Cognitive Bias Modification for Risky Sex and Alcohol Use

 描述（由申请人提供）：性冒险与许多负面结果有关，如艾滋病毒感染，意外怀孕和性侵犯。研究表明，饮酒是危险性行为的一个重要预测因素（乔治等人，2014; Purdie等人，2011），减少饮酒可能对减少危险性行为很重要。当审慎的认知控制过程比自动接近倾向弱时，可能会发生性冒险。对酒精暗示的接近偏差与饮酒行为的增加有关，也可能影响个人关于安全套使用的决策过程。操纵杆认知偏差修正（CBM）的干预措施，使用的方法回避任务（AAT）的修改版本正在成为有效的治疗工具，通过修改许多疾病和问题行为的内隐过程。也就是说，如果一个人被训练去关注或远离特定的信息，症状可能会减少，行为可能会改变。先前的实验研究已经成功地改变了各种认知偏差远离酒精刺激，并随后减少了饮酒行为（Wiers等人，2010; 2011）。目前的研究试图通过修改参与者对酒精刺激的内隐接近偏差来复制以前的研究。此外，目前的研究旨在训练参与者同时接近安全套刺激。增加参与者对安全套刺激的接近偏差可能会增加他们在性接触中使用安全套的概率。本研究采用2（训练：训练/假手术）× 3（时间：前测/后测/3个月随访）设计，探讨是否可以修改内隐认知偏差，以减少对酒精刺激的接近偏差，增加对避孕套的接近偏差。参与者将是年龄在18-25岁之间的大学生，他们适度饮酒，并且在数据收集前的三个月内与非正式的非承诺性伴侣进行了至少三次不使用避孕套的性交。参与者将被随机分配到积极训练组或假训练对照组。主动训练组的参与者将接受明确的训练，以使回避运动（推动操纵杆）远离酒精刺激和接近运动（拉动操纵杆）接近避孕套的图片。本研究旨在检验基线时内隐接近-回避偏差与饮酒和安全套之间的关系。此外，本研究还将调查干预对酒精和避孕套方法偏差的影响，3个月随访时干预对酒精和避孕套使用的影响，干预后认知偏差是否介导了3个月随访时相应行为的变化，以及酒精使用的变化是否介导了危险性行为的变化。

 DESCRIPTION (provided by applicant): Sexual risk taking is associated with many negative outcomes such as HIV infection, unplanned pregnancy, and sexual assault. Research indicates that alcohol use is a significant predictor of risky sexual behavior (George et al., 2014; Purdie e al., 2011), and reducing alcohol use might be important in reducing risky sex. Sexual risk taking may occur when deliberative cognitive control processes are weaker than automatic approach tendencies. Approach biases toward alcohol cues are associated with increased drinking behavior and may also impact an individual's decision-making process regarding condom use. Joystick cognitive bias modification (CBM) interventions using a modified version of the approach avoidance task (AAT) are emerging as effective treatment tools by modifying implicit processes for many disorders and problematic behaviors. Namely, if an individual is trained to attend to or attend away from specific information, symptoms may be reduced and behavior may be changed. Previous experimental research has been successful in modifying various cognitive biases away from alcohol stimuli and subsequently reducing drinking behavior (Wiers et al., 2010; 2011). The current study seeks to replicate previous research by modifying participants' implicit approach biases away from alcohol stimuli. Additionally, the current study seeks to train participants to simultaneously approach condom stimuli. Increasing participants approach bias toward condom stimuli may subsequently increase their probability of using condoms during sexual encounters. This study examines whether implicit cognitive biases can be modified to decrease approach bias toward alcohol stimuli and increase approach bias toward condoms using a 2 (Training: training/sham) x 3 (Time: pretest/posttest/3-month follow-up) design. Participants will be college students between the ages of 18-25, who drink moderately, and have engaged in sexual intercourse without a condom at least three times with a casual, non-committed partner during the three months prior to data collection. Participants will be randomly assigned to either an active training group or a sham training control group. Participants in the active training group will be explicitly trained to make avoidance movements (pushing a joystick) away from alcohol stimuli and approach movements (pulling a joystick) toward pictures of condoms. The current study aims to test associations between the implicit approach-avoidance biases and drinking and condoms at baseline. In addition, this study will investigate the effects of the intervention on alcohol and condom approach biases, the effects of the intervention on alcohol and condom use at the 3- month follow-up, if cognitive biases post-intervention mediate changes in corresponding behavior at 3-month follow-up, and if changes in alcohol use mediate changes in risky sex.