Personality disorders, decision making and sexual risk behaviors

人格障碍、决策和性危险行为

• 批准号: 7849357
• 负责人: Ramani S Durvasula
• 金额: $ 37.46万
• 依托单位: CALIFORNIA STATE UNIVERSITY LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-22 至 2014-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7849357
• 关键词: Accounting; Acute; Address; Adherence; Adult; Affect; Affective; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Anus; Attention; Back; Behavioral; Borderline Personality Disorder; Characteristics; Chronic; Clinical; Communities; Contracts; Data; Databases; Decision Making; Development; Diagnosis; Disease; Disinhibition; Drug usage; Enrollment; Equation; Event; Figs - dietary; Frequencies; Functional disorder; Funding; Gender; Geography; Goals; Grant; HIV; Health; Impulsivity; Individual; Infection; Intervention; Interview; Literature; Manuscripts; Measures; Mediator of activation protein; Mental disorders; Modeling; Mood Disorders; Moods; National Institute of General Medical Sciences; Nature; Outcome; Participant; Pattern; Personality; Personality Disorders; Persons; Pharmaceutical Preparations; Population; Positioning Attribute; Prevention program; Process; Psychopathology; Psychosocial Factor; Publications; Publishing; Race; Reporting; Research; Research Personnel; Research Project Grants; Risk; Risk Behaviors; Risk Factors; Risk Reduction; Role; Sampling; Severities; Sex Behavior; Sex Orientation; Structure; Substance abuse problem; Symptoms; Techniques; Testing; Time; TimeLine; Treatment Efficacy; Vagina; Visit; Woman; Work; cohort; disorder risk; executive function; experience; follow-up; high risk behavior; high risk sexual behavior; indexing; intervention program; men; operation; programs; public health relevance; sex; sex risk; sexually active

DESCRIPTION (provided by applicant): While the role of major psychopathology has been addressed in the literature on sexual risk, relatively less attention has been placed on the personality disorders (PD). The chronic nature of the interpersonal dysfunction, impulsivity, and impaired decision making that characterize these disorders suggest that PD is an important predictor of sexual risk behavior engagement both prior to and after becoming infected with HIV. The present study builds upon the work generated by the Health Adherence Research Project (NIGMS S06 GM08101; Durvasula - PI), which suggests PD is a risk factor for riskier sexual practices. The proposed study will enroll a sample of 200 HIV+ and 200 HIV- sexually active adults (total N = 400), stratified by gender and sexual orientation and examine the relationship between psychopathology, particularly PD, and sexual risk behaviors. In addition, the intervening role of decision making on the PD-risk relationship will be examined. PD and major psychopathology will be assessed using multiple measures including structured psychiatric interviews. Sexual risk behaviors and drug and alcohol use will be assessed using a Time Line Follow-back (TLFB) Interview, a technique which will provide event level analysis of sexual behaviors, partners and contexts. Participants will be seen twice over 3 months, with psychiatric assessment administered at the baseline visit, and the TLFB administered at the 3 month follow-up. Given the hypothesized multi-determined nature of sexual behavior, multivariate techniques including Structural Equation Modeling using the EQS approach, MANOVA and regression will be used to test the simultaneous relationships between predictors, mediators and outcome. By describing this relationship using carefully elaborated indices of sexual risk in an urban, diverse sample, and identifying mechanisms by which PD and psychopathology influence sexual risk, particularly decision making, intervention programs can be developed which target the specific antecedents of risk experienced by this persons with PD. This grant will also further the development of the PI as an independent investigator and position her to pursue R34 and R01 level funding to continue this line of research. PUBLIC HEALTH RELEVANCE: Understanding predictors of sexual risk behaviors is instrumental in the development of HIV intervention and prevention programs. Using a detailed assessment of sexual behavior and psychopathology, this study will describe the interrelated role of personality disorders, major psychopathology, and decision making on sexual risk in HIV+ and HIV- men and women.

描述（由申请人提供）：虽然关于性风险的文献已经阐述了主要精神病理学的作用，但对人格障碍（PD）的关注相对较少。这些疾病所特有的人际功能障碍、冲动和决策受损等慢性性质表明，PD 是感染 HIV 之前和之后发生性危险行为的重要预测因素。本研究建立在健康依从性研究项目 (NIGMS S06 GM08101; Durvasula - PI) 的工作基础上，该项目表明 PD 是高风险性行为的一个危险因素。拟议的研究将招募 200 名 HIV+ 和 200 名 HIV- 性活跃成年人样本（总共 N = 400），按性别和性取向分层，并检查精神病理学（特别是 PD）与性危险行为之间的关系。此外，还将研究决策对PD-风险关系的干预作用。 PD 和主要精神病理学将使用多种措施进行评估，包括结构化精神病学访谈。将使用时间线追踪（TLFB）访谈来评估性危险行为以及药物和酒精的使用，该技术将提供性行为、伴侣和背景的事件级别分析。参与者将在 3 个月内接受两次检查，在基线访视时进行精神评估，并在 3 个月的随访时进行 TLFB。鉴于假设的性行为的多决定性质，包括使用 EQS 方法的结构方程模型、多元方差分析和回归在内的多元技术将用于测试预测变量、中介变量和结果之间的同时关系。通过在城市、多样化的样本中使用精心设计的性风险指数来描述这种关系，并确定帕金森病和精神病理学影响性风险的机制，特别是决策制定，可以制定针对帕金森病患者经历的特定风险前因的干预计划。这笔赠款还将进一步促进 PI 作为独立研究者的发展，并使她能够寻求 R34 和 R01 级别的资金来继续这一研究领域。 公共卫生相关性：了解性危险行为的预测因素有助于制定艾滋病毒干预和预防计划。通过对性行为和精神病理学的详细评估，本研究将描述人格障碍、主要精神病理学以及 HIV+ 和 HIV- 男性和女性性风险决策的相互关联作用。