Ego depletion and implicit and explicit determinants of condom use intentions: an experimental study among young men.

BACKGROUND: The Reflective Impulsive Model of Strack and Deutsch (2004) is a dual-process model and could be a dynamic theoretical framework of sexual risk behavior that is able to predict condom use under different circumstances. If we apply the Reflective Impulsive Model to sexual risk behavior, implicit attitudes regarding sexual risk behavior should have a stronger impact on behavior when working memory capacity is low. Explicit attitudes have a strong impact on intentions, which diminishes as participants have less working memory capacity. METHODS: In this study, we induced a state of ego depletion to examine the impact of low working memory capacity on implicit and explicit attitudes and condom use intentions. Young, male participants ( N = 66) were randomly assigned to either an ego depletion condition (difficult calculus task) or a placebo condition (easy calculus task). At baseline, a questionnaire measuring explicit attitudes and intentions to use a condom, and an Implicit Association Test measuring implicit attitudes towards condoms were administered. After the ego calculus task, participants once more completed the questionnaire and Implicit Association Test. RESULTS: We found no evidence that ego depletion had an effect on intentions to use a condom in young men. Explicit attitudes predicted intentions to use a condom, regardless of participants' state. We found no relationship between implicit condom attitudes and intentions to use a condom, neither in the ego depletion nor in the placebo condition. CONCLUSIONS: The implications of this null finding are discussed.

The Effect of Alcohol and Sexual Arousal on Explicit and Implicit Condom Attitudes and Intentions to Use a Condom.

Alcohol and sexual arousal are contextual determinants of condomless sex. Dual-process theory postulates that two types of cognitive processing contribute to the regulation of behavior: one that is fast, intuitive and automatic, and another that is slower and deliberative. This study applied a dual-process model to investigate condomless sexual behavior, highlighting the potential importance of implicit attitudes in condomless sex. We investigated whether the impact of alcohol and sexual arousal on condom use-related attitudes and intentions was explained by diminished working memory capacity, as dual-process models suggest. We also investigated whether this effect could be explained by implicit and explicit attitudes toward condom use. Male participants (N = 30) were randomized using a 2 × 2 within-subjects design that manipulated alcohol intoxication (placebo vs. alcohol beverages) and sexual arousal (neutral vs. erotic movie clips). We measured participants' working memory capacity, intentions to use a condom, and explicit and implicit attitudes toward condom use. Significant main effects of alcohol intoxication and sexual arousal on working memory capacity were found. No significant interaction was found for the combined effect of alcohol intoxication and sexual arousal on intentions to use a condom. There was no significant effect of implicit attitudes on intentions to use a condom, although a trend toward significance (p = 0.06) was found for the effect of implicit attitudes on intentions to use a condom when participants were in a state of alcohol intoxication. Theoretical and practical implications of this study are discussed.

Gender Differences in the Relationship of Sexual Functioning with Implicit and Explicit Sex Liking and Sex Wanting: A Community Sample Study.

The present study aimed to investigate associations of automatic and controlled cognition with sexual functioning, and moderation of these associations by working memory capacity in a community sample of heterosexual women (N = 65) and men (N = 51). Participants performed two single-target Implicit Association Tests (ST-IATs) to assess implicit liking and wanting of erotic stimuli. The Sexual Opinion Survey (SOS) was used to assess explicit liking of sex. The International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI) were used to assess sexual function. Working memory capacity was assessed using the Towers of Hanoi task and mood using the Hospital Anxiety and Depression Scale (HADS). In female participants, higher levels of sexual functioning co-occurred with stronger implicit associations of erotic stimuli with wanting, whereas implicit sex liking was unrelated to level of sexual functioning. In male participants, higher levels of sexual functioning co-occurred with lower implicit liking of erotic stimuli, whereas implicit sex wanting was unrelated to sexual functioning. Higher erotophilia scores were related to higher levels of sexual functioning in both women and men, but anxiety and depression symptoms were unrelated to sexual functioning. Working memory capacity did not moderate the associations between erotophilia and sexual functioning.

Sexual Arousal and Implicit and Explicit Determinants of Condom Use Intentions.

Being sexually aroused may be an important risk factor contributing to sexual decision making. Dual-process cognitive models, such as the reflective-impulsive model of Strack and Deutsch (2004), could be used to explain the effect of sexual arousal on intentions to use a condom. In this study, we investigated whether explicit and implicit attitudes toward condom use can predict intentions to use a condom when participants are sexually aroused and not aroused. In a within-subjects experimental design, male participants (N = 27) watched both a neutral and an erotic movie clip in counterbalanced order. After each clip, participants completed a questionnaire assessing their intentions to use a condom and explicit condom attitudes, followed by a wanting Implicit Association Test (IAT; Greenwald et al., 2003) and a liking IAT to assess their implicit attitudes to unsafe sex. In concordance with the reflective-impulsive model, we found that when participants were not sexually aroused, their intentions to use a condom were solely predicted by their explicit attitudes. However, when they were sexually aroused, intentions to use a condom were predicted by both explicit and implicit attitudes toward condom use.

Could differences in implicit attitudes to sexual concurrency play a role in generalized HIV epidemics?

Background: Sexual partner concurrency has been implicated in the genesis of generalized HIV epidemic in South Africa. Most South Africans, however, disapprove of concurrency in surveys. These surveys test individuals' explicit attitudes which are susceptible to a number of important biases such as the social desirability bias. Assessment of implicit cognitions have been found to be better predictors of behaviour in socially sensitive domains. We hypothesized that South Africans may have implicit attitudes more tolerant of concurrency than lower concurrency prevalence populations. Methods: To test this hypothesis, we developed a concurrency-implicit association test (C-IAT) and compared the C-IATs of samples of South African and Belgian university students. Results: We found a large and statistically significant difference in the C-IAT between the South Africans (D600-score = -0.009, indicating absence of preference for concurrency or monogamy) and Belgians (D600-score = 0.783, indicating a strong preference for monogamy; t-test = 13.3; P < 0.0001). The effect size measure, Cohen's d, was found to be 0.88, which is considered a large effect size in this field. Conclusions: Our results are compatible with the thesis that differences in implicit attitudes to concurrency play a role in the genesis of generalised HIV epidemics.

Implicit attitudes to sexual partner concurrency vary by sexual orientation but not by gender-A cross sectional study of Belgian students.

High rates of sexual partner concurrency have been shown to facilitate the spread of various sexually transmitted infections. Assessments of explicit attitudes to concurrency have however found little difference between populations. Implicit attitudes to concurrency may vary between populations and play a role in generating differences in the prevalence of concurrency. We developed a concurrency implicit associations test (C-IAT) to assess if implicit attitudes towards concurrency may vary between individuals and populations and what the correlates of these variations are. A sample of 869 Belgian students (mean age 23, SD 5.1) completed an online version of the C-IAT together with a questionnaire concerning sexual behavior and explicit attitudes to concurrency. The study participants C-IATs demonstrated a strong preference for monogamy (-0.78, SD = 0.41). 93.2% of participants had a pro-monogamy C-IAT. There was no difference in this implicit preference for monogamy between heterosexual men and women. Men who have sex with men and women who have sex with women were more likely to exhibit implicit but not explicit preferences for concurrency compared to heterosexual men and women. Correlates of the C-IAT varied between men and women.