Distress Tolerance: Links with Family Emotional Climate and Adolescent HIV Risk

痛苦耐受力：与家庭情绪氛围和青少年艾滋病毒风险的联系

• 批准号: 7554516
• 负责人: JUDE A CASSIDY
• 金额: $ 22.5万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-25 至 2010-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7554516
• 关键词: 12 year old; 16 year old; Address; Adolescent; Adult; Alcohol or Other Drugs use; Behavior; Behavioral Mechanisms; Child; Climate; Cognition; Cross-Sectional Studies; Data; Data Set; Daughter; Development; Distress; Emotional; Ethnic Origin; Family; Family Relationship; Gender Role; Genetic Predisposition to Disease; Goals; HIV; Individual; Laboratories; Link; Literature; Longitudinal Studies; Mediating; Mediator of activation protein; Modeling; Mothers; Negative Reinforcements; Participant; Public Health; Research; Risk; Risk Behaviors; Risk Factors; Risk-Taking; Role; Substance abuse problem; Time; Work; adolescent substance use; base; behavior measurement; cost effective; drug abuser; emotional distress; high risk sexual behavior; innovation; intervention program; response; theories

DESCRIPTION (provided by applicant): Converging evidence indicates that an individual's difficulty tolerating distress has important links to substance abuse, a key behavior that places adolescents at risk for HIV (Brandon et al., 2003; Brown, Lejuez, Kahler, & Strong, 2002; Daughters, Lejuez, Bornovalova et al., 2005; Daughters, Lejuez, Kahler et al., 2005; Quinn, Brandon, & Copeland, 1996). This body of research has emerged from studies with adult drug abusers utilizing behavioral measures of distress tolerance to assess one's ability to persist in goal directed behavior in the presence of intense emotional discomfort, or simply, one's ability to effectively tolerate emotional distress. More recently, we have established a similar link in adolescents (Daughters, Lejuez et al., 2007). Although links of low distress tolerance with risky sexual behavior have not been examined previously, there are theoretical and empirical reasons that suggest that this link may exist as well (see Lejuez, 2007). Given compelling evidence that an individual's difficulty tolerating distress has important links to substance abuse, and potential links to risky sexual behavior, attempts to understand the precursors of distress tolerance in adolescents have considerable public health relevance. Several theoretical perspectives and considerable empirical evidence suggest that the emotional climate of the family and the quality of family relationships have major implications for a child's functioning, including engagement in risk behaviors (e.g., Bornstein, 2002; Maccoby, 2007). Further, examination of theory and research (e.g., Bowlby, 1969/1982; Cassidy & Shaver, 1999; Eisenberg et al., 1998; Gottman et al., 1996, 1997) suggests two aspects of family emotional climate that may be linked to adolescent distress tolerance: (a) maternal response to distress, and (b) adolescent attachment. Thus, it appears useful to examine links between family factors and adolescent capacity to tolerate emotional distress, and the subsequent development of HIV risk behavior. The proposed cross-sectional study has several goals. First, we seek to extend previous work examining links between adolescent distress tolerance and HIV risk behavior by providing further evidence of the link between adolescent distress tolerance and substance use, as well as by examining, for the first time, the link between distress tolerance and risky sexual behavior. Second, we will attempt to elucidate risk factors for low distress tolerance by focusing on the family emotional climate. Finally, in the context of a negative- reinforcement-based model of HIV risk, we will examine distress tolerance as a mediator of the link between family emotional context and HIV risk behavior. An advantage of this study is that participants (240 13- to 16- year-olds) will be taken from an ongoing longitudinal study of HIV risk behavior that does not address family emotional climate. This approach is cost effective and provides opportunities to enhance an existing data set including other relevant indicators of HIV from genetic vulnerability and environmental adversity through behavioral measurement of risk-taking propensity. PUBLIC HEALTH RELEVANCE Considerable evidence indicates that difficulties persisting in goal-directed behavior in the context of emotional distress (distress intolerance) is linked to substance use problems. We will expand the scope of this work in two important and innovative ways: (a) by examining whether distress intolerance is also linked to risky sexual behavior, and (b) by considering whether distress intolerance can be predicted by family emotional context. Because these data will contribute to the development of a more comprehensive model of vulnerability to HIV risk behavior, they will in turn be useful in creating effective intervention programs.

描述(由申请人提供)：越来越多的证据表明，个人难以忍受痛苦与药物滥用有重要联系，这是一种将青少年置于艾滋病毒风险中的关键行为(Brandon等人，2003；Brown，Lejuez，Kahler，&Strong，2002；Daughters，Lejuez，Bornovalova等人，2005；Daughters，Lejuez，Kahler等人，2005；Quinn，Brandon，&Copeland，1996)。这项研究源于对成年吸毒者的研究，他们使用痛苦耐受性的行为测量来评估一个人在存在强烈的情绪不适时坚持目标导向行为的能力，或者仅仅是一个人有效忍受情绪痛苦的能力。最近，我们在青少年中建立了类似的联系(女儿，Lejuez等人，2007年)。尽管以前没有研究过低痛苦耐受性与危险性行为的联系，但有理论和经验上的理由表明，这种联系也可能存在(见Lejuez，2007)。鉴于令人信服的证据表明，一个人难以忍受痛苦与滥用药物有重要联系，并可能与危险的性行为有关，试图了解青少年承受痛苦的前兆具有相当大的公共卫生意义。一些理论观点和大量的经验证据表明，家庭的情感氛围和家庭关系的质量对儿童的功能有重大影响，包括参与危险行为(例如，Bornstein，2002；Maccoby，2007)。此外，对理论和研究(例如，Bowlby，1969/1982；Cassidy&Shaver，1999；Eisenberg et al.，1998；Gottman et al.，1996,1997)的研究表明，家庭情绪氛围的两个方面可能与青少年的痛苦承受能力有关：(A)母亲对痛苦的反应，以及(B)青少年依恋。因此，研究家庭因素与青少年忍受情绪困扰的能力以及随后发展的艾滋病毒危险行为之间的联系似乎是有用的。这项拟议的横断面研究有几个目标。首先，我们试图通过提供青春期痛苦耐受性和药物使用之间联系的进一步证据，以及首次研究痛苦耐受性和危险性行为之间的联系，来扩展之前研究青少年痛苦耐受性和艾滋病毒危险行为之间的联系。其次，我们将试图通过关注家庭情绪氛围来阐明低痛苦耐受性的危险因素。最后，在基于负面强化的艾滋病毒风险模型的背景下，我们将考察痛苦耐受性作为家庭情感背景和艾滋病毒风险行为之间联系的中介。这项研究的一个好处是，参与者(240名13至16岁的青少年)将从一项正在进行的艾滋病毒风险行为的纵向研究中获得，该研究没有涉及家庭情感氛围。这一办法具有成本效益，并提供了机会，通过对冒险倾向的行为衡量，加强现有的数据集，包括遗传脆弱性和环境逆境中艾滋病毒的其他相关指标。 与公共健康相关大量证据表明，在情绪困扰(痛苦不耐受)背景下难以坚持目标导向的行为与物质使用问题有关。我们将以两种重要和创新的方式扩大这项工作的范围：(A)研究痛苦不容忍是否也与危险的性行为有关，以及(B)考虑家庭情感背景是否可以预测痛苦不容忍。由于这些数据将有助于开发更全面的艾滋病毒风险行为易感性模型，它们反过来将有助于创建有效的干预计划。