ in their interest and willingness to discuss sexual matters from those who elected not to participate in the study.
Second, as the measure of risky sexual behaviors included in the present study did not assess whether those behaviors were occurring within romantic or sexual encounters within
86 the past six months, this adds some complications to the interpretations of our findings. For
instance, while the influence of parental support was investigated in the overall sample as well
as a subsample of romantically involved emerging adults, we did not separately examine the
model in the subsample of emerging adults only engaging in casual sex encounters. Similarly,
we did not consider the context of sexual behavior in the comprehensive models investigating
the attachment and sexual systems. Indeed, the pathways that connect social support and
attachment to sexual outcomes are likely more complex than was examined in the present
study; however, a challenge to these questions was the limitation of variables to include for our
sample size without losing predictive power. Thus, it is recommended that future research in
this area continue to parcel out the ways in which the effects of attachment or social support
on sexual development may differ depending on the context where the sexual behavior occurs.
Future studies employing multiple-group path analysis utilizing context of sexual behavior as
comparison groups may be important next steps.
Furthermore, there are some limitations relating to the design of the study. First, the study was cross-sectional. Although the models in the present study hypothesize directional influenced between the variables based on existing research, it is not possible to come to any causal conclusions about the relationships that emerged. Future research in this area is encouraged to utilize longitudinal designs to further understand the nature and causal directions of certain associations. In addition, this study relied on participants’ retrospective self-reports of sexual behavior, which could potentially be influenced by biases and distortions and contribute to trouble accurately recalling the frequencies of certain behaviors assessed. To
87 address this issue, further research might consider utilizing other methods, such as diary recordings, to improve accuracy of recording based on estimate errors.
88 Table 1
Frequencies for General Demographics
Variables Frequency (n) Percent (%)
Age Total Sample n = 290 (192 women; 97 men) M = 20.74 SD = 1.81
18 26 9.0 19 56 19.3 20 64 22.1 21 50 17.2 22 42 14.5 23 29 10.0 24 12 4.1 25 11 3.8
Sex Male 97 33.4 Female 192 66.2
Classification Freshman 58 20.0 Sophomore 53 18.3 Junior 70 24.1 Senior 98 33.8 Other 8 2.8
Race African-American 63 21.7 Native American 0 0.0 Caucasian 123 42.6 Asian 19 6.6 Latino/Latina 59 20.4 Multi-Racial 25 8.6
Sexual Orientation Straight 256 88.3 Gay/Lesbian 12 4.1 Bisexual 12 4.1 Transgender 1 0.4 Other 3 1.0 Prefer not to answer 1 0.3 (table continues)
89 Frequencies for General Demographics (continued).
Variables n %
Religious Affiliation Protestant 124 42.8 Catholic 42 14.5 Jewish 2 0.7 Islamic 3 1.0 Eastern Religions 2 0.7 Spiritual, Not Religious 42 14.5 None 47 16.2 Other 28 9.7
Importance of Religion Very unimportant 57 19.7 Unimportant 37 12.8 Neutral 68 23.4 Important 85 29.3 Very important 43 14.8
Employed Yes 164 56.6 No 126 43.4
Current Living Arrangement On-campus with roommates (e.g. dorm) 65 22.4 On-campus alone 14 4.8 Off-campus with biological parent(s) 34 11.7 Off-campus with roommates 155 53.4 Off-campus alone 22 7.6
Parent Information Married, living together 160 55.2 Married, living apart 9 3.1 Divorced, mother remarried 16 5.5 Divorced, father remarried 17 5.9 Divorced, both remarried 26 9.0 Divorced, neither remarried 31 10.7 Mother deceased 3 1.0 Father deceased 6 2.1 Never married 16 5.5 Other 6 2.1 (table continues)
90 Frequencies for General Demographics (continued).
Variables n %
Father’s Education Level Less than a high school degree 24 8.3 High school degree 67 23.2 Vocational training/trade school 15 5.2 Some college 42 14.5 Community/Jr. college degree 15 5.2 College degree 68 23.5 Some graduate courses 8 2.8 Master’s degree 30 10.4 Professional degree 20 6.9
Mother’s Education Level Less than a high school degree 27 9.3 High school degree 43 14.8 Vocational training/trade school 12 4.1 Some college 69 23.8 Community/Jr. college degree 22 7.6 College degree 78 26.9 Some graduate courses 7 2.4 Master’s degree 26 9.0 Professional degree 6 2.1
College Student Generation First Generation 108 37.4 Non-first generation 181 62.4
Changes in Relationship with Father since Beginning College Much better 34 11.7 Better 110 37.9 About the same 113 39.0 Worse 21 7.2 Much Worse 9 3.1
Changes in Relationship with Mother since Beginning College Much better 61 21.0 Better 93 32.1 About the same 115 39.7 Worse 16 5.5 Much Worse 5 1.7
91 Table 2
Frequencies for Romantic and Sexual History Demographics – All Participants
Variables n %
Age of First Date 12 or younger 15 5.2 13-15 115 39.7 16-18 120 41.4 18+ 26 9.0 Never been on a date 14 4.8
Currently in Romantic Relationship Yes 156 53.8 No 134 46.2
Length of Time in Current Relationship Less than 3 months 24 15.0 3-6 months 29 18.1 7-12 months 19 11.9 1-2 years 41 25.6 More than 2 years 47 29.4
Expected Length of Current Relationship Less than a month 7 2.4 1-3 months 11 3.8 3-6 months 10 3.4 7-12 months 11 3.8 More than a year 37 29.4 I expect to marry this person 83 52.5
Dating Relationships in Past Year 0 61 21.0 1 156 53.8 2 48 16.6 3 9 3.1 4 or more 15 5.2
Previously had Sexual Intercourse Yes 230 79.3 No 56 19.3 (table continues)
92 Frequencies for Romantic and Sexual History Demographics – All Participants (continued).
Variables n %
Consider Self Virgin Yes 56 19.3 No 230 79.3
Oral Sex but not Intercourse Considered Virgin Yes 221 76.2 No 65 22.4
Anal Sex but not Intercourse Considered Virgin Yes 63 21.7 No 222 76.6
Visited Health Care Professional for Issues or Testing related to Sexual Activity Yes 119 41.0 No 166 57.2
Previous STD Diagnosis Yes 18 6.2 No 267 92.1
93 Table 3
Frequencies for Sexually Active Participant Demographics
Variables n %
Age of First Intercourse 8 1 0.4 11 1 0.4 12 5 2.2 13 4 1.7 14 29 12.5 15 29 12.5 16 42 18.1 17 44 19.0 18 38 16.4 19 22 9.5 20 9 3.9 21 3 1.3 22 4 1.7 23 1 0.4
Planned First Intercourse Yes 102 43.6 No 132 56.4
Contraceptive use at First Intercourse Yes 159 68.8 No 72 31.2
Partner at First Intercourse Boyfriend/Girlfriend 167 71.4 Friend 39 16.7 Casual acquaintance 20 8.5 Someone you just met 8 3.4
Change in Relationship after First Intercourse We became closer 140 59.8 We grew apart 54 18.6 I lost respect for my partner 11 3.8 My partner lost respect for me 4 1.4 I lost respect for myself 25 8.6 (table continues)
94 Frequencies for Sexually Active Participant Demographics (continued).
Variables n %
Been Pregnant or Caused Pregnancy Yes 22 9.6 No 208 90.4
Number of Sexual Partners 1 38 16.6 2 35 15.3 3 30 13.1 4 18 7.9 5-10 76 33.2 11-20 20 8.7 21 or more 12 5.2
Ever Engaged in Casual Sex Yes 158 67.5 No 76 32.5
Number of Casual Sex Partners 0 71 30.9 1 41 17.8 2 28 12.2 3 26 11.3 4 or more 64 27.8
95 Table 4
Means, Standard Deviations, Ranges for All Variables
Variable M SD Possible Actual Range Range
Social Provisions Scale (SPS)
Overall Support 83.12 8.69 24-96 51-96
Mother Support 75.74 12.92 24-96 24-96
Father Support 68.44 15.68 24-96 27-95
Partner Support 74.40 14.11 24-96 27-96
Experiences in Close Relationships (ECR)
Avoidant Attachment 51.36 18.99 18-126 18-105
Anxious Attachment 66.76 21.66 18-126 18-126
Sexual Motives Scale (SMS)
Intimacy 18.59 5.32 5-25 5-25
Enhancement 21.65 6.14 6-30 6-30
Peer 5.93 2.27 5-25 5-22
Coping 8.99 4.15 5-25 5-25
Self 8.66 3.97 4-20 4-20
Partner 5.50 2.71 4-20 4-20
Self-Efficacy for Protective Sexual Behaviors
Refusing Unwanted Intercourse 25.90 7.48 8-40 8-40
Questioning Potential Partners 20.93 4.31 5-25 5-25
Using Condoms 32.30 6.58 8-40 8-40
Total Score 79.09 13.25 21-105 37-105
(table continues)
96 Means, Standard Deviations, Ranges for All Variables (continued).
Variable M SD Possible Actual Range Range
Sexual Risk Survey (SRS)
Overall Sexual Risk 46.84 65.9 0-∞ 0-425
Sexual Risk with Uncommitted Partners 7.54 23.38 0-∞ 0-341
Risky Sex Acts 32.30 53.47 0-∞ 0-371
Impulsive Sexual Behaviors 4.09 5.84 0-∞ 0-58
Intent to Engage in Risky Sexual Behaviors 1.10 3.10 0-∞ 0-25
Risky Anal Sex Acts 1.89 5.89 0-∞ 0-42
97 Table 5
Means, Standard Deviations, Ranges for Recoded Sexual Risk Survey (SRS) Total Score &
Subscales
Possible Actual Variable M SD Range Range
Overall Sexual Risk 13.89 11.44 0-92 0-66
Sexual Risk with Uncommitted Partners 4.29 5.34 0-32 0-29
Risky Sex Acts 5.19 4.58 0-20 0-20
Impulsive Sexual Behaviors 3.21 3.43 0-20 0-17
Intent to Engage in Risky Sexual Behaviors 0.61 1.28 0-8 0-7
Risky Anal Sex Acts 0.60 1.47 0-12 0-9
98 Table 6
Correlations for Key Variables and Scales’ Alpha Coefficients
Variable 1 2 3 4 5 6 7 8 9
1. Mother Support (SPS) (.93) .40** .16** -.21** -.23** .04 -.12* .10 -.13* 2. Father Support (SPS) (.94) .31** -.19** -.20** .04 -.14* .10 -.07 3. Partner Support (SPS) (.93) -.50** -.28** .23** -.19** .04 -.10 4. Avoidant Attachment (ECR) (.93) .14* -.42** .20** -.07 .12* 5. Anxious Attachment (ECR) (.93) .19** .30** -.08 .05 6. Intimacy Sex Motives (SMS) (.94) .10 -.02 -.10 7. Coping Motives (SMS) (.84) -.29 ** .20** 8. Overall Sexual Self-Efficacy (SEPSB) (.86) -.36** 9. Total Sexual Risk Taking (SRS) (.87)
* = p < .05. ** = p < .01. Values have been rounded to two decimal places.
99 Table 7
Correlations for Key Variables and Scales’ Alpha Coefficients: Females Only
Variable 1 2 3 4 5 6 7 8 9
1. Mother Support (SPS) (.93) .41** .20** -.21** -.33** .01 -.22** .20** -.17* 2. Father Support (SPS) (.94) .35** -.19** -.23** .01 -.24** .19* -.17* 3. Partner Support (SPS) (.93) -.50** -.33** .24** -.23** .03 -.10 4. Avoidant Attachment (ECR) (.93) .22** -.41** .21** .02 .02 5. Anxious Attachment (ECR) (.93) .16* .44** -.27** .24** 6. Intimacy Sex Motives (SMS) (.94) .17* -.11 -.06 7. Coping Motives (SMS) (.84) -.27** .10 8. Overall Sexual Self-Efficacy (SEPSB) (.86) -.30** 9. Total Sexual Risk Taking (SRS) (.87)
* = p < .05. ** = p < .01. Values have been rounded to two decimal places.
100 Table 8
Correlations for Key Variables and Scales’ Alpha Coefficients: Males Only
Variable 1 2 3 4 5 6 7 8 9
1. Mother Support (SPS) (.93) .39** .06 -.20 -.12 .08 .10 -.13 -.08 2. Father Support (SPS) (.94) .25* -.18 -.13 .10 .08 -.05 .05 3. Partner Support (SPS) (.93) -.48** -.24* .21* -.10 .02 -.09 4. Avoidant Attachment (ECR) (.93) .00 -.46** .15 -.21* .27** 5. Anxious Attachment (ECR) (.93) .23* .08 .15 -.17 6. Intimacy Sex Motives (SMS) (.94) -.01 .13 -.14 7. Coping Motives (SMS) (.84) -.26* .32** 8. Overall Sexual Self-Efficacy (SEPSB) (.86) -.40** 9. Total Sexual Risk Taking (SRS) (.87)
* = p < .05. ** = p < .01. Values have been rounded to two decimal places.
101 Table 9
Indices of Fit for Direct Effects Models
Index p Value
Model 1 Chi Square Test of Model Fit 3.575 .059 Comparative Fit Index .960 Root Mean Square Residual .095 Normed Fit Index .953 Incremental Fit Index .966
Model 2a Chi Square Test of Model Fit .012 .913 Comparative Fit Index 1.000 Root Mean Square Residual .000 Normed Fit Index 1.001 Incremental Fit Index 1.010
Model 2b Chi Square Test of Model Fit 3.171 .366 Comparative Fit Index .997 Root Mean Square Residual .019 Normed Fit Index .963 Incremental Fit Index .998
102 Table 10
Indices of Fit for Indirect Effects Models Index p Value
Model 3 Chi Square Test of Model Fit 3.575 .059 Comparative Fit Index .984 Root Mean Square Residual .095 Normed Fit Index .980 Incremental Fit Index .985
Model 4 Chi Square Test of Model Fit 3.757 .059 Comparative Fit Index .983 Root Mean Square Residual .095 Normed Fit Index .980 Incremental Fit Index .985
Model 5a Chi Square Test of Model Fit .012 .913 Comparative Fit Index 1.000 Root Mean Square Residual .000 Normed Fit Index 1.000 Incremental Fit Index 1.011
Model 5b Chi Square Test of Model Fit 3.171 .366 Comparative Fit Index 1.000 Root Mean Square Residual .019 Normed Fit Index .972 Incremental Fit Index .998 Model 6a Chi Square Test of Model Fit .012 .913 Comparative Fit Index .908 Root Mean Square Residual .000 Normed Fit Index 1.000 Incremental Fit Index 1.011
Model 6b Chi Square Test of Model Fit 3.171 .366 Comparative Fit Index .998 Root Mean Square Residual .019 (table continues) 103 Indices of Fit for Indirect Effects Models (continued). Normed Fit Index .974 Incremental Fit Index .99
104 Males
*
* **
Females
*** *
***
Figure 1. Model 1. Direct effects of romantic attachment on risky sexual behavior (SRS_Total) and health-promoting sexual beliefs (SEPSB_Total) for men and women.
*** Parameter is significant at the .001 level, ** Parameter is significant at the .01 level, *Parameter is significant at the .05 level
105 Males
** *
Females
** *
Figure 2. Model 2a. Direct effects of parental support on risky sexual behavior (SRS_Total) and health-promoting sexual beliefs (SEPSB_Total) for men and women (full sample).
*** Parameter is significant at the .001 level, ** Parameter is significant at the .01 level, *Parameter is significant at the .05 level
106 Males
** ** *
** *
** *
Females
* ** *
** *
** *
Figure 3. Model 2b. Direct effects of parental and partner support on risky sexual behavior (SRS_Total) and health-promoting sexual beliefs (SEPSB_Total) for romantically involved men and women (partial sample).
*** Parameter is significant at the .001 level, ** Parameter is significant at the .01 level, *Parameter is significant at the .05 level
107 Males
* ***
* **
** *
Females
***
*** *** ***
Figure 4. Model 3. Risky sexual behavior as a function of romantic attachment specified to occur through sexual motives.
*** Parameter is significant at the .001 level, ** Parameter is significant at the .01 level, *Parameter is significant at the .05 level
108 Males
***
* * **
Females
***
* * ***
*** **
Figure 5. Model 4. Health-promoting sexual beliefs as a function of romantic attachment to occur through sexual motives.
*** Parameter is significant at the .001 level, ** Parameter is significant at the .01 level, *Parameter is significant at the .05 level
109 Males
*** ** *
Females
** * *
Figure 6. Model 5a. Risky sexual behavior as a function of parental support specified to occur through sexual motives (full sample)
*** Parameter is significant at the .001 level, ** Parameter is significant at the .01 level, *Parameter is significant at the .05 level
110 Males
** *
** *
** * *
Females
** *
** *
** * *
Figure 7. Model 5b. Risky sexual behavior as a function of parental and support specified to occur through sexual for romantically involved men and women (partial sample).
*** Parameter is significant at the .001 level, ** Parameter is significant at the .01 level, *Parameter is significant at the .05 level
111 Males
** * *
Females
** * *** *
Figure 8. Model 6a. Health promoting sexual beliefs as a function of parental support specified to occur through sexual motives for men and women (full sample)
*** Parameter is significant at the .001 level, ** Parameter is significant at the .01 level, *Parameter is significant at the .05 level
112 Males
** *
** *
* ** *
Females
** *
** * *
* ** *
Figure 9. Model 6b. Health promoting sexual beliefs as a function of parental support specified to occur through sexual motives for romantically involved men and women (partial sample)
*** Parameter is significant at the .001 level, ** Parameter is significant at the .01 level, *Parameter is significant at the .05 level
113 APPENDIX A
INFORMED CONSENT
114 SUBJECT CONSENT TO PARTICIPATE IN RESEARCH Emerging Adult Sexual Behaviors Study You are being asked to participate in a study examining sexual development during emerging adulthood. The goal of this study is to better understand various influences on the sexual behavior of young adults.
YOUR PARTICIPATION
If you agree to participate, the time commitment will be approximately one hour. You will fill out questionnaires asking about your romantic relationships, sexual behaviors, social support, and substance use.
CONFIDENTIALITY
To safeguard your privacy your consent form will be separated from the questionnaires. Only the researchers will see your specific responses and your name will not be on any of the materials. All of your responses will be kept confidential. Only summarized data will be reported concerning the study. Please feel free to ask questions at any time by emailing [email protected].
BENEFITS
Your participation may help us understand more about sexual development, and what we learn may eventually help parents, young adults, and those who work with young adults and their families.
POSSIBLE RISK
Because the questions will ask about your personal relationship and sexual history it may ask for information you feel is personal and could be distressing for you to tell. If you experience distress please let the researcher know immediately. They will be prepared to help you find assistance.
VOLUNTARY PARTICIPATION/WITHDRAWAL
Your participation in this study is voluntary. If anything about participating in this study makes you feel uncomfortable, you are free to withdraw from the study at any time without penalty, prejudice, or loss of benefits to which you would otherwise be entitled.
115 If you have any questions or concerns, feel free to contact us.
Nicole Stillo, M.S. Vicki L. Campbell, Ph.D. Graduate Student Associate Professor of Psychology University of North Texas University of North Texas Email: [email protected] Email: [email protected]
If you are willing to participate, please sign the consent on the following page.
116 APPENDIX B
DEMOGRAPHICS QUESTIONNAIRE
117 Demographics Questionnaire
INSTRUCTIONS: In the space next to the items below, please enter the number that best answers the question. Fill in information when requested in the spaces provided. Please answer every item.
Please tell us about you.
_____ Age
_____ Gender 1. Female 2. Male 3. Other
_____ Year of birth (e.g., 70 if born in 1970)
_____ Year in school 1. Freshman 2. Sophomore 3. Junior 4. Senior 5. Other (please specify) ______
_____ Your grade point average in school (fill in).
_____ Ethnic/racial background 1. African American 2. Native American 3. Caucasian 4. Asian 5. Latino/Latina 6. Multi-racial (please specify) ______7. Other (please specify) ______
_____ Religious affiliation 1. Protestant (Christian) 2. Catholic 3. Jewish 4. Islamic 5. Eastern religions 6. Spiritual, Not religious 7. None 8. Other (please specify) ______
_____ Are you currently employed? 1. Yes 2. No
_____ How much time do you work at a job each week? 1. More than 35 hours a week 2. 25-35 hours 3. 15-24 hours 4. Less than 15 hours
118 ____ How important is religion to you? 1. Very unimportant 2. Unimportant 3. Neutral 4. Important 5. Very important
_____ How would you describe where you live? 1. On-campus with roommates (e.g. dorm) 2. On-campus alone 3. Off-campus with biological parent(s) or guardian 4. Off-campus with roommates (e.g. apartment or house) 5. Off-campus alone
_____ How long have you lived at your current residence? 1. Less than 1 month 2. 1 month – 1 year 3. 1-2 years 4. More than 2 years
Please tell us about your parents.
_____ Are your parents: 1. Married, living together 2. Married, living apart 3. Divorced, mother remarried 4. Divorced, father remarried 5. Divorced, both remarried 6. Divorced, neither remarried 7. Both parents deceased 8. Mother deceased 9. Father deceased 10. Never married 11. Other (please specify) ______
_____ What is your father’s educational level? 1. Less than a high school degree 2. High school degree 3. Vocational training/trade school 4. Some college 5. Community/Jr. college degree 6. College degree 7. Some graduate courses 8. Master’s degree 9. Professional degree (for example Ph.D., M.D., J.D.)
_____ What is your mother’s educational level? 1. Less than a high school degree 2. High school degree 3. Vocational training/trade school 4. Some college 5. Community/Jr. college degree
119 6. College degree 7. Some graduate courses 8. Master’s degree 9. Professional degree (for example Ph.D., M.D., J.D.)
What is your father’s occupation? To preserve confidentiality, please state generally (e.g., clerk in store vs. clerk in Wal-Mart)
______
What is your mother’s occupation? To preserve confidentiality, please state generally (e.g., clerk in store vs. clerk in Wal-Mart)
______
_____ How has your relationship with your father changed since you started college? 1. Much better 2. Better 3. About the same 4. Worse 5. Much Worse
_____ How has your relationship with your mother changed since you started college? 1. Much better 2. Better 3. About the same 4. Worse 5. Much Worse
Please tell us about your romantic history.
_____ How old were you when you went out on your first date? 1. 12 or younger 2. 13-15 3. 16-18 4. 18 or older 5. I have never been on a date
_____ Are you currently involved in a romantic relationship? 1. Yes 2. No
_____ How long have you been involved with your current partner? 1. Less than 3 months 2. 3 to 6 months 3. 7 to 12 months 4. 1 year to 2 years 5. More than 2 years 6. I am not in a relationship
120 _____ How much longer do you think your relationship with your current partner will last? 1. Less than a month 2. 1-3 months 3. 3-6 months 4. 6-12 months 5. More than a year 6. I expect to marry this person 7. I am not in a relationship
_____ How much do your friends like your current partner? 1. None 2. A little 3. Some 4. Quite a lot 5. A great deal 6. Don’t know 7. I am not in a relationship
_____ How much do your parents like your current partner? 1. None 2. A little 3. Some 4. Quite a lot 5. A great deal 6. Don’t know 7. I am not in a relationship
_____ If you are not currently in a romantic relationship, when were you last involved with a romantic partner? 1. Less than a month ago 2. 1-3 months ago 3. 3-6 months ago 4. 6-12 months ago 5. 1-2 years ago 6. More than 3 years ago 7. I have never been involved in a romantic relationship
_____ If you are not currently in a romantic relationship, how long did your last romantic relationship last? 1. Less than 3 months 2. 3 to 6 months 3. 7 to 12 months 4. 1 year to 2 years 5. More than 2 years 6. I have never been involved in a romantic relationship
_____ All Participants: In the LAST YEAR, how many romantic relationships have you had (including your current one if applicable)? 1. 0 2. 1 3. 2 4. 3 5. 4 or more
121 Please tell us about your sexual history.
_____ Women: At what age did you have your first period? (Women fill in, others leave blank)
_____ Do you consider yourself a virgin? 1. Yes 2. No
_____ Would you consider someone who has had oral sex but not intercourse a virgin? 1. Yes 2. No _____ Would you consider someone who has had anal sex but not intercourse a virgin? 1. Yes 2. No
_____ Have you ever been diagnosed with a sexually transmitted disease, such as gonorrhea, syphilis, herpes, Chlamydia, HIV/AIDS? 1. Yes 2. No
_____ Have you ever had sexual intercourse? 1. Yes 2. No
_____ Do you consider yourself to be one or more of the following (list all that apply): 1. Straight 2. Gay or lesbian 3. Bisexual 4. Transgender 5. Other (please specify): ______6. I prefer not to answer
_____ Have you ever visited a health are professional or clinic for issues or testing related to sexual activity? 1. Yes 2. No
_____ If you have never had sexual intercourse, why haven’t you? (Select the most important reason). 1. I have had sex 2. Religious beliefs 3. Nobody wants to have sex with me 4. I’m not ready 5. I can’t get birth control 6. I’m not in love 7. Pressure from my parents to wait 8. Pressure from my friends to wait 9. I don’t want to 10. Your partner would lose respect for you 11. You would feel guilty 12. It would upset your parents 13. Other (please specify): ______
122 IF YOU HAVE NEVER HAD SEXUAL INTERCOURSE, PLEASE TURN TO THE NEXT SECTION
_____ How old were you when you had sexual intercourse for the first time? (Fill in)
_____ Did you discuss and plan your first sexual experience with your partner? 1. Yes 2. No
_____ The first time you had sexual intercourse, did you or your partner use contraception? 1. Yes 2. No
_____ Who was this person? 1. Boyfriend/girlfriend 2. Friend 3. Casual acquaintance 4. Someone you just met
_____ How did the experience change the quality of the relationship (choose one)? 1. We became closer 2. We grew apart 3. I lost respect for my partner 4. My partner lost respect for me 5. I lost respect for myself
_____ How many different partners have had sexual intercourse with (including your current partner, if applicable)? (Fill in)
_____ How many different partners have you had sexual intercourse with within the past six months (including your current partner, if applicable)? 1. 0 2. 1 2. 2 3. 3 4. 4 or more
_____ Have you ever had sexual intercourse outside the context of an exclusive romantic relationship? 1. Yes 2. No
_____ Within the past six months have you had sexual intercourse outside the context of an exclusive romantic relationship? 1. Yes 2. No
_____ How many different people have you had sexual intercourse with, who you did not consider a boyfriend/girlfriend at the time? 1. 0 2. 1 3. 2 4. 3 5. 4 or more
123 _____ Have you ever been pregnant or have you ever gotten anyone pregnant? 1. Yes 2. No
_____ If you answered yes, how many times? (Fill in)
If you answered yes, what was the outcome of each pregnancy? (Fill in the number of pregnancies that resulted in each of the following outcomes) _____ Birth _____ Abortion _____ Miscarriage
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