Force of Habit: the Role of Routinized, Automatic Behaviors along the Path of Self-Regulation and Alcohol-Related Problems

The Implicit Sexual Risk Assessment: A Pilot Study of a Novel Behavioral Task

Risky sexual behaviors are a significant public health concern. Laboratory experiments are necessary to identify causal determinants of risky sexual behavior. However, experiments often rely on analogue sexual risk behavior, assessed by self-reported intentions in response to a sexual scenario. Using behavioral tasks to assess risk taking may be a valuable addition to self-reported intention outcome measures. The Balloon Analogue Risk Task (BART) is a commonly used measure of general risk-taking. However, BART's associations with sexual risk-taking have been mixed. In this pilot study, we developed a task akin to the BART, the Implicit Sexual Risk Assessment (ISRA), which incorporates sexual stimuli. We hypothesized sexual arousal would increase risk taking on ISRA relative to BART. Using a within-persons experimental design, 79 participants (52% women, mean age = 19.5 (SD = 1.42)) were randomized to condition (i.e., arousal versus neutral) and completed the BART and ISRA tasks. As expected, sexual arousal was associated with increased risk-taking (i.e., adjusted pumps) on ISRA relative to BART. However, this was unexpectedly the result of decreased pumps on BART instead of increased pumps on ISRA. Neither BART nor ISRA were significantly associated with sexual risk behavior or intentions. Null findings are qualified by the fact that sexual arousal was not significantly associated with sexual risk intentions.

Daily Associations Among Alcohol Intoxication, Partner Familiarity, Participant Effortful Control, Urgency, and PrEP Uptake on Sexual Behavior in Men Who Have Sex with Men

The purpose of this study was to examine the effects of alcohol intoxication and its interaction with contextual or situation (partner familiarity) and individual differences variables (effortful control, urgency, and whether taking pre-exposure prophylaxis (PrEP) medication) on sexual behaviors in men who have sex with men (MSM), a subgroup for whom HIV continues to be a major public health problem in the U.S. The participants were 236 men recruited from two northeastern U.S. cities and aged 21-50 years, M = 27.8). These men participated in a 6-week (two 3-week sampling bursts) experience sampling method (ESM) study. The ESM data were collected via use of software installed on the participant's own or study-provided mobile phone. Individual differences variables were measured by participants' completing questionnaires measuring effortful control and urgency, and the participant's self-report of whether he was currently taking PrEP. The ESM data pertained to sexual behavior as well as situation variables of familiarity of relevant sexual partners and number of standard alcohol drinks consumed. The results generally were consistent with hypotheses, as alcohol intoxication showed a curvilinear relation to the occurrence of condomless anal intercourse. Furthermore, the likelihood of occurrence of condomless anal sex increased with increased familiarity of the sexual partner. Similarly, taking PrEP increased the likelihood of occurrence of condomless anal sex. At the same time, alcohol's effects were moderated by all three individual differences variables as expected, but the prediction that partner familiarity would moderate alcohol's effects on the occurrence of condomless sex was not supported. Clinical implications of the findings center on the application of the data to HIV prevention programs toward inclusion of more empirically supported, nuanced information on the relation between acute alcohol intoxication and sexual behavior. Directions for further research address the need for additional testing and refinement of a person × situation approach to alcohol and sexual behavior. Furthermore, it is argued that it is important to refine further the concept of sexual risk in the context of taking PrEP and to conduct more detailed, multivariate studies of the relation between taking PrEP and patterns of sexual behavior.

Examining the alcohol-related consequences of adult drinkers who self-report medicating low mood with alcohol: An analysis of the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions survey data

The aim of this paper is to examine the alcohol-related consequences experienced by adults who reported a 2-week period of low mood and identified as a 'self-medicator' compared to those who do not. Our focus is on assessing whether the conceptualization of alcohol use disorder severity differs across adult drinkers who self-medicate with alcohol during a period of low mood, compared to those who do not. This study used secondary data from the NESARC survey. The analytic sample consisted of 5945 participants who answered questions from the alcohol abuse/dependence (alcohol experiences) section, in the last 12 months. The sample was split into four groups by whether they self-medicated with alcohol or not, drank alcohol in the last year, and their drinking class. The findings indicated that a one-factor model was the best fit, and all items were a strong indicator of alcohol use disorder. The two-parameter model had the best fit, indicating that the diagnostic criteria were placed as a good fit along a continuum of severity. It was revealed that the hazardous drinking group who self-medicated, experienced more consequences even at low levels of severity. As the self-medicating hazardous drinking group also showed the highest estimates for alcohol use disorder severity, this may indicate that this group is composed of high-functioning self-medicators who are trying to regulate their drinking, and may not be as clinically high risk as expected, due to their drinking patterns.