The role of attachment and emotion regulation difficultiesin predicting aggressiveness and self-injurious behavior in male subjects with substance use disorder

The main purpose of this study is to examine the effects of attachment, psychopathology and emotion regulation difficulties in predicting aggression and self-injurious behavior in males with substance use disorder. In addition, the mediating role of emotion regulation difficulties between attachment and aggression and self-injurious behavior was also investigated. 252 males with substance use disorder participated in the study. Attachment (RSQ), emotional regulation difficulties (DERS), psychopathology (BSE), aggression (AQ) and self-injurious behaviors (ISAS) were measured by self-reportscales. The effects of variables on aggression and self-injurious behavior were assessed by hierarchical regression analysis. The findings of the research revealed that attachment, difficulties in regulating emotion, and psychopathology hierarchically predicted both aggression and self-injurious behavior. The findings also revealed that difficulties in emotion regulation mediated the relation between attachment and aggression and self-injurious behavior. According to findings, in men with substance use disorder, aggression level tend to increase as hostility, insecure attachment and anxiety levels increase. When attachment and psychopathology are controlled, the lack of emotion regulation strategies and the increase in impulsiveness are associated with increased aggression. Moreover, when negative emotions are experienced, lack of appropriate emotion regulation strategies, increased impulsivity and hostility increase the likelihood of exhibiting self-injurious behavior. Hostility and emotion dysregulation are significant risk factors that increase self-injurious behavior in men with substance use disorder. While difficulties in emotion regulation have a partial mediating effect between fearful attachment and aggression, there is no significant mediating relationship between other insecure attachment styles (preoccupied, dismissing) and aggression. On the other hand, while difficulties in emotion regulation have a full mediating effect between fearful attachment and self-injurious behavior, there is no significant mediating effect between self-injurious behavior and other forms of insecure attachment (preoccupied, dismissing). These findings emphasize the importance of hostility, secure attachment, use of appropriate emotion regulation strategies, and controlof impulsivity while experiencing negativeemotions in the prevention of aggression and self-injurious behavior in men with substance use disorders. Keywords: Substance use disorders; Adult attachment; Difficulties in emotion regulation; Non-suicidal self-injurious behavior; Aggression.