The moderated mediation effect of emotion dysregulation and stress reactivity on the relationship between childhood maltreatment and self-efficacy for avoiding sexual behaviors

Abstract

The ability to refuse unprotected sexual behavior is a skill that could prevent a number of negative health outcomes, including HIV/AIDS infection and transmission. The present study uniquely adds to the extant literature by investigating the effects of stress reactivity (indexed by cardiac reactivity) and emotion dysregulation on self-efficacy in avoiding potentially risky sexual behaviors among women. Participants were a sample of 60 women age 18–25 years, oversampled for a history of childhood maltreatment (40 women reported a history of physical, emotional and/or sexual abuse or neglect). Findings indicated that emotion dysregulation mediated the relationship between severity of childhood maltreatment and self-efficacy for avoidance of sexual activities, but only for women who also showed high stress reactivity. These results suggest that women with a history of childhood maltreatment, and in particular those who are highly reactive to stress, would potentially benefit from prevention programs for risky sexual activities that aim to reduce emotion dysregulation.

Keywords:

• emotional vulnerabilities
• risky sexual behaviors
• childhood abuse
• sexual abuse
• cardiovascular reactivity
• sexual behaviors

Notes on contributors

Alessandra H. Rellini, Ph.D., is Associate Professor at the University of Vermont. She received her Ph.D. in clinical psychology from the University of Texas at Austin after completing a Clinical Internship at Yale School of Medicine. Her work specializes in the study of sexual psychophysiology in women exposed to childhood maltreatment.

Michael J. Zvolensky, Ph.D., is the Hugh Roy and Lillie Cranz Cullen Distinguished University Professor at the University of Houston. He received his doctoral degree in clinical psychology from West Virginia University. An expert on anxiety disorders, Zvolensky has focused much of his research on untangling the interrelated relationship between anxiety and addiction.

David Rosenfield, Ph.D., is Associate Professor at the Southern Methodist University in Texas. His research has focused on improving statistical methodologies utilized to assess longitudinal data especially in the area of violence, risky sexual activities and mental health.

Notes

1. Age was not included as a covariate in the primary analyses because age was missing for two participants. Given our relatively small sample size, we chose to maximize the number of participants in the analyses. However, we repeated the analyses with age included as an additional covariate and found results identical to those reported.

2. Note that the regression coefficients reported in the text and in Figure 1 are standardized regression coefficients, which enhance interpretation of the magnitude of the effects. However, for the mediation analyses, the unstandardized regression coefficients were used to calculate the significance of the mediated pathway.