(p. 158) Intimate Romantic Relationships in Young Adulthood: A Biodevelopmental Perspective
Roman is a 21-year-old male who grew up in a family characterized by much conflict and instability. His parents were alcoholics and while drinking they engaged in domestic violence. When not drinking, his parents were very attentive and caring toward him and were involved in his life. His parents separated several times before finally divorcing when he was 13 years of age. Roman has not had many close friendships over the years. He acknowledges that he has difficulty maintaining friends in part because he loses his temper easily. He also notes that he has trouble sustaining romantic relationships. He relates that he enters relationships with much enthusiasm, often sharing intimate details extremely early on in relationships, perhaps too early. He gets jealous easily and fears that the relationship will end. He has trouble managing conflicts with partners and notes that he has had physical altercations with partners.
A major goal of adolescence and young adulthood is to develop a healthy sense of sexuality. According to the National Commission on Adolescent Health, this means appreciating one’s body, delaying sexual behavior until cognitively, emotionally, and physically mature, and engaging in responsible relationships that are consensual, mutually respecting, nonexploitive, pleasurable, and protective against pregnancy and sexually transmitted infections (STIs) (Haffner, 1995). Implicit in this definition is that an individual both feel an appreciation or respect for oneself and also one’s romantic partner.
In the present chapter, we describe young adult relationships within a biological and developmental framework. We begin this chapter by discussing the biological underpinnings of social behavior. Next, we review developmental theories on attachment and intimacy that suggest that early relationships between parent and child and peer relationships provide the basis for later romantic relationships. We end this chapter with a discussion of young adult romantic and sexual relationships by reviewing the data on sexual behavior, sexually transmitted infections, and relationship quality and conflict within romantic relationships among this population.
Theoretical Understanding of the Development of Intimacy
Neurobiological Basis of Pair Bonding and Romantic Attachment
An animal model that has been widely used to help understand biology’s role in social behavior is the prairie vole (Insel & Young, 2001), a mammal that forms monogamous pair bonds (Williams, Insel, Harbaugh, & Carter, 1994). Oxytocin has been implicated in pair bonding for female prairie voles (Insel & Hulihan, 1995; Williams et al., 1994), and vasopressin has been implicated in pair bonding for male prairie voles (Insel & Hulihan, 1995; Winslow, Hastings, (p. 159) Carter, & Insel, 1993). That is, when oxytocin was administered to nonmating prairie voles, partner preference developed for females but not for males. In contrast, infusion of vaso-pressin in nonmating prairie voles resulted in partner preference for males but not females. When oxytocin was blocked by antagonists in mating prairie voles, pair bonding in females was prevented and when vasopressin was blocked by antagonists, pair bonding in males was prevented (Insel & Hulihan, 1995).
In humans, oxytocin and vasopressin increase during sexual arousal, orgasm, and self-stimulation (Carmichael et al., 1987; Carmichael, Warburton, Dixen, & Davidson, 1994; Murphy, Seckl, Burton, Checkley, & Lightman, 1987). Other research has found an association between the release of oxytocin and affiliation cues toward a romantic partner (Gonzaga, Turner, Keltner, & Campos, 2006). Further research (Bartels & Zeki, 2004) has indicated that certain regions of the brain’s reward system that have an increased number of oxytocin and vaso-pressin receptors become activated when individuals view pictures of their romantic partners, while other regions of the brain that have been implicated as playing a role in negative emotions, such as judgment, become deactivated. Interestingly, some of the same regions activated for romantic love were activated for maternal love. Insel and Young (2001) have suggested that ‘‘for attachment to occur, these neuropep-tides must link social stimuli to dopamine pathways associated with reinforcement’’ (p. 135).
Early interactions with parents can lay the foundation for later romantic relationships, and thus, it is important to have insight into these formative relationships. Bowlby (1969) proposed that an attachment between parent and child develops based on parental responsiveness to infant needs. Ainsworth (1979) further noted that varying levels of parent responsiveness can result in different attachment styles. If a caregiver consistently responds to a child’s needs and distress, the child develops a ‘‘secure’’ attachment. Such children are able to explore their environment and cope with distress, knowing that their mother is nearby to help if needed. If a caregiver overreacts or inconsistently responds to a child’s needs, then an ‘‘ambivalent/anxious’’ attachment can result. These children may respond ambivalently to their mothers; at times, they may cling to them and at other times they may display anger toward them. If a caregiver does not respond at all or is rejecting of a child’s needs, then an ‘‘avoidant’’ attachment style can develop. Children with an avoidant attachment style often will appear detached from their mother and may not respond to their mother upon her return. Through the parent–child attachment, the child learns whether he or she can count on the parent to be there and whether he or she can turn to the parent during periods of distress. According to Bowlby (1973), these early interactions between parent and infant create what he referred to as ‘‘internal mental models’’ or blueprints for relationships. They tell individuals what to expect in a relationship, how to interpret different experiences within a relationship, and how to respond in relationships.
Support for the relationship of attachment to romantic relationships has been found; for example, perceiving parents as being supportive was found to be associated with perceiving romantic partners as supportive (Furman, Simon, Shaffer, & Bouchey, 2002). In another study, inappropriate physical or intimate contact and role-reversal behaviors (e.g., child nurturing the parent or acting in a caretaking role) by the parent during early adolescence were related to higher levels of physical perpetration and victimization within young adult romantic relationships (Linder & Collins, 2005). It could be that when individuals experience such negative interactions with their parents they do not learn how to regulate their emotions and deal with conflict in their romantic relationships (Linder & Collins, 2005).
Adult relationships and attachment styles can be characterized in much the same way as those between the parent and child (Hazan & Shaver, 1987). Young adults with secure attachment styles tend to have positive relationships. That is, they are more likely than those in the other attachment groups to value and experience intimacy within a relationship (Mikulincer & Erev, 1991; Monteoliva & Garcia-Martinez, 2005). They tend to experience more satisfaction and (p. 160) happiness and less loneliness in their romantic relationships (Hazan & Shaver, 1987; Monteoliva & Garcia-Martinez, 2005; Moore & Leung, 2002). Compared to those with other attachment styles, those with secure attachment styles perceive themselves more positively in terms of attractiveness (Bogaert & Sadava, 2002) and tend to be more comfortable communicating and expressing emotions and concerns within the romantic relationship (Furman & Simon, 2006). Given all this, it is not surprising that they experience more stability within the relationship and perceive the relationship as likely to endure (Hazan & Shaver, 1987; Monteoliva & Garcia-Martinez, 2005).
Individuals with anxious attachment styles seek and strongly desire intimacy but have difficulty achieving it (Hazan & Shaver, 1987). It could be that ambivalent persons interact with partners in a way that distances them from their partner or it could be that they choose partners who have little interest or ability to develop an intimate relationship. They tend to be dependent and jealous (Hazan & Shaver, 1987) and to fear abandonment (Bogaert & Sadava, 2002). Attachment anxiety is associated with increased sexual risk. Those with greater attachment anxiety compared to those with lower attachment anxiety have less confidence in using condoms and more negative beliefs about condoms, such as: ‘‘using condoms means they do not trust their partner’’ and ‘‘a partner would be upset if they used condoms’’ (Kershaw et al., 2007). In terms of sexual behavior, higher attachment anxiety is related to an earlier age of first intercourse, more lifetime sexual partners, more infidelity, less frequent communication with partners about contraception and HIV/AIDS, decreased use of condoms, and a greater likelihood of having unprotected sex with a risky partner (Bogaert & Sadava, 2002; Feeney, Peterson, Gallois, & Terry, 2000; Kershaw et al., 2007).
It has been thought that those with avoidant styles may be less interested than those with other attachment styles in developing close, committed sexual relationships. They are less likely to report qualities consistent with a well-functioning (e.g., satisfying) relationship, and they are more likely to fear intimacy and closeness (Hazan & Shaver, 1987), minimize or avoid discussing concerns in the relationship (Furman & Simon, 2006), and foresee the relationship as ending (Hazan & Shaver, 1987; Monteoliva & Garcia-Martinez, 2005). These findings are consistent with a more accepting view of casual sex (Feeney, Noller, & Patty, 1993) and to be more likely to engage in sex for manipulative reasons than those with secure or anxious attachment styles (Davis, Shaver, & Vernon, 2004).
Hence, these results suggest that in order to foster healthy sexuality, one most also foster the development of secure emotional attachments in early childhood. In addition, understanding individuals’ attachment styles may be useful when intervening therapeutically.
Social Cognitive Theory
According to social cognitive theory, individuals can develop skills and behaviors by observing or attending to models in their environment, storing the information learned, and then enacting on behaviors based on certain expected outcomes (Bandura, 1989). This theory would suggest that parents could play an influential role in their offspring’s development of romantic relationships through their modeling of behaviors in their own romantic relationships. Children observe parents interacting in their romantic relationship and learn to imitate these behaviors later on in their adult romantic relationships.
Research examining the relationship between family structure (i.e., married versus divorced) and young adult children’s romantic relationships found that those from married families tended to fare better in their romantic relationships than those from divorced families. For instance, young adult children from married/ intact families were more likely than those from divorced families to experience intimacy (Ensighn, Scherman, & Clark, 1998) and a secure attachment with their romantic partners (Summers, Forehand, Armistead, & Tannenbaum, 1998) and less likely to have negative perceptions of marriage (e.g., fears of relationship ending) (Wallerstein & Lewis, 2004). Maternal remarriage is also associated with positive outcomes; young adult children of mothers who remarry compared to young adult children of mothers who do not remarry reported (p. 161) increased intimacy and passion and fewer problems in romantic relationships (Shulman, Scharf, Lumer, & Maurer, 2001).
More recent research suggests that it may not be the family structure per se that is important but rather the specific attitudes and behaviors children witness in their parents’ romantic relationships. For instance, Cunningham and Thorton (2006) found a relationship between parents and young adult children’s attitudes toward premarital sex, cohabitation, and being single, especially when parents’ marital quality was high. In terms of behaviors, cross-sectional studies have found that interparental conflict was related to less intimacy in young adults’ romantic relationships (Ensighn et al., 1998) and more accepting attitudes of aggression in romantic relationships, including verbal and physical aggression toward romantic partners (Kinsfogel & Grych, 2004). In a longitudinal study, parental marital discord at age 13 predicted marital discord at age 30 years. This study further found that specific negative behaviors, such as jealousy, proneness to anger, and moodiness, were associated with poorer adult marriages (Amato & Booth, 2001). These findings taken together support social cognitive theory and suggest that parents need to be mindful of the behaviors they display and model in their romantic relationships.
Sullivan, Erikson, and Gilligan: Theories of Intimacy
Sullivan (1953) noted that preadolescence marks an important period with regard to the development of intimate relationships as it is during this time that individuals begin forming relationships with same-sex peers. He argued that although qualities necessary for romantic relationships, such as intimacy and closeness, are founded in parental relationships, the growth and enhancement of such qualities take place through friendships. For the first time, individuals learn to become sensitive to the needs of others and to develop and pursue common goals. Sullivan further proposed that after an individual develops same-sex relationships in preadolescence and opposite sex relationships in early adolescence, he or she can concentrate on developing a sense of self in late adolescence.
Recent research lends support to Sullivan’s theory of intimacy. Early friendships appear to serve as a practice ground for individuals to experiment with skills or competencies, such as reciprocity and cooperation. Relationships with best friends have been shown to have a direct effect on the capacity for closeness and commitment in romantic relationships (Scharf & Mayseless, 2001). Further, perceptions of support and negative interactions in current friendships are associated with perceptions in current romantic relationships (Connolly, Furman, & Konarski, 2000). Having better quality friendships also appears to serve as a protective factor against perpetration and victimization in later romantic relationships. It could be that individuals with positive experiences in friendships expect to have the same types of interactions in their romantic relationships or it could be that those with positive friendships possess the necessary skills (e.g., conflict resolution) to negotiate relationships effectively (Linder & Collins, 2005).
In keeping with Sullivan’s theory, research also has demonstrated that friendships mediate the connection between parent relationships and romantic relationships (Furman et al., 2002; Scharf & Mayseless, 2001). Similarities between friendships and romantic relationships, such as the contemporary nature of friendships with romantic relationships and the equal status associated with each, may help explain why friendships seem to play a more influential role. Also it is often through peer networks that romantic relationships emerge; hence, romantic relationships developing out of these peer networks are likely to be similar to the friendships existing within them (Connolly et al., 2000).
Erikson (1968) proposed that individuals develop through eight life stages that build on each other. At each stage, there is a psychosocial crisis to be addressed that includes both positive and negative poles. Erikson believed that during adolescence, the psychosocial crisis is ‘‘identity versus identity confusion’’ and that during young adulthood the psychosocial crisis is ‘‘intimacy versus isolation.’’ In order to develop an identity, Erikson noted that the adolescent ‘‘must make a series of ever-narrowing selections of personal, occupational, sexual, and ideological commitments’’ (1968, p. 245). According to him, a true (p. 162) sense of identity consists of ‘‘a feeling of being at home in one’s body, a sense of knowing where one is going, and an inner assuredness of anticipated recognition from those who count’’ (1968, p. 165). Given that he believed that each stage builds upon the other, Erikson theorized that identity must be fully formed in order for there to be real intimacy, which he described as a ‘‘counterpointing as well as a fusing of identities’’ (1968, p. 135). For Erikson, if a strong sense of identity is not established, one’s identity could get lost in the relationship.
Sullivan and Erikson’s theories of intimacy can seem contradictory. As noted above, Sullivan’s theory proposed that intimacy develops before identity and Erikson’s theory suggests the opposite—that identity must be present before intimacy develops. Researchers have examined the timing of identity and the timing of intimacy to help resolve this debate. According to a review of studies, there is some support for identity needing to be intact before intimacy can give rise, but this seems to be more true for men than for women (Orlofsky, 1993). This leads to another interesting point as to whether men and women differ with respect to identity and intimacy development. Carol Gilligan has argued that Erikson’s theory of identity development was male biased as it did not take into account the female perspective. According to Gilligan, identity may precede intimacy for males, but for women identity and intimacy develop simultaneously. She believed that women come to define themselves within the context of their relationships (Gilligan, 1979). When considering these differing views, it may be better not to conclude that one (i.e., identity or intimacy) precedes the other but rather to conclude that identity and intimacy are forever intertwined. That is, the more one develops a sense of self, the more able one is to seek out relationships and experience closeness, and the more one establishes intimacy in a relationship, the more one learns about oneself and is able to develop a stronger sense of self.
The Intimacy Process Model
Reiss and Patrick (1996) proposed an intimacy process model illustrating intimacy as a complex, continual process through which a series of interactions between two partners take place over time. In their model, each partner influences the other through his/her thoughts, feelings, and behavior. Communication of emotions is a central part of the intimacy process model as well as the response to the emotion. According to the model, the ‘‘self-disclosing person’’ either verbally or nonverbally expresses a thought or feeling to the ‘‘responsive listener.’’ Typically, individual factors (e.g., needs, values) as well as situational factors (e.g., goals of the relationship) influence what is expressed by the self-discloser. The responsive listener perceives the self-expression within his or her own framework of individual and situational factors and responds according to these. The response is interpreted within the self-disclosing person’s framework of individual and situational factors which thereby determines how the self-disclosing person feels about the response. If the self-disclosing person experiences the response as supportive, validating, and caring, then the interaction could be experienced as intimate. If the response is viewed by the self-discloser as distancing or rejecting, the interaction would not be experienced as intimate. The responsive listener then has a reaction to the self-discloser’s reaction. If the responsive listener’s response to the self-disclosing person is viewed in a positive manner, then the responsive listener will feel appreciated and valued. The more each person in the interaction feels validated or appreciated, the more likely intimate interactions are to occur in the future.
Reiss and Patrick (1996) further noted that attachment and intimacy have many commonalties. For instance, attachment and intimacy both involve a bond between two people, require individuals to regulate and express emotions, involve responsiveness to the other individual, and are associated with positive health outcomes.
Romantic and Sexual Relationships
Romantic relationships begin to evolve over the adolescent period, giving rise to young adult relationships. Although many young adolescents may show interest in dating, few report being in a current romantic relationship (Connolly, Craig, Goldberg, & Pepler, 1999; Feiring, 1996). If they are in a relationship, it is typically brief (p. 163) (Feiring, 1996), and it may be nonexclusive (Short et al., 2003). By late adolescence, romantic relationships are longer in duration as the dyad begins to take precedence over the peer group. Qualities, such as reciprocity and commitment, become more important in romantic relationships at this stage (Connolly & Goldberg, 1999).
During adolescence and young adulthood, individuals form their sexual identity, the label (e.g., heterosexual, homosexual) used by a person to define his or her sexual attractions, thoughts, and behaviors (Diamond, 2003). Previously, homosexual-committed relationships were thought to be pathological and inferior to heterosexual relationships (Roisman, Clausell, Holland, Fortuna, & Elieff, 2008). However, recent studies have not found this to be the case. Individuals in same- and opposite-sex committed relationships have been found to report similar levels of satisfaction and to perform similarly on observed measures of relationship quality (Roisman et al., 2008). Further, variables that predict relationship satisfaction and stability in heterosexual relationships also have been shown to predict relationship satisfaction and stability in homosexual relationships (Kurdek, 2004). Therefore, committed relationships appear to function the same way regardless of whether the relationship is same sex or opposite sex.
According to the National Survey of Adolescent and Young Adults: Sexual Health Knowledge, Attitudes, and Experiences, 11% of young adult males and 29% of young adult females reported that they were currently married, living as married, or had been married (Kaiser Family Foundation, 2003). Many young adults have a series of monogamous steady relationships. Within these relationships, a majority of young adults said that they feel that it is an expectation that they will have sex. In addition, they believe that it is expected that by a certain age they will be sexually experienced. This might help explain why 61% of the young adults surveyed believed that it is good idea to wait to have sex but at the same time acknowledged that most people do not wait (Kaiser Family Foundation, 2003). While most individuals believe that sex should occur within steady relationships, not all sexual encounters occur in a steady relationship. In the literature, such encounters have been referred to in a variety of ways, such as casual sex, hookups, one-night stands, and anonymous sex (Cubbins & Tanfer, 2000; Grello, Welsh, & Harper, 2006; Paul, McManus, & Hayes, 2000). Among a sample of undergraduate students, 53% reported having had sex with someone whom they were not romantically involved (Grello et al., 2006). One-third of these were with persons the individual did not know very well; the remainder was with friends. The latter has led to the term ‘‘friends with benefits.’’ These are relationships that are often emotionally intimate, involve occasional sex, but for some reason are not labeled as ‘‘boyfriend/girlfriend’’ relationships. Gender differences exist with regard to the frequency and impact of casual relationships. First, more males than females reported having engaged in a casual coital relationship (Grello et al., 2006; Paul et al., 2000). Second, while both genders reported entering relationships being aware that it was casual, more females than males believed that it could possibly evolve into a romantic relationship. Finally, although males who have had casual sex tend to have the fewest depressive symptoms, females who have had casual sex tend to have the most depressive symptoms (Grello et al., 2006).
Results from the national survey and other studies with young adult and college populations have indicated that by this age, most have engaged in some sexual behavior. For example, 80% of the young adults (18 to 24 years) in the National Survey of Adolescent and Young Adults: Sexual Health Knowledge, Attitudes, and Experiences (Kaiser Family Foundation, 2003) reported that they have had sexual intercourse. Almost one-fourth (24%) of the young adult virgins in this survey noted that they had engaged in ‘‘intimate’’ behavior with a partner and 12% said that they had experienced oral sex. While some individuals initiate intercourse during their early adolescent years, one in four stated that their first experience occurred in young adulthood (Kaiser Family Foundation, 2003). Most young adults with vaginal sex experience have had more than one sexual partner, with approximately 40% of the young adults in the national survey reporting having had between 2 to 5 lifetime sexual partners. Of concern is that 14% of them (p. 164) have had 10 or more lifetime sexual partners (Kaiser Family Foundation, 2003). Sexually experienced young adults engage in a variety of sexual behaviors; for example, 84% reported having had oral sex as well (Kaiser Family Foundation, 2003). The rates of heterosexual anal intercourse among nonvirgin college populations range between 20% to 32% (Baldwin & Baldwin, 2000; Civic, 2000; Flannery, Ellingson, Votaw, & Schaefer, 2003).
Gender and race/ethnic differences are apparent in sexual history/behavior of young adults. Young adult males have had more lifetime partners than females and report initiating intercourse at an earlier age. White adolescents/ young adults are more likely to have engaged in oral sex than African American and Latino ado-lescents/young adults; however, African American and Latino adolescent/young adults initiate sexual intercourse at earlier ages than white adolescents/young adults. African Americans also report having more partners. Asian American adolescents/young adults report the lowest rates of sexual activity (Kaiser Family Foundation, 2003).
Research has found that adolescents and young adults report that the most common reasons for engaging in sex are for sexual pleasure and intimacy-related purposes. Other reasons include coping with negative emotions, self-affirmation, partner approval, and peer approval. Motives for having sex have been found to differ by gender. Males tend to report a greater range of motives for having sex than women. Having sex for intimacy-related purposes appears to be protective against sexual risk-taking behavior. This could be because sexual behavior is more likely to occur within a monogamous, steady relationship (Cooper, Shapiro, & Powers, 1998).
Sexually Transmitted Infections
Over half of the 18.9million sexually transmitted infections (STIs) diagnosed every year are among young people ages 15 to 24 (Weinstock, Berman, & Cates, 2004). For example, Chlamydia is more prevalent among the 15- to 19-year old and 20- to 24-year-old age groups than any other age groups (Centers for Disease Control and Prevention, 2006) and the highest prevalence rate among women for the human papillomavirus is in the 20- to 24-year-old age group (Dunne et al., 2007). Sexually transmitted infections are not just found among those with multiple partners. Approximately 50% of those infected with an STI had only one partner within the last year (Ford, Jaccard, Millstein, Bardsley, & Miller, 2004). Women experience the burden of STIs, as they and their offspring can suffer serious long-term complications, including pelvic inflammatory disease, cervical cancer, pregnancy complications, infertility, neonatal complications, and even death (Aral, 2001; Boonstra, 2000; Hutto, 1987; Nahmias et al., 1971; Stagno & Whitley, 1999).
Despite the high prevalence rates of STIs among this age group, the majority of young adults do not perceive themselves to be at risk for STI infection (Ford et al., 2004), and many are not protecting themselves against STIs. For example, a study involving a national sample of young adults found that 55% percent reported using condoms ‘‘regularly’’ (Kaiser Family Foundation, 2003). Other studies with college students and military recruits suggest that inconsistent condom use can range from 64% to 71% (Civic, 2000; Hwang, Shafer, Pollack, Chang, & Boyer, 2007; Roberts & Kennedy, 2006). Even if condoms are used, they are often used ineffectively; one study with young adult women found that in the 3 months prior, 44% delayed condom use and 19% experienced condom slippage/ breakage (Civic et al., 2002). A recent literature review suggested that young people do not use condoms for the following reasons: lack of knowledge about STIs, low perceived risk, inaccurate assumption that oral contraceptives protect against STIs, male resistance to condoms, difficulties negotiating condom use (especially for women), and implication that condoms convey mistrust (East, Jackson, O’Briaen, & Peters, 2007).
Relationship Quality and Conflict
Previous research has indicated that the majority of late adolescent/young adults reported feeling satisfied in their romantic relationships (Auslander et al., 2007; Cramer, 2004). Support seems to play an influential role in relationship (p. 165) satisfaction with those reporting higher levels of support also reporting higher degrees of relationship satisfaction (Cramer, 2004). Over time, differences in opinion occur, and how individuals handle these differences also seems to be important with regard to relationship satisfaction. Among a college population, a negative conflict style (e.g., becoming irritated, avoiding discussion) was found to be associated with lower relationship satisfaction (Cramer, 2000).
Unfortunately, dating violence is not an uncommon event in young adulthood. According to a review of the literature conducted by Lewis and Fremouw (2001), the prevalence rates of physical violence within a romantic relationship typically fall between 21% and 45%. These rates are much higher when dating violence is defined more broadly to include both psychological and sexual victimization. In fact, in a longitudinal study following women through college, 88% of them reported that they had been verbally threatened, physically assaulted, or sexually assaulted by a romantic partner (Smith, White, & Holland, 2003). While one often thinks of dating violence as being one way, it can often be bidirectional. Among a sample of female college students, 28% reported both perpetrating violence and being victimized within dating relationship (Orcutt, Garcia, & Pickett, 2005). There are gender differences with regard to dating violence. Women tend to report at least equal but sometimes higher rates of perpetrating violence than men, while men tend to report higher rates of victimization than women. However, women tend to experience more consequences or injury from dating violence than do men (Orcutt et al., 2005). Longitudinal studies have indicated that previous exposure to violence, whether it be child physical abuse, witness to domestic violence as a child, or assault during adolescence, predicts dating violence in young adulthood (Linder & Collins, 2005; Smith et al., 2003).
Major developmental tasks of young adulthood include achieving intimacy and developing a healthy sense of sexuality. We are beginning to develop a better understanding of the role neurobiology plays in romantic attachments. A young adult’s ability to form satisfying, lasting, and healthy relationships appears to be largely influenced by his or her early relationshipswith parents and friends. It is easy to focus on the adverse outcomes of sexual relationships such as STIs; however, it is important to remember that sexuality is a natural part of these intimate relationships, can provide pleasure, and represents an important way to express closeness and intimacy.(p. 166)
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