The long-term outcome of a personal network-oriented HIV prevention intervention for injection drug users: The SAFE study

Social influence processes have been found to affect numerous drug and health-related behaviors. We postulated that by using a network-oriented intervention it may be possible to capitalize on social influence processes to reduce human immunodeficiency virus (HIV) risk behaviors. The present study used an experimental study design for delivering a psychoeducational acquired immunodeficiency syndrome (AIDS) preventive intervention to injection drug sharing networks. Participants were recruited from the ALIVE study, an epidemiological study in Baltimore. In the present paper we examine the self-reported behavioral outcomes of 117 injection drug users 18 months after the baseline interview. HIV seronegative experimental participants reported significantly less frequent needle sharing and less injecting of heroin and cocaine than controls. In multiple logistic regression models of HIV seronegative participants, there was a significant negative association between assignment to the experimental group and the HIV-related behaviors of needle sharing and sharing of cookers in the prior 6 months; controls were 2.8 times more likely than experimentals to report needle sharing and were 2.7 times more likely to report sharing cookers. The results of this 18-month follow-up suggest that among injection drug users network-oriented interventions may be a promising approach to HIV prevention.     

Changing Drug Users’ Risk Environments: Peer Health Advocates as Multi-level Community Change Agents

Peer delivered, social oriented HIV prevention intervention designs are increasingly popular for addressing broader contexts of health risk beyond a focus on individual factors. Such interventions have the potential to affect multiple social levels of risk and change, including at the individual, network, and community levels, and reflect social ecological principles of interaction across social levels over time. The iterative and feedback dynamic generated by this multi-level effect increases the likelihood for sustained health improvement initiated by those trained to deliver the peer intervention. The Risk Avoidance Partnership (RAP), conducted with heroin and cocaine/crack users in Hartford, Connecticut, exemplified this intervention design and illustrated the multi-level effect on drug users’ risk and harm reduction at the individual level, the social network level, and the larger community level. Implications of the RAP program for designing effective prevention programs and for analyzing long-term change to reduce HIV transmission among high-risk groups are discussed from this ecological and multi-level intervention perspective.     

My place,your place,and no place: Behavior settings as a risk factor for HIV-related injection practices of drug users in Baltimore,Maryland

Information is sparse on the social context of illicit drug injection behaviors and their relationship to HIV infection. This study examined relationships between injection settings, injecting with others, and HIV risk behaviors of sharing needles and not cleaning contaminated needles in a sample of 630 inner-city injecting drug users in Baltimore, MD. Through open-ended interviews, five primary settings of injection behavior were identified. These settings included one's own, friends' and mother's residence, shooting galleries, and semipublic areas. Most participants reported injecting in their own residence (92%) and friends' residence (86%) in the prior 6 months. In a multiple regression analysis, injecting at friends' residence, in shooting galleries, and in semipublic areas and frequency of injecting with others were significantly associated with frequency of sharing uncleaned needles, “slipping” (i.e., failure to disinfect shared needles), and not always cleaning used needles before injecting. Results suggest that interventions may benefit from targeting settings as well as behaviors to reduce the spread of HIV. This research was supported by grants DA04334, DA05911, DA06313, and DA08985 from the National Institute on Drug Abuse.     

Developmental trajectories to heroin dependence: Theoretical and clinical issues

We have built up a great deal of insight into the early developmental trajectories that lead to heroin use. These cluster under five domains: social disadvantage, parental drug use/psychopathology, childhood abuse and neglect, early onset psychopathology and antisocial behaviors, and a developmental sequence of drug onsets. While not all heroin users have these risk factors, the broad clinical picture shows these early correlates to be the predominant presentation. We discuss each of the early psychosocial correlates of heroin dependence, as well as possible early interventions. Given the chronicity of heroin dependence, interventions to prevent heroin use emerging would reduce the considerable burden of disease associated with the disorder.     

Why is the receipt of social support associated with increased psychological distress? an examination of three hypotheses

Abstract

Although there is a great deal of research linking social support with favourable psychological well-being outcomes a number of contradictory findings have been published showing support to be associated with increased psychological distress. These contrary findings arise when social support is measured as the receipt of supportive behavior rather than perceptions of support availability and quality. This paper examines three hypotheses that have been advanced to explain why the receipt of support is associated with distress. The first of these hypotheses (the support mobilisation hypothesis) argues that the relationship is a spurious one, and that it is a product of distressing circumstances which increase both support receipt and psychological distress. The other two hypotheses (the inequity hypothesis and the esteem threat hypothesis) both argue that receiving support actually causes distress. We tested these hypotheses in two samples. One sample was a group of individuals who reported having some form of disability (N = 106). the other sample was a 'healthy' comparison group (N = 134). Our analyses showed that in both groups the receipt of support was significantly and positively related to reports of anxiety, but not to reports of depression. Among the 'healthy' sample, controlling for subjects' sex largely explained the positive association between support receipt and anxiety. This was not the case among the 'disabled sample, where the inequity hypothesis received the strongest support. The implications of these findings for interventions based around the provision of social support are examined.     

The logic of social exchange: has natural selection shaped how humans reason? Studies with the Wason selection task

In order to successfully engage in social exchange--cooperation between two or more individuals for mutual benefit--humans must be able to solve a number of complex computational problems, and do so with special efficiency. Following Marr (1982), Cosmides (1985) and Cosmides and Tooby (1989) used evolutionary principles to develop a computational theory of these adaptive problems. Specific hypotheses concerning the structure of the algorithms that govern how humans reason about social exchange were derived from this computational theory. This article presents a series of experiments designed to test these hypotheses, using the Wason selection task, a test of logical reasoning. Part I reports experiments testing social exchange theory against the availability theories of reasoning; Part II reports experiments testing it against Cheng and Holyoak's (1985) permission schema theory. The experimental design included eight critical tests designed to choose between social exchange theory and these other two families of theories; the results of all eight tests support social exchange theory. The hypothesis that the human mind includes cognitive processes specialized for reasoning about social exchange predicts the content effects found in these experiments, and parsimoniously explains those that have already been reported in the literature. The implications of this line of research for a modular view of human reasoning are discussed, as well as the utility of evolutionary biology in the development of computational theories.     

An investigation of some hypotheses concerning rape and murder

The study compared three groups of incarcerated criminals, including 40 men convicted of rape, 40 convicted of murder (of another male) and 40 sentenced for property offenses. A number of personality and attitude scales, behavioral records and a binocular rivalry test were used to test various hypotheses concerning rape and murder. Rapists and murderers did not differ on general control of aggressive behavior but both showed more control than convicted felons. In the binocular rivalry task rapists and murderers were less prone to perceive sexuality than property felons, but the three groups did not differ on perceived aggression toward women. Rapists and murderers were more prone to deny feminine traits than property felons. Rapists had heterosexual experience with more partners than property felons. The three groups did not differ on attitudes toward women or on disinhibition as a mode of sensation seeking. In general, rapists resemble murderers more than ordinary felons and the evidence does not support hypotheses that characterize them as significantly more hostile toward women than are other types of criminals.     

Construct Validity of the Balloon Analogue Risk Task (BART): Relationship with MDMA Use by Inner-City Drug Users in Residential Treatment

In a program of research assessing the validity of the balloon analogue risk task (BART; C. W. Lejuez et al., 2002) as a measure of risk taking, the BART was administered to a sample of inner-city drug users in residential treatment (n = 76). Construct validity of the BART was evaluated by measuring risk-taking behavior and 3,4-methylenedioxymethamphetamine (MDMA) use while controlling for self-reported impulsivity, sensation seeking, polysubstance use, and demographic variables. Supporting the construct validity of the BART, while controlling for interrelated variables in the context of logistic regression analyses, (BART) risk-taking propensity accounted for significant incremental variance in differentiating MDMA users from non-users. BART scores, polysubstance use, and younger age were most associated with MDMA use, and together these variables were associated with 91% classification accuracy in predicting MDMA use.     

The association between heroin use and anxiety sensitivity among inner-city individuals in residential drug use treatment

The current study represents an initial investigation of the association between heroin use and anxiety sensitivity (AS). Within a sample of 172 inner-city treatment seeking drug users, AS was compared across past year (1) heroin users with no crack/cocaine use (n=12); (2) crack/cocaine users with no heroin use (n=66); (3) users of both heroin and crack/cocaine (n=45); and (4) individuals with no use of heroin or crack/cocaine (n=49). Consistent with expectations, primary heroin users evidenced higher levels of AS than all other groups, with these differences also evidenced for the physical and social subscales. Differences in AS total score and physical subscale score persisted after controlling for demographic variables, depressive symptoms, and primary use of drugs other than heroin and crack/cocaine including alcohol, nicotine, marijuana, and hallucinogens. Findings suggest a unique relationship between AS and heroin, and set the stage for future work explicating the direction of the observed association.     

Risk-taking orientation and injury among youth workers: examining the social influence of supervisors, coworkers, and parents

Despite youths' susceptibility to social influence, little research has examined the extent to which social factors impact youths' risk-taking orientation and injury at work. Drawing on social influence and behavioral intention theories, this study hypothesized that perceived supervisory influence, coworker risk taking, and parental risk taking serve as key exogenous variables of risk-taking orientation at work. Risk-taking orientation was further hypothesized to serve as a direct predictor and full mediator of work injury. The effect of parental risk taking was also hypothesized to be mediated through global risk taking, which in turn was posited to predict risk-taking orientation at work. Longitudinal results from 2,542 adolescents working across a wide spectrum of jobs supported hypothesized linkages, although there was some evidence of partially mediated mechanisms. Coworker risk taking was a relatively strong predictor of youths' risk-taking orientation at work.     

The social value of risk-taking

In this study, the following hypothesis concerning the social value of risk-taking is advanced: young men who wish to assert themselves and to gain prestige tend to take greater risks in public when together with other young men than do young men who do not have these wishes, whereas there is no such difference in risk-taking in private. This hypothesis is empirically tested and is supported.     

Attitudes,risk perception and risk-taking behaviour among regular cyclists in Norway

The main aim of the study was to investigate whether attitudes toward traffic safety, risk perception, worry, risk tolerance, safety priority, and accident involvement are associated with cyclists’ risk-taking behaviour. Two types of cyclists’ risk-taking behaviour were studied: (1) ‘violation of traffic rules, and (2) ‘conflicts with other road users when cycling’. The study was based on a questionnaire survey carried out in 2017 among regular cyclists in Norway (n = 426). The results revealed that cyclists’ risk-taking behaviour was influenced by their attitudes, risk perception, and accident involvement. Pragmatic attitudes toward traffic rule violations and safety priority were found to be important predictors of the frequency of rule violations when cycling. Attitudes towards the enforcement of traffic rules for cyclists and dissatisfaction with the traffic rules for cyclists were found to be important predictors for the frequency of situations involving conflicts with other road users. Risk perception and accident involvement were found to be associated with conflicts with other road users, but not with rule violations when cycling. The findings show that risk perception and attitudes toward traffic safety are important for cyclists’ risk-taking behaviour in traffic. The road infrastructure and the traffic regulations are primarily planned for car drivers and pedestrians. If cyclists’ attitudes are to be changed, the cycling infrastructure and traffic rules for cyclists would need to be adjusted to cyclists as road users. When building new infrastructure and implementing new safety measures for cyclists, it is important to include attitude campaigns, as well as communications to the public about safety and the risks linked to cycling. Attitude campaigns could be used to strengthen the authorities’ communications that cyclists are prioritized as road users.     

Heroin addicts reporting previous heroin overdoses also report suicide attempts

Nonfatal heroin overdoses and suicide attempts are both common among heroin addicts, but there is limited knowledge about the association between them. The sample in the present study consisted of 149 regular heroin users in Malmö, Sweden. Out of these 98 had taken an unintentional heroin overdose at some time and 51 had made at least one attempt to commit suicide (but not using heroin). Suicide attempts were significantly more common among those who had taken unintentional overdoses as compared with those who had never taken any overdose (p < 0.01). The more overdoses, the greater the risk of suicide attempt.     

奖赏和损失情境下男性海洛因戒断者的风险决策缺陷

摘 要 采用修改版的多伦多赌博任务考察决策情境对海洛因戒断者风险决策的影响。研究结果主要发现,海洛因戒断者在损失情境下的风险寻求决策比率与吸毒年限显著正相关,这种相关提示了风险决策背景下海洛因成瘾者持续使用毒品与其较低的损失敏感性之间的复杂交互作用。其次,海洛因戒断者在做出风险决策后收到消极反馈时的风险规避倾向可以负向预测其风险寻求决策比率,这可能进一步反映了海洛因戒断者风险感知的钝化或其对消极反馈信息的整合加工存在异常。     

Mind the gap: bridging economic and naturalistic risk-taking with cognitive neuroscience

Economists define risk in terms of the variability of possible outcomes, whereas clinicians and laypeople generally view risk as exposure to possible loss or harm. Neuroeconomic studies using relatively simple behavioral tasks have identified a network of brain regions that respond to economic risk, but these studies have had limited success predicting naturalistic risk-taking. By contrast, more complex behavioral tasks developed by clinicians (e.g. Balloon Analogue Risk Task and Iowa Gambling Task) correlate with naturalistic risk-taking but resist decomposition into distinct cognitive constructs. We propose here that to bridge this gap and better understand neural substrates of naturalistic risk-taking, new tasks are needed that: are decomposable into basic cognitive and/or economic constructs; predict naturalistic risk-taking; and engender dynamic, affective engagement.     

Social norms in adolescent risk engagement and recommendation

Social influence is an important determinant of adolescent risk-taking, but little is known about how social norms contribute to adolescents’ tendency to recommend and engage in risky behaviours. Using the Adolescent Risk-taking Questionnaire, we assessed subjects’ (n = 198, age = 10–26) propensity to engage in and recommend risk-taking as well as their perception of risk norms. Adolescents recommended risk-taking more often compared to children and young adults. Perceived social norms were the most important factor predicting engagement in risky behaviours, and adolescents perceived risk-taking to be more normative than children or adults. Our findings highlight two mechanisms that contribute to adolescent risk-taking, active recommendation and perceived social norms. On this basis, we discuss potential means to attenuate excessive adolescent risk-taking.     

Consequences of Economic Inequality for the Social and Political Vitality of Society: A Social Identity Analysis

Economic inequality has been found to have pernicious effects, reducing mental and physical health, decreasing societal cohesion, and fueling support for nativist parties and illiberal autocratic leaders. We start this review with an outline of what social identity theorizing offers to the study of inequality. We then articulate four hypotheses that can be derived from the social identity approach: the fit hypothesis, the wealth-categorization hypothesis, the wealth-stereotype hypothesis, and the sociostructural hypothesis. We review the empirical literature that tests these hypotheses by exploring the effect of economic inequality, measured objectively by metrics such as the Gini coefficient as well as subjectively in terms of perceptions of economic inequality, on wealth categorization (of others and the self), the desire for more wealth and status, intergroup hostility, attitudes towards immigrants, prosocial behavior, stereotyping, the wish for a strong leader, the endorsement of conspiracy theories, and collective action intentions. As we will show, this research suggests that economic inequality may have even more far-reaching consequences than commonly believed. Indeed, investigating the effects of economic inequality on citizens' sociopolitical behaviors may be increasingly important in today's turbulent political and social landscape.     

Preventing HIV infection among injecting drug users: Intuitive and counter-intuitive findings

The disease now called AIDS was first reported among injecting drug users in 1981. This article reviews the last 15 years of research on preventing HIV infection and AIDS among injecting drug users. Many of the findings were surprising in the context of previous understandings of the illicit injection of psychoactive drugs—both with respect to the much-larger-than-expected size of the epidemic and the much-greater-than-expected potential for behavior change among drug injectors (IDU). The research is reviewed within a framework of eight issues: the importance of the problem in the United States, the global diffusion of injecting drug use, the global diffusion of HIV among IDUs, potential rapid spread of HIV among IDUs, risk reduction among IDUs, community-level prevention, syringe exchange programs, and developing a public-health perspective on psychoactive drug use.     

Preventing HIV infection among injecting drug users: Intuitive and counter-intuitive findings

The disease now called AIDS was first reported among injecting drug users in 1981. This article reviews the last 15 years of research on preventing HIV infection and AIDS among injecting drug users. Many of the findings were surprising in the context of previous understandings of the illicit injection of psychoactive drugs—both with respect to the much-larger-than-expected size of the epidemic and the much-greater-than-expected potential for behavior change among drug injectors (IDU). The research is reviewed within a framework of eight issues: the importance of the problem in the United States, the global diffusion of injecting drug use, the global diffusion of HIV among IDUs, potential rapid spread of HIV among IDUs, risk reduction among IDUs, community-level prevention, syringe exchange programs, and developing a public-health perspective on psychoactive drug use.