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Major Depression and Risky Sexual Behavior Among Substance Dependent Patients: The Moderating Roles of Distress Tolerance and Gender

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Abstract

The goal of the present study was to examine the main and interactive effects of major depressive disorder (MDD), distress tolerance (DT), and gender on multiple indices of risky sexual behavior (RSB) within a sample of 185 substance dependent patients in residential substance abuse treatment. Participants were interviewed to establish current MDD (as well as other Axis I and II diagnoses) and completed a behavioral measure of DT, the Paced Auditory Serial Addition Task-Computerized Version. Results provided evidence of a MDD × DT interaction for number of different past year commercial and casual sexual partners with which penetrative sex occurred. Post hoc analyses demonstrated that participants with current MDD and low DT reported the greatest number of commercial and casual sexual partners. Results highlight one psychological vulnerability (DT) that may improve our understanding of the complex relationship between depression and RSB. Treatment implications of findings are discussed.

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References

  • Alvy, L. M., McKirnan, D. J., Mansergh, G., Koblin, B., Colfax, G. N., Flores, S. A., et al. (2011). Depression is associated with sexual risk among men who have sex with men, but is mediated by cognitive escape and self-efficacy. AIDS and Behavior, 15, 1171–1179.

    Article  PubMed  Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author.

  • Anestis, M. D., Gratz, K. L., Bagge, C. L., & Tull, M. T. (in press). The interactive role of distress tolerance and borderline personality disorder in suicide attempts among substance users in residential treatment. Comprehensive Psychiatry.

  • Anestis, M. D., Lavender, J. M., Marshall-Berenz, E. C., Gratz, K. L., Tull, M. T., & Joiner, T. E. (in press). Multi-method evaluation of distress tolerance measures: Interrelations and associations with impulsive behaviors. Cognitive Therapy and Research.

  • Anestis, M. D., Selby, E. A., Fink, E. L., & Joiner, T. E. (2007). The multifaceted role of distress tolerance in dysregulation eating behaviors. International Journal of Eating Disorders, 40, 718–726.

    Article  PubMed  Google Scholar 

  • Anestis, M. D., Tull, M. T., Bagge, C. L., & Gratz, K. L. (2012). The moderating role of distress tolerance in the relationship between posttraumatic stress disorder symptom clusters and suicidal behavior among trauma-exposed substance users in residential treatment. Archives of Suicide Research, 16, 198–211.

    Article  PubMed  Google Scholar 

  • Axelrod, S. R., Perepletchikova, F., Holtzman, K., & Sinha, R. (2011). Emotion regulation and substance use frequency in women with substance dependence and borderline personality disorder receiving dialectical behavior therapy. American Journal of Drug and Alcohol Abuse, 37, 37–42.

    Article  PubMed  Google Scholar 

  • Bellis, D. J. (1990). Fear of AIDS and risk reduction among heroin-addicted female street prostitutes: Personal interviews with 72 Southern California subjects. Journal of Alcohol and Drug Education, 35, 26–37.

    Google Scholar 

  • Bernstein, A., Marshall, E. C., & Zvolensky, M. J. (2011). Multi-method evaluation of distress tolerance measures and construct(s): Concurrent relations to mood and anxiety psychopathology and quality of life. Journal of Experimental Psychopathology, 2, 386–399.

    Google Scholar 

  • Blake, D. D., Weathers, F. W., Nagy, L., Kaloupek, D. G., Klauminzer, G., Charney, D. S., et al. (1990). The Clinician Administered PTSD Scale. Boston: National Center for PTSD, Behavioral Science Division.

    Google Scholar 

  • Bornovalova, M. A., Daughters, S. B., & Lejuez, C. W. (2010). Motivations for sexual risk behavior across commercial and casual partners among male urban drug users: Contextual features and clinical correlates. Behavior Modification, 34, 219–246.

    Article  PubMed  Google Scholar 

  • Bornovalova, M. A., Gratz, K. L., Daughters, S. B., Hunt, E. D., & Lejuez, C. W. (2012). Initial RCT of a distress tolerance treatment for individuals with substance use disorders. Drug and Alcohol Dependence, 122, 70–76.

    Article  PubMed  Google Scholar 

  • Bornovalova, M. A., Gratz, K. L., Daughters, S. B., Nick, B., Delany-Brumsey, A., Lynch, T. R., et al. (2008). A multimodal assessment of the relationship between emotion dysregulation and borderline personality disorder among inner-city substance users in residential treatment. Journal of Psychiatric Research, 42, 717–726.

    Article  PubMed  Google Scholar 

  • Brief, D. J., Bollinger, A. R., Vielhauer, M. J., Berger-Greenstein, J. A., Morgan, E. E., Brady, S. M., et al. (2004). Understanding the interface of HIV, trauma, post-traumatic stress disorder, and substance use and its implications for health outcomes. AIDS Care, 16(Supplement 1), S97–S120.

    Article  PubMed  Google Scholar 

  • Buckner, J. D., Keough, M. E., & Schmidt, N. B. (2007). Problematic alcohol and cannabis use among young adults: The roles of depression and discomfort and distress tolerance. Addictive Behaviors, 32, 1957–1963.

    Article  PubMed  Google Scholar 

  • Carey, M. P., Carey, K. B., Maisto, S. A., Gordon, C. M., & Vanable, P. A. (2001). Prevalence and correlates of sexual activity and HIV-related risk behavior among psychiatric outpatients. Journal of Consulting and Clinical Psychology, 69, 846–850.

    Article  PubMed  CAS  Google Scholar 

  • Carey, M. P., Carey, K. B., Maisto, S. A., Schroder, K. E. E., Vanable, P. A., & Gordon, C. M. (2004). HIV risk behavior among psychiatric outpatients: Association with psychiatric disorder, substance use disorder, and gender. Journal of Nervous and Mental Disease, 192, 289–296.

    Article  PubMed  Google Scholar 

  • Carter, J. D., Joyce, P. R., Mulder, R. T., Luty, S. E., & McKenzie, J. (2000). Gender differences in the presentation of depressed outpatients: A comparison of descriptive variables. Journal of Affective Disorders, 61, 59–67.

    Article  PubMed  CAS  Google Scholar 

  • Catania, J. A., Binson, D., Dolcini, M. M., Stall, R., Choi, K. H., Pollack, L. M., et al. (1995). Risk factors for HIV and other sexually transmitted diseases and prevention practices among US heterosexual adults: Changes from 1990 to 1992. American Journal of Public Health, 85, 1492–1499.

    Article  PubMed  CAS  Google Scholar 

  • Centers for Disease Control and Prevention [CDC]. (2011). HIV surveillance report: Diagnoses of HIV infection and AIDS in the United States and dependent areas, 2009. Centers for Disease Control and Prevention Web site: http://www.cdc.gov/hiv/topics/surveillance/basic.htm. Accessed 22 Jun 2012.

  • Chapman, A. L., Gratz, K. L., & Brown, M. Z. (2006). Solving the puzzle of deliberate self-harm: The experiential avoidance model. Behaviour Research and Therapy, 44, 371–394.

    Article  PubMed  Google Scholar 

  • Clen, S. L., Mennin, D. S., & Fresco, D. M. (2011). Major depressive disorder. In M. J. Zvolensky, A. Bernstein, & A. A. Vujanovic (Eds.), Distress tolerance (pp. 149–170). New York, NY: Guilford Press.

    Google Scholar 

  • Compton, W. M., Cottler, L. B., Shillington, A. M., & Price, R. K. (1995). Is antisocial personality disorder associated with increased HIV risk behaviors in cocaine users? Drug and Alcohol Dependence, 37, 37–43.

    Article  PubMed  CAS  Google Scholar 

  • Cougle, J. R., Timpano, K. R., & Goetz, A. R. (2012). Exploring the unique and interactive roles of distress tolerance and negative urgency in obsessions. Personality and Individual Differences, 52, 515–520.

    Article  Google Scholar 

  • Crepaz, N., & Marks, G. (2001). Are negative affective states associated with HIV sexual risk behaviors? A meta-analytic review. Journal of Health Psychology, 20, 291–299.

    Article  CAS  Google Scholar 

  • Darke, S., Hall, W., Heather, N., Ward, J., & Wodak, A. (1991). The reliability and validity of a scale to measure HIV risk-taking behaviour among intravenous drug users. AIDS, 5, 181–185.

    Article  PubMed  CAS  Google Scholar 

  • Daughters, S. B., Lejuez, C. W., Bornovalova, M. A., Kahler, C. W., Strong, D. R., & Brown, R. A. (2005a). Distress tolerance as a predictor of early treatment dropout in a residential substance abuse treatment facility. Journal of Abnormal Psychology, 114, 729–734.

    Article  PubMed  Google Scholar 

  • Daughters, S. B., Lejuez, C. W., Kahler, C. W., Strong, D. R., & Brown, R. A. (2005b). Psychological distress tolerance and duration of most recent abstinence attempt among residential treatment-seeking substance abusers. Psychology of Addictive Behaviors, 19, 208–211.

    Article  PubMed  Google Scholar 

  • Daughters, S. B., Sargeant, M. N., Bornovalova, M. A., Gratz, K. L., & Lejuez, C. W. (2008). The relationship between distress tolerance and antisocial personality disorder among male inner-city treatment seeking substance users. Journal of Personality Disorders, 22, 509–524.

    Article  PubMed  Google Scholar 

  • Dennhardt, A. A., & Murphy, J. G. (2011). Associations between depression, distress tolerance, delay discounting, and alcohol-related problems in European American and African American college students. Psychology of Addictive Behaviors, 25, 595–604.

    Article  PubMed  Google Scholar 

  • Evans, J. L., Hahn, J. A., Page-Shafer, K., Lum, P. J., Stein, E. S., Davidson, P. J., et al. (2003). Gender differences in sexual and injection risk behavior among active young injection drug users in San Francisco (the UFO Study). Journal of Urban Health, 80, 137–146.

    Article  PubMed  Google Scholar 

  • Fenton, K. A., Johnson, A. M., McManus, S., & Erens, B. (2001). Measuring sexual behavior: Methodological challenges in survey research. Sexually Transmitted Infections, 77, 84–92.

    Article  PubMed  CAS  Google Scholar 

  • First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1996). Structured clinical interview for DSM-IV Axis I Disorders-Patient edition (SCIP-I/P, Version 2.0). New York, NY: New York State Psychiatric Institute.

    Google Scholar 

  • Folkman, S., Chesney, M. A., Pollack, L., & Phillips, C. (1992). Stress, coping, and high-risk sexual behavior. Health Psychology, 11, 218–222.

    Article  PubMed  CAS  Google Scholar 

  • Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). Mini-mental state: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.

    Article  PubMed  CAS  Google Scholar 

  • Fox, H. C., Hong, K. A., & Sinha, R. (2008). Difficulties in emotion regulation and impulse control in recently abstinent alcoholics compared with social drinkers. Addictive Behaviors, 33, 388–394.

    Article  PubMed  CAS  Google Scholar 

  • Gonzalez, V. M., Reynolds, B., & Skewes, M. C. (2011). Role of impulsivity in the relationship between depression and alcohol problems among emerging adult college drinkers. Experimental and Clinical Psychopharmacology, 19, 303–313.

    Article  PubMed  Google Scholar 

  • Gordon, C. M., Forsyth, A. D., Stall, R., & Cheever, L. W. (2005). Prevention interventions with persons living with HIV/AIDS: State of the science and future directions. AIDS Education and Prevention, 17, 6–20.

    Article  PubMed  Google Scholar 

  • Gorka, S. M., Ali, B., & Daughters, S. B. (2012). The role of distress tolerance in the relationship between depressive symptoms and problematic alcohol use. Psychology of Addictive Behaviors, 26, 621–626.

    Google Scholar 

  • Grant, B. F., Stinson, F. S., Dawson, D. A., Chou, P., Dufour, M. C., Compton, W., et al. (2004). Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry, 61, 807–816.

    Article  PubMed  Google Scholar 

  • Gratz, K. L., Bornovalova, M. A., Delany-Brumsey, A., Nick, B., & Lejuez, C. W. (2007). A laboratory-based study of the relationship between childhood abuse and experiential avoidance among inner-city substance users: The role of emotional nonacceptance. Behavior Therapy, 38, 256–268.

    Article  PubMed  Google Scholar 

  • Gratz, K. L., Hepworth, C., Tull, M. T., Paulson, A., Clarke, S., Remington, B., et al. (2011). An experimental investigation of emotional willingness and physical pain tolerance in deliberate self-harm: The moderating role of interpersonal distress. Comprehensive Psychiatry, 52, 63–74.

    Article  PubMed  Google Scholar 

  • Gratz, K. L., Rosenthal, M., Tull, M. T., Lejuez, C. W., & Gunderson, J. G. (2006). An experimental investigation of emotion dysregulation in borderline personality disorder. Journal of Abnormal Psychology, 115, 850–855.

    Article  PubMed  Google Scholar 

  • Hanson, K. L., Luciana, M., & Sullwold, K. (2008). Reward-related decision-making deficits and elevated impulsivity among MDMA and other drug users. Drug and Alcohol Dependence, 96, 99–110.

    Article  PubMed  Google Scholar 

  • Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M., & Strosahl, K. (1996). Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64, 1152–1168.

    Article  PubMed  CAS  Google Scholar 

  • Hellinger, F. J. (1998). Cost and financing of care for persons with HIV disease: An overview. Health Care Financing Review, 19, 1–14.

    Google Scholar 

  • Holtgrave, D. R., & Pinkerton, S. D. (1997). Updates of illness and quality of life estimates for use in economic evaluations of HIV prevention programs. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 16, 54–62.

    Article  PubMed  CAS  Google Scholar 

  • Howell, A. N., Leyro, T. M., Hogan, J., Buckner, J. D., & Zvolensky, M. J. (2010). Anxiety sensitivity, distress tolerance, and discomfort intolerance in relation to coping and conformity motives for alcohol use and alcohol use problems among young adult drinkers. Addictive Behaviors, 35, 1144–1147.

    Article  PubMed  Google Scholar 

  • Hutchinson, A. B., Farnham, P. G., Dean, H. D., Ekwueme, D. U., del Rio, C., Kamimoto, L., et al. (2006). The economic burden of HIV in the United States in the era of highly active antiretroviral therapy: Evidence of continuing racial and ethnic differences. Journal of Acquired Immune Deficiency Syndromes, 43, 451–457.

    Article  PubMed  Google Scholar 

  • Hutton, H. E., Lyketsos, C. G., Zenilman, J. M., Thompson, R. E., & Erbelding, R. J. (2004). Depression and HIV risk behaviors among patients in a sexually transmitted disease clinic. American Journal of Psychiatry, 161, 912–914.

    Article  PubMed  Google Scholar 

  • Iverson, K. M., Follette, V. M., Pistorello, J., & Fruzetti, A. E. (in press). An investigation of experiential avoidance, emotion dysregulation, and distress tolerance in young adult outpatients with borderline personality disorder symptoms. Personality Disorder: Theory, Research, and Treatment.

  • Johnson, M. E., Fisher, D. G., Montoya, I., Booth, R., Rhodes, F., Andersen, M., et al. (2000). Reliability and validity of not-in-treatment drug users’ follow-up self-reports. AIDS and Behavior, 4, 373–380.

    Article  Google Scholar 

  • Kaiser, A. J., Milich, R., Lynam, D. R., & Charnigo, R. J. (2012). Negative urgency, distress tolerance, and substance abuse among college students. Addictive Behaviors, 37, 1075–1083.

    Article  PubMed  Google Scholar 

  • Kalichman, S. C., Rompa, D., & Cage, M. (2005). Group interventions to reduce HIV transmission risk behavior among persons living with HIV/AIDS. Behavior Modification, 29, 256–285.

    Article  PubMed  Google Scholar 

  • Kelly, J. A., & Kalichman, S. C. (2002). Behavioral research in HIV/AIDS primary and secondary prevention: Recent advances and future directions. Journal of Consulting and Clinical Psychology, 70, 626–639.

    Article  PubMed  Google Scholar 

  • Klein, H., Elifson, K. W., & Sterk, C. E. (2008). Depression and HIV risk behavior practices among “at risk” women. Women and Health, 48, 167–188.

    Article  Google Scholar 

  • Klinkenberg, W. D., & Sacks, S. (2004). Mental disorders and drug abuse in persons living with HIV/AIDS. AIDS Care, 16(Suppl. 1), S22–S42.

    Article  PubMed  Google Scholar 

  • Knauz, R. O., Safren, S. A., O’Cleirigh, C., Capistrant, B. D., Driskell, J. R., Aguilar, D., et al. (2007). Developing an HIV-prevention intervention for HIV-infected men who have sex with men in HIV care: Project enhance. AIDS and Behavior, 11, S117–S126.

    Article  PubMed  Google Scholar 

  • Koblin, B. A., Husnik, M. J., Colfax, G., Huang, Y., Madison, M., Mayer, K., et al. (2006). Risk factors for HIV infection among men who have sex with men. AIDS, 21, 731–739.

    Article  Google Scholar 

  • Leith, K. P., & Baumeister, R. F. (1996). Why do bad moods increase self-defeating behavior? Emotion, risk tasking, and self-regulation. Journal of Personality and Social Psychology, 71, 1250–1267.

    Article  PubMed  CAS  Google Scholar 

  • Lejuez, C. W., Bornovalova, M. A., Daughters, S. B., & Curtin, J. J. (2005). Differences in impulsivity and sexual risk behavior among inner-city crack/cocaine users and heroin users. Drug and Alcohol Dependence, 77, 169–175.

    Article  PubMed  CAS  Google Scholar 

  • Lejuez, C. W., Kahler, C. W., & Brown, R. A. (2003). A modified computer version of the Paced Auditory Serial Addition Task (PASAT) as a laboratory-based stressor. The Behavior Therapist, 26, 290–293.

    Google Scholar 

  • Levin, L. I., Peterman, T. A., Renzullo, P. O., Lasley-Bibbs, V., Shu, X. O., Brundage, J. F., et al. (1995). HIV-1 seroconversion and risk behaviors among young men in the US Army. The Seroconversion Risk Factor Study Group. American Journal of Public Health, 85, 1500–1506.

    Article  PubMed  CAS  Google Scholar 

  • Leyro, T. M., Zvolensky, M. J., & Bernstein, A. (2010). Distress tolerance and psychopathological symptoms and disorders: A review of the empirical literature among adults. Psychological Bulletin, 136, 576–600.

    Article  PubMed  Google Scholar 

  • Linehan, M. M. (1993). Cognitive behavioral treatment of borderline personality disorder. New York: Guilford Press.

    Google Scholar 

  • Lucenko, B. A., Malow, R. M., Sanchez-Martinez, M., Jennings, T., & Dévieux, J. G. (2003). Negative affect and HIV risk in alcohol and other drug (AOD) abusing adolescent offenders. Journal of Child and Adolescent Substance Abuse, 13, 1–17.

    Article  PubMed  Google Scholar 

  • MacCallum, R. C., Zhang, S., Preacher, K. J., & Rucker, D. D. (2002). On the practice of dichotomization of quantitative variables. Psychological Methods, 7, 19–40.

    Article  PubMed  Google Scholar 

  • McCusker, J., Goldstein, R., Bigelow, C., & Zorn, M. (1995). Psychiatric status and HIV risk reduction among residential drug abuse treatment clients. Addiction, 90, 1377–1387.

    Article  PubMed  CAS  Google Scholar 

  • McDermott, M. D., Tull, M. T., Gratz, K. L., Daughters, S. B., & Lejuez, C. W. (2009). The role of anxiety sensitivity and difficulties in emotion regulation in posttraumatic stress disorder among crack/cocaine dependent patients in residential substance abuse treatment. Journal of Anxiety Disorders, 23, 591–599.

    Article  PubMed  Google Scholar 

  • McGowan, J. P., Shah, S. S., Ganea, C. E., Blum, S., Ernst, J. A., Irwin, K. L., et al. (2004). Risk behavior for transmission of human immunodeficiency virus (HIV) among HIV-seropositive individuals in an urban setting. Clinical Infectious Diseases, 38, 122–127.

    Article  PubMed  Google Scholar 

  • McHugh, R. K., Daughters, S. B., Lejuez, C. W., Murray, H. W., Hearon, B. A., Gorka, S. M., et al. (2011). Shared variance among self-report and behavioral measures of distress intolerance. Cognitive Therapy and Research, 35, 266–275.

    Article  Google Scholar 

  • McKeganey, N. P. (1994). Prostitution and HIV: What do we know and where might research be targeted in the future? AIDS, 8, 1215–1226.

    Article  PubMed  CAS  Google Scholar 

  • Meade, C. S. (2006). Sexual risk behavior among persons dually diagnosed with severe mental illness and substance use disorder. Journal of Substance Abuse Treatment, 30, 147–157.

    Article  PubMed  Google Scholar 

  • Meade, C. S., & Sikkema, K. J. (2005). HIV risk behavior among adults with severe mental illness: A systematic review. Clinical Psychology Review, 25, 433–457.

    Article  PubMed  Google Scholar 

  • Messman-Moore, T. L., Walsh, K. L., & DiLillo, D. (2010). Emotion dysregulation and risky sexual behavior in revictimization. Child Abuse and Neglect, 34, 967–976.

    Article  PubMed  Google Scholar 

  • Mitchell, M. M., & Latimer, W. W. (2009a). Gender differences in high risk sexual behaviors and injection practices associated with perceived HIV risk among injection drug users. AIDS Education and Prevention, 21, 384–394.

    Article  PubMed  Google Scholar 

  • Mitchell, M. M., & Latimer, W. W. (2009b). Unprotected casual sex and perceived risk of contracting HIV among drug users in Baltimore, Maryland: Evaluating the influence of non-injection versus injection drug user status. AIDS Care, 21, 221–230.

    Article  PubMed  Google Scholar 

  • Munroe, C. D., Kibler, J. L., Ma, M., Dollar, K. M., & Coleman, M. (2010). The relationship between posttraumatic stress symptoms and sexual risk: Examining potential mechanisms. Psychological Trauma: Theory, Research, Practice, and Policy, 2, 49–53.

    Article  Google Scholar 

  • Must, A., Szabó, Z., Bódi, N., Szász, A., Janka, Z., & Kéri, S. (2006). Sensitivity to reward and punishment and the prefrontal cortex in major depression. Journal of Affective Disorders, 90, 209–215.

    Article  PubMed  Google Scholar 

  • Nolen-Hoeksema, S. (2001). Gender differences in depression. Current Directions in Psychological Science, 10, 173–176.

    Article  Google Scholar 

  • Patterson, T. L., Goldenberg, S., Gallardo, M., Lozado, R., Orozovich, P., Abramovitz, D., et al. (2009). Correlates of HIV, sexually transmitted infections, and associated high-risk behaviors among male clients of female sex workers in Tijuana, Mexico. AIDS, 24, 1765–1771.

    Article  Google Scholar 

  • Perdue, T., Hagan, H., Thiede, H., & Valleroy, L. (2003). Depression and HIV risk behavior among Seattle-area injection drug users and young men who have sex with men. AIDS Education and Prevention, 15, 81–92.

    Article  PubMed  Google Scholar 

  • Piccinelli, M., & Wilkinson, G. (2000). Gender differences in depression: Critical review. The British Journal of Psychiatry, 177, 486–492.

    Article  PubMed  CAS  Google Scholar 

  • Reisner, S. L., Mimiaga, M. J., Skeer, M., Bright, D., Cranston, K., Isenberg, D., et al. (2009). Clinically significant depressive symptoms as a risk factor for HIV infection among Black MSM in Massachusetts. AIDS and Behavior, 13, 798–810.

    Article  PubMed  Google Scholar 

  • Reynolds, E. K., Magidson, J. F., Bornovalova, M. A., Gwadz, M., Ewart, C. K., Daughters, S. B., et al. (2010). Application of the social action theory to understand factors associated with risky sexual behavior among individuals in residential substance abuse treatment. Psychology of Addictive Behaviors, 24, 311–321.

    Article  PubMed  Google Scholar 

  • Richards, J. M., Daughters, S. B., Bornovalova, M. A., Brown, R. A., & Lejuez, C. W. (2011). Substance use disorders. In M. J. Zvolensky, A. Bernstein, & A. A. Vujanovic (Eds.), Distress tolerance (pp. 171–197). New York, NY: Guilford Press.

    Google Scholar 

  • Risser, J. M. H., Timpson, S. C., McCurdy, S. A., Ross, M. W., & Williams, M. L. (2006). Psychological correlates of trading sex for money among African American crack cocaine smokers. The American Journal of Drug and Alcohol Abuse, 32, 645–653.

    Article  PubMed  Google Scholar 

  • Rogers, M. A., Kasai, K., Koji, M., Fukuda, R., Iwanami, A., Nakagome, K., et al. (2004). Executive and prefrontal dysfunction in unipolar depression: A review of neuropsychological and imaging evidence. Neuroscience Research, 50, 1–11.

    Article  PubMed  Google Scholar 

  • Rosenheck, R., Ngilangwa, D., Manongi, R., & Kapiga, S. (2010). Treatment-seeking behavior for sexually transmitted infections in a high-risk population. AIDS Care, 22, 1350–1358.

    Article  PubMed  Google Scholar 

  • Safren, S. A., Traeger, L., Skeer, M. R., O’Cleirigh, C., Meade, C. S., Covahey, C., et al. (2010). Testing a social-cognitive model of HIV transmission risk behaviors in HIV-infected MSM with and without depression. Health Psychology, 29, 215–221.

    Article  PubMed  Google Scholar 

  • Schloss, H. M., & Haaga, D. A. F. (2011). Interrelating behavioral measures of distress tolerance with self-reported experiential avoidance. Journal of Rational-Emotive Cognitive-Behavioral Therapy, 29, 53–63.

    Article  Google Scholar 

  • Semple, S. J., Patterson, T. L., & Grant, I. (2000). Psychosocial predictors of unprotected anal intercourse in a sample of HIV positive gay men who volunteer for a sexual risk reduction intervention. AIDS Education and Prevention, 12, 416–430.

    PubMed  CAS  Google Scholar 

  • Seth, P., Raiji, P. T., DiClemente, R. J., Wingood, G. M., & Rose, E. (2009). Psychological distress as a correlate of a biologically confirmed STI, risky sexual practices, self-efficacy and communication with male sex partners in African-American female adolescents. Psychology, Health, and Medicine, 13, 291–300.

    Google Scholar 

  • Shapiro, S. S., & Wilk, M. B. (1965). An analysis of variance test for normality (complete samples). Biometrika, 52, 591–611.

    Google Scholar 

  • Simons, J. S., & Gaher, R. M. (2005). The Distress Tolerance Scale: Development and validation of a self-report measure. Motivation and Emotion, 29, 83–102.

    Article  Google Scholar 

  • Simons, J. S., Maisto, S. A., & Wray, T. B. (2010). Sexual risk taking among young adult alcohol and marijuana users. Addictive Behaviors, 35, 533–536.

    Article  PubMed  Google Scholar 

  • Stall, R., Mills, T. C., Williamson, J., Hart, T., Greenwood, G., Paul, J., et al. (2003). Association of co-occurring psychosocial health problems and increased vulnerability to HIV/AIDS among urban men who have sex with men. American Journal of Public Health, 93, 939–942.

    Article  PubMed  Google Scholar 

  • Stein, M. D., Solomon, D. A., Herman, D. S., Anderson, B. J., & Miller, I. (2003). Depression severity and drug injection HIV risk behaviors. American Journal of Psychiatry, 160, 1659–1662.

    Article  PubMed  Google Scholar 

  • Subramaniam, G. A., Stitzer, M. L., Woody, G., Fishman, M. J., & Kolodner, K. (2009). Clinical characteristics of treatment-seeking adolescents with opioid versus cannabis/alcohol use disorders. Drug and Alcohol Dependence, 99, 141–149.

    Article  PubMed  Google Scholar 

  • Tabachnick, B. G., & Fidell, L. S. (2007). Using multivariate statistics (5th ed.). Boston, MA: Allyn & Bacon/Pearson Education.

    Google Scholar 

  • Tull, M. T., Gratz, K. L., Coffey, S. F., Weiss, N. H., & McDermott, M. J. (in press). Examining the interactive effect of posttraumatic stress disorder, distress tolerance, and gender on residential substance use disorder treatment retention. Psychology of Addictive Behaviors.

  • Tull, M. T., Gratz, K. L., & Weiss, N. H. (2011). Exploring associations between borderline personality disorder, crack/cocaine dependence, gender, and risky sexual behavior among substance dependent inpatients. Personality Disorders: Theory, Research, and Treatment, 2, 209–219.

    Article  Google Scholar 

  • Tull, M. T., Weiss, N. H., Adams, C. E., & Gratz, K. L. (2012). The contribution of emotion dysregulation to risky sexual behavior within a sample of patients in residential substance abuse treatment. Addictive Behaviors, 37, 1084–1092.

    Article  PubMed  Google Scholar 

  • Tyndall, M. W., Patrick, D., Spittal, P., Li, K., O’Schaughnessy, M. V., & Schecter, M. T. (2002). Risky sexual behaviors among injection drug users with high HIV prevalence: Implications for STD control. Sexually Transmitted Infections, 78(Suppl. 1), i170–i175.

    Article  PubMed  Google Scholar 

  • Weatherby, N. L., Needle, R., Cesari, H., Booth, R. E., McCoy, C. B., Watters, J. K., et al. (1994). Validity of self-reported drug use among injection drug users and crack cocaine users recruited through street outreach. Evaluation and Program Planning, 17, 347–355.

    Article  Google Scholar 

  • Weinhardt, L. S., Carey, K. B., & Carey, M. P. (2000). HIV risk sensitization following a detailed sexual behavior interview: A preliminary investigation. Journal of Behavioral Medicine, 23, 393–398.

    Article  PubMed  CAS  Google Scholar 

  • Wood, E., Schachar, J., Li, K., Stoltz, J., Shannon, K., Miller, C., et al. (2007). Sex trade involvement is associated with elevated HIV incidence among injection drug users in Vancouver. Addiction Research and Theory, 15, 321–325.

    Article  Google Scholar 

  • Zanarini, M. C., Frankenburg, F. R., Sickel, A. E., & Young, L. (1996). Diagnostic interview for DSM-IV personality disorders. Unpublished measure. Boston, MA: McLean Hospital.

  • Zanarini, M. C., Skodol, A. E., Bender, D., Dolan, R., Sanislow, C., Schaefer, E., et al. (2000). The collaborative longitudinal personality disorders study: Reliability of Axis I and II diagnoses. Journal of Personality Disorders, 14, 291–299.

    Article  PubMed  CAS  Google Scholar 

  • Zvolensky, M. J., Bernstein, A., & Vujanovic, A. A. (2011a). Distress tolerance. New York, NY: Guilford Press.

    Google Scholar 

  • Zvolensky, M. J., Leyro, T. M., Bernstein, A., & Vujanovic, A. A. (2011b). Historical perspectives, theory, and measurement of distress tolerance. In M. J. Zvolensky, A. Bernstein, & A. A. Vujanovic (Eds.), Distress tolerance (pp. 3–27). New York, NY: Guilford Press.

    Google Scholar 

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Acknowledgments

Support for this study was provided in part by R21 DA022383 from the National Institute on Drug Abuse of the National Institutes of Health awarded to the first author. The authors would like to thank Dr. Carl W. Lejuez, Dr. Scott F. Coffey, Bettye Van Norman, Nicole H. Weiss, Michael J. McDermott, Melissa Soenke, Sarah Anne Moore, Rachel Brooks, and Jessica Fulton for their assistance with this project.

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  1. Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, 39216, USA

    Matthew T. Tull & Kim L. Gratz

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  1. Matthew T. Tull
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  2. Kim L. Gratz
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Correspondence to Matthew T. Tull.

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Tull, M.T., Gratz, K.L. Major Depression and Risky Sexual Behavior Among Substance Dependent Patients: The Moderating Roles of Distress Tolerance and Gender. Cogn Ther Res 37, 483–497 (2013). https://doi.org/10.1007/s10608-012-9490-3

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