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Affect Regulation and HIV Risk Among Youth in Therapeutic Schools

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Abstract

The acquisition of affect regulation skills is often impaired or delayed in youth with mental health problems but the relationship between affect dysregulation and risk behaviors has not been well studied. Baseline data from adolescents (N = 417; ages 13–19) recruited from therapeutic school settings examined the relationship between affect dysregulation, substance use, self-cutting, and sexual risk behavior. Analyses of covariance demonstrated that adolescents who did not use condoms at last sex, ever self-cut, attempted suicide, used alcohol and other drugs and reported less condom use self-efficacy when emotionally aroused were significantly more likely (p < .01) to report greater difficulty with affect regulation than peers who did not exhibit these behaviors. General patterns of difficulty with affect regulation may be linked to HIV risk behavior, including condom use at last sex. HIV prevention strategies for youth in mental health treatment should target affect regulation in relation to multiple risk behaviors.

Resumen

La adquisición de habilidades para regular los afectos con frecuencia se deteriora o se dilata en jóvenes con problemas de salud mental, pero la relación entre la desregulación del afecto y las conductas de riesgo no han sido bien estudiadas. Evaluaciones iniciales de adolescentes (N = 417; edades de 13–19) reclutados en el entorno de escuelas terapéuticas examinaron la relación entre la desregulación del afecto, el uso de drogas, el auto cortarse y las conductas sexuales de riesgo. Análisis de covarianza demostraron que los adolescentes que no usaron el condón durante su última relación sexual, alguna vez se auto cortaron, intentaron suicidarse, usaron alcohol y otras drogas y reportaron ser menos eficaces en cuanto al uso del condón cuando fueron provocados emocionalmente, fueron significativamente mas propensos (p < .01) a reportar un nivel mas alto de dificultad con la regulación de los afectos que sus compañeros quienes no experimentaron esas conductas. Los patrones generales de dificultad en cuanto a la regulación de los afectos pueden estar conectados a las conductas de riesgo de contraer el VIH, incluyendo el uso del condón durante la última relación sexual. Las estrategias de prevención del VIH para jóvenes en tratamiento de salud mental deben de incluir la regulación de los afectos con relación a las múltiples conductas de riesgo.

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References

  1. Tice D, Bratslavsky E, Baumeister R. Emotional distress regulation takes precedence over impulse control: if you feel bad, do it! J Pers Soc Psychol. 2001;80:53–67.

    Article  PubMed  CAS  Google Scholar 

  2. Houck C, Hadley W, Lescano C, Pugatch D, Brown L, Group PSS. Suicide attempt and sexual risk behavior: relationship among adolescents. Arch Suicide Res. 2008;12(1):39–49.

    Google Scholar 

  3. Bell C, McBride D. Affect regulation and prevention of risky behaviors. JAMA. 2010;304(5):565–6.

    Article  PubMed  CAS  Google Scholar 

  4. Folkman S, Lazarus R. Stress processes and depressive symptomology. J Abnorm Psychol. 1986;2:107–13.

    Article  Google Scholar 

  5. Kagan J. On emotion and its development: a working paper. The development of affect. New York: Plenum; 1978. p. 11–42.

  6. Kopp C. Regulation of distress and negative emotions: a developmental view. Dev Psychol. 1989;25:343–54.

    Article  Google Scholar 

  7. Sheeber L, Hops H, Davis B. Family processes in adolescent depression. Clin Child Fam Psychol Rev. 2001;4:19–35.

    Article  PubMed  CAS  Google Scholar 

  8. Sheeber L, Allen N, Davis B, Sorensen E. Regulation of negative affect during mother-child problem-solving interactions: adolescent depressive status and family processes. J Abnorm Child Psychol. 2000;28:467–79.

    Article  PubMed  CAS  Google Scholar 

  9. Fritsch S, Donaldson D, Spirito A, Plummer B. Personality characteristics of adolescent suicide attempters. Child Psychiatry Hum Dev. 2000;30:219–35.

    Article  PubMed  CAS  Google Scholar 

  10. Zlotnick C, Donaldson D, Spirito A, Pearlstein T. Affect regulation and suicide attempts in adolescent inpatients. J Am Acad Child Adolesc Psychiatry. 1997;36(6):793–8.

    Article  PubMed  CAS  Google Scholar 

  11. DiClemente R, Wingood G, Crosby R, Sionean C, Brown L, Rothbaum B, Zimand E, Cobb B, Harrington K, Davies S. A prospective study of psychological distress and sexual risk behavior among black adolescent females. J Pediatr. 2001;108(5):e85.

    Google Scholar 

  12. Hessler D, Katz L. Associations between emotional competence and adolescent risky behavior. J Adolesc. 2010;33:241–6.

    Article  PubMed  Google Scholar 

  13. Raffaelli M, Crockett L. Sexual risk in adolescence: the role of self-regulation and attraction to risk. Dev Psychol. 2003;39:1036–46.

    Article  PubMed  Google Scholar 

  14. Brown L, Houck C, Hadley W, Lescano C. Self-cutting and sexual risk among adolescents in intensive psychiatric treatment. Psychiatr Serv. 2005;56(2):216–8.

    Google Scholar 

  15. Brown L, Houck C, Grossman C, Lescano C, Frenkel J. Frequency of adolescent self-cutting as a predictor of HIV risk. J Dev Behav Pediatr. 2008;29:161–5.

    Article  PubMed  Google Scholar 

  16. Lescano C, Brown L, Miller P, Puster K. Unsafe sex: do feelings matter? J Prev Interv Commun. 2007;33:51–62.

    Article  Google Scholar 

  17. Brown L, Tolou-Shams M, Lescano C, Houck C, Zeidman J, Pugatch D, Lourie K, Project SHIELD Study Group. Depressive symptoms as a predictor of sexual risk among African American adolescents and young adults. J Adolesc Health. 2006;39:444.e1–8.

  18. Thompson R Jr, Auslander W. Substance use and mental health problems as predictors of HIV sexual risk behaviors among adolescents in foster care. Health Soc Work. 2011;36(1):33–43.

    Article  PubMed  Google Scholar 

  19. Deas-Nesmith D, Brady K, White R, Campbell S. HIV-risk behaviors in adolescent substance abusers. J Subst Abuse Treat. 1999;16(2):169–72.

    Article  PubMed  CAS  Google Scholar 

  20. Morrison-Beedy D, Carey M, Crean H, Jones S. Risk behaviors among adolescent girls in an HIV prevention trial. West J Nurs Res. 2010;4:1–22.

    Google Scholar 

  21. Tarter R. Etiology of adolescent substance abuse: a developmental perspective. Am J Addict. 2002;11:171–91.

    Article  PubMed  Google Scholar 

  22. Sussman S, Dent C, Galaif E. The correlates of substance abuse and dependence among adolescents at high risk for drug abuse. J Subst Abuse. 1997;9:241–55.

    Article  PubMed  CAS  Google Scholar 

  23. Brown L, Danovsky M, Lourie K, DiClemente R, Ponton L. Adolescents with psychiatric disorders and the risk of HIV. J Am Acad Child Adolesc Psychiatry. 1997;36:1609–17.

    PubMed  CAS  Google Scholar 

  24. Donenberg G. Mental health aspects of HIV. Annual NIMH research conference on the role of families in preventing and adapting to HIV/AIDS. Los Angeles, CA; 2001.

    Google Scholar 

  25. Donenberg G, Emerson E, Bryant F, Wilson H, Weber-Shifrin E. Understanding AIDS-risk behavior among adolescents in psychiatric care: links to psychopathology and peer relationships. J Am Acad Child Adolesc Psychiatry. 2001;40(6):642–53.

    Article  PubMed  CAS  Google Scholar 

  26. Donenberg G, Wilson H, Emerson E, Bryant F. Holding the line with a watchful eye: the impact of perceived parental permissiveness and parental monitoring on risky sexual behavior among adolescents in psychiatric care. AIDS Educ Prev. 2002;14:138–57.

    Article  PubMed  Google Scholar 

  27. Cochran S, Mays V. Women and AIDS-related concerns. Am Psychol. 1989;44:529–35.

    Article  PubMed  CAS  Google Scholar 

  28. Phillips K, Power M. A new self-report measure of emotion regulation in adolescents: the regulation of emotions questionnaire. Clin Psychol Psychother. 2007;14:145–56.

    Article  Google Scholar 

  29. Shields A, Cicchetti D. Emotion regulation among school-age children: the development and validation of a new criterion Q-Sort scale. Dev Psychol. 1997;33:906–16.

    Article  PubMed  CAS  Google Scholar 

  30. Parker J, Taylor G, Bagby R. The 20-item Toronto Alexithymia Scale III. Reliability and factorial validity in a community population. J Psychsom Res. 2003;55:269–75.

    Google Scholar 

  31. Gratz KL, Roemer L. Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the difficulties in emotion regulation scale. J Psychopathol Behav Assess. 2008;26:41–54.

    Article  Google Scholar 

  32. Zeman J, Shipman K, Penza-Clyve S. Development and initial validation of the Children’s Sadness Management Scale. J Nonverbal Behav. 2001;25(3):187–205.

    Article  Google Scholar 

  33. Pelcovitz D, van der Kolk B, Roth S, Mandel F, Kaplan S, Resick P. Development of a criteria set and a structured interview for disorders of extreme stress (SIDES). J Trauma Stress. 2007;10(1):3–15.

    Google Scholar 

  34. Lescano C, Brown L, Miller P, Puster K. Unsafe sex: do feelings matter? J Prev Interv Commun. 2007;33(1–2):51–62.

    Article  Google Scholar 

  35. Goodman R. Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry. 2001;40(11):1337–45.

    Article  PubMed  CAS  Google Scholar 

  36. Goodman R, Meltzer H, Bailey V. The Strengths and Difficulties Questinnaire: a pilot study on the validity of the self-report version. Eur Child Adolesc Psychiatry. 1998;7:125–30.

    Article  PubMed  CAS  Google Scholar 

  37. SPSS I. SPSS. 15.0 for Windows ed.

  38. Cheetham A, Allen N, Yucel M, Lubman D. The role of affective dysregulation in drug addiction. Clin Psychol Rev. 2010;30:621–34.

    Google Scholar 

  39. Simons J, Carey K. Risk and vulnerability for marijuana use problems: the role of affect dysregulation. Addict Behav. 2002;16:72–5.

    Article  Google Scholar 

  40. Romer D, Hornik R, Stanton B, Black M, Li X, Ricardo I, Feigelman S. “Talking” computers: a reliable and private method to conduct interviews on sensitive topics with children. J Sex Res. 1997;34:3–9.

    Article  Google Scholar 

Download references

Acknowledgments

Research supported by NIMH Grant R01 MH066641to Rhode Island Hospital and University of Illinois at Chicago, and by the Lifespan/Brown/Tufts Center for AIDS Research (P30 AI042853).

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Authors and Affiliations

  1. Bradley Hasbro Children’s Research Center, Rhode Island Hospital, Warren Alpert Medical School of Brown University, One Hoppin Street, Suite 204, Providence, RI, 02903, USA

    Larry K. Brown, Christopher Houck, Marina Tolou-Shams & Justin Mello

  2. Department of Mental Health Law & Policy, Louis de la Parte Florida Mental Health Institute, University of South Florida, Tampa, FL, USA

    Celia Lescano

  3. Institution for Juvenile Research, University of Illinois at Chicago, Chicago, IL, USA

    Geri Donenberg

Authors
  1. Larry K. Brown
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  2. Christopher Houck
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  3. Celia Lescano
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  4. Geri Donenberg
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  5. Marina Tolou-Shams
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  6. Justin Mello
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Correspondence to Larry K. Brown.

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Brown, L.K., Houck, C., Lescano, C. et al. Affect Regulation and HIV Risk Among Youth in Therapeutic Schools. AIDS Behav 16, 2272–2278 (2012). https://doi.org/10.1007/s10461-012-0220-3

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  • DOI: https://doi.org/10.1007/s10461-012-0220-3

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