Dimensions of acculturation: Associations with health risk behaviors among college students from immigrant families.

In the present study, we examined a bidimensional model of acculturation (which includes both heritage and U.S. practices, values, and identifications) in relation to hazardous alcohol use, illicit drug use, unsafe sexual behavior, and impaired driving. A sample of 3,251 first- and second-generation immigrant students from 30 U.S. colleges and universities completed measures of behavioral acculturation; cultural values (individualism, collectivism, and self-construal); ethnic and U.S. identity; and patterns of alcohol and drug use, engagement in potentially unsafe sexual activities, and driving while (or riding with a driver who was) intoxicated. Results indicate that heritage practices and collectivist values were generally protective against health risk behaviors, with collectivist values most strongly and consistently protective. Nonetheless, heritage identifications were positively associated with sexual risk taking for Hispanics. U.S. practices, values, and identifications were not consistently related to risk behavior participation. Results are discussed in terms of bidimensional approaches to acculturation, the immigrant paradox, and implications for counseling practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differences in impulsivity and risk-taking propensity between primary users of crack cocaine and primary users of heroin in a residential substance-use program.

Crack cocaine use is more associated with impulsivity and a propensity to take risks than heroin use, yet no studies have examined this relationship in the absence of acute drug effects. The current study examined impulsivity (using the Delay Discounting Task) and risk-taking propensity (using the Balloon Analogue Risk Task) across independent groups of primary crack cocaine users with minimal heroin use (n=16) and primary heroin users with minimal crack cocaine use (n=11) in residential treatment, with all participants drug abstinent during participation. Crack cocaine users evidenced greater levels of impulsivity and risk-taking propensity, with only the difference in impulsivity persisting after controlling for age and gender. These data hold potential theoretical importance in understanding differences between crack cocaine and heroin users, as the findings cannot be attributed solely to acute pharmacological drug effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Childhood sexual abuse and sexual risk behavior among men and women attending a sexually transmitted disease clinic.

Childhood sexual abuse (CSA) is associated with a wide range of negative outcomes. The authors investigated the relation between CSA and sexual risk behavior in 827 patients recruited from a sexually transmitted disease (STD) clinic. Overall, CSA was reported by 53% of women and 49% of men and was associated with greater sexual risk behavior, including more sexual partners, unprotected sex, and sex trading. Alcohol use for men and drug use for women mediated the relation between CSA and the number of sexual partners in the past 3 months; intimate partner violence mediated the relation between CSA and the number of episodes of unprotected sex in the past 3 months for women. These results document the prevalence of CSA among patients seeking care for an STD and can be used to tailor sexual risk reduction programs for individuals who were sexually abused. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personality and the predisposition to engage in risky or problem behaviors during adolescence.

Longitudinal data from a representative sample of 1,978 Black and White adolescents were used to examine the role of personality in multiple risk or problem behaviors. Results indicate that covariation among diverse behaviors (educational underachievement, delinquent behavior, substance use, sexual behavior) can be adequately modeled by a single higher order factor, and that impulsivity and avoidance coping serve as generalized risk factors for involvement in these behaviors. Whereas none of the personality variables examined explained change in problem behaviors once established, avoidance coping prospectively predicted involvement among a subgroup of adolescents with little or no prior involvement. Results suggest that dysfunctional styles of regulating emotions and emotionally driven behaviors are core features of risky or problem behaviors during adolescence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Randomized trial to reduce club drug use and HIV risk behaviors among men who have sex with men.

The authors examined the effectiveness of motivational interviewing (MI) on club drug use and risky sex in non-treatment-seeking men who have sex with men (MSM). MSM (N = 150) were assessed and randomly assigned to 4 sessions of MI or an educational control intervention. Follow-up occurred at quarterly intervals for 1 year. Primary outcomes were days of any club drug use and number of unsafe sex acts. On average, club drug use declined during follow-up. A significant interaction effect showed that MI was associated with less club drug use during follow-up compared with education but only among participants with lower severity of drug dependence (p     

Alcohol-involved sexual risk behavior among heavy drinkers living with HIV/AIDS: Negative affect, self-efficacy, and sexual craving.

Evidence of the effects of negative affect (NA) and sexual craving on unprotected sexual activity remains scant. We hypothesized that NA and sexual craving modify the same day association between low self-efficacy to use condoms and unprotected anal or vaginal sex, and the same-day association between alcohol use during the 3 hours prior to sexual activity and unprotected sex. We used an electronic daily diary, drawing on a sample of 125 men and women recruited from an agency serving economically disadvantaged persons living with HIV/AIDS. Casual or steady partner type designation and perceived partner HIV serostatus were also examined. Findings support the hypothesized moderating effects of high NA and sexual craving on the association between low self-efficacy and unprotected sex, and the association between alcohol use and unprotected sex. Implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mediation of a preventive intervention's 6-year effects on health risk behaviors.

Using data from a 6-year longitudinal follow-up sample of 240 youth who participated in a randomized experimental trial of a preventive intervention for divorced families with children ages 9 to 12, the current study tested mechanisms by which the intervention reduced substance use and risky sexual behavior in mid to late adolescence (15–19 years old). Mechanisms tested included parental monitoring, adaptive coping, and negative errors. Parental monitoring at 6-year follow-up mediated program effects to reduce alcohol and marijuana use, polydrug use, and other drug use for those with high pretest risk for maladjustment. In the condition that included a program for mothers only, increases in youth adaptive coping at 6-year follow-up mediated program effects on risky sexual behavior for those with high pretest risk for maladjustment. Contrary to expectation, program participation increased negative errors and decreased adaptive coping among low-risk youth in some of the analyses. Ways in which this study furthers our understanding of pathways through which evidence-based preventive interventions affect health risk behaviors are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of contextual risk, impulsivity, and parental knowledge in the development of adolescent antisocial behavior.

The present study (a) tests main and moderational effects of neighborhood and family risk, and adolescent impulsivity on the development of male and female antisocial behavior (ASB) and (b) examines the extent to which these effects work indirectly through parental knowledge. Adolescents (N = 4,597; 51% male) reported on informal social control in their neighborhoods, their family types, and impulsivity at age 12, and on parental monitoring and ASB at ages 13 and 15 years. Neighborhoods were further defined as risk and nonrisk in economic deprivation by census-level data. Main effects of neighborhood risk, single parenthood, and impulsivity on ASB were found for male and female adolescents. For female adolescents, impulsivity interacted with neighborhood economic deprivation and with family type in the prediction of parental knowledge. Impulsivity and contextual risk factors in part increased adolescent ASB through decreasing parental knowledge. Theoretical and policy implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The influence of general identity disturbance on reports of lifetime substance use disorders and related outcomes among sexual minority adults with a history of substance use.

Previous research has shown that sexual minority (i.e., nonheterosexual) individuals report increased problematic substance use involvement, compared with their sexual majority counterparts. We hypothesize that feelings of an unstable sense of self (i.e., identity disturbance) may potentially drive problematic substance use. The purpose of the current study is to examine identity disturbance among sexual minorities as a potential explanatory mechanism of increased sexual minority lifetime rates of substance dependence. Measures of identity disturbance and three indicators of sexual orientation from lifetime female (n = 16,629) and male (n = 13,553) alcohol/illicit drug users in Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were examined. Findings generally showed that the increased prevalence of alcohol dependence, illicit drug dependence, and combined alcohol/illicit drug dependence as well as a younger age of alcohol use initiation among sexual minority women was associated with elevated levels of identity disturbance. The results were consistent with a mediational role for identity disturbance in explaining the association between sexual minority status and substance dependence and were generally replicated among male sexual minority respondents. The current research suggests that identity disturbance, a predictor of substance use, may contribute to heightened risk for substance dependence among certain subgroups of sexual minority individuals. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

A multimethod analysis of impulsivity in nonsuicidal self-injury.

Impulsivity has been proposed as an important construct in nonsuicidal self-injury (NSSI). Yet, research on the relationship of impulsivity to NSSI has been mixed. The present study clarified this relationship using a multifaceted measure of impulsivity (i.e., UPPS Impulsive Behavior Scale), and a computer-based behavioral measure of inhibitory control (i.e., a stop-signal task). Participants were 82 confirmed self-injurers and 86 controls recruited from a college population. Self-injurers and controls performed similarly on the stop-signal task. On the UPPS, self-injurers were best distinguished by Urgency (committing rash decisions when faced with negative emotions), and distinguished to a lesser degree by lack of Premeditation (inability to delay action in order to plan) and Sensation Seeking (seeking excitement and adventure). Among self-injurers, lack of Perseverance (inability to stay with a task through completion) predicted more recent and frequent NSSI. Conceptual and clinical implications are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Addressing HIV risk behavior among pregnant drug abusers: An overview.

Both sex- and drug-related HIV risk behavior are common among pregnant drug abusers. In the absence of intervention, these behaviors are likely to continue throughout pregnancy, placing the women and their unborn children at risk of contracting HIV. Drug treatment programs have been found to have limited impact on these behaviors. Although certain drug risk behaviors have been shown to decrease during drug treatment, sex-related risk behavior remains largely unaffected. Similarly, knowledge- and skill-based HIV risk reduction interventions have demonstrated modest efficacy. Therefore, there is a need to develop new interventions that directly target sex- and drug-related HIV risk behavior among pregnant drug abusers, taking advantage of a period in the women's lives in which the potential negative consequences of risk behavior are more significant given the possible impact on their unborn children and in which there may be a heightened desire to make healthier behavior choices. Recent work suggests that a promising new direction for the field may be incorporating motivational interviewing components into traditional HIV risk reduction interventions, which focus on providing HIV risk information and building sex- and drug-related HIV risk reduction skills. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexual compulsivity, state affect, and sexual risk behavior in a daily diary study of gay and bisexual men.

Researchers have identified a strong link between sexual compulsivity (SC) and risky sexual behavior among men who have sex with men (MSM). Meanwhile, affect/mood has also been connected with negative sexual health outcomes (sexually transmitted infection/human immunodeficiency virus [HIV] transmission, sexual risk, sex under the influence of drugs/alcohol). Given that SC is characterized by marked distress around one's own sexual behavior, affect may play a central role in SC and HIV risk behavior. Data were taken from the Pillow Talk Project, a pilot study conducted in 2008–2009 with 50 highly sexually active MSM (9 or more male sex partners, ≤ 90 days), of which half displayed SC symptoms and half did not. Forty-seven men completed a daily diary online for 30 days (n = 1,060 diary days), reporting on their sexual behavior and concurrent affect: positive activation, negative activation, anxious arousal, and sexual activation. We conducted HLM analyses using daily affect (Level 1, within subjects) and SC and HIV status (Level 2, between subjects) to predict sexual behavior outcomes. Increased negative activation (characterized by fear, sadness, anger, and disgust) was associated with reduced sexual risk behavior, but less so among sexually compulsive MSM. Sexual activation was associated with increased sexual risk taking, but less so among sexually compulsive MSM. Anxious arousal was associated with increased sexual behavior, but not necessarily sexual risk taking. Findings indicate that affect plays key roles in sexual behavior and sexual risk taking; however, the association between affect and behavior may be different for sexually compulsive and non-sexually compulsive MSM. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Integration of impulsivity and positive mood to predict risky behavior: Development and validation of a measure of positive urgency.

In 3 studies, the authors developed and began to validate a measure of the propensity to act rashly in response to positive affective states (positive urgency). In Study 1, they developed a content-valid 14-item scale, showed that the measure was unidimensional, and showed that positive urgency was distinct from impulsivity-like constructs identified in 2 models of impulsive behavior. In Study 2, they showed that positive urgency explained variance in risky behavior not explained by measures of other impulsivity-like constructs, differentially explained positive mood-based risky behavior, differentiated individuals at risk for problem gambling from those not at risk, and interacted with drinking motives and expectancies as predicted to explain problem drinking behavior. In Study 3, they confirmed the hypothesis that positive urgency differentiated alcoholics from both eating-disordered and control individuals. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Work-related risk factors and employee substance use: Insights from a sample of Israeli blue-collar workers.

Although studies have found evidence that certain workplace conditions in North American enterprises may serve as risk factors for alcohol and illicit drug use, little is known regarding the generalizability of these findings to enterprises in other countries. To address this gap, we collected data from a random sample of 569 blue-collar workers employed in nine different facilities of one of Israel's largest manufacturing firms. The results of zero-inflated Poisson and ordered probit regressions partly confirmed earlier findings reported in North America, with a heightened rate of a substance use among those perceiving (a) more permissive drinking norms, (b) lower supervisor ability to handle substance use problems, (c) greater exposure to job hazards, and (d) lower levels of coworker interactions. Permissive drinking norms were also found to moderate the associations between the other risk factors and substance use. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Specifying the impulsivity of female inmates with borderline personality disorder.

Impulsivity is regarded as a core feature of borderline personality disorder (BPD; M. C. Zanarini, J. G. Gunderson, & F. R. Frankenburg, 1989) despite lack of evidence from laboratory research (D. M. Dougherty, J. M Bjork, H. C. G. Huckabee, F. G. Moeller, & A. C. Swann, 1999). This study examined impulsivity in incarcerated women with BPD using a passive avoidance task (J. P. Newman & W. A. Schmitt, 1998) and the Impulsiveness-Monotony Avoidance-Detachment inventory (IMD; D. Schalling, 1978). As predicted, incarcerated women diagnosed with BPD committed more passive avoidance errors and reported more impulsivity on the IMI than controls. These findings identify disinhibition as a potentially important component of the impulsivity that characterizes BPD. Specifying the impulsive behavior identified with BPD may contribute to the effective assessment and management of the disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Misperceived risk among female adolescents: Social and psychological factors associated with sexual risk accuracy.

This study of 411 urban female adolescents had 3 objectives: (a) assess the relationship between perceived risk and sexual risk behavior (condom use, number of partners, partner risk, presence of STDs, and aggregate sexual risk), (b) assess the accuracy of risk perceptions, and (c) identify variables related to inaccurate sexual risk perceptions. Participants were classified as accurate or inaccurate risk perceivers on the basis of actual sexual behavior and perceived risk. Accurate versus inaccurate risk perceivers were compared on psychological maintenance variables (self-esteem, distress, and coping), relationship context variables (partnership duration and pressure to have unprotected sex), and risk knowledge at different levels of sexual risk. Approximately half of the participants underestimated the risk of their sexual behavior. Accurate and inaccurate risk perceivers differed on risk knowledge, partnership duration, and pressure to have unprotected sex. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Agreement between prospective interactive voice response telephone reporting and structured recall reports of risk behaviors in rural substance users living with HIV/AIDS.

Sound measurement of risk behaviors is essential to guide tailored risk reduction strategies as HIV infection patterns shift toward rural minorities, particularly in the southeastern United States where HIV disease remains highly stigmatized. Interactive Voice Response (IVR) systems appear to enhance reports of sensitive behaviors and can support telehealth applications to extend the reach of care in rural, underserved areas. This study evaluated the feasibility and data quality of an IVR telephone reporting system with rural substance users living with HIV/AIDS. Community-dwelling patients were recruited from a nonprofit HIV medical clinic in rural Alabama (N = 35 men, 19 women). Participants engaged in daily IVR reporting of substance use and sexual practices for up to 10 weeks. IVR reports were compared with retrospective Timeline Followback (TLFB) interview reports for the same period. IVR and TLFB reports showed good to excellent agreement for summary measures of alcohol consumption and sexual activity. Agreements for illicit drug use reports were less satisfactory. Reports of monetary spending on alcohol and drugs were significantly higher on the IVR. Most individuals showed good agreements for reports of day-to-day alcohol and drug use and sexual practices. The study established the utility of IVR assessment with rural, disadvantaged adults living with HIV/AIDS who are priority targets for risk reduction interventions. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Sexual and drug use behaviors among women crack users: implications for prevention

The literature suggests that important and contributing factors in the rise of HIV and AIDS among women are crack use and the exchange of sex for drugs or money. However, not all women who use crack report they are exchanging sex for drugs or money. Thus, women are at differential risk for HIV and AIDS. The purpose of this study is to compare and describe women crack users (n = 292) who reported exchanging sex for drugs and money with women crack users who did not report exchanging sex. Results indicated that both women crack users who exchanged sex (n = 162) and women crack users who did not exchange sex (n = 130) were likely to be African American, to be about the same age, to have had incomes below +500 during the previous month, to have had similar education and martial backgrounds, to have had unprotected sexual intercourse as often, to have had similar drug use patterns, and to have initiated drug use at similar ages. However, women who exchanged sex had more sexual partners, had unprotected oral sex more often, used drugs before and during sex more often, and had a higher rate of sexually transmitted diseases than women who did not exchange sex. In addition, women who exchanged sex were also twice as likely to be homeless, four times more likely to have been in treatment, and twice as likely to have been arrested and charged/booked two or more times in their lifetime than women who did not exchange sex.     

Target groups for preventing AIDS among intravenous drug users: II. The "hard" data studies.

Studies were reviewed with respect to three different target groups for preventing AIDS among intravenous (IV) drug users by (a) providing drug abuse treatment for those who want to stop injecting drugs, (b) providing "safer" injection for those who are likely to continue injecting, and (c) preventing drug injection among those who are at high risk for beginning to inject. The studies reviewed were limited to those that include "hard" data: validated self-reports, seroprevalence outcomes, or self-reports of behavior that is opposed to any of the demand characteristics generated by the research setting. For two groups of current IV drug users—those entering drug treatment and those continuing to inject—these hard data studies show rapidly induced AIDS risk reduction but suggest a need for large-scale change maintained over long time periods. In terms of preventing initial injection, alternative forms of intense drug use have emerged but have not supplanted drug injection, and basic knowledge of AIDS does not appear to deter initial drug injection. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression ratings, reported sexual risk behaviors, and methamphetamine use: Latent growth curve models of positive change among gay and bisexual men in an outpatient treatment program.

Although the cessation of substance use is the principal concern of drug treatment programs, many individuals in treatment experience co-occurring problems such as mood disruptions and sexual risk behaviors that may complicate their recovery process. This study assessed relationships among dynamic changes tracked over time in methamphetamine use, depression symptoms, and sexual risk behaviors (unprotected anal intercourse) in a sample of 145 methamphetamine-dependent gay and bisexual males enrolled in a 16-week outpatient drug treatment research program. Participants were randomly assigned into 1 of 4 conditions: contingency management (CM), cognitive behavioral therapy (CBT; the control condition), combined CM and CBT, and a tailored gay-specific version of the CBT condition. Using latent growth curve models, the authors assessed the relationship of means (intercepts) and the slopes of the 3 measures of interest over time to test whether changes in methamphetamine use predicted declining rates of depression and risky sexual behavior in tandem. Participants with the greatest downward trajectory in methamphetamine use (urine verified) reported the greatest and quickest decreases in reported depressive symptoms and sexual risk behaviors. The control group reported the most methamphetamine use over the 16 weeks; the tailored gay-specific group reported a more rapidly decreasing slope in methamphetamine use than the other participants. Findings indicate that lowering methamphetamine use itself has a concurrent and synergistic effect on depressive symptoms and risky sexual behavior patterns. This suggests that some users who respond well to treatment may show improvement in these co-occurring problems without a need for more intensive targeted interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)