Attachment style and condom use - PowerPoint Presentation

Slide1

Attachment style and condom use across and within dating relationships

Panos Kordoutis

Panteion University of Social and Political Sciences, Greece

Konstantinos

Keskinis

University of Amsterdam, the NetherlandsSlide2

Past and new HIV interventions → not very successful, becausethey usually focus on individual characteristics

they are not always based on psychological theories

People are aware of HIV/other STDs and condom’s value, but they don’t consistently use it, especially within close relationships.

Context and goalSlide3

Individual-specific It considers condom use decision as an individual decision

It focuses on individual factors like gender, age, age of sexual debut, condom use at sexual debut, attachment styles (an individual-dispositional factor)

Relationship-specific

It considers condom use decision as a common decision between partners It focuses on relationship factors like relationship type, duration, condom use at first sexual intercourse in the relationship, partners’ age difference, coital sex frequency

Context and goal : Two different approaches in researchSlide4

The different role of individual and relationship factors as predictors of condom use behaviorWe investigated this role with four different dependent variables:Condom use frequency across different relationships

Condom use frequency in a specific relationship

Condom use behavior at the beginning of the relationship (first intercourse)Most recent condom use behavior in the relationship (last intercourse)

Goal of this studySlide5

Introduction (attachment theory: extension to adulthood and relation to sexuality – hypotheses)Method (participants, procedure)Results (four regression analyses)

Discussion

Conclusions (possible implications in health interventions)

Outline Slide6

Attachment theory (Bowlby, 1969, 1973, 1980)Children interact with their primary caregivers (usually mothers)

They develop

cognitive working models of self and other  affect their later interactions

Attachment theory in adulthood (

Hazan & Shaver, 1987)Adult romantic relationships  many similarities with early attachment relationships Individual differences in adult attachment’s cognitive working models of self and others  consistent with attachment theory

Attachment theory Slide7

Individual differences in adulthood  four different attachment styles (Bartholomew & Horowitz, 1991): Secure (positive self-image and image of others) 

desire for relationships, comfort with intimacy, autonomy Preoccupied

(negative self-image and positive image of others)  desire for relationships, fear of rejection

Fearful (negative self-image and image of others)  avoidance of relationships, desire for emotional closeness, fear of rejectionDismissing (positive self-image and negative image of others)  avoidance of relationships, denial of emotional closeness

Attachment theorySlide8

The sexual system is strongly connected with the attachment systemSexual behavior is connected with partners’ interaction goals in relatingWe predict an association between attachment style and condom use behavior:

Condom use requires communication between partners, so high anxiety and fear of rejection may prevent it

Condom non-use may be considered as an indication of trust and higher intimacy

Attachment styles and condom useSlide9

Individual factors and attachment styles will be strong predictors of condom use behavior during the last 12 months and at the beginning of a specific relationship but not at the most recent intercourse of a relationship or condom use frequency during a relationshipRelationship factors will influence condom use behavior at the level of a specific relationship (most recent intercourse and frequency of condom use).

Main hypotheses Slide10

339 participants (men = 158, women = 181)University and Technical College students Age mean: 21 They lived in Athens (63%), Thessaloniki (15%), and other cities (22%) in Greece

Participant selection criteria:

Students

Sexually active

Involved in a current or previous but recent (less than 12 months) relationshipduration of relationship  at least one week53.4% had current, 46,6% referred to a past relationship Relationship duration

M= 501.17 days, SD = 538.18

MethodSlide11

Questions about demographics (gender, age, residence

,

occupation, family status)Relationship Questionnaire (RQ, , Bartholomew & Horowitz, 1991)

Four descriptions of attachment patterns

Participants first chose the pattern that was most descriptive of themselvesParticipants then rated themselves on a scale ranging from 1 (it absolutely describes me) to 7 (it does not describe me at all) Questions on sexual behavior (sexual profile)Past:

number of past sexual intercourses, number of past sexual partners, age of sexual debut, condom use at sexual debut

Present: number of sexual partners during the last 12 months

Materials and procedureSlide12

Questions on the specific relationship:Present relationships  relationship begginning

time

Past relationships  beginning and endFrequency of sexual intercourse (1= no sexual intercourse, 7= everyday)

Questions about the partner:

Gender, age, education Open question about the relationshipFree description (a focus manipulation)

Questions about condom use

Frequency during the last 12 months (7-point scale,1= never, 5 = many times, 7 = always)

At the first intercourse of the relationship (Yes/No)

At the most recent intercourse of the relationship (Yes/No)

Frequency during the relationship (7 – point scale)

Materials and procedure Slide13

Voluntary and anonymous participationThey completed the questionnaire individually Procedure lasted about 15 minutes They completed the questionnaire in the university or technical college.

Materials and procedureSlide14

Dependent variables:Condom use frequency during the last 12 monthsCondom use

at the first intercourse of the relationship

Condom use at the most recent intercourse of the relationship

Condom use frequency during the relationship

Predictors Individual variables in analysis 1. Both individual and relationship variables in analyses 2,3,4. Results: 4 regression analyses Slide15

Low stress in combination with low avoidance (secure attachment) and condom non-use at sexual debut  less frequent condom use during the last 12 monthsThe older the age of sexual debut and condom use at sexual debut 

greater condom use at the first sexual intercourse of the most recent relationship

Higher coital sex frequency in the relationship, partner’s higher education level, and condom use at the first relationship intercourse  greater condom use at the most recent intercourse of the relationship

Partner’s higher education level and condom use at the first intercourse of the relationship

 more frequent condom use during the relationshipResults : 4 regression analysesSlide16

Individual and relationship characteristicsDuring 12 months1st intercourse (relationship)

Most recent

intercourse (relationship)During (relationship)

β

ORORβ Secure

-.12*

C

ondom

use at sexual debut

.24****

22.54****

Age of sexual debut

1.35*

Coital sex frequency in the relationship

.63***

Partner’s education

1.35***

.11*

Condom use at 1

st

intercourse of the relationship

7.30****

.35****

****

p

< .0001 ***

p

< .0005 *

p

< .05

Results : 4 regression analysesSlide17

Variables

Β

SEB

β

R

2

Δ

R

2

Step

1

.007

Gender

.05

.19

-.02

Age

-.07

.05

-.08

Step 2

.031

.024

Secure

-.11

.05

-.12*

Fearful

.02

.05

.02

Preoccupied

-.07

.04

-.09+

Dismissing.01.04.01Step 3.098****.067 Age of sexual debut.10.06.10 Condom use at sexual debut 1.15.26.24**** Number of partners during life.02.01.10Step 4.098****.000 Number of partners (last 12 months)-.01.04-.01

Hierarchical regression analysis (criterion variable: condom use during the last 12 months)Slide18

Variables

Β

SEB

Wald

Gender

.13.31

.17 Age.03

.08

.21

Secure

-.13

.09

1.96

Fearful

-.12

.08

2.26

Preoccupied

.05

.07

.37

Dismissing

-.06

.07

.64

Number

of partners in life

.04

.03

1.62

Age of sexual debut

.30

.13

5.13* Condom use at sexual debut3.12.4157.21**** Number of partners (last 12 months).02.09.07

Partner’s age

-.04.07.30Partner’s education-.07.14.29Relationship duration.00.001.99Coital sex frequency in the relationship-.20.171.43Logistic regression analysis (criterion variable: condom use at the first sexual intercourse of the relationship)Slide19

Variables

Β

SEB

Wald

Gender

-.29.241.42

Age-.09

.06

1.79

Secure

-.05

.07

.54

Fearful

.06

.06

.82

Preoccupied

-.05

.06

.66

Dismissing

-.04

.06

.59

Number

of partners in life

.00

.02

.00

Age of sexual debut

.11

.08

1.70 Condom use at sexual debut.69.334.37 Number of partners (last 12 months)-.06.051.32

Partner’s age

-.01.05.01Partner’s education.30.108.26***Relationship duration.00.002.03Coital sex frequency in the relationship-.46.1410.18***Condom use at 1st relat. intercourse1.99.4420.55****Logistic regression analysis (criterion variable: condom use at the most recent sexual intercourse of the relationship)Slide20

Variables

Β

SEB

β

Gender

-.20.22-.05

Age-.11

.06

-.10

Secure

-.09

.06

-.08

Fearful

.00

.06

.00

Preoccupied

-.06

.05

-.07

Dismissing

-.03

.05

-.03

Number

of partners in life

-.00

.02

-.01

Age of sexual debut

.17

.07

.15 Condom use at sexual debut1.35.31.23 Number of partners (last 12 months)-.04.04-.06

Partner’s age

.00.04.01Partner’s education.15.08.11*Relationship duration.00.00-.09Coital sex frequency in the relationship-.15.09-.09Condom use at 1st relat. intercourse 1.95.33.35****Hierarchical regression analysis (criterion variable: frequency of condom use during the relationship)Slide21

Attachment styles and other individual factors  significant predictors only during the last 12 months and at the first sexual intercourse of the most recent relationshipRelationship factors  significant during the relationship and at the most recent sexual intercourse It appears that attachment styles and other individual factors predict a general tendency of condom use and relationship factors predict self-protective behavior within the context of a specific relationship.

DiscussionSlide22

Secure style (low stress, low avoidance): although there is strong evidence that it is the most functional style in close relationships and psychological well-being, it may undermine self – protective behaviorcondom initiation and use may be perceived as a threat to the intimacy, trust, and increased comfort in the relationship that secure style motivates.The marginal significance of the preoccupied style effect (high stress, low avoidance) enhances this latter point.

Discussion Slide23

Condom use at sexual debut  significant predictor of condom use both during the last 12 months and at the first sexual intercourse of the relationship. It may function as a pattern that influences later behavior. Early age of sexual debut  consistently with previous research, people who engage early in sexual activity appear to be more vulnerable to sexual risk behavior.

Sexual activity in young age may be connected with other factors, such as lower education, less knowledge about HIV/other STDs and less communication with partners.

Discussion Slide24

Condom use at the first sexual intercourse of the relationship  significant in both frequency and most recent sexual intercourse condom use: it may also function as a pattern forming later sexual behavior and influencing both partners. Higher educational level of partner  also significant in both cases: based on the high educational level of the sample (university and technical college students), it is likely that the compatible education level of the partner enhances communication and condom use.

Higher coital sex frequency  it makes partners feel more comfortable with intimacy and have an illusion of trust, so it can undermine self-protective behavior.

DiscussionSlide25

2 different levels of self-protective behaviorGeneral tendency  influenced more by individual and dispositional factors

Within a specific relationship  influenced more by the context of this relationship

Health interventions should focus on early age

enhance communication and negotiation skills and educate people to distinguish trust and intimacy from self-protective behavior

take into account that many people may consistently use condoms across sexual contacts and relationships, but inconsistently within a specific relationship, because they are influenced by contextual factors Conclusions