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）：综合证据表明，个体难以忍受痛苦与药物滥用有重要联系，药物滥用是青少年面临艾滋病毒风险的关键行为（Brandon 等人，2003 年；Brown、Lejuez、Kahler 和 Strong， 2002 年，莱胡埃斯、博诺瓦洛娃等人，2005 年；莱胡埃斯、卡勒等人， 2005 年；奎因、布兰登和科普兰，1996 年）。这项研究源自对成年吸毒者的研究，利用痛苦耐受性的行为测量来评估一个人在强烈情绪不适的情况下坚持目标导向行为的能力，或者简单地说，一个人有效忍受情绪困扰的能力。最近，我们在青少年中建立了类似的联系（Daughters, Lejuez et al., 2007）。尽管先前尚未研究过低痛苦耐受性与危险性行为之间的联系，但理论和经验原因表明这种联系也可能存在（参见 Lejuez，2007）。鉴于有令人信服的证据表明，个人难以忍受痛苦与药物滥用有重要联系，并且与危险性行为有潜在联系，因此尝试了解青少年痛苦耐受性的前兆具有相当大的公共卫生相关性。一些理论观点和大量的经验证据表明，家庭的情绪氛围和家庭关系的质量对儿童的功能有重大影响，包括参与危险行为（例如，Bornstein，2002；Maccoby，2007）。此外，对理论和研究的检验（例如，Bowlby，1969/1982；Cassidy & Shaver，1999；Eisenberg 等，1998；Gottman 等，1996，1997）表明家庭情绪氛围的两个方面可能与青少年痛苦耐受性：(a) 母亲对痛苦的反应，以及 (b) 青少年依恋。因此，检查家庭因素与青少年承受情绪困扰的能力以及随后艾滋病毒危险行为的发展之间的联系似乎很有用。拟议的横断面研究有几个目标。首先，我们寻求通过提供青少年痛苦耐受性与药物滥用之间联系的进一步证据，以及首次检查痛苦耐受性与艾滋病毒风险行为之间的联系，来扩展之前研究青少年痛苦耐受性与艾滋病毒风险行为之间联系的工作。危险的性行为。其次，我们将通过关注家庭情绪氛围来尝试阐明低痛苦承受能力的风险因素。最后，在基于负强化的艾滋病毒风险模型的背景下，我们将研究痛苦耐受力作为家庭情绪背景与艾滋病毒风险行为之间联系的中介因素。这项研究的一个优点是，参与者（240 名 13 至 16 岁的孩子）将来自一项正在进行的艾滋病毒风险行为纵向研究，该研究并未涉及家庭情绪氛围。这种方法具有成本效益，并通过对冒险倾向的行为测量，提供了增强现有数据集的机会，包括来自遗传脆弱性和环境逆境的其他艾滋病毒相关指标。公共卫生相关性大量证据表明，在情绪困扰（痛苦不耐受）的情况下，难以坚持以目标为导向的行为与物质使用问题有关。我们将以两种重要且创新的方式扩大这项工作的范围：（a）检查痛苦不容忍是否也与危险的性行为有关，以及（b）考虑是否可以通过家庭情感背景来预测痛苦不容忍。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，因此它们反过来将有助于制定有效的干预计划。