Psychische Störungen bei HIV-Infektion und Aids

The human immunodeficiency virus (HIV) is the pathogen responsible for acquired immune deficiency syndrome (AIDS). Worldwide there are currently about 40 million people infected with HIV and an estimated 44,000 in Germany. If left untreated after a few years the infection leads to the manifestation of AIDS and eventually to death through opportunistic infections and malignant tumors. Infection with HIV is not curable. Nevertheless, antiretroviral treatment can slow the progress of the disease and prolong life expectancy significantly. Once antiretroviral treatment has started the medication must be taken regularly and lifelong. Serious side effects of the medication pose a significant stress on physical and psychological well-being and impair adherence. Infection with HIV means a total change in life perspectives and requires extensive adaptations in lifestyle. Problems with adaptation and mental disorders (e.g. depression, anxiety disorders, adjustment disorder) are, therefore, frequent. With disease progression neurocognitive impairments are increasingly likely. Mental disorders and neurocognitive impairments adversely affect treatment adherence, increase health risk behavior and reduce immune function. Psychological interventions contribute significantly to the reduction in health risk behavior, improve treatment adherence and are successful in the treatment of depression and anxiety.     

团体音乐辅导提高地震灾区初中生心理弹性的研究

目的：考查团体音乐辅导对提高地震灾区初中生心理弹性的效果。方法：选取心理弹性较低的地震灾区初中生22名,随机分入干预组和控制组,对干预组进行团体音乐辅导。结果：后测结果表明,与控制组相比,干预组被试的心理弹性及其相关因素指标均有显著改善;两个月后的回访结果显示,干预组被试得分与后测无显著差异,仍显著优于前测。结论：团体音乐辅导能够有效地提高地震灾区初中生的心理弹性水平,并具有一定的长效性。     

Quality of life in patients before and after kidney transplantation

Abstract The aim of the present study was to differentially determine quality of life (QOL) in patients with end-stage renal disease (ESRD) after successful kidney transplantation (RT, Group A) compared with ESRD patients on a waiting list for RT (Group B). and with healthy controls (Group C) because opinions vary as to which treatment modality can best assure ESRD patients a high QOL. Groups A, B and C each consisted of 149 persons, matched for age and gender. The Munich Quality of Life Dimensions List (MLDL) was used to measure global aspects of QOL. Distinct aspects of QOL were investigated by the Brief Symptom Inventory (BSI) and the Questionnaire for Social Support (K-22). Groups A and C reported similar QOL. Which was significantly higher than in group B (p < .0001). This was particularly true for the physical and psychological status and daily activities, but not for the social situation. Groups A and B reported similar social support, which was significantly, lower than in group C (p < 006). Both ESRD groups reported higher satisfaction with social support than healthy controls (p < .0001). Successful RT nor only improved distinct aspects of QOL in patients with ESRD, but even put them on par with healthy controls regarding physical and psychological QOL. Lower social support and higher satisfaction with social support in both groups of ESRD patients should be evaluated further. From a clinical viewpoint. the improvement of physical and psychological aspects of QOL in RT patients is impressive; but more attention should be paid to constantly low social support in this group of patients. International multi center longitudinal studies to investigate QOL in ESRD patients under different treatments am necessary.     

Structuralism and experimental aesthetics: Bridging some gaps

Structuralism in psychology has much to do with what Berlyne called his rival tradition in aesthetics, the speculative and interpretative approach. Berlyne's concern with motivation can be retained while structuralism's emphasis on understanding is accepted.This paper was originally presented at the Berlyne Symposium, American Psychological Association Meeting, San Francisco, August 1977. Support from the Connaught Development Grant to Scarborough College is acknowledged.     

Challenges to providing a support group for HIV-positive prisoners in South Africa

In prison populations around the world, the prevalence of HIV is often higher than that of the general population. The prison population is at high risk for HIV infection, particularly through the sharing of contaminated needles and high-risk sexual activity. Counselling is regarded as a key element in the prevention and treatment of HIV infection. Support groups provide essential supportive counselling for HIV-positive individuals struggling to cope. This paper looks at the challenges to providing a support group for HIV-positive prisoners. The author's experience of attempting to provide a support group highlights two key challenges: organisational issues which lead to disruptions for the group; and challenges to ensuring confidentiality, a core ethical principle in HIV counselling.     

Reading Plays to Enhance Professional Development

Writing in a narrative style, the authors describe the continuing education model of the Red Well Theater Group. The model combines a study group format with a play reading performance module to enhance the professional development of the Group’s members and their audiences of colleagues. The educational goals are to: 1) didactically study the principles and practice of group therapy; 2) theatrically illuminate concepts, relational themes, and small group dynamics relevant to group therapy; 3) experientially deepen therapist empathy for the challenge of being in a group; and 4) provide a vitalizing experience in support of therapist well-being. As an example of this model in action, the authors elaborate their experience preparing The Great God Pan, by Amy Herzog, for presentation at the 2014 American Group Psychotherapy Association (AGPA) Annual Meeting.     

Supervision groups for health advisers working with patients with HIV disease

This paper describes a case supervision group with health advisors working in a clinic specializing in the treatment of patients with HIV Infection. Themes discussed in the group are presented with an evaluation of the group intervention, some consideration of group process and the health advisers views on their work. This is discussed in relation to present research into occupational stress in this field.     

Childhood Sexual Abuse and Intimate Relationships: A Support Group for Male Partners

Individual and group therapy modalities are common approaches to treating survivors of child sexual abuse (CSA). Survivors have identified a number of interpersonal problems that they experience with romantic partners but little is known about the partner’s perspective. Additionally, partners of abuse survivors are generally excluded from the treatment process. A short-term support group for the partners of adult survivors of sexual abuse was conducted concurrently with an Incest Resolution Group. The goal of the Partner’s Support Group was to gain greater understanding of the interpersonal relational problems as experienced by the partners, and to provide support, insight, and education regarding the impact of CSA. Clinical implications are discussed.     

Evaluating a primary prevention program for children of divorce

The effectiveness of a primary prevention program for children of divorce is evaluated. Subjects included 82 mother-child pairs. Mothers had been separated for 33 months or less and did not have prior histories of using mental health services. Subjects were assigned to one of four conditions: (a) the Children's Support Group alone (CSG), (b) the CSG and the Single Parents' Support Group (SPSG), (c) the SPSG alone, or (d) a no-treatment control group. Data collected before, after, and 5 months following intervention, were analyzed using analyses of covariance with preintervention scores as covariates and pre-post and post-follow-up difference scores as dependent measures. Children in the CSG-alone condition improved most in self-concept and parents in the SPSG-alone condition improved the most in adjustment. Improvements were either maintained or did not change differentially across groups at follow up. Adaptive social skills of CSG-alone children compared to children in the CSG/SPSG groups showed significant post-to-follow-up improvements.     

Quality of life in patients before and after kidney transplantation

Abstract

The aim of the present study was to differentially determine quality of life (QOL) in patients with end-stage renal disease (ESRD) after successful kidney transplantation (RT, Group A) compared with ESRD patients on a waiting list for RT (Group B). and with healthy controls (Group C) because opinions vary as to which treatment modality can best assure ESRD patients a high QOL.

Groups A, B and C each consisted of 149 persons, matched for age and gender. The Munich Quality of Life Dimensions List (MLDL) was used to measure global aspects of QOL. Distinct aspects of QOL were investigated by the Brief Symptom Inventory (BSI) and the Questionnaire for Social Support (K-22).

Groups A and C reported similar QOL. Which was significantly higher than in group B (p < .0001). This was particularly true for the physical and psychological status and daily activities, but not for the social situation. Groups A and B reported similar social support, which was significantly, lower than in group C (p < 006). Both ESRD groups reported higher satisfaction with social support than healthy controls (p < .0001).

Successful RT nor only improved distinct aspects of QOL in patients with ESRD, but even put them on par with healthy controls regarding physical and psychological QOL.

Lower social support and higher satisfaction with social support in both groups of ESRD patients should be evaluated further. From a clinical viewpoint. the improvement of physical and psychological aspects of QOL in RT patients is impressive; but more attention should be paid to constantly low social support in this group of patients. International multi center longitudinal studies to investigate QOL in ESRD patients under different treatments am necessary.     

Exploring the role,needs and challenges of relatives of mothers with HIV or HIV and psychosis: A qualitative study

This study explored types and nature of supports by relatives of mothers living with HIV and psychosis in comparison to mothers with HIV only. Interview data on their experiences of their roles, needs and challenges were collected from 33 relatives on mothers with HIV and psychosis (n=12, females=10, blacks =12, age ranges 21 to 62) and those with HIV only (n=21, females=16, blacks =21, age ranges 18 to 63). The data were thematically analysed utilizing Atlas.ti. The results showed that relatives in both groups provided a variety of supporting roles. Important challenges were experiencing the negative consequences of especially HIV in combination with psychosis in their lives and dealing with the caregiving responsibilities without having enough information. Important strengths included utilizing support networks and remaining hopeful. Support needs for carers of mothers living with HIV related psychosis or HIV only, can be enhanced with increasing social and material resources at the community level. Supporting needs can be addressed by empowering communities through psycho-education.     

Reality testing and self-reported AIDS self-care behavior.

This investigation examined the relationship between reality testing and AIDS self-care behavior for 509 urban college students. It was hypothesized that reality testing may become impaired in sexual interactions that carry the risk of HIV infection, leading to imperfect adoption of safer sex practices. Reality testing, measured by the Bell Object Relations and Reality Testing Inventory, was significantly related to AIDS knowledge as measured by the AIDS Prevention Survey of Thomas and not significantly related to self-reported safer sex behavior, measured by Bassman's HIV Infection Prevention Scale.     

Book reviews

Beth Haasl and Jean Marnocha, Bereavement Support Group Program for Children
Giuliana Prata, A Systemic Harpoon into Family Games: Preventive Interventions into Therapy
Robert Wilkins, Behaviour Problems in Children – Orthodox and Paradox in Therapy     

Saints and Sinners: Training Papua New Guinean (PNG) Christian Clergy to Respond to HIV and AIDS Using a Model of Care

Papua New Guinea has experienced a growing HIV/AIDS epidemic. The Christian Churches have played a vital role in responding to HIV, through community support, encouragement and social change. Strong, effective Church leadership can help create safe environments of care and support for those infected and for prevention of HIV. Method A series of trainings in capacity development for clergy were undertaken by the National AIDS Council Secretariat (NACS)/National HIV/AIDS Support Project (NHASP). Results A model “Church’s Response to HIV and AIDS in a Care Continuum” was developed to assist the training. This paper discusses the model and the lessons learned.

School adjustment of adolescents affected by HIV and AIDS: A case study

The study examined the school adjustment of South African adolescents affected by HIV and AIDS . Participants were a convenient sample of 60 adolescents from a secondary school in a major South African city (females = 73 .33%, 50% affected by HIV and AIDS, grade 8 = 40%, grade 9 = 30%, grade 10 = 30%, age range = 16–18 years) . Data on their personal functioning were gathered using the Beck Youth Inventory^TM and the Enhanced School Support Inventory (ESSI) . The data analysis comprised between-group and within-group comparisons, using the t-test statistic . Findings suggest that adolescents affected by HIV and AIDS had significantly lower psychological and behavioural functioning than their typical other peers . Results also show that these affected learners had lower school adjustment than their typical peers . The schools environment can support comprehensive interventions to addresses psychosocial vulnerability among adolescents affected by HIV and AIDS .     

Towards an ecological understanding of mutual-help groups: The social ecology of “fit”

Adopted an ecological framework to view mutual-help groups, and illustrated its usefulness by examining aspects of the social ecology of "fit" among 163 members of Compassionate Friends (bereaved parents; CF), Multiple Sclerosis (MS), and Overeaters Anonymous (OA) groups. Concerning person-group fit, personal Spirituality was positively related to (a) Providing Support, and to (b) Group Satisfaction for members of a group whose helping ecology emphasized "reliance on a higher power" (OA). (Contrary to prediction, the relationship with Group Satisfaction was also manifest for members of MS). Furthermore, OA members reported higher levels of Spirituality than CF members. Concerning helping mechanism-focal problem fit, Friendship Development was positively related to Group Satisfaction only for individuals with a focal problem characterized by high levels of social network disruption (MS). In addition, Time in Group was inversely related to Depression for members of life stress (CF) and medical disorder (MS) groups, but not for members of a "behavioral control" type group (OA). The implications of the ecological perspective for future research are discussed.     

Multidimensional Assessment of Spirituality/Religion in Patients with HIV: Conceptual Framework and Empirical Refinement

A decade ago, an expert panel developed a framework for measuring spirituality/religion in health research (Brief Multidimensional Measure of Religiousness/Spirituality), but empirical testing of this framework has been limited. The purpose of this study was to determine whether responses to items across multiple measures assessing spirituality/religion by 450 patients with HIV replicate this model. We hypothesized a six-factor model underlying a collective of 56 items, but results of confirmatory factor analyses suggested eight dimensions: Meaning/Peace, Tangible Connection to the Divine, Positive Religious Coping, Love/Appreciation, Negative Religious Coping, Positive Congregational Support, Negative Congregational Support, and Cultural Practices. This study corroborates parts of the factor structure underlying the Brief Multidimensional Measure of Religiousness/Spirituality and some recent refinements of the original framework.     

Finding Voice: The Photovoice Method of Data Collection in HIV and AIDS-Related Research

This study examined the efficacy of photovoice as a research technique to explore the lives of children and families living in the context of HIV and AIDS. Participants were volunteers at a Day Care and Support Centre (n=18), and members of a community support group consisting of People Living with AIDS (n=5). The findings revealed that the photovoice method is particularly useful for dealing with the ‘unspoken’ lived experience of children and families.