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Learn More. Impulsivity is a personality-based risk factor that has been well studied in relation to risky sexual behavior. Recent conceptualizations of impulsivity have proposed multidimensional facets comprised of premeditation, perseverance, sensation seeking, negative urgency, and positive urgency UPPS-P model.
Prior studies have found that these facets are associated with risky sexual behavior in adolescent and college student samples, but no prior studies have evaluated them in clinical samples. Lack of premeditation was also tested as a moderator of the relationship between facets of impulsivity and both risky sex outcomes. demonstrated that sensation seeking, negative urgency, and positive urgency were correlated with risky sex behaviors.
Additionally, multiple regression analyses indicated that sensation seeking was uniquely associated with the of sexual partners in the past 5 years, whereas positive urgency was uniquely associated with unprotected sex while under the influence. Finally, a ificant interaction between lack of premeditation and negative urgency suggests that at-risk young adults with both high negative urgency and lack of premeditation were the likeliest to have the most sexual partners in the past 5 years.
This study adds to the current understanding of the relationship between reward- and affect-driven facets of impulsivity and risky sexual behaviors and may lend utility to the development of interventions for at-risk populations. Risky sexual behavior contributes to ificant disease burden as well as unplanned pregnancy. Each year, there are approximately 20 million new cases of sexually transmitted diseases STDs and nearly one-half of STD incidences occur among youth aged 15—24 years of age Centers for Disease Control and Prevention, b.
A study conducted in estimated that in the U. Risky sexual behaviors are more prevalent in adults with a history of externalizing behaviors. For example, young adults with a history of childhood antisocial behavior are twice as likely to have earlier i. Multiple studies have found that substance use behaviors are associated with more risky sexual behaviors during young adulthood Cavazos-Rehg et al. The robust associations between antisocial behavior, substance use, and risky sex indicate that there may be underlying personality traits influencing these problem behaviors. One personality trait commonly associated with risky sexual behavior is impulsivity Charnigo et al.
Impulsivity is associated with behaviors such as sex while using drugs or with a partner using drugs Charnigo et al. A meta-analysis of studies with adolescent samples revealed ificant, but small, effects of the four original UPPS impulsivity traits with risky sexual behavior and no marked differences in the size of the four effects Dir et al. In contrast, studies with college student samples show that the impulsivity-risky sex relation may be driven by specific impulsivity facets.
Although many studies have tested impulsivity as a multifacted trait in relation to sexual behavior, all prior studies described ly used non-clinical samples. It is important to study these associations in clinical samples as findings from such studies can be particularly helpful in informing prevention and intervention efforts for at-risk populations.
The current study extended these studies by examining whether these same facets drove the association between impulsivity and sexual risk behaviors. Given that sensation seeking and affective urgency are also related to externalizing psychopathology Anestis et al. They found lack of premeditation interacted with sensation seeking in predicting drinking consequences, drug use, and drug consequences for college students. Conversely, this interaction effect did not ificantly influence antisocial behaviors, the only outcome that was unrelated to substance use. Another study exploring the developmental asymmetry hypothesis examined risky driving behaviors and found that lack of premeditation moderated and strengthened the positive association between sensation seeking and driving under the influence Luk et al.
This implies that the synergistic effects of sensation seeking and lack of premeditation may be specific to substance use related outcomes. The aforementioned studies that examined the relationships between different facets of impulsivity and risky sex did not test whether there were interactions between the facets in relation to sex behaviors. Thus, another goal of this study was to determine if lack of premeditation enhanced the associations between other impulsivity facets and risky sex in an at-risk sample.
The goals of this study were to examine five dimensions of impulsivity as unique and interactive predictors of risky sex behaviors. Our hypotheses were:. Following studies utilizing clinical samples Anestis et al. Based on the developmental asymmetry model presented by McCabe et al. We utilized cross-sectional data from a multisite longitudinal research project on genetics of antisocial drug dependence Derringer et al.
Participants in Denver and San Diego were identified via residential or outpatient treatment programs, involvement with the criminal justice system or special schools for youth with behavioral problems, who were at high risk for having a substance use disorder and conduct disorder. At the time of recruitment participants were 13—19 years old and had to meet one or more lifetime substance dependence symptom and at least one conduct disorder symptom.
Given the large and difficult-to-follow sample that was geographically dispersed, there was variability in the amount of time from the baseline interview to follow-up on average 6. Impulsivity and risky sex behavior measures were only included in the follow-up assessment. Therefore, the current study focused only on this time point. The University of California, San Diego, and the University of Colorado, Denver institutional review boards approved all subject recruitment and assessment procedures.
Informed consent was obtained from all individual participants included in the study. For all items, response options ranged from 1 Strongly Disagree to 4 Strongly Agree. Participants responded to two self-report items assessing of sexual partners in the past 5 years and frequency of past-year unprotected sex under the influence. Compared to participants with data on past-year unprotected sex under the influence, those with missing data on this item were ificantly older M age Given that age differences in both impulsivity and sexual behaviors have been reported ly Herbenick et al.
Prior to the primary analyses, we evaluated whether there were ificant multicollinearity issues using variance inflation factors VIFwith a threshold VIF of 2 or above indicating the presence of multicollinearity. Descriptive data were analyzed to determine the optimal model for each outcome. Due to the continuous and normally distributed nature of the data, we utilized linear regression for the sexual partners in the past 5 years outcome variable.
Descriptive analyses of past-year unprotected sex under the influence data revealed overdispersion, and thus, negative binomial regression was used to analyze this count data. The study hypotheses were tested in three steps using regression analyses. First, the effects of the impulsivity dimensions and related covariates on each risky sex outcome were estimated to test for unique main effects.
Second, we tested our moderation hypotheses by including interaction terms between lack of premeditation and the other four impulsivity dimensions. All independent variables were mean-centered prior to the moderation analyses to assist with interpretation of. Third, we dropped all nonificant predictors in the final trimmed model to ensure that the key findings were not attributable to potential suppression effects. All analyses were conducted in SPSS Sensation seeking, negative urgency and positive urgency were positively correlated with of sexual partners in the past 5 years and past-year unprotected sex while under the influence.
Linear regression estimates predicting the of sexual partners in the past 5 years are presented in Table 3. Age, being male, and sensation seeking were ificant predictors, and there was a ificant interaction between lack of premeditation and negative urgency see Fig.
Inclusion of the premeditation-negative urgency interaction term explained an additional 1. The interaction presented in Fig. Negative binomial regression for the frequency of past-year unprotected sex while under the influence outcome are presented in Table 4. Being male, sensation seeking, and positive urgency were associated with unprotected sex under the influence in the past year. None of the interactions between impulsivity dimensions and lack of premeditation were ificant.
The final trimmed model revealed that males were 1.
Additionally, for every one-unit increase on the positive urgency scale, participants were 1. Premed lack of premeditation, IRR incidence rate ratio, l. This study examined unique and interactive associations between different facets of impulsivity and risky sexual behaviors in an at-risk clinical sample of young adults with a history of conduct and substance use problems.
Our hypothesis that negative urgency and sensation seeking would be the best predictors of risky sex behaviors was supported.
We found that sensation seeking, negative urgency and positive urgency were all positively correlated with both of partners in the past 5 years and unprotected sex under the influence in the past year. Given that sensation seeking and positive urgency are theoretically considered to be reward-driven facets of impulsivity, and that negative and positive urgency are defined by rash responses to extreme affect, our current study suggests that these three facets may be of particular importance among at-risk young adults.
Overall, these findings confirmed that trait impulsivity measures are capable of capturing ificant individual differences in relation to risky sex behaviors among young adults with a history of substance use and externalizing behaviors. Our analyses, which included covariates, facets of impulsivity, as well as interactions between lack of premeditation and the other four facets of impulsivity revealed that sensation seeking was associated with the of sexual partners in the past 5 years.
Furthermore, our findings added to findings that consistently found negative urgency and sensation seeking to be associated with problematic behaviors, such as disordered eating in clinical samples Anestis et al. Examining the past-year unprotected sex while under the influence outcome more closely revealed that it was uniquely associated with positive urgency. In addition, gender, a covariate, had a ificant association, showing an increased risk among males for past-year engagement in unprotected sex while under the influence.
These findings were slightly different from research with a college sample, which found that positive urgency was positively associated with unprotected sex among women but not men Simons et al. The present study found a unique ificant interaction between lack of premeditation and negative urgency, but only for the of sexual partners in the past 5 years outcome variable.
At-risk young adults with high negative urgency and lack of premeditation were most likely to have the most sexual partners in the past 5 years. McCabe et al. Our current findings were slightly different than those of McCabe et al. When negative urgency is combined with lack of premeditation, or giving less careful thought to potentially more adaptive coping strategies, the combination of high levels of those impulsivity facets puts individuals at higher risk for negative consequences related to having numerous sexual partners.
Moving forward, exploring the underlying factors of this interaction, such as identifying risky sex related cognitions and motivations e. This study had several limitations. First, the UPPS-P impulsivity scale was only assessed at follow-up; as such, only cross-sectional data were available for the present study, which limited the ability to evaluate causal inference.
Second, the measurement of risky sex behaviors was based on two retrospective self-reported items, which are prone to self-report and recall biases. Although utilizing single items to capture specific risky sex behaviors is a common practice e. As the present study was a secondary data analysis of a longitudinal study, the skip pattern was not ideal for this specific research question. We addressed this issue by controlling for it statistically; however, it is possible past-year unprotected sex under the influence may be overestimated.
Nevertheless, this study has important clinical implications with regard to the prevention of risky sex behaviors among at-risk young adults. This was the first known study to examine facets of impulsivity as they relate to risky sex behaviors among an at-risk young adult sample. It is important to underscore the associations of affective urgency and sensation seeking facets with risky sex behaviors, which may influence conceptualizations of interventions that may have to include components that address emotion regulation and risk-taking.
In addition, the current findings supported the utility of the UPPS-P impulsivity measure as a clinical or screening tool to identify individuals who might be at elevated risk for risky sex behaviors. Moreover, this study supported the developmental asymmetry theory proposed by McCabe et al. These findings underscored the importance of personality factors as they relate to risky sex behaviors and the importance of incorporating such factors into prevention and intervention programs specifically tailored for young adults with a history of externalizing psychopathology.
The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The sponsoring agencies were not involved in the de, analyses, or development of this article, or the decision to submit this paper for publication. Conflict of interest The authors declare that they have no conflict of interest. National Center for Biotechnology InformationU. Arch Sex Behav. Author manuscript; available in PMC Jul Inga Curry1, 2 Jeremy W.
Luk2, 3 Ryan S. Trim1, 2 Christian J. Hopfer4 John K. Hewitt5 Michael C. Stallings5 Sandra A. Brown2 and Tamara L. Wall 1, 2. Inga Curry 1 V. Jeremy W. Ryan S. Trim 1 V. Christian J. John K. Michael C.Adult seeking sex Pelham
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