Childhood Sexual Abuse, Attachments in Childhood and Adulthood, and Coercive Sexual Behaviors in Community Males.

583853 research-article2015

SAXXXX10.1177/1079063215583853Sexual AbuseLangton et al.

Article

Childhood Sexual Abuse, Attachments in Childhood and Adulthood, and Coercive Sexual Behaviors in Community Males: Main Effects and a Moderating Function for Attachment

Sexual Abuse: A Journal of Research and Treatment 1–32 © The Author(s) 2015 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/1079063215583853 sax.sagepub.com

Calvin M. Langton1,2, Zuwaina Murad1, and Bianca Humbert1

Abstract Associations between self-reported coercive sexual behavior against adult females, childhood sexual abuse (CSA), and child–parent attachment styles, as well as attachment with adult romantic partners, were examined among 176 adult community males. Attachment style with each parent and with romantic partners was also investigated as a potential moderator. Using hierarchical multiple regression analysis, avoidant attachment with mothers in childhood (and also with fathers, in a second model) accounted for a significant amount of the variance in coercive sexual behavior controlling for scores on anxious ambivalent and disorganized/disoriented attachment scales, as predicted. Similarly, in a third model, avoidance attachment in adulthood was a significant predictor of coercive sexual behavior controlling for scores on the anxiety attachment in adulthood scale. These main effects for avoidant and avoidance attachment were not statistically significant when CSA and control variables (other types of childhood adversity, aggression, antisociality, and response bias) were added in each of the models. But the interaction between scales for CSA and avoidance attachment in adulthood was significant, demonstrating incremental validity in a final step, consistent with a hypothesized moderating function for 1Ryerson

University, Toronto, Ontario, Canada of Toronto, Ontario, Canada

2University

Corresponding Author: Calvin M. Langton, Ph.D., C. Psych., Ryerson University, 350 Victoria Street, Toronto, Ontario, Canada M5B 2K8. Email: [email protected] or [email protected]

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attachment in adulthood. The correlation between CSA and coercive sexual behavior was .60 for those with the highest third of avoidance attachment scores (i.e., the most insecurely attached on this scale), .24 for those with scores in the middle range on the scale, and .01 for those with the lowest third of avoidance attachment scores (i.e., the most securely attached). Implications for study design and theory were discussed. Keywords attachment, childhood sexual abuse, coercive sexual behavior, rape, antisociality, childhood maltreatment

Introduction Attachment theory has proven a rich theoretical framework in investigations of psychopathology over the life span (DeKlyen & Greenberg, 2008; Dozier, StovallMcClough, & Albus, 2008) as well, in a distinct literature, as a promising framework for understanding the perpetration of sexual aggression and abuse (e.g., Rich, 2006; Smallbone, 2006). With regard to the former body of work, the role of attachment as a moderator of the association between early childhood adversity and psychopathology has been demonstrated in a small but growing number of studies (Aspelmeier, Elliott, & Smith, 2007; Busuito, Huth-Bocks, & Puro, 2014). To date, however, no studies have tested a hypothesized moderator function for attachment on the association between a history of childhood sexual abuse (CSA) and the perpetration of coercive sexual behavior (Jespersen, Lalumière, & Seto, 2009; Sigurdsson, Gudjonsson, Asgeirsdottir, & Sigfusdottir, 2010). To address this gap, the present study tests this hypothesized moderation function with a nonclinical sample of adult males, examining direct and interaction effects for maternal and paternal childhood attachment and also romantic attachment in adulthood in separate models.

Childhood Sexual Abuse Estimates of the prevalence of CSA in the general population and among distinct populations have been found to vary considerably on the basis of methodological differences between studies (Dhaliwal, Gauzas, Antonowicz, & Ross, 1996; Finkelhor, 1994). In a recent meta-analysis, prevalence rates for CSA (broadly defined) were 18% to 20% for women and 8% for men (Stoltenborgh, van Ijzendoorn, Euser, & BakermansKranenburg, 2011). In terms of specific types of CSA, Barth, Bermetz, Heim, Trelle, and Tonia (2013) reported pooled prevalence estimates for forced intercourse and mixed sexual abuse for girls of 9% and 15%, respectively, and corresponding rates of 3% and 8% for boys. These data are especially troubling given the link between CSA (and other forms of maltreatment in childhood) and psychopathology (e.g., Dhaliwal et al., 1996; Molnar, Buka, & Kessler, 2001; Springer, Sheridan, Kuo, & Carnes, 2007). Among the adverse outcomes documented, there is evidence from clinical, forensic, and representative general population samples to suggest that a history of CSA is


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associated with increased risk for sexual abuse against others (e.g., Barbaree & Langton, 2006; DeLisi, Kosloski, Vaughn, Caudill, & Trulson, 2014; Knight & SimsKnight, 2003; Seto & Lalumière, 2010; Worling, 1995). In a meta-analysis of 17 studies, with total Ns of 1,037 (individuals with sexual offenses) and 1,762 (comparison groups), and using various definitions of CSA, Jespersen et al. (2009) found rates as low as 4% and as high as 82% among those with sexual offenses compared with rates between 0% and 58% among comparison groups; the resulting weighted average odds ratio of 3.36 (indicating a prevalence rate more than 3 times as high for those with sexual offenses) represented a statistically significant difference. Of interest, Jespersen et al. found that, overall, the two groups did not differ in terms of histories of physical abuse, emotional abuse, or neglect. Evidence also suggests that CSA is a significant predictor of coercive sexual behavior in cross-sectional studies that control for other childhood adversities (Seto et al., 2010; Sigurdsson et al., 2010). In a representative sample of almost 4,000 Swedish and Norwegian male youth (with a mean age of 18.1 years), Seto et al. (2010) found that those who reported CSA were more than 3 times (unadjusted odds ratio = 3.65) as likely to have engaged in sexually coercive behavior as those who had not experienced it, a figure that dropped to twice as likely (adjusted odds ratio = 2.17) when controlling for antisocial behavior, substance use, and sexual behavior variables. Interest in the link between CSA and later sexually abusive behavior is driven, in part, by the evidence that CSA appears to be a developmental risk factor for later sexually aggressive or abusive behavior (Knight & Sims-Knight, 2011; Miner et al., 2010; Seto & Lalumière, 2010), consistent, in broad terms, with the sexually abused–sexual abuser hypothesis (see, for example, Seto, 2008; Ward, Polaschek, & Beech, 2006) and the more general cycle of violence hypothesis (see, for example, Dodge, Bates, & Pettit, 1989; Widom & Maxfield, 2001). Of course, the fact that most individuals who experience CSA do not go on to sexually offend against others (e.g., Salter et al., 2003; Widom & Ames, 1994; Widom & Massey, 2015) and that many individuals who have been convicted of sexual crimes do not report a history of CSA (e.g., Hanson & Slater, 1988; Jespersen et al., 2009) suggest that a history of CSA cannot, on its own, account for the emergence of sexually aggressive or otherwise abusive behavior in adolescence or adulthood. Clearly, further investigation of additional factors is needed if the empirical association is to be better understood.

Attachment Theory One important body of work relevant here is in the area of attachment theory, rooted in Bowlby’s (1969, 1973, 1979) seminal theorizing about the adaptive significance of the relationship that develops between caregivers and infant. Central to this is the child’s resulting working models of self and others and the implications of these working models for development, psychological functioning, and social well-being over the life span. Attachment theory holds that interpersonal relationships (grounded in awareness of one’s own and others’ mental states as well as reflective capacity), personality, and affect regulation all develop from the basis provided by this early


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attachment, which reflects the caregiver’s sensitivity and responsiveness to the infant as well as the infant’s temperament (Goldsmith & Alansky, 1987). Highly influential has been the classification system developed by Ainsworth and her colleagues based on their Stranger Situation paradigm (Ainsworth, Blehar, Waters, & Wall, 1978). The system included three dyadic categories, two of which reflect types of insecure attachments. The first, Anxious Ambivalent, is characterized by withdrawn, inconsistent, and uninvolved behaviors by the mother, and infant behaviors that reflect an ambivalence toward the mother, including distress at the separation from the mother in the situation but a minimal response to her efforts to comfort on her return. The second, Anxious Avoidant, is characterized by maternal behavior that is either intrusively overinvolved or rejecting, and an infant response that is less distressed by separation from the mother, and reflects avoidance rather than proximity-seeking behaviors when reunited with the mother. For the third category, Secure, the mother tends to be sensitive and responsive, and the infant exhibits low levels of avoidance or resistance behaviors and higher levels of proximity-seeking and contact maintenance behaviors. Main and Solomon (1986) added a third insecure category, Disorganized/Disoriented, reflecting high levels of avoidance and resistance but also proximity-seeking and contact maintenance behaviors as well as various maladaptive behaviors. Later work extended this framework to conceptualize and investigate adult romantic relationships (Bartholomew & Horowitz, 1991; Hazan & Shaver, 1987). Most recently, theoretical and empirical work suggests that insecure attachment in adult romantic relationships can be understood in terms of two underlying dimensions, one reflecting anxiety (that is, excessive anxiety regarding the nature of significant relationships and an extreme need for interdependence) and the other reflecting avoidance (involving avoidance of intimate relationships and an overevaluation of independence; Fraley, Waller, & Brennan, 2000), with secure attachment represented by lower scores on indices of these dimensions (Fraley, n.d.). The associations between secure attachment and indices of healthy adaptive development (Berlin, Cassidy, & Appleyard, 2008; Fox & Hane, 2008) and between insecure attachment and psychopathology (DeKlyen & Greenberg, 2008; Dozier et al., 2008) are well established. Furthermore, there is evidence to suggest that the associations between psychopathology and insecure attachment may be distinct from those commonly associated with CSA (Alexander, 1993; Alexander et al., 1998). Of note, Savage (2014) concluded from her qualitative review of 78 studies that there is a robust association between insecure attachment (operationalized in various ways including attachment categories, continuous measures of attachment, separation or loss, parental bonding, and parental sensitivity) and physically aggressive behavior. Turning to the perpetration of sexually abusive behavior specifically, Marshall (1993) argued in an influential article that “childhood attachments and the adult capacity for intimacy are essential links in the chain of development underlying the emergence of an inappropriate sexual disposition” (p. 109). In essence, the absence of a secure attachment bond in childhood, in conjunction with other deficits in those who go on in adolescence or adulthood to sexually abuse others, is thought to undermine the development of interpersonal skills needed to achieve intimacy with others in


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adulthood (Stirpe, Abracen, Stermac, & Wilson, 2006). Certainly, research has shown that both adolescents and adults who commit sexual offenses tend to be characterized by loneliness and a lack of intimacy (e.g., Bumby & Hansen, 1997; Cortoni & Marshall, 2001; Marshall & Hambley, 1996; Miner & Munns, 2005). Researchers have also found insecure childhood and adult attachment styles among individuals convicted of sexual offenses, particularly attachment avoidance, and predominantly fearful–avoidant adult attachment (e.g., Bogaerts, Vanheule, & Declercq, 2005; Hudson & Ward, 1997; Jamieson & Marshall, 2000; Smallbone & Dadds, 1998; Stirpe et al., 2006; Ward, Hudson, & Marshall, 1996). Of particular interest, Smallbone and Dadds (2000, 2001) undertook a pair of studies using self-report measures with samples of undergraduate students. In both studies, an index of insecure attachment in childhood (assessed using a questionnaire developed by Hazan & Shaver, 1987) was a statistically significant predictor in a hierarchical regression model in which indices of aggression and antisociality were also included. Importantly, the model in each study included six childhood attachment scales (secure, anxious, and avoidant scales for both mother and father). Among the sample of 162 in the 2000 article, only paternal avoidant attachment among the six attachment styles predicted coercive sexual behavior, which was also predicted by antisociality. For the sample of 119 in their 2001 article, it was maternal avoidant attachment among the six attachment styles, and also aggression, which accounted for a unique portion of the variance in coercive sexual behavior. Although these results are clearly important, according to Savage (2014; who was referring to the broader literature in her review), the inclusion of both maternal and paternal indices of childhood attachment together in analyses such as these may mean a study is “overcontrolled by including factors that have substantial theoretical overlap” (p. 171). Investigations of maternal and paternal attachment styles in separate models may therefore be instructive. To date, the research looking at childhood and adult attachment styles in adults who sexually abuse others has relied almost exclusively on the use of self-report measures with recognized psychometric limitations and also limited correspondence with Ainsworth’s classification system (Crowell, Fraley, & Shaver, 2008). This is problematic if the field is to move beyond the current state of knowledge. Of interest, Parkes (2006) described the development and use of a comprehensive self-report measure with scales corresponding to Ainsworth’s classifications. Although the preliminary set of psychometric properties he reported for the Retrospective Attachment Questionnaire in research on bereavement with a clinical sample was encouraging, the measure has yet to be utilized in research investigating attachment and sexual aggression. Similarly, advancements in the assessment of adult attachment style using self-report (Fraley et al., 2000) have not been used in studies with individuals who have been convicted of sexual offenses or who selfreport acts of sexual aggression. The current study incorporates these developments.

Child Maltreatment and Attachment The maltreatment–insecure attachment hypothesis holds that childhood maltreatment is a causal factor in the formation of insecure attachment during childhood and with


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adult partners, and empirical evidence is consistent with this (Baer & Martinez, 2006; Cicchetti, 2004; Morton & Browne, 1998) although, in the case of attachment in childhood, a bidirectional relationship is certainly plausible. Furthermore, associations between CSA, insecure attachment, and psychopathology have been reported in retrospective studies with adults (Alexander et al., 1998; Roche, Runtz, & Hunter, 1999). But a connection between CSA and attachment has received little attention with perpetrators of sexual abuse. Smallbone and McCabe (2003) obtained retrospectively recalled “autobiographies” from a heterogeneous sample of men convicted of sexual offenses from which a history of CSA and also attachment with parents was determined. Only 31% and 41% of the sample were considered to have had insecure childhood maternal and paternal attachments, respectively, which, as those researchers observed, render the etiological significance of insecure childhood attachment in sexual offending less straightforward especially given that approximately 38% of the general population are estimated to have experienced insecure childhood attachment (Campos, Barrett, Lamb, Goldsmith, & Stenberg, 1983). However, Smallbone and McCabe did find that those individuals who were classified as having had an insecure attachment were more likely to also have reported CSA. Similarly, Craissati, McClurg, and Browne (2002) found that in a combined sample of 76 individuals convicted of sexual offenses, those who reported CSA had significantly lower scores on the maternal care scale of the Parent Bonding Instrument (PBI; Parker, Tupling, & Brown, 1979) than those without a history of CSA, and to be significantly more likely to have their mothers’ parenting style categorized as affectionless control (uncaring but overprotective) based on PBI scores. Of interest, there is a small but growing body of evidence demonstrating that attachment moderates the association between early adverse events (including types of abuse) and psychopathology (Busuito et al., 2014; Reinert & Edwards, 2009). Focusing specifically on CSA, Whiffen, Judd, and Aube (1999) found partial support for this moderation effect with a nonclinical sample of 60 women with partners. They found that lower levels of comfort with “closeness” (a subscale of the Revised Adult Attachment Scale [Collins & Read, 1990]) was associated with higher levels of depression among those women with a history of CSA compared with those without such a history. Aspelmeier et al. (2007) also reported partial support for a moderation effect. Among 324 female undergraduate students, those who reported CSA and more secure attachment (inferred from the quality of peer communications on a subscale of The Inventory of Parent and Peer Attachment [IPPA; Armsden & Greenberg, 1987] and, in a separate model, with parents on the alienation subscale of the IPPA) also reported fewer trauma symptoms compared with those reporting CSA and less secure attachment. On the basis of these findings, it seems reasonable to postulate that attachment might similarly moderate the association between CSA and later sexually coercive behavior (Rich, 2009; Ward & Siegert, 2002). Rich (2009) has noted that secure attachment triggers distress-regulating and support-seeking behaviors in the face of anxiety-provoking or otherwise adverse events or life circumstances (Atkinson & Goldberg, 2004). Expanding on this, Rich suggests that


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Langton et al. . . . security of attachment is implied in the capacity for close and connected relationships to parents, and other adults, and further in the capacity to form bonded relationships to community organizations like schools, accept and connect with prosocial norms and values, demonstrate self-regulation, and experience self-efficacy [capacities the development of which may be impaired by adverse experiences in childhood]. Secure attachment thus serves more as a rubric, or as a class of protective factors, under which these other protective factors may be included. (pp. 141-142)

Clearly, multivariate modeling of these interrelationships will be needed to test these propositions. But, first, an empirical demonstration of a purported moderating function for attachment, with tests for attachment in childhood and, separately, as an adult, is required. The present study tested the following hypotheses with a nonclinical convenience sample of adult males: Hypothesis 1: Avoidant attachment in childhood (both maternal and paternal scales) and avoidance attachment in adulthood each is significantly and positively correlated with coercive sexual behavior, CSA, other types of adverse experiences in childhood, aggression, and antisociality. Hypothesis 2: Maternal avoidant attachment in childhood accounts for a significant portion of the variance in coercive sexual behavior controlling for other maternal attachment styles, and maternal avoidant attachment remains a significant predictor controlling for CSA, other adverse experiences in childhood, as well as aggression and antisociality. Hypothesis 3: Maternal avoidant attachment in childhood moderates the association between CSA and coercive sexual behavior, demonstrated by a significant interaction effect between maternal avoidant attachment in childhood and CSA, with a stronger positive association between CSA and coercive sexual behavior among those with higher avoidant attachment scores and a weaker association among those with lower (i.e., more secure) avoidant attachment scores. This interaction effect is significant when controlling for other adverse experiences in childhood, aggression, and antisociality. Hypothesis 4: Paternal avoidant attachment in childhood accounts for a significant portion of the variance in coercive sexual behavior controlling for other paternal attachment styles, and paternal avoidant attachment remains a significant predictor controlling for CSA, other adverse experiences in childhood, as well as aggression and antisociality. Hypothesis 5: Paternal avoidant attachment in childhood moderates the association between CSA and coercive sexual behavior, demonstrated by a significant interaction effect between paternal avoidant attachment in childhood and CSA, with a stronger positive association between CSA and coercive sexual behavior among those with higher avoidant attachment scores and a weaker association among those with lower (i.e., more secure) avoidant attachment scores. This interaction effect is significant when controlling for other adverse experiences in childhood, aggression, and antisociality.


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Sexual Abuse Hypothesis 6: Avoidance attachment in adulthood accounts for a significant portion of the variance in coercive sexual behavior controlling for anxiety attachment, and avoidance attachment remains a significant predictor controlling for CSA, other adverse experiences in childhood, as well as aggression and antisociality. Hypothesis 7: Avoidance attachment in adulthood moderates the association between CSA and coercive sexual behavior, demonstrated by a significant interaction effect between avoidance attachment in adulthood and CSA, with a stronger positive association between CSA and coercive sexual behavior among those with higher avoidance attachment scores and a weaker association among those with lower (i.e., more secure) avoidance attachment scores. This interaction effect is significant when controlling for other adverse experiences in childhood, aggression, and antisociality.

Method Participants One hundred seventy-six adult males were recruited from the community in the Greater Toronto area. The mean age of participants was 30.20 years (SD = 10.60, range = 18.2557.67). In terms of highest educational level attained, 18% of the sample did not complete high school, 9% graduated high school, 59% completed one or more years of postsecondary education, and nearly 9% completed a graduate/professional degree (5% did not specify). Just under a quarter of the sample was unemployed, 23% identified themselves as either full-time students or part-time students also employed, 33% were employed part-time or full-time, and 1% was retired (19% did not specify). Fifty-two percent of the sample described themselves as Caucasian, 13% as South or South East Asian, 10% as Black, 6% as Latin American, 3% as Chinese, 2% as Filipino, and 2% as Aboriginal (11% described themselves as mixed, other, or did not specify). Ninety-two percent of the sample described themselves as heterosexual, with 2% identifying themselves as bisexual (6% did not specify). Data for a single participant who described himself as exclusively homosexual were excluded, thus the final sample was 175.

Measures Coercive sexual behavior. Sexual assault perpetration against women was measured using a 16-item version of the Sexual Experiences Survey (SES; Koss & Oros, 1982) modified by Abbey, Parkhill, BeShears, Clinton-Sherrod, and Zawacki (2006). Respondents are asked about unwanted sexual contact they may have perpetrated since the age of 14 against adult women (or peer-age girls during their teenage years). The 16-item version includes 3 items about unwanted sexual contact short of intercourse, 3 items about attempts to have unwanted sexual intercourse, 5 items about unwanted sexual intercourse, and 5 items about unwanted sexual acts (oral sex, anal sex, or penetration by a foreign object) but excludes a single item included by Abbey et al. that specifically used the word “rape.” Different means of coercion are covered, from use of arguments


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Langton et al. Table 1. Psychometric Properties of the Dependent and Independent Variables. Range

M

SD

α

164 167 161

6.97 3.28 2.96

4.21 2.53 2.41

.82 .73 .69

160 164 159

6.11 3.44 2.88

3.74 2.67 2.51

171 170

3.60 3.26

Actual

Skew

0-18 0-11 0-15

0-18 0-10 0-14

0.34 0.62 1.23

.77 .76 .70

0-18 0-11 0-15

0-15 0-11 0-11

0.32 0.67 0.99

1.19 1.05

.93 .92

1.00-7.00 1.00-7.00

1.00-6.39 1.00-7.00

0.10 0.58

173 0.47 1.46 173 0.36 1.03 173 0.43 1.28 174 1.89 2.06 167 80.16 20.72 168 2.42 0.35 166 5.89 3.59 172 0.22 0.55

.79 .68 .80 .75 .93 .75 .73 .94

0-12 0-8 0-8 0-9 29-145 1.00-4.00 0-20 0.00-5.00

0-12 0-8 0-8 0-9 34-138 1.72-3.92 0-17 0.00-3.50

4.90 3.94 4.22 1.10 0.15 1.05 0.62 3.87

n

Maternal attachment (RAQ) Anxious ambivalent Avoidant Disorganized/disoriented Paternal attachment (RAQ) Anxious ambivalent Avoidant Disorganized/disoriented Adult attachment (ECR-R) Anxiety Avoidance Childhood sexual abuse (CSA) By any individual By mother or nonparent By father or nonparent Adverse experiences (ACE-M) Aggression (AQ) Antisociality (CCS) Impression management (IM) Coercive sexual behavior (SES-M)

Potential

Note. RAQ = Retrospective Attachment Questionnaire scales; ECR-R = Experiences in Close Relationships–Revised scales; CSA = modified version of Item 3 in the Adverse Childhood Experience (ACE) Questionnaire; ACE-M = modified nine-item ACE Questionnaire, excludes sexual abuse item; AQ = Aggression Questionnaire; CCS = Criminogenic Cognitions Scale; IM = Impression Management scale; SES-M = modified version of the Sexual Experiences Survey.

through to physical force. Items are averaged to give a total score. Abbey et al. reported an alpha of .88. For the present sample, it was .94 (see Table 1). Attachment in childhood. The Retrospective Attachment Questionnaire (RAQ; Parkes, 2006), designed to assess attachments with parents in childhood, includes items in sections covering childhood characteristics and experiences and also parents’ characteristics and history. Combinations of items in these two sections are intended to represent the dyadic nature of attachment. Respondents indicate Yes or No to items (one item is coded “never,” “sometimes,” or “often”), with separate responses for their mother and father in the parent-related section of items. Item scores relating to maternal attachment in childhood and paternal attachment in childhood can be summed to generate three scales (anxious ambivalent, avoidant, and disorganized/disoriented), consistent with Ainsworth and Main’s categories. Lower scores on the scales indicate more secure attachment patterns.


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The Anxious Ambivalent Attachment subscale consists of 18 items, the Avoidant Attachment subscale has 11 items, and the Disorganised/Disoriented Attachment scale is made up of 15 items. Parkes (2006) reported acceptable psychometric properties for the attachment scales, including test–retest reliabilities (.67 to .83) and internal reliabilities (≥.80). For the present sample, alphas for the maternal and paternal scales ranged from .69 to .82. Attachment in adulthood. The Experiences in Close Relationships–Revised questionnaire (ECR-R; Fraley et al., 2000) is a revision of the ECR questionnaire (Brennan, Clark, & Shaver, 1998) developed using techniques based on Item Response Theory. The questionnaire, designed to assess two dimensions of adult attachment (anxiety and avoidance), consists of 36 items. The two scales have 18 items each, which respondents rate on a 7-point scale (from strongly disagree to strongly agree). Items are averaged to obtain scale scores. The two-factor structure of the measure has been independently confirmed (Sibley, Fischer, & Liu, 2005; Sibley & Liu, 2004). Internal reliabilities of ≥.91 have been reported for the two scales (Sibley et al., 2005; Sibley & Liu, 2004), with a high degree of temporal stability also reported (Sibley et al., 2005; Sibley & Liu, 2004). For the present sample, alphas for the anxiety and avoidance scales were .93 and .92, respectively. Sexual abuse in childhood and other types of adverse childhood experiences. A modified version of the Adverse Childhood Experience (ACE; Felitti et al., 1998) questionnaire was used to assess sexual abuse and other adverse experiences in childhood. This selfreport measure was developed in the context of epidemiological work to survey adults’ exposure to various stressful and traumatic experiences in childhood. Ten items are answered either “Yes” or “No” (with some items asking whether an adversity was experienced “often or very often” and other items asking whether an adversity was “ever” experienced). Items tap verbal, physical, and sexual abuse, as well as neglect and various indicators of household dysfunction. Adequate test–retest reliabilities have been reported for both ACE total and individual items (Dube, Williamson, Thompson, Felitti, & Anda, 2004). For the present sample, the alpha for the 9-item modified ACE (sexual abuse item excluded—see below) was .75. The measure was modified in four ways. First, a distinction was made between adversity in childhood (younger than 12 years of age) and adversity in adolescence, with the former used for indices in the present study to exclude the possibility that sexually coercive behavior (the dependent variable) could temporally precede the adverse experience (an independent variable). Second, a nine-item version, scored as per the original ACE but excluding the item concerning sexual abuse, was used in the present study to control for adverse experiences other than sexual abuse, the latter being investigated as a distinct set of variables (see below). Third, a 3-point scale was used so that respondents provided a rating (never, rarely to sometimes, and often to very often) for each item with reference to their mother, their father, and any other adult separately. Fourth, each item was disaggregated into the less severe and more severe examples of particular adversities described in the original item. These last two


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modifications enabled the creation of scales in place of a simple dichotomy as per the original ACE format. So the single sexual abuse item, “Did an adult or person at least 5 years older than you ever . . . Touch or fondle you or have you touch their body in a sexual way? or Attempt or actually have oral, anal, or vaginal intercourse with you?” was replaced by six items, one set of three (pertaining to the respondent’s mother, father, and any other adult) for the less severe focal adversity and one set of three for the more severe adversity. The father-related pair of items for this example was “Did your father or stepfather touch or fondle you or have you touch his body in a sexual way?” and “Did your father or stepfather attempt or actually have oral or anal intercourse with you?” For the present study, the six items concerning sexual abuse were used. Three scales were generated. The first summed all six sexual abuse items (mother, father, any other adult; α = .79). The second summed the four sexual abuse items for the mother and any adult other than the father (α = .68). The third summed the four sexual abuse items for the father and any adult other than the mother (α = .80). This afforded indices of sexual abuse for which product terms with maternal and paternal attachment styles could be generated without obvious confound. Aggression. Aggression was measured using the 29-item Aggression Questionnaire (AQ; Buss & Perry, 1992), which provides a total score as well as indices of four manifestations of aggression: (a) physical aggression, (b) verbal aggression, (c) anger, and (d) hostility. Items are rated on a 5-point scale (from extremely uncharacteristic of me to extremely characteristic of me). Scores are summed, with only the total score used in the present study. Buss and Perry reported high indices of reliability (internal = .89, test–retest = .80) and also of convergent and discriminant validity. For the present sample, the alpha for total score was .93. Antisociality. As a proxy for antisociality, the Criminogenic Cognitions Scale (CCS; Tangney, Meyer, Furukawa, & Cosby, 2002) was used. This is a 25-item questionnaire that assesses five dimensions: (a) notions of entitlement, (b) failure to accept responsibility, (c) short-term orientation, (d) insensitivity to the impact of crime, and (e) negative attitudes toward authority. Respondents rate statements using a 4-point scale (from strongly disagree to strongly agree). Items are averaged to obtain a total score (dimension scores were not examined in the present study). Tangney et al. (2012) reported its psychometric properties in a study of 552 jail inmates. Indices of internal reliability (.81) as well convergent and discriminant validity were high. For the present sample, the alpha for total score was .75. Impression management. The Impression Management (IM) scale, one of two 20-item scales comprising the Balanced Inventory of Desirable Responding–7 (BIDR-7; Paulhus, 1998) was used to assess the tendency to present oneself in a favorable light (i.e., deliberate dissimulation through lying or faking good). Respondents rate the degree to which each statement is true for them using a 5-point scale. Only the extreme ratings, taken to reflect exaggeration, are assigned points. Item scores are summed to create


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the scale total and an adjustment is made for missing items, as per the manual. Paulhus described a range of psychometric properties for the IM scale, citing evidence of its internal reliability (≥.81 using various samples) as well as strong convergent and discriminant validity. For the present sample, the alpha was .73.

Procedure The study was approved by the Ryerson University research ethics board. Recruitment flyers were posted on the online classified websites Craigslist and Kijiji. Interested individuals contacted the researchers by email or telephone. The research, part of a larger project, was described as a questionnaire study of various aspects of men’s childhood experiences, their relationships in adulthood, and features of their personality, which would include questions about sexual behaviors and illegal activities. During the informed consent process, it was explained that participation was voluntary and anonymous (personal identifiers were not collected on the set of questionnaires). Participants were also told they could skip any questions/items and withdraw without penalty. Administration of the questionnaires was undertaken in small groups. Participants received CAN$20.00 and were seated at individual tables in a room on the university campus of the first author with substantial space around them to ensure confidentiality while completing the questionnaires.

Results Engaging in one or more instances of coercive sexual behavior against a peer-age or adult female since the age of 14 was reported by 35.5% of the sample. Nearly 17% of the sample reported being sexually abused before the age of 12, with fewer than 3% reporting sexual abuse by their mother, 4% reporting sexual abuse by their father, and 14.5% reporting sexual abuse by someone other than a parent, before the age of 12. Means, standard deviations, alphas, range and skew for all of the measures are reported in Table 1. All measures demonstrated adequate internal reliability, with alphas for all but two scales ≥.70 and all ≥.68. A maximum range of scores was obtained for 6 of the 16 scales, with most scales’ scores spanning much of the possible range. Twelve of 16 scales showed positive skew, so a log transformation was employed; this was done for all scales to ensure consistency. Analyses that follow use these transformed scores. The first hypothesis was generally supported. No p value adjustment was made for the correlations reported in Table 2 (see Rothman, 1990). Avoidant attachment in childhood and adulthood was significantly and positively correlated with coercive sexual behavior (rs = .22-.25, p < .01) as well as with CSA (rs = .18-.24, p < .05), other types of childhood adversity (rs = .20-.54, p < .05), and also aggression (rs = .38-.46, p < .001) and antisociality (rs = .22-.26, p < .01). Interestingly, both maternal and paternal disorganized/disoriented attachment scales were also significantly positively correlated with coercive sexual behavior (r = .21, p < .01 and .19, p < .05, respectively) but the scales for anxious ambivalent attachment in childhood and anxiety attachment in adulthood were not.


13


.13 .24**

.24** .19*

.36*** .10

.15 .11

.22** .54*** .46*** .23** −.26** .23**

.36*** .95*** .63***

.92*** .37*** .40***

.14 .28*** .35*** .21** −.15 .04

— .63***

2

— .38*** .49***

1

Maternal

.30*** .58*** .42*** .27** −.20* .21**

.32*** .29***

.15 .14

.45*** .62*** .74***

—

3

.14 .28*** .42*** .26** −.17* .07

.16* .12

.40*** .14

— .42*** .50***

4

.23** .54*** .44*** .22** −.27** .22**

.23** .18*

.14 .25**

— .56***

5

Paternal

.34*** .67*** .39*** .19* −.21* .19*

.34*** .29***

.12 .15

—

6

.07 .07 .28*** .00 −.11 .09

.07 .11

— .23**

7

Adult

.19* .20* .38*** .26** −.25** .25**

.19* .14

—

8

.99*** .45*** .17* .11 −.13 .39***

— .94***

9

.92*** .39*** .13 .02 −.04 .26**

—

10

12

13

15

— −.49*** — .27*** −.35***

14

Control variables

— .44*** — .16* .35*** — .12 .20** .45*** −.15 −.19* −.45*** .39*** .25** .21**

11

Childhood sexual abuse

Note. Pearson correlation coefficients are reported between variable transformed scores. 1 to 6 are Retrospective Attachment Questionnaire scales; 7 and 8 are Experiences in Close Relationships–Revised scales; 9 to 11 (CSA = Childhood Sexual Abuse scales) are based on a modified version of the Adverse Childhood Experience questionnaire; 12 (ACE-M) is a modified nine-item version of the Adverse Childhood Experience questionnaire, which excludes sexual abuse; 13 is the Aggression Questionnaire; 14 is the Criminogenic Cognitions Scale; 15 (IM) is the Impression Management scale; 16 (CSB = Coercive Sexual Behavior) is a modified version of the Sexual Experiences Survey. aSexually abused in childhood by any individual. bSexually abused in childhood by mother or a nonparent. cSexually abused in childhood by father or a nonparent. *p < .05, two-tailed. **p < .01, two-tailed. ***p < .001, two-tailed.

11. CSAc 12. ACE-M 13. Aggression 14. Antisociality 15. IM 16. CSB

Maternal attachment 1. Anxious 2. Avoidant 3. Disorganized Paternal attachment 4. Anxious 5. Avoidant 6. Disorganized Adult attachment 7. Anxiety 8. Avoidance Child sexual abuse 9. CSAa 10. CSAb

Attachment style

Table 2. Correlations Between the Dependent and Independent Variables.

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Of note, the correlations between maternal and paternal attachment scales ranged in size from medium to large (rs = .36-.95, p < .001). This was particularly the case for corresponding scales (e.g., maternal avoidant and paternal avoidant scales: r = .95, p < .001), which is explained in part by the fact that half or more of the items (all those pertaining to childhood experiences) for corresponding maternal and paternal scales are identical. Significant correlations were found between anxious ambivalent attachment in childhood scales and adult anxiety attachment (rs = .36 and .40, p < .001), and between avoidant attachment in childhood scales and adult avoidance attachment (rs = .24 and .25, p < .01). As well as small to medium size correlations between attachment scales and the three CSA scales, correlations for the scales for sexual abuse by any individual and by father or nonparent were small but significant and positive with aggression (rs = .17 and .16, p < .05, respectively). CSA and antisociality were not significantly correlated. The three CSA scales were highly correlated with each other (rs = .92-.99, p < .001), consistent with the intention that each provided an inclusive index of sexual abuse, with two of the three scales simply excluding sexual abuse by one or other parent (which was, in this sample, relatively rare). Each was also significantly correlated with the ACE scale (which excluded sexual abuse; rs = .39-.45, p < .001). With the exception of the maternal anxious ambivalent attachment scale, the adult anxiety attachment scale, and all three CSA scales, correlations between scales and the impression management scale were all significant and negative (rs = −.17 - −.49, p < .05), indicating that as participants endorsed higher levels of, for example, aggression, antisociality, or coercive sexual behavior, they demonstrated lower levels of social desirability response bias. In light of these associations, the impression management scale was included in each of hierarchical multiple regression models used to test Hypotheses 2 to 7. Of note, the mean score on this scale was not significantly different from those reported by Paulhus (1998) for a sample of prisoners or a sample of college students. The second hypothesis, concerning the prediction of coercive sexual behavior by the maternal avoidant attachment scale, was partially supported (see Table 3). In the hierarchical multiple regression model to test this hypothesis, the maternal avoidant attachment variable was centered. This was to counter multicollinearity, a consideration given the inclusion, in a final step of the model, of the product term using this variable (i.e., Maternal avoidant attachment × CSA). Maternal avoidant attachment accounted for a unique portion of the variance in coercive sexual behavior when entered in the first step along with maternal anxious ambivalent and disorganized/disoriented attachment scales. This first step accounted for 8% of the variance in coercive sexual behavior (F = 4.164, df = 3, 144, p = .007). When the scales for sexual abuse in childhood (by father or nonparent, centered, to counter multicollinearity given the inclusion in a final step of the product term using this variable), adverse experiences in childhood (excluding sexual abuse), aggression, antisociality, and impression management were entered in the second step, however, avoidant attachment was no longer significant. The impression management and CSA scales were significant predictors along with the maternal anxious ambivalent attachment scale, the sign of the latter’s coefficient indicating an inverse relationship with coercive sexual behavior. This second step accounted for 25%


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Langton et al.

Table 3. Hierarchical Multiple Regression Analyses Predicting Coercive Sexual Behavior From Maternal Attachment, Childhood Sexual Abuse, Control Variables, and the Interaction Between Maternal Avoidant Attachment and Childhood Sexual Abuse (N = 148).

Step 1 Maternal attachment Anxious ambivalent Avoidant Disorganized Step 2 Maternal attachment Anxious ambivalent Avoidant Disorganized Childhood sexual abuse Adverse childhood experiences Aggression Antisociality Impression management Step 3 Maternal attachment Anxious ambivalent Avoidant Disorganized Childhood sexual abuse Adverse childhood experiences Aggression Antisociality Impression management Childhood sexual abuse × Avoidant attachment

B

SE

β

−0.06 0.09 0.06

0.04 0.04 0.05

−0.15 0.21* 0.14

−0.07 0.06 0.01 0.18 0.01 −0.02 0.31 −0.11

0.04 0.04 0.05 0.06 0.04 0.10 0.26 0.04

−0.17* 0.14 0.03 0.26** 0.03 −0.02 0.11 −0.26**

−0.07 0.07 0.00 0.14 0.01 −0.01 0.24 −0.11 0.33

0.04 0.04 0.05 0.06 0.04 0.10 0.26 0.04 0.18

−0.16 0.16 0.01 0.20* 0.02 −0.01 0.08 −0.26** 0.15†

Note. Adverse childhood experiences exclude sexual abuse. Childhood sexual abuse refers to sexual abuse by the father or an adult other than the mother. This variable score is centered as is the variable score for maternal avoidant attachment. ΔR2 = .08 for Step 1, p = .007; ΔR2 = .17 at Step 2, p < .001; ΔR2 = .02 at Step 3, p = .072. †p = .07. *p < .05. **p < .01.

of the variance in coercive sexual behavior, representing a statistically significant increase in R2 with the resulting model also statistically significant (F = 5.854, df = 8, 139, p < .001). The third hypothesis, that there would be a significant interaction between maternal avoidant attachment and CSA, was tested by entering the product term for these centered variables in the third step but it was not supported; the increase in R2 was not statistically significant although the model remained so (F = 5.654, df = 9, 138, p < .001).


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Checks for multicollinearity were carried out between the three maternal attachment scales and also for each scale in the model. A Tolerance value of .10 is recommended as the minimum acceptable level (Tabachnick & Fidell, 2001). Acceptable levels of Tolerance were found for each maternal attachment style in Step 1 of the regression model (values ≥.55) and for each variable in Steps 2 and 3 (values ≥.46). But inspection of a scatterplot of the standardized residuals of the dependent variable against its standardized predicted values and a histogram of its standardized residuals suggested the presence of heteroskedasticity. To address this, following Hayes and Cai (2007), heteroscedasticity-consistent regression results, which adjust the standard errors on the basis of the heteroscedasticity present in the data but do not affect the R, R2, and coefficient values, were generated for Step 3. In this model, the CSA variable was no longer significant but impression management remained statistically significant. A second hierarchical multiple regression analysis was undertaken to test the fourth hypothesis, which posited that the paternal avoidant attachment would predict coercive sexual behavior. Partial support for this was obtained (see Table 4), with paternal avoidant attachment (centered), accounting for a unique portion of the variance in coercive sexual behavior in Step 1 in which paternal anxious ambivalent and disorganized/disoriented attachment scales were also entered but not significant. This first step accounted for 7% of the variance in coercive sexual behavior (F = 3.454, df = 3, 142, p = .018). But with the entry of scales for CSA (by mother or nonparent, centered), adverse experiences in childhood (excluding sexual abuse), aggression, antisociality, and impression management in Step 2, only impression management was significant. This second step accounted for 19% of the variance in coercive sexual behavior, representing a statistically significance increase in R2 with the resulting model also statistically significant (F = 3.975, df = 8, 137, p < .001). In Step 3, the product term for paternal avoidant attachment and CSA in childhood was entered but was not statistically significant, contrary to Hypothesis 5. The increase in R2 was not statistically significant although the model remained so (F = 3.623, df = 9, 136, p < .001). Acceptable levels of Tolerance were again found for each paternal attachment style in Step 1 of the regression model (values ≥.55) and for each variable in Steps 2 and 3 of the regression model (values ≥.40), suggesting that multicollinearity was not an issue. Given this set of results, heteroscedasticity-consistent standard errors were not estimated. To test the final pair of hypotheses, that adult avoidance attachment would predict coercive sexual behavior and would moderate the association between CSA in childhood and coercive sexual behavior, a third hierarchical multiple regression analysis was carried out (see Table 5). Partial support was found for the sixth hypothesis; adult avoidance attachment (centered) accounted for a unique portion of the variance in coercive sexual behavior when entered in a first step along with adult anxiety attachment (collinearity was not an issue given the small correlation between these two scales of the ECR-R). This first step accounted for 5% of the variance in coercive sexual behavior (F = 4.166, df = 2, 160, p = .017). But with the entry of scales for CSA (by any adult, centered), adverse experiences in childhood (excluding sexual abuse), aggression, antisociality, and impression management in Step 2, only the CSA and


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Langton et al.

Table 4. Hierarchical Multiple Regression Analyses Predicting Coercive Sexual Behavior From Paternal Attachment, Childhood Sexual Abuse, Control Variables, and the Interaction Between Paternal Avoidant Attachment and Childhood Sexual Abuse (N = 146).

Step 1 Paternal attachment Anxious ambivalent Avoidant Disorganized Step 2 Paternal attachment Anxious ambivalent Avoidant Disorganized Childhood sexual abuse Adverse childhood experiences Aggression Antisociality Impression management Step 3 Paternal attachment Anxious ambivalent Avoidant Disorganized Childhood sexual abuse Adverse childhood experiences Aggression Antisociality Impression management Childhood sexual abuse × Avoidant attachment

B

SE

β

−0.03 0.09 0.04

0.04 0.04 0.05

−0.08 0.21* 0.10

−0.04 0.05 −0.01 0.08 0.05 −0.02 0.34 −0.12

0.04 0.05 0.05 0.06 0.05 0.11 0.27 0.04

−0.09 0.12 −0.03 0.11 0.11 −0.02 0.12 −0.26**

−0.04 0.05 −0.01 0.14 0.04 −0.03 0.32 −0.12 0.18

0.04 0.05 0.05 0.06 0.05 0.11 0.27 0.04 0.19

−0.09 0.12 −0.02 0.20* 0.10 −0.03 0.11 −0.27** 0.08

Note. Adverse childhood experiences exclude sexual abuse. Childhood sexual abuse refers to sexual abuse by the mother or an adult other than the father. This variable score is centered as is the variable score for paternal avoidant attachment. ΔR2 = .07 at Step 1, p = .018; ΔR2 = .12 at Step 2, p = .002; ΔR2 = .005 at Step 3, p = .358. *p < .05. **p < .01.

impression management scales were significant predictors. This second step accounted for 22% of the variance in coercive sexual behavior, representing a statistically significance increase in R2 with the resulting model also statistically significant (F = 6.247, df = 7, 155, p < .001). To test for the postulated interaction effect, the product term for adult avoidance attachment and CSA was then entered in Step 3 and, consistent with the seventh hypothesis, was found to account for a unique portion of the variance in coercive sexual behavior as well as demonstrate incremental predictive validity over


18

Sexual Abuse

Table 5. Hierarchical Multiple Regression Analyses Predicting Sexually Coercive Behavior From Adult Attachment, Childhood Sexual Abuse, Control Variables, and the Interaction Between Adult Avoidance Attachment and Childhood Sexual Abuse (N = 163). B Step 1 Adult attachment Anxiety Avoidance Step 2 Adult attachment Anxiety Avoidance Childhood sexual abuse Adverse childhood experiences Aggression Antisociality Impression management Step 3 Adult attachment Anxiety Avoidance Childhood sexual abuse Adverse childhood experiences Aggression Antisociality Impression management Childhood sexual abuse × Avoidance attachment

SE

β

0.02 0.24

0.08 0.09

0.02 0.22**

0.03 0.11 0.16 0.03

0.08 0.09 0.05 0.03

0.03 0.10 0.24** 0.07

−0.07 0.32 −0.11

0.10 0.25 0.04

−0.06 0.11 −0.25**

0.11 0.09 0.11 0.02

0.08 0.08 0.05 0.03

0.10 0.08 0.17* 0.04

−0.07 0.24 −0.10 1.56

0.09 0.24 0.04 0.38

−0.07 0.09 −0.22** 0.31***

Note. Adverse childhood experiences exclude sexual abuse. Childhood sexual abuse refers to sexual abuse by any individual. This variable score is centered as is the variable score for adult avoidance attachment. ΔR2 = .049 at Step 1, p = .017; ΔR2 = .171 at Step 2, p < .001; ΔR2 = .076 at Step 3, p < .001. *p < .05. **p < .01. ***p < .001.

CSA and impression management, which both remained significant predictors in this third step. This final step accounted for 30% of the variance in coercive sexual behavior, representing a statistically significant increase in R2, with this final model also statistically significant (F = 8.078, df = 8, 154, p < .001). (This interaction effect was also found to be statistically significant in a model using untransformed scores and no centering of variables.) Multicollinearity was not a concern with acceptable levels of Tolerance again found for each variable in Step 3 of the regression model (values ≥.59). But, as with the


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Langton et al.

Figure 1. Lines of best fit for the highest, middle third, and lowest scores on the ECR-R avoidance attachment scale plotted for CSA and coercive sexual behavior. Note. ECR-R = Experiences in Close Relationships–Revised; CSA = childhood sexual abuse.

previous models, inspection of the scatterplot and histogram of residuals suggested that heteroscedasticity was again an issue, so heteroscedasticity-consistent standard errors were calculated. With these, the product term remained statistically significant (β = 0.31, SE = .52, p = .003) but CSA was no longer significant (β = .17, SE = .06, p = .080) nor was impression management (β = −.22, SE = .05, p = .054). The final model remained statistically significant (F = 3.228, df = 8, 154, p = .002). As a check on the effect of the highest scores on this interaction effect, the highest six scores were Winsorized on the coercive sexual behaviors dependent variable and also on the independent variables CSA and adult avoidance attachment. The product term remained statistically significant in both the standard hierarchical multiple regression model and in the heteroscedasticityconsistent multiple regression model using these scales with Winsorized data. This interaction effect is depicted in Figure 1, which shows the lines of best fit for the lowest third, middle third, and highest third of scores on the adult avoidance scale, with coercive sexual behavior plotted along the x-axis and CSA plotted along the y-axis. The R2 linear for the lowest third of scores was .0002, the R2 linear for the


20

Sexual Abuse

middle third of scores was .06, and the R2 linear for the highest third of scores was .36. Thus, the correlation between coercive sexual behavior and sexual abuse in childhood was .60 for participants in the sample with the highest third of scores on the ECR-R avoidance scale (indicating the highest levels of avoidance attachment insecurity in adulthood) but the correlations for those with the middle third and lowest third of scores was .24 and .01, respectively.

Discussion Main Findings and Previous Work Using the RAQ in a study on sexual aggression for the first time, the univariate association between avoidant attachment with parents in men’s childhoods was positively and statistically significantly associated with later coercive sexual behavior toward women, as was avoidant attachment in adulthood (using the ECR-R for the first time in such an investigation), but anxious ambivalent attachment in childhood and anxiety attachment in adulthood were not, consistent with the first hypothesis concerning these associations. The associations held for both mother and father figures. Disorganized/disoriented attachment with both parent figures was also significantly correlated with coercive sexual aggression, an important finding given that brief questionnaire measures used in previous studies have not afforded an index of this insecure attachment style. Associations between avoidant attachment (and also the other two insecure attachment styles in childhood) with aggression and antisociality were also significant. Smallbone and Dadds (2000) reported a similar set of univariate associations using a brief questionnaire to assess prototypical attachment styles in childhood, but in a separate study they failed to replicate most of these results with the same questionnaire using a sample of male undergraduate students comparable to their initial sample (Smallbone & Dadds, 2001). These univariate results suggest there is a general association between insecure attachment styles in childhood and heightened levels of aggression and antisocial tendencies in adulthood and, for avoidant and disorganized/disoriented attachment, coercive sexual behavior, broadly consistent with the robust associations in the wider attachment literature between insecure attachment and various types of psychopathology (DeKlyen & Greenberg, 2008; Dozier et al., 2008). However, the multivariate analyses clearly indicated that of the three insecure childhood attachment styles only avoidant attachment, and separately adult avoidance attachment, account for unique portions of the variance in coercive sexual behavior. Smallbone and Dadds’s (2000, 2001) inclusion of the maternal and paternal attachment scales in the same regression models render comparison of results tenuous but it is of interest that avoidant attachment in childhood (maternal in one sample, paternal in the other) in their models was also the significantly predictive. Baker, Beech, and Tyson (2006) made a case for the importance of disorganized/disoriented attachment, pointing out the limitations in the methodology that have precluded its assessment in most investigations, and implicating it in serious sexual offending. Although not significant in a multivariate model


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Langton et al.

with avoidant attachment in the present sample of community males, further investigation with adjudicated samples that include those with sexual offenses is needed to better understand associations with this distinct attachment style. Smallbone and Dadds (2000, 2001) did not include an index of childhood adversity of any kind in their investigations. Given the associations between various types of childhood maltreatment and adversity and insecure attachment styles (Baer & Martinez, 2006), and between childhood maltreatment and later violence (Widom & Maxfield, 2001), most specifically CSA and later sexually aggressive or abuse behavior toward others (Jespersen et al., 2009), inclusion of indices of childhood adversities and particularly CSA are important in multivariate modeling of coercive sexual behavior if their relative contributions are to be better understood. In the present study, the univariate analyses indicated that childhood maltreatment, using a single general index, and CSA were associated with each other, consistent with findings reported elsewhere concerning poly-victimization (Finkelhor, Ormrod, & Turner, 2007) and co-occurrence of various adverse events in childhood (Dong, Anda, Dube, Giles, & Felitti, 2003). These indices were also associated with avoidant and disorganized/disoriented attachment in childhood (the use of three indices of CSA was warranted to avoid an obvious confounding between maternal/paternal attachment styles and sexual abuse by that same parent) and also avoidant attachment in adulthood. Although these small to medium effect sizes do not, of course, permit inferences about causation, it is noteworthy that they are not large enough to suggest that childhood maltreatment and attachment styles in childhood are confounded in this study. Inconsistent with the second, fourth, and sixth hypotheses, avoidant attachment in childhood and avoidance attachment in adulthood were not significant predictors in the multivariate analyses when CSA and the control variables were included in the models. In both the maternal attachment model and the adult attachment model, CSA accounted for a unique portion of the variance in coercive sexual behavior even when controlling for its interaction with avoidance attachment, the effects of other types of childhood adversity, aggression, and antisociality, broadly consistent with the sexually abused–sexual abuser hypothesis (Jespersen et al., 2009; cf. Widom & Massey, 2015). However, the hypothesized moderating function for attachment, specifically that lower scores on the avoidant and avoidance attachment scales (indicative of more secure attachment in childhood and adulthood) would moderate the association between CSA and coercive sexual behavior, was partially supported. The product terms failed to reach statistical significance (p = .07 and p = .36 in the maternal and paternal models, respectively, corresponding to Hypotheses 3 and 5) for attachment in childhood. But for adult avoidance attachment, a statistically significant interaction effect with CSA was found (Hypothesis 7), even in the heteroscedasticity-consistent regression results, consistent with a moderating function for attachment reported in other studies (e.g., Aspelmeier et al., 2007). Attachment effectively served as a buffer; those with a history of CSA and a more secure adult attachment style (here, lower scores on the avoidance attachment scale) were less likely to engage in coercive sexual behavior than those with CSA histories and a less secure adult attachment style (here, higher scores on the avoidance attachment scale).


22

Sexual Abuse

To our knowledge, this is the first empirical demonstration that attachment, measured using a psychometrically sound continuous scale, can serve a protective function for those at risk for coercive sexual behavior. It is not clear why the moderating function was found for adult attachment but not attachment in childhood. It could be due to the retrospective nature of the ratings for the latter in contrast to ratings of adult attachment, which would reflect current appraisal. Such methodological issues aside, it may be that it is significant relationships in adulthood (and perhaps in adolescence too) rather than in childhood, which have the capacity to effect change at one or, more likely, multiple levels (i.e., intra- and interindividual, environmental) in those with a history of CSA, in the very contexts in which sexually coercive behavior can occur (certainly it is possible that adult attachment plays a more proximal role in behavior in adulthood). Unfortunately, these analyses do not elucidate the mechanism(s) through which such a protective function may occur. A clearer understanding of the mechanism through which CSA and coercive sexual behavior are associated likely represents one important starting point, before turning to the complexity of the attachment construct itself. Although this study concerned self-reported sexually coercive behavior in a nonadjudicated community sample rather than confirmed charges or convictions for sexual offenses, the findings can be meaningfully considered with reference to studies with convicted samples. Much of the research on attachment in individuals who have committed sexual crimes has adopted a categorical approach, frequently drawing on Bartholomew’s model of adult attachment (Bartholomew, 1990; Bartholomew & Horowitz, 1991). But Fraley and his colleagues have argued on the basis of taxonomic analyses with various samples (and data generated using interview and self-report measures as well as the Strange Situation paradigm) that variation in attachment should be modeled using dimensions not categories (e.g., Fraley & Waller, 1998). Nevertheless, it is possible to interpret regression analyses such as that reported here with reference to Bartholomew’s attachment prototypes by simultaneously considering the two adult attachment dimensions of the ECR-R (Fraley, n.d.). The pattern of coefficients in the first step of the regression model in Table 5 indicates that the avoidance dimension was significantly associated with coercive sexual behavior but the anxiety dimension was not. Broadly consistent with findings reported in the extant literature (e.g., Hudson & Ward, 1997; Jamieson & Marshall, 2000; Ward, Hudson, & Marshall, 1996), this pattern of coefficients suggests that those with higher scores on the avoidance scale (conceptually aligned with Bartholomew’s fearful and dismissing prototype) were more likely to report coercive sexual behavior with women than those with lower avoidance scores (i.e., the secure or preoccupied individuals).

Theoretical Implications These results can also be considered with reference to the integrated theory of sexual offending developed by Ward and Beech (2008). This theory, which seeks to explain etiology and persistence, holds that there are three main sources for offense-related vulnerabilities. The first is brain development (encompassing evolutionary


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Langton et al.

considerations, genetic determinants, and neurobiological functioning), the second involves both distal and proximal factors in the individual’s ecological niche (defined as “the set of potentially adverse social and cultural circumstances, personal circumstances, and physical environments confronting each person in the course of development throughout life,” p. 25), and the third concerns neuropsychological functioning (discussed in terms of the motivational/emotional system, the action selection and control system, and the perception and memory system). Interrelations among these are thought to cause distinct clinical phenomena, which Ward and Beech suggest can be viewed as acute risk factors (Hanson & Harris, 2000) that are directly associated with sexual aggression or abuse. Ward and Beech (2008) discuss childhood sexual victimization in terms of the individual’s ecological niche and the effect of this constellation of factors on core functional systems that, in turn, affect psychological and social development. They point out too the disruption of functional systems through brain-based abnormalities as might result from, for example, child maltreatment (Beech & Mitchell, 2005). They discuss attachment in terms of disturbances in the motivational/emotional system, noting that genetic inheritance, cultural upbringing, and negative individual experiences can all adversely affect this system. Maladaptive regulation of the influence of goals and values in, for example, the establishment of strong interpersonal relationships, on the action selection and control system and failure to adjust states in terms of proximal environmental demands can result in the psychological and social deficits associated with sexual offending. These disturbances in the motivational/emotional system Ward and Beech suggest represent what others have referred to as stable dynamic risk factors (Hanson & Harris, 2000). They go on to note that among the clinical phenomena, social difficulties (such as need for intimacy and control) reflect this dysfunction in the motivational/emotional system, which they further explain in terms of attachment. Findings from the present study are consistent with components of this model, demonstrating one of the purported interrelations (between early childhood adversity, here CSA, and attachment) and confirming one aspect of this relationship in terms of a moderating effect. But, as noted above, the focus of the present study was sexually coercive behavior in a convenience sample of community males and no data concerning arrests or convictions for sexual offenses were collected. Replication of the findings is needed. Investigation with an adjudicated sample is also necessary to address, first, the question of whether or not secure attachments in childhood or as an adult have a direct association with desistance, as is suggested by their inclusion as ordinal variables in guidelines for the assessment of protective factors within the structured professional judgment approach (see Borum, Bartel, & Forth, 2003; de Vogel, de Ruiter, Bouman, & de Vries Robbé, 2012). The second question to be addressed is whether attachment moderates an association between CSA and sexual recidivism (the evidence suggesting that CSA is a risk factor for sexual recidivism is equivocal; see Hanson & Morton-Bourgon, 2005, and Mallie, Viljoen, Mordell, Spice, & Roesch, 2011). More studies that model the relationships within the model and elucidate the mechanisms through which effects are moderated and mediated are needed. Dimensional measures represent an important element of such work, effectively


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ameliorating concerns over small cell sizes, but larger samples than that available for the present set of analyses will be necessary for such work. In particular, investigations that examine childhood attachment styles as well as attachment styles in various relationships in adulthood (Fraley, Heffernan, Vicary, & Brumbaugh, 2011) and at focal points in time (McKillop, Smallbone, Wortley, & Andjic, 2012) within integrated models should be undertaken. In the present cross-sectional design, the correlation between attachments in childhood and adulthood were generally small to medium in size. Longitudinal studies will be important in modeling change over time in these and other associations.

Limitations Although partial or full support for a number of key hypotheses was found, the present study was subject to a number of methodological limitations that should be noted. Advances in the understanding of sexual violence can be considerably advanced though the use of cross-sectional designs (Knight & Sims-Knight, 2011), but the use of such a design does preclude inferences about causation, as is the case here. Reliance on self-report measures in the present study also raises the issue of a social desirability bias in responding. The rate of self-reported coercive sexual behavior (36%) was lower than that found by Abbey et al. (2006) using the SES with another community sample (64%). Factors affecting males’ self-reported sexual aggression are not well understood (Kolivas & Gross, 2007), but inclusion of the Impression Management scale in each of the hierarchical regression models afforded a means of statistically controlling for social desirability response bias. Even so, the finding that it was a significant predictor in the models (with the exception of the most stringent, using heteroscedasticity-consistent regression results) highlights an important consideration when measuring sexual coercion and aggression through self-report. Retrospective reporting of experiences extending back into early childhood may also be subject to errors in recall, resulting in an unknown degree of correspondence with actual past experiences. The rate of CSA was higher (17%) than the combined prevalence rate for convenience samples (10%) reported by Stoltenborgh et al. (2011). Furthermore, although the RAQ was selected because of psychometric limitations of other self-report measures of attachment in childhood, the correlations between corresponding maternal and paternal attachment scales ranged in size from medium to large. This was to be expected given the overlap in items comprising these scales, but it does raise the question of whether the differential associations and potential moderating functions of maternal and paternal attachment styles were adequately investigated using the RAQ (cf. McKillop et al., 2012; Reinert & Edwards, 2009). Clearly, further investigation of the psychometric properties of this promising self-report measure is needed. Another limitation is the possible selection bias resulting from using an online recruitment strategy (see, for example, Antoun, Zhang, Conrad, & Schober, 2013; Buller et al., 2012; Sullivan et al., 2011). Certainly, representative samples have been recruited online (e.g., Fenner et al., 2012) and significant differences on study variables between samples recruited online and those recruited through offline methods


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are not inevitable (e.g., Briones, 2014). Furthermore, on the basis of their meta-analysis of 51 studies of survey research, Dodou and de Winter (2014) concluded that there was no difference in social desirability between online and offline participation designs. But research is needed to investigate potential biases associated with online recruitment and participation methodologies compared with offline methodologies in survey studies on sexual coercion. This concern again underscores the need for replication of the findings reported here. Despite these limitations, the present findings do make a contribution to the knowledge base regarding the importance of attachment in understanding sexually coercive behavior. The study corroborates findings from previous work on the associations between CSA, insecure attachment, and coercive sexual behavior within integrated models. By including a broader set of theoretically relevant and empirically supported predictors within each regression model, potential confounding effects not incorporated in previous work were controlled. Measures of attachment not used in earlier studies’ multivariate models appeared to be psychometrically sound and informative. Finally, as one of only a few investigations of a moderating function for attachment, the significant interaction with CSA should stimulate further investigations that will contribute to a theoretically informed empirical foundation for prevention efforts (Gidycz, Orchowski, & Edwards, 2011) and attachment-informed intervention work with those who have sexually assaulted others (Rich, 2006; Slade, 2008). Acknowledgments We would like to thank Colin Parkes for his clarifications regarding scoring of the RAQ, and James Worling as well as the anonymous reviewers for their helpful comments on earlier versions of this article. We also wish to thank our research assistants, Martin Bryan and Amy McDowell, and to acknowledge the assistance of Sylvia Langton with manuscript preparation.

Declaration of Conflicting Interests The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding The author(s) received no financial support for the research, authorship, and/or publication of this article.

References Abbey, A., Parkhill, M. R., BeShears, R., Clinton-Sherrod, A., & Zawacki, M. (2006). Crosssectional predictors of sexual assault perpetration in a community sample of single African American and Caucasian men. Aggressive Behavior, 32, 54-67. doi:10.1002/ab.20107 Ainsworth, M. D. S., Blehar, M. C., Waters, E., & Wall, S. (1978). Patterns of attachment: A psychological study of the strange situation. Hillsdale, NJ: Lawrence Erlbaum. Alexander, P. C. (1993). The differential effects of abuse characteristics and attachment in the prediction of long-term effects of sexual abuse. Journal of Interpersonal Violence, 8, 346362. doi:10.1177/088626093008003004


26

Sexual Abuse

Alexander, P. C., Anderson, C. L., Brand, B., Schaeffer, C. M., Grelling, B. Z., & Kretz, L. (1998). Adult attachment and long-term effects in survivors of incest. Child Abuse & Neglect, 22, 45-61. doi:10.1016/S0145-2134(97)00120-8 Antoun, C., Zhang, C., Conrad, F. G., & Schober, M. F. (2013, May). Comparisons of online recruitment strategies: Craigslist, Google Ads and Amazon’s Mechanical Turk. Poster presented at the Annual Conference of the American Association of Public Opinion Research, Boston, MA. Armsden, G. C., & Greenberg, M. T. (1987). The Inventory of Parent and Peer Attachment: Individual differences and their relationship to psychological well-being in adolescence. Journal of Youth and Adolescence, 16, 427-454. doi:10.1007/BF02202939 Aspelmeier, J. E., Elliott, A. N., & Smith, C. H. (2007). Childhood sexual abuse, attachment, and trauma symptoms in college females: The moderating role of attachment. Child Abuse & Neglect, 31, 549-566. doi:10.1016/j.chiabu.2006.12.002 Atkinson, L., & Goldberg, S. (2004). Applications of attachment: The integration of developmental and clinical traditions. In L. Atkinson & S. Goldberg (Eds.), Attachment issues in psychopathology and intervention (pp. 3-25). Mahwah, NJ: Lawrence Erlbaum. Baer, J. C., & Martinez, C. D. (2006). Child maltreatment and insecure attachment: A meta-analysis. Journal of Reproductive and Infant Psychology, 24, 187-197. doi:10.1080/02646830600821231 Baker, E., Beech, A., & Tyson, M. (2006). Attachment disorganization and its relevance to sexual offending. Journal of Family Violence, 21, 221-231. doi:10.1007/s10896-006-9017-3 Barbaree, H. E., & Langton, C. M. (2006). The effects of child sexual abuse and family environment. In H. E. Barbaree & W. L. Marshall (Eds.), The juvenile sex offender (2nd ed., pp. 58-76). New York, NY: Guilford. Barth, J., Bermetz, L., Heim, E., Trelle, S., & Tonia, T. (2013). The current prevalence of child sexual abuse worldwide: A systematic review and meta-analysis. International Journal of Public Health, 58, 469-483. doi:10.1007/s00038-012-0426-1 Bartholomew, K. (1990). Avoidance of intimacy: An attachment perspective. Journal of Social and Personal Relationships, 7, 147-178. doi:10.1177/0265407590072001 Bartholomew, K., & Horowitz, L. M. (1991). Attachment styles among young adults: A test of a four-category model. Journal of Personality and Social Psychology, 61, 226-244. doi:10.1037/0022-3514.61.2.226 Beech, A. R., & Mitchell, I. J. (2005). A neurobiological perspective on attachment problems in sexual offenders and the role of selective serotonin re-uptake inhibitors in treatment of such problems. Clinical Psychology Review, 25, 153-182. doi:10.1016/j.cpr.2004.10.002 Berlin, L. J., Cassidy, J., & Appleyard, K. (2008). The influence of early attachment on other relationships. In J. Cassidy & P. R. Shaver (Eds.), Handbook of attachment: Theory, research, and clinical application (2nd ed., pp. 333-347). New York, NY: Guilford. Bogaerts, S., Vanheule, S., & Declercq, F. (2005). Recalled parental bonding, adult attachment style, and personality disorders in child molesters: A comparative study. Journal of Forensic Psychiatry & Psychology, 16, 445-458. doi:10.1080/14789940500094524 Borum, R., Bartel, P. A., & Forth, A. E. (2003). SAVRY: Structured Assessment of Violence Risk in Youth. Tampa: University of South Florida. Bowlby, J. (1969). Attachment and loss: Attachment (Vol. 1). New York, NY: Basic Books. Bowlby, J. (1973). Attachment and loss: Separation—Anxiety and anger (Vol. 2). New York, NY: Basic Books. Bowlby, J. (1979). The making and breaking of affectional bonds. London, England: Tavistock.


27

Langton et al.

Brennan, K. A., Clark, C. L., & Shaver, P. R. (1998). Self-report measurement of adult attachment: An integrative overview. In J. A. Simpson & W. S. Rholes (Eds.), Attachment theory and close relationships (pp. 46-76). New York, NY: Guilford. Briones, E. M. (2014). An evaluation of alternative methods for online survey recruitment: The equivalency of data collected through Amazon Mechanical Turk and Second Life to traditional undergraduate student samples (Unpublished master’s thesis). University of Texas–Pan American, Edinburg. Buller, D. B., Meenan, R., Severson, H., Halperin, A., Edwards, E., & Magnusson, B. (2012). Comparison of 4 recruiting strategies in a smoking cessation trial. American Journal of Health Behavior, 36, 577-588. doi:10.5993/AJHB.36.5.1 Bumby, K. M., & Hansen, D. J. (1997). Intimacy deficits, fear of intimacy, and loneliness among sexual offenders. Criminal Justice and Behavior, 24, 315-331. doi:10.1177/0093854897024003001 Buss, A. H., & Perry, M. (1992). The Aggression Questionnaire. Journal of Personality and Social Psychology, 63, 452-459. doi:10.1037/0022-3514.63.3.452 Busuito, A., Huth-Bocks, A., & Puro, E. (2014). Romantic attachment as a moderator of the association between childhood abuse and posttraumatic stress disorder symptoms. Journal of Family Violence, 29, 567-577. doi:10.1007/s10896-014-9611-8 Campos, J. J., Barrett, K. C., Lamb, M. E., Goldsmith, H. H., & Stenberg, C. (1983). Socioemotional development. In M. M. Haith (Ed.), Handbook of child psychology: Infancy and developmental psychology (Vol. 2, pp. 783-917). New York, NY: Wiley. Cicchetti, D. (2004). An odyssey of discovery: Lessons learned through three decades of research on child maltreatment. American Psychologist, 59, 731-741. doi:10.1037/0003066X.59.8.731 Collins, N. L., & Read, S. J. (1990). Adult attachment, working models, and relationship quality in dating couples. Journal of Personality and Social Psychology, 58, 644-663. doi:10.1037/0022-3514.58.4.644 Cortoni, F., & Marshall, W. L. (2001). Sex as a coping strategy and its relationship to juvenile sexual history and intimacy in sexual offenders. Sexual Abuse: A Journal of Research and Treatment, 13, 27-43. doi:10.1177/107906320101300104 Craissati, J., McClurg, G., & Browne, K. (2002). The parental bonding experiences of sex offenders: A comparison between child molesters and rapists. Child Abuse & Neglect, 26, 909-921. doi:10.1016/S0145-2134(02)00361-7 Crowell, J. A., Fraley, R. C., & Shaver, P. R. (2008). Measurement of individual differences in adolescent and adult attachment. In J. Cassidy & P. R. Shaver (Eds.), Handbook of attachment: Theory, research, and clinical application (2nd ed., pp. 599-634). New York, NY: Guilford. DeKlyen, M., & Greenberg, M. T. (2008). Attachment and psychopathology in childhood. In J. Cassidy & P. R. Shaver (Eds.), Handbook of attachment: Theory, research, and clinical application (2nd ed., pp. 637-665). New York, NY: Guilford. DeLisi, M., Kosloski, A. E., Vaughn, M. G., Caudill, J. W., & Trulson, C. R. (2014). Does childhood sexual abuse victimization translate into juvenile sexual offending? New evidence. Violence and Victims, 29, 620-635. doi:10.1891/0886-6708 de Vogel, V., de Ruiter, C., Bouman, Y., & de Vries Robbé, M. (2012). SAPROF: Guidelines for the assessment of protective factors for violence risk (2nd ed.). Utrecht, The Netherlands: De Forensische Zorgspecialisten. Dhaliwal, G. K., Gauzas, L., Antonowicz, D. H., & Ross, R. R. (1996). Adult male survivors of childhood sexual abuse: Prevalence, sexual abuse characteristics, and long-term effects. Clinical Psychology Review, 16, 619-639. doi:10.1016/S0272-7358(96)00018-9


28

Sexual Abuse

Dodge, K. A., Bates, J. E., & Pettit, G. S. (1989). Mechanisms in the cycle of violence. Science, 250, 1678-1683. Dodou, D., & de Winter, J. C. F. (2014). Social desirability is the same in offline, online, and paper surveys: A meta-analysis. Computers in Human Behavior, 36, 487-495. Dong, M., Anda, R. F., Dube, S. R., Giles, W. H., & Felitti, V. J. (2003). The relationship of exposure to childhood sexual abuse to other forms of abuse, neglect, and household dysfunction during childhood. Child Abuse & Neglect, 27, 625-639. doi:10.1016/S01452134(03)00105-4 Dozier, M., Stovall-McClough, K. C., & Albus, K. E. (2008). Attachment and psychopathology in adulthood. In J. Cassidy & P. R. Shaver (Eds.), Handbook of attachment: Theory, research, and clinical application (2nd ed., pp. 718-744). New York, NY: Guilford. Dube, S. R., Williamson, D. F., Thompson, T., Felitti, V. J., & Anda, R. F. (2004). Assessing the reliability of retrospective reports of adverse childhood experiences among adult HMO members attending a primary care clinic. Child Abuse & Neglect, 28, 729-737. doi:10.1016/j.chiabu.2003.08.009 Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., . . . Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experience (ACE) Study. American Journal of Preventive Medicine, 14, 245-258. doi:10.1016/S07493797(98)00017-8 Fenner, Y., Garland, S. M., Moore, E. E., Jayasinghe, Y., Fletcher, A., Tabrizi, S. N., . . . Wark, J. D. (2012). Web-based recruiting for health research using a social networking site: An exploratory study. Journal of Medical Internet Research, 14(1), e20. doi:10.2196/jmir.1978 Finkelhor, D. (1994). The international epidemiology of child sexual abuse. Child Abuse & Neglect, 18, 409-417. doi:10.1016/0145-2134(94)90026-4 Finkelhor, D., Ormrod, R. K., & Turner, H. A. (2007). Poly-victimization: A neglected component in child victimization trauma. Child Abuse & Neglect, 31, 7-26. doi:10.1016/j. chiabu.2006.06.008 Fox, N. A., & Hane, A. A. (2008). Studying the biology of human attachment. In J. Cassidy & P. R. Shaver (Eds.), Handbook of attachment: Theory, research, and clinical applications (2nd ed., pp. 217-240). New York, NY: Guilford. Fraley, R. C. (n.d.). Information on the Experiences in Close Relationships-Revised (ECRR) Adult Attachment Questionnaire. Retrieved from http://internal.psychology.illinois. edu/~rcfraley/measures/ecrr.htm Fraley, R. C., Heffernan, M. E., Vicary, A. M., & Brumbaugh, C. C. (2011). The Experiences in Close Relationships-Relationship Structures questionnaire: A method for assessing attachment orientations across relationships. Psychological Assessment, 23, 615-625. doi:10.1037/a0022898 Fraley, R. C., & Waller, N. G. (1998). Adult attachment patterns: A test of the typological model. In J. A. Simpson & W. S. Rholes (Eds.), Attachment theory and close relationships (pp. 77-114). New York, NY: Guilford. Fraley, R. C., Waller, N. G., & Brennan, K. A. (2000). An item response theory analysis of self-report measures of adult attachment. Journal of Personality and Social Psychology, 78, 350-365. doi:10.1037/0022-3514.78.2.350 Gidycz, C. A., Orchowski, L. M., & Edwards, K. M. (2011). Primary prevention of sexual violence. In J. W. White, M. P. Koss & A. E. Kazdin (Eds.), Violence against women and children, Volume 2: Navigating solutions (pp. 159-179). Washington, DC: American Psychological Association.


29

Langton et al.

Goldsmith, H. H., & Alansky, J. A. (1987). Maternal and infant temperamental predictors of attachment: A meta-analytic review. Journal of Consulting and Clinical Psychology, 55, 805-816. doi:10.1037/0022-006X.55.6.805 Hanson, R. K., & Harris, A. J. R. (2000). Where should we intervene? Dynamic predictors of sexual offence recidivism. Criminal Justice and Behavior, 27, 6-35. doi:10.1177/0093854800027001002 Hanson, R. K., & Morton-Bourgon, K. E. (2005). The characteristics of persistent sexual offenders: A meta-analysis of recidivism studies. Journal of Consulting and Clinical Psychology, 73, 1154-1163. doi:10.1037/0022-006X.73.6.1154 Hanson, R. K., & Slater, S. (1988). Sexual victimization in the history of child sexual abusers: A review. Annals of Sex Research, 1, 485-499. doi:10.1177/107906328800100402 Hayes, A. F., & Cai, L. (2007). Using heteroscedasticity-consistent standard error estimators in OLS regression: An introduction and software implementation. Behavior Research Methods, 39, 709-722. doi:10.3758/BF03192961 Hazan, C., & Shaver, P. (1987). Romantic love conceptualized as an attachment process. Journal of Personality and Social Psychology, 52, 511-524. doi:10.1037/0022-3514.52.3.511 Hudson, S. M., & Ward, T. (1997). Intimacy, loneliness, and attachment style in sexual offenders. Journal of Interpersonal Violence, 12, 323-339. doi:10.1177/088626097012003001 Jamieson, S., & Marshall, W. L. (2000). Attachment styles and violence in child molesters. The Journal of Sexual Aggression, 5, 88-98. doi:10.1080/13552600008413301 Jespersen, A. F., Lalumière, M. L., & Seto, M. C. (2009). Sexual abuse history among adult sex offenders and non-sex offenders: A meta-analysis. Child Abuse & Neglect, 33, 179-192. doi:10.1016/j.chiabu.2008.07.004 Knight, R. A., & Sims-Knight, J. E. (2003). The developmental antecedents of sexual coercion against women: Testing alternative hypotheses with structural equation modelling. Annals of the New York Academy of Sciences, 989, 72-85. Knight, R. A., & Sims-Knight, J. E. (2011). Risk factors for sexual violence. In J. W. White, M. P. Koss & A. E. Kazdin (Eds.), Violence against women and children, Volume 1: Mapping the terrain (pp. 125-150). Washington, DC: American Psychological Association. Kolivas, E. D., & Gross, A. M. (2007). Assessing sexual aggression: Addressing the gap between rape victimization and perpetration prevalence rates. Aggression and Violent Behavior, 12, 315-328. doi:10.1016/j.avb.2006.10.002 Koss, M. P., & Oros, C. J. (1982). Sexual Experience Survey: A research instrument investigating sexual aggression and victimization. Journal of Consulting and Clinical Psychology, 50, 455-457. doi:10.1037/0022-006X.50.3.455 Main, M., & Solomon, J. (1986). Discovery of an insecure-disorganized/disoriented attachment pattern. In T. B. Brazelton & M. W. Yogman (Eds.), Affective development in infancy (pp. 95-124). Westport, CT: Ablex. Mallie, A. L., Viljoen, J. L., Mordell, S., Spice, A., & Roesch, R. (2011). Childhood abuse and adolescent sexual re-offending: A meta-analysis. Child Youth Care Forum, 40, 401-417. doi:10.1007/s10566-010-9136-0 Marshall, W. L. (1993). The role of attachments, intimacy, and loneliness in the etiology and maintenance of sexual offending. Sexual & Marital Therapy, 8, 109-121. doi:10.1080/14681990903550191 Marshall, W. L., & Hambley, L. S. (1996). Intimacy and loneliness, and their relationship to rape myth acceptance and hostility toward women among rapists. Journal of Interpersonal Violence, 11, 586-592. doi:10.1177/088626096011004009


30

Sexual Abuse

McKillop, N., Smallbone, S., Wortley, R., & Andjic, I. (2012). Offenders’ attachment and sexual abuse onset: A test of theoretical propositions. Sexual Abuse: A Journal of Research and Treatment, 24, 591-610. doi:10.1177/1079063212445571 Miner, M. H., & Munns, R. (2005). Isolation and normlessness: Attitudinal comparisons of adolescent sex offenders, juvenile offenders, and nondelinquents. International Journal of Offender Therapy and Comparative Criminology, 49, 491-504. doi:10.1177/0306624X04274103 Miner, M. H., Robinson, B. E., Knight, R. A., Berg, D., Swinburne Romine, R., & Netland, J. (2010). Understanding sexual perpetration against children: Effects of attachment style, interpersonal involvement, and hypersexuality. Sexual Abuse: A Journal of Research and Treatment, 22, 58-77. doi:10.1177/1079063209353183 Molnar, B. E., Buka, S. L., & Kessler, R. C. (2001). Child sexual abuse and subsequent psychopathology: Results from the National Comorbidity Survey. American Journal of Public Health, 91, 753-760. doi:10.2105/AJPH.91.5.753 Morton, N., & Browne, K. D. (1998). Theory and observation of attachment and its relation to child maltreatment: A review. Child Abuse & Neglect, 22, 1093-1104. doi:10.1016/S01452134(98)00088-X Parker, G., Tupling, H., & Brown, L. B. (1979). A parental bonding instrument. British Journal of Medical Psychology, 52, 1-10. doi:10.1111/j.2044-8341.1979.tb02487.x Parkes, C. M. (2006). Love and loss: The roots of grief and its complications. New York, NY: Routledge. Paulhus, D. L. (1998). Manual for the Paulhus Deception Scales: BIDR Version 7. Toronto, Ontario, Canada: Multi-Health Systems. Reinert, D. F., & Edwards, C. E. (2009). Childhood physical and verbal mistreatment, psychological symptoms, and substance use: Sex differences and the moderating role of attachment. Journal of Family Violence, 24, 589-596. doi:10.1007/s10896-00909257-0 Rich, P. (2006). Attachment and sexual offending: Understanding and applying attachment theory to the treatment of juvenile sexual offenders. New York, NY: Wiley. Rich, P. (2009). Juvenile sex offenders: A comprehensive guide to risk evaluation. New York, NY: Wiley. Roche, D., Runtz, M. G., & Hunter, M. A. (1999). Adult attachment: A mediator between child sexual abuse and later psychological adjustment. Journal of Interpersonal Violence, 14, 184-207. doi:10.1177/088626099014002006 Rothman, K. J. (1990). No adjustments are needed for multiple comparisons. Epidemiology, 1, 43-46. Salter, D., McMillan, D., Richards, M., Talbot, T., Hodges, J., Bentivim, A., . . . Skuse, D. (2003). Development of sexually abusive behavior in sexually victimised males: A longitudinal study. The Lancet, 361, 471-476. doi:10.1016/S0140-6736(03)12466-X Savage, J. (2014). The association between attachment, parental bonds and physically aggressive and violent behavior: A comprehensive review. Aggression and Violent Behavior, 19, 164-178. doi:10.1016/j.avb.2014.02.004 Seto, M. C. (2008). Pedophilia and sexual offending against children: Theory, assessment, and intervention. Washington, DC: American Psychological Association. Seto, M. C., Kjellgren, C., Priebe, G., Mossige, S., Svendin, C. G., & Långström, N. (2010). Sexual coercion experience and sexually coercive behavior: A population study of Swedish and Norwegian male youth. Child Maltreatment, 15, 219-228. doi:10.1177/1077559510367937 Seto, M. C., & Lalumière, M. L. (2010). What is so special about male adolescent sexual offending? A review and test of explanations through meta-analysis. Psychological Bulletin, 136, 526-575. doi:10.1037/a0019700


31

Langton et al.

Sibley, C. G., Fischer, R., & Liu, J. H. (2005). Reliability and validity of the Revised Experiences in Close Relationships (ECR-R) self-report measure of adult romantic attachment. Personality and Social Psychology Bulletin, 31, 1524-1536. Sibley, C. G., & Liu, J. H. (2004). Short-term temporal stability and factor structure of the revised Experiences in Close Relationships (ECR-R) measure of adult attachment. Personality and Individual Differences, 36, 969-975. doi:10.1016/S0191-8869(03)00165-X Sigurdsson, J. F., Gudjonsson, G., Asgeirsdottir, B. B., & Sigfusdottir, I. D. (2010). Sexually abusive youth: What are the background factors that distinguish them from other youth? Psychology, Crime, & Law, 16, 289-303. doi:10.1080/10683160802665757 Slade, A. (2008). The implications of attachment theory and research for adult psychotherapy: Research and clinical perspectives. In J. Cassidy & P. R. Shaver (Eds.), Handbook of attachment: Theory, research, and clinical application (2nd ed., pp. 762-782). New York, NY: Guilford. Smallbone, S. W. (2006). An attachment-theoretical revision of Marshall and Barbaree’s integrated theory of the etiology of sexual offending. In W. L. Marshall, Y. M. Fernandez, L. E. Marshall & G. A. Serran (Eds.), Sexual offender treatment: Controversial issues (pp. 93-107). Chichester, UK: John Wiley. Smallbone, S. W., & Dadds, M. R. (1998). Childhood attachment and adult attachment in incarcerated adult male sex offenders. Journal of Interpersonal Violence, 13, 555-573. doi:10.1177/088626098013005001 Smallbone, S. W., & Dadds, M. R. (2000). Attachment and coercive sexual behavior. Sexual Abuse: A Journal of Research and Treatment, 12, 3-15. doi:10.1177/107906320001200102 Smallbone, S. W., & Dadds, M. R. (2001). Further evidence for a relationship between attachment insecurity and coercive sexual behavior in nonoffenders. Journal of Interpersonal Violence, 16, 22-35. doi:10.1177/088626001016001002 Smallbone, S. W., & McCabe, B. (2003). Childhood attachment, childhood sexual abuse, and onset of masturbation among adult sexual offenders. Sexual Abuse: A Journal of Research and Treatment, 15, 1-10. doi:10.1023/A:1020616722684 Springer, K. W., Sheridan, J., Kuo, D., & Carnes, M. (2007). Long-term physical and mental health consequences of childhood physical abuse: Results from a large population-based sample of men and women. Child Abuse & Neglect, 31, 517-530. doi:10.1016/j.chiabu.2007.01.003 Stirpe, T., Abracen, J., Stermac, L., & Wilson, R. (2006). Sexual offenders’ state-of-mind regarding childhood attachment: A controlled investigation. Sexual Abuse: A Journal of Research and Treatment, 18, 289-302. doi:10.1177/107906320601800307 Stoltenborgh, M., van Ijzendoorn, M. H., Euser, E. M., & Bakermans-Kranenburg, M. J. (2011). A global perspective on child sexual abuse: Meta-analysis of prevalence around the world. Child Maltreatment, 16, 79-101. doi:10.1177/1077559511403920 Sullivan, P. S., Khosropour, C. M., Luisi, N., Amsden, M., Coggia, T., Wingood, G. M., & DiClemente, R. J. (2011). Bias in online recruitment and retention of racial and ethnic minority men who have sex with men. Journal of Medical Internet Research, 13, 93-105. doi:10.2196/jmir.1797 Tabachnick, B. G., & Fidell, L. S. (2001). Using multivariate statistics (4th ed.). Boston, MA: Allyn and Bacon. Tangney, J. P., Meyer, P., Furukawa, E., & Cosby, B. (2002). Criminogenic Beliefs and Attitude Scale. Fairfax, VA: George Mason University. Tangney, J. P., Stuewig, J., Furukawa, E., Kopelovich, S., Meyer, P. J., & Cosby, B. (2012). Reliability, validity, and predictive utility of the 25-item Criminogenic Cognitions Scale (CCS). Criminal Justice and Behavior, 39, 1340-1360. doi:10.1177/0093854812451092


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Ward, T., & Beech, A. R. (2008). An integrated theory of sexual offending. In D. H. Laws & W. T. O’Donohue (Eds.), Sexual deviance: Theory, assessment, and treatment (2nd ed., pp. 21-36). New York, NY: Guilford. Ward, T., Hudson, S. M., & Marshall, W. L. (1996). Attachment style in sex offenders: A preliminary study. The Journal of Sex Research, 33, 17-26. doi:10.1080/00224499609551811 Ward, T., Polaschek, D., & Beech, A. R. (2006). Theories of sexual offending. Chichester, UK: Wiley. Ward, T., & Siegert, R. J. (2002). Toward a comprehensive theory of child sexual abuse: A theory knitting perspective. Psychology, Crime & Law, 8, 319-351. doi:10.1080/10683160208401823 Whiffen, V. E., Judd, M. E., & Aube, J. A. (1999). Intimate relationships moderate the association between childhood sexual abuse and depression. Journal of Interpersonal Violence, 14, 940-954. doi:10.1177/088626099014009002 Widom, C. S., & Ames, M. A. (1994). Criminal consequences of childhood sexual victimization. Child Abuse & Neglect, 18, 303-318. doi:10.1016/0145-2134(94)90033-7 Widom, C. S., & Massey, C. (2015). A prospective examination of whether childhood sexual abuse predicts subsequent sexual offending. Journal of the American Medical Association Pediatrics, 169(1), e143357. doi:10.1001/jamapediatrics.2014.3357 Widom, C. S., & Maxfield, M. G. (2001). An update on the “cycle of violence.” Washington, DC: U.S. Department of Justice, Officer of Justice Program, National Institute of Justice. Worling, J. R. (1995). Sexual abuse histories of adolescent male sex offenders: Differences based on the age and gender of their victims. Journal of Abnormal Psychology, 104, 610613. doi:10.1037/0021-843X.104.4.610


Health risk behaviors and medical sequelae of childhood sexual abuse.

Avoidant and compulsive sexual behaviors in male and female survivors of childhood sexual abuse.

Psychological sequelae of sexual abuse in childhood.

Assessing the association between childhood sexual abuse and adult sexual experiences in women with sexual difficulties.

Population-attributable risk of childhood sexual abuse for symptoms of depression and suicidal ideation in adulthood.

Adverse childhood experiences and sexual victimization in adulthood.

Persisting hallucinations following childhood sexual abuse.

Medical and psychiatric symptoms in women with childhood sexual abuse.

Dissociative symptoms in relation to childhood physical and sexual abuse.

Catholicism and childhood sexual abuse: women's coping and psychotherapy.

physical abuse and sexual dysfunction in patients with social anxiety disorder.

Childhood sexual abuse and suicidal behavior: a meta-analysis.

Medical symptoms, health risk, and history of childhood sexual abuse.

Anogenital Warts in Childhood - Always a Marker for Sexual Abuse?

Reactions to research participation in victims of childhood sexual abuse.

Long-term effects of intrafamilial sexual abuse in childhood.

Use of the colposcope in childhood sexual abuse examinations.

Effects of childhood sexual abuse on childbirth: one woman's story.

Frontotemporal Dementia-Like Syndrome Following Recall of Childhood Sexual Abuse.

Breastfeeding Duration after Childhood Sexual Abuse: An Australian Cohort Study.

Childhood sexual abuse: impact on a community's mental health status.

A prospective examination of whether childhood sexual abuse predicts subsequent sexual offending.

Mediators of sexual functioning and marital quality in chronically depressed adults with and without a history of childhood sexual abuse.

Linguistic changes in expressive writing predict psychological outcomes in women with history of childhood sexual abuse and adult sexual dysfunction.