Emotion Dysregulation and Risky Behavior Among People Who Inject Drugs

 描述：注射吸毒者共用注射器和其他注射设备(PWID)是传播和感染包括艾滋病毒和丙型肝炎在内的血液传播疾病的一个重要风险因素。最近对芝加哥大都会地区的年轻PWID进行的一项研究发现，在过去六个月中，超过40%的人使用共用注射器，超过75%的人共用其他注射设备。这项研究还发现，物质诱导性抑郁症(SIMD)和边缘性人格障碍(BPD)与共用接受性注射器显著相关。情绪失调是BPD的一个标志性症状，并与严重的抑郁障碍有关。这些发现指出了负面情绪和情绪调节困难在维持注射风险行为方面的可能作用。针对PWID的预防干预计划可能有助于解决这些问题，但需要进一步的研究来阐明驱动青少年PWID中负面情绪、情绪失调和HIV/丙型肝炎危险行为之间联系的机制。为了更全面地了解情绪失调与艾滋病毒/丙型肝炎病毒危险行为之间的关系，我们需要在日常活动的背景下实时收集数据。生态瞬时评估(EMA)是一种收集此类数据的方法，通常使用手持计算机或移动电话等便携式电子设备。这种方法大大减少了与回溯回忆相关的偏见，并可以捕捉到情绪和行为随着时间的推移而产生的相互影响。我们将使用分层随机时间抽样设计，在两周的时间内获得PWID的情绪状态、物质使用和注射行为的代表性样本。将进行基线评估，以评估心理健康和情绪失调。本研究将测试生态瞬时评估(EMA)用于研究注射毒品青少年(PWID)情绪和行为的可接受性和可行性，并将收集日常活动背景下青少年PWID情绪调节、情绪和注射行为的初步数据。这项研究的结果将有助于开展一项更大规模的研究，以检验PWID患者的负面情绪、情绪失调和注射风险行为之间的关系。本研究将对有情绪调节困难的PWID的干预实践，减少危险注射行为，促进药物使用和心理健康的进入治疗具有一定的指导意义。

 DESCRIPTION: Sharing of syringes and other injection equipment among people who inject drugs (PWID) is a significant risk factor for transmission and acquisition of blood-borne diseases including HIV and hepatitis C. A recent study of young PWID in the Chicago metropolitan area found that over 40% used a shared syringe, and over 75% shared other injection equipment in the past six months. This study also found that substance- induced major depression (SIMD) and borderline personality disorder (BPD) were significantly associated with receptive syringe sharing. Emotion dysregulation is a hallmark symptom of BPD, and is implicated in major depressive disorders. These findings point to the possible role of negative affect and emotion regulation difficulties in perpetuating injection risk behavior. Prevention intervention programs for PWID may be able to help address these problems, however further research is needed to elucidate the mechanisms that drive the linkages between negative affect, emotion dysregulation and HIV/HCV risk behavior among young PWID. In order to more fully understand the relationship between emotion dysregulation and HIV/HCV risk behavior, we need to collect data in real-time, in the context of everyday activities. Ecological momentary assessment (EMA) is a method for collecting such data, commonly using a portable electronic device such as a handheld computer or mobile phone. This methodology greatly reduces biases associated with retrospective recall, and can capture the interplay of mood and behavior over time. We will use a stratified random time-sampling design to obtain a representative sample of PWID's emotional state, substance use, and injection behavior over a 2-week period. Baseline assessments will be conducted to evaluate mental health and emotion dysregulation. This study will test the acceptability and feasibility of ecological momentary assessment (EMA) to study mood and behavior in young people who inject drugs (PWID), and will gather preliminary data on emotion regulation, mood, and injection behavior among young PWID in the context of everyday activities. The results of this study will inform the development of a larger study to examine the associations among negative affect, emotion dysregulation, and injection risk behavior in PWID. This research will have implications for intervention practices for PWID with emotion regulation difficulties, to reduce risky injection behavior and to promote entry into treatment for substance use and mental health.