Alcohol myopia and sexual abdication: Examining the moderating effect of child sexual abuse

Abstract

HIV and other sexually transmitted infections (STIs) are a major public health concern for women, and women who engage in risky sexual behaviors are at greater risk of contracting STIs. Risky sexual behaviors may include sexual abdication, that is, willingness to let a partner decide how far to go sexually, though this concept has not been well studied. Alcohol intoxication is a well-known risk factor for risky sexual decision making, and Alcohol Myopia Theory (AMT) is a cognitive physiological model that has been used to explain this relationship. One version of AMT is The Inhibitory Conflict Model which suggests that in order for intoxication to influence decision making, there must be high conflict between instigatory and inhibitory cues in the environment. The saliency of these cues is influenced by individual difference factors. One individual difference factor that has consistently been associated with both increased alcohol use and sexual risk taking is child sexual abuse (CSA) history. Few experimental studies examine in-the-moment sexual decision making involving alcohol when inhibition conflict is manipulated. Furthermore, it is unknown how alcohol intoxication, CSA severity, and inhibition conflict may interact to influence women's in-the-moment abdication likelihood. The current study examined these relationships with 132 women randomized into a 2 (alcohol, control) x 2 (high conflict, low conflict) experimental design. Following completion of a CSA questionnaire, participants read and projected themselves into an eroticized scenario in which there was either a condom present (high conflict) or a condom absent (low conflict), and then indicated how likely they were to abdicate. Regression analyses yielded a significant 3-way interaction between CSA severity, alcohol and conflict condition on abdication likelihood. When there was high conflict in the scenario, abdication decreased as CSA severity increased for sober women, whereas abdication increased as CSA severity increased for intoxicated women. When there was low conflict, CSA severity and alcohol intoxication had no influence on abdication. These results may help explain the association between alcohol and risky sexual decision making among women with CSA.