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Distress Tolerance: Links with Family Emotional Climate and Adolescent HIV Risk

痛苦耐受力：与家庭情绪氛围和青少年艾滋病毒风险的联系

基本信息

批准号：
7690298
负责人：
JUDE A CASSIDY
金额：
$ 18.75万
依托单位：
UNIV OF MARYLAND, COLLEGE PARK
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-09-25 至 2011-07-31
项目状态：
已结题

项目摘要

DESCRIPTION (provided by applicant): Converging evidence indicates that an individual's difficulty tolerating distress has important links to substance abuse, a key behavior that places adolescents at risk for HIV (Brandon et al., 2003; Brown, Lejuez, Kahler, & Strong, 2002; Daughters, Lejuez, Bornovalova et al., 2005; Daughters, Lejuez, Kahler et al., 2005; Quinn, Brandon, & Copeland, 1996). This body of research has emerged from studies with adult drug abusers utilizing behavioral measures of distress tolerance to assess one's ability to persist in goal directed behavior in the presence of intense emotional discomfort, or simply, one's ability to effectively tolerate emotional distress. More recently, we have established a similar link in adolescents (Daughters, Lejuez et al., 2007). Although links of low distress tolerance with risky sexual behavior have not been examined previously, there are theoretical and empirical reasons that suggest that this link may exist as well (see Lejuez, 2007). Given compelling evidence that an individual's difficulty tolerating distress has important links to substance abuse, and potential links to risky sexual behavior, attempts to understand the precursors of distress tolerance in adolescents have considerable public health relevance. Several theoretical perspectives and considerable empirical evidence suggest that the emotional climate of the family and the quality of family relationships have major implications for a child's functioning, including engagement in risk behaviors (e.g., Bornstein, 2002; Maccoby, 2007). Further, examination of theory and research (e.g., Bowlby, 1969/1982; Cassidy & Shaver, 1999; Eisenberg et al., 1998; Gottman et al., 1996, 1997) suggests two aspects of family emotional climate that may be linked to adolescent distress tolerance: (a) maternal response to distress, and (b) adolescent attachment. Thus, it appears useful to examine links between family factors and adolescent capacity to tolerate emotional distress, and the subsequent development of HIV risk behavior. The proposed cross-sectional study has several goals. First, we seek to extend previous work examining links between adolescent distress tolerance and HIV risk behavior by providing further evidence of the link between adolescent distress tolerance and substance use, as well as by examining, for the first time, the link between distress tolerance and risky sexual behavior. Second, we will attempt to elucidate risk factors for low distress tolerance by focusing on the family emotional climate. Finally, in the context of a negative- reinforcement-based model of HIV risk, we will examine distress tolerance as a mediator of the link between family emotional context and HIV risk behavior. An advantage of this study is that participants (240 13- to 16- year-olds) will be taken from an ongoing longitudinal study of HIV risk behavior that does not address family emotional climate. This approach is cost effective and provides opportunities to enhance an existing data set including other relevant indicators of HIV from genetic vulnerability and environmental adversity through behavioral measurement of risk-taking propensity. PUBLIC HEALTH RELEVANCE Considerable evidence indicates that difficulties persisting in goal-directed behavior in the context of emotional distress (distress intolerance) is linked to substance use problems. We will expand the scope of this work in two important and innovative ways: (a) by examining whether distress intolerance is also linked to risky sexual behavior, and (b) by considering whether distress intolerance can be predicted by family emotional context. Because these data will contribute to the development of a more comprehensive model of vulnerability to HIV risk behavior, they will in turn be useful in creating effective intervention programs.

描述（由申请人提供）：越来越多的证据表明，个体难以忍受痛苦与药物滥用有重要联系，而药物滥用是青少年感染艾滋病毒的一种关键行为（Brandon et al., 2003; Brown, Lejuez, Kahler, & Strong, 2002; Daughters, Lejuez， Bornovalova等人，2005;Daughters, Lejuez， Kahler等人，2005;Quinn, Brandon, & Copeland, 1996）。这一研究主体来自于对成年药物滥用者的研究，利用痛苦耐受的行为测量来评估一个人在强烈情绪不适的情况下坚持目标导向行为的能力，或者简单地说，一个人有效忍受情绪困扰的能力。最近，我们在青少年中建立了类似的联系（Daughters, Lejuez et al., 2007）。虽然以前没有研究过低度承受痛苦与高风险性行为之间的联系，但理论和经验上的原因表明，这种联系也可能存在（见Lejuez， 2007）。鉴于令人信服的证据表明，个人难以忍受痛苦与药物滥用有重要联系，并与危险的性行为有潜在联系，因此，试图了解青少年痛苦耐受的前体具有相当大的公共卫生相关性。一些理论观点和大量的经验证据表明，家庭的情感氛围和家庭关系的质量对儿童的功能有重大影响，包括参与风险行为（例如，bernstein, 2002; Maccoby, 2007）。此外，对理论和研究（如Bowlby， 1969/1982; Cassidy & Shaver, 1999; Eisenberg et al., 1998; Gottman et al., 1996, 1997）的检验表明，家庭情绪气候的两个方面可能与青少年的痛苦容忍有关：(a)母亲对痛苦的反应，(b)青少年的依恋。因此，研究家庭因素与青少年忍受情绪困扰的能力之间的联系，以及随后艾滋病毒风险行为的发展，似乎是有用的。提出的横断面研究有几个目标。首先，我们试图通过提供青少年痛苦承受能力和药物使用之间联系的进一步证据，以及首次检查痛苦承受能力和危险性行为之间的联系，来扩展先前研究青少年痛苦承受能力和艾滋病毒风险行为之间联系的工作。其次，我们将尝试通过关注家庭情绪气候来阐明低痛苦耐受性的风险因素。最后，在基于负强化的艾滋病毒风险模型的背景下，我们将研究痛苦容忍作为家庭情感环境与艾滋病毒风险行为之间联系的中介。这项研究的一个优点是参与者（240名13至16岁的青少年）将从一项正在进行的HIV风险行为纵向研究中选取，该研究不涉及家庭情感环境。这种方法具有成本效益，并提供机会通过对冒险倾向的行为测量来增强现有的数据集，包括来自遗传易感性和环境逆境的其他有关艾滋病毒指标。