Mainville Cathryn H, Richardson Mark A, Brady Stephen M, Berger-Greenstein Jori, Bacic Janine
a Division of Psychiatry , Boston University School of Medicine.
b Department of Psychological & Brain Sciences , Boston University.
Behav Med. 2017 Jul-Sep;43(3):165-175. doi: 10.1080/08964289.2017.1301874.
The present study examined the relationship between characteristics associated with personality disorders, substance use, and HIV risk among adults with a history of serious mental illness. Participants included 103 adults with antisocial or borderline personality disorder, serious mental illness, and recent HIV risk behavior. The sample was predominately male (64%), diverse (42% African American and 13% Hispanic), and homeless/marginally housed (76%). In order to examine the relationship between personality characteristics and risk we constructed a risk index comprising key symptoms of antisocial and borderline personality disorders, namely; impulsivity, affective instability, and disregard for safety of self/others. Contrary to our primary hypotheses, risk index scores did not predict HIV risk behavior and substance abuse did not mediate this risk. Exploratory analyses did reveal that women engaged in significantly more risk behaviors than their male counterparts and that risk scores were a significant predictor of total sex acts for women but not men. In addition, increased emotional dysregulation was a significant predictor of condomless sex acts for women but not men. Finally, recent alcohol use and increased impulsivity was associated with more condomless oral sex for men and women. These results suggest the relationship among serious mental illness, personality disorder, substance abuse, and gender is complex and merits further study.
本研究调查了有严重精神疾病史的成年人中，与人格障碍、物质使用及感染艾滋病毒风险相关的特征之间的关系。参与者包括103名患有反社会或边缘型人格障碍、严重精神疾病且近期有感染艾滋病毒风险行为的成年人。样本主要为男性（64%），具有多样性（42%为非裔美国人，13%为西班牙裔），且无家可归/居住条件差（76%）。为了研究人格特征与风险之间的关系，我们构建了一个风险指数，该指数包含反社会和边缘型人格障碍的关键症状，即冲动性、情感不稳定以及对自身/他人安全的漠视。与我们的主要假设相反，风险指数得分并不能预测感染艾滋病毒的风险行为，物质滥用也未介导这种风险。探索性分析确实显示，女性比男性参与的风险行为显著更多，并且风险得分是女性而非男性性行为总数的显著预测因素。此外，情绪调节障碍加剧是女性而非男性无保护性行为的显著预测因素。最后，近期饮酒和冲动性增加与男性和女性更多的无保护口交行为相关。这些结果表明，严重精神疾病、人格障碍、物质滥用和性别之间的关系很复杂，值得进一步研究。
