Neurocognitive & Psychiatric Dimensions of Hot, But Not Cool, Impulsivity Predict HIV Sexual Risk Behaviors among Drug Users in Protracted Abstinence
BACKGROUND:
Impulsivity
is an important risk factor for HIV risky drug and sexual behaviors. Research
identifies hot (i.e. affectively-mediated, reward-based) and cool (motoric,
attentional, independent of context) neurocognitive and psychiatric dimensions
of impulsivity, though the impact of specific drugs of abuse on these varieties
of impulsivity remains an open question.
OBJECTIVES:
The
present study examined the associations of neurocognitive and psychiatric
varieties of hot and cool impulsivity with measures of lifetime and recent
sexual risk behaviors among users of different classes of drugs.
METHODS:
The study
sample was comprised of drug users in protracted (> 1 year) abstinence:
heroin mono-dependent (n = 61), amphetamine mono-dependent (n = 44), and
polysubstance dependent (n = 73). Hot impulsivity was operationalized via
neurocognitive tasks of reward-based decision-making and symptoms of
psychopathy. Cool impulsivity was operationalized via neurocognitive tasks of
response inhibition and symptoms of attention deficit/hyperactivity disorder
(ADHD).
RESULTS:
Hot
impulsivity was associated with sexual risk behaviors among heroin and
amphetamine users in protracted abstinence, whereas cool impulsivity was not
associated with sexual risk behaviors among any drug-using group.
Neurocognitive hot impulsivity was associated with recent (past 30-day) sexual
risk behaviors, whereas psychopathy was associated with sexual risk behaviors
during more remote time-periods (past 6 month and lifetime) and mediated the
association between heroin dependence and past 6-month sexual risk behaviors.
CONCLUSION:
Assessments
and interventions aimed at reducing sexual risk behaviors among drug users
should focus on hot neurocognitive and psychiatric dimensions of impulsivity,
such as decision-making and psychopathy. Cool dimensions of impulsivity such as
response inhibition and ADHD were not related to sexual risk behaviors among
drug users in protracted abstinence.
- 1 Department of Psychology , University of Illinois at Chicago , Chicago , IL , USA.
- 2 Department of Psychiatry , Institute for Drug and Alcohol Studies, Virginia Commonwealth University School of Medicine , Richmond , VA , USA.
- Am J Drug Alcohol Abuse. 2016 Feb 2:1-11.
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