Alcohol and implicit process in sexual risk behavior in MSM

描述（由申请人提供）：本提案侧重于PA-11-006的两个目标：物质使用和滥用，风险决策和艾滋病毒/艾滋病：1)物质使用如何改变关于艾滋病毒风险行为决策中的显性（努力）与隐含（自动）过程的贡献，以及2)实验室方法和模拟如何与现实世界的风险行为相关？该研究结合了酒精管理实验与随后的经验抽样（ESM）研究的创新配对，以测试实验室结果的外部有效性。旨在减少艾滋病毒风险行为的干预措施往往侧重于教育人们了解风险，增强他们避免风险的动机，并提高与健康选择相一致的技能。然而，对于“在紧要关头”进行风险选择的过程，人们的认识存在相当大的差距。将自动过程、内隐认知和联想记忆的研究纳入健康风险行为的研究和预防，是改善公众健康的重要机会，但在很大程度上尚未实现（Stacy et al., 2010）。自动评估和方法偏差可以通过条件反射成功地再训练，从而导致相应的行为变化（Chen & Bargh, 1999； Houben等人，2010；Wiers等人，2010）。不同领域的研究支持一种自我控制的双过程模型。这些模型假设自我控制由两个维度组成，一个是快速行动，反射性，“自动”维度，另一个是缓慢行动，深思熟虑或努力维度（Lieberman, 2007; Wiers et al., 2007）。自动、反身、控制强调情感过程，而努力控制维度可能主要由高阶的“执行”控制过程组成（Lieberman, 2007）。当自动接近行为的强度超过审慎认知控制过程的强度时，可能会产生危险的性行为。提出的实验研究旨在提高对酒精、内隐过程和努力控制在男性风险性选择中的作用的理解

DESCRIPTION (provided by applicant): This proposal focuses on two aims of PA-11-006: Substance Use and Abuse, Risky Decision Making and HIV/AIDS: 1) How does substance use shift the contribution of explicit (effortful) versus implicit (automatic) processes in decision-making about HIV-risk behavior, and 2) How do laboratory methods and simulations relate to real world risky behavior? The study incorporates an innovative pairing of an alcohol administration experiment with a subsequent experience sampling (ESM) study to test the external validity of the laboratory results. Interventions designed to reduce HIV risk behavior frequently focus on educating people about risks, increasing their motivation to avoid risks, and improving skills congruent with healthy choice. However, there are considerable gaps in knowledge about the processes involved in risky choice "during the heat of the moment." Incorporating research on automatic processes, implicit cognition, and associative memory into the study and prevention of health risk behaviors is an important and largely unrealized opportunity for improving public health (Stacy et al., 2010). Automatic evaluations and approach biases can be successfully retrained via conditioning, resulting in corresponding changes in behavior (Chen & Bargh, 1999; Houben et al., 2010; Wiers et al., 2010). Research in diverse fields supports a dual-process model of self-control. Such models posit that self-control consists of two dimensions, a fast acting, reflexive, "automatic" dimension and a slower acting, deliberative or effortful dimension (Lieberman, 2007; Wiers et al., 2007). Automatic, reflexive, control emphasizes affective processes, while the effortful control dimension may consist largely of higher-order "executive" control processes (Lieberman, 2007). Risky sexual behavior may result when the strength of automatic approach behaviors exceeds the strength of deliberative cognitive control processes. The proposed experimental study seeks to improve understanding of the role of alcohol, implicit processes, and effortful control in risky sexual choice in men who have sex with men (MSM). We propose that alcohol intoxication increases the strength of relatively automatic approach biases toward sexual stimuli while simultaneously decreasing the role of more deliberative decision-making processes controlled by executive brain functions. This shift toward more implicit or automatic processes coupled with the decreased role of explicit decision- making processes increases the likelihood of sexual risk behavior and potentially limits the effectiveness of interventions that focus solely on explicit processes to promote behavioral change. The long-term aim of this research is explicating processes occurring in the "heat of the moment" when an individual's better judgment seems conspicuously absent and the drive for immediate gratification peaks. The proposed study will lay a foundation for innovative approaches to treatment that address both automatic and effortful processes to reduce sexual risk behavior in MSM.