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Risky sexual behaviours: The role of substance

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 ARTICLE

Risky sexual behaviours: The role of substance use, psychopathic

traits, and attachment insecurity among adolescents and
young adults in Quebec
Carmen Lemelin,1 Yvan Lussier,1 Stéphane Sabourin,2 Audrey Brassard,3 and Christopher Naud 1
1 Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, QC
2 Department of Psychology, Université Laval, Laval, QC
3 Department of Psychology, Université de Sherbrooke, Sherbrooke, QC

The purpose of this study was to examine how substance use, psychopathic traits, and attachment repre-
sentations explain sexual risk-taking in adolescence. Variables used to define risky sexual behaviours
were age at first sexual intercourse and number of lifetime sexual partners. A sample of 1,553 adolescents
and young adults completed a battery of questionnaires including measures of substance use, psycho-
pathic traits, attachment representations, and sexual behaviours. Structural equation modelling demon-
strated that, in the present sample, risky sexual behaviours were best modelled through both direct effects
of avoidant attachment representations and indirect effects of psychopathic traits and abandonment anxiety
through increases in substance use. This model was gender-invariant and may represent a contemporary
trend toward homogenization of sexual practices among young people in Quebec.

KEY WORDS: Risky sexual behaviour, substance use, psychopathic traits, attachment insecurity, adolescents

INTRODUCTION Risky sexual behaviours in adolescence result from a variety

Whether studied from an evolutionary (Ellis et al., 2012), de-
velopmental psychopathological (Steinberg, 2008), or psycho-
analytic (Kernberg, 2011) theoretical perspective, adolescent
sexual risk-taking has been conceptualized as a behavioural
strategy aimed at increasing physical pleasure, gaining social
status and dominance in peer groups, achieving socio-emo-
tional independence from one’s parents, resolving intimacy/
identity issues, or enhancing future reproductive success and
pair bonding. A relatively early age at first sexual intercourse
and an elevated number of sexual partners may lead to reward-
ing life experiences and promote adaptive outcomes for some
adolescents. However, for others, early sexual debut may be
costly and trigger a chain of events resulting in immediate
negative outcomes (e.g., sexually transmitted infection, un-
wanted pregnancy, family conflicts, loss of reputation) that
may extend into the future (e.g., lower educational achieve-
ments and occupational status, fragile adult couple relation-
ships, higher prevalence of mental or personality disorders)
(Institute of Medecine and National Research Council, 2011).
of neurobiological changes that increase responsiveness to
physical and socio-emotional rewards at a time when impulse-
control safeguards against immediate gratification are still not
fully established (Dodge & Albert, 2012). However, there are
marked individual differences in adolescent sexual behaviours,
and neurobiological variation is also expressed through a wide
array of other disinhibited behaviours (e.g., use of psychoactive
substances), personality traits, and attachment representations.
The prevalence of early sexual behaviours in adolescence
has been examined in various population surveys. In a national
survey conducted in 2003, 12% of Canadian males and 13%
of Canadian females had experienced sexual intercourse by
the age of 14–15 years and for adolescents between 15 and 17
years of age, 28% had experienced sexual intercourse (Roter-
mann, 2005). In the province of Quebec, where the present
study was conducted, 17% of males and 22% of females 14 to
15 years-old had experienced sexual intercourse (Garriguet,
2005). Early sexual experiences are often associated with a
higher overall number of sexual partners. Indeed, the earlier
teenagers become sexually active, the higher the number of

Acknowledgements: This research was made possible by a Social Sciences and Humanities Research Council of Canada grant awarded to the
second author.
Correspondence concerning this article should be addressed to Yvan Lussier, Department of Psychology, Université du Québec à Trois-Rivières,
C.P. 500, Trois-Rivières, Québec, Canada G9A 5H1. E-mail: yvan.lussier@uqtr.ca.

The Canadian Journal of Human Sexuality 23(3), 2014, pp. 189–199; doi:10.3138/cjhs.2625 189
Carmen Lemelin et al.

sexual partners they report (Chun & Mobley, 2010; Garriguet, chopathic traits. To examine these potential gender differences,
2005; Le Gall & Le Van, 2007; Petersen & Hyde, 2010). In the the invariance of our model was tested in this study. Empirical
present study, the determinants of observed variation in adoles- support for the proposed model is now briefly reviewed.
cent sexual risk-taking are examined using an individual differ-
ences framework. Early sexual behaviours are thought to be
facilitated by poor impulse control, opportunistic behaviours ROMANTIC ATTACHMENT
stemming from psychopathic personality traits, and insecure
Attachment representations can be examined along two
attachment orientations which are mediated by substance
well-established empirical dimensions: anxiety and avoidance
use. In addition, adolescent sexual risk-taking behaviours are
(Bartholomew, 1990; Mikulincer & Shaver, 2003). Anxiety re-
more frequently observed in young males than in young
fers to fear of rejection, clinging behaviours, and hyper-
females, whereas the negative developmental burden of early
vigilance to relational threats fueled by a lack of self-esteem.
sexual activity is higher in young females (Mahalik et al., 2013).
Two models exist to describe typical adolescent life Avoidance is characterized by self-sufficiency and discomfort
with intimacy. Attachment avoidance reduces vulnerability to
choices, such as sexual risk-taking and the use of psychoactive
negative emotions that might result from rejection or lack of
substances, and psychopathic behaviour: problem-behaviour
availability and support from the attachment figure.
theory (Jessor, Donovan, & Costa, 1991) and the social devel-
Attachment orientations and adolescent sexuality exert a
opmental model (Lonczak, Abbott, Hawkins, Kosterman, &
great influence on the development of an individual’s identity
Catalano, 2002). Problem- behaviour theory conceptualizes
and on the development of knowledge about self and others
teenage sexual activity as part of a behavioural pattern that
(Guidano, 1987). As teens get older, they distance themselves
includes risky sexual behaviour, substance use and delinquent
activities (referred to as psychopathic behaviours). These from their parents and increasingly turn toward romantic
partners to obtain emotional support (Buhrmester & Furman,
behaviours co-vary and co-occur in adolescence and are influ-
1987). This attachment figure shifting process from parent to
enced by social (e.g., attachment to parents or lovers) and
partner develops progressively (Friedlmeier & Granqvist, 2006).
contextual variables (e.g., situational problems). The social
Adolescents even come to prefer and refer to their romantic
developmental model (Lonczak et al., 2002) refers to multiple
partner as their main attachment figure, particularly in ongoing
levels or sources of influence on adolescent development (e.g.,
relationships of two years or more (Hazan & Zeifman, 1994),
surrounding context, parents’ and the child’s emotional and
thus supplanting parents in the social/interpersonal hierarchy
social skills) that promote or hinder adolescent social devel-
opment. Together, these factors may influence teenagers to (Furman & Wehner, 1997). Adolescents with a history of in-
secure attachment to their mother who report high levels of
develop risky sexual behaviours, to use psychoactive substances,
abandonment anxiety are more likely to describe their roman-
or to become involved in delinquent activities. Both models
tic partner as their main attachment figure, compared to those
focus on sexual risk-taking, substance use and psychopathic
with a history of insecure attachment who report high levels
personality traits as core marker variables of social develop-
of attachment avoidance (Friedlmeier & Granqvist, 2006).
ment in adolescence. It is in light of these models that number
Furthermore, teens carry out exploration behaviours in the
of sexual partners and age at first intercourse were selected as
presence of their romantic partner, as do young children in
markers of risky sexual behaviour in relation to substance use
and psychopathy. In addition, during adolescence, psycho- the presence of their parents. They are also inclined to seek
protection and comfort from their partner when facing situa-
pathic personality traits and romantic attachment are in-
tions that appear threatening. Moreover, they seem to protest
creasingly conceptualized as an evolving set of internal repre-
in situations of involuntary separation, just as the departure
sentations that guide adolescent behaviours such as sexual
of a parent may elicit a separation call from a young child.
risk-taking and substance abuse (Catchpole, 2008; Kubak,
Lastly, the majority of adults involved in an intimate relation-
2009). As such, these variables are included in the present
ship report that their main attachment figure is their romantic
study as indicators of more stable individual differences that
partner (Doherty & Feeney, 2004).
may explain substance use and sexual activity.
In addition, it is important to determine whether modifi- Attachment-related avoidant adolescents have fewer inti-
mate relationships and experience loving feelings less often
cations need to be made to the proposed model to account for
than their securely- or anxiously-attached peers, whereas an-
gender differences. For example, a recent meta-analysis showed
xious adolescents fall in love more often and enter romantic
that, compared to females, males are more avoidant and less
relationships at an earlier age (Tracy, Shaver, Albino, & Cooper,
anxious in their attachment representations and behaviours
2003). Studies indicate that, during adolescence, secure individ-
(Del Giudice, 2011). Likewise, psychopathic traits are report-
uals experience more steady and exclusive dating relationships
edly more prevalent, severe, and consequential in men than in
(lasting six months or more) than those with insecure attach-
women (Patrick, 2006). It may well be that, in young females,
sexual risk-taking mainly emerges to assuage abandonment ment styles (Furman & Wehner, 1997). Later in adolescence,
secure teenagers also report experiencing high-quality relation-
anxiety and fear of rejection while in young males, these be-
ships (Simpson, 1990) and intimacy (Bartholomew & Horowitz,
haviours may be mostly determined by poor impulse control,
1991).
opportunistic attitudes, and the desire to impress one’s peers,
features present in individuals showing elevated levels of psy-

190 The Canadian Journal of Human Sexuality 23(3), 2014, pp. 189–199; doi:10.3138/cjhs.2625

ADOLESCENT ROMANTIC ATTACHMENT AND
SEXUAL RISK BEHAVIOUR
The role of attachment orientations is also significant for sexual
experience. In one study, attachment-related avoidant adoles-
cents were least likely to have ever had intercourse (52%) com-
pared to secure (66%) or anxious adolescents (69%) (Tracy et
al., 2003). Anxious teenage girls were more likely to report
having had sexual intercourse than their peers, whereas in
boys, attachment security is associated with an increased like-
lihood of having had intercourse. However, Tracy et al. found
no significant association between attachment representations
and the number of sexual partners. Likewise, Szielasko,
Symons, and Price (2013) did not find a significant associa-
tion between the number of sexual partners and attachment
anxiety or avoidance. Nevertheless, avoidance in sexual rela-
tionships and male gender status did predict multiple partners.
PSYCHOPATHY
Psychopathy refers to attitudes and behaviours evocative of
delinquent conduct. Researchers have identified two distinct
dimensions of psychopathy: primary psychopathy and second-
ary psychopathy (Harpur, Hare, & Hakstian, 1989; Karpman,
1948). Primary psychopathy refers to a tendency to be insensi-
tive, selfish, and show empathic dysfunction (Blair et al., 2004).
These individuals are also described as manipulative, cruel,
dishonest, and fearless (Fowles, 1980; Harpur et al., 1989;
Karpman, 1948). Secondary psychopathy is related to emo-
tion regulation deficits (impulsivity and poor management of
anxiety), intolerance for frustration, rapid mood changes,
concrete and short-term planning and an inability to pursue
goals over a long period (Harpur et al., 1989; Karpman, 1948).
These deficits result partly from maladaptive family processes
also associated with attachment insecurity.
Many similarities can be drawn between attachment-related
avoidance, as defined by romantic attachment theory, and psy-
chopathy (Frodi, Dernevik, Sepa, Philipson & Bragesjö, 2001;
Outcalt, 2007; Rosenstein & Horowitz, 1996). Both concepts
imply a reticence to express feelings. In both cases, individuals
have had a difficult childhood and have typically had repeated
experiences of rejection. This suggests that psychopathy may
be associated with love and sexual relationships. To date, few
studies have examined psychopathic traits, attachment orien-
tations, and sexual behaviours in adolescents.
One study found that adolescents who show psychopathic
personality traits display insecure attachment styles (Catchpole,
2008). College students who obtain high scores of both attach-
ment avoidance and attachment anxiety also obtain high pri-
mary and secondary psychopathy scores (Mack, Hackney, &
Pyle, 2011). Young adults who display avoidant attachment
and elevated psychopathic traits are more likely than others
to experience relationship break-ups, and these individuals
report not being affected by these separations (Davis, Shaver,
& Vernon, 2004). They do not seem to perceive the warning
The Canadian Journal of Human Sexuality 23(3), 2014, pp. 189–199; doi:10.3138/cjhs.2625
Risky sexual behaviours
signs of decreased commitment and possible break-up threats.
While psychopathic traits are related to casual sex, promis-
cuous behaviours, mate poaching, and infidelity in adults
(Schmitt, Realo, Voracek, & Allik, 2008), to our knowledge,
there are no studies examining whether these associations
emerge in adolescence.
SUBSTANCE USE
Several studies have shown significant associations between
substance use and sexual behaviours among adolescents and
young adults. Alcohol use in romantic relationships is posi-
tively correlated with sexual activity (Cooper & Orcutt, 1997).
The use of psychoactive substances is also associated with age
(first intoxication typically occurs between the ages of 12 and
16 years; Johnston, O’Malley, Bachman, & Schulenberg, 2007),
gender (girls consume fewer drugs and less frequently than
boys; Johnston et al., 2007), socio-economic status (poverty
and living in the suburbs are related to increased substance
use; Droomers, Schrijvers, Casswell, & Mackenbach, 2003;
Hanson & Chen, 2007), and social network (substance use
is increased when friends, relatives, or lovers also use alco-
hol or drugs; Bachman, Wadsworth, O’Malley, Johnston, &
Schulenberg, 1997).
In a study of 16-year-olds, there was a mediated relation-
ship between early sexual behaviours, alcohol use, and the
number of sexual partners at age 19 (Zimmer-Gembeck,
Siebenbruner, & Collins, 2004). In the 2011 National Youth
Risk Behaviour Survey, among in the US, among currently
sexually active high-school students, 26% of males and 18.1%
of females had drunk alcohol or used drugs before their last
sexual intercourse (Eaton et al., 2012). Attachment also
appears to affect teenagers’ substance use. As compared to
their secure peers, avoidant adolescents are more frequent
alcohol users and report being intoxicated more often (Tracy
et al., 2003).
Insecurely-attached adolescents are more likely to report
having used alcohol or drugs during their first sexual relation-
ship (Tracy et al., 2003). Psychopathic traits may also increase
an individual’s tendency to use illicit substances. A study
found that 14- and 15-year-old teenagers who reported using
marijuana weekly had significantly more psychopathic traits
and committed more crimes than those who did not use
the drug as regularly (Monshower, Van Dorsselaer, Gorter,
Verdurmen, & Vollebergh, 2004). It is not clear if this last
result extends to risky sexual behaviours.
The Present Study
This brief literature review indicates that there is a lack of
studies that simultaneously consider the interplay of attach-
ment representations, psychopathic traits, and substance use
to understand adolescent high risk sexual behaviours. It is
therefore difficult to ascertain the specific contribution of each
of these factors. The present study first proposes a model to
191
Carmen Lemelin et al.
test direct links between all these variables. In the second step,
a mediational model will stipulate that the association between
attachment and psychopathy on one hand, and sexual risk-
taking on the other hand, is solely explained by substance
use. The choice of a mediational model, obtained through
structural equation modelling, was justified by theoretical cri-
teria outlined earlier and was also deemed acceptable con-
sidering the lack of well-established empirical guidelines in
this area of research. Past studies were strictly correlational
and did not consider these variables simultaneously. More-
over, many studies examining risky sexual behaviours also
used mediators rather than moderators to maximize their
understanding of adolescent sexuality (Brakefield, Wilson, &
Donenberg, 2012; Kashubeck-West & Szymanski, 2008; Lester
et al., 2010; Mezzich et al., 1997). Lastly, the gender invari-
ance of the model will be tested because some sex differences
have been reported in the pattern of substance use, psycho-
pathic personality traits and sexual risk-taking (Ruiz, Stevens,
Fuhriman, Bogart, & Korchmaros, 2009).
METHOD
Participants and Procedures
The sample consisted of 1,553 participants. Of these, 1530
reported gender information (1062 females, 468 males). The
participants ranged in age from 16 to 20 years (M ¼ 18.21,
SD ¼ 2.54). Participants had an average income of 5,375.04
CDN$ (SD ¼ 4.431) and an average of 11.58 years of educa-
tion (SD ¼ 1.31; 49.5% were recruited from high schools,
50.2% from colleges, and 0.3% from universities). Regarding
their level of relationship involvement, 15% reported they
had never been in any serious relationship, whereas nearly
one out of two respondents reported having been in one or
two serious romantic relationships (M ¼ 1.69 relationships;
SD ¼ 1.32). More specifically, six participants were married,
78 were cohabiting, 727 had a partner with whom they were
not cohabiting, and 736 were single at the time of the study.
Participants were solicited on a voluntary basis within high-
schools, colleges, and universities in the province of Quebec,
Canada. Questionnaires were distributed in class to partici-
pants. They were asked to complete several questionnaires at
home, including those related to the present study, and to re-
turn them by mail in a prepaid envelope. Participants spent an
average of one hour answering the questionnaires. Compensa-
tion of $5 was offered. The study was approved by the ethics
committee of the Université du Québec à Trois-Rivières.
Measures
Attachment. The Experience in Close Relationships question-
naire (ECR; Brennan, Clark, & Shaver, 1998, Lafontaine &
Lussier, 2003) assesses attachment representations in romantic
relationships. It contains 36 items divided into two dimensions:
avoidance (18 items) and anxiety (18 items). Participants indi-
cate their level of agreement or disagreement with each state-
ment on a scale of 1 to 7 (ranging from ‘‘strongly disagree’’ to
‘‘strongly agree’’). To estimate the internal consistency underly-
192 The Canadian Journal of Human Sexuality 23(3), 2014, pp. 189–199; doi:10.3138/cjhs.2625
ing these two latent dimensions, items from each scale are
subdivided into three composite scores of six items. The
authors of the questionnaire obtained alpha coefficients of
.94 for the avoidance scale and .91 for the anxiety scale
(Brennan et al., 1998). In the present study, the reliability co-
efficients were respectively .92 and .88 for the scales of avoid-
ance and anxiety.
Psychopathy. The Self-Report Psychopathy Scale (Levenson,
Kiehl, & Fitzpatrick, 1995; Savard, Sabourin, & Lussier, 2006)
is an instrument containing 26 items. The questionnaire in-
cludes two scales, one measuring primary psychopathy (16
items) and the other measuring secondary psychopathy (10
items). In the present study, the latent factor Psychopathy was
derived from four composite scores, two for primary and two
for secondary psychopathy in which the items were randomly
distributed. Primary psychopathy refers to attitudes of selfish-
ness, manipulation, and malevolence toward others, whereas
secondary psychopathy measures impulsivity and pessimism.
Participants respond to the different items using a four-point
Likert scale ranging from ‘‘extremely disagree’’ to ‘‘extremely
agree.’’ The presence of psychopathic traits in an individual
can be determined using cutoff scores developed by Brinkley,
Schmitt, Smith, and Newman (2001) on the global score of
psychopathy. Scores of 58 or more correspond to what is
observed in prison inmates, scores between 49 and 57 reflect
the presence of moderate psychopathic traits, and scores of 48
or less reveal the absence of these traits in the individual.
Internal consistency coefficients for these scales are .82 for
primary psychopathy and .63 for secondary psychopathy
whereas the alpha for the total scale is .85 (Levenson et al.,
1995). In the present study, Cronbach alpha coefficients were
.78 for primary psychopathy, .62 for secondary psychopathy,
and .77 for the global psychopathy scale. The alpha for sec-
ondary psychopathy was not ideal, but acceptable for research
purposes. In addition, in our structural equation models, its
measurement contribution to the general psychopathy latent
variable was strong.
Substance use. Alcohol and drug use was assessed by three
questions measuring consumption frequency of alcoholic bever-
ages, soft drugs (e.g., marijuana) and hard drugs (e.g., cocaine).
A Likert-type scale with five different frequency choices (never,
once a month or less, 2 to 4 times a month, 2–3 times a week,
4 times a week or more) is presented to participants who are
asked to quantify the frequency of their consumption. The
substance use latent factor is composed of these three indica-
tors. In the present study, the reliability coefficient was .53.
This coefficient is unsurprisingly low because the scale is
very short and also because teenagers who drink alcohol do
not necessarily use drugs. However, in our structural equation
analyses, these three items proved to be significant indicators
of the latent substance use factor.
Sexuality. Two questions measured sexual risk-taking: 1)
age at first consenting sexual intercourse and 2) number of
sexual partners to date. Risky sexual behaviour was considered
a latent factor composed of these two variables. Each was
treated as a continuous variable and represented an indicator
of sexual risk-taking. For the structural equation analyses,

Table 1. Correlations between participants’ romantic attachment dimensions, psychopathy, substance use and sexuality variables
M SD
1. Anxiety 3.68 .98
2. Avoidance 2.31 .92
3. Psychopathy 51.32 8.64
4. Substance use 2.37 1.77
5. Age at first sexual intercourse 15.31 1.47
6. Number of partners 3.15 3.41
Note: *p < .05. **p < .01. ***p < .001.
the number of sexual partners was reverse-coded to ensure
factor consistency.
Since the objective of the study was to examine the simul-
taneous interplay of attachment, psychopathy and substance
use on the prediction of risky sexual behaviours, structural
equation modelling analyses were conducted using robust
estimation with maximum likelihood (ML) approach. Robust
estimation was used because it is relatively insensitive to de-
partures from normality assumptions. Each structural equa-
tion model was tested using several fit indices, some of which
are less influenced by sample size, namely the Comparative
Fit Index (CFI; Bentler, 1990), the Non-standard Fitting In-
dex (NNFI), and the Root Mean Square Error of Approxima-
tion (RMSEA, Steiger, 2000). The CFI is used to compare the
fit of the theoretical model to an alternative model based on
the assumption that the observed variables are non-correlated.
The index obtained by this comparison varies from 0 to 1.
When the CFI is equal or superior to .95, it is possible to con-
clude that the model adequately fits the data (Bentler, 1990).
The same reasoning is followed for the NNFI which also has a
value ranging from 0 to 1. An index of .90 or higher demon-
strates a good fit of the model. The RMSEA calculates the
average error of fit between the submitted model and the
data. An index equal to or less than .10 corresponds to an
adequate fit of the model (Browne & Cudeck, 1993). The Chi-
square test is perceived to decrease in validity as sample size
increases. It is therefore preferable to use the w2/ df ratio
(Jöreskog & Sörbom, 1993). When the value of the ratio falls
between 1 and 5, the fit between the proposed theoretical
model and the data is satisfactory. Chi-squares were com-
puted using the Satorra and Bentler (1994) robust method of
estimation.
RESULTS
Descriptive Analyses
At the time of the study, 70.7% (n ¼ 1098) of the total sample
of participants (N ¼ 1,553) had experienced sexual intercourse.
There were 7.3% (n ¼ 113) of respondents who reported an
early sexual debut (i.e., before the age of 14). This threshold
of sexual precocity was set by Garriguet (2005). There were
29.7% (n ¼ 461) of respondents who had experienced their
first sexual intercourse at age 14 to 15 and the average age at
first sexual intercourse was 15.31 years (SD ¼ 1.47).
The Canadian Journal of Human Sexuality 23(3), 2014, pp. 189–199; doi:10.3138/cjhs.2625
Risky sexual behaviours
1 2 3 4 5
.26***
.29*** .29***
.03 .05 .24**
.04 .30*** .03 .24***
.03 .05 .13*** .33*** .39***
Among participants who had experienced intercourse,
38.5% (n ¼ 455) had only had one sexual partner. Nearly half
of respondents (47%, n ¼ 519) reported at least two partners,
but no more than five, whereas 8.6% (n ¼ 93) had between
six and nine sexual partners, and 5.3% (n ¼ 58) had more
than 10 partners. The average number of sexual partners was
3.15 (SD ¼ 3.41) and there was no significant difference
between young females (M ¼ 3.19, SD ¼ 3.46) and males
(M ¼ 3.0, SD ¼ 3.20), t(1072) ¼ 0.91, p ¼ .36.
Means and standard deviations for all measures are pre-
sented in Table 1. Applying the cutoff points described above
revealed that 20% of participants showed clinically significant
psychopathic traits (scores above 57). Alcohol was unques-
tionably the substance used by the largest number of partici-
pants: 91% had used alcohol at least once. Approximately
four out of five participants (81%) reported using alcohol be-
tween 1 and 4 times a month, while 10% used it at least twice
a week. A little less than a third of participants (30%) reported
using soft drugs between 1 and 4 times a month, and 9% used
them at least twice a week. Finally, 91% of participants had
never used hard drugs, 8% did use hard drugs 1 to 4 times a
month, while less than 2% used them at least twice a week.
Young females and males differed significantly on the
frequency of alcohol use (girls: M ¼ 1.51, SD ¼ 0.79; boys:
M ¼ 1.71, SD ¼ 0.89, t(1521) ¼ 4.39, p < .001, Cohen’s
d ¼ .24), soft drug use (girls: M ¼ 0.62, SD ¼ 1.00; boys:
M ¼ 0.90, SD ¼ 1.30, t(716.33) ¼ 4.15, p < .001, d ¼ .24),
primary psychopathy (girls: M ¼ 29.19, SD ¼ 5.93; boys:
M ¼ 33.04, SD ¼ 6.87, t(786.88) ¼ 10.52, p < .001, d ¼ .60),
and attachment-related avoidance (girls: M ¼ 2.23, SD ¼ 0.91;
boys: M ¼ 2.48, SD ¼ 0.92, t(1508) ¼ 4.99, p < .001, d ¼ .27).
The effect sizes for gender differences were relatively small
(<.30, Cohen, 1992), except for primary psychopathy which
was moderate.
Correlational Analyses
Correlations between romantic attachment, psychopathy,
substance use, and sexual behaviour are presented in Table 1.
Inspection of the correlation matrix leads to three important
observations. First, with the exception of a link between
avoidance and sexual behaviours, attachment representations
and psychopathic traits are only weakly associated with risky
adolescent sexual behaviours. Second, alcohol and drug use
are moderately correlated with sexual behaviours. Third, sub-
193
Carmen Lemelin et al.

Figure 1. Mediational structural equation model of romantic attachment, psychopathy, substance use and sexuality. All coefficients
are significant at p < .05. Explained variance for substance use: R 2 ¼ .13. Explained variance for sexuality: R 2 ¼ .43.

stance use is related to psychopathic traits, but not to attach-
ment representations.
Structural Equation Modelling
Fit indices for measurement models of all latent variables (at-
tachment, psychopathy, substance use, and sexual risk-taking)
indicated that factors were adequately related to their indica-
tors, CFI ¼ .97; NNFI ¼ .95; RMSEA ¼ .04; S-B w2/ df ¼ 3.87
(see Figure 1).
A direct effect model from attachment representations and
psychopathic traits to risky sexual behaviours was first esti-
mated (CFI ¼ .96; NNFI ¼ .95; RMSEA ¼ .05; S-B w2/ df ¼
1.96). Fit indices were adequate. This model explained 14%
of the variation in sexual behaviours. Whereas attachment-
related avoidance negatively predicted sexual risk-taking (B ¼
0.490, p < .05), psychopathic traits were a positive predictor
of this variable (B ¼ 1.675, p < .05). Attachment anxiety
was not significantly related to risky sexual behaviours (B ¼
0.017, p ¼ .75). When we tested the direct effects of attach-
ment representations and psychopathic traits on substance use,
the fit of the model remained satisfactory and the explained
proportion of variance reached 15%, CFI ¼ .95; NNFI ¼ .90;
RMSEA ¼ .04; S-B w2/ df ¼ 3.20. Anxious (B ¼ 0.036, p <
.05) and avoidant representations (B ¼ 0.030, p < .05) were
negatively related to substance use but positively related to
psychopathic traits (B ¼ 0.539, p < .05). Lastly, a mediational
model between attachment, psychopathic traits, substance use,
and risky sexual behaviours was tested. Substance use was now
conceptualized as a mediator of the association between attach-
ment and psychopathic traits on one hand, and risky sexual
behaviours on the other hand.
Results of the mediational model are presented in Figure 1.
This model, combining direct and indirect effects, explained

194 The Canadian Journal of Human Sexuality 23(3), 2014, pp. 189–199; doi:10.3138/cjhs.2625

43% of the variance in sexual risk-taking and showed satisfac-
tory fit indices, CFI ¼ .96; NNFI ¼ .96; RMSEA ¼ .044; w2/
df ¼ 3.87. Attachment anxiety and psychopathic traits signifi-
cantly predicted risky sexual behaviours through substance
use; anxiety was associated with reduced substance use while
psychopathic traits predicted higher alcohol and drug use. In
addition to these indirect associations, avoidant attachment
representations directly predicted less sexual risk-taking. Since
studies have shown gender differences on some of these vari-
ables, an analysis of the model’s between-gender invariance
was performed. The model proved to be invariant between
young females and males, CFI ¼ .96; NNFI ¼ .96; RMSEA ¼
.044; w2 ¼ 335.42 df ¼ 160, p ¼ .55.
DISCUSSION
Adolescent sexual risk-taking serves multiple developmental
functions. For young females and males, these behaviours
contribute to the construction, affirmation, and consolidation
of different aspects of one’s general sense of personal identity,
including gender identity, social status, intimacy regulation,
and sexual identity. Because early sexual debut generally pre-
dicts maladaptive outcomes, the search to identify precursors
of these behaviours has important practical implications. In
the present study, the prevalence of sexual risk-taking in ado-
lescents under 14 years of age is noteworthy and reached 7%,
a proportion that is congruent with what has been observed
in large population samples (Eaton et al., 2012). Furthermore,
nearly a third of our respondents had had sexual intercourse
for the first time at age 14 or 15. These adolescents may not
be well-prepared to deal with some of the potential negative
outcomes of their sexual behaviours.
There were no significant gender differences in this pattern
of results. Teenage boys did not engage in sexual intercourse
earlier or with more partners than girls. This finding is incon-
sistent with results of previous studies which have found that
boys become sexually active earlier and with more partners
than girls (Eaton et al., 2012). Whereas one should be cautious
not to over-interpret results that support the null hypothesis,
the absence of gender effects does not support the main pre-
dictions from evolutionary or social learning models that, for
biological or cultural reasons, young females should be more
guarded against early sexual behaviours and multiple partners
either because they are more protective of their future paren-
tal investments or because they are differentially rewarded for
protecting their sexual security and reputation (Poppen, 1995).
Whether this represents a cross-national difference between
American and French-Canadian teens, with whom the present
study was conducted, a contemporary trend toward homogeni-
zation of sexual practices (Poppen, 1995) or a finding specific
to a sub-group of adolescents with mental health problems
(Seth et al., 2012) will have to be determined in future studies.
Our findings show that sexual risk-taking is predicted by
substance use as well as by attachment representations and
psychopathic traits. The role of alcohol and drug use in the
The Canadian Journal of Human Sexuality 23(3), 2014, pp. 189–199; doi:10.3138/cjhs.2625
Risky sexual behaviours
onset of sexual intercourse in adolescence is already well-
documented (Boislard P. & Poulin, 2011; Capaldi, Stoolmiller,
Clark, & Owen, 2002). However, to our knowledge, the deter-
mining role of personality traits typical of psychopathy, such
as social dominance, emotional detachment, impulsiveness
and aggressiveness, in understanding the sexual behaviours
of adolescents has not been studied. In the present study, sub-
stance use mediated the relationship between psychopathic
traits and early sexual behaviours. This finding is an important
contribution to the literature because it supports the hypothesis
that sexual risk-taking is partly explained by disinhibited
behaviours which emerge from dispositional impulsivity and
insensitivity. Thus, for a specific sub-group of adolescents who
present elevated psychopathic traits, there may be a higher risk
that early sexual debut may produce maladaptive outcomes
because sexual behaviours represent opportunistic behaviours
emitted in a context of coldness, coercion and striving for
dominance, facilitated by alcohol and/or drug use.
The present study also provides novel findings regarding
the relationship between attachment representations and ado-
lescent sexual behaviours; although the attachment model is
well-validated in adults, empirical investigations of this nature
are extremely scarce in adolescent populations. Our results
revealed that avoidant and anxious attachment representa-
tions play a protective role against adolescent sexual risk-
taking. The findings for avoidance are partially consistent with
those of Tracy et al. (2003), who found that avoidant adoles-
cents became sexually active later than their secure and
anxious peers, and had lower frequency of intercourse during
the 6 months before the study. Although the evidence for the
role of substance use is somewhat mixed, along with Tracy
et al., our results indicate that, in adolescents, attachment-
related avoidance is a significant obstacle to the development
of sexual behaviours. Past studies have shown that early
sexual debut often occurs in stable romantic relationships
(Rodgers, 1996), and adolescents with avoidant attachment
representations are known to have fewer and less serious
romantic relationships (Tracy et al., 2003). This potential dis-
comfort with sexual intimacy in close relationships extends to
cohabiting and married couples, in which avoidance predicts
reduced sexual activity with one’s partner (Brassard, Shaver, &
Lussier, 2007) and more infidelity (Russell, Baker, & McNulty,
2013).
Attachment anxiety also significantly slowed the transition
to an active and diversified sex life but only when mediated
by lower substance use. This finding is not consistent with
the results of Tracy et al., or with the hypothesis that early
sexual behaviours are a behavioural response to overwhelm-
ing attachment fears. However, anxiously-attached cohabiting
adults report less frequent sexual intercourse (Brassard et al.,
2007). Future studies will be needed to clarify the role of
attachment anxiety in the transition from adolescence to
adulthood. It is not clear whether anxious attachment in ado-
lescence is a marker of future sexual inhibition, or if the shift in
primary attachment figures from parents to sexual/romantic
partners masks the ‘‘real’’ association between attachment
195
Carmen Lemelin et al.
anxiety and sexuality in adolescence. For example, Tobey
(2001) showed that teenage girls whose attachment to their
mother is insecure are likely to experience early sexual inter-
course. In the present study, only attachment to the romantic
partner was measured. It may be important in future investi-
gations with adolescents to assess attachment to parents and
to the romantic/sexual partner.
Finally, it is important to note that the structural relations
tested in the present study were all gender-invariant. The
possible explanations for this lack of significant difference
are numerous and should be examined in future studies: for
instance, systematic misreporting of sexual behaviours by young
males and females, cross-national disparities, progressive stan-
dardization of sexual experiences, or emergent changes that
may take place more clearly only after the transition to adult-
hood is completed. Furthermore, because recent studies have
identified the role of pubertal maturation in sexual risk-taking
(e.g., James, Ellis, Schlomer, & Garber, 2012), it may be im-
portant to examine potential gender disparities in sexuality
in light of early puberty.
Whatever the causal pathways, the present findings suggest
the simultaneous action of two distinct effects: insecurely-
attached adolescents are less willing than their securely-
attached peers to engage in early sexual intercourse and to
have more partners, whereas adolescents with psychopathic
traits may be impulsive decision-makers especially when under
the influence of alcohol or drugs. Thus, our results are consis-
tent with an individual differences perspective on adolescent
sexual risk-taking. Variations in these traits and behaviours
may help to identify adolescents who are prone to sexual im-
pulsivity and who put themselves at risk of experiencing the
consequences of under-controlled decision-making in the
sexual domain. In adolescents, attachment representations,
psychopathic traits, and substance use are difficult to change
and can be moving targets. Multi-component programs de-
signed to enhance self-regulation, socioemotional skills and
attachment strategies may help reduce some of the negative
outcomes associated with early sexual onset and high numbers
of sexual partners.
Although the present study examined sexuality as a risk
factor, it is important to recognize that, in adolescence, sexual
behaviours generally also have an adaptive function associated
with positive contributions to psychosocial outcomes and iden-
tity development. Future research should attempt to separate
adaptive from risky sexual behaviours and study their multiple
consequences simultaneously. To be sexually active allows teens
to experience, for the first time, a situation of great intimacy
and interdependence, in which both partners can learn from
each other while promoting self-disclosure and love (Patrick,
Maggs, & Abar, 2007). Sexual activity within a teenage couple
may confirm the maturity of the relationship and demonstrate
commitment (Patrick et al., 2007). At a certain age, sexually
active adolescents may come to be perceived by their peers as
popular, desirable and mature (O’Sullivan, Meyer-Balhburg, &
Watkins, 2000). Thus, this brings about social gains (Kinsman,
Romer, Furstenberg, & Schwarz, 1998) by which adolescents
may demonstrate their independence from their parents.
196 The Canadian Journal of Human Sexuality 23(3), 2014, pp. 189–199; doi:10.3138/cjhs.2625
Future research in this area would also benefit from a
longitudinal examination of the association between attach-
ment representations, psychopathic traits, substance use, and
sexual decision-making in adolescents. The relationship be-
tween adolescent sexual decision-making and these predis-
posing or precipitating factors is complex, and early sexual
behaviours may bring about negative changes in attachment
security and intensify psychopathic traits. The validity of
dynamic, bidirectional models will need to be tested rigorously.
This may help to more accurately assess the consequences of
early sexual behaviours and multiple partners on subsequent
outcomes and on longstanding relationships in emerging
adulthood.
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