Varieties of Impulsivity in Opiate and Stimulant Users

描述（由申请人提供）：本项目的总体目标是更好地了解冲动在药物成瘾中的作用。“冲动性”的缺陷与几乎所有种类的成瘾行为有关，并与危险的性行为和注射做法有关，这些做法是艾滋病毒传播的一些主要媒介。然而，冲动性是文献中描述的最多方面的结构之一，具有各种特质样人格和精神病学维度，以及基于表现的神经行为表现。虽然许多物质依赖个体（SDI）表现出受损的冲动控制的冲动性的神经行为的措施，当然不是所有的SDI表现出这种损害。这表明，在一些额外的风险因素，如更暂时稳定的个性和精神层面的冲动的个体差异可能会增加基于性能的神经行为冲动控制缺陷的SDI的脆弱性。这种基于性能的缺陷也可能是特定滥用药物的独特药理学/毒理学特性的函数。因此，该项目的主要目标之一是调查不同的冲动性概念方法在空间数据基础设施中的表现有何不同，以及这种差异是否是所使用的特定类型非法药物的一种功能。该项目的另一个目标是研究冲动的各个方面与高风险性行为和注射风险行为最密切相关，以及这些高风险行为是否因滥用特定药物而有所不同。本研究的具体目的如下：（1）在“纯”兴奋剂使用者、“纯”阿片类药物使用者和非药物使用对照组中，探讨不同类别的药物（阿片类药物和兴奋剂）与特质样人格和精神（ADHD和精神病）冲动性指数对认知和运动冲动性神经行为指标的影响。(2)采用基于表现的运动和认知冲动性测量方法，探讨时间稳定的类特质人格的个体差异与冲动性精神指标之间的关联模式。(3)评估冲动的不同特质和表现表现与增加艾滋病毒感染和传播风险的高危行为之间的关联，例如阿片类药物和兴奋剂使用者的性行为和注射风险行为。这项研究将在保加利亚进行，那里的吸毒模式是独特的，因为对多种物质的依赖并不常见，这将有助于我们避免在SDI中使用多种物质这一具有挑战性的方法问题。从拟议的研究数据将提供新的知识，在SDI的冲动，对不同类别的药物滥用的冲动的各个方面的具体影响，和桥梁的差距差距冲动的个体差异可能会影响关键的危险行为。因此，预计这项研究将对制定空间数据基础设施的生物和心理干预措施以及在保加利亚建立可持续的研究能力产生重要影响。公共卫生相关性：预计该项目将对制定药物依赖者的生物和心理预防和干预战略产生重要影响。更具体地说，该项目将特别有助于提高治疗效果，办法是根据冲动性各方面的个体差异，将客户与治疗相匹配，这可以通过各种治疗方式或技术来解决。该项目还可能对艾滋病毒预防工作产生重大影响，为减少危害预防和干预战略提供信息，旨在减少吸毒者的高风险性行为和注射行为，吸毒者是艾滋病毒传播的主要媒介。

DESCRIPTION (provided by applicant): The overall aim of this project is to better understand the role of impulsivity in drug addiction. Deficits in "impulsivity" are implicated in virtually all kinds of addictive behaviors and are related to risky sexual and injection practices, some of the primary vectors of HIV transmission. However, impulsivity is one of the most multifaceted constructs described in the literature that has a variety of trait-like personality and psychiatric dimensions, as well as performance-based neurobehavioral manifestations. Although many substance dependent individuals (SDIs) show impaired impulse control on performance-based neurobehavioral measures of impulsivity, certainly not all SDIs manifest such impairments. This suggests that individual differences in some additional risk factors such as the more temporally stable personality and psychiatric dimensions of impulsivity may increase vulnerability to performance-based neurobehavioral impulse control deficits in SDIs. Such performance-based deficits may also be a function of the unique pharmacological / toxicological properties of the specific drug of abuse. Therefore, one of the main goals of the project is to investigate how different conceptual approaches to impulsivity differ in their manifestations in SDIs and whether such differences are a function of the specific type of illicit drug used. An additional goal of the project is to examine which of the various dimensions of impulsivity are most closely related to high-risk sexual and injection risk behaviors and whether such high-risk behaviors differ as a function of the specific drug of abuse. The study has the following specific aims: (1) To investigate the associations of different classes of drugs (opiates and stimulants) and trait-like personality and psychiatric (ADHD and psychopathy) indices of impulsivity on performance on neurobehavioral measures of cognitive and motor impulsivity among groups of "pure" stimulant users, "pure" opiate users, and non-drug using controls. (2) To investigate the patterns of associations between individual differences in temporally stable trait-like personality and psychiatric indices of impulsivity with performance-based measures of motor and cognitive impulsivity. (3) To evaluate the associations between different trait- and performance-based manifestations of impulsivity with high risk behaviors that increase risk for HIV infection and transmission, such as sexual and injection risk practices among opiate and stimulant users. The research will be conducted in Bulgaria, where patterns of drug use are unique in that polysubstance dependence is uncommon, which will help us avoid the challenging methodological problem of polysubstance use among SDIs. Data from the proposed study will provide new knowledge on impulsivity in SDIs, on the specific effects of different classes of drugs of abuse on various dimensions of impulsivity, and bridge the gap on how individual differences in impulsivity might influence critical risky behaviors. Therefore, the study is expected to have important implications for the development of biological and psychological interventions for SDIs and for building sustainable research capacity in Bulgaria. PUBLIC HEALTH RELEVANCE: The project is expected to have important implications for the development of biological and psychological prevention and intervention strategies for substance dependent individuals. More specifically, the project will be particularly relevant for helping increase treatment efficacy by matching clients to treatment, based on individual differences in various dimensions of impulsivity, which could be addressed by various treatment modalities or techniques. The project could also have significant implications for HIV prevention efforts by informing harm-reduction prevention and intervention strategies aimed at reducing high-risk sexual and injection behaviors in drug users, who are some of the primary vectors for HIV transmission.