Validation of the Sexual Discounting Task for Use in Adolescents.

The Sexual Discounting Task (SDT) was developed to evaluate the effects of delay on decision making as it relates to sexual risk-taking behaviors. Though previously validated with other populations, including urban emerging adults, the current study sought to validate the SDT with adolescents. A sample of adolescents (N = 155; 61% female) between ages 14 and 21 (Mage = 19.5 years) was recruited to complete the SDT (involving choices between immediate unprotected sex and delayed sex with a condom with hypothetical sexual partners) and the Delay Discounting Task (a delay discounting task for money outcomes). Additionally, they completed several self-report measures assessing demographics, sexual behavior, and sexual history. If the condom was readily available, respondents were more likely to use a condom for partners who were judged "most likely to have an STI" and for those that participants were "least likely to have sex with." Moreover, when a condom was not immediately available, greater self-reported sexual risk-taking was related to greater sexual discounting (i.e., greater effects of delay on decreasing condom use). Furthermore, sexual discounting was greater among partners deemed more desirable and those judged "least likely to have an STI." Differences in sexual discounting were significant after controlling for immediately available condom use. Findings from the current study suggest that the SDT is clinically meaningful for adolescents and is sensitive to factors that influence real-world decisions to use condoms. Future treatment and prevention should consider delay discounting as an important variable affecting sexual risk behavior.

Sensation seeking, sexual orientation, and drug abuse symptoms in a community sample of emerging adults.

Increased use of drugs is associated with a number of factors including high sensation seeking and sexual minority status (through group-specific minority stress). We sought to examine how personality traits like sensation seeking may influence drug abuse among sexual minority individuals. Participants were 217 emerging adults (Mage = 20.23, SD = 0.85) recruited from Amazon Mechanical Turk (MTurk). Of these participants, 67.7% identified as heterosexual, 9.7% as gay or lesbian, 21.2% as bisexual, and 1.4% indicated other sexual orientations. Sensation seeking and drug abuse were self-reported using the Brief Sensation Seeking Scale and the Drug Abuse Screening Test, respectively. A preliminary multiple analysis of variance indicated no significant mean differences for these variables as a function of sex or sexual orientation. Next, sexual minority status, Brief Sensation Seeking Scale scores, sex and their interactions were entered into a linear regression predicting Drug Abuse Screening Test scores. Results revealed a significant moderation, such that the positive relationship between Brief Sensation Seeking Scale total scores and Drug Abuse Screening Test total scores was stronger for sexual minorities (ß = 0.14, P = 0.00) compared to heterosexuals (ß = 0.04, P = 0.04), controlling for sex. These results demonstrate, while sensation seeking and sexual minority status may selectively indicate risk for drug use, sexual minorities high in sensation seeking may be at especially high risk for problems related to drug abuse. More research examining the addiction etiology of sexual minority individuals would inform targeted interventions for this population.

Hyperalgesia after a Drinking Episode in Young Adult Binge Drinkers: A Cross-Sectional Study.

AIMS: Rodent studies propose potential mechanisms linking excessive drinking and pain hypersensitivity (hyperalgesia), such that stress hormones (i.e. epinephrine and cortisol) mediate induction and maintenance of alcohol withdrawal-induced hyperalgesia. The first aim of this study was to examine whether hyperalgesia would occur within 48 h after a drinking episode in healthy young adult binge drinkers. The second was to examine whether stress hormones and negative effect would be associated with binge drinking or alcohol withdrawal-associated hyperalgesia. METHODS: A cross-sectional experiment was conducted in five groups with naturally occurring drinking (mean age = 19.6, range 18-29 years): abstainers (n = 43, 54% female), moderate drinkers with (n = 50, 50% female) or without recent drinking (i.e. within 48 h, n = 23, 26% female) and binge drinkers with (n = 36, 58% female) or without recent drinking (n = 25, 44% female). All types of drinkers endorsed drinking about 2-3 times a month and 2-3 years of drinking history. RESULTS: Muscle pressure pain thresholds were significantly lower in the binge group with recent drinking compared to other groups, but cutaneous mechanical and heat pain thresholds were not significantly different across the five groups. Basal epinephrine levels were significantly higher in binge groups regardless of recent drinking, but cortisol and negative effect were not significantly different across the five groups. CONCLUSIONS: This is the first study to show that alcohol withdrawal-associated muscle hyperalgesia may occur in healthy episodic binge drinkers with only 2-3 years of drinking history, and epinephrine may play a role in binge drinking-associated hyperalgesia.

Delay Discounting of Protected Sex: Relationship Type and Sexual Orientation Influence Sexual Risk Behavior.

Sexual discounting, which describes delay discounting of later protected sex vs. immediate unprotected sex (e.g., sex now without a condom vs. waiting an hour to have sex with a condom), is consistently linked to sexual risk behavior. Estimates suggest that over two-thirds of HIV transmissions occur between individuals in committed relationships, but current sexual discounting tasks examine sexual discounting only with hypothetical strangers, leaving a gap in our understanding of sexual discounting with committed sexual partners. We used the Sexual Discounting Task (SDT) to compare discounting rates between men who have sex with men (MSM; n = 99) and heterosexual men (n = 144) and tested a new SDT condition evaluating sexual discounting with main partners. MSM in committed relationships discounted protected sex with their main partner at higher rates than heterosexual men, and discounting rates correlated with self-report measures of condom use, impulsivity/sensation seeking, and substance use. These findings suggest that sexual discounting is a critical factor potentially related to increased HIV transmission between MSM in committed relationships and may be an important target for intervention and prevention.

Correction to: Delay Discounting of Protected Sex: Relationship Type and Sexual Orientation Influence Sexual Risk Behavior.

In the original publication of the article, the corresponding author was processed incorrectly. The corresponding author for this article should be: Woo-Young Ahn.

Using automated computer vision and machine learning to code facial expressions of affect and arousal: Implications for emotion dysregulation research.

As early as infancy, caregivers' facial expressions shape children's behaviors, help them regulate their emotions, and encourage or dissuade their interpersonal agency. In childhood and adolescence, proficiencies in producing and decoding facial expressions promote social competence, whereas deficiencies characterize several forms of psychopathology. To date, however, studying facial expressions has been hampered by the labor-intensive, time-consuming nature of human coding. We describe a partial solution: automated facial expression coding (AFEC), which combines computer vision and machine learning to code facial expressions in real time. Although AFEC cannot capture the full complexity of human emotion, it codes positive affect, negative affect, and arousal-core Research Domain Criteria constructs-as accurately as humans, and it characterizes emotion dysregulation with greater specificity than other objective measures such as autonomic responding. We provide an example in which we use AFEC to evaluate emotion dynamics in mother-daughter dyads engaged in conflict. Among other findings, AFEC (a) shows convergent validity with a validated human coding scheme, (b) distinguishes among risk groups, and (c) detects developmental increases in positive dyadic affect correspondence as teen daughters age. Although more research is needed to realize the full potential of AFEC, findings demonstrate its current utility in research on emotion dysregulation.

Drug Use Status in Youth: The Role of Gender and Delay Discounting.

BACKGROUND: Evidence from gender and delay discounting studies suggests these variables may influence drug use in youth. However, no studies to date have examined sexual discounting with regard to drug use in youth. OBJECTIVES: The present study examined gender and delay discounting, both monetary and sexual, with regard to the drug use status of alcohol, tobacco, and marijuana. METHODS: Youth aged 14-21 years (n = 155) provided demographic and drug use information and completed behavioral tasks assessing monetary and sexual discounting in a single laboratory session. Chi-square and analysis of variance were used to assess group differences. RESULTS: Across drug use status, differences in gender and sexual discounting but not monetary discounting were found. Moderate drinkers and smokers were more likely to be male and displayed steeper sexual discounting rates. However, no interaction effect between gender and discounting differences on drug use status was observed. CONCLUSIONS: Findings suggest that drug use may manifest differently by gender and highlight the domain specificity of sexual discounting. These findings further highlight the need to incorporate gender and domain-specific discounting measures when investigating drug use pathology and interventions in youth.

Adverse Childhood Experiences Among Lesbian, Gay, Bisexual, and Queer Veterans.

INTRODUCTION: Adverse childhood experiences portend vulnerability to numerous physical and mental health concerns across the lifespan. Separate bodies of work suggest that both lesbian, gay, bisexual, and queer individuals and military veterans are more likely to report adverse childhood experiences than their non-lesbian, gay, bisexual, and queer and non-veteran counterparts, respectively. Although lesbian, gay, bisexual, and queer veterans experience health disparities compared with non-lesbian, gay, bisexual, and queer veterans, the prevalence of adverse childhood experiences among individuals with both lesbian, gay, bisexual, and queer and veteran identities is yet unknown. METHODS: Participants were U.S. military veterans (N=14,461) from 18 states that included Sexual Orientation and Gender Identity and adverse childhood experiences modules in the 2019 and 2020 Behavioral Risk Factor Surveillance System survey. Multivariable logistic regression was used to determine the odds of adverse childhood experiences reported by lesbian, gay, bisexual, and queer veterans compared with those reported by non-lesbian, gay, bisexual, and queer veterans. Analyses were conducted in 2023. RESULTS: While accounting for sociodemographic factors, lesbian, gay, bisexual, and queer veterans were more likely to report living with someone who experienced mental illness (AOR=2.17, 95% CI=1.35, 3.51), emotional abuse (AOR=1.58, 95% CI=1.11, 2.25), and sexual abuse (AOR=2.21, 95% CI=1.29, 3.76) than non-lesbian, gay, bisexual, and queer veterans. CONCLUSIONS: With past work indicating that childhood abuse experiences are especially predictive of adverse health in adulthood, these findings suggest that a higher prevalence of adverse childhood experiences among lesbian, gay, bisexual, and queer veterans may contribute to health disparities among this population.

Primary sources of health care among LGBTQ+ veterans: Findings from the Behavioral Risk Factor Surveillance System.

OBJECTIVE: This study examined the primary source of health care between veterans with lesbian, gay, bisexual, queer and similar identities (LGBTQ+) and non-LGBTQ+ veterans. DATA SOURCES AND STUDY SETTING: Veterans (N = 20,497) from 17 states who completed the CDC's Behavioral Risk Factor Surveillance System from 2016 to 2020, including the Sexual Orientation and Gender Identity and Health Care Access modules. STUDY DESIGN: We used survey-weighted multiple logistic regression to estimate average marginal effects of the prevalence of utilization of Veteran's Health Administration (VHA)/military health care reported between LGBTQ+ and non-LGBTQ+ veterans. Prevalence estimates were adjusted for age group, sex, race and ethnicity, marital status, educational attainment, employment status, survey year, and US state. DATA COLLECTION METHODS: Study data were gathered via computer-assisted telephone interviews with probability-based samples of adults aged 18 and over. Data are publicly available. PRINCIPAL FINDINGS: Overall, there was not a statistically significant difference in estimated adjusted prevalence of primary use of VHA/military health care between LGBTQ+ and non-LGBTQ+ veterans (20% vs. 23%, respectively, p = 0.13). When examined by age group, LGBTQ+ veterans aged 34 and younger were significantly less likely to report primary use of VHA/military health care compared to non-LGBTQ+ veterans (25% vs. 44%, respectively; p = 0.009). Similarly, in sex-stratified analyses, fewer female LGBTQ+ veterans than female non-LGBTQ+ veterans reported VHA/military health care as their primary source of care (13% vs. 29%, respectively, p = 0.003). Implications and limitations to these findings are discussed. CONCLUSIONS: Female and younger LGBTQ+ veterans appear far less likely to use VHA/military for health care compared to their cisgender, heterosexual peers; however, because of small sample sizes, estimates may be imprecise. Future research should corroborate these findings and identify potential reasons for these disparities.

Rapid, precise, and reliable measurement of delay discounting using a Bayesian learning algorithm.

Machine learning has the potential to facilitate the development of computational methods that improve the measurement of cognitive and mental functioning. In three populations (college students, patients with a substance use disorder, and Amazon Mechanical Turk workers), we evaluated one such method, Bayesian adaptive design optimization (ADO), in the area of delay discounting by comparing its test-retest reliability, precision, and efficiency with that of a conventional staircase method. In all three populations tested, the results showed that ADO led to 0.95 or higher test-retest reliability of the discounting rate within 10-20 trials (under 1-2 min of testing), captured approximately 10% more variance in test-retest reliability, was 3-5 times more precise, and was 3-8 times more efficient than the staircase method. The ADO methodology provides efficient and precise protocols for measuring individual differences in delay discounting.

Attitudes Toward Gay Men and Lesbian Women Moderate Heterosexual Adults' Subjective Stress Response to Witnessing Homonegativity.

Minority stress theory posits that members of a stigmatized group, such as sexual minorities (lesbian, gay, bisexual, and other non-heterosexual individuals), are particularly subject to ill effects of minority-specific events (stressors), including overt homonegativity. Although adverse effects of homonegativity are well documented for sexual minorities, little is known about effects of witnessing homonegativity on heterosexual individuals. As a growing number of heterosexual individuals hold accepting views of sexual minority individuals, some detrimental effects of homonegativity may extend to heterosexual individuals. For example, prior studies demonstrate that when racial majority-group members witness discrimination against minority-group members, they may experience stress response, particularly if they hold positive attitudes toward the minority-group. In this experimental study, 263 heterosexual adults (Mage = 34.47 years, SD = 9.67, 51.7% female) were randomized to either witness homonegativity or to a control condition. Participants rated subjective stress on a 0-100 visual analogue scale both immediately before and after the film-based induction. Participants also completed a measure of their attitudes toward gay men and lesbian women. Moderation analyses indicated that participants who were more accepting of gay men and lesbian women experienced greater stress after the induction than those with less accepting views. Implications and limitations of these findings are discussed.

The Indirect Effect of Emotion Regulation on Minority Stress and Problematic Substance Use in Lesbian, Gay, and Bisexual Individuals.

Lesbian, gay, and bisexual (LGB) individuals report higher levels of problematic alcohol and substance use than their heterosexual peers. This disparity is linked to the experience of LGB-specific stressors, termed minority stress. Additionally, bisexual individuals show increased rates of psychopathology, including problematic alcohol and substance use, above and beyond lesbian and gay individuals. However, not everyone experiencing minority stress reports increased rates of alcohol and substance misuse. Emotion regulation (ER), which plays a critical role in psychopathology in general, is theorized to modulate the link between minority stress and psychopathology. However, it remains largely unknown whether ER plays a role in linking instances of minority stress with substance and alcohol use outcomes. To address the gap, the current study assessed 305 LGB individuals' instances of minority stress, ER, and substance and alcohol use outcomes. We assessed the role of ER in problematic alcohol and substance use among LGB individuals using moderated mediation, where sexual minority status was entered as the moderator, and ER difficulties was entered as the mediator. The results indicated significant indirect effects of minority stress, through ER difficulties, on both problematic alcohol and substance use. However, there was no significant interaction with sexual orientation status, suggesting that ER may be important for all LGB individuals in predicting problematic alcohol and substance use. These results highlight the important role that ER plays between instances of minority stress and substance and alcohol use in LGB individuals, suggesting that ER skills may serve as a novel target for intervention.