Emotion regulation and cognitive function as mediating factors for the association between lifetime abuse and risky behaviors in women of color

Background Lifetime abuse (i.e., childhood abuse, intimate partner violence) has been linked to risky behavioral outcomes (i.e., alcohol use, risky sex). Women who experience lifetime abuse have poor emotion regulation and may have problems with executive functioning, which could help explain the relationship between lifetime abuse and risky behaviors. However, research on executive functioning and emotion regulation as mediators of this relationship has been limited. In the present study, we examined this association. We hypothesized that lifetime abuse would be related to greater difficulty in emotion regulation and executive function, which would also be associated with greater alcohol use and risky sex. Methods This cross-sectional study included 150 women with a history of lifetime abuse who were assessed for alcohol use using the AUDIT Score; emotion regulation was measured using the Difficulties with Emotion Regulation Scale (DERS); risky sex was measured using question: “in the last 90 days, how many people did you have anal or vaginal sex without using a condom? Executive function was assessed using the NIH Toolbox. Results The mediation model followed the self-regulation theory, which proposes executive function as the higher-order cognitive process. Results showed that executive function deficit and poor emotion regulation significantly mediated the relationship between lifetime abuse and alcohol use severity (indirect effect = .097, SE .031, 95% CI = .035 to .158). Conclusion Our findings suggest executive function and emotion regulation as a potential mechanism for alcohol use severity in women who experienced lifetime abuse (i.e., childhood abuse and intimate partner violence).