Cognitive Bias Modification for Risky Sex and Alcohol Use

 描述(由申请人提供)：性风险与许多负面后果有关，如艾滋病毒感染、意外怀孕和性侵犯。研究表明，酒精使用是危险性行为的重要预测因素(George等人，2014；Purdie等人，2011)，减少酒精使用可能对减少危险性行为很重要。当深思熟虑的认知控制过程弱于自动接近倾向时，可能会发生性风险。对酒精暗示的态度偏差与更多的饮酒行为有关，也可能影响个人关于避孕套使用的决策过程。操纵杆认知偏差修正(CBM)干预使用改进版本的接近回避任务(AAT)，通过修改许多障碍和问题行为的隐含过程，成为有效的治疗工具。也就是说，如果一个人被训练去注意或注意特定的信息，症状可能会减少，行为可能会改变。以前的实验研究已经成功地改变了各种认知偏差，使其远离酒精刺激，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偏向来复制之前的研究。此外，目前的研究试图训练参与者同时接触避孕套刺激。越来越多的参与者倾向于使用避孕套刺激，这可能会增加他们在性行为中使用避孕套的可能性。本研究采用2(训练：训练/假)×3(时间：前测/后测/3个月随访)设计，检验内隐认知偏向是否可以被修改以减少对酒精刺激的偏向，而增加对避孕套的偏向。参与者将是年龄在18-25岁之间的大学生，他们适度饮酒，在数据收集之前的三个月里，至少与随意的、没有承诺的伴侣发生过三次没有使用避孕套的性行为。参与者将被随机分配到积极训练组或假训练控制组。积极训练组的参与者将接受明确的培训，使他们做出避开酒精刺激的回避动作(推动操纵杆)，并接近避孕套图片的动作(拉动操纵杆)。目前的研究旨在测试内隐接近回避偏见与基线饮酒和避孕套之间的关系。此外，本研究将调查干预对酒精和避孕套使用偏向的影响，在3个月随访时干预对酒精和避孕套使用的影响，如果干预后的认知偏向在3个月随访时调节相应行为的变化，以及酒精使用的变化是否调节危险性行为的变化。

 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.