1
|
Thamotharan S, Hahn HA, Ramos A, Harris B, Johnson MW, Fields SA. Validation of the Sexual Discounting Task for Use in Adolescents. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:2291-2304. [PMID: 38480647 DOI: 10.1007/s10508-024-02830-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 06/14/2024]
Abstract
The Sexual Discounting Task (SDT) was developed to evaluate the effects of delay on decision making as it relates to sexual risk-taking behaviors. Though previously validated with other populations, including urban emerging adults, the current study sought to validate the SDT with adolescents. A sample of adolescents (N = 155; 61% female) between ages 14 and 21 (Mage = 19.5 years) was recruited to complete the SDT (involving choices between immediate unprotected sex and delayed sex with a condom with hypothetical sexual partners) and the Delay Discounting Task (a delay discounting task for money outcomes). Additionally, they completed several self-report measures assessing demographics, sexual behavior, and sexual history. If the condom was readily available, respondents were more likely to use a condom for partners who were judged "most likely to have an STI" and for those that participants were "least likely to have sex with." Moreover, when a condom was not immediately available, greater self-reported sexual risk-taking was related to greater sexual discounting (i.e., greater effects of delay on decreasing condom use). Furthermore, sexual discounting was greater among partners deemed more desirable and those judged "least likely to have an STI." Differences in sexual discounting were significant after controlling for immediately available condom use. Findings from the current study suggest that the SDT is clinically meaningful for adolescents and is sensitive to factors that influence real-world decisions to use condoms. Future treatment and prevention should consider delay discounting as an important variable affecting sexual risk behavior.
Collapse
Affiliation(s)
- Sneha Thamotharan
- Office of Justice, Equity, Diversity, & Inclusion, Advocate Health-Health Sciences System, Wake Forest University School of Medicine, Bowman Gray Center for Medical Education, Winston Salem, NC, USA
| | - Hunter A Hahn
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Ashley Ramos
- Allergy and Immunology, Children's National Hospital, Washington, DC, USA
| | - Bethany Harris
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, 77845, USA
| | - Matthew W Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sherecce A Fields
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, 77845, USA.
| |
Collapse
|
2
|
Rasmussen EB, Camp L, Lawyer SR. The Use of Nonmonetary Outcomes in Health-Related Delay Discounting Research: Review and Recommendations. Perspect Behav Sci 2024; 47:523-558. [PMID: 39099748 PMCID: PMC11294320 DOI: 10.1007/s40614-024-00403-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2024] [Indexed: 08/06/2024] Open
Abstract
Delay discounting (DD) refers to the tendency to devalue an outcome as a function of its delay. Most contemporary human DD research uses hypothetical money to assess individual rates of DD. However, nonmonetary outcomes such as food, substances of misuse, and sexual outcomes have been used as well, and have advantages because of their connections to health. This article reviews the literature on the use of nonmonetary outcomes of food, drugs, and sexual outcomes in relation to health and reinforcer pathologies such as substance use disorders, obesity, and sexual risk behaviors, respectively, and makes a case for their use in discounting research. First, food, substances, and sex may be more ecologically valid outcomes than money in terms of their connections to health problems and reinforcer pathologies. Second, consistent trends in commodity-specific (i.e., domain) effects, in which nonmonetary outcomes are discounted more steeply than money, enhance variation in discounting values. Third, commodity-specific changes in discounting with treatments designed to change health choices are described. Finally, methodological trends such as test-retest reliability, magnitude effects, the use of hypothetical versus real outcomes, and age-related effects are discussed in relation to the three outcome types and compared to trends with monetary discounting. Limitations that center around individual preferences, nonsystematic data, and deprivation are discussed. We argue that researchers can enhance their DD research, especially those related to health problems and reinforcer pathologies, with the use of nonmonetary outcomes. Recommendations for future directions of research are delineated.
Collapse
Affiliation(s)
- Erin B. Rasmussen
- Department of Psychology, Idaho State University, Stop 8112, Pocatello, ID 83209-8112 USA
| | - Lillith Camp
- Department of Psychology, Idaho State University, Stop 8112, Pocatello, ID 83209-8112 USA
| | - Steven R. Lawyer
- Department of Psychology, Idaho State University, Stop 8112, Pocatello, ID 83209-8112 USA
| |
Collapse
|
3
|
Bibriescas N, Wainwright K, Thomas R, Lopez V, Romanowich P. Differential relationships between discount rates and health behaviors in an ethnically diverse college sample. Front Public Health 2022; 10:943499. [PMID: 36016889 PMCID: PMC9396243 DOI: 10.3389/fpubh.2022.943499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 07/22/2022] [Indexed: 01/21/2023] Open
Abstract
Previous research has demonstrated associations between delay discount rate and engagement in several health behaviors. The delay discount rate is also inversely associated with social discount rates, a putative measure for sharing. However, there is little research that examines whether delay and social discount rates are differentially associated with health behavior engagement, and even less research examining the impact of ethnicity on these relationships. This study investigated whether delay and/or social discount rates predict three health behaviors varying in sociality: sexually transmitted infection (STI) testing, alcohol consumption and exercise frequency in an ethnically diverse university sample. The results showed that neither delay nor social discount rate significantly predicted alcohol consumption and exercise frequency. However, increasing social discount rates (i.e., decreased sharing) was associated with a decreased likelihood to be tested for STIs. Ethnicity significantly contributed to two models, indicating differences in STI testing and alcohol consumption across ethnicities. Ethnic differences in these health behaviors were consistent with many previous health behavior studies, suggesting a profitable way to research cultural contingencies and test the reliability of the ethnically diverse data. These findings indicate that the social discount rate is differentially associated with health behaviors with more social aspects (i.e., health behaviors related to sex) in college students.
Collapse
Affiliation(s)
- Natashia Bibriescas
- Department of Educational Psychology, The University of Texas at Austin, Austin, TX, United States
| | - Katherine Wainwright
- Department of Psychology, The University of Texas at San Antonio, San Antonio, TX, United States
| | - Rebecca Thomas
- Ecampus Research Unit, Oregon State University, Corvallis, OR, United States
| | - Victoria Lopez
- Department of Psychology, The University of Texas at San Antonio, San Antonio, TX, United States
| | - Paul Romanowich
- Department of Psychology, Gonzaga University, Spokane, WA, United States,*Correspondence: Paul Romanowich
| |
Collapse
|
4
|
Gebru NM, Kalkat M, Strickland JC, Ansell M, Leeman RF, Berry MS. Measuring Sexual Risk-Taking: A Systematic Review of the Sexual Delay Discounting Task. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:2899-2920. [PMID: 35838897 PMCID: PMC9555011 DOI: 10.1007/s10508-022-02355-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 06/15/2023]
Abstract
The Sexual Delay Discounting Task (SDDT; Johnson & Bruner, 2012) is a behavioral economic task that assesses sexual risk-taking by measuring likelihood of immediate and delayed condom use. The SDDT is ecologically valid and has been used to test effects of various substances on sexual risk-taking. However, considerable variety in implementation, analysis, and reporting of the SDDT may limit rigor and reproducibility of findings. The current review synthesized studies that used the SDDT to evaluate these possible variabilities systematically. A two-step search (citation-tracking and keyword-based search) was conducted to identify studies that met inclusion criteria (i.e., used the SDDT). Eighteen peer-reviewed articles met inclusion criteria. The SDDT has been implemented primarily in three populations: individuals who use cocaine, men who have sex with men, and college students. Comparable results across diverse populations support the SDDT's validity. A few studies administered substances before the SDDT. Evidence suggests that while cocaine and alcohol increased sexual risk-taking under some conditions, buspirone decreased preference for immediate condomless sex. There was also heterogeneity in the determination of data orderliness (i.e., outliers) and inconsistent reporting of task design and analysis. Considerable differences present in methodologic approaches could influence results. Reducing variation in the administration, analysis, and reporting of the SDDT will enhance rigor and reproducibility and maximize the task's tremendous potential.
Collapse
Affiliation(s)
- Nioud Mulugeta Gebru
- Department of Health Education and Behavior, Center for Behavioral Economic Health Research;, University of Florida, P.O. Box 118210, Gainesville, FL, 32611, USA.
- Clinical and Translational Science Institute, University of Florida, Gainesville, FL, USA.
| | - Meher Kalkat
- Department of Health Education and Behavior, Center for Behavioral Economic Health Research;, University of Florida, P.O. Box 118210, Gainesville, FL, 32611, USA
| | - Justin C Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Margaret Ansell
- Department of Health Education and Behavior, Center for Behavioral Economic Health Research;, University of Florida, P.O. Box 118210, Gainesville, FL, 32611, USA
| | - Robert F Leeman
- Department of Health Education and Behavior, Center for Behavioral Economic Health Research;, University of Florida, P.O. Box 118210, Gainesville, FL, 32611, USA
- Yale School of Medicine, New Haven, CT, USA
| | - Meredith S Berry
- Department of Health Education and Behavior, Center for Behavioral Economic Health Research;, University of Florida, P.O. Box 118210, Gainesville, FL, 32611, USA
- Department of Psychology, University of Florida, Gainesville, FL, USA
| |
Collapse
|
5
|
Johnson MW, Strickland JC, Herrmann ES, Dolan SB, Cox DJ, Berry MS. Sexual discounting: A systematic review of discounting processes and sexual behavior. Exp Clin Psychopharmacol 2021; 29:711-738. [PMID: 33001694 PMCID: PMC8977071 DOI: 10.1037/pha0000402] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Behavioral processes underlying sexual behavior are important for understanding normal human functioning and risk behavior leading to sexually transmitted infections (STIs). This systematic review examines delay and probability discounting in human sexual behavior through synthesis of 50 peer-reviewed, original research articles. Sixteen studies focusing exclusively on monetary delay discounting found small effect size positive correlations with sexual risk behaviors. Eleven studies examined delay or probability discounting of sexual behavior itself using tasks that varied duration, frequency, or quality of sex to determine value. Results show delay and uncertainty of sex causes systematic decreases in value. These studies also show consistent medium effect size relationships between sexual discounting measures and sexual health and substance use, supporting utility above and beyond monetary discounting. Twenty-three studies have modeled clinically relevant decision-making, examining effects of delay until condom availability and STI contraction probability on condom use. Observational and experimental designs found condom-use discounting is elevated in high-risk substance use populations, is sensitive to context (e.g., partner desirability), and is more robustly related to sexual risk compared with monetary discounting or condom use decisions when no delay/uncertainty was involved. Administering cocaine, alcohol, and, for some participants, methamphetamine increased condom-use discounting with minimal effect on monetary discounting or condom use when no delay/uncertainty was involved. Reviewed studies robustly support that sexual behavior is highly dependent on delay and probability discounting, and that these processes strongly contribute to sexual risk. Future research should exploit these systematic relationships to design behavioral and pharmacological approaches to decrease sexual risk behavior. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
Affiliation(s)
- Matthew W. Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Justin C. Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | | | - Sean B. Dolan
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - David J. Cox
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Meredith S. Berry
- Human Behavioral Pharmacology and Decision-Making Laboratory, Department of Health Education and Behavior, University of Florida, Gainesville, FL, United States
- Department of Psychology, University of Florida, Gainesville, FL, United States
| |
Collapse
|
6
|
Draps M, Sescousse G, Wilk M, Obarska K, Szumska I, Żukrowska W, Majkowska A, Kowalewska E, Szymanowska J, Hamerska U, Trybuś M, Golec K, Adamska I, Szymczak K, Gola M. An empirical study of affective and cognitive functions in Compulsive Sexual Behavior Disorder. J Behav Addict 2021; 10:657-674. [PMID: 34550905 PMCID: PMC8997196 DOI: 10.1556/2006.2021.00056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 07/19/2021] [Accepted: 08/06/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND AND AIMS Despite the inclusion of the Compulsive Sexual Behavior Disorder (CSBD) in the International Classification of Diseases, very little is known about the underlying affective and cognitive processes. To fill this gap, we compared CSBD subjects and Healthy-Controls (HC) across negative/positive valence, cognitive and sensorimotor systems, as proposed by the Research Domain Criteria framework. METHODS 74 heterosexual CSBD and 66 matched HC males were studied with 10 questionnaires and 8 behavioral tasks. Analyses were conducted with frequent and Bayesian statistics. RESULTS CSBD individuals showed significantly higher (than HC) punishment sensitivity, anxiety, depression, compulsivity, and impulsivity symptoms. Frequentist statistical analysis revealed significant interaction between subject group and condition in Incentive Delay Task, concerning the strength of motivation and hedonic value of erotic rewards. Bayesian analysis produced evidence for the absence of group differences in Facial Discrimination Task, Risk-Ambiguity Task, and Learning Task. Also, Bayesian methods provided evidence for group differences in the Emotional Stroop Task and the Incentive Delay Task. Sexual Discounting Task, Attentional Network Task, and Stop Signal Task produced mixed results. CONCLUSIONS Higher punishment sensitivity and impulsivity among CSBD subjects, along with significant interaction between these groups and erotic vs. non-erotic reward processing is in line with previous findings on negative/positive valence alterations in CSBD patients. This result shows that there are similarities to substance and behavioral addictions. The absence of group differences and mixed results related to cognitive and sensorimotor systems raise concerns to what extent CSBD resembles a wide spectrum of impairments observed in disorders, and demand further research.
Collapse
Affiliation(s)
- Małgorzata Draps
- Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland,Corresponding author. Tel.: +48 (22) 583 13 80/81. E-mail:
| | - Guillaume Sescousse
- Lyon Neuroscience Research Center, The National Center for Scientific Research and The National Institute of Health and Medical Research, Lyon, France
| | - Mateusz Wilk
- Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | | | - Izabela Szumska
- Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | | | | | - Ewelina Kowalewska
- Department of Psychiatry, Centre of Postgraduate Medical Education, Warsaw, Poland
| | | | - Urszula Hamerska
- SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Magda Trybuś
- SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Karolina Golec
- Faculty of Psychology, Warsaw University, Warsaw, Poland
| | | | - Karol Szymczak
- Institute of Psychology, The Maria Grzegorzewska University, Warsaw, Poland
| | - Mateusz Gola
- Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland,Swartz Center for Computational Neuroscience, Institute for Neural Computations, University of California San Diego, San Diego, USA
| |
Collapse
|
7
|
Wongsomboon V, Cox DJ. Sexual Arousal Discounting: Devaluing Condom-Protected Sex as a Function of Reduced Arousal. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:2717-2728. [PMID: 33483850 DOI: 10.1007/s10508-020-01907-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 12/05/2020] [Accepted: 12/11/2020] [Indexed: 06/12/2023]
Abstract
Sexual discounting is a growing area of research aimed at identifying factors that reduce people's reported willingness to have safe sex. One commonly reported reason for condom non-use is that a condom reduces sexual arousal. However, researchers have yet to isolate the specific role of sexual arousal using a sexual discounting framework. We extended past research by measuring how sexual arousal reduced people's willingness to have condom-protected sex ("sexual arousal discounting": SAD). College students (n = 379; 67.5% females) selected partners they most wanted and least wanted to have sex with and were randomized to one of two groups. In one group, participants rated their willingness to have sex with a condom if their own arousal decreased (from 100 to 10%) from condom use. The other group completed the same task except their partner's arousal decreased from condom use instead of their own. We observed a three-way interaction between arousal levels, most versus least desirable partners, and self versus partner groups. Participants' willingness to have condom-protected sex systematically reduced as a function of sexual arousal. This was observed more with the most (vs. least) desirable partner and in the self-arousal (vs. partner-arousal) group but only when the partner was their least desirable. Men (vs. women) displayed more arousal discounting but only with the most desirable partner. Finally, higher arousal discounting was associated with lower safe-sex self-efficacy and higher reported frequency of unprotected sex in the past 3 months. This study demonstrates how reduced sexual arousal from condom use can be measured as a factor influencing sexual risk-taking.
Collapse
Affiliation(s)
- Val Wongsomboon
- Department of Psychology, University of Florida, 945 Center Dr., Gainesville, FL, 32603, USA.
| | - David J Cox
- Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| |
Collapse
|
8
|
Berry MS, Sweeney MM, Dolan SB, Johnson PS, Pennybaker SJ, Rosch KS, Johnson MW. Attention-Deficit/Hyperactivity Disorder Symptoms Are Associated with Greater Delay Discounting of Condom-Protected Sex and Money. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:191-204. [PMID: 32328913 DOI: 10.1007/s10508-020-01698-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 03/25/2020] [Accepted: 03/30/2020] [Indexed: 06/11/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is associated with increased risk of detrimental life outcomes. Recent research also indicates that ADHD is associated with sexual risk behavior, such as unprotected sex. Some risky sexual behaviors may be driven, in part, by preference for immediate rewards, referred to as delay discounting, which is prominent in etiological models of ADHD. Therefore, the present study examined the effect of delay on preference for both monetary and sexual outcomes in adults with many ADHD symptoms (both on and off medication) and with fewer ADHD symptoms. Online participants (N = 275; n = 161 males, n = 114 females) completed a monetary delay discounting task, assessing preference for smaller sooner versus larger delayed hypothetical money, and the Sexual Delay Discounting Task, assessing preference for condom use in hypothetical casual sex scenarios based on delay until condom availability. Those with greater ADHD symptoms discounted delayed monetary outcomes as well as delayed condom-protected sex (i.e., preferred sooner money rewards and immediate unprotected sex) significantly more than those with fewer symptoms; however, no effect of current medication use was found across monetary or sexual delay discounting among those with greater ADHD symptoms. This study is the first to demonstrate the relation between ADHD symptoms and reduced condom-use likelihood. Increased discounting of delayed condom-protected sex might constitute one mechanism of risky sexual behavior among individuals with ADHD symptoms. Interventions geared toward increasing condom use in situations in which condoms may otherwise be unavailable, may mitigate risky sexual behaviors and their associated harms in this population.
Collapse
Affiliation(s)
- Meredith S Berry
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Suite 3000, Baltimore, MD, 21224, USA
- Department of Health Education and Behavior, University of Florida, Gainesville, FL, USA
- Department of Psychology, University of Florida, Gainesville, FL, USA
| | - Mary M Sweeney
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Suite 3000, Baltimore, MD, 21224, USA
| | - Sean B Dolan
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Suite 3000, Baltimore, MD, 21224, USA
| | - Patrick S Johnson
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Suite 3000, Baltimore, MD, 21224, USA
- Department of Psychology, California State University, Chico, Chico, CA, USA
| | - Steven J Pennybaker
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Suite 3000, Baltimore, MD, 21224, USA
| | - Keri S Rosch
- Center for Neurodevelopmental and Imaging Research and Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Matthew W Johnson
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Suite 3000, Baltimore, MD, 21224, USA.
| |
Collapse
|
9
|
Dolan SB, Johnson PS, Johnson MW. The Hotel Room Purchase Task: Effects of Gender and Partner Desirability on Demand for Hypothetical Sex in Individuals with Disordered Cocaine Use and Controls. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:1251-1262. [PMID: 31989411 PMCID: PMC8977073 DOI: 10.1007/s10508-020-01634-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 01/07/2020] [Accepted: 01/09/2020] [Indexed: 05/03/2023]
Abstract
Hypothetical purchase tasks allow for rapid assessment of behavioral economic demand for numerous commodities and are useful in evaluating reinforcer pathologies, such as substance and behavioral addiction. Currently, there is not a task for evaluating demand for sex without requiring implicit engagement in sex work. The current study used a novel purchase task with hotel rooms for sex as the hypothetical commodity to assess demand for sex in individuals with disordered cocaine use, a population that frequently engages in risky sexual behavior. Adults meeting criteria for cocaine abuse or dependence (13 males, ten females) and noncocaine-using controls (eight males, three females) chose hypothetical sexual partners from a series of photographs and endorsed two partners with whom they would most and least like to have sex. Participants then completed the hotel purchase task for both partners, wherein they reported how many nights at a hotel room, at prices from $10 to $1280 per night, they would purchase in a year. Demand intensity was significantly greater and demand elasticity was significantly lower for the most preferred relative to the less preferred partner. Males demonstrated significantly greater intensity and lesser elasticity for sex than females. Demand metrics did not differ between the cocaine and control group. This task may serve as a useful measure of demand for sex without requiring implicit hypothetical engagement in sex work. Future studies exploring the relation between task performance and other characteristics such as sexual dysfunction, in addition to acute substance administration effects, may further determine the task's clinical utility.
Collapse
Affiliation(s)
- Sean B Dolan
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, 5510 Nathan Shock Dr., Suite 3026, Baltimore, MD, 21224, USA
| | - Patrick S Johnson
- Department of Psychology, California State University, Chico, Chico, CA, USA
| | - Matthew W Johnson
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, 5510 Nathan Shock Dr., Suite 3026, Baltimore, MD, 21224, USA.
| |
Collapse
|
10
|
Odum AL, Becker RJ, Haynes JM, Galizio A, Frye CCJ, Downey H, Friedel JE, Perez DM. Delay discounting of different outcomes: Review and theory. J Exp Anal Behav 2020; 113:657-679. [PMID: 32147840 DOI: 10.1002/jeab.589] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 12/12/2019] [Accepted: 02/05/2020] [Indexed: 02/02/2023]
Abstract
Steep delay discounting is characterized by a preference for small immediate outcomes relative to larger delayed outcomes and is predictive of drug abuse, risky sexual behaviors, and other maladaptive behaviors. Nancy M. Petry was a pioneer in delay discounting research who demonstrated that people discount delayed monetary gains less steeply than they discount substances with abuse liability. Subsequent research found steep discounting for not only drugs, but other nonmonetary outcomes such as food, sex, and health. In this systematic review, we evaluate the hypotheses proposed to explain differences in discounting as a function of the type of outcome and explore the trait- and state-like nature of delay discounting. We found overwhelming evidence for the state-like quality of delay discounting: Consistent with Petry and others' work, nonmonetary outcomes are discounted more steeply than monetary outcomes. We propose two hypotheses that together may account for this effect: Decreasing Future Preference and Decreasing Future Worth. We also found clear evidence that delay discounting has trait-like qualities: People who steeply discount monetary outcomes steeply discount nonmonetary outcomes as well. The implication is that changing delay discounting for one outcome could change discounting for other outcomes.
Collapse
|
11
|
Sweeney MM, Berry MS, Johnson PS, Herrmann ES, Meredith SE, Johnson MW. Demographic and sexual risk predictors of delay discounting of condom-protected sex. Psychol Health 2020; 35:366-386. [PMID: 31311321 PMCID: PMC6962567 DOI: 10.1080/08870446.2019.1631306] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 06/10/2019] [Indexed: 10/26/2022]
Abstract
Objective: Sexual delay discounting describes the decreased likelihood of condom-protected sex if a condom is not immediately available, which can be quantitatively summarised using the Sexual Delay Discounting Task (SDDT). The present studies determined the extent to which condom use likelihood as assessed by the SDDT is associated with self-reported sexual risk behaviours and demographics in two online samples of adults. Design: Study 1 (n = 767) assessed demographics, sexual risk behaviour, and delay discounting, and examined relations between these variables using correlation and regression. Study 2 (n = 267) examined whether real-world instances of unprotected sex because a condom was not immediately available predicted greater sexual discounting. Main outcome measures: Sexual delay discounting, condom use. Results: Both studies observed significant positive relations between sexual delay discounting and self-reported sexual risk behaviours, and found that males tended to show greater sexual discounting. In Study 2, 46% of the sample self-reported having unprotected sex because a condom was not immediately available, and these individuals showed significantly greater sexual delay discounting. Conclusion: These results extend prior findings by demonstrating that delay is a critical variable underlying real-life sexual risk behaviour among non-clinical samples. The SDDT is an ecologically valid measure of these processes.
Collapse
Affiliation(s)
- Mary M. Sweeney
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Meredith S. Berry
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Patrick S. Johnson
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Evan S. Herrmann
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Steven E. Meredith
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Matthew W. Johnson
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| |
Collapse
|
12
|
Strickland JC, Marks KR, Bolin BL. The condom purchase task: A hypothetical demand method for evaluating sexual health decision-making. J Exp Anal Behav 2020; 113:435-448. [PMID: 32056222 DOI: 10.1002/jeab.585] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 01/25/2020] [Accepted: 01/27/2020] [Indexed: 12/16/2022]
Abstract
Behavioral economic theory has proved useful for understanding the influence of delay and probability on sexual health decision-making. Demand is another principle at the intersection of microeconomics and psychology that has helped advance research relevant to health behaviors. The purpose of the present study was to develop and test a demand measure related to sexual health decision-making and the influence of sexually transmitted infection (STI) risk. Participants (N = 438) recruited using Amazon Mechanical Turk completed a commodity purchase task assessing hypothetical condom demand. Condom demand was evaluated at varied prices for use with hypothetical sexual partners that varied in STI risk. Demand was characterized by prototypic decreases in consumption with increases in cost. Higher partner STI risk was associated with greater intentions for condom-protected sex at no cost and smaller decreases in condom demand with increases in cost. Price sensitivity was also related to individual difference factors relevant to sexual health (e.g., alcohol use severity, lower STI knowledge). This study supports the utility of a condom purchase task for indexing condom valuation and capturing individual difference and contextual risk factors relevant to STI transmission. Future studies may leverage this methodology as a means to study sexual health decision-making.
Collapse
Affiliation(s)
- Justin C Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine
| | - Katherine R Marks
- Department of Behavioral Science, University of Kentucky College of Medicine
| | - B Levi Bolin
- Department of Behavioral Science, University of Kentucky College of Medicine
| |
Collapse
|
13
|
Leeman RF, Rowland BHP, Gebru NM, Potenza MN. Relationships among impulsive, addictive and sexual tendencies and behaviours: a systematic review of experimental and prospective studies in humans. Philos Trans R Soc Lond B Biol Sci 2020; 374:20180129. [PMID: 30966924 DOI: 10.1098/rstb.2018.0129] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Impulsivity's relationships to addictive and sexual behaviours raise questions regarding the extent impulsivity may constitute a vulnerability factor for subsequent addictive and sexual behaviours and/or results from each of these. Here, we systematically reviewed empirical support for impulsivity as a precipitating factor or a consequence of addictive or sexual behaviours. We restricted ourselves to recent, human studies with assessments over time, including at least one measure of impulsivity, addictive and sexual behaviours, yielding a review including 29 published reports from 28 studies. Findings point to generalized, self-reported impulsivity as a predictor of addictive and sexual behaviours at a wide range of severity, with elements of both impulsivity and compulsivity to these acts. Alcohol consumption often increases impulsive behaviour, including inclinations towards impulsive and potentially compulsive sexual acts. Research using the Sexual Delay Discounting Task has yielded findings linking impulsivity, addictive and sexual behaviour and as such is a valuable research tool that should be used more extensively. The present review identified gaps to be addressed in further research that concurrently examines facets of impulsivity, addictive and sexual behaviours, especially because criteria for compulsive sexual behaviour disorder have been included in the eleventh edition of the International Classification of Diseases. This article is part of the theme issue 'Risk taking and impulsive behaviour: fundamental discoveries, theoretical perspectives and clinical implications'.
Collapse
Affiliation(s)
- Robert F Leeman
- 1 Department of Health Education and Behavior, College of Health and Human Performance and the Center for Addiction Research and Education, University of Florida , Gainesville, FL 32611 , USA.,2 Department of Psychiatry, Yale School of Medicine , New Haven, CT 06510 , USA
| | - Bonnie H P Rowland
- 1 Department of Health Education and Behavior, College of Health and Human Performance and the Center for Addiction Research and Education, University of Florida , Gainesville, FL 32611 , USA
| | - Nioud Mulugeta Gebru
- 1 Department of Health Education and Behavior, College of Health and Human Performance and the Center for Addiction Research and Education, University of Florida , Gainesville, FL 32611 , USA
| | - Marc N Potenza
- 2 Department of Psychiatry, Yale School of Medicine , New Haven, CT 06510 , USA.,3 Child Study Center and the Department of Neuroscience, Yale School of Medicine , New Haven, CT 06510 , USA.,4 Connecticut Council on Problem Gambling , Wethersfield, CT 06109 , USA.,5 Connecticut Mental Health Center , New Haven, CT 06519 , USA
| |
Collapse
|
14
|
Knittel AK, Lorvick J. Self-reported sexually-transmitted infections and criminal justice involvement among women who use drugs. Addict Behav Rep 2019; 10:100219. [PMID: 31692579 PMCID: PMC6806366 DOI: 10.1016/j.abrep.2019.100219] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 08/14/2019] [Accepted: 09/08/2019] [Indexed: 01/29/2023] Open
Abstract
Background Women involved in the criminal justice system in the United States have high rates of sexually transmitted infections (STI). It is unknown whether criminal justice involvement is a marker for other risk behavior, such as sex exchange or drug use, or criminal justice involvement itself increases risk directly. Methods This study examines the relationship between STI and the frequency and duration of arrest, probation, and incarceration in a sample of women who use drugs (n = 394) in Oakland, California who reported having been tested for STI in the past six months. Logistic regression models of STI using criminal justice measures as independent variables were used, and subsequent estimates were adjusted for demographics, sex exchange, specific drugs used, and number of sexual partners. Results Any time spent in jail in the past year was associated with higher odds of recent STI (UOR = 2.28, 95%CI [1.41–3.51]), and short incarcerations (2–3 weeks) in jail most substantially increased the odds of an STI diagnosis (UOR = 7.65, 95%CI [1.03, 56.68]). Arrest and probation were not significantly associated with STI. After adjusting for the covariates, particularly sex exchange and opioid use, none of the criminal justice-related variables were significantly associated with STI. Conclusions A substantial portion of the increased risk of STI that is associated with criminal justice involvement for women who use drugs is likely due to sex exchange. Longitudinal studies are needed to temporally separate criminal justice exposures, drug use, sex exchange, and STI outcomes. Criminal justice involvement is common for women who use drugs. Short jail incarcerations (2–3 weeks) were associated with an increased odds of STI, largely accounted for by sex exchange and opioid use. Qualitative studies that examine why women's sexual partnerships, opioid use, and sex exchange change after incarceration are needed.
Collapse
Affiliation(s)
- Andrea K Knittel
- Division of General Obstetrics and Gynecology, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, United States of America
| | - Jennifer Lorvick
- Urban Health Program, RTI International, San Francisco, CA, United States of America
| |
Collapse
|
15
|
Jones J, Guest JL, Sullivan PS, Kramer MR, Jenness SM, Sales JM. Concordance between monetary and sexual delay discounting in men who have sex with men. Sex Health 2019; 15:214-222. [PMID: 29212590 DOI: 10.1071/sh17111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 09/15/2017] [Indexed: 11/23/2022]
Abstract
Background Delay discounting has been found to be associated with numerous health-related outcomes, including risky sexual behaviour. To date, it is unclear whether delay discounting measured in different domains is associated within individuals. The goal of this study was to assess the concordance of monetary and sexual delay discounting in men who have sex with men. METHODS Participants completed an online survey, including the Monetary Choice Questionnaire and the Sexual Discounting Task. Linear regression models were used to assess the association between monetary and sexual discount rates. RESULTS Sexual discount rates did not predict monetary discount rates. There was a substantial amount of clustering of sexual discount rates, requiring sexual discounting data to be categorised. CONCLUSIONS Monetary and sexual delay discounting are distinct processes that are not necessarily associated within individuals, and monetary delay discounting is not an appropriate proxy measure for sexual impulsivity. Data from the Sexual Discounting Task are typically rank-transformed for analysis. These data suggest that this might be an invalid method of analysis. Future studies should investigate the distribution of their data to determine if it is appropriate to analyse sexual discounting data as a continuous measure.
Collapse
Affiliation(s)
- Jeb Jones
- Department of Epidemiology, Emory University, 1518 Clifton Road, Atlanta, GA 30322
| | - Jodie L Guest
- Department of Epidemiology, Emory University, 1518 Clifton Road, Atlanta, GA 30322
| | - Patrick S Sullivan
- Department of Epidemiology, Emory University, 1518 Clifton Road, Atlanta, GA 30322
| | - Michael R Kramer
- Department of Epidemiology, Emory University, 1518 Clifton Road, Atlanta, GA 30322
| | - Samuel M Jenness
- Department of Epidemiology, Emory University, 1518 Clifton Road, Atlanta, GA 30322
| | - Jessica M Sales
- Department of Behavioral Sciences and Health Education, Emory University, 1518 Clifton Road, Atlanta, GA 30322
| |
Collapse
|
16
|
Ssewamala FM, Sensoy Bahar O, Tozan Y, Nabunya P, Mayo-Wilson LJ, Kiyingi J, Kagaayi J, Bellamy S, McKay MM, Witte SS. A combination intervention addressing sexual risk-taking behaviors among vulnerable women in Uganda: study protocol for a cluster randomized clinical trial. BMC Womens Health 2019; 19:111. [PMID: 31419968 PMCID: PMC6697981 DOI: 10.1186/s12905-019-0807-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 07/31/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Sub-Saharan Africa (SSA) has the highest number of people living with HIV/AIDS, with Nigeria, South Africa, and Uganda accounting for 48% of new infections. A systematic review of the HIV burden among women engaged in sex work (WESW) in 50 low- and middle-income countries found that they had increased odds of HIV infection relative to the general female population. Social structural factors, such as the sex work environment, violence, stigma, cultural issues, and criminalization of sex work are critical in shaping sexually transmitted infection (STI)/HIV risks among WESW and their clients in Uganda. Poverty is the most commonly cited reason for involvement in sex work in SSA. Against this backdrop, this study protocol describes a randomized controlled trial (RCT) that tests the impact of adding economic empowerment to traditional HIV risk reduction (HIVRR) to reduce new incidence of STIs and HIV among WESW in Rakai and the greater Masaka regions in Uganda. METHODS This three-arm RCT will evaluate the efficacy of adding savings, financial literacy and vocational training/mentorship to traditional HIVRR on reducing new incidence of STI infections among 990 WESW across 33 hotspots. The three arms (n = 330 each) are: 1) Control group: only HIVRR versus 2) Treatment group 1: HIVRR plus Savings plus Financial Literacy (HIVRR + S + FL); and 3) Treatment group 2: HIVRR plus S plus FL plus Vocational Skills Training and Mentorship (V) (HIVRR + S + FL + V). Data will be collected at baseline (pre-test), 6, 12, 18 and 24-months post-intervention initiation. This study will use an embedded experimental mixed methods design where qualitative data will be collected post-intervention across all conditions to explore participant experiences. DISCUSSION When WESW have access to more capital and/or alternative forms of employment and start earning formal income outside of sex work, they may be better able to improve their skills and employability for professional advancement, thereby reducing their STI/HIV risk. The study findings may advance our understanding of how best to implement gender-specific HIV prevention globally, engaging women across the HIV treatment cascade. Further, results will provide evidence for the intervention's efficacy to reduce STIs and inform implementation sustainability, including costs and cost-effectiveness. TRIAL REGISTRATION ClinicalTrials.gov , ID: NCT03583541 .
Collapse
Affiliation(s)
- Fred M Ssewamala
- Brown School, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA.
| | - Ozge Sensoy Bahar
- Brown School, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA
| | - Yesim Tozan
- College of Global Public Health, New York University, New York City, NY, USA
| | - Proscovia Nabunya
- Brown School, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA
| | | | - Joshua Kiyingi
- International Center for Child Health and Development, Masaka, Uganda
| | | | | | - Mary M McKay
- Brown School, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA
| | - Susan S Witte
- Columbia University School of Social Work, New York City, NY, USA
| |
Collapse
|
17
|
Mayo-Wilson LJ, Glass NE, Ssewamala FM, Linnemayr S, Coleman J, Timbo F, Johnson MW, Davoust M, Labrique A, Yenokyan G, Dodge B, Latkin C. Microenterprise intervention to reduce sexual risk behaviors and increase employment and HIV preventive practices in economically-vulnerable African-American young adults (EMERGE): protocol for a feasibility randomized clinical trial. Trials 2019; 20:439. [PMID: 31315685 PMCID: PMC6637550 DOI: 10.1186/s13063-019-3529-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 06/15/2019] [Indexed: 01/08/2023] Open
Abstract
Background Economic vulnerability, such as homelessness and unemployment, contributes to the HIV risk among racial minorities in the U.S., who are disproportionately infected. Yet, few economic-strengthening interventions have been adapted for HIV prevention in economically-vulnerable African-American young adults. Engaging Microenterprise for Resource Generation and Health Empowerment (EMERGE) is a feasibility randomized clinical trial of an HIV prevention microenterprise intervention with integrated text messages (“nudges”) that are informed by behavioral economic principles. The trial aims to reduce sexual risk behaviors and increase employment and uptake of HIV preventive behaviors. Methods/design In total, 40 young adults who are African-American, aged 18–24, live in Baltimore City, have experienced at least one episode of homelessness in the last 12 months, are unemployed or underemployed (fewer than 10 h per week), are not enrolled in school, own a cell phone with text messaging, and report at least one episode of unprotected or unsafe sex in the prior 12 months will be recruited from two community-based organizations providing residential supportive services to urban youth. Participants will undergo a 3-week run-in period and thereafter be randomly assigned to one of two groups with active interventions for 20 weeks. The first group (“comparison”) will receive text messages with information on job openings. The second group (“experimental”) will receive text messages with information on job openings plus information on HIV prevention and business educational sessions, a mentored apprenticeship, and a start-up grant, and business and HIV prevention text messages based on principles from behavioral economics. The two primary outcomes relate to the feasibility of conducting a larger trial. Secondary outcomes relate to employment, sexual risk behaviors, and HIV preventive practices. All participants will be assessed using an in-person questionnaire at pre-intervention (prior to randomization) and at 3 weeks post-intervention. To obtain repeated, longitudinal measures, participants will be assessed weekly using text message surveys from pre-intervention up to 3 weeks post-intervention. Discussion This study will be one of the first U.S.-based feasibility randomized clinical trials of an HIV prevention microenterprise intervention for economically-vulnerable African-American young adults. The findings will inform whether and how to conduct a larger efficacy trial for HIV risk reduction in this population. Trial registration ClinicalTrials.gov, NCT03766165. Registered on 4 December 2018. Electronic supplementary material The online version of this article (10.1186/s13063-019-3529-7) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Larissa Jennings Mayo-Wilson
- Department of International Health, Social and Behavioral Interventions Program, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E5038, Baltimore, MD, 21205, USA. .,Department of Applied Health Science, Indiana University School of Public Health, 1025 E. 7th Street, Bloomington, IN, USA.
| | - Nancy E Glass
- Johns Hopkins University School of Nursing, 525 N. Wolfe Street, Baltimore, MD, USA
| | - Fred M Ssewamala
- Washington University in St. Louis, The Brown School, Goldfarb, One Brookings, Drive, St. Louis, MO, USA
| | | | - Jessica Coleman
- Department of International Health, Social and Behavioral Interventions Program, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E5038, Baltimore, MD, 21205, USA
| | - Fatmata Timbo
- Department of International Health, Social and Behavioral Interventions Program, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E5038, Baltimore, MD, 21205, USA
| | - Matthew W Johnson
- Behavioral Pharmacology Research, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD, USA
| | - Melissa Davoust
- Department of International Health, Social and Behavioral Interventions Program, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E5038, Baltimore, MD, 21205, USA
| | - Alain Labrique
- Department of International Health, Social and Behavioral Interventions Program, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E5038, Baltimore, MD, 21205, USA
| | - Gayane Yenokyan
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, USA
| | - Brian Dodge
- Department of Applied Health Science, Indiana University School of Public Health, 1025 E. 7th Street, Bloomington, IN, USA
| | - Carl Latkin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Hampton House 737, Baltimore, MD, USA
| |
Collapse
|
18
|
Kamel-Khodabandeh A, Mirzaee M, Jahani Y, Sharifi H. Sex under Influence of Drugs: A Nationwide Survey among Iranian Female Sex Workers. ADDICTION & HEALTH 2019; 10:205-215. [PMID: 31263519 PMCID: PMC6593167 DOI: 10.22122/ahj.v10i4.566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Background Due to the high level of sexual relationships, prostitute women are faced with many dangers, including acquired immune deficiency syndrome (AIDS), sexually transmitted infections (STIs), fertility problems, drug use, etc. In this regard, addict prostitute women are exposed to more risks because drug use is considered as an outstanding factor in those associated with transmission of AIDS and being in an insecure sexual relationship. The purpose of this study was to find out the variables influential on the level of drug use, before or during sexual relationship. Methods In 2010, 625 prostitute women were selected by multistage sampling from 21 centers out of 12 provinces. Then, we used a standard questionnaire for gathering data by a face-to-face interview. The multilevel ordinal logistic regression in survey model was used to find out the relationship between variables and the level of drug use before or during sexual relationship. Findings The number of monetary customers at the last working day [adjusted odds ratio (AOR): 1.87, 95% confidence interval (CI): 1.50-2.32] and having sexual relationship during the past month with monetary customers (AOR: 4.77, 95% CI: 2.61-8.70) were significantly related to the level of drug use before or during sexual relationship in the past month. Conclusion Since the level of drug use before or during sexual relationship was higher in women who had more daily sexual relationships, these women are exposed to the consequences of drug use; thus, identifying the status of this group of women is important to plan for future injuries.
Collapse
Affiliation(s)
- Atiyeh Kamel-Khodabandeh
- Department of Biostatistics and Epidemiology, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Moghaddameh Mirzaee
- Associate Professor, Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Yunes Jahani
- Associate Professor, Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Sharifi
- Associate Professor, HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| |
Collapse
|
19
|
Kuiper LB, Coolen LM. Compulsive Sexual Behavior in Humans and Preclinical Models. CURRENT SEXUAL HEALTH REPORTS 2018. [DOI: 10.1007/s11930-018-0157-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|
20
|
Lemley SM, Jarmolowicz DP, Parkhurst D, Celio MA. The Effects of Condom Availability on College Women's Sexual Discounting. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:551-563. [PMID: 28913688 DOI: 10.1007/s10508-017-1040-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 06/28/2017] [Accepted: 07/10/2017] [Indexed: 06/07/2023]
Abstract
College students commonly engage in risky sexual behaviors, such as casual sexual encounters and inconsistent condom use. Discounting paradigms that examine how individuals devalue rewards due to their delay or uncertainty have been used to improve our understanding of behavioral problems, including sexual risk. The current study assessed relations between college women's sexual partners discounting and risky sexual behavior. In this study, college women (N = 42) completed two sexual partners delay discounting tasks that assessed how choices among hypothetical sexual partners changed across a parametric range of delays in two conditions: condom availability and condom unavailability. Participants also completed two sexual partners probability discounting tasks that assessed partner choices across a parametric range of probabilities in condom availability and unavailability conditions. Additionally, participants reported risky sexual behavior on the Sexual Risk Survey (SRS). Participants discounted delayed partners more steeply in the condom availability condition, but those differences were significant only for those women with three or fewer lifetime sexual partners. There were no consistent differences in discounting rate across condom availability conditions for probability discounting. Sexual partners discounting measures correlated with risky sexual behaviors as measured by the SRS, but a greater number of significant relations were observed with the condoms-unavailable delay discounting task. These findings suggest the importance of examining the interaction of inconsistent condom use and multiple partners in examinations of sexual decision-making.
Collapse
Affiliation(s)
- Shea M Lemley
- Department of Applied Behavioral Science, University of Kansas, 4041 Dole Developmental Center, 1000 Sunnyside Ave., Lawrence, KS, 66045, USA.
| | - David P Jarmolowicz
- Department of Applied Behavioral Science and Problem Gambling Research and Education Support System, University of Kansas, 1000 Sunnyside Ave., Lawrence, KS, 66045, USA
| | - Daniel Parkhurst
- Department of Applied Behavioral Science, University of Kansas, 4050 Dole Developmental Center, 1000 Sunnyside Ave., Lawrence, KS, 66045, USA
| | - Mark A Celio
- Department of Behavioral and Social Sciences, Brown University, Box G-121-5, 121 S. Main Street, Providence, RI, 02915, USA
| |
Collapse
|
21
|
Jones J, Guest JL, Sullivan PS, Sales JM, Jenness SM, Kramer MR. The association between monetary and sexual delay discounting and risky sexual behavior in an online sample of men who have sex with men. AIDS Care 2018; 30:844-852. [PMID: 29397755 DOI: 10.1080/09540121.2018.1427851] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Delay discounting is a measure of impulsivity that has been found to be associated with numerous health-related outcomes. To the extent that delay discounting is associated with sexual risk-taking, it might serve as a marker for HIV risk or as the basis for novel HIV prevention interventions. The goal of the current study was to examine the association between monetary and sexual delay discounting and condomless anal intercourse (CAI) in a cross-sectional sample of men who have sex with men. Based on previous findings, we examined whether these associations were age-dependent. Sexual, but not monetary, delay discounting was found to be associated with CAI in the past 12 months. These results suggest that delay discounting is associated with sexual risk-taking. More high risk sexual behaviors and their associations with delay discounting should be investigated in the future.
Collapse
Affiliation(s)
- Jeb Jones
- a Department of Epidemiology , Rollins School of Public Health, Emory University , Atlanta , GA , USA
| | - Jodie L Guest
- a Department of Epidemiology , Rollins School of Public Health, Emory University , Atlanta , GA , USA.,b Department of Family and Preventive Medicine , School of Medicine, Emory University , Atlanta , GA , USA
| | - Patrick S Sullivan
- a Department of Epidemiology , Rollins School of Public Health, Emory University , Atlanta , GA , USA
| | - Jessica M Sales
- c Department of Behavioral Sciences and Health Education , Rollins School of Public Health, Emory University , Atlanta , GA , USA
| | - Samuel M Jenness
- a Department of Epidemiology , Rollins School of Public Health, Emory University , Atlanta , GA , USA
| | - Michael R Kramer
- a Department of Epidemiology , Rollins School of Public Health, Emory University , Atlanta , GA , USA
| |
Collapse
|
22
|
Koffarnus MN, Kaplan BA. Clinical models of decision making in addiction. Pharmacol Biochem Behav 2018; 164:71-83. [PMID: 28851586 PMCID: PMC5747979 DOI: 10.1016/j.pbb.2017.08.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 08/08/2017] [Accepted: 08/21/2017] [Indexed: 01/25/2023]
Abstract
As research on decision making in addiction accumulates, it is increasingly clear that decision-making processes are dysfunctional in addiction and that this dysfunction may be fundamental to the initiation and maintenance of addictive behavior. How drug-dependent individuals value and choose among drug and nondrug rewards is consistently different from non-dependent individuals. The present review focuses on the assessment of decision-making in addiction. We cover the common behavioral tasks that have shown to be fruitful in decision-making research and highlight analytical and graphical considerations, when available, to facilitate comparisons within and among studies. Delay discounting tasks, drug demand tasks, drug choice tasks, the Iowa Gambling Task, and the Balloon Analogue Risk Task are included.
Collapse
Affiliation(s)
- Mikhail N Koffarnus
- Virginia Tech Carilion Research Institute, 2 Riverside Circle, Roanoke, VA 24016, United States.
| | - Brent A Kaplan
- Virginia Tech Carilion Research Institute, 2 Riverside Circle, Roanoke, VA 24016, United States
| |
Collapse
|
23
|
Collado A, Johnson PS, Loya JM, Johnson MW, Yi R. Discounting of Condom-Protected Sex as a Measure of High Risk for Sexually Transmitted Infection Among College Students. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:2187-2195. [PMID: 27699562 PMCID: PMC5893305 DOI: 10.1007/s10508-016-0836-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 08/02/2016] [Accepted: 08/09/2016] [Indexed: 05/03/2023]
Abstract
The study examined sexual delay discounting, or the devaluation of condom-protected sex in the face of delay, as a risk factor for sexually transmitted infection (STI) among college students. Participants (143 females, 117 males) completed the sexual delay discounting task (Johnson & Bruner, 2012) and questionnaires of risky sexual behavior, risk perception, and knowledge. Participants exhibited steeper sexual delay discounting (above and beyond general likelihood of having unprotected sex) when partners were viewed as more desirable or less likely to have a STI, with males demonstrating greater sexual delay discounting than females across most conditions. Importantly, greater self-reported risky sexual behaviors were associated with higher rates of sexual delay discounting, but not with likelihood of using a condom in the absence of delay. These results provide support for considering sexual delay discounting, with particular emphasis on potential delays to condom use, as a risk factor for STI among college students.
Collapse
Affiliation(s)
- Anahí Collado
- Alvord, Baker, and Associates, LLC, 3200 Tower Oaks Blvd, Suite 200, Rockville, MD, 20852, USA.
| | - Patrick S Johnson
- Psychology Department, California State University-Chico, Chico, CA, USA
| | - Jennifer M Loya
- Psychology Department, George Mason University, Fairfax, VA, USA
| | - Matthew W Johnson
- School of Medicine, Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Richard Yi
- Psychology Department, University of Maryland- College Park, College Park, MD, USA
| |
Collapse
|
24
|
Wongsomboon V, Robles E. Devaluation of Safe Sex by Delay or Uncertainty: A Within-Subjects Study of Mechanisms Underlying Sexual Risk Behavior. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:2131-2144. [PMID: 27473071 DOI: 10.1007/s10508-016-0788-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 05/26/2016] [Accepted: 06/03/2016] [Indexed: 05/06/2023]
Abstract
The value of safe sex may be discounted based on contextual factors associated with an opportunity for sex. College students in a within-subjects study selected hypothetical sexual partners from a set of pictures and classified them based on attractiveness and estimated chance of having an sexually transmitted infection (STI). In the Sexual Delay Discounting (SDD) task, participants rated their likelihood (0-100 %) of waiting for some period of time (e.g., 3 h) to have protected sex with their selected partners, when they could have immediate sex without protection. In the Sexual Probability Discounting (SPD) task, participants rated their likelihood of having protected sex if the opportunity was uncertain (e.g., 50 %), when they could have unprotected sex for sure (100 %). All participants included in the final analyses were aware of and had a positive attitude towards protection against STIs as they were likely to have immediate (or certain) protected sex. Results from 432 delay data in the SDD task and 488 probability data in the SPD task showed that participants' preference for safe sex systematically decreased as the delay to and odds against having safe sex increased. However, this preference was altered by the participants' perception of their partner's attractiveness and STI risk.
Collapse
Affiliation(s)
- Val Wongsomboon
- School of Social and Behavioral Sciences, Arizona State University, 4701 W. Thunderbird Road, Glendale, AZ, 85306, USA.
| | - Elias Robles
- School of Social and Behavioral Sciences, Arizona State University, 4701 W. Thunderbird Road, Glendale, AZ, 85306, USA
| |
Collapse
|
25
|
Behavioral Economic Predictors of Alcohol and Sexual Risk Behavior in College Drinkers. PSYCHOLOGICAL RECORD 2017. [DOI: 10.1007/s40732-017-0239-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
26
|
Johnson MW, Herrmann ES, Sweeney MM, LeComte RS, Johnson PS. Cocaine administration dose-dependently increases sexual desire and decreases condom use likelihood: The role of delay and probability discounting in connecting cocaine with HIV. Psychopharmacology (Berl) 2017; 234:599-612. [PMID: 27921140 PMCID: PMC5343757 DOI: 10.1007/s00213-016-4493-5] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 11/21/2016] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Although cocaine use has been linked to sexual HIV risk behavior for decades, the direct effects of cocaine on sexual desire and sexual decision-making are unexamined. Research suggests delay discounting (devaluation of future outcomes) and probability discounting (devaluation of uncertain outcomes) play roles in condom use decisions. This study examined the effect of cocaine administration on sexual desire, hypothetical condom use, and discounting tasks. METHODS This double-blind, within-subjects study compared the effects of 0, 125, and 250 mg/70 kg oral cocaine HCl in 12 cocaine users. Measures included sexual desire and other subjective ratings, the Sexual Delay Discounting Task, the Sexual Probability Discounting Task, and monetary delay and probability discounting tasks. RESULTS Cocaine caused dose-related increases in sexual desire and prototypical stimulant abuse-liability ratings. Relative to placebo, cocaine did not significantly alter condom use likelihood when condoms were immediately available or when sex was associated with 100% certainty of sexually transmitted infection (STI). In contrast, cocaine dose-dependently strengthened the effect of delay (sexual delay discounting) and STI uncertainty (sexual probability discounting) in decreasing condom use likelihood. Cocaine caused no significant change in monetary delay and probability discounting. CONCLUSION This is the first study showing that cocaine administration increases sexual desire. Detrimental effects of cocaine on sexual risk were only observed when safer sex required delay, or STI risk was uncertain (representative of many real-world scenarios), suggesting a critical role of discounting processes. Lack of monetary effects highlights the importance of studying clinically relevant outcomes when examining drug effects on behavioral processes.
Collapse
Affiliation(s)
- Matthew W Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD, 21224, USA.
| | - Evan S Herrmann
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD, 21224, USA
- Columbia College of Physicians and Surgeons, New York State Psychiatric Institute, New York, NY, USA
| | - Mary M Sweeney
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD, 21224, USA
| | - Robert S LeComte
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD, 21224, USA
| | - Patrick S Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD, 21224, USA
- Department of Psychology, California State University, Chico, CA, USA
| |
Collapse
|
27
|
Abstract
Although increased impulsivity (delay discounting) is an important risk factor for drug abuse, the impact of delay on drug taking has received relatively little attention. This study examined delay discounting of the μ-opioid receptor agonist remifentanil in rhesus monkeys (n=4) responding for intravenous infusions under a concurrent choice procedure. Dose-effect curves for remifentanil were determined by varying the dose available on one lever (0.001-0.32 μg/kg/infusion) while keeping the dose available on the other lever (0.1 μg/kg/infusion) the same. Dose-effect curves were determined when both infusions were delivered immediately and when delivery of the fixed dose was delayed (15-180 s). When both doses of remifentanil were delivered immediately, monkeys chose the large dose. Delaying delivery of the fixed dose reduced choice of that dose and increased choice of small immediately available doses. Extending previous studies, these results show that the effects of delay on choice between two doses of a μ-opioid receptor agonist are consistent with hyperbolic discounting. Delaying delivery of a preferred reinforcer (e.g. large dose of drug) reduces its effectiveness and increases the effectiveness of small immediately available doses. This effect of delay, particularly on drug self-administration, might contribute to drug abuse.
Collapse
|
28
|
Hayashi Y, Miller K, Foreman AM, Wirth O. A behavioral economic analysis of texting while driving: Delay discounting processes. ACCIDENT; ANALYSIS AND PREVENTION 2016; 97:132-140. [PMID: 27614547 PMCID: PMC5154926 DOI: 10.1016/j.aap.2016.08.028] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 08/24/2016] [Accepted: 08/26/2016] [Indexed: 05/09/2023]
Abstract
The purpose of the present study was to examine an impulsive decision-making process underlying texting while driving from a behavioral economic perspective. A sample of 108 college students completed a novel discounting task that presented participants with a hypothetical scenario in which, after receiving a text message while driving, they rated the likelihood of replying to a text message immediately versus waiting to reply for a specific period of time. Participants also completed a delay discounting task in which they made repeated hypothetical choices between obtaining a larger amount of money available after a delay and an equal or lesser amount of money available immediately. The results show that the duration of the delay is a critical variable that strongly determines whether participants choose to wait to reply to a text message, and that the decrease in the likelihood of waiting as a function of delay is best described by a hyperbolic delay discounting function. The results also show that participants who self-reported higher frequency of texting while driving discounted the opportunity to reply to a text message at greater rates, whereas there was no relation between the rates of discounting of hypothetical monetary rewards and the frequency of texting while driving. The results support the conclusion that texting while driving is fundamentally an impulsive choice.
Collapse
Affiliation(s)
- Yusuke Hayashi
- Pennsylvania State University, Hazleton, 76 University Drive, Hazleton, PA 18202, USA.
| | - Kimberly Miller
- Pennsylvania State University, Hazleton, 76 University Drive, Hazleton, PA 18202, USA
| | - Anne M Foreman
- National Institute for Occupational Safety and Health, 1095 Willowdale Rd, Morgantown, WV 26505, USA
| | - Oliver Wirth
- National Institute for Occupational Safety and Health, 1095 Willowdale Rd, Morgantown, WV 26505, USA
| |
Collapse
|
29
|
Koffarnus MN, Johnson MW, Thompson-Lake DGY, Wesley MJ, Lohrenz T, Montague PR, Bickel WK. Cocaine-dependent adults and recreational cocaine users are more likely than controls to choose immediate unsafe sex over delayed safer sex. Exp Clin Psychopharmacol 2016; 24:297-304. [PMID: 27454677 PMCID: PMC5017011 DOI: 10.1037/pha0000080] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Cocaine users have a higher incidence of risky sexual behavior and HIV infection than nonusers. Our aim was to measure whether safer sex discount rates-a measure of the likelihood of having immediate unprotected sex versus waiting to have safer sex-differed between controls and cocaine users of varying severity. Of the 162 individuals included in the primary data analyses, 69 met the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR) criteria for cocaine dependence, 29 were recreational cocaine users who did not meet the dependence criteria, and 64 were controls. Participants completed the Sexual Discounting Task, which measures a person's likelihood of using a condom when one is immediately available and how that likelihood decreases as a function of delay to condom availability with regard to 4 images chosen by the participants of hypothetical sexual partners differing in perceived desirability and likelihood of having a sexually transmitted infection. When a condom was immediately available, the stated likelihood of condom use sometimes differed between cocaine users and controls, which depended on the image condition. Even after controlling for rates of condom use when one is immediately available, the cocaine-dependent and recreational users groups were more sensitive to delay to condom availability than controls. Safer sex discount rates were also related to intelligence scores. The Sexual Discounting Task identifies delay as a key variable that impacts the likelihood of using a condom among these groups and suggests that HIV prevention efforts may be differentially effective based on an individual's safer sex discount rate. (PsycINFO Database Record
Collapse
Affiliation(s)
- Mikhail N. Koffarnus
- Virginia Tech Carilion Research Institute, Virginia Tech, Roanoke, VA 24016, USA
| | - Matthew W. Johnson
- Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA
| | - Daisy G. Y. Thompson-Lake
- Menninger Department of Psychiatry and Behavioral Science, Baylor College of Medicine, Houston, TX 77030, USA
| | - Michael J. Wesley
- Virginia Tech Carilion Research Institute, Virginia Tech, Roanoke, VA 24016, USA
| | - Terry Lohrenz
- Virginia Tech Carilion Research Institute, Virginia Tech, Roanoke, VA 24016, USA
| | - P. Read Montague
- Virginia Tech Carilion Research Institute, Virginia Tech, Roanoke, VA 24016, USA
| | - Warren K. Bickel
- Virginia Tech Carilion Research Institute, Virginia Tech, Roanoke, VA 24016, USA
| |
Collapse
|
30
|
Age-dependent effects in the association between monetary delay discounting and risky sexual behavior. SPRINGERPLUS 2016; 5:852. [PMID: 27386301 PMCID: PMC4919197 DOI: 10.1186/s40064-016-2570-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 06/14/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND Monetary delay discounting is a measure of impulsivity associated with substance use and abuse, problem gambling, and other health-related outcomes. More recently, delay discounting has been shown to be associated with risky sexual behavior. We analyzed survey data from men who have sex with men who completed a monetary discounting task and reported sexual behaviors in the previous 12 months. FINDINGS Monetary delay discounting was associated with condomless anal intercourse among young (18-24 years), but not older, men who have sex with men. CONCLUSIONS Monetary delay discounting may identify young men at increased risk of engaging in HIV risk behaviors.
Collapse
|
31
|
Collado A, Loya JM, Yi R. The Effects of Deprivation and Satiation on Decision-Making Related to Risky Sex. PSYCHOLOGICAL RECORD 2016. [DOI: 10.1007/s40732-016-0168-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
32
|
Johnson PS, Sweeney MM, Herrmann ES, Johnson MW. Alcohol Increases Delay and Probability Discounting of Condom-Protected Sex: A Novel Vector for Alcohol-Related HIV Transmission. Alcohol Clin Exp Res 2016; 40:1339-50. [PMID: 27129419 PMCID: PMC4968206 DOI: 10.1111/acer.13079] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 03/28/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Alcohol use, especially at binge levels, is associated with sexual HIV risk behavior, but the mechanisms through which alcohol increases sexual risk taking are not well-examined. Delay discounting, that is, devaluation of future consequences as a function of delay to their occurrence, has been implicated in a variety of problem behaviors, including risky sexual behavior. Probability discounting is studied with a similar framework as delay discounting, but is a distinct process in which a consequence is devalued because it is uncertain or probabilistic. METHODS Twenty-three, nondependent alcohol users (13 male, 10 female; mean age = 25.3 years old) orally consumed alcohol (1 g/kg) or placebo in 2 separate experimental sessions. During sessions, participants completed tasks examining delay and probability discounting of hypothetical condom-protected sex (Sexual Delay Discounting Task, Sexual Probability Discounting Task) and of hypothetical and real money. RESULTS Alcohol decreased the likelihood that participants would wait to have condom-protected sex versus having immediate, unprotected sex. Alcohol also decreased the likelihood that participants would use an immediately available condom given a specified level of sexually transmitted infection (STI) risk. Alcohol did not affect delay discounting of money, but it did increase participants' preferences for larger, probabilistic monetary rewards over smaller, certain rewards. CONCLUSIONS Acute, binge-level alcohol intoxication may increase sexual HIV risk by decreasing willingness to delay sex in order to acquire a condom in situations where one is not immediately available, and by decreasing sensitivity to perceived risk of STI contraction. These findings suggest that delay and probability discounting are critical, but heretofore unrecognized, processes that may mediate the relations between alcohol use and HIV risk.
Collapse
Affiliation(s)
- Patrick S Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Mary M Sweeney
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Evan S Herrmann
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Matthew W Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| |
Collapse
|
33
|
Jarmolowicz DP, Lemley SM, Mateos A, Sofis MJ. A multiple-stimulus-without-replacement assessment for sexual partners: Purchase task validation. J Appl Behav Anal 2016; 49:723-9. [PMID: 27178093 DOI: 10.1002/jaba.313] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 12/11/2016] [Indexed: 01/23/2023]
Abstract
The current study developed and tested a multiple-stimulus-without-replacement (MSWO) assessment for potential sexual partners for use in research on human immunodeficiency virus. College students (N = 41) first completed an MSWO assessment and then completed a hypothetical purchase task for encounters with partners identified by the MSWO as high, median, and low preference. Overall, hypothetical purchase task responding was consistent with that from the MSWO, in that the highest valuation was observed for the high-preference partner and the lowest for the low-preference partner. Potentially interesting individual differences in purchase task responding, however, were obtained; some subjects showed differentiated responding among the 3 preference levels (n = 15), whereas others similarly valued high- and median-preference partners (n = 5), and others similarly valued low- and median-preference partners (n = 18).
Collapse
|
34
|
Paglieri F. Social choice for one: On the rationality of intertemporal decisions. Behav Processes 2016; 127:97-108. [PMID: 27118422 DOI: 10.1016/j.beproc.2016.04.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 04/14/2016] [Accepted: 04/18/2016] [Indexed: 10/21/2022]
Abstract
When faced with an intertemporal choice between a smaller short-term reward and a larger long-term prize, is opting for the latter always indicative of delay tolerance? And is delay tolerance always to be regarded as a manifestation of self-control, and thus as a rational solution to intertemporal dilemmas? I argue in favor of a negative answer to both questions, based on evidence collected in the delay discounting literature. This highlights the need for a nuanced understanding of rationality in intertemporal choice, to capture also situations in which waiting is not the optimal strategy. This paper suggests that such an understanding is fostered by adopting social choice theory as a promising framework to model intertemporal decision making. Some preliminary results of this approach are discussed, and its potential is compared with a much more studied formal model for intertemporal choice, i.e. game theory.
Collapse
Affiliation(s)
- Fabio Paglieri
- Goal-Oriented Agents Lab (GOAL), ISTC-CNR, Via San Martino della Battaglia 44, 00185 Roma, Italy.
| |
Collapse
|
35
|
Meredith SE, Sweeney MM, Johnson PS, Johnson MW, Griffiths RR. Weekly Energy Drink Use Is Positively Associated with Delay Discounting and Risk Behavior in a Nationwide Sample of Young Adults. JOURNAL OF CAFFEINE RESEARCH 2016; 6:10-19. [PMID: 26989563 PMCID: PMC4779981 DOI: 10.1089/jcr.2015.0024] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background: Energy drink use is associated with increased risk behavior among adolescents and college students. This study examined this relationship in a nationwide sample of young adults and also examined relations between energy drink use and delay discounting. Methods: Participants were 874 U.S. adults 18-28 years of age with past 30-day consumption of caffeine and alcohol. Participants completed an online survey of energy drink use, drug use, sexual activity, alcohol misuse (alcohol use disorders identification test [AUDIT]), sensation seeking (four-item Brief Sensation Seeking Scale [BSSS-4]), and delay discounting of monetary rewards and condom use. Results: Over one-third of participants (n = 303) reported consuming energy drinks at least once per week. Weekly energy drink users were more likely than less-than-weekly energy drink users to report a recent history of risk behaviors, including cigarette smoking (56% vs. 28%, p < 0.0001), illicit stimulant use (22% vs. 6%, p < 0.0001), and unprotected sex (63% vs. 45%, p < 0.0001). Covariate-adjusted analyses found that weekly energy drink users did not have significantly higher BSSS-4 scores (3.5 vs. 3.1, p = 0.098), but they had higher mean AUDIT scores (8.0 vs. 4.8, p < 0.0001), and they more steeply discounted delayed monetary rewards. Although weekly energy drink users did not show steeper discounting of delayed condom use, they showed a lower likelihood of using a condom when one was immediately available. Conclusions: This study extends findings that energy drink use is associated with risk behavior, and it is the first study to show that energy drink use is associated with monetary delay discounting.
Collapse
Affiliation(s)
- Steven E. Meredith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Calhoun Cardiology Center, University of Connecticut School of Medicine, Farmington, Connecticut
| | - Mary M. Sweeney
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Patrick S. Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Matthew W. Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Roland R. Griffiths
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, Maryland
| |
Collapse
|
36
|
Reed DD, Becirevic A, Atchley P, Kaplan BA, Liese BS. Validation of a Novel Delay Discounting of Text Messaging Questionnaire. PSYCHOLOGICAL RECORD 2016. [DOI: 10.1007/s40732-016-0167-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
37
|
Appelhans BM, French SA, Pagoto SL, Sherwood NE. Managing temptation in obesity treatment: A neurobehavioral model of intervention strategies. Appetite 2015; 96:268-279. [PMID: 26431681 DOI: 10.1016/j.appet.2015.09.035] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Revised: 08/26/2015] [Accepted: 09/28/2015] [Indexed: 12/31/2022]
Abstract
Weight loss outcomes in lifestyle interventions for obesity are primarily a function of sustained adherence to a reduced-energy diet, and most lapses in diet adherence are precipitated by temptation from palatable food. The high nonresponse and relapse rates of lifestyle interventions suggest that current temptation management approaches may be insufficient for most participants. In this conceptual review, we discuss three neurobehavioral processes (attentional bias, temporal discounting, and the cold-hot empathy gap) that emerge during temptation and contribute to lapses in diet adherence. Characterizing the neurobehavioral profile of temptation highlights an important distinction between temptation resistance strategies aimed at overcoming temptation while it is experienced, and temptation prevention strategies that seek to avoid or minimize exposure to tempting stimuli. Many temptation resistance and temptation prevention strategies heavily rely on executive functions mediated by prefrontal systems that are prone to disruption by common occurrences such as stress, insufficient sleep, and even exposure to tempting stimuli. In contrast, commitment strategies are a set of devices that enable individuals to manage temptation by constraining their future choices, without placing heavy demands on executive functions. These concepts are synthesized in a conceptual model that categorizes temptation management approaches based on their intended effects on reward processing and degree of reliance on executive functions. We conclude by discussing the implications of our model for strengthening temptation management approaches in future lifestyle interventions, tailoring these approaches based on key individual difference variables, and suggesting high-priority topics for future research.
Collapse
Affiliation(s)
- Bradley M Appelhans
- Department of Preventive Medicine, Rush University Medical Center, 1700 W Van Buren St, Suite 470, Chicago, IL 60612, USA; Department of Behavioral Sciences, Rush University Medical Center, 1645 W Jackson Blvd Suite 400, Chicago, IL 60612, USA.
| | - Simone A French
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S 2nd Street, Suite 300, Minneapolis, MN 55454, USA.
| | - Sherry L Pagoto
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.
| | - Nancy E Sherwood
- HealthPartners Institute for Education and Research, 8170 33rd Ave S, Mail Stop 23301A, Bloomington, MN 55425, USA.
| |
Collapse
|
38
|
Examining Delay Discounting of Condom-Protected Sex Among Men Who Have Sex with Men Using Crowdsourcing Technology. AIDS Behav 2015; 19:1655-65. [PMID: 26066395 DOI: 10.1007/s10461-015-1107-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Some men who have sex with men (MSM) have unprotected anal intercourse (UAI) in situations that put them at risk for HIV infection despite having the knowledge and skills to avoid these risks. The present study examined the potential role of delay discounting in sexual HIV risk behavior among MSM. Participants (n = 108) completed the Sexual Discounting Task and a questionnaire regarding UAI and other variables associated with HIV risk (e.g., age, socioeconomic status, substance use, psychiatric problems). MSM discounted the value of condom-protected anal intercourse in a manner that was orderly, hyperbolic, and sensitive to partner characteristics that likely influence realworld decisions about using condoms. Steeper discounting was associated with UAI, and other factors related to sexual HIV risk among MSM, including young age, socioeconomic disadvantage, substance use, sex under the influence of substances, and depression). Delay discounting is likely a critical, but underappreciated facet of HIV risk among MSM.
Collapse
|
39
|
White TJ, Redner R, Skelly JM, Higgins ST. Examination of a recommended algorithm for eliminating nonsystematic delay discounting response sets. Drug Alcohol Depend 2015. [PMID: 26208791 PMCID: PMC4752816 DOI: 10.1016/j.drugalcdep.2015.07.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To examine (1) whether use of a recommended algorithm (Johnson and Bickel, 2008) improves upon conventional statistical model fit (R(2)) for identifying nonsystematic response sets in delay discounting (DD) data, (2) whether removing such data meaningfully effects research outcomes, and (3) to identify participant characteristics associated with nonsystematic response sets. METHODS Discounting of hypothetical monetary rewards was assessed among 349 pregnant women (231 smokers and 118 recent quitters) via a computerized task comparing $1000 at seven future time points with smaller values available immediately. Nonsystematic response sets were identified using the algorithm and conventional statistical model fit (R(2)). The association between DD and quitting was analyzed with and without nonsystematic response sets to examine whether the inclusion or exclusion impacts this relationship. Logistic regression was used to examine whether participant sociodemographics were associated with nonsystematic response sets. RESULTS The algorithm excluded fewer cases than the R(2) method (14% vs. 16%), and was not correlated with logk as is R(2). The relationship between logk and the clinical outcome (spontaneous quitting) was unaffected by exclusion methods; however, other variables in the model were affected. Lower educational attainment and younger age were associated with nonsystematic response sets. CONCLUSIONS The algorithm eliminated data that were inconsistent with the nature of discounting and retained data that were orderly. Neither method impacted the smoking/DD relationship in this data set. Nonsystematic response sets are more likely among younger and less educated participants, who may need extra training or support in DD studies.
Collapse
Affiliation(s)
- Thomas J. White
- Vermont Center on Behavior and Health, University of Vermont,Departments of Psychiatry, University of Vermont
| | - Ryan Redner
- Vermont Center on Behavior and Health, University of Vermont,Departments of Psychiatry, University of Vermont
| | | | - Stephen T. Higgins
- Vermont Center on Behavior and Health, University of Vermont,Departments of Psychiatry, University of Vermont,Psychology, University of Vermont
| |
Collapse
|
40
|
Quisenberry AJ, Eddy CR, Patterson DL, Franck CT, Bickel WK. Regret Expression and Social Learning Increases Delay to Sexual Gratification. PLoS One 2015; 10:e0135977. [PMID: 26280349 PMCID: PMC4539230 DOI: 10.1371/journal.pone.0135977] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 07/28/2015] [Indexed: 11/24/2022] Open
Abstract
Objective Modification and prevention of risky sexual behavior is important to individuals’ health and public health policy. This study employed a novel sexual discounting task to elucidate the effects of social learning and regret expression on delay to sexual gratification in a behavioral task. Methods Amazon Mechanical Turk Workers were assigned to hear one of three scenarios about a friend who engages in similar sexual behavior. The scenarios included a positive health consequence, a negative health consequence or a negative health consequence with the expression of regret. After reading one scenario, participants were asked to select from 60 images, those with whom they would have casual sex. Of the selected images, participants chose one image each for the person they most and least want to have sex with and person most and least likely to have a sexually transmitted infection. They then answered questions about engaging in unprotected sex now or waiting some delay for condom-protected sex in each partner condition. Results Results indicate that the negative health outcome scenario with regret expression resulted in delayed sexual gratification in the most attractive and least STI partner conditions, whereas in the least attractive and most STI partner conditions the negative health outcome with and without regret resulted in delayed sexual gratification. Conclusions Results suggest that the sexual discounting task is a relevant laboratory measure and the framing of information to include regret expression may be relevant for prevention of risky sexual behavior.
Collapse
Affiliation(s)
- Amanda J. Quisenberry
- Virginia Tech Carilion Research Institute, Roanoke, Virginia, United States of America
| | - Celia R. Eddy
- Virginia Tech Carilion Research Institute, Roanoke, Virginia, United States of America
- Virginia Tech, Department of Statistics, Blacksburg, Virginia, United States of America
| | - David L. Patterson
- Virginia Tech Carilion Research Institute, Roanoke, Virginia, United States of America
| | - Christopher T. Franck
- Virginia Tech Carilion Research Institute, Roanoke, Virginia, United States of America
- Virginia Tech, Department of Statistics, Blacksburg, Virginia, United States of America
| | - Warren K. Bickel
- Virginia Tech Carilion Research Institute, Roanoke, Virginia, United States of America
- * E-mail:
| |
Collapse
|
41
|
Jarmolowicz DP, Lemley SM, Asmussen L, Reed DD. Mr. right versus Mr. right now: A discounting-based approach to promiscuity. Behav Processes 2015; 115:117-22. [DOI: 10.1016/j.beproc.2015.03.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 02/27/2015] [Accepted: 03/02/2015] [Indexed: 10/23/2022]
|
42
|
Delay and probability discounting of sexual and monetary outcomes in individuals with cocaine use disorders and matched controls. PLoS One 2015; 10:e0128641. [PMID: 26017273 PMCID: PMC4445907 DOI: 10.1371/journal.pone.0128641] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 04/29/2015] [Indexed: 12/11/2022] Open
Abstract
Individuals with cocaine use disorders are disproportionately affected by HIV/AIDS, partly due to higher rates of unprotected sex. Recent research suggests delay discounting of condom use is a factor in sexual HIV risk. Delay discounting is a behavioral economic concept describing how delaying an event reduces that event’s value or impact on behavior. Probability discounting is a related concept describing how the uncertainty of an event decreases its impact on behavior. Individuals with cocaine use disorders (n = 23) and matched non-cocaine-using controls (n = 24) were compared in decision-making tasks involving hypothetical outcomes: delay discounting of condom-protected sex (Sexual Delay Discounting Task), delay discounting of money, the effect of sexually transmitted infection (STI) risk on likelihood of condom use (Sexual Probability Discounting Task), and probability discounting of money. The Cocaine group discounted delayed condom-protected sex (i.e., were more likely to have unprotected sex vs. wait for a condom) significantly more than controls in two of four Sexual Delay Discounting Task partner conditions. The Cocaine group also discounted delayed money (i.e., preferred smaller immediate amounts over larger delayed amounts) significantly more than controls. In the Sexual Probability Discounting Task, both groups showed sensitivity to STI risk, however the groups did not differ. The Cocaine group did not consistently discount probabilistic money more or less than controls. Steeper discounting of delayed, but not probabilistic, sexual outcomes may contribute to greater rates of sexual HIV risk among individuals with cocaine use disorders. Probability discounting of sexual outcomes may contribute to risk of unprotected sex in both groups. Correlations showed sexual and monetary results were unrelated, for both delay and probability discounting. The results highlight the importance of studying specific behavioral processes (e.g., delay and probability discounting) with respect to specific outcomes (e.g., monetary and sexual) to understand decision making in problematic behavior.
Collapse
|
43
|
Dariotis JK, Johnson MW. Sexual discounting among high-risk youth ages 18-24: implications for sexual and substance use risk behaviors. Exp Clin Psychopharmacol 2015; 23:49-58. [PMID: 25545764 PMCID: PMC4350924 DOI: 10.1037/a0038399] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Youth under 25 show substantial sexual and substance use risk behaviors. One factor associated with risk behaviors is delay discounting, the devaluation of delayed outcomes. This study determined if delay discounting for sexual outcomes is related to sexual risk and substance use among 18-24 year olds. Females (70) and males (56) completed the Sexual Discounting Task, which assessed their likelihood of having unprotected immediate sex versus waiting for sex with a condom, at various delays, with 4 hypothetical sexual partners selected from photographs: the person they most wanted to have sex with, least wanted to have sex with, judged most likely to have a sexually transmitted infection (STI), and judged least likely to have an STI. They also completed instruments assessing HIV knowledge, sexual behaviors, substance use, risk attitudes, inhibition, impulsivity, and sensation-seeking. Condom use likelihood generally decreased with increasing delay. Preference for immediate, unprotected sex was greater for partners whom participants most (vs. least) wanted to have sex with and judged least (vs. most) likely to have an STI. Preference for immediate, unprotected sex in the "most want to have sex with" and "least likely to have an STI" conditions was related to greater lifetime risky sexual partners, lifetime number of unique substances used, disregard of social approval/danger, disinhibition, and sensation/excitement-seeking. Males showed greater likelihood of unprotected sex than females when condom use was undelayed, but delay similarly affected condom use between sexes. Delay discounting should be considered in strategies to minimize youth risk behavior.
Collapse
Affiliation(s)
- Jacinda K. Dariotis
- Johns Hopkins Bloomberg School of Public Health, Department of Population, Family, and Reproductive Health, Center for Adolescent Health, Hopkins Population Center
| | - Matthew W. Johnson
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Behavioral Pharmacology Research Unit
| |
Collapse
|