Adolescent decision making and HIV risk avoidance: Neurocognitive factors

描述（由申请人提供）：青少年感染包括艾滋病毒/艾滋病在内的性传播疾病（std）的风险很大，是艾滋病毒/艾滋病发病率没有下降的少数艾滋病毒风险群体之一（疾病预防控制中心，2005年）。与一般青少年人群相比，涉及司法的青少年第一次性交年龄更小，性伴侣数量更多，安全套使用率更低，导致意外怀孕和性传播疾病的发生率更高（例如，Teplin, Mericle, McClelland & Abram, 2003）。数据表明，在高风险情况下做出行为决定的关键大脑区域仍在青春期发育。不幸的是，目前，许多得到最好支持的性风险预防规划依赖于发达的认知控制系统（例如，动机访谈；MI），这对于处于神经发育阶段的青少年来说可能不太容易获得。因此，拟议研究的目标是建立在我们之前对该人群（1R01 AA017390-01）的成功工作的基础上，以测试两种不同类型的基于理论的干预措施；一种依赖于完善的控制系统（MI），另一种依赖于更基本的行为方法（行为技能训练；BST）。通过这种创新的综合方法，我们希望在我们之前的工作基础上：(2)了解与控制系统和奖励系统相关的神经认知激活的可变性是否预测了这两种干预方法在减少艾滋病毒/性病高风险青少年的危险性行为方面的有效性；(3)检查基于fmri的任务的神经认知反应与一组易于在扫描仪外管理的平行认知任务之间的相关性，以评估神经认知发现转化为现实应用的潜力。拟议的研究预计将提供关键数据，以改善高危青少年减少艾滋病毒/性病风险的规划。

DESCRIPTION (provided by applicant): Adolescents are at great risk for sexually transmitted diseases (STDs) including HIV/AIDS, and are one of few HIV risk groups for whom HIV/AIDS incidence is not declining (CDC, 2005). Compared to the general adolescent population, justice-involved adolescents are younger at first intercourse, have a greater number of sex partners, and lower rates of condom use, resulting in higher rates of unintended pregnancy and STDs (e.g., Teplin, Mericle, McClelland & Abram, 2003). Data suggests that key brain regions integral for making decisions about behavior in high risk situations are still developing during adolescence. Unfortunately, at present, many of the best-supported sexual risk prevention programming rely on well-developed cognitive control systems (e.g., motivational interviewing; MI), which may be less accessible for adolescents at this stage of neurodevelopment. Thus, the goal of the proposed study is to build on our previous successful work with this population (1R01 AA017390-01) to test two different types of theory-based interventions; one that relies upon well-developed control systems (MI) versus one that relies on a more basic behavioral approach (Behavioral Skills Training; BST). Through this innovative, integrative approach, we hope to build upon our prior work to: (1) demonstrate associations between risky sexual behavior with the reward and control networks in the brain, (2) understand whether variability in neurocognitive activation associated with the control and reward systems predicts the effectiveness of these two intervention approaches to reduce risky sexual behavior among justice- involved adolescents at high risk for HIV/STDs, and (3) examine the correlation between neurocognitive responses to the fMRI-based tasks to a parallel set of cognitive tasks that are easily administered outside of the scanner to assess the potential for the translation of neurocognitive findings into real-world application. The proposed research is expected to provide critical data that will improve HIV/STD risk reduction programming with high risk adolescents.