Predicting intention to use condoms in homosexual men: an application and extension of the theory of reasoned action

A questionnaire based upon the Theory of Reasoned Action was developed and tested to identify predictors of intention to use condoms. Behavioral intentions, attitudes and subjective normative beliefs, behavioral norms, and age of HIV-positive status were included on the questionnaire. Internal consistency of the four components was high, with Cronbach's alpha coefficients of 0.76-0.87. Qualitative data were collected over 2 months from 194 homosexual men who participated in Sydney's homosexual community. Participants aged 17-64 years of mean age 29.5 attended individual interviews or small focus groups to discuss their views concerning condom use. 15% reported having tested HIV-positive, 59% tested negative, and 26% reported not knowing their HIV serostatus. According to logistic modeling, the significant predictors of intentions to use a condom were attitudes and behavioral norms, while HIV antibody positive status and age directly influence behavioral intentions to use a condom. About 50% of men over age 25 years intended to use a condom, irrespective of HIV status. Overall, 59% of men aged 25 years and younger intended to use a condom; 22% of HIV-positive men and 63% of HIV-negative men.     

Correlates of perceived HIV-related stigma among HIV-positive pregnant women in rural Mpumalanga province,South Africa

The study investigated correlates of perceived HIV-related stigma among 673 HIV-positive women from rural Mpumalanga province, South Africa (mean age 28 years old, SD = 5.73 years). The women completed measures of HIV-related stigma experience and related personal factors. Following multivariable logistic regression, results showed that lack of male involvement during the ante-natal visits was significantly associated with all four perceived HIV-related stigma factors. Lower income, intimate partner violence (IPV), lower education, and experienced HIV-related stigma were associated with a combination of the four components of perceived HIV-related stigma. From these findings, we conclude that higher levels of education, income, and partner involvement are protective factors against perceived HIV-related stigma, at multiple layers. Improving on adult education and income generating activities can help in reducing HIV-related stigma. Male partner involvement in their partner’s pregnancy, the initiation of support groups for both women and men, as well as community-based IPV prevention interventions may help to reduce perceived HIV-related stigma among women living with HIV.     

Attributional Style, Self-Esteem, and Human Immunodeficiency Virus: A Test of the Hopelessness and Self-Esteem Theories of Depression

Research on the hopelessness and self-esteem theories of depression (Abramson, Metalsky, & Alloy, 1989; Metalsky, Joiner, Hardin, & Abramson, 1993) suggests that HIV-infected persons with depressotypic attributional style (AS) and low self-esteem (SE) may be at risk for onset of a syndrome referred to as hopelessness depression (HD). In a prospective study conducted to test these theories, measures of anxiety and depression, AS, and SE were administered to 85 HIV+ and 43 HIV– men; symptoms were reassessed 6 months later. Results indicated that: (1) The interaction of AS, SE, and HIV status predicted change in HD symptoms, but not overall depression or anxiety symptoms; (2) HIV+ men with depressotypic AS and high SE had increased HD symptom levels while other men with high SE had decreased HD symptom levels; (3) HD symptoms remained stable over the 6-month interval among men with low SE; and (4) High SE predicted decreases in anxiety symptoms among HIV– men, but not among HIV+ men. Contrary to the study hypothesis, these findings suggest that among individuals with life-threatening illnesses such as HIV infection, those with depressotypic AS and high SE may be at highest risk for onset of HD.     

Insomnia and eating expectancies among college students: the role of emotion dysregulation

There is limited understanding of the relation between insomnia and aspects of eating among college students though available data suggest salient clinical relationships. The present study explored a potential transdiagnostic mechanism in the relation between insomnia symptoms and eating expectancies. Participants were a racially/ethnically diverse sample of 1589 college students (80.4% females; Mage = 22.2 years, SD = 5.27) from an urban university. Primary analysis included three regression-based models of eating expectancies. Insomnia symptoms served as the predictor, and emotion dysregulation served as the indirect (mediator) variable in all models. Results indicated that insomnia symptoms yielded a significant indirect effect through emotion dysregulation on expectancies of eating to help manage negative affect, alleviate boredom, and lead to feeling out of control. Students experiencing insomnia symptoms may be at higher risk for experiencing dysregulated emotions and consequently maladaptive eating expectancies compared to good sleepers.     

Knowledge and causal attributions for mental disorders in HIV-positive children and adolescents: results from rural and urban Uganda

Increasing availability of antiretroviral treatment (ART) has led HIV to be considered a chronic disease, shifting attention to focus on quality of life including mental wellbeing. We investigated knowledge and causal attributions for mental disorders in HIV-positive children and adolescents in rural and urban Uganda. This qualitative study was nested in an epidemiological mental health study among HIV-positive children and adolescents aged 5–17 years in rural and urban Uganda. In-depth interviews were conducted with caregivers of HIV-positive children (5–11 years) and adolescents (12–17 years) in HIV care. Interviews were audio recorded with permission from participants and written consent and assent sought before study procedures. Thirty eight participants (19 caregivers, 19 children/adolescents) were interviewed. Age range of caregivers was 28–69 years; majority were female (17). Caregivers had little knowledge on mental disorders ;only 3 related the vignette to a mental problem and attributed it to: improper upbringing, violence, poverty and bereavement. Five adolescents identified vignettes as portraying mental disorders caused by: ill-health of parents, bereavement, child abuse, discrimination, HIV and poverty. Caregivers are not knowledgeable about behavioural and emotional challenges in HIV-positive children/adolescents. Mental health literacy programmes at HIV care clinics are essential to enhance treatment-seeking for mental health.     

Perceived discrimination and mental health symptoms among Black men with HIV

People living with HIV (PLWH) exhibit more severe mental health symptoms, including depression and posttraumatic stress disorder (PTSD) symptoms, than do members of the general public. We examined whether perceived discrimination, which has been associated with poor mental health in prior research, contributes to greater depression and PTSD symptoms among HIV-positive Black men who have sex with men (MSM), who are at high risk for discrimination from multiple stigmatized characteristics (HIV-serostatus, race/ethnicity, sexual orientation). A total of 181 Black MSM living with HIV completed audio computer-assisted self-interviews (ACASI) that included measures of mental health symptoms (depression, PTSD) and scales assessing perceived discrimination due to HIV-serostatus, race/ethnicity, and sexual orientation. In bivariate tests, all three perceived discrimination scales were significantly associated with greater symptoms of depression and PTSD (i.e., reexperiencing, avoidance, and arousal subscales; all p values < .05). The multivariate model for depression yielded a three-way interaction among all three discrimination types (p < .01), indicating that perceived racial discrimination was negatively associated with depression symptoms when considered in isolation from other forms of discrimination, but positively associated when all three types of discrimination were present. In multivariate tests, only perceived HIV-related discrimination was associated with PTSD symptoms (p < .05). Findings suggest that some types of perceived discrimination contribute to poor mental health among PLWH. Researchers need to take into account intersecting stigmata when developing interventions to improve mental health among PLWH.     

What Happens in Therapy? Adolescents’ Expectations and Perceptions of Psychotherapy

A measure of adolescent pre-treatment expectations/perceptions of psychotherapy was developed, evaluated, and used to examine adolescent expectancies of psychotherapy. The development of the Psychotherapy Expectations and Perceptions Inventory (PEPI) is described and initial psychometric properties reported. Utilizing a sample of adolescents (N = 546), expectancies of psychotherapy were assessed using the PEPI. Results indicate adequate internal consistency and a 3 factor structure. Specifically, factors identified were labeled (1) measuring negative expectancies, (2) process/outcome expectancies, and (3) expectancies for a positive therapeutic relationship. Boys reported greater negative expectancies, but also greater expectancies for a positive therapeutic relationship. Girls reported greater therapy process/outcome expectancies. Prior contact with mental illness was not related to any studied factors. Clinicians may benefit from assessing adolescent expectancies to facilitate rapport and engagement in the therapy to foster more therapeutic change. Future research that examines the relationships between specific demographic characteristics (e.g., socioeconomic status, race/ethnicity, etc.) and service utilization variables among adolescents is warranted.     

Correlates of relationship, psychological, and sexual behavioral factors for HIV risk among Indian women

The rate of HIV/AIDS among women in India is expected to rise yet few studies have examined factors related to HIV risk among Indian women. The objective of this prospective, cross-sectional study was to characterize similarities and differences in the relationships, psychological well-being, and sexual behaviors among Indian women (N=459). Both HIV positive (N=216) and negative (N=243) women from urban and rural areas in India were included in this study. Chi-square, analysis of variance, and logistic regression analyses revealed that in both geographic groups, HIV-positive women were significantly more likely to report marital dissatisfaction, a history of forced sex, domestic violence, depressive symptoms and husband's extra marital sex when compared to the HIV-negative women. Findings also indicate that specific factors related to the quality of the marital relationship such as domestic violence, martial dysfunction, and depressive symptoms may be related to HIV-related risks for women. Implications for future research and culturally relevant interventions are discussed.     

An Emotionally Inexpressive (Type C) Coping Style Influences HIV Disease Progression at Six and Twelve Month Follow-ups

This study examined the effects of specific psychosocial factors on the progression of HIV infection in 200 HIV-1 seropositive but asymptomatic men and women. At baseline, participants' disease status was determined, and they were administered self-report assessments of coping style, social support and loneliness. Participants were classified at 6 and 12 month follow-ups as progressed or unchanged, compared to their baseline status. In logistic regression analyses, higher baseline Type C coping scores (indicating emotional inexpressiveness and decreased recognition of needs and feelings) significantly predicted progression at 6 months ( p <0.01) and 12 months ( p <0.02), but only among participants classified at baseline as CDC-A2 (between 200-499 CD4 cells/mm 3 ). In participants originally classified as CDC-A1 (CD4 cell counts > 500/mm 3 ), no psychosocial variable showed any significant relationship. Results emphasize the need to consider the disease context, as well as the interaction between biological and psychological factors in contributing to disease progression.     

青少年饮酒期望与饮酒行为的关系:追踪研究的证据

通过对1000余名青少年为期一年的追踪调查,探讨了青少年饮酒期望与饮酒行为之间的关系,同时考察了饮酒期望的发展和性别差异。研究结果表明:(1)一年来青少年的饮酒行为、饮酒消极期望和饮酒积极期望都显著增加;女生的饮酒行为和饮酒积极期望的增加都显著高于男生。(2)第二次测查时,青少年的饮酒行为、饮酒积极期望和饮酒消极期望高于一年前原同年级的学生。(3)饮酒积极期望、消极期望和饮酒行为之间的基本关系一年来没有发生变化:消极期望可能降低饮酒行为,积极期望可能增加饮酒行为,消极期望对积极期望与饮酒行为的关系具有显著的调节作用。但是消极期望对饮酒行为的作用降低,积极期望的作用升高。     

母亲消极教养、同伴侵害与FKBP5基因对青少年抑郁的影响

累积压力假说与匹配-不匹配假说均可解释远端和近端逆境对个体抑郁的影响, 但鲜有研究考察遗传基因在其中的调节作用。采用问卷法和DNA分型技术, 对970名青少年进行间隔3年的追踪调查。分别以母亲消极教养、同伴侵害为远端和近端压力指标, FKBP5基因多位点累加得分为遗传指标, 考察三者对青少年抑郁的交互作用及性别差异。结果发现, 在男青少年中, E × E × G显著。当累加得分较高、同伴侵害水平较高时, 母亲消极教养显著负向预测抑郁, 符合匹配-不匹配假说; 累加得分较低时, E × E不显著, 但倾向于以累积压力假说的方式发挥作用。女青少年中, E × E × G不显著。研究结果提示, 在男青少年中, 累积压力假说与匹配-不匹配假说均可阐明抑郁的发生机制, 分别适用于携带不同FKBP5基因多位点累加得分的个体。     

Changes in health status after one year for persons at-risk for and with HIV infection

Abstract

Health status is an important component of the evaluation of patient outcome in HIV infection where disease is chronic, progressive, and debilitating. This paper compares patient self-report for 9 dimensions of health status for patients followed in ATHOS (AIDS Time-Oriented Health Outcome Study). We compared changes in functioning after 12 months for 1, 524 patients with varying HIV disease severity: 238 asymptomatic, 447 symptomatic, 441 AIDS, and 398 HIV-negative individuals who are at-risk for infection.

Declines in health status were observed for all HIV-infected persons, including also asymptomatic patients. Individuals with symptomatic disease or AIDS had significant declines (p < 0.001) in physical functioning, energy, global health, pain, and increased disease symptoms, but no significant declines in health distress, cognition, or mental health. Persons with AIDS had greater declines than those with symptomatic disease. All HIV-infected individuals reported significantly fewer hours at work and more disability days than HIV-negative patients from similar risk pools. The adverse impact that HIV infection has on the health status of HIV-positive asymptomatic individuals is striking; HIV-negative individuals are more similar to HIV-positive individuals than to the general population.     

Alcohol expectancies and context-specific drinking behaviors among female college athletes

Alcohol expectancies have been associated with drinking behaviors among college students. Few studies, however, have focused on researcher-labeled "positive" and "negative" expectancies as well as the valuations (i.e., desirability) of these expectancies. Moreover, research on the correlates of heavy drinking among female college athletes remain relatively sparse, despite the prevalence of elevated alcohol use in this population. We examined the associations of expectancies and valuations with frequency of heavy drinking and context-specific drinking behaviors. The sample consisted of 145 female college athletes (mean age=19.6; range=17 to 22) who completed self-report surveys and indicated alcohol use in the past 30 days. Regression analyses indicated that favorable valuations of negative expectancies were related to heavy drinking, and that valuations accounted for significant proportions of variance in the model. Elevated endorsement of negative expectancies was also associated with the perceived likelihood of heavy use in convivial and personal-social drinking contexts, and favorable valuations of these expectancies accounted for significant variance in these models. These findings highlight the relevance of negative expectancies and valuations with respect to heavy drinking and context-specific drinking behaviors among female college athletes. The perception of "negative" effects of alcohol as "positive" could help explain the high rates of problematic drinking among female athletes. Future research considerations and potential implications for assessment and prevention efforts are discussed.     

Interactions between early parenting and a polymorphism of the child's dopamine transporter gene in predicting future child conduct disorder symptoms

Mounting evidence suggests that genetic risks for mental disorders often interact with the social environment, but most studies still ignore environmental moderation of genetic influences. The authors tested interactions between maternal parenting and the variable number tandem repeat (VNTR) polymorphism in the 3' untranslated region of the dopamine transporter gene in the child to increase understanding of gene-environment interactions involving early parenting. Participants were part of a 9-year longitudinal study of 4- to 6-year-old children who met criteria for attention-deficit/hyperactivity disorder (ADHD) and demographically matched controls. Maternal parenting was observed during standard mother-child interactions in Wave 1. The child's conduct disorder (CD) symptoms 5-8 years later were measured using separate structured diagnostic interviews of the mother and youth. Controlling for ADHD symptoms and child disruptive behavior during the mother-child interaction, there was a significant inverse relation between levels of both positive and negative parenting at 4-6 years and the number of later CD symptoms, but primarily among children with 2 copies of the 9-repeat allele of the VNTR. The significant interaction with negative parenting was replicated in parent and youth reports of CD symptoms separately.     

大学生内隐艾滋病污名的刻板解释偏差研究

该研究随机抽取120名大学生,采用刻板解释偏差（SEB）对艾滋病内隐污名进行了探讨。结果发现：大学生对艾滋病有关的主语在积极行为情境下的归因数量显著少于在消极行为情境下的归因数量。对艾滋病有关的主语在与积极行为情景下的外归因数量显著少于消极行为情境下的外归因数量。这一结果表明大学生被试不存在内隐艾滋病污名。由于SEB方法的一些特点,内隐艾滋病污名还需进一步的验证,SEB作为测查高社会赞许性的内隐心理现象的有效性还需进一步讨论。     

Coping-related expectancies and dispositions as prospective predictors of coping responses and symptoms

We used Rotter's (1954, 1982) social learning theory and Kirsch's (1985, 1999) response expectancy extension thereof to clarify distinctions between coping-related expectancies (beliefs about the outcomes of coping efforts) and coping dispositions (tendencies to use particular coping responses), specifically focusing on the role of generalized expectancies for negative mood regulation (NMR) as a predictor of individual differences in coping and well-being. Two studies using structural equation modeling provided support for direct and indirect associations between NMR expectancies and symptoms of depression. In Study 1 NMR expectancies predicted situational avoidance coping responses and symptoms of depression and anxiety, independent of dispositional avoidance coping tendencies. In Study 2, NMR expectancies were associated with depressive symptoms, concurrently and prospectively, independent of dispositional optimism and pessimism. Both studies indicated that NMR expectancies are more strongly associated with depressive symptoms than with symptoms of anxiety and physical illness. Results underscore the importance of distinguishing between expectancies and other personality variables related to coping.     

The Nature and Correlates of Psychological Adjustment in Gay Men with AIDS-Related Conditions1

This study assessed differences in the psychological adjustment of gay men who tested positive for the antibody to the human immunodeficiency virus (HIV). Twenty-one were symptomatic for AIDS, and 27 were asymptomatic. A group of 15 gay men who tested negative for the HIV was included as a comparison group. Men in the three groups were equivalent on demographic variables. Symptomatic men reported more health problems than either asymptomatic or seronegative men. Relative to men who were symptomatic, those who were asymptomatic reported more death anxiety, less optimism, and greater severity of psychological distress, and reported more frequent use of avoidance and distancing as coping strategies. The poor psychological functioning of asymptomatic subjects was attributed to the uncertainty regarding their future health status. Generally, positive psychological well-being of symptomatic and asymptomatic men was related to the infrequent use of avoidance coping strategies and high satisfaction with perceived social support.     

Spared at Random: Survivor Reactions in the Gay Community1

Many gay men who have tested negative for HIV were sexually active prior to a general awareness of how HIV is transmitted. Based on the work of Lifton (1980), such HIV-negative gay men may be considered “survivors” since they have witnessed the deaths of many members of their community and have been spared. Survivors may be expected to manifest one or more of three survivor reactions: guilt about surviving (HIV-related guilt), anxiety about dying (AIDS-related death anxiety), and blunted affect. The present study employed structural equation modeling in samples of HIV-negative (N= 129) and HIV-positive (N= 95) gay men to assess psychological and behavioral variables predictive of the presence of a survivor reaction. Survivor reactions were uniquely predicted among HIV-negative gay men. The larger the number of sexual partners HIV-negative gay men reported having had prior to 1984, the more likely they were to experience a survivor reaction. Greater satisfaction with social support from gay friends, and, indirectly, gay-related community group involvement, was associated with being less likely to experience a survivor reaction.     

Predictors of the first onset of a major depressive episode and changes in depressive symptoms across adolescence: stress and negative cognitions

This 6-year longitudinal study examined stressors (e.g., interpersonal, achievement), negative cognitions (self-worth, attributions), and their interactions in the prediction of (a) the first onset of a major depressive episode (MDE), and (b) changes in depressive symptoms in adolescents who varied in risk for depression. The sample included 240 adolescents who were first evaluated in Grade 6 (M = 11.86 years old; SD = 0.57; 54.2% female) and then again annually through Grade 12. Stressful life events and depressive diagnoses were assessed with interviews; negative cognitions and depressive symptoms were assessed with self-report questionnaires. Discrete time hazard modeling revealed a significant interaction between interpersonal stressors and negative cognitions, indicating that first onset of an MDE was predicted by high negative cognitions in the context of low interpersonal stress, and by high levels of interpersonal stressors at both high and low levels of negative cognitions. Analyses of achievement stressors indicated significant main effects of stress, negative cognitions, and risk in the prediction of an MDE, but no interactions. With regard to the prediction of depressive symptoms, multilevel modeling revealed a significant interaction between interpersonal stressors and negative cognitions such that among adolescents with more negative cognitions, higher levels of interpersonal stress predicted higher levels of depressive symptoms, whereas at low levels of negative cognitions, the relation between interpersonal stressors and depression was not significant. Risk (i.e., maternal depression history) and sex did not further moderate these interactions. Implications for intervention are discussed.     

The relationship of negative mood regulation expectancies with rumination and distraction

Individuals high in negative mood regulation expectancies believe that a wide variety of actions has the potential to improve their negative mood. According to response expectancy theory, negative mood regulation expectancies affect mood in a nonvolitional and self-confirming manner. The present study evaluated this claim by assessing the ability of negative mood regulation expectancies to predict current depression after controlling for a variety of volitional coping responses, including rumination, distraction, active coping, and avoidant coping. 105 Introduction to Psychology college students at the University of Connecticut, 47 men and 58 women (M age = 20.3 yr., SD = 1.5), completed measures of each of the latter constructs for course credit. Results were consistent with response expectancy theory: negative mood regulation expectancies predicted current depression above and beyond coping behaviors. In addition, higher negative mood regulation expectancies were associated with greater use of adaptive coping responses. Results of this study further support the notion that effects of negative mood regulation expectancies on mood cannot be fully accounted for by intentional coping behaviors.