Distress Tolerance: Links with Family Emotional Climate and Adolescent HIV Risk

痛苦耐受力：与家庭情绪氛围和青少年艾滋病毒风险的联系

基本信息

批准号：
7554516
负责人：
JUDE A CASSIDY
金额：
$ 22.5万
依托单位：
UNIV OF MARYLAND, COLLEGE PARK
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-09-25 至 2010-07-31
项目状态：
已结题

项目摘要

DESCRIPTION (provided by applicant): Converging evidence indicates that an individual's difficulty tolerating distress has important links to substance abuse, a key behavior that places adolescents at risk for HIV (Brandon et al., 2003; Brown, Lejuez, Kahler, & Strong, 2002; Daughters, Lejuez, Bornovalova et al., 2005; Daughters, Lejuez, Kahler et al., 2005; Quinn, Brandon, & Copeland, 1996). This body of research has emerged from studies with adult drug abusers utilizing behavioral measures of distress tolerance to assess one's ability to persist in goal directed behavior in the presence of intense emotional discomfort, or simply, one's ability to effectively tolerate emotional distress. More recently, we have established a similar link in adolescents (Daughters, Lejuez et al., 2007). Although links of low distress tolerance with risky sexual behavior have not been examined previously, there are theoretical and empirical reasons that suggest that this link may exist as well (see Lejuez, 2007). Given compelling evidence that an individual's difficulty tolerating distress has important links to substance abuse, and potential links to risky sexual behavior, attempts to understand the precursors of distress tolerance in adolescents have considerable public health relevance. Several theoretical perspectives and considerable empirical evidence suggest that the emotional climate of the family and the quality of family relationships have major implications for a child's functioning, including engagement in risk behaviors (e.g., Bornstein, 2002; Maccoby, 2007). Further, examination of theory and research (e.g., Bowlby, 1969/1982; Cassidy & Shaver, 1999; Eisenberg et al., 1998; Gottman et al., 1996, 1997) suggests two aspects of family emotional climate that may be linked to adolescent distress tolerance: (a) maternal response to distress, and (b) adolescent attachment. Thus, it appears useful to examine links between family factors and adolescent capacity to tolerate emotional distress, and the subsequent development of HIV risk behavior. The proposed cross-sectional study has several goals. First, we seek to extend previous work examining links between adolescent distress tolerance and HIV risk behavior by providing further evidence of the link between adolescent distress tolerance and substance use, as well as by examining, for the first time, the link between distress tolerance and risky sexual behavior. Second, we will attempt to elucidate risk factors for low distress tolerance by focusing on the family emotional climate. Finally, in the context of a negative- reinforcement-based model of HIV risk, we will examine distress tolerance as a mediator of the link between family emotional context and HIV risk behavior. An advantage of this study is that participants (240 13- to 16- year-olds) will be taken from an ongoing longitudinal study of HIV risk behavior that does not address family emotional climate. This approach is cost effective and provides opportunities to enhance an existing data set including other relevant indicators of HIV from genetic vulnerability and environmental adversity through behavioral measurement of risk-taking propensity. PUBLIC HEALTH RELEVANCE Considerable evidence indicates that difficulties persisting in goal-directed behavior in the context of emotional distress (distress intolerance) is linked to substance use problems. We will expand the scope of this work in two important and innovative ways: (a) by examining whether distress intolerance is also linked to risky sexual behavior, and (b) by considering whether distress intolerance can be predicted by family emotional context. Because these data will contribute to the development of a more comprehensive model of vulnerability to HIV risk behavior, they will in turn be useful in creating effective intervention programs.

描述（由申请人提供）：融合证据表明，个人的难以容忍困扰与药物滥用有重要联系，这是使青少年面临艾滋病毒风险的关键行为（Brandon等，2003； Brown，Brown，Lejuez，Kahler，Kahler，＆Strong，2002; lejuez，Lejuez，Lejuez，Bornovalova et al。 Brandon和Copeland，1996）。这项研究的体系来自对成年虐待者的研究，利用遇险宽容的行为度量来评估一个人在存在激烈的情绪不适的情况下，或者简单地有效地容忍情绪困扰的能力。最近，我们在青少年建立了类似的联系（女儿，Lejuez等，2007）。尽管以前尚未对低遇险宽容与风险性行为的联系联系，但理论和经验原因表明这种联系也可能存在（参见Lejuez，2007年）。鉴于令人信服的证据表明，个人难以容忍的困难与滥用毒品具有重要联系，并与风险的性行为有潜在的联系，因此试图了解青少年的遇险宽容的先兆具有相当大的公共卫生相关性。几种理论观点和可观的经验证据表明，家庭的情感氛围和家庭关系的质量对孩子的功能具有重大影响，包括参与风险行为（例如Bornstein，2002; Maccoby，2007）。此外，对理论与研究的研究（例如Bowlby，1969/1982； Cassidy＆Shaver，1999; Eisenberg et al。，1998; Gottman等，1996，1996，1997）提出了家庭情感气氛的两个方面，这些方面可能与青少年的痛苦承受能力联系在一起：（a）对苦恼的孕妇响应：（a）孕妇的孕育和（b）Adecmend andemend。因此，检查家庭因素与青少年能力之间的联系以容忍情绪困扰以及随后的艾滋病毒风险行为的发展似乎很有用。拟议的横断面研究有多个目标。首先，我们试图扩展以前的工作，通过提供进一步的证据，证明青少年遇险耐受性和使用物质之间的联系，以及首次检查遇险宽容与风险的性行为之间的联系，从而扩展了研究青少年遇险宽容与艾滋病毒风险行为之间的联系。其次，我们将通过关注家庭情感气氛来阐明低遇险容忍度的风险因素。最后，在基于负面强化的艾滋病毒风险模型的背景下，我们将研究遇险宽容，作为家庭情感环境与艾滋病毒风险行为之间联系的调解人。这项研究的一个优点是，参与者（240名13至16岁的孩子）将从正在进行的艾滋病毒风险行为的纵向研究中获取，该研究无法解决家庭情感氛围。这种方法具有成本效益，并提供了增强现有数据集的机会，包括其他相关的艾滋病毒指标，从遗传脆弱性和环境逆境到行为衡量冒险倾向。公共卫生相关性的大量证据表明，在情绪困扰（遇险不容忍）的背景下，目标指导行为的困难与药物使用问题有关。我们将以两种重要且创新的方式扩大这项工作的范围：（a）检查遇险不耐受是否也与危险的性行为有关，（b）考虑是否可以通过家庭情感环境来预测遇险不耐受。由于这些数据将有助于开发更全面的艾滋病毒风险行为脆弱性模型，因此它们反过来又将有助于创建有效的干预计划。