Effects of Cocaine and HIV on Decision Making Involving Potential Losses

可卡因和艾滋病毒对涉及潜在损失的决策的影响

基本信息

批准号：
8691776
负责人：
CHRISTINA S MEADE
金额：
$ 19.63万
依托单位：
DUKE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-07-01 至 2016-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8691776
关键词：
AIDS prevention AIDS/HIV problem Accounting Address Adult Affect Alcohol or Other Drugs use Behavior Behavioral Brain Clinical Clinical Psychology Cocaine Cocaine Dependence Cocaine Users Complex Computer Simulation Decision Making Development Disease Disease Progression Drug Addiction Drug Use Disorder Economic Models Economics Evaluation Figs - dietary Gambling Goals HIV HIV Infections HIV Seropositivity HIV risk Individual Individual Differences Intervention Lateral Methods Modeling Morbidity - disease rate NIH Program Announcements Neurocognitive Deficit Outcome Overweight Persons Pharmaceutical Preparations Physics Population Prefrontal Cortex Probability Process Relative (related person)Research Rewards Risk Risk Assessment Risk Behaviors Risk-Taking Sampling Sex Behavior Sexual Transmission Substance abuse problem Technetium Tc 99m ciprofloxacin Translations Uncertainty Ventral Striatum Vulnerable Populations Work case control clinical practice cognitive neuroscience design executive function experience high risk innovation insight mortality multidisciplinary neuroeconomics neuroimaging neuromechanism neuropsychiatry novel patient oriented research programs public health relevance relating to nervous system response reward processing sex risk stimulant abuse theories transmission process willingness

项目摘要

DESCRIPTION (provided by applicant): Individuals addicted to stimulant drugs like cocaine are at high risk for engaging in sexual behaviors that contribute to the acquisition of HIV and, once infected, to the forward transmission of HIV to others. HIV-related decision making, like most real-world decisions, involves the valuation of potential gains and losses in the context of uncertain outcomes. Cocaine dependence and HIV infection can each disrupt brain circuits that regulate executive functions involved in decision making. We postulate that these neural changes affect the processing of reward evaluation and outcome uncertainty and contribute to sexual risk behavior. Our preliminary work suggests that cocaine dependence increases loss aversion (i.e., overweighting of potential losses relative to potential gains), and that HIV infecton is associated with greater risk taking propensity among persons with cocaine dependence. Moreover, loss aversion is positively correlated with sexual risk behavior, suggesting that basic decision making processes may be predictive of more complex real-world behavior. The proposed research builds upon our prior work by combining functional neuroimaging, behavioral risk assessment, and computational modeling to: (1) isolate the effects of cocaine dependence and HIV infection on decision making processes, specifically loss aversion and ambiguity tolerance, and (2) examine the relationship between these decision making processes and sexual risk behavior. Using a case-control design, we will examine behavioral choice and brain activity during monetary gambles that vary independently on the value of gains and losses and the certainty of outcomes. The sample will include 80 adults who differ on cocaine and HIV status, comprising four distinct groups (20/group). Our multidisciplinary team, with expertise in clinical psychology, cognitive neuroscience, behavioral neuroeconomics, and MR physics, has extensive experience conducting patient-oriented research on HIV risk behavior in persons with drug dependence and is uniquely poised to successfully implement this innovative and clinically important project. Results of this R21 proposal will provide unique insights into the mechanisms underlying HIV-related decision making, providing support for a subsequent R01 application to further investigate how HIV disease progression may affect neural processes that contribute to "risky" decision making among cocaine users. This research has strong potential for translation to clinical practice, informing the development of novel interventions to more effectively reduce risk behavior by directly targeting underlying neurocognitive deficits, with the ultimate goal of reducing HIV- related morbidity and mortality in persons with drug use disorders.

描述（由申请人提供）：对可卡因等刺激药物的人有高风险，从事性行为的高风险，这些行为有助于获得艾滋病毒，一旦感染了艾滋病毒向他人的前进传播。与大多数现实世界的决策一样，与艾滋病毒相关的决策涉及在不确定结果的背景下对潜在损益的估值。可卡因依赖性和艾滋病毒感染会破坏调节决策涉及的执行功能的大脑电路。我们假设这些神经变化会影响奖励评估和结果不确定性的处理，并导致性风险行为。我们的初步工作表明，可卡因依赖性增加了损失的厌恶厌恶（即相对于潜在增长的潜在损失超重），并且HIV感染与可卡因依赖性患者的倾向更大的风险相关。此外，损失厌恶与性风险行为呈正相关，表明基本决策过程可能可以预测更复杂的现实世界行为。拟议的研究通过将功能性神经影像学，行为风险评估和计算建模结合到我们先前的工作为基础：（1）隔离可卡因依赖性和HIV感染对决策过程的影响，特别是损失厌恶和歧义耐受性，以及（2）检查这些决策过程与性风险行为之间的关系。使用案例对照设计，我们将在货币赌博过程中检查行为选择和大脑活动，这些货币赌博在收益和损失的价值以及结果的确定性上独立变化。样本将包括80名在可卡因和艾滋病毒状况不同的成年人，包括四个不同的组（20/组）。我们的多学科团队在临床心理学，认知神经科学，行为神经经济学和MR物理学方面具有专业知识，拥有丰富的经验，这些经验在药物依赖的患者中对患者的艾滋病毒风险行为进行研究，并具有独特的准备，可以成功实施这一创新和临床重要的项目。。该R21提案的结果将为与HIV相关的决策的基础机制提供独特的见解，从而为随后的R01应用提供支持，以进一步研究HIV疾病进展如何影响可卡因使用者中“风险的”决策的神经过程。这项研究具有转化为临床实践的强大潜力，可以通过直接针对潜在的神经认知缺陷来开发新的干预措施，以更有效地降低风险行为，并最终的目标是降低药物使用障碍患者的HIV相关发病率和死亡率。