Avoidance, Anxiety, and Sex: The Influence of Romantic Attachment on HIV-Risk among Pregnant Women

Kershaw, Trace; Milan, Stephanie; Westdahl, Claire; Lewis, Judith A.; Rising, Sharon Schindler; Fletcher, Rachel; Ickovics, Jeannette R.

doi:10.1007/s10461-006-9153-z

Cited by 34 publications

(43 citation statements)

References 60 publications

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“…26,27 This was a prospective study following participants from early pregnancy through 1 year postpartum. Participants were recruited from large university affiliated obstetrics and gynecology clinics within the New Haven Hospital System, New Haven, Connecticut and Grady Memorial Hospital, Atlanta, Georgia.…”

Section: Methodsmentioning

confidence: 99%

Social Support and Social Conflict as Predictors of Prenatal Depression

Westdahl

Milan

Magriples³

et al. 2007

Obstetrics &Amp; Gynecology

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141

119

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OBJECTIVE-To estimate how social support and social conflict relate to prenatal depressive symptoms and to generate a brief clinical tool to identify women at increased psychosocial risk.METHODS-This is a prospective study following 1,047 pregnant women receiving care at two university-affiliated clinics from early pregnancy through 1 year postpartum. Structured interviews were conducted in the second trimester of pregnancy. Hierarchical and logistic regressions were used to examine potential direct and interactive effects of social support and conflict on prenatal depressive symptoms measured by the Center for Epidemiologic Studies-Depression Scale.RESULTS-Thirty-three percent of the sample reported elevated levels of depressive symptoms predicted from sociodemographic factors, social support, and social conflict. Social support and conflict had independent effects on depressive symptoms although social conflict was a stronger predictor. There was a "dose-response," with each increase in interpersonal risk factor resulting in consequent risk for probable depression based on symptom reports (Center for Epidemiologic Studies-Scale greater than or equal to 16). A composite of one social support and three conflict items were identified to be used by clinicians to identify interpersonal risk factors for depression in pregnancy. Seventy-six percent of women with a composite score of three or more high-risk responses reported depressive symptoms.CONCLUSION-Increased assessment of social support and social conflict by clinicians during pregnancy can identify women who could benefit from group or individual interventions to enhance supportive and reduce negative social interactions.Pregnancy is a time of profound physical and emotional change that inherently affects interpersonal relationships. Social interactions and conflict and the individual's response to them can be crucial triggers for depression. 1,2 Social conflict can be defined as behaviors or interactions perceived as harmful, critical, and hostile and contribute to poor psychological outcome. 3-5 Interpersonal risk factors such as insufficient social support and aggravated social conflict may have profound effects on women's mental and physical health during pregnancy, 6-10 influencing pregnancy outcomes either directly or indirectly through unhealthy life style factors such as smoking or alcohol. 11-14 Among women who gave birth to low birth weight infants, women who experienced any interpersonal conflict gave birth to infants with a mean weight of 261 g lower than women without conflict. 15 There are also societal costs, including increased use of healthcare resources and lost productivity. 16 MATERIALS AND METHODSData for this study are from a larger study of young pregnant women (ages 14−25) enrolled in a randomized controlled trial aimed at promoting improved outcomes through group prenatal care. 26,27 This was a prospective study following participants from early pregnancy through 1 year postpartum. Participants were recruited from large unive...

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Section: Methodsmentioning

confidence: 99%

Social Support and Social Conflict as Predictors of Prenatal Depression

Westdahl

Milan

Magriples³

et al. 2007

Obstetrics &Amp; Gynecology

Self Cite

141

119

View full text Add to dashboard Cite

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“…As shown in Study 2, this was due to security and anxiety priming causing participants to perceive sexual partners as less of a threat to their sexual health. Although the experimental designs of these studies makes them an important contribution to the attachment and sexuality literature, the meta-analytic consistency of the findings for the effects of attachment on condom use attitudes, across the three studies, makes them particularly valuable, given the conflicting findings obtained from previous correlational studies (e.g., Bogaert & Sadava, 2002;Feeney et al, 2000;Kershaw et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

“…One possible explanation for this association, advanced by Feeney et al, is that anxiously attached people engage in risky sex and hold such attitudes because they fear that noncompliance with their partners' wishes will jeopardize their relationships (see Davis, Shaver, & Vernon, 2004). These findings, however, seem at odds with findings of a positive association between secure attachment style and negative attitudes towards condom use (Bogaert & Sadava, 2002), or between avoidant attachment style and negative attitudes towards condom use (Kershaw et al, 2007). The inconsistencies in this literature could be on account of a number of factors, such as the use of different scales to measure attachment, the use of ad-hoc measures of condom use attitudes, and the study of different populations.…”

Section: Attachment Styles and Condom Usementioning

confidence: 99%

“…Participants, online, were exposed to either an attachment (secure, anxious, avoidant) or a control prime, via guided imagery, and were then asked to complete questionnaires assessing, among other things, attitudes toward condom use. Correlational research on attachment and condom use attitudes has supported multiple permutations of associations between attachment style and condom use preferences; some investigations have found that anxiety is associated with negative evaluations of condom use (Feeney et al, 1999(Feeney et al, , 2000Strachman & Impett, 2009), some have found security is associated with negative evaluations of condom use (Bogaert & Sadava, 2002), and others have found that both anxiety and avoidance are associated with negative evaluations of condom use (Kershaw et al, 2007).…”

Section: Studymentioning

confidence: 99%

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The Causal Effects of Relational Security and Insecurity on Condom Use Attitudes and Acquisition Behavior

Sakaluk

Gillath

2015

Arch Sex Behav

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Research on attachment and condom use has been limited to correlational studies of selfreport measures, yielding inconsistent results. Here, we examined the causal effects of attachment priming on self-reported condom use attitudes and an observational measure of condom acquisition behavior. In three experiments, participants were exposed to one of three attachment primes (security, anxiety, or avoidance) or a control prime. For Study 1, participants in the security and anxiety conditions preferred condom non-use to a greater extent, compared to participants in the avoidance condition. This effect was replicated in Study 2, and was mediated by perceptions of sexual health threat. In Study 3, the effect of security priming on condom acquisition behavior was eliminated through the use of a framing manipulation, though, the effect of primed attachment on condom use attitudes was not significant. A Meta-Analysis, however, revealed that the predicted effects of attachment priming were consistent across the three studies, supporting the role of attachment in evaluations of condom use. Priming attachment security or anxiety lead participants to perceive their sexual partners as less of a sexual health threat, resulting in a devaluation of condom use. Primed security also reduced condom acquisition behavior, though this negative effect eliminated by framing condoms as protecting a partner's sexual health. Overall, these studies suggest that relational factors, such as attachment, require greater consideration when studying sexual health and designing interventions.

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“…32, nº 3 (octubre) vinculadas emocionalmente, cuya finalidad podría ser la autoafirmación, llegando a ser más promiscuas y pudiendo distorsionar la percepción de los riesgos inherentes a la actividad sexual (Allen et al, 2003;Kershaw et al, 2007;Schachner y Shaver, 2004;Tracy et al, 2003).…”

Section: Introductionunclassified

Disposición al riesgo en la actividad sexual de adolescentes: El rol de los modelos internos de apego, de las relaciones de apego con padres e iguales y de las dificultades de regulación emocional.

2016

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Resumen: El objetivo de este estudio es analizar la relación existente entre la disposición al riesgo en las relaciones sexuales en personas adolescentes y variables afectivo-emocionales tales como el apego a la madre, al padre, a los iguales, los estilos de apego y las dificultades de regulación emocional. Han participado 1911 adolescentes escolarizados, de ambos sexos, entre 15 y 20 años. Los resultados indican que la seguridad del apego se relaciona inversamente con la disposición al riesgo en las relaciones sexuales, mientras que las dificultades de regulación muestran una asociación positiva, con diferencias entre sujetos sexualmente activos y no activos. Se han hallado diferencias por género, y por categorías de apego, así como entre las personas sexualmente activas y no activas. Palabras clave: Apego, adolescencia, comportamiento sexual, regulación emocional, conductas de riesgo. Abstract:The aim of this study is to analyze the relationship between risktaking in sexual relationships and affective-emotional variables such as attachment to mother, father, peers, attachment styles and difficulties in emotional regulation capacity in adolescence. 1911 adolescent students of both sexes between 15 and 20 years of age participated. Results indicate that attachment security is inversely related to risk-taking in sexual relationships. Less risk-taking is associated with attachment to mother and peers in sexually inactive adolescents while in the sexually active with the capacity for emotional regulation. Differences were found in gender and attachment styles and among sexually active and inactive adolescents.

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Avoidance, Anxiety, and Sex: The Influence of Romantic Attachment on HIV-Risk among Pregnant Women

Cited by 34 publications

References 60 publications

Social Support and Social Conflict as Predictors of Prenatal Depression

Social Support and Social Conflict as Predictors of Prenatal Depression

The Causal Effects of Relational Security and Insecurity on Condom Use Attitudes and Acquisition Behavior

Disposición al riesgo en la actividad sexual de adolescentes: El rol de los modelos internos de apego, de las relaciones de apego con padres e iguales y de las dificultades de regulación emocional.

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