Iowa Gambling Task performance and emotional distress interact to predict risky sexual behavior in individuals with dual substance and HIV diagnoses

Abstract

HIV+ substance-dependent individuals (SDIs) show emotional distress and executive impairment, but in isolation these poorly predict sexual risk. We hypothesized that an executive measure sensitive to emotional aspects of judgment (Iowa Gambling Task; IGT) would identify HIV+ SDIs whose sexual risks were influenced by emotional distress. We assessed emotional distress and performance on several executive tasks in 190 HIV+ SDIs. IGT performance interacted significantly with emotional distress, such that only in better performers were distress and risk related. Our results are interpreted using the somatic marker hypothesis and indicate that the IGT identifies HIV+ SDIs for whom psychological distress influences HIV risk.

Keywords:

• Substance dependence
• HIV
• AIDS
• Executive functioning
• Emotion
• Sexual risk

Acknowledgments

Supported by HHS R01DA12828 to Eileen Martin-Thormeyer from the National Institute on Drug Abuse.

Notes

¹Removal of the Stroop error outliers and these transformations somewhat improved the fit of the model, and thus these changes were retained. However, analyses run with and without these alterations showed a largely unchanged significance pattern for all effects.

²This method is preferred to dichotomizing one of the predictors, as dichotomization reduces power and may under certain specific circumstances result in the detection of spurious effects (Maxwell & Delaney, 1993).