Alcohol and Implicit Process in Sexual Risk Behavior in MSM

MSM 性危险行为中的酒精和内隐过程

• 批准号: 9269425
• 负责人: STEPHEN A MAISTO
• 金额: $ 6.41万
• 依托单位: SYRACUSE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-07-20 至 2020-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9269425
• 关键词: AIDS/HIV problem; Address; Affect; Affective; Alcohol consumption; Alcohol or Other Drugs use; Alcoholic Intoxication; Alcohols; Behavior; Behavioral; Beverages; Blood alcohol level measurement; Brain; Clinical Psychology; Cognition; Computers; Consumption; Contracts; Coupled; Decision Making; Development; Dimensions; Dose; Effectiveness of Interventions; Environment; Evaluation; Event; Foundations; Future; HIV; HIV risk; Health; Heating; Incidence; Individual; Infection; Intoxication; Judgment; Knowledge; Laboratories; Literature; Longitudinal Studies; Measures; Memory; Methods; Modeling; Motivation; Participant; Personal Satisfaction; Placebo Control; Population; Prefrontal Cortex; Prevention; Process; Public Health; Randomized; Research; Rewards; Risk; Risk Behaviors; Role; Sampling; Sampling Studies; Self-control as a personality trait; Short-Term Memory; Social Psychology; Stimulus; Structure; Substance abuse problem; Testing; Water; analog; approach behavior; cognitive control; cognitive neuroscience; conditioning; design; developmental psychology; executive function; experience; high risk; high risk sexual behavior; improved; innovation; men who have sex with men; novel; research study; response; sex; sex risk; sexual risk taking; simulation; skills; therapy design

DESCRIPTION (provided by applicant): This proposal focuses on two aims of PA-11-006: Substance Use and Abuse, Risky Decision Making and HIV/AIDS: 1) How does substance use shift the contribution of explicit (effortful) versus implicit (automatic) processes in decision-making about HIV-risk behavior, and 2) How do laboratory methods and simulations relate to real world risky behavior? The study incorporates an innovative pairing of an alcohol administration experiment with a subsequent experience sampling (ESM) study to test the external validity of the laboratory results. Interventions designed to reduce HIV risk behavior frequently focus on educating people about risks, increasing their motivation to avoid risks, and improving skills congruent with healthy choice. However, there are considerable gaps in knowledge about the processes involved in risky choice "during the heat of the moment." Incorporating research on automatic processes, implicit cognition, and associative memory into the study and prevention of health risk behaviors is an important and largely unrealized opportunity for improving public health (Stacy et al., 2010). Automatic evaluations and approach biases can be successfully retrained via conditioning, resulting in corresponding changes in behavior (Chen & Bargh, 1999; Houben et al., 2010; Wiers et al., 2010). Research in diverse fields supports a dual-process model of self-control. Such models posit that self-control consists of two dimensions, a fast acting, reflexive, "automatic" dimension and a slower acting, deliberative or effortful dimension (Lieberman, 2007; Wiers et al., 2007). Automatic, reflexive, control emphasizes affective processes, while the effortful control dimension may consist largely of higher-order "executive" control processes (Lieberman, 2007). Risky sexual behavior may result when the strength of automatic approach behaviors exceeds the strength of deliberative cognitive control processes. The proposed experimental study seeks to improve understanding of the role of alcohol, implicit processes, and effortful control in risky sexual choice in men who have sex with men (MSM). We propose that alcohol intoxication increases the strength of relatively automatic approach biases toward sexual stimuli while simultaneously decreasing the role of more deliberative decision-making processes controlled by executive brain functions. This shift toward more implicit or automatic processes coupled with the decreased role of explicit decision- making processes increases the likelihood of sexual risk behavior and potentially limits the effectiveness of interventions that focus solely on explicit processes to promote behavioral change. The long-term aim of this research is explicating processes occurring in the "heat of the moment" when an individual's better judgment seems conspicuously absent and the drive for immediate gratification peaks. The proposed study will lay a foundation for innovative approaches to treatment that address both automatic and effortful processes to reduce sexual risk behavior in MSM.

描述（由申请人提供）：本提案侧重于PA-11-006的两个目标：物质使用和滥用、风险决策和HIV/AIDS：1）物质使用如何改变HIV风险行为决策中外显（努力）与内隐（自动）过程的贡献，以及2）实验室方法和模拟如何与真实的世界风险行为相关？该研究采用了一种创新的配对酒精管理实验与随后的经验抽样（ESM）研究，以测试实验室结果的外部效度。旨在减少艾滋病毒风险行为的干预措施往往侧重于教育人们了解风险，提高他们避免风险的动机，并提高与健康选择相一致的技能。然而，在“一时冲动”下，对风险选择所涉及的过程的认识存在相当大的差距。“将对自动过程、内隐认知和联想记忆的研究扩展到对健康风险行为的研究和预防中，是改善公共健康的一个重要但在很大程度上尚未实现的机会（斯泰西等人，2010年）。自动评估和接近偏差可以通过条件反射成功地重新训练，从而导致行为的相应变化（Chen & Bargh，1999; Houben et al.，2010; Wiers等人，2010年）。不同领域的研究支持自我控制的双重过程模型。这种模型表明，自我控制由两个维度组成，一个是快速行动的，反射的，“自动”维度，另一个是缓慢行动的，深思熟虑的或努力的维度（Lieberman，2007; Wiers等人，2007年）。自动，反射，控制强调情感过程，而努力控制维度可能主要由高阶“执行”控制过程组成（Lieberman，2007）。当自动接近行为的强度超过审慎认知控制过程的强度时，可能会导致危险的性行为。这项拟议的实验研究旨在提高对酒精、内隐过程和努力控制在男性风险性选择中的作用的理解， 与男性发生性关系（MSM）。我们认为，酒精中毒增加了对性刺激的相对自动的方法偏见的强度，同时减少了执行大脑功能控制的更多的深思熟虑的决策过程的作用。这种向更多内隐或自动过程的转变，加上外显决策过程的作用下降，增加了性风险行为的可能性，并可能限制了只关注外显过程以促进行为改变的干预措施的有效性。这项研究的长期目标是解释发生在“瞬间的热度”时的过程，当一个人的更好的判断似乎明显缺乏，立即满足的驱动力达到顶峰。这项拟议的研究将为创新的治疗方法奠定基础，解决自动和努力的过程，以减少男男性接触者的性风险行为。