Professional Documents
Culture Documents
A Research Paper
Submitted in Partial Fulfilment of the Requirements for the Degree of
Master of Science in Clinical Psychology
of
The University of the West Indies
Denise Dumas-Koylass
83740820
2013
i
ATTACHMENT STYLES AND SEXUAL BEHAVIOURS
ABSTRACT
Denise Dumas-Koylass
This paper examines the relationship between attachment styles and sexual
behaviour. Understanding the variables that influence sexual behaviour is
important to the process of designing therapeutic interventions and
psychoeducational sessions that are relevant to the needs of individuals struggling
with risky sexual behaviour. It was hypothesized that a significant relationship
would exist between insecure attachment styles and risky sexual behaviour. In
order to test the research hypothesis, the study used a quantitative correlational
research design to examine the relationship between the two variables.
Participants in this study were 269 men and women between the ages of 18 to 49
years who completed three (3) questionnaires, a demographic questionnaire, the
Experiences in Close Relationships Revised (ECR-R) and the Sexual Risk Survey
(SRS). Nonparametric tests were utilized to analyze the data. The overall results
of the study indicate that participants with insecure avoidant attachment styles
engage in more risky sexual behaviours than those with a secure attachment style.
The implications of the research for psychotherapy are discussed.
Keywords: attachment style, risky sexual behaviour, internal working model
ii
ATTACHMENT STYLES AND SEXUAL BEHAVIOURS
Acknowledgments
Finally, I thank my husband, Ronald Koylass, and our sons, Jason, David
and Andre, for their genuine interest in my academic endeavours and their
unwavering love and support during my time of study. Thank you.
iii
ATTACHMENT STYLES AND SEXUAL BEHAVIOURS
Dedication
iv
ATTACHMENT STYLES AND SEXUAL BEHAVIOURS
Table of Contents
Abstract
Acknowledgments................................................................................................... ii
Dedication .............................................................................................................. iii
List of Figures ....................................................................................................... vii
List of Tables ....................................................................................................... viii
Chapter 1 ................................................................................................................. 1
Introduction to the Study ........................................................................................ 1
Overarching Objective ........................................................................................ 1
General Introduction and Justification ................................................................ 1
Operational Definitions ....................................................................................... 2
Risky sexual behaviour ................................................................................... 2
Attachment ...................................................................................................... 2
Internal working model ................................................................................... 3
Attachment style ............................................................................................. 3
Chapter 2 ................................................................................................................. 4
Literature Review.................................................................................................... 4
Risky Sexual Behaviour ...................................................................................... 4
Attachment Theory ............................................................................................. 5
Internal working model ................................................................................... 7
Long term impact of attachment models ........................................................ 8
Adult attachment styles ................................................................................... 9
Secure attachment style............................................................................. 12
v
ATTACHMENT STYLES AND SEXUAL BEHAVIOURS
Insecure dismissive-avoidant attachment style ......................................... 12
Insecure anxious-preoccupied attachment style........................................ 12
Insecure fearful-avoidant attachment style ............................................... 13
Attachment Style and Sexual Behaviour .......................................................... 13
Research Questions and Major Hypotheses ...................................................... 14
Chapter 3 ............................................................................................................... 16
Method .................................................................................................................. 16
Participants ........................................................................................................ 16
Research Design................................................................................................ 19
Measures ........................................................................................................... 19
Demographic questionnaire .......................................................................... 19
Experiences in Close Relationships Revised (ECR-R)................................. 19
Sexual Risk Survey (SRS) ............................................................................ 21
SRS Factors ............................................................................................... 21
Procedure .......................................................................................................... 23
Ethical protocol ............................................................................................. 23
Recruitment ................................................................................................... 23
Major stages of data analysis ........................................................................ 24
Field test ........................................................................................................ 27
Reliability...................................................................................................... 27
Convergent validity....................................................................................... 31
Concurrent validity ....................................................................................... 31
Chapter 4 ............................................................................................................... 33
vi
ATTACHMENT STYLES AND SEXUAL BEHAVIOURS
Results ................................................................................................................... 33
Testing of Normality ......................................................................................... 33
Profile of Attachment Styles ............................................................................. 33
Overview of Hypothesis Testing ...................................................................... 36
Overview of Results .......................................................................................... 36
Attachment styles and sexual behaviours ..................................................... 36
Risky sex acts ................................................................................................ 36
Impulsive sexual behaviours ......................................................................... 37
Risky anal sex acts ........................................................................................ 37
Secure vs. insecure dismissive-avoidant attachment style. ........................... 38
Secure vs. insecure fearful-avoidant attachment style. ................................. 40
Secure vs. insecure anxious-preoccupied attachment style. ......................... 41
Chapter 5 ............................................................................................................... 42
Discussion ............................................................................................................. 42
Chapter 6 ............................................................................................................... 45
Limitations and Recommendations....................................................................... 45
Limitations ........................................................................................................ 45
Recommendations ............................................................................................. 46
Therapeutic Interventions ............................................................................. 46
Psychoeducational workshops ...................................................................... 48
References ............................................................................................................. 49
Appendix A: Copy of Research Instrument
Appendix B: Ethics Approval Document (UWI)
vii
ATTACHMENT STYLES AND SEXUAL BEHAVIOURS
List of Figures
FIGURE
1.
2.
3.
44
viii
ATTACHMENT STYLES AND SEXUAL BEHAVIOURS
List of Tables
TABLE
1.
17
2.
26
3.
29
4.
30
5.
31
scales
6.
32
scales
7.
34
8.
38
9.
39
10.
40
style
11.
41
Chapter 1
Introduction to the Study
Overarching Objective
The focus of this study is to explore the relationship between attachment
styles and sexual behaviour in adults. It is hoped that the research findings would
contribute to the development of effective therapeutic interventions and
psychoeducational sessions for individuals and groups struggling with risky
sexual behaviour.
General Introduction and Justification
Understanding the variables impacting sexual behaviour is important for
mental health practitioners working with individual clients as well as for those
working in the public health arena. Risky sexual behaviour continues to place
persons at risk for unplanned pregnancies and sexually transmitted infections
(STIs) such as the Human Immunodeficiency Virus (HIV).
In this regard, the HIV/AIDS epidemic continues to be a critical public
health issue for countries such as Trinidad and Tobago. In the 2010 Report on the
Global AIDS Epidemic, the UNAIDS/WHO Working Group estimated that the
prevalence rate of adults aged 15-49 living with HIV in Trinidad and Tobago was
estimated at around 1.5% compared to the prevalence percentage of <0.1% in
Japan, 0.3% in Canada and 0.6% in the United States of America (USA).
Operational Definitions
Risky sexual behaviour. The Centers for Disease Control and Prevention
(2010) define risky sexual behaviour as behavior that increases ones risk of
contracting sexually transmitted infections and experiencing unintended
pregnancies. It includes having sex at an early age, having multiple sexual
partners, having sex while under the influence of alcohol or drugs, and
unprotected sexual behaviors (Centers for Disease Control and Prevention, 2010).
Ciesla, Roberts and Hewitt (2004) state that it is important to understand
the underlying interpersonal and affective motives influencing risky sexual
behaviour. They propose that attachment theory (Bowlby, 1980) may provide a
useful framework through which to explore the interpersonal nature (p. 109) of
sexual behaviour.
Attachment. Bowlby defined attachment as an enduring affective bond
characterized by a tendency to seek and maintain proximity to a specific person,
particularly when under stress (Bowlby, 1969 cited in Levy and Orlans, 2000, p.
6). Bowlby theorized that the evolutionary purpose of attachment is survival, that
is, that the safety of human infants is designed to be optimized by maintaining
proximity to their primary caregiver, usually their mother (Fisher & McKnulty,
2010).
Berghaus (2011) explains that as a child engages with his or her primary
caregiver, he or she experiences either responsiveness, rejection, or some
combination of both. Eventually, the infant learns to predict caregiver responses
based on actual experience (p. 6). Attachment theory therefore emphasizes the
importance of the bond that develops between a child and his or her primary
caregiver and the consequences that this bond has on the childs future
relationships (Morsunbul, 2009, p. 234).
Internal working model. In Bowlbys book Loss: Sadness and
Depression (1980), he described the concept of the internal working model.
Attachment theory holds that a child develops an internal working model, about
both self and others, based on actual early experiences with their primary
caregiver. According to Bowlby, this internal working model, which consolidates
by the end of adolescence and becomes resistant to change in adulthood,
influences an individuals relationships with significant others over the lifespan.
Attachment style. Attachment style refers to the way a child relates to
a primary caregiver figure or the way an adult relates to significant others in the
context of intimate relationships (Psychology Glossary, 2013).
The focus of this study was to explore the relationship between adult
attachment styles and sexual behaviour in order to provide information that could
contribute to the development of therapeutic interventions and psychoeducational
sessions for individuals and groups struggling with risky sexual behaviour. A
review of the literature on these two variables is outlined below.
Chapter 2
Literature Review
separating infants from their mothers and observing the behaviour of the children
upon the eventual return of their mothers. On the basis of her observations,
Ainsworth classified the children participating in her experiment into three
groups: (a) securely attached; (b) avoidantly attached; and (c) ambivalently
attached.
Securely attached children feel safe to explore their environment because
they are confident that their mother would be readily available to protect them if
needed. Attachment theory holds that infants develop secure attachments when
their primary caregiver behaves in a sensitive manner and is responsive to their
needs (McLeod, 2008). As a result, they develop a positive working model of
themselves and have mental representations of others as being helpful, while
viewing themselves as worthy of respect (Jacobsen & Hoffman, 1997).
Some children adopt an ambivalent style of behaviour. They demonstrate
clingy and dependent behaviour and yet reject comfort from their primary
caregiver. Attachment theory holds that the anxious-ambivalent child does not
develop a sense of security due to the inconsistent level of response from his or
her attachment figure and, as a result, does not feel sufficiently confident to
explore new environments (McLeod, 2008). Furthermore, ambivalent children
develop a negative self-image and learn to exaggerate their emotional responses
as a way to gain attention (Kobak et al., 1973).
Previous research therefore indicates that children who start their lives built on a
foundation of secure attachment have a developmental advantage over insecurely
attached children (Levy and Orlans, 2000).
Internal working model. Attachment theory holds that human beings
develop an internal working model about both self and others based on their early
experiences with their primary caregiver. In Bowlbys book Attachment and
Loss: Vol. 2. Separation: Anxiety and Anger (1973), he described the concept of
the internal working model as follows:
Each individual builds working models of the world and of himself in it,
with the aid of which he perceives events, forecasts the future, and
constructs his plans. In the working models of the world that anyone
builds, a key feature is his notion of who his attachment figures are, where
they may be found, and how they may be expected to respond. Similarly,
in the working model of the self that anyone builds, a key feature is his
notion of how acceptable or unacceptable he himself is in the eyes of his
attachment figures (Bowlby, 1973, p. 203 cited in Pietromonaco &
Feldman Barrett, 2000, p. 155).
There are therefore two key features of these working models of
attachment: the first is the individuals image of significant other as likely to
respond in a positive manner and the second is the individuals image of self, as
likely to gain a positive response (Morsunbul, 2009). This mental representation
of the self and others helps the individual to predict and understand their
environmentand establish a psychological sense of felt security (cf.
Bretherton, 1985; Sroufe & Waters, 1977 cited in Pietromonaco & Feldman
Barrett, 2000, p. 155).
Internal working models, or mental representations, are theorized to firstly
include specific content about self and others that includes information about
what happened in earlier experiences with attachment figures, as well as the
emotions associated with those experiences (Bretherton, 1985 cited in
Pietromonaco & Feldman Barrett, 2000), and secondly to involve unconscious
processes that influence what information individuals attend to, how they
interpret events in their world, and what they remember (Pietromonaco &
Feldman Barrett, 2000, p. 156).
Long term impact of attachment models. Bowlby (1979) held that such
internal working models, which consolidate by the end of adolescence and
become resistant to change in adulthood, influence an individuals thought,
feeling and behaviour in adult relationships (Pietromonaco & Feldman Barrett,
2000, p. 155). Other researchers such as Hazan and Shaver (1987) and Meyer
(2011) support this perspective that attachment patterns established in childhood
will continue to affect an individual for the remainder of his or her life (Meyer,
2011, p. 3).
Adult attachment styles. Adult attachment refers to an individuals
stable tendency to seek and maintain closeness to one or a few significant others.
Ainsworth (1989) held that the identifying feature of an attachment relationship
is that it serves the function of providing felt security (Pietromonaco & Feldman
Barrett, 2000, p. 167).
Hazan and Shaver (1987) applied Bowlbys attachment theory to the study
of adult romantic behaviour. They identified three adult attachment styles:
secure, avoidant and anxious-ambivalent. In the context of attachment theory,
avoidance is defined as the extent to which individuals limit intimacy with
others (Holmes and Johnson, 2009, p. 835) and anxiety is defined as the extent
to which individuals worry about abandonment and rejection (Holmes and
Johnson, 2009, p. 835). These styles, which are reflective of attachment patterns
formed in childhood, are explained below:
Secure adults were defined as those who appear to be comfortable with
closeness in their relationships, and they were not particularly worried
about others rejecting them; anxious-ambivalent adults appeared to seek
excessive closeness and were concerned that they would be rejected; and
avoidant adults appeared uncomfortable with closeness and found it
difficult to depend on others (Pietromonaco & Feldman Barrett, 2000, p.
156).
10
Figure I
Adult Attachment Styles
11
Figure II
Internal Working Model
12
13
14
2.
15
16
Chapter 3
Method
Participants
A sample of 269 adults between the ages of 18-49 years participated in the
study. 35.3 % of the participants were aged 21-22 years and 19.7% were over the
age of 25 years. More females (73.6%) than males (26.4%) participated in the
study and 92% of the participants were university students.
The sample was racially and ethnically diverse, with 33.8% East Indian;
29% Black; 32.7% Multi-racial; and 1.9% Caucasian. 25.3% of the participants
were Roman Catholic, 21.6% were Pentecostal, 14.1% were Hindu and 4.8%
were Muslim.
45% of the participants were single and did not have a steady relationship;
40.9% were single with a steady partner; 6.7% were married; 3% were living with
a partner; .4% were separated; .and 7% were divorced. 17.5% were in a
relationship for 2 5 years and 13.4% were in a relationship for 1 2 years.
90.7% of the participants identified their sexual orientation as heterosexual, 4.5%
as bisexual and 3.70% as homosexual. Sociodemographic characteristics of the
study sample are outlined in Table I.
17
Table I
Demographic Profile of the Sample (N 269)
Demographic / background variable
Mean age (SD)
21.31
(1.76)
Age Range
1849
Sex
% Male
26.4
% Female
73.6
35.3
29.0
% Secondary school
20.4
Race / Ethnicity
% African
29.0
% East Indian
33.8
% Multi-racial
33.7
Sexual orientation
% Heterosexual
90.7
% Homosexual
3.7
% Bisexual
4.5
18
Religion
% Catholic
25.3
% Pentecostal
21.6
% Hinduism
14.1
% Islam
4.8
45.0
40.9
% Married
6.7
% Separated
0.4
% Divorced
0.7
17.5
13.4
% not applicable
40.1
19
Research Design
The present study used a quantitative correlational research design to
examine the relationship between two variables, attachment styles and sexual
behaviours. Three (3) questionnaires designed to identify demographics,
attachment style and sexual behaviour were completed by participants.
Measures
The purpose of the present research was to examine the relationship
between attachment styles and sexual behaviour in adult participants. In order to
explore this relationship, participants were presented with three questionnaires: a
demographic questionnaire, the Experiences in Close Relationships Revised
(ECR-R) and the Sexual Risk Survey (SRS). A copy of the research instrument is
provided at Appendix A.
Demographic questionnaire. Participants reported demographic data
such as age, ethnicity, religion, highest level of education and sexual orientation.
Participants were also required to answer questions about their sexual risk taking
(such as age of sexual debut, number of sexual partners and birth control
practices) and whether they had experienced any health consequences from risky
sexual behaviour (such as concerns about or actual unplanned pregnancies and
sexually transmitted infections).
Experiences in Close Relationships Revised (ECR-R). Nosko et al.
(2011) explain that various ways exist to measure adult attachment. The current
study utilized the Experiences in Close Relationships-Revised (ECR-R) Adult
Attachment Questionnaire developed by Fraley, Waller and Brennan (2000). The
20
ECR-R is a self-report measure that uses a 7-point Likert-type scale to assess how
participants generally experience current and previous intimate relationships.
The measure, which contains 36 items, is designed to assess romantic
attachment on the basis of the four (4) adult attachment styles identified by
Bartholomew and Horowitz (1991) namely: (i) secure, (ii) anxious-preoccupied,
(iii) dismissive-avoidant and (iv) fearful-avoidant.
The ECR-R is a revised version of the Experiences in Close Relationships
Questionnaire (ECR) developed by Brennan, Clark and Shaver (1998). The items
on the ECR-R were selected from the same item pool as those from the ECR but
were selected using more modern techniques based on Item Response Theory as
explained below:
Both the ECR and ECR-R are designed to assess individual experiences
with respect to attachment-related anxiety (i.e. the extent to which people
are insecure vs. secure about the availability and responsiveness of
romantic partners) and attachment-related avoidance (i.e. the extent to
which people are uncomfortable being close to others vs. secure
depending on others) (Fraley, n.d.).
The ECR-R was selected for this study because it was reported to have
sound psychometric properties. Briere, Godbout & Runtz (2012) report that the
ECRR has demonstrated in numerous studies alphas of .90 or higher, high test
retest reliability, as well as good structural and discriminant validity (p. 305306). Sibley and Liu (2004) performed separate exploratory and conrmatory
factor analyses which indicated that the ECR-R provided a reliable and
replicable dual factor self-report measure of adult romantic attachment (p. 969).
21
2.
3.
22
4.
5.
SRS Factor 5: Risky Anal Sex Acts: this subscale contains three
items describing risky anal sex acts (Turchik & Garske, 2008,
p.8).
23
Procedure
Ethical protocol. This study was approved by the Ethics Committee,
Faculty of Medical Sciences, University of the West Indies, St. Augustine. A
copy of the Ethics Approval Document has been provided at Appendix B. All
aspects of the research in this study were carried out in accordance with the
ethical guidelines of the University of the West Indies (1998), the British
Psychological Society (2010) and the American Psychological Association
(2010).
Recruitment. Recruitment of the sample of 269 participants was
accomplished through community-based and respondent-driven sampling.
Participants were recruited through direct contact and the use of flyers on the
campuses of three tertiary institutions in Trinidad: the University of the West
Indies (UWI), the School of Accounting and Management (SAM) and the
University of the Southern Caribbean (USC). Internet recruitment was also
utilized with participants being recruited through social media such as Facebook.
In addition, emails were issued to all students of UWI by UWIs Marketing
Department.
Interested individuals were provided with an online link to the website,
Survey Monkey.com in order to gain access anonymously to the online
instrument. Once on the specified website, interested persons were required to
read the Informed Consent document which was provided on the first page of the
survey instrument. Participants could only proceed to complete the questionnaire
after they had indicated that they were over 18 years, had read the Informed
24
Consent document and were willing to participate in the survey. All data were
collected anonymously by Survey Monkey and no codes were used to identify
any participant.
All participants who completed the survey were offered the opportunity to
enter in a prize drawing by emailing their contact particulars to the researcher
after they had exited the Survey Monkey website. The prize winner was then
randomly selected by the Marketing Department of the University of the West
Indies.
Major stages of data analysis. All participant data was exported directly
into Microsoft Excel by Survey Monkey. Participant scores for the 18 items
within each ECR-R scale were then averaged, using Excel, to determine each
participants anxiety and avoidance scores. In accordance with the instructions of
the instrument developers (Fraley, n. d.), questions 09, 11, 20, 22, 26, 27, 28, 29,
30, 31, 33, 34, 35 and 36 were reverse keyed before averaging.
The median score for avoidance, i.e. MAVOID, and the median score for
anxiety, i.e. MANX, were computed and participants assigned to one of the four
attachment styles, (i) secure, (2) insecure dismissive-avoidant, (3) insecure
fearful-avoidant and (4) insecure anxious-preoccupied in accordance with the
following instructions:
1. if the participants anxiety score was <MANX and the persons avoidance
score was <MAVOID, then he/she was assigned to the Secure group;
2.
25
if the participants anxiety score was <MANX and the persons avoidance
score was >=MAVOID, then he/she was assigned to the DismissiveAvoidant group;
26
Table II
SRS Recoding Value Specifications
0
Item 1
2-3
5+
Item 2
2-3
5+
Item 3
2-3
5+
Item 4
1-2
3-5
6-14
15+
Item 5
1-2
3-5
6-19
20+
Item 6
3-5
6+
Item 7
3-4
5+
Item 8
3-6
7+
Item 9
1-4
5-19
20-64
65+
Item 10
1-3
4-10
11-49
50+
Item 11
1-5
6-15
16-44
45+
Item 12
1-4
5-11
12-39
40+
Item 13
1-2
3-4
5-10
11+
Item 14
1-2
3-5
6-10
11+
Item 15
1-2
3-5
6-9
10+
Item 16
2-3
4-5
6+
Item 17
2-3
5+
Item 18
1-3
4-8
9-19
20+
Item 19
1-2
3-4
5-8
9+
Item 20
2-3
4-9
10+
Item 21
2-3
5+
Item 22
4+
Item 23
3-4
5+
27
Field test. A pilot study was conducted to pre-test the research instrument.
The 30 participants surveyed during the pilot indicated in their anonymous online
responses that they understood the instructions and that they had not experienced
any challenges in completing the survey.
Reliability. The pilot study was also used to check the internal
consistency reliability of the ECR-R and SRS. The results of the pilot study
indicated a very good internal consistency, with a Cronbach's alpha of .95 for the
SRS and .94 for the ECR-R.
The internal consistency reliability of both measures was then re-tested
with the study sample of 269 participants. The Cronbachs Alpha value of the
ECR-R 18-item anxiety and 18-item avoidance scales were .92 and .93
respectively, suggesting very good internal consistency reliability.
The Cronbachs Alpha value for the entire SRS 23-item scale was also
very good at .90. However, the value of the five SRS Factors varied depending on
the number of items in each category as follows: Cronbachs Alpha value of .92
for the 8-item SRS Factor 1, .86 for the 5-item SRS Factor 2, .75 for the 5-item
SRS Factor 3, .69 for the 2-item SRS Factor 4 and .68 for the 3-item SRS Factor
5. Pallant (2001) indicated that lower Cronbach values tend to be found with
shorter scales, e.g. a scale with less than ten items.
Construct validity. Confirmatory factor analysis was conducted to
evaluate the factor structure of both scales. Although the ECR-R has
demonstrated satisfactory validity and reliability in other studies (Sibley and Liu,
2004; Sibley, Fischer & Liu, 2005), it was necessary to investigate whether the
28
29
Table III
Factor Loadings: ECR-R
Initial Eigenvalues
Anxiety
Component
Total
% of
Cumulative
Variance
Total
% of
Cumulative
Variance
4.502
56.274
56.274
4.502
56.274
.760
9.500
65.774
.760
9.500
.661
8.259
74.034
.661
8.259
.504
6.302
80.336
.504
6.302
.477
5.965
86.301
.477
5.965
.411
5.142
91.443
.411
5.142
.350
4.380
95.823
.350
4.380
.334
4.177
100.000
.334
4.177
6.379
57.993
57.993
6.379
57.993
.891
8.099
66.092
.710
6.455
72.547
.573
5.214
77.761
.514
4.676
82.437
.465
4.227
86.664
.437
3.971
90.635
.326
2.964
93.599
.264
2.397
95.996
10
.230
2.087
98.083
11
.211
1.917
100.000
56.274
Avoidance
Component
Table IV
57.993
30
Re16
0.705
0.166
0.283
0.21 0.082
Re17
0.548
0.054
0.171
0.541 0.055
Re19
0.728
0.075
0.296
0.048 0.054
Re20
0.742
0.131
0.216
0.085 0.128
Re21
0.77
0.193
0.079
0.229 0.069
Re22
0.842
0.164
0.044
0.055 0.015
Re23
0.839
0.126
0.068
0.134 0.239
Re8
0.641
0.442
0.297
0.115
Re9
0.133
0.877
-0.03
0.006 0.067
Re10
0.208
0.833
0.034
0.019 0.024
Re11
0.151
0.791
Re12
0.045
0.704
Re18
0.285
0.592 -0.017
0.141
Re1
0.132
0.125
0.709
0.241 0.057
Re6
0.239
0.19
0.715
0.084 0.021
Re7
0.436
0.098
Re3
0.175
-0.02
0.582
0.422 0.084
0.11 -0.098
0.315
0.669 0.148
Re4
0.064 -0.049
0.244
0.733 0.029
Re5
0.245
0.128 -0.144
0.818 0.032
Re13
0.29
0.251 -0.002
0.012 0.723
0.226 0.805
0.06
0.19
e14
0.063
0.084
0.005
Re15
0.054
0.195
31
Table V
Convergent validity: Correlations between the SRS Factors and other scales
Scales
SRS
SRS
SRS
SRS
SRS
Factor I
Factor 2
Factor 3
Factor 4
Factor 5
.29**
.51**
.19**
-.008
.17**
.59**
.62**
.31**
.064
.31**
.35**
.63**
.25**
.05
.26
32
Table VI
Concurrent Validity: Correlations between the SRS Factors and other scales
Scales
SRS
SRS
SRS
SRS
SRS
Factor I
Factor
Factor
Factor 4
Factor
.38**
.66**
.24**
.01
.26**
.44**
.28**
.29**
.13*
.24**
.16*
.33
-.02
-.03
.17**
.17**
.24**
.08
-.09
.21**
33
Chapter 4
Results
Testing of Normality
Tests of normality were conducted and the results of the KolmogorovSmirnov statistic were found to be significant, that is, below 0.05. Since the
results of the normality tests indicated violation of the assumption of normality,
nonparametric statistical tests, such as the Kruskal-Wallis and Mann-Whitney U
Tests were utilized.
Profile of Attachment Styles
Attachment style was measured with the use of the modified ECR-R. The
results showed that 38 participants belonged to the Secure Attachment Style
(14.1%), 95 participants belonged to the Dismissive-Avoidant Attachment Style
(35.3%), 44 participants belonged to the Fearful-Avoidant Attachment Style
(16.4%) and 92 participants belonged to the Anxious-Preoccupied Attachment
Style (34.2%). The demographic characteristics of the participants, grouped
according to their attachment style, are outlined in Table VII.
34
Table VII
Profile of Respondents Grouped by Attachment Styles
Secure
Dismissing
Fearful
Preoccupied
22
21
over 25
21
% Male
34.2
29.5
18.2
23.9
% Female
65.8
70.5
81.8
76.1
% Black
28.9
27.4
22.7
33.7
% East Indian
31.6
37.9
34.1
30.4
% Multi-Racial
39.5
28.4
38.6
31.5
Average age
Gender
Race / Ethnicity
Religion
% Roman Catholic
21.1
25.3
25
27.2
% Pentecostal
10.5
26.3
20.5
21.7
% Hindu
18.4
14.7
9.1
14.1
% Muslim
5.3
5.3
4.5
4.3
3.2
3.3
% CAPE A Levels
26.3
21.1
6.8
23.9
21.1
34.7
34.1
23.9
% Assoc. Degree
5.3
4.2
6.8
6.5
% Bachelor
39.5
28.4
45.5
35.9
% Graduate
5.3
4.2
4.5
5.4
35
Secure
Dismissing
Fearful
Preoccupied
% Heterosexual
84.2
92.6
88.6
92.4
% Homosexual
5.3
3.2
6.8
2.2
% Bisexual
10.5
3.2
2.3
4.3
47.4
50.5
40.9
40.2
39.5
35.8
47.7
43.5
% Married
2.6
10.5
2.6
1.1
9.1
2.2
% .5 1 year
7.9
7.4
6.8
6.5
% 1 2 years
10.5
12.6
18.2
13.0
% 2 5 years
13.2
14.7
22.7
19.6
% 5 10 years
10.5
7.4
2.3
9.8
% 13 years or younger
5.3
7.4
2.3
3.3
% 14 years
2.6
0.0
0.0
3.3
% 15 years
5.3
4.2
15.9
1.1
% 16 years
0.0
4.2
4.5
12.0
% 17 years
13.2
9.5
18.2
13.0
% 18 years
13.2
13.7
18.2
6.5
% 19 years or older
28.9
18.9
15.9
31.5
Sexual Orientation
Relationship status
7.6
36
Overview of Results
Attachment styles and sexual behaviours. The Kruskal-Wallis Test is
the non-parametric alternative to the one-way analysis of variance (ANOVA)
(Pallant, 2001) and is used to generate a between-groups comparative analysis. It
was used in this study in order to evaluate the hypothesis that there would be a
statistically significant difference in sexual behaviours between secure and
insecure attachment styles, with insecurely attached participants predicted to score
higher on average on the variable of risky sexual behaviour.
Risky sex acts. Consistent with predictions, significant differences were
found. Participants with an Insecure Dismissive-Avoidant Attachment Style
37
scored the highest with regard to SRS Factor 2: Risky Sex Acts, X2 (3, N = 269) =
9.07, p = .03. Insecure Dismissive-Avoidant participants had an average rank of
151.84, while Secure participants had an average rank of 123.89. However, in
contrast to predictions, Insecure Anxious-Preoccupied participants had the lowest
average rank at 121.43.
Impulsive sexual behaviours. Consistent with predictions, significant
differences were found. Participants with an Insecure Fearful-Avoidant
Attachment Style scored the highest with regard to SRS Factor 3: Impulsive
Sexual Behaviours, X2 (3, N = 269) = 12.76, p = .005. Fearful-avoidant
participants had the highest average rank of 165.73, while Secure participants had
an average rank of 148.84. Interestingly, Insecure Anxious-Preoccupied
participants again had the lowest average rank at 118.65.
Risky anal sex acts. Consistent with predictions, significant differences
were found. Participants with an Insecure Fearful-Avoidant Attachment Style
were also found to significantly score the highest with regard to SRS Factor 5:
Risky Anal Sex Acts, X2 (3, N = 269) = 18.81, p < .001. Insecure FearfulAvoidant participants had the highest average rank of 161.74, while Secure
participants had an average rank of 135.45. Once again, Anxious-Preoccupied
participants had the lowest average rank at 123.71.
Table VIII depicts the results of the Kruskal-Wallis Test for differences in
sexual behaviours between participants with different attachment styles.
38
Table VIII
Kruskal-Wallis Test: Attachment Styles and Sexual Behaviours
Chi-Square
Df
Asymp. Sig.
SRS
SRS
SRS
SRS
SRS
Factor 1
Factor 2
Factor 3
Factor 4
Factor 5
2.674
9.074
12.760
7.502
18.806
.445
.028
.005
.058
.000
39
Table IX
Mann-Whitney Test: Secure vs. Dismissive-Avoidant Attachment Styles
SRS
SRS
SRS
SRS
SRS
Factor 1
Factor 2
Factor 3
Factor 4
Factor 5
Mann-Whitney U
1704.000
1427.500
1559.500
1580.000
1776.000
Wilcoxon W
6264.000
2168.500
6119.500
6140.000
6336.000
-.596
-1.973
-1.241
-1.984
-.238
.551
.048
.215
.047
.812
Z
Asymp. Sig. (2-tailed)
40
Secure vs. insecure fearful-avoidant attachment style. A MannWhitney U Test was performed to evaluate the hypothesis that participants with
an Insecure Fearful-Avoidant Attachment Style would score higher on average on
the variable of risky sexual behaviours than participants with a Secure Attachment
Style.
Consistent with predictions, the results of the test were in the expected
direction and significant. Specifically, participants with a Fearful-Avoidant
Attachment Style were found to have a higher score with regard to SRS Factor 5:
Risky Anal Sex Acts, z = -2.08, p = .04, r = .1.
Table X depicts the results of the Mann-Whitney U Test for the
differences between participants with a Secure Attachment Style and participants
with an Insecure Fearful-Avoidant Attachment Style with regard to sexual
behaviours.
Table X
Mann-Whitney U Test: Secure vs. Insecure Fearful-avoidant Attachment Styles
Mann-Whitney U
Wilcoxon W
Z
Asymp. Sig. (2-tailed)
SRS
SRS
SRS
SRS
SRS
Factor 1
Factor 2
Factor 3
Factor 4
Factor 5
782.500
758.500
747.000
781.000
665.000
1523.500
1499.500
1488.000
1771.000
1406.000
-.563
-.773
-.833
-.781
-2.084
.574
.440
.405
.435
.037
41
Secure vs. insecure anxious-preoccupied attachment style. A MannWhitney U Test was performed to evaluate the hypothesis that participants with
an Insecure Anxious-Preoccupied Attachment Style would score higher on
average on the variable of risky sexual behaviour than participants with a Secure
Attachment Style.
Contrary to predictions, the results of the test were significant, but not in
the expected direction. Specifically, participants with a Secure Attachment Style
were found to have a higher score with regard to SRS Factor 3: Impulsive Sexual
Behaviours than participants with an Insecure Anxious-Preoccupied Attachment
Style, z = -1.95, p = .05, r = .1. Table XI depicts the results of the Mann-Whitney
U Test for the differences between participants with secure attachment styles and
insecure anxious-preoccupied attachment styles with regard to sexual behaviours.
Table XI
Mann-Whitney U Test: Secure vs. Insecure Anxious-preoccupied Attachment
Styles
SRS
SRS
SRS
SRS
SRS
Factor 1
Factor 2
Factor 3
Factor 4
Factor 5
Mann-Whitney U
1643.000
1715.000
1378.500
1711.000
1589.000
Wilcoxon W
5921.000
5993.000
5656.500
2452.000
5867.000
-.650
-.186
-1.948
-.264
-1.623
.516
.853
.051
.792
.105
Z
Asymp. Sig. (2-tailed)
42
Chapter 5
Discussion
The present study examined the relationship between attachment styles
and sexual behaviours and asked questions about the differences in sexual
behaviours between individuals with secure and insecure attachment styles. In
this regard, it was hypothesized that:
H1. participants with insecure attachment styles would engage in more risky
sexual behaviours than participants with a secure attachment style;
H2. participants with an Insecure Anxious-Preoccupied Attachment Style
would engage in more risky sexual behaviours than participants with a
Secure Attachment Style;
H3. participants with an Insecure Fearful-Avoidant Attachment Style would
engage in more risky sexual behaviours than participants with a Secure
Attachment Style; and
H4. participants with an Insecure Dismissive-Avoidant Attachment Style would
engage in more risky sexual behaviours than participants with a Secure
Attachment Style.
The results outlined in Chapter 4 suggest that the following conclusions
can be made about the study sample. Consistent with predictions, participants
with insecure attachment styles, specifically participants with an Insecure FearfulAvoidant and an Insecure Dismissive-Avoidant Attachment Style engaged in
more risky sexual behaviours than participants with a Secure Attachment Style.
In this regard, significant differences in behaviours were found for SRS Factor 2:
43
Risky Sex Acts, SRS Factor 3: Impulsive Sexual Behaviours and SRS Factor 5:
Risky Anal Sex Acts.
Both styles of attachment are rooted in avoidance which involves limiting
emotional, if not sexual, intimacy with others. Dismissive-avoidant individuals
tend to avoid close relationships because they see others as clingy, needy and
dependent (Holmes and Johnson, 2009, p. 835). Fearful-avoidant individuals
also tend to avoid emotionally intimate relationships, but their concern is rooted
in fear of rejection and in distrust of others.
On the other hand, contrary to predictions, evidence did not suggest that
participants with an Insecure Anxious-Preoccupied Attachment Style engaged in
more risky sexual behaviours than participants with a Secure Attachment Style.
Rather, significant differences were found for SRS Factor 3: Impulsive Sexual
Behaviours, with a higher mean assigned to participants with a Secure Attachment
Style.
The safer sexual behaviours of participants with an Insecure AnxiousPreoccupied Attachment Style may be explained by their risk-adverse nature.
Anxious-preoccupied individuals worry about abandonment and rejection
(Holmes and Johnson, 2009, p. 835) and do not feel sufficiently confident to take
chances and explore new environments (McLeod, 2008). Thus, their early
experiences with rejecting primary caregivers may have taught them to avoid
risky environments such as unsafe sexual situations. An overview of the four
attachment styles is depicted in Figure III.
44
Figure III
Four-category model of adult attachment (Bartholomew & Horowitz, 1991)
Positive
Negative
(low dependence)
(high dependence)
Secure
Preoccupied
Comfortable with
Preoccupied with
intimacy and
relationships, high
autonomy
emotional reactivity
Dismissing
Fearful
Negative
Dismissive of
Afraid of intimacy
(high
attachment; counter-
and rejection;
dependent
believes self to be
Positive
Internal
(low
working
avoidance)
model of
others
(avoidance)
avoidance)
worthy of rejection;
high emotional
reactivity
Retrieved from: http://apt.rcpsych.org/content/12/6/440/F1.large.jpg
The focus of this study was to explore the relationship between adult
attachment styles and sexual behaviours in order to provide information that could
be used in the development of therapeutic interventions and psychoeducational
sessions for individuals and groups struggling with risky sexual behaviour.
Recommendations in this regard are outlined in Chapter 6.
45
Chapter 6
Limitations and Recommendations
Limitations
The present study presents a number of limitations. Most of the
participants were female university students and the small study sample of male
participants indicates a high risk of making Type II errors. Additionally, the
present research was based on self-report and retrospective data and is therefore
limited by its reporting of mainly subjective assessments.
Through the review of literature and the research, it is evident that
understanding all the biopsychosocial factors that influence risky sexual
behaviour, such as attachment styles, is a challenging task. In order to strengthen
the generalizability of the findings, future studies should collect data from
substantially wider and larger samples of both male and female participants.
Additionally, researchers interested in exploring the relationship between
attachment style and risky sexual behaviour should consider the conduct of
longitudinal studies. Such research would add value to the development of
appropriate therapeutic interventions for individuals and groups struggling with
risky sexual behaviour.
46
Recommendations
Therapeutic Interventions. Research indicates that mental health
professionals working with clients seeking to address risky sexual behaviour
should explore the possible impact of attachment-related issues and, where
appropriate, tailor the intervention based on the clients attachment style. In this
regard, a 2009 study on the relationship between attachment style and risk taking
recommended that mental health professionals working with clients seeking to
address risk taking behaviour should consider whether modification can be made
in attachment styles (Morsunbul, 2009, p. 238).
Bowlby (1988) believed that individuals can change their attachment style
and that therapists can play a significant role in this process by providing a safe
and secure base for the client to explore their issues and change negative internal
working models. He emphasized the importance of paying attention to the quality
of the therapeutic relationship and of being present with the client, that is,
empathic, responsive and attentive. Bowlby held that:
the therapeutic relationship should reflect the attachment relationship and
reported that the role of the counsellor was to be the substitute attachment
figure for the client. Thus, the counsellor provides the secure base needed
in order for the client to process his or her current psychological
functioning (Meyer, 2011, p. 4).
47
therapist can counter the clients negative relationship with an early caregiver
through what they referred to as emotional attunement the ability to
empathize and respond appropriately to the clients verbal and non-verbal cues in
a way that communicates to the client that he or she is understood and accepted.
Meyer (2011) posits that the ability to learn a new attachment pattern is
possible because of the process of neuroplasticity, or the ability for the brain to
rewire or reorganize itself (p. 1) in response to new environmental stimuli such
as a healthy therapeutic relationship.
Meyer (2011) goes on to explain that an important task of the counsellor
is to form an attachment with the client that establishes a secure attachment and
from which the client could use this relationship as a secure basis for other
relationships (p. 2). In this regard, it is therefore critical that the therapist
understands his or her own attachment style and seeks help to treat with any
possible attachment-related issues that may impair the development of a healthy
therapeutic relationship with the client.
In summary, the results of the study indicate that mental health
professionals working with clients seeking to address risky sexual behaviour
should explore the possible impact of attachment-related issues and, where
appropriate, tailor the interventions based on the clients attachment style. In this
regard, therapists should pay attention to establishing a secure space in which
clients can feel safe to engage in healthy self-reflection, to be more accepting of
themselves and to develop more positive internal working models of themselves
and others which are required to engage in more healthy behaviour.
48
49
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51
52
53
54
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Skowronski, D. P. and Goh, W. Y. (2012). Attachment Styles and Sexual
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55
Appendix A
10
11
12
13
14
15
16
17
18
19
Appendix B
20
21
22
23
24
25