Psychological and Cognitive Mechanisms of Sexual Compulsivity and HIV Risk

性强迫症和艾滋病毒风险的心理和认知机制

• 批准号: 8299467
• 负责人: MICHAEL H MINER
• 金额: $ 36.64万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-07-11 至 2014-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8299467
• 关键词: AIDS prevention; Accounting; Address; Affect; Anus; Anxiety; Arousal; Behavior; Behavior Control; Behavioral; Behavioral inhibition; Characteristics; Cognitive; Communities; Conflict (Psychology); Controlled Study; Data; Depressed mood; Development; Disease; Disinhibition; Emotional; Emotions; Equation; Future; HIV; HIV Seropositivity; Healthcare; Impairment; Impulsivity; Individual; Intervention; Knowledge; Lead; Libido; Measures; Mental Depression; Methods; Modeling; Monitor; Multiple Partners; Neighborhoods; Neurologic; Newspapers; Outcome; Participant; Patient Self-Report; Population; Prevention; Prevention approach; Process; Psychological reinforcement; Psychometrics; Public Health; Recruitment Activity; Regulation; Research; Research Project Grants; Reversal Learning; Rewards; Risk; Self Efficacy; Services; Sex Behavior; Sexual Arousal; Sexual Partners; Short-Term Memory; Sorting - Cell Movement; Source; Stimulus; Substance abuse problem; Syndrome; Training; Unsafe Sex; addiction; base; behavior change; behavior influence; case control; cognitive control; condoms; design; discounting; effective intervention; high risk sexual behavior; improved; male; men who have sex with men; negative mood; novel; psychologic; safer sex; sex risk; sexual encounter; theories; therapy development; transmission process; treatment program

DESCRIPTION (provided by applicant): Project Summary Sexual Compulsivity (SC), or high levels of sexual behavior combined with a perceived lack of control, is strongly associated with unprotected sex and other HIV sexual risk behaviors. This association has been ro- bust across populations, but particularly strong in men who have sex with men (MSM). This proposal builds on our previous research which found that SC is associated with sero-discordant unprotected anal intercourse in HIV-positive MSM even after controlling for other known correlates (e.g., condom use self-efficacy, intentions to practice safer sex, etc.). However, while the association between SC and unsafe sex has considerable em- pirical support, the manner in which SC confers this increased risk, and therefore how to best influence such processes in order to reduce risk, is as yet, unknown. SC has been conceptualized as an addictive disorder, an impulsive disorder, and as a compulsive disorder. Others have questioned the existence of SC as a defin-able disorder and attribute the increased sexual behavior to high sex drive. Common across all conceptualiza-tions are four factors: negative affect, sexual arousal, behavioral inhibition, and cognitive control. These fac- tors influence HIV risk by interfering with the ability to manage one's sexual impulses, which would lead to multiple sexual encounters, and through impairments in the ability to consider multiple reinforcement contin- gencies and to consider the long-term consequences of pleasurable behavior which interferes with condom use. This study will provide needed empirical data to clarify the characteristics of SC and how it leads to in- creased levels of HIV sexual risk behavior. Specifically, this study uses a case-control design to compare two groups of MSM, 125 MSM with SC and 125 MSM without SC. We will recruit participants from the community using Craig's list, a newspaper that targets the GLBT community, and posting flyers in neighborhoods with high concentrations of GLBT residents. We will also recruit from a treatment program that provides services for substance abuse and sexual compulsivity in GLBT individuals. Our study explores the relationship between sexual arousal and negative mood by measuring sexual arousal to erotic stimuli following the induction of two types of negative mood (depression and anxiety). We explore the influence of behavioral activation, sexual excitation, behavioral inhibition, and sexual inhibition by the use of four standardized psychometric measures, and we explore the influence of cognitive control through the use of three cognitive tasks: the Stroop task that measures conflict monitoring, the Reversal learning task that measures inhibitory control, and the Delayed dis- counting task that measures the tendency to favor either smaller immediate or larger delayed rewards. This multi-method strategy will allow us to characterize SC and to provide needed empirical data to identify, and therefore help address, the underlying mechanisms that influence unsafe sexual behavior. The findings of this study will further a nuanced approach to the development of interventions and allow for targeting the most re- source-intensive prevention efforts at those individuals most likely to spread HIV. N:\SPA Research\Grants\Miner RO1 resubmssion Jan_2011\Final Documents\Project Summary 12-30-2010.docx

描述（由申请人提供）：项目概述性强迫（SC），或高水平的性行为加上缺乏控制，与无保护的性行为和其他艾滋病毒性风险行为密切相关。这种关联在人群中并不普遍，但在男男性行为者（MSM）中尤为明显。这一建议建立在我们之前的研究基础上，该研究发现，即使在控制了其他已知的相关因素（例如，避孕套使用的自我效能，进行更安全的性行为的意图等）之后，SC与hiv阳性MSM中血清不一致的无保护肛交有关。然而，尽管SC与不安全性行为之间的关联有相当多的实证支持，但SC赋予这种增加风险的方式，以及因此如何最好地影响这些过程以降低风险，目前尚不清楚。SC已被概念化为成瘾障碍，冲动障碍和强迫症。其他人质疑SC作为一种可定义的障碍的存在，并将性行为的增加归因于强烈的性欲。所有概念化的共同因素有四个：负面影响、性唤起、行为抑制和认知控制。这些因素影响艾滋病毒的风险，因为它们干扰了一个人控制性冲动的能力，而性冲动会导致多次性接触，它们损害了一个人考虑多重强化偶发事件的能力，也损害了一个人考虑干扰使用避孕套的愉快行为的长期后果的能力。本研究将提供必要的经验数据，以阐明SC的特征及其如何导致HIV性风险行为水平的增加。具体来说，本研究采用病例对照设计来比较两组男男性行为者，125名男男性行为者与125名男男性行为者，125名男男性行为者与125名男男性行为者，我们将使用Craig's list（一份针对GLBT群体的报纸）从社区招募参与者，并在GLBT居民高度集中的社区张贴传单。我们还将从一个治疗项目中招募人员，该项目为lgbt人群提供药物滥用和性强迫症的治疗服务。本研究通过测量两种负性情绪（抑郁和焦虑）诱导后的性唤起，探讨了性唤起与负性情绪之间的关系。我们通过使用四种标准化的心理测量方法来探索行为激活、性兴奋、行为抑制和性抑制的影响，并通过使用三个认知任务来探索认知控制的影响：测量冲突监控的Stroop任务，测量抑制控制的逆转学习任务，以及测量倾向于较小的即时奖励或较大的延迟奖励的延迟计数任务。这种多方法策略将使我们能够描述性行为的特征，并提供必要的经验数据来识别，从而帮助解决影响不安全性行为的潜在机制。这项研究的发现将进一步为干预措施的发展提供一种细致入微的方法，并允许针对那些最有可能传播艾滋病毒的个体进行最密集的资源预防工作。N:\SPA Research\Grants\Miner RO1重新提交Jan_2011\最终文件\项目总结12-30-2010.docx