Persons and Substances

I have argued elsewhere that the psychological criterion of personalidentity entails that a person is not an object, but a series ofpsychological events. As this is somewhat counter-intuitive,I consider whether the psychological theorist can argue that a person, while not a substance, exists in a way that is akin to theway that substances exist. I develop ten criteria that such a`quasi-substance' should meet, and I argue that a reasonablecase can be made to show that the psychological theorist's conception of a person meets these criteria.     

Locke on Persons and Other Kinds of Substances

Locke's commentators are divided about whether Locke thinks that the idea of a person is a substance idea or a mode idea. I use Locke's theory of kinds to argue for an intermediate interpretation on which the idea of a person is a substance idea that contains a mode idea. As a result, while proponents of the substance interpretation correctly claim that ‘person’ designates a kind of substance, proponents of the mode interpretation are nonetheless correct in insisting that mode ideas play an important role in Locke's account of persons and personal identity.     

Tailoring Cognitive Behavioral Therapy for Trauma-Exposed Persons Living With HIV

This treatment development report describes the need for evidence-based psychosocial trauma-focused treatment for people living with comorbid posttraumatic stress disorder (PTSD) and HIV. Individuals with HIV have higher rates of exposure to traumatic events and PTSD than the general public, and they also experience additional consequences of PTSD on the management of their chronic disease (e.g., established link between PTSD symptoms and lack of adherence to antiretroviral therapy [ART]). We used the empirically supported ADAPT-ITT approach to consider the initial steps in adapting evidence-based Cognitive Processing Therapy (CPT) for individuals with PTSD and HIV. This paper reviews a case example that involved various clinical issues that may arise when providing trauma-focused treatment for people living with HIV including HIV-stigma, disease management, and the need for making multicultural adaptations to psychotherapy. This case example illustrates how trauma-focused treatment may benefit from enhancement to address additional barriers that may arise over the course of PTSD treatment in this population. Feasibility of engaging and delivering a "full dose" of evidence-based PTSD treatment among individuals living with HIV is discussed. While evidence-based treatments can reduce PTSD symptom severity, issues related to chronic disease coping and HIV-related stigma management could be integrated to augment the efficacy of treatment for individuals with HIV. Adaptive intervention research targeting PTSD in persons living with HIV warrants further attention, especially given the association between PTSD and adherence to ART.     

The Relationship Between Attitudes Toward Persons Who Are Gay and Persons With AIDS,and HIV and AIDS Knowledge

A total of 86 counseling students were assessed on their attitudes toward persons who are gay, attitudes toward persons with AIDS (Acquired Immune Deficiency Syndrome), and level of HIV (human immunodeficiency virus) and AIDS knowledge. Demographic data consisted of sex, age, and HIV- and AIDS-related training. Results indicated that the attitudinal and knowledge variables were correlated so that positive attitudes toward both groups corresponded with high levels of knowledge. There were no significant differences among these variables on the demographic factors. Implications of these results are discussed, with special emphasis placed on counselor education.     

Psychological Effects of a Life Review Intervention for Persons With HIV Disease

The purpose of this study was to evaluate a life review intervention for persons with HIV disease. Twenty-seven adults with HIV disease (16 had been diagnosed with AIDS) were randomly assigned to 1 of 3 conditions: a group life review intervention (n = 8), a traditional support group (n = 9), or a waiting list (n = 10). Using a pre-post design, participants were compared on psychological measures of optimism, self-esteem, purpose in life, coping ability, psychological distress, and death anxiety. Although analyses revealed no significant differences between the interventions, statistical trends and participants' written evaluations favored the life review intervention. Attrition was a significant problem. Discussion focuses on the special problems encountered in conducting psychological intervention research with an HIV-positive population.     

Social Relations,Coping, and Psychological Distress Among Persons With HIV/AIDS1

The interrelationships among social support, coping style, and psychological distress were examined using longitudinal data from a sample of 212 persons with HIV/AIDS. Structural equation modeling analyses showed significant indirect effects on psychological distress for avoidant coping, feeling loved and understood, satisfaction with support, rejection by family members, discrimination because of HIV status, and number of AIDS symptoms. The inclusion of negative social interactions in the model is an important extension of the stress‐support literature. Feeling loved and understood mediated the relationship between social support and coping style choice. Results highlight the multidimensional nature of the processes that shape psychological outcomes in HIV disease. and suggest several potential points of intervention, including social‐support efforts that increase the sense that one matters to others, and interventions to assist patients to move from avoidant to active coping strategies.     

Verbal Implicit Sequence Learning in Persons Who Stutter and Persons With Parkinson's Disease

The authors investigated the integrity of implicit learning systems in 14 persons with Parkinson's disease (PPD), 14 persons who stutter (PWS), and 14 control participants. In a 120-min session participants completed a verbal serial reaction time task, naming aloud 4 syllables in response to 4 visual stimuli. Unbeknownst to participants, the syllables formed a repeating 8-item sequence. PWS and PPD demonstrated slower reaction times for early but not late learning trials relative to controls reflecting delays but not deficiencies in general learning. PPD also demonstrated less accuracy in general learning relative to controls. All groups demonstrated similar limited explicit sequence knowledge. Both PWS and PPD demonstrated significantly less implicit sequence learning relative to controls, suggesting that stuttering may be associated with compromised functional integrity of the cortico-striato-thalamo-cortical loop.     

Counseling Persons With Disabilities: Summary and Projections

The author summarizes the findings of the other articles in this feature in terms of progress made during the last decade, as well as problems remaining. The author proposes several idealistic scenarios for counselors and other human development specialists to use as guidelines for future work with people who are disabled.     

Retention of Implicit Sequence Learning in Persons Who Stutter and Persons With Parkinson's Disease

ABSTRACT. The authors investigated the retention of implicit sequence learning in 14 persons with Parkinson's disease (PPD), 14 persons who stutter (PWS), and 14 control participants. Participants completed a nonsense syllable serial reaction time task in a 120-min session. Participants named aloud 4 syllables in response to 4 visual stimuli. The syllables formed a repeating 8-item sequence not made known to participants. After 1 week, participants completed a 60-min retention session that included an explicit learning questionnaire and a sequence generation task. PPD showed retention of general learning equivalent to controls but PWS's reaction times were significantly slower on early trials of the retention test relative to other groups. Controls showed implicit learning during the initial session that was retained on the retention test. In contrast, PPD and PWS did not demonstrate significant implicit learning until the retention test suggesting intact, but delayed, learning and retention of implicit sequencing skills. All groups demonstrated similar limited explicit sequence knowledge. Performance differences between PWS and PPD relative to controls during the initial session and on early retention trials indicated possible dysfunction of the cortico-striato-thalamo-cortical loop. The etiological implications for stuttering, and clinical implications for both populations, of this dysfunction are discussed.     

With Liberty and Some Justice for a Few: Thinking Theologically about Criminal Justice

The current crisis in the American criminal justice system begs for theological response, and its sources need theological critique. The recent proposed statement of the ELCA draws attention to the needs of victims of crime and their families, and makes sensible recommendations for paths to greater justice. In doing so it is important to remember what forms of justice are possible under the jurisdiction of fallible, earthly institutions.     

GPS: A Randomized Controlled Trial of Sexual Health Counseling for Gay and Bisexual Men Living With HIV

Gay, bisexual, and other men who have sex with men (GBM) continue to have high rates of HIV and sexually transmitted infections, including syphilis. GBM have therefore been identified by public health agencies as a high-priority population to reach with prevention initiatives. Despite the importance of mental health in preventing HIV and related infections, there is a shortage of credentialed mental health professionals to deliver behavioral Counseling interventions. The current study evaluated the efficacy of GPS, a community-based and peer-delivered sexual health promotion motivational interviewing–based intervention for HIV-positive GBM who engaged in condomless anal sex (CAS) in the past 2 months. GPS prevention counseling demonstrated a 43% relative reduction at 3-month follow-up in CAS with serodiscordant partners and significant reductions in sexual compulsivity. The study demonstrated that community-based counselors can administer an efficacious motivational interviewing program, and suggests a continued benefit of counseling methods to promote the sexual health of higher risk populations.     

Comparing the Self-Concepts of Persons With and Without Physical Disabilities

Tam and Watkins (1995b) explored the basis of self-concepts of physically disabled and nondisabled Hong Kong Chinese adults and developed the hierarchical multidimensional self-concept models. Two questionnaires that measure self-concept were developed and validated for those groups. The questionnaires share 41 common items in 6 self-concept areas. In the present study, the 2 groups' responses were compared via univariate analysis of variance. The nondisabled participants (n % 200) were found to have statistically significantly higher means than their disabled counterparts (n % 214) in total self-concept, material self-concepts, and physical self-concepts. There were no significant differences in their family, social, and work self-concepts. The nondisabled participants reported greater openness (indicated by higher self-criticism scores).     

Assessing Language Competence: Guidelines for Assisting Persons With Limited English Proficiency in Research and Clinical Settings

Current guidelines indicate that therapeutic interactions must be in the client's primary language. This article addresses the ethical dilemmas faced by monolingual clinicians and researchers who must assess the foreign language competence of an interpreter. Guidelines are proposed for assessing language competence of staff in clinical and research settings. Las directrices actuales indican que la interacción terapéutica debe tomar lugar en el primer idioma del cliente. Este artículo trata los dilemas éticos que confrontan los clínicos e investigadores monolingües que tienen que asesorar la competencia linguística de un intérprete. Se proponen directrices para el asesoramiento linguístico de personal en escenarios clínicos y de investigación.     

Religio-Biography, Coping, and Meaning-Making Among Persons with HIV/AIDS

Recently, quality of life studies among patients with HIV/AIDS have shown high levels of life satisfaction. Spiritual and religious factors may contribute to these positive outcomes. We interviewed 19 patients with HIV/AIDS in order to understand better the role of religious‐spiritual biographies and orientations in quality of life, and found four patterns to describe the ways in which past experiences with religion/spirituality and religious/spiritual meaning‐making help to explain how patients are currently coping with HIV/AIDS. We illustrate each of these patterns with a prototypic patient: (1) the Deferring Believer (“God allows things to happen for a reason.”); (2) the Collaborating Believer (“This is where I'm supposed to be.”); (3) the Religious/Spiritual Seeker (“I'm trying to get my life together.”); and (4) the Self‐Directing Believer (“What else is new?”). The findings support a previously described theoretical model of meaning‐making in response to adversity, and they suggest the value of life course and narrative approaches to understanding religious coping.     

AIDS Stigma and Contact With Persons With AIDS: Effects of Direct and Vicarious Contact.1

This paper examines the relationship between AIDS-related stigma and (a) direct, personal contact with people with AIDS (PWAs), and (b) vicarious contact—through mass media—with a public figure with AIDS or HIV. Data are presented from a 2-wave national telephone survey with a probability sample of US. adults (ns = 538 at Wave 1; 382 at Wave 2) and an oversample of Black Americans (ns = 607 and 420, respectively). Direct contact with a PWA was associated with less support for coercive AIDS policies, less blame for PWAs, and less avoidance of PWAs. Vicarious contact–operationalized as the self-reported impact of Earvin “Magic” Johnson's disclosure of his HIV infection–appeared to have its greatest impact among respondents who previously had manifested high levels of stigma. In that group, levels of stigma diminished somewhat to the extent that respondents reported having been strongly influenced by Johnson's announcement.     

对麻醉药品的严格管理与癌症患者止痛的合理需求

药物止痛是治疗癌症疼痛的主要方法,而阿片类止痛药是治疗中、重度癌症疼痛的关键性用药.给癌症疼痛患者充分应用阿片类药物,并不意味着可以放松对此类药物的控制和管理,对麻醉药品进行严格管理可确保癌症疼痛患者合法、安全、合理用药.正确认识及合理使用麻醉药品是实现WHO提出"让癌症患者不痛"目标的重要保证.     

The Effects of Time Pressure on Controlling Reactions to Persons With Mental Illness

Population surveys suggest that the general public stigmatizes persons with mental illness less than in the past. However, implicit attitude measures find that immediate reactions to mentally ill persons are still negative among both the general public and people diagnosed with mental illness. Time-course data suggest that these reactions may be dynamic, with immediate negative reactions becoming less prejudicial over time. We manipulated time pressures imposed upon social judgments about a mentally ill person. Participants perceived a mentally ill person as dangerous when forced to respond quickly; participants given ample time to respond were less likely to have this perception.