Self-Regulation & Attentional Mechanisms of Sexual Risk Taking in Young Drinkers

描述(申请人提供)：18-24岁酗酒的年轻人感染人类免疫缺陷病毒(HIV)和其他性传播感染(STI)的风险更高。然而，年轻人酗酒和艾滋病毒/性传播感染危险行为背后的因素和机制还没有被很好地了解，而且大多数现有的促进安全性行为的努力并不是针对这一独特的人群进行的。因此，仍然需要进行研究，重点是更好地了解哪些因素最有可能转化为更有效的、有经验支持的干预措施，以减少酗酒的年轻人的艾滋病毒/性传播感染风险行为。一个这样的因素，也是特别有希望的干预目标，涉及自我调节的概念，即超越欲望、思想、情绪和行为模式的能力，否则可能会导致潜在的不良结果。事实上，在实验室研究中发现，在“一时之热”时自我监管不力会导致危险的性行为决策，而且通常与艾滋病毒/性传播感染的危险行为有关。然而，尽管一些初步研究表明这些过程发挥了重要作用，但到目前为止，还没有研究系统地测试1)特定的自我调节缺陷是否会导致艾滋病毒/性传播感染风险行为，以及2)针对这些自我调节机制变化的干预措施是否有可能减少年轻人的艾滋病毒/性传播感染风险行为。这项拟议的研究将检验以下假设：1)注意过程是HIV/STI危险行为和酗酒背景下自我调节机制失败的基础，2)修改指示安全与危险性行为的线索的注意处理减少了性行为活跃的年轻饮酒者的HIV/STI危险行为。这项拟议的研究通过两种方式检验了这些假设。首先，将进行一项实验室研究，以阐明与成瘾和冲动控制行为中的自我调节失败有关的注意过程，但迄今为止，这些注意过程在调节HIV/STI危险行为方面的潜在作用尚未得到明确解决。为此，眼球跟踪软件将测量对计算机化性决策任务中描绘的高风险和低风险假设性伴侣的风险相关信息(例如，过去使用避孕套的频率、以前的性伴侣数量)的视觉注意力。其次，这项研究将考察实验中采用的安全性行为模式--一种改编自认知疗法的注意力调节策略--是否会影响参与者的性决策和对任务中与风险相关的信息的注意模式。这项拟议研究的长期目标是1)为有关认知过程在性决策中的作用的有前景的新兴文献做出贡献，2)为更多基于经验的干预措施奠定基础，以减少艾滋病毒/性传播感染的风险行为，特别是在酗酒的个人中。 公共卫生相关性：虽然酗酒的年轻人感染人类免疫缺陷病毒(HIV)和其他性传播感染(STI)的风险增加，但性行为风险行为背后的机制尚未得到很好的了解，而且艾滋病毒/STI风险行为减少干预措施并不总是解决可能对引发行为改变至关重要的机制。这项拟议的研究假设，注意力过程导致未能抑制艾滋病毒/性传播感染的危险行为，并且改变对性风险和奖励线索的关注可以减少性行为活跃的年轻饮酒者的性风险。该项目有可能促进我们对构成性风险行为的基本认知过程的理解，并为开发基于经验的艾滋病毒/性传播感染风险行为减少干预措施提供一个跳板。

DESCRIPTION (provided by applicant): Young adults aged 18-24 who abuse alcohol are at heightened risk for contracting human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs). However, the factors and mechanisms underlying alcohol abuse and HIV/STI risk behaviors in young adults are not well understood, and most existing efforts to promote safer sex behaviors have not been tailored to this unique population. Thus, there continues to be a need for research that focuses on an improved understanding of the factors that are most likely to translate into more effective, empirically-supported interventions for HIV/STI risk behavior reduction in young adults who abuse alcohol. One such factor, and especially promising target for intervention, involves the concept of self-regulation, or the capacity to override desires, thoughts, emotions, and behavior patterns that otherwise might lead to potentially undesirable outcomes. Indeed, poor self-regulation in the "heat of the moment" has been found to lead to risky sexual decision making in laboratory studies and is generally associated with HIV/STI risk behavior. However, while some initial studies suggest an important role for these processes, to date no research has systematically tested 1) whether specific self-regulatory deficiencies contribute to HIV/STI risk behavior and 2) whether interventions that target changes in these self-regulatory mechanisms may have the potential to reduce HIV/STI risk behavior in young adults. The following hypotheses will be tested in the proposed research: 1) Attentional processes underlie failures in self-regulatory mechanisms in the context of HIV/STI risk behavior and alcohol abuse, and 2) the modification of attentional processing of cues indicative of safe vs. risky sex decrease HIV/STI risk behaviors in sexually active young drinkers. The proposed research tests these hypotheses in two ways. First, a laboratory study will be conducted to elucidate the attentional processes that have been implicated in failures to self-regulate in addictive and impulse control behaviors, but which have, to date, not been explicitly addressed in terms of their potential role in the regulation of HIV/STI risk behavior. To do so, eye-tracking software will measure visual attention to risk- related information (e.g., frequency of past condom use, # of previous sexual partners) of high and low risk hypothetical sexual partners depicted on a computerized sexual decision making task. Second, the study will examine whether an experimentally-adopted safe-sex schema - an attention-regulation strategy adapted from cognitive therapy - influences participants' sexual decision making and attention patterns to risk-related information on the task. The long-term goals of the proposed research are 1) to contribute to a promising, emerging literature on the role of cognitive processes in sexual decision making, and 2) to lay the groundwork for more empirically-based interventions for HIV/STI risk behavior reduction, particularly in individuals who abuse alcohol. PUBLIC HEALTH RELEVANCE: While young adults who abuse alcohol are at increased risk for contracting human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs), the mechanisms underlying sexual risk behavior are not well understood, and HIV/STI risk behavior reduction interventions do not always address mechanisms that may be crucial for eliciting behavior change. The proposed study hypothesizes that attentional processes contribute to failures to inhibit HIV/STI risk behaviors, and that modifying attention to sexual risk and reward cues can decrease sexual risk taking in sexually active young drinkers. This project has the potential to further our understanding of basic cognitive processes that underlie sexual risk behavior, as well as to provide a springboard for development of empirically-based HIV/STI risk behavior reduction interventions.