The Implicit Sexual Risk Assessment: A Pilot Study of a Novel Behavioral Task.

Risky sexual behaviors are a significant public health concern. Laboratory experiments are necessary to identify causal determinants of risky sexual behavior. However, experiments often rely on analogue sexual risk behavior, assessed by self-reported intentions in response to a sexual scenario. Using behavioral tasks to assess risk taking may be a valuable addition to self-reported intention outcome measures. The Balloon Analogue Risk Task (BART) is a commonly used measure of general risk-taking. However, BART's associations with sexual risk-taking have been mixed. In this pilot study, we developed a task akin to the BART, the Implicit Sexual Risk Assessment (ISRA), which incorporates sexual stimuli. We hypothesized sexual arousal would increase risk taking on ISRA relative to BART. Using a within-persons experimental design, 79 participants (52% women, mean age = 19.5 (SD = 1.42)) were randomized to condition (i.e., arousal versus neutral) and completed the BART and ISRA tasks. As expected, sexual arousal was associated with increased risk-taking (i.e., adjusted pumps) on ISRA relative to BART. However, this was unexpectedly the result of decreased pumps on BART instead of increased pumps on ISRA. Neither BART nor ISRA were significantly associated with sexual risk behavior or intentions. Null findings are qualified by the fact that sexual arousal was not significantly associated with sexual risk intentions.

Affect and drinking behavior: Moderating effects of involuntary attention to emotion and distress tolerance.

This study tested a multiple group path model in a sample of young adults (n = 402; 233 university participant pool/169 Amazon MTurk) linking positive and negative affect to alcohol consumption and problems via enhancement and coping motives, respectively. Motivational models of alcohol use suggest that individuals drink in order to alleviate negative affective states or to enhance positive moods or feelings. Deficits in modulating attention toward emotional experience (i.e., involuntary attention to emotion [IAE]); and poor distress tolerance may contribute to maladaptive patterns of substance use (i.e., negative reinforcement). As negative affect increases, those with deficits in the ability to efficiently attend to emotions as well as the inability to withstand distress may seek more external means of regulating unwanted or intrusive emotional experiences via alcohol. It was hypothesized that involuntarily attending to one's emotions would contribute to negative reinforcement drinking and problems. Coping motives were directly associated with alcohol-related problems, while enhancement motives were directly associated with problems both directly and indirectly via alcohol consumption. The hypothesized interaction between negative affect and IAE to coping motives was conditional upon levels of distress tolerance, with the moderating effect of involuntary attention being significant at high but not low levels of distress tolerance. Distress tolerance exhibited direct, inverse associations with alcohol-related problems. This pathway was significant over and above the direct effects of both coping motives and alcohol consumption. This suggests that while tolerance for emotional distress may reduce negative reinforcement drinking, it also fosters adaptive regulation when intoxicated. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Effects of alcohol, rumination, and gender on the time course of negative affect.

This study modelled associations between gender, ruminative cognitive style, alcohol use, and the time course of negative affect over the course of 43,111 random assessments in the natural environment. Participants (N = 263) completed 49 days of experience sampling over 1.3 years. The data indicated that rumination at baseline was positively associated with alcohol dependence symptoms at baseline as well as higher negative affect over the course of the study. Consistent with negative reinforcement models, drinking served to decrease the persistence of negative affect from moment to moment. However, this ameliorative effect of drinking was evident only among women, suggesting an increased risk for negative reinforcement driven drinking behaviour. In addition, rumination appeared to counteract the desired effects of alcohol on mood among women. This suggests that women who ruminate more may be motivated to consume larger amounts of alcohol to achieve the desired effects. Overall, the results indicate that ruminative cognitive style and the persistence of negative affect from moment to moment may reflect an individual vulnerability for the development of alcohol use disorder especially among women.

Pituitary apoplexy.

OBJECTIVE: Pituitary apoplexy is a rare yet potentially fatal disease. We reviewed the combined experience of the University of Virginia in Charlottesville, VA, and Groote Schuur Hospital, University of Cape Town, South Africa, with 62 cases of pituitary apoplexy. METHODS: An Internet web site with a database was constructed, and the records of 62 patients were entered into the database from both institutions and then systematically analyzed. RESULTS: The average age of patients was 51.1 years; 60% were male, and the average length of follow-up was 55 months. The average time of presentation was 14.2 days after the ictus, and 81% had no previous history of pituitary tumor. Headache was the most common presenting symptom (87%). Diminished visual acuity was found in 56% of patients, bitemporal hemianopia in 34%, ocular palsies in 45%, and diminished level of consciousness in 13%. Seventy-three percent of the patients had laboratory evidence of hypopituitarism, and 8% had diabetes insipidus. Fifty-eight patients underwent surgery, 3 were treated conservatively, and 1 died before intervention. Histological examination revealed hemorrhagic infarction in 47%, simple infarction in 40%, and frank hemorrhage in 8%. Seventy-nine percent had a good outcome, although 83% required subsequent hormonal replacement therapy. CONCLUSION: Pituitary apoplexy is often misdiagnosed because the majority of patients have undetected pituitary adenomas, and the presentation is often mistaken for subarachnoid hemorrhage. Most cases of pituitary apoplexy occur spontaneously, although precipitating factors have been suggested. Magnetic resonance imaging is the imaging modality of choice. Treatment includes high-dose corticosteroid administration and surgery. Transsphenoidal surgery is indicated in patients with diminished levels of consciousness, hypothalamic dysfunction, and visual deterioration. Conservative management for patients with isolated cranial nerve palsies has been advocated but remains controversial.