The Role of Disinhibition in Cognition and Sexual Risk Behavior of Adolescent Girls

Purpose: Black girls engage in higher sexual risk behavior (SRB) and are affected by HIV and sexually transmitted infections (STIs), disproportionately, yet knowledge gaps persist regarding the role of neurocognitive and psychosocial determinants. The purpose of this study was to examine the: 1) neuro-psychosocial profile of girls with high SRB vs low SRB and 2) association between depression, disinhibition sensation seeking, cognitive function and SRB in a sample of 65 Black girls 65 AA females ages 15-23 years.

Methods: We used a cross-sectional study design, guided by the Biopsychosocial Model of Risk Taking. Girls completed a computerized battery of cognitive function tests, including the Information Sampling Task (IST), the Stockings of Cambridge (SOC), Cambridge Gambling Task (CGT), and the Affective Go/No-Go (AGN) and demographic, psychosocial and SRB-related surveys. Scores >1 on a SRB index (0-6) indicated high SRB. Bivariate correlations, analysis of variance and regression statistics were calculated using SPSS(R) statistical software package version 22.

Results: Mean age was 17.8±1.9 years. Mean age at sexual debut was 15.5±2.6. Girls with high SRB (vs low SRB) were/had significantly: older (18.6 vs 16.9) and greater mean: depression (11.58 vs 7.26), disinhibition (4.29 vs 2.77) and lower mean: coping (165.14 vs 177.73) and accuracy on IST (poorer impulse control) (6.43 vs 7.38). Higher SRB scores were significantly (p<.05) associated with higher: age (r= .41), disinhibition (r=.34), depression (r=.33), boredom susceptibility (r=.27) scores and poorer/lower: coping (r=−.26), seeking spiritual support (r=−.29) and impulse control: IST sampling errors (r=.30), IST total correct (r=−.30), IST mean # boxes opened/trial (r=−.32). Girls with higher disinhibition were more likely to have higher SRB [Exp(B)=3.08, p=.09], while accounting for covariates (all non-significant). Greater disinhibition was also (Beta= .47, p=.001) associated with higher SRB index scores in a model accounting for 58.7% variance (R2=.587), beyond covariates (non-significant).

Conclusion: Higher SRB is associated with disinhibition and poorer impulse control in our sample of Black girls. Those interested in helping AA girls to minimize their SRB should provide tailored HIV/STI prevention efforts based on important links between psychosocial factors, including disinhibition, and impulse control. Findings can be used to facilitate future imaging, longitudinal and intervention studies.

References:

1. Donahue, K., Van Hulle, C., Rodgers, J. L., & D'Onofrio, B. M. (2014). Psychosocial Predictors of Adolescent Sexual Risk Behavior: A Quasi-Experimental Analysis in a Nationally Representative Sample of American Youths. Journal of Adolescent Health, 54(2 Supplement), S15-S16.

2. Steinberg, L. (2010). A dual systems model of adolescent risk‐taking. Developmental psychobiology, 52(3), 216-224.

3. Danielson, C. K., Walsh, K., McCauley, J., Ruggiero, K. J., Brown, J. L., Sales, J. M., Rose, E., Wingood, G., & DiClemente, R. J. (2014). HIV-Related Sexual Risk Behavior Among African American Adolescent Girls. Journal of Women's Health, 23(5), 413-419.

4. Smith, A., Chein, J., & Steinberg, L. (2013). Impact of socio-emotional context, brain development, and pubertal maturation on adolescent decision-making. Hormones and Behavior, 64, 323-332.

5. Shulman, E., Harden, K., Chein, J., & Steinberg, L. (2014). The development of impulse control and sensation-seeking in adolescence: Independent or interdependent processes? Journal of Research on Adolescence. Advance online publication. doi: 10.1111/jora.12181

6. Steinberg, L. (2014). Age of opportunity: Lessons from the new science of adolescence.  New York: Houghton Mifflin Harcourt