Role of emotion dysregulation in sexual risk-taking among African American adolescent girls in juvenile detention

Background: Adolescents with conduct problems often have difficulty regulating emotional reactions to stressful events, which may contribute to sexual risk behavior. As adolescent girls involved in the juvenile justice system are disproportionately affected by sexually transmitted infections (STIs), it is crucial to understand whether emotion regulation is associated with sexual risk behaviors. Here, we test the hypothesis that responding to distress through rumination or thoughts of self-harm (internal dysregulation) and taking negative feelings out on other individuals or objects (external dysregulation) is positively associated with sexual risk behaviors and STI diagnoses.

Methods: Baseline data were collected from 145 African American girls 13-17 years participating in an HIV/STI prevention program in a juvenile detention facility during 2009-2010. Participants reported demographic information, how often they use internal and external dysregulatory strategies, number of sexual partners, and condom use. STI data were obtained from intake STI tests at the detention facility. Multivariate regression models were used to assess associations between internal and external regulation for the three outcomes, while controlling for age and education.

Results: External emotion dysregulation was positively associated with number of lifetime sex partners (b=2.70, p<.05) and STI diagnosis (b=.86, p<.05) and negatively associated with condom use in the past 90 days (b=-.11, p<.05). Internal regulation was not significant in any models.

Conclusion: Coping with negative emotions by acting out against others may play an important role in sexual risk among girls in juvenile detention. Additional research is warranted to develop interventions that promote healthy coping strategies in this population.