Thibodeau, M., Lavoie, F., Hébert, M. & Blais, M. (2017). Pathways linking child maltreatment and adolescent sexual risk behaviors: The role of attachment security. The Journal of Sex Research, 1-12.
The current study sought to examine mechanisms of the association between child maltreatment (CM; sexual abuse, physical abuse, neglect, and witnessing conjugal violence) and sexual risk behaviors (SRBs) in adolescents. More specifically, the authors used a representative sample of sexually active adolescents from Quebec public high schools to investigate the potential mediating role of attachment insecurity in this association. The sample of 1,900 adolescents was recruited via a one-stage stratified cluster sample of Quebec high schools. Participants completed self-administered questionnaires in Fall 2011 (Time 1) on CM and Spring 2012 (Time 2) on SRBs and attachment security. Results indicate that there is a direct, significant relationship between two types of CM (neglect and sexual abuse) and all three of the SRBs studied (number of sexual partners, age at first intercourse, and casual sexual behavior) for both females and males. Path analyses determined that neglect was positively associated with both anxious and avoidant attachment and in turn, both types were associated with an increased number of sexual partners. Regarding age at first intercourse, however, only avoidant attachment explains the association with younger intercourse age, and this appears true only for males. A separate path analysis was performed for casual sexual behavior (at least one sexual contact with an acquaintance or stranger in the past six months) and found that sexual abuse, neglect, and witnessing conjugal violence was positively associated with avoidant attachment while neglect was positively associated with avoidant attachment. Casual sexual behavior, in turn, was exclusively associated with avoidant attachment and thus, neglect. The probability of casual sexual behaviors was 0.22 for nonvictims of sexual abuse and 0.31 for victims of sexual abuse. Similarly, the probability of casual sexual behaviors for participants who experienced an average level of neglect was 0.22 but increased to 0.26 when the neglect level was high. Overall, the research concluded that for males, casual sexual behaviour was significantly more common (25.3% vs. 15.9%) and there was a significant, indirect association between neglect and younger age at first intercourse via avoidant attachment. This association was not found for females in this sample; however, a small association was found between anxious attachment and age at first intercourse for females.
The present study provides an important addition to the extant literature on the relationship between CM and SRBs and learns from past methodological shortcomings, particularly considering the inclusion of gender differences in its analysis. In addition, the authors controlled for two variables noted as potentially confounding in previous research, mother’s education and family structure, in their statistical models. Furthermore, the use of a representative sample increases the generalizability of results while the prospective design increased the findings' predictive power. However, since the age of CM was not measured and the study design was not longitudinal, conclusions should be interpreted carefully, especially with regard to causality. In addition, the use of an attachment measure that required participants to have been in a romantic relationship excluded some teens (N=40) that may present some specific characteristics. This research is also limited by its measures of CM. The evaluation of physical abuse was restricted to one item (“Have you ever been physical hit by a member of your family?”) that did not specify whether the perpetrator of violence was a parent or sibling, causing potential confusion for participants. Moreover, emotional or psychological abuse was not among the types of CM studied, but two items in neglect appear to refer to forms of emotional maltreatment: “ridicule or humiliate you; treat you with coldness, indifference, or in a way that you felt unloved.”