African-American women are the fastest growing population contracting Human Immunodeficiency Virus(HIV). Infection is commonly in the context of heterosexual intercourse with unsafe sexual practices and isindependent of psychiatric diagnosis or substance dependence co-morbidity. A history of childhood sexualabuse (CSA) has been linked to increased risk of. HIV infection, with increasing intensity and chronicity ofabuse associated with increasing risk. Imaging studies examining effects of stress have identified the medialprefrental cortex, hippocampus, and amygdala (medial temporal lobe) as brain regions that are particularly'vulnerable. Importantly, these are areas associated with emotion, memory or decision processing. The goalof the proposed studies is to test the hypothesis that childhood sexual abuse, especially in African-Americanwomen, leads to sustained changes in neural circuits even as adults and that these changes predisposesexually abused women to impaired decision making when making choices regarding unsafe sexualbehaviors. This hypothesis will be tested by: 1) rigorous clinical description of adult African American andCaucasian women self reported to have experienced CSA; 2) psychological assessment of executivedecision making with the Stroop Test, the Emotional Stroop Test, and the Iowa Gambling Task; 3) functionalmagnetic resonance imaging (fMRI) of the decision-making and behavioral inhibition neural circuits activatedby provocation with the Stroop Test, Emotional Stroop, Iowa Gambling Task; and 4) correlation of theobjective CSA data with the neuropsychological and functional imaging data. If, as we postulate, womenwith CSA have significant alterations in thought processes that increase risk of dangerous sexual behaviorthen defining the brain circuits altered may suggest therapeutic strategies in the future. Comparison of bothCSA+ African American and Caucasian women with age-, education, and socio-economically matchedcontrol subjects without CSA histories will also reveal possible racial differences in CSA-provoked changes.
Showing the most recent 10 out of 64 publications
