Risky decision making in girls w/foster care involvement: Prevention implications

说明(由申请人提供)：有寄养参与的女孩可能特别容易受到虐待经历的负面影响，与寄养中的生物抚养的儿童和男孩相比，与同龄人相处的能力较差(Leve等人，2007年)。这些女孩经常经历高比率的性虐待和虐待，经历了无数次照顾者转变，并表现出危险的决策行为，这体现在她们参与吸毒、与年长的反社会男性的关系、她们的怀孕率以及她们参与危及健康的性行为，这些行为的代价是巨大的(Kerr等人，2008年；Leve&Chamberlain，2005a；2005b；Pawlby等人，1997；Underwood，1998)。了解这一人群的决策尤为重要，因为他们早孕的风险增加，并将风险传递给第二代。然而，关于参与寄养的青春期女孩的决策过程与风险决策相关的决策过程知之甚少。这项提议旨在弥合这一知识差距。目前的提案旨在进行假设驱动的探索性研究，以进一步了解决策可能如何与这些女孩的危及健康的性行为和药物使用有关。利用一个独特的机会来研究参与寄养的女孩的现有样本，样本由100名女孩组成，她们在进入中学之前参加了一项旨在预防吸毒、犯罪和危及健康的性行为的随机干预试验(R01 MH054257；2003年12月1日至2008年11月30日)。在拟议的研究中，我们打算解决四个研究问题。首先，我们将研究参与寄养的女孩决策过程的几个关键方面。具体地说，我们预测样本将显示出高水平的风险决策，无论是为了实现收益还是为了避免损失，加上对风险/回报或有变化的敏感度降低，这将标志着避免(或接近)风险选项(即适应性决策)。其次，我们将从女孩的早期经历来考察青春期风险决策的预测。第三，我们将研究危险决策与危及健康的性行为、吸毒和犯罪之间的关系。最后，我们将对以前进行的有组织的预防性干预对胜任决策技能的影响进行事后审查。拟议的工作将为后续项目提供必要的基础，这些项目旨在了解有寄养经历的青少年群体中适应性决策的神经基础，以及旨在前瞻性地检查这类人群决策过程的可塑性以最终降低吸毒和危及健康的性行为风险的项目。 公共卫生相关性：当前项目与确定可能与高风险决策有关的具体脆弱性因素具有直接相关性。此外，拟议的项目有可能对驱动现实生活中危及健康的行为的机制提供更深层次的概念化。这项工作有可能产生重要的见解，可能有助于研究人员开发干预措施，旨在促进高危人群中儿童更好的决策，最终减少药物使用和相关问题。

DESCRIPTION (provided by applicant): Girls with foster care involvement may be particularly vulnerable to the negative effects of maltreatment experiences, as indicated by poorer functioning with peers when compared to biologically-reared children and boys in foster care (Leve et al., 2007). These girls have often experienced high rates of sexual abuse and maltreatment, have had numerous caregiver transitions, and show risky decision-making behavior as evidenced by their engagement in drug use, their association with older antisocial males, their pregnancy rates, and their engagement in health-risking sexual behaviors, the costs of which are great (Kerr et al., 2008; Leve & Chamberlain, 2005a; 2005b; Pawlby et al., 1997; Underwood, 1998). It is particularly important to understand decision making in this population due to their increased risk for early pregnancy and the transmission of risk to a second generation. However, little is known about the decision-making processes associated with risky decision making in adolescent girls with foster care involvement. This proposal aims to bridge this gap in knowledge. The current proposal aims to conduct hypothesis-driven exploratory research to further the understanding of how decision making might be associated with health-risking sexual behaviors and drug use for these girls. Capitalizing on a unique opportunity to study an existing sample of girls with foster care involvement, the sample consists of 100 girls who participated in a randomized intervention trial prior to entering middle school that was aimed at preventing the onset of drug use, criminality, and health-risking sexual behaviors (R01 MH054257; December 1, 2003- November 30, 2008). In the proposed study, we intend to address four research questions. First, we will examine several key aspects of decision-making processes in girls with foster care involvement. Specifically, we predict that the sample will show high levels of risky decision making for both risks to achieve gains and ones to avoid losses, coupled with a diminished sensitivity to changes in risk/reward contingencies that would signal avoiding (or approaching) a risky option (i.e., adaptive decision making). Second, we will investigate the prediction of risky decision making during adolescence from the girls' early experiences. Third, we will examine associations between risky decision making and health-risking sexual behaviors, drug use, and delinquency. Finally, we will conduct a post-hoc examination of the effects of the previously conducted structured preventive intervention on competent decision-making skills. The proposed work will provide necessary groundwork for subsequent projects aimed at understanding the neural substrates of adaptive decision making in adolescent populations with foster care experiences, and projects aimed at prospectively examining the malleability of decision-making processes in such populations to ultimately reduce risk for drug use and health-risking sexual behavior. PUBLIC HEALTH RELEVANCE: The current project has direct relevance to identifying specific vulnerability factors that may be associated with risky decision making. Further, the proposed project has the potential to provide a deeper conceptualization of the mechanisms that drive real-life health-risking behaviors. This work has the potential to yield important insights that may help researchers develop interventions aimed at promoting better decision making in children in high-risk populations, ultimately reducing drug use and associated problems.