The mediational effect of affect regulation on the relationship between attachment and internalizing/externalizing behaviors in adolescent males who have sexually offended

Abstract

Research has shown that adults who sexually offend frequently report perpetrating a sexual offense for the first time during childhood/adolescence; therefore in this preliminary study, we examine the possible covariates related to offending sexually in adolescents. For this study, 62 incarcerated adolescents at a correctional facility in Alabama completed self-report questionnaires regarding demographic information, internalizing/externalizing behavior problems, attachment, and affect regulation. The results of this study indicate that attachment is related to internalizing and externalizing behaviors, as well as, both adaptive affect regulation and maladaptive affect regulation. Through path analyses, this study was the first to test and find that affect regulation ability mediated the relationship between attachment and externalizing behavior; however, it did not mediate the relationship between attachment and internalizing behavior. Interestingly, maladaptive affect regulation appeared to have a stronger influence on problem behaviors than adaptive affect regulation for these adolescents. The findings from this study could help professionals identify more successful therapeutic interventions for these adolescents and consequently prevent later sexual offending and further negative, individual or societal outcomes.

Introduction

In modern Western society, sexual abuse is a significant problem due to its prevalence, severity, and degree of harm to its victims. Sexual abuse is considered to be one of the major societal ills along with violent crimes, poverty, disease, and substance abuse (Barbaree & Marshall, 2005). The effect of sexual abuse on victims' affect regulation, attachment, and problem behaviors has been studied more often than has those same behaviors for the victimizers. Those who sexually offend are defined as individuals who have been convicted in a criminal court of a sexual crime; these crimes include sexual contact that involves coercion, manipulation or power, or is committed against individuals who are unable to give their informed consent (Barbaree & Marshall, 2005). Males perpetrate the substantial majority of reported sexual crimes/offenses (Federal Bureau of Investigation [FBI], 2001). Adolescents under an age fixed by law (18 according to most states) who have committed a sexual offense are charged as minors (Barbaree & Marshall, 2005) and are often remanded to juvenile justice centers for incarceration and treatment.

Until the 1980's, sexual offending by juveniles was often discounted as experimentation or developmental curiosity and available research mainly focused on investigating deviant sexual behavior in adults (Becker, 1998, Veneziano and Veneziano, 2002). However, crime reports and victim surveys have shown that adolescents (males and females) are responsible for about 20% of rapes and 50% of cases of child sexual abuse (Lowenstein, 2006). The Bureau of Justice Statistics reported that 32% of the rapes/sexual assaults in 2007 were perceived as being committed by individuals between the ages of 12–20 (Bureau of Justice Statistics [BJS], 2007). These estimates might even be conservative due to the fact that sexual abuse incidents often are unreported and only a small number of reports result in an arrest (Groth & Loredo, 1981). It has been noted that many male adult sexual offenders report an early reliance on sexualized coping processes and report that their pattern of offenses began during their adolescence or childhood years (Marshall & Marshall, 2000). The high prevalence rates of adolescents and early onset of deviant sexual behavior in males makes a strong case for further research to be conducted with this young, male population.

Previous findings indicate that adolescents who sexually offend often have an insecure attachment (Marshall, Hudson, & Hodkinson, 1993) and have experienced many disruptions in their lives (Barbaree & Langton, 2005) and/or abuse (Veneziano & Veneziano, 2002) that are related to insecure attachment. These adolescents also are known to have difficulty regulating their emotions (Burton, Cullen, Evans, Alarid, & Dunaway, 1998) and display numerous internalizing (Becker et al., 1991, Blaske et al., 1989) and externalizing behavior problems (Ferrara & McDonald, 1996, Langstrom and Lindblad, 2000). We know that affect dysregulation and insecure attachment are associated with one another (Burk and Burkhart, 2003, Cicchetti and Toth, 1995) and that attachment and negative outcomes, such as, psychological difficulties, substance abuse/use, and types of criminal behaviors are also associated (Burk & Burkhart, 2003). However, no evidence has yet been cited that describes the mechanism by which attachment is associated with internalizing behavior and externalizing behavior problems for those who sexually offend. In this study, we conducted path analyses to test if affect regulation is this mechanism for these adolescents. Adolescents who have sexually offended are an understudied population and this is a preliminary study of our hypothesis in this population. Because this pilot study is an initial attempt to establish that the relationship between attachment and problem behaviors might be mediated by affect regulation, we have not included a comparison group. This study also cannot prove causality but we may later be able to test for causality in our intervention work with this population. In the following sections, we will review the evidence that has led us to pursue this line of research. All research reviewed is only about adolescent males who have sexually offended, unless otherwise specified. We focus only on males because males perpetrate the substantial majority of reported sexual offenses and there are likely differences in perpetrators based on gender (Matthews, Hunter, & Vuz, 1997).

Many male adolescents who sexually offend have been found to have various internalizing and/or externalizing behavior problems (Fehrenbach et al., 1986, Kahn and Chambers, 1991, Katz, 1990, Langstrom and Lindblad, 2000, Miner and Crimmins, 1995). The most often reported internalizing symptoms for these adolescents are depression, anxiety, a lack in social competence/social skills, social awkwardness or isolation, and poor peer relationships (related to inhibition and withdrawal) (Becker et al., 1991, Blaske et al., 1989). In fact, they often display more internalizing problems than other types of juvenile delinquents (Van Wijk et al., 2006).

Adolescents who sexually offend have been found to be more depressed than both juvenile delinquents and non-delinquent adolescents (Katz, 1990). These adolescents have an appreciably higher level of depressive symptomatology than would be expected of a random sample of male adolescents (Kaplan, Hong, & Weinhold, 1984). Becker et al. (1991) found that 42% of the adolescents attained scores above 15 on the Beck Depression Inventory (BDI; Beck, Ward, Mendelson, Mock, & Erbaugh, 1961), which is indicative of major depression. In addition, the boys who reported a personal history of being physically or sexually abused themselves had even higher depression scores.

Adolescents who sexually offend often have higher anxiety rates than assaultive offenders (Blaske et al., 1989). They also have high social anxiety and fear of heterosexual interactions and more overall anxiety and distress during any social situation (Katz, 1990). This high anxiety and fear might contribute to these adolescents exhibiting more difficulties in peer relationships and interactions. In general, these adolescents have inadequate social skills, poor peer relationships, and are often socially isolated (Fehrenbach et al., 1986, Katz, 1990). This population also has significant deficits in social competence (Knight & Prentky, 1993). They have been found to feel more social distress and perceive themselves as less socially competent than both delinquent adolescents and non-delinquent adolescents (Katz, 1990). Social awkwardness and/or isolation are characteristics that are related to withdrawal symptoms (Veneziano & Veneziano, 2002), and adolescents who sexually offend have more withdrawal symptoms (Katz, 1990). These adolescents report feeling estranged (i.e., withdrawn) in their relations with others and lonelier and more socially isolated than non-delinquent adolescents (Blaske et al., 1989). They appear to have less ability to bond emotionally (low levels of emotional warmth and closeness) with peers than non-offending adolescents (Blaske et al., 1989). This relationship between internalizing symptoms and social isolation may be bi-directional. Adolescents who have a difficult time meeting social tasks are thought to be at higher risk for sexual offending (Marshall et al., 1993). Emotional loneliness can lead to the desire to become close to others. If this need for emotional closeness exists in combination with sexual behavior, promiscuity, and/or sexual preoccupation then an increase in sexual deviancy may result as these adolescents escalate their attempts to achieve intimacy by having sexual contact with others (Marshall, 1989).

Researchers have seldom examined internalizing and externalizing behaviors together in this population despite the fact that these problems often co-occur for them (Russo & Beidel, 1994). Much of the available adolescent sex offender research focuses on externalizing behavior problems; in fact, sexual offending itself can be described as an externalizing behavior problem. Externalizing behavior problems consist of problems that are displayed in an individual's outward behavior, which reflect the adolescent negatively acting on his/her environment. These can include hyperactivity, inattentiveness, delinquency, disruptiveness, destructiveness, and aggressive behaviors (Campbell et al., 2000, Hinshaw, 1987). High percentages of externalizing behaviors have been found in adolescents who have sexually offended. Studies indicate that 30% to 60% of adolescents who sexually offend display some attention deficit disorder symptoms (Ferrara & McDonald, 1996; Kavoussi, Kaplan, & Becker, 1988). Interviews with outpatient male adolescent sexual offenders have shown that Conduct Disorder, which is highly defined by externalizing behavior problems, was their most common diagnosis and high levels of Attention Deficit Hyperactivity Disorder were also present (Kavoussi et al., 1988). Similarly, a descriptive study in Sweden by Langstrom and Lindblad (2000) found that 62% of the sample had problems with hyperactivity, attention, or concentration in school, 45% had language problems (including difficulties in speech, reading, or writing), and 52% had previously been convicted of a criminal offense: 41% of non-sexual crimes only, 4% of sex crimes only, and 11% of non-sexual and sexual crimes combined. These previous criminal offenses mainly were destruction of property and theft, as well as, violent acts against others, such as assault. Also noteworthy, 23% of the adolescents had been convicted more than twice (Langstrom & Lindblad, 2000).

Poor attachment bonds are known to be related to negative outcomes, such as, psychological difficulties, sexual offending and other types of criminal behavior or substance abuse/use (Burk & Burkhart, 2003). Hudson and Ward (1997) proposed that lack of social competence and emotional loneliness (internalizing behavior problems) frequently found in those who have sexually offended may be related to their internal working models for romantic relationships. Those who sexually offend may be less able to establish and maintain emotional relationships with others (Barbaree et al., 1993, Marshall et al., 1993) which can be considered a factor of insecure attachment (Marshall, 1989) or internalizing behavior problems. Attachment insecurity leads to deficits in necessary skills for achieving intimacy in close relationships and this can result in emotional loneliness and social isolation. Marshall (1989) proposed that those who sexually offend seek intimacy through sexual activity and continued failure in intimacy results in an expansion of sexual activity range, eventually resulting in a sexual offense (externalizing behavior problem). Baker, Beech, and Tyson (2006) wrote a conceptual paper that argued that disorganized attachment style could account for some of the known features of sexual offenders, such as aggression and socio-affective problems. In a study of average male undergraduate students in Australia, insecure attachment during childhood, especially paternal attachment, was associated with antisocial behavior, aggression, and coercive sexual behavior (externalizing behavior). In fact, their results indicated that childhood attachment independently predicted coercive sexual behavior even after controlling for antisociality and aggression (Smallbone & Dadds, 2000). Since sexually coercive behavior was examined, these findings would lead us to believe that a relationship exists between attachment and externalizing behaviors in adolescents who have sexually offended.

Attachment theory provides a unique conceptual perspective to examine possible motivation for some sexual offenses and the contexts that contribute to deviant sexual behaviors (Burk & Burkhart, 2003). Much of the research on attachment processes for this population, in respect to maladaptive interpersonal outcomes/behaviors, has focused on the distinction between secure and insecure attachment (Burk & Burkhart, 2003); whereas, some focused on the three distinctive attachment styles (Smallbone & Dadds, 2000); and others focused on a fourth category referred to as the disorganized attachment style (Baker et al., 2006). No matter which classification has been used, it is widely accepted that individuals who have sexually offended are likely to be insecurely attached (Marshall et al., 1993). Adolescents who are securely attached to their caregiver have been found to display lower sexually aggressive behaviors (Kobayashi, Sales, Becker, Figueredo, & Kaplan, 1995).

Bowlby, 1969, Bowlby, 1975, Bowlby, 1980 proposed that one source of adult psychopathology may be the patterns of early interactions between a child and his/her caregiver. Disruptive childhood experiences with caregiver(s) can cause a child to have an insecure or disorganized attachment style (Marshall et al., 1993). The way in which attachment bonds are formed makes it essential to review the early backgrounds of these individuals. Their early environments often have high rates of parent–child conflict and a lack of positive involvement between parent and child. Considerable evidence exists that indicates a variety of disruptive experiences in the childhood of adolescents who have sexually offended (Barbaree & Langton, 2005), such as being raised with severe family problems (Veneziano & Veneziano, 2002). These family backgrounds are often described as featuring drunkenness, inconsistency, emotional neglect or rejection, hostility, criminal activities, social isolation, and many other problematic circumstances (Marshall & Marshall, 2000). Family factors such as family instability, disorganization, and violence have commonly been found for these adolescents (Bagley and Shewchuk-Dann, 1991, Morenz and Becker, 1995). A study of juveniles who had sexually offended (Kobayashi et al., 1995) found that those who had been physically abused by their father and those who had been sexually abused by a male were more sexually aggressive.

Frequent disruptive experiences, such as, sexual, physical, and/or mental abuse are often part of the childhood for these adolescents. Research suggests that 25–50% of adolescents who sexually offend have experienced physical abuse and/or neglect as children (Becker and Hunter, 1997, Veneziano and Veneziano, 2002). A study of young perpetrators proposed that at least 49% had been sexually abused (Johnson, 1988); others have suggested rates of 50–80% of the adolescents suffered sexual victimization in their past (Friedrich and Luecke, 1988, Ryan et al., 1987); and some have found results as high as 90% (Veneziano, Veneziano, & Legrand, 2000). Being sexually abused during childhood is known to be associated in adolescence with having a disorganized or insecure attachment style (McCormack, Hudson, & Ward, 2002). Abuse of any kind, of course, is a major attachment disruption in these children's lives. Obviously, all of these factors are associated with impaired parent–child attachment (Pithers & Gray, 1998). Clearly, attachment problems, characterized by neglectful or rejecting parenting, lead to poor self-esteem, the inability to form attachments, and other influences that make youths susceptible to becoming sex offenders (Marshall et al., 1993, Marshall and Mazzucco, 1995).

Affect regulation is highly related to attachment (Hudson & Ward, 1997). In fact, early attachment relationships have been accepted as the origin of affect regulation during infancy (Ainsworth & Bowlby, 1991). In the attachment relationship in infancy, children learn affect regulation strategies to maintain the proximity of a caregiver, especially in stressful situations (Robinson, Emde, & Korfmacher, 1997). Children develop secure attachment when their caregivers are responsive and available. Securely attached children are able to regulate their distress using strategies that illicit comfort and support from caregivers and allow them to return to exploration (Ainsworth, Blehar, Waters, & Wall, 1978). If caregivers are emotionally unavailable or rejecting an avoidant-insecure attachment is developed in which individuals attempt to avoid communicating distressing emotions, such as anger (Allen, Moore, & Kuperminc, 1997). Anxious-insecure attachment is developed when caregivers are inconsistent and the children are then both fearful of and angry with their caregivers and become hypervigilant to attachment experiences, displaying affect regulation strategies that actually heighten their distress (Allen et al., 1997).

Affect regulation involves the awareness, expression, and control of the aspects of an emotional experience (Garber and Dodge, 1991, Keiley, 2002, Keiley and Seery, 2001). Generally, affect regulation is used to decrease unfavorable and increase favorable conditions, which allows individuals to endure or tolerate their feelings (Tomkins, 1963). When individuals have the ability to successfully regulate their emotional experiences, they can make rational decisions (Keiley & Seery, 2001). Adolescents who have sexually offended experience problems in the process of developing useful affect regulation strategies (Burton et al., 1998). Affect-regulation is one of the earliest developmental tasks of childhood and it begins in the context of early family life; therefore, the way in which an individual's family regulates emotion will influence how they regulate their emotion in the future. This is certainly the case for these male adolescents. Youth who sexually offend often come from families with high levels of negative affect and low levels of positive affect (Blaske et al., 1989). Some have rigid family boundaries that provide the youth with few ways to meet their emotional needs and many are denied healthy examples of how to handle affect and high arousal (Larson & Maddock, 1986). Caregivers often react with intense pursuit (abuse) or withdrawal (neglect) to their own emotional experiences (Hunter and Figueredo, 1999) resulting in punitive experiences for their offspring and poor models for managing arousal.

Hudson and Ward (1997) found that a strong relationship between attachment style and maladaptive affect regulation exists in adult sexual offenders. This association appears to be bi-directional. When affect regulation does not develop satisfactorily, disorganization in, or problems with, forming later attachments to others is likely to exist (Burk and Burkhart, 2003, Cicchetti and Toth, 1995). Being unable to regulate affect adequately promotes difficulties in establishing and maintaining effective peer relationships; whereas, being able to regulate affect well promotes future success in establishing and maintaining effective relationships with peers (Howes & Cicchetti, 1993). As described previously, adolescents who have sexually offended have a difficult time forming and maintaining relationships with others. These difficulties may be related to poor affect regulation ability.

Maladaptive affect regulation, or affective dysregulation, can contribute to problem behaviors in adolescents who sexually offend. Maladaptive affect regulation strategies include aggression, denial, the “silent treatment,” depression, phobic behavior, and violence. When individuals cannot manage successfully to regulate their internal affective experience, they may experience a loss of control (under control) or may shut down their affective experience (over control) (Keiley & Seery, 2001).

An over control of emotion can leave individuals unable to solve the problems they face and possibly avoid similar situations in the future (Tomkins, 1963). A more constricted or internalizing behavior occurs when affect is over-controlled. When affective experience is denied, avoided, or shut down, individuals develop anxiety disorders, depression, or addictions (Keiley and Seery, 2001, Tomkins, 1963). These types of internalizing behaviors occur when individuals attempts to control all emotion (Garber & Dodge, 1991). On the other hand, individuals who are not successful in regulating their affective experience show a loss of control (under control) and react impulsively. Their impulsive reactions initiate external actions that are violent or excessive, for example, physical fighting or extreme hysteria (Keiley & Seery, 2001). Externalizing or out-of-control behaviors emerge when affect is under-controlled (Garber & Dodge, 1991). When individuals are unable to regulate their affect, they become impulsive, aggressive, or criminally active (Keiley & Seery, 2001) and display more hyperactive and inattentive behavior since they have difficulty regulating and redirecting themselves. Adolescents who are unable to regulate their emotions often act out aggressively or disruptively when they become emotionally aroused or overwhelmed by emotions.

Adolescents who have sexually offended are most often insecurely attached, have a variety of internalizing and externalizing behavior problems, and have difficulties adequately regulating their affect. As previously discussed, early attachment quality influences the development of affect regulation. The conceptual paper by Burk and Burkhart (2003) reviews literature and proposes disorganized attachment as a diathesis for sexually deviant behavior in the population of adolescents who have sexually offended. Disorganized attachment style has been seen often in the relational behaviors of children from extremely chaotic, abusive, or neglectful environments. These adolescents often come from environments that feature early disruptive experiences that support the claim that these adolescents have insecure or disorganized attachment (Burk & Burkhart, 2003). Insecure attachment (or disorganized attachment) is believed to hinder an individual's ability to acquire critical self-regulatory skills, lead to less organized self-perceptions, and create negative emotional states. These adolescents have difficulty delaying gratification and they exhibit poor control over sexual and other impulses (Kavoussi et al., 1988, Marshall et al., 1993). Insecure attachment is associated with individuals relying on externally based self-regulatory strategies (including strategies of interpersonal control) like sexual offending behavior (Burk & Burkhart, 2003). Therefore, these individuals have the possibility of becoming more reliant on externally based ways of self-regulating. Thus, poor affect regulation strategies can lead to the development of numerous internalizing and/or externalizing behaviors. Most of the research reviewed has only examined, at most, two of these constructs at once. And none has focused on what mechanism might exist for the development of problem behaviors in this population. Our study, therefore, investigates, for the first time, the relationships between attachment and externalizing and internalizing problems as mediated by affect regulation in the population of male adolescents who sexually offend.