Reducing Alcohol-Related Sexual Risk Behavior

摘要 尽管大量间歇性饮酒(HED)和性侵犯行为(SAB)受到越来越多的关注，但高 发病率持续存在，现有的预防计划效果甚微。计划同时瞄准 HED和SAB可能更有效，因为大多数性侵犯发生在犯罪者、受害者或两者都有 喝多了。这样的项目在大学女生中显示出了一些希望，但只有一项小型公开试验(n= 20)对大学男生进行了一项调查。危险性行为(RSB)也与HED高度共存 和SAB。尽管针对HED和RSB的预防计划已经显示出这两种情况的减少 这项拟议的研究将第一次测试综合预防计划的有效性，该计划 同时瞄准SAB、HED和RSB。拟议中的研究还开辟了新的领域，将 来自尖端认知科学方法的技能培训。我们之前的研究表明，男性在 SAB的较高风险表明女性对性兴趣的认知存在基于表现的缺陷，而我们的 初步数据为认知训练的有效性提供了证据，在认知训练中，男性接受逐一试验和 对他们处理与女性性兴趣相关的线索的能力进行逐块反馈。成立为法团 认知训练部分可提高SAB预防方法的有效性，SAB通常具有 注重意识或教育，而不是技能发展。个性化反馈方法 代表了HED最有效的预防方法之一，类似的方法已经显示 承诺解决SAB的风险。通过将个性化反馈与认知技能培训相结合 方法，有可能针对SAB的关键可改变的危险因素，包括对性行为的误解 兴趣、强奸支持态度、同伴影响、HED和RSB。据我们所知，拟议的研究将 率先将个性化反馈和认知技能相结合--培训方法可降低男性患糖尿病的风险 实施SAB。这项拟议的研究将包括三个阶段，总共涉及190名性活跃和 酗酒的大学生。第一阶段将审查可行性(n=10)，第二阶段将是公开试验(n=40) 检查干预成分的可接受性和有效性。结果和定性数据来自 第二阶段的访谈将用于改进和简化干预。第三阶段规模较小(n=140) 随机对照试验(RCT)将这一新的计算机管理程序与常规服务进行比较 (SAU)。预防计划将包括两次计算机管理的会议(每次60-90分钟) 整合个性化反馈和认知训练方法。我们假设，相对于SAU， 预防计划将导致个性化反馈和认知训练目标的变化(例如， 对变化的准备和认知技能)，以及对HED、SAB和 RSB。这项初步研究的结果将支持完全基于网络的计划的更大规模的临床试验，以及 这种做法很容易在广泛的范围内实施，而且很可能会受到年轻人的欢迎。

Abstract Despite increased attention to heavy episodic drinking (HED) and sexually aggressive behavior (SAB), high rates persist, and existing prevention programs are minimally effective. Programs that simultaneously target HED and SAB may be more effective as most sexual assaults occur when the perpetrator, victim, or both have been drinking. Such programs have shown some promise in college women but only one small open trial (n = 20) has been conducted with college men. Risky sexual behaviors (RSB) are also highly comorbid with HED and SAB. Although prevention programs targeting HED and RSB have demonstrated reductions in both behaviors, the proposed study will be the first to test the efficacy of an integrative prevention program that simultaneously targets SAB, HED, and RSB. The proposed study also breaks new ground by incorporating skills training derived from cutting-edge cognitive science methods. Our prior research shows that men at higher risk for SAB demonstrate performance-based deficits in perceptions of women’s sexual interest, and our preliminary data provide evidence for the efficacy of cognitive training, in which men receive trial-by-trial and block-by-block feedback on their ability to process cues relevant to women’s sexual interest. Incorporation of a cognitive training component may increase the efficacy of prevention approaches for SAB, which have typically focused on awareness or education rather than skill development. Personalized feedback approaches represent one of the most effective prevention approaches for HED and similar approaches have shown promise in addressing risk for SAB. By combining personalized feedback and cognitive skills training approaches, it is possible to target the key modifiable risk factors for SAB, including misperceptions of sexual interest, rape supportive attitudes, peer influence, HED, and RSB. To our knowledge, the proposed study will be the first to integrate personalized feedback and cognitive skills-training approaches to reduce men’s risk of perpetrating SAB. The proposed study will include three phases and involve a total of 190 sexually active and heavy drinking college men. Phase I will examine feasibility (n = 10), and Phase II will be an open trial (n = 40) examining the acceptability and efficacy of intervention components. Outcome and qualitative data from interviews in Phase II will be used to refine and streamline the intervention. Phase III will be a small (n = 140) randomized controlled trial (RCT) comparing this novel computer-administered program to services as usual (SAU). The prevention program will include two computer-administered sessions (60-90 minutes each) integrating personalized feedback and cognitive-training approaches. We hypothesize that, relative to SAU, the prevention program will lead to changes in personalized feedback and cognitive training targets (e.g., readiness to change and cognitive skills) and less engagement in and attitudes supportive of HED, SAB, and RSB. Findings of this preliminary study will support a larger clinical trial of a fully web-based program, an approach that could easily be implemented on a broad scale and is likely to be well received by young adults.