Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Suite 3000, Baltimore, MD, 21224, USA.
Department of Health Education and Behavior, University of Florida, Gainesville, FL, USA.
Arch Sex Behav. 2021 Jan;50(1):191-204. doi: 10.1007/s10508-020-01698-8. Epub 2020 Apr 23.
Attention-deficit/hyperactivity disorder (ADHD) is associated with increased risk of detrimental life outcomes. Recent research also indicates that ADHD is associated with sexual risk behavior, such as unprotected sex. Some risky sexual behaviors may be driven, in part, by preference for immediate rewards, referred to as delay discounting, which is prominent in etiological models of ADHD. Therefore, the present study examined the effect of delay on preference for both monetary and sexual outcomes in adults with many ADHD symptoms (both on and off medication) and with fewer ADHD symptoms. Online participants (N = 275; n = 161 males, n = 114 females) completed a monetary delay discounting task, assessing preference for smaller sooner versus larger delayed hypothetical money, and the Sexual Delay Discounting Task, assessing preference for condom use in hypothetical casual sex scenarios based on delay until condom availability. Those with greater ADHD symptoms discounted delayed monetary outcomes as well as delayed condom-protected sex (i.e., preferred sooner money rewards and immediate unprotected sex) significantly more than those with fewer symptoms; however, no effect of current medication use was found across monetary or sexual delay discounting among those with greater ADHD symptoms. This study is the first to demonstrate the relation between ADHD symptoms and reduced condom-use likelihood. Increased discounting of delayed condom-protected sex might constitute one mechanism of risky sexual behavior among individuals with ADHD symptoms. Interventions geared toward increasing condom use in situations in which condoms may otherwise be unavailable, may mitigate risky sexual behaviors and their associated harms in this population.
注意缺陷多动障碍（ADHD）与不良生活结局的风险增加有关。最近的研究还表明，ADHD 与性风险行为有关，例如无保护性行为。一些危险的性行为可能部分是由对即时奖励的偏好驱动的，这被称为延迟折扣，在 ADHD 的病因学模型中表现得尤为明显。因此，本研究考察了延迟对有大量 ADHD 症状（用药和未用药）和较少 ADHD 症状的成年人对金钱和性结果的偏好的影响。在线参与者（N=275；n=161 名男性，n=114 名女性）完成了一项货币延迟折扣任务，评估了对较小的即时奖励与较大的延迟奖励的偏好，以及性延迟折扣任务，评估了对假设的随意性行为中使用避孕套的偏好，基于延迟到避孕套可用的时间。那些 ADHD 症状更严重的人对延迟的金钱结果和延迟的避孕套保护的性行为（即更喜欢即时的金钱奖励和无保护的性行为）的折扣程度明显高于症状较轻的人；然而，在有更多 ADHD 症状的人中，无论使用货币还是性延迟折扣，目前的药物使用都没有影响。这项研究首次证明了 ADHD 症状与降低使用避孕套可能性之间的关系。延迟的避孕套保护性行为的折扣增加可能是 ADHD 症状患者的一种危险性行为机制。针对在可能无法获得避孕套的情况下增加避孕套使用的干预措施，可能会减轻该人群的危险性行为及其相关危害。
