Cross-Lagged Associations of Insecure Attachment Style, Alcohol Use, and Sexual Behavior During Emerging Adulthood

Patterns of Sexual Risk Behaviors and Sexuality-Related Risk Factors among Young Adults in Germany: Implications for Prevention and Therapy

Sexual risk behavior (SRB) includes behavioral (sex without contraception, sexualized substance use, sex work, sexual partner violence, other sexual activities that harm oneself or others) and affective subtypes (sexuality-related feelings of shame/guilt, relationship impairments) and leads to psychosocial and health-related consequences. Young adults comprise a vulnerable group regarding the development of SRB. The study aimed to identify SRB patterns among young adults and their relation to sexuality-related risk factors. A cross-sectional online survey measured behavioral and affective aspects of SRB with nine items. Latent class analysis was conducted to identify patterns of SRB. Gender, sexual orientation, age of first intercourse, number of sexual partners, hypersexuality, and sexual dysfunction were captured as risk factors via multinomial logistic regression. Within this convenience sample (n = 609; nfemale = 365; nmale = 245; Mage = 23.1 years), the SRB patterns unremarkable (67%; low values in all SRB subtypes), shame-ridden (17%; high values in sexual feelings of shame/guilt) and risky sexual behavior (16%; high values in all subtypes of SRB, especially sexualized drug use) were identified. The shame-ridden and risky patterns were strongly associated with higher hypersexuality values, the risky pattern moreover with being non-heterosexual, of younger age at first sexual experience, and a higher number of sexual partners. Male and sexual minority participants demonstrated SRB more often than females and heterosexuals. Within prevention and treatment of SRB, it seems beneficial to address sexuality-related feelings of shame/guilt and addictive patterns (concerning sexual behaviors/substances) via gender- and diversity-sensitive measurements.

The Psychology of Kink: A Cross-Sectional Survey Investigating the Association Between Adult Attachment Style and BDSM-Related Identity Choice in China

BDSM is a type of sexual preference that includes bondage and discipline, dominance and submission, and sadism and masochism. Research has identified three specific power exchange roles in the practice of BDSM: dominance, submission, and switch. It has also been suggested that attachment style potentially influences BDSM interests. This study investigated the potential roles of attachment style in driving BDSM identity. A questionnaire was completed by a cross-sectional Chinese sample (n = 3310, age range 18-30 years), including 1856 BDSM practitioners (436 men, 1420 women). To assess attachment style, the questionnaire included a Chinese translation of the Adult Attachment Scale as well as items surveying BDSM interests. Compared to non-BDSM practitioners, attachment styles were not significantly different from BDSM practitioners. However, practitioners with different BDSM identities showed a significant difference in their attachment styles. Secure and avoidant attachment styles were associated with dominance, whereas submissiveness recorded high average scores of separation anxiety in both males and females. BDSM identities based on gender revealed that 60.5% of female practitioners assumed the role of submissiveness and this group recorded the highest average scores of separation anxiety among all groups. These results show that BDSM identity is related to attachment style. However, the results did not support the hypothesis that attachment styles potentially drive BDSM identities. Further research is needed to explore other psychological processes that drive BDSM identities in order to provide guidance for BDSM practitioners in choosing suitable identities, thereby helping practitioners to choose suitable identity partners and avoid negative experiences during BDSM participation.

The prevalence of alcohol references in music and their effect on people's drinking behavior: A systematic review and meta-analysis

Understanding the prevalence of alcohol references in music and their impact on alcohol drinking behavior is important given the increased accessibility to daily music listening with the proliferation of smart devices. In this review, we estimate the pooled prevalence of alcohol references in music and its association with drinking behavior. Systematic searches were conducted across four major databases (MEDLINE, PsycINFO, EMBASE, and CINHAL). Articles were selected following duplicate checking, title and abstract screening, and full-text review. Studies reporting the prevalence of alcohol-referencing music and/or investigating its association with drinking behavior were included. Pooled prevalence with 95% confidence intervals (CIs) were computed using a random effects model. Of 1007 articles identified, 26 met inclusion criteria and 23 studies comprising 12,224 songs were eligible for meta-analysis. The overall pooled prevalence of alcohol references in music (including lyrics and videos) was 24.0% (95% CI: 19.0%-29.0%). The pooled prevalence was 22.0% (95% CI: 16.0%-29.0%) for only lyrics, 25.0% (95% CI: 18.0%-33.0%) for only the visual elements of music videos, and 29.0% (95% CI: 21.0%-38.0%) for both the lyrical content and the visual components. Only three studies assessed the relationship between listening to music with alcohol references and drinking behavior, and all three reported a positive association. Whereas almost a quarter of all songs included references to alcohol, public health preventive measures are needed to reduce alcohol exposure from music. Future research is needed to understand fully the effect of music with alcohol references on drinking behavior.

Latent Heterogeneity of Online Sexual Experiences and Associations With Sexual Risk Behaviors and Behavioral Health Outcomes in Chinese Young Adults: Cross-Sectional Study

BACKGROUND

Online sexual experiences (OSEs) are becoming increasingly common in young adults, but existing papers have reported only on specific types of OSEs and have not shown the heterogeneous nature of the repertoire of OSEs. The use patterns of OSEs remain unclear, and the relationships of OSEs with sexual risk behaviors and behavioral health outcomes have not been evaluated.

OBJECTIVE

This study aimed to examine the latent heterogeneity of OSEs in young adults and the associations with sexual risk behaviors and behavioral health outcomes.

METHODS

The 2021 Youth Sexuality Study of the Hong Kong Family Planning Association phone interviewed a random sample of 1205 young adults in Hong Kong in 2022 (male sex: 613/1205, 50.9%; mean age 23.0 years, SD 2.86 years) on lifetime OSEs, demographic and family characteristics, Patient Health Questionnaire-4 (PHQ-4) scores, sex-related factors (sexual orientation, sex knowledge, and sexual risk behaviors), and behavioral health outcomes (sexually transmitted infections [STIs], drug use, and suicidal ideation) in the past year. Sample heterogeneity of OSEs was analyzed via latent class analysis with substantive checking of the class profiles. Structural equation modeling was used to examine the direct and indirect associations between the OSE class and behavioral health outcomes via sexual risk behaviors and PHQ-4 scores.

RESULTS

The data supported 3 latent classes of OSEs with measurement invariance by sex. In this study, 33.1% (398/1205), 56.0% (675/1205), and 10.9% (132/1205) of the sample were in the abstinent class (minimal OSEs), normative class (occasional OSEs), and active class (substantive OSEs), respectively. Male participants showed a lower prevalence of the abstinent class (131/613, 21.4% versus 263/592, 44.4%) and a higher prevalence of the active class (104/613, 17.0% versus 28/592, 4.7%) than female participants. The normative class showed significantly higher sex knowledge than the other 2 classes. The active class was associated with male sex, nonheterosexual status, higher sex desire and PHQ-4 scores, and more sexual risk behaviors than the other 2 classes. Compared with the nonactive (abstinent and normative) classes, the active class was indirectly associated with higher rates of STIs (absolute difference in percentage points [Δ]=4.8%; P=.03) and drug use (Δ=7.6%; P=.001) via sexual risk behaviors, and with higher rates of suicidal ideation (Δ=2.5%; P=.007) via PHQ-4 scores.

CONCLUSIONS

This study provided the first results on the 3 (abstinent, normative, and active) latent classes of OSEs with distinct profiles in OSEs, demographic and family characteristics, PHQ-4 scores, sex-related factors, and behavioral health outcomes. The active class showed indirect associations with higher rates of STIs and drug use via sexual risk behaviors and higher rates of suicidal ideation via PHQ-4 scores than the other 2 classes. These results have implications for the formulation and evaluation of targeted interventions to help young adults.

Investigation of the Effect of Sexual Attitudes and Attachment Styles of Spouses of Cancer Patients on Their Psychological Resilience

It is pointed out that the attachment styles of spouses are also very important in terms of coping with the psychological problems experienced in illness and sexual satisfaction. The aim of this study is to investigate the effect of sexual attitudes and attachment styles of spouses of cancer patients on their psychological resilience. The research was carried out as a descriptive study based on the relational screening model between January and November 2021. A total of 429 spouses of cancer patients who met the inclusion criteria were included in the study. The data were collected online using the Participant Information Form, which was prepared by the researcher, Resilience Scale for Adults (RSA), Experiences in Close Relationships Scale (ECR-S), and Hendrick Sexual Attitude Scale (BSAS). Data analyses included descriptive statistics, Mann-Whitney U -test, Kruskal-Wallis, and linear regression using the SPSS 25.0 program. Two hundred forty-six women and 183 men were included in the study, and it has been detected that RSA scores of female participants were higher than male participants. In addition, a positive relation between RSA scores and ECR-S scores ( r = 0.247) and a negative relation between RSA and BSAS ( r = -0.414) were detected ( p < 0.05). It was determined that the psychological resilience of spouses of cancer patients was related to sexual attitudes and attachment styles.