Preventive Behaviors Related to Women's Genital Tract Infections

Abstract Introduction: Attachment styles are important factors in determining the psychological harms in people especially aggression. Objective: This study aimed at determining the level of aggression in different types of attachment styles in 15 to 17-year-old high school students in Rasht city. Methods: This correlational descriptive study was conducted on 576 students studying at first to third grade of high school in Rasht in 2013. The study sample was classified based on district classification of Office of Education, type of school, sex and grade. 46 classes (n=576 students) were selected by systematic random sampling method. Classes were considered as clusters. Data collection tool was a questionnaire including three parts. First part contained demographic characteristics such as age, sex, grade, field of study, and type of school, birth order, having siblings, education level of family breadwinner, father's job and family income. Second part was the aggression questionnaire by Arnold and Perry which had 29 questions and 4 sub-scales (Physical and verbal aggression, anger, hostility).Total score of the questionnaire ranged from 29 to 145. Thus, the minimum and maximum scores of physical aggression (Min=9, Max=45), verbal aggression (Min=5, Max=25), anger (Min=7, Max=35) and hostility (Min=8, Max=40) were obtained. Scores higher than the mean showed aggression in all of them. Third part comprised of an adult attachment style questionnaire by Hazan and Shaver with 15 questions on secure, avoidant and anxious-ambivalent attachment styles. The final score was calculated based on sum of all obtained scores. Minimum and Maximum scores in all three aspects ranged from 5 to 35. Scores higher than the mean showed using that aspect. To determine the reliability of the aggression tool, a pilot study was conducted on 25 samples. Cronbach's alpha coefficient was obtained 0.85 for determining the internal consistency of the instrument for all questions and 0.73 for physical aggression, 0.78 for verbal aggression, 0.74 for anger and 0.78 for hostility sub-scales. Due to the frequent use of this questionnaire in many papers, re-determining its validity was discarded. In order to confirm the scientific validity of the attachment style questionnaire, content validity was used. Internal consistency of this instrument was investigated in a pilot study using Cronbach's alpha coefficient. The alpha coefficient was obtained 0.88 for avoidant, 0.69 for anxious-ambivalent and 0.68 for secure attachment styles. Data were analyzed by descriptive statistics (frequency, percent, mean, standard deviation and median) and inferential statistics (Kruskal-wallis and multivariate logistic regression). P<0.05 was considered the significant level. Results: The mean age of study samples was 15.5 &plusmn;0.9 years old. Majority of them were girl (54.1%), first year high school student (49.1%) in public schools (88%) in field of Experimental Sciences (39.9%) with high school graduate parents (44.4%), a brother (45.7%), no sister (46%), three family members (63.7%), average family monthly income eqal 150 &ndash; 200 $ (25.9%) and self-employed father's job (51.6%). Based on the findings, none of the demographic variables had a statistically significant relationship with total score of aggression in adolescents. Moreover, the results showed that the total aggression score was significant in terms of attachment styles (p <0.002). Backward multivariate logistic regression model reveled a significant association between attachment styles by controlling for demographic variables with adolescent aggression score. Adolescents with anxious-ambivalent attachment style were 1.8 times more aggressive than the ones with secure attachment style (P=0.027). Furthermore, among individual and social variables, field of study and education level of parents were associated with aggression score. Adolescents who had parents with lower education level than high school diploma were less aggressive than the students with university educated parents (p=0.046). About field of study, adolescents in Humanities (p=0.019), Experimental Sciences (p=0.030) and Mathematics (p=0.017) were less aggressive compared to students in Work and Knowledge. Conclusion: According to the study findings, adolescents with a secure attachment style had lower aggression than the ones with avoidant and anxiety styles. Secure and avoidant attachment styles had the highest and lowest frequency, respectively. The quality of a person's attachment can predict the kind of his/her relationship in the future as well as rate of growth, health, copping strategies with emotions and stresses, independency and mental disorders.