A systematic review of interventions for anxiety in people with HIV

People with human immunodeficiency virus (HIV) show elevated anxiety levels compared to the general population. Anxiety can predate HIV infection or be triggered by HIV diagnosis and the many stresses that emerge during the course of HIV disease. Many psychological and pharmacological therapies have been shown to treat anxiety in the general population but a systematic understanding of which interventions have been tested in and are effective with HIV-seropositive individuals is needed. This review examines all published intervention studies on anxiety and HIV from 1980 to 2009 covered by the databases MedLine (1980-2009) and PsycINFO (1980-2009) for a definitive account of effectiveness of interventions and an indication of prevalence of HIV-related anxiety and measurement within studies. Standard systematic research methods were used to gather quality published papers on HIV and anxiety, searching published data bases according to quality inclusion criteria. From the search, 492 papers were generated and hand searched resulting in 39 studies meeting adequacy inclusion criteria for analysis. Of these, 30 (76.9%) were implemented in North America (the USA and Canada), with little representation from developing countries. Thirty-three (84.6%) studies recruited only men or mostly men. A total of 50 interventions were investigated by the 39 studies; 13 targeted HIV, symptoms or associated outcomes/conditions, 20 directly targeted anxiety and another 17 indirectly targeted anxiety. Twenty-four (48%) interventions were effective in reducing anxiety (including 11 indirect interventions), 16 (32%) were ineffective and 10 (20%) had an unknown effect on anxiety. Sixty-five percent of interventions directly targeting anxiety were effective. Psychological interventions (especially cognitive behavioural stress management interventions and cognitive behavioural therapy) were generally more effective than pharmacological interventions. Only three studies provided prevalence rates - these ranged from 13% to 80%. Anxiety was measured using 16 different instruments. Our detailed data suggest that interventions are both effective and available, although further research into enhancing efficacy would be valuable. Also, the vast majority of studies were Western-based, no studies looked at children or adolescents and few looked specifically at women. An international effort to harmonise measurement of anxiety is also missing. There is a need to routinely log anxiety in those with HIV infection during the course of their disease, to provide specific data on women, young people and those in diverse geographic areas and incorporate management into care protocols.     

Early Health Risk Factors for Violence: Conceptualization, Review of the Evidence, and Implications

Violence and aggression are public health problems that can benefit from ongoing research into risk reduction and prevention. Current developmental theories of violence and aggression emphasize biological and psychosocial factors, particularly during adolescence. However, there has been less focus on understanding the interactive, multiplicative effects of these processes. Furthermore, little attention has been given to the pre-, peri-, and postnatal periods, where prevention and intervention may yield effective results. Early health risk factors that influence negative behavioral outcomes include prenatal and postnatal nutrition, tobacco use during pregnancy, maternal depression, birth complications, traumatic brain injury, lead exposure, and child abuse. There is an ample literature to suggest that these early health risk factors may increase the likelihood of childhood externalizing behaviors, aggression, juvenile delinquency, adult criminal behavior, and/or violence. This paper proposes an early health risk factors framework for violence prediction, built on existing developmental theories of criminal behavior and supported by empirical findings. This framework addresses gaps in the adolescent psychopathology literature and presents a novel conceptualization of behavioral disturbance that emphasizes the pre-, peri-, and post-natal periods, when a child's development is critical and the opportunity for behavioral and environmental modification is high. Implications for such a framework on violence prevention programs are discussed.     

Deficits in early-stage face perception in excessive internet users

Excessive Internet use is associated with a limited ability to communicate effectively socially, which depends largely on the capacity for perception of the human face. We used a passive visual detection paradigm to compare the early stages of the processing of face-related information in young excessive Internet users (EIUs) and healthy normal subjects by analyzing event-related potentials (ERPs) elicited by faces and by nonface stimuli (tables), each presented in the upright and inverted position. The P1 and N170 components of the spectrum of ERPs elicited at occipital-temporal sites by the viewing of faces were larger and peaked sooner than the same ERP components elicited by tables, and inverted faces significantly enhanced and delayed the N170 component. EIUs had a generally smaller P1 component than did normal subjects, whether elicited by faces or by tables, and the N170 effect, or difference in amplitude of the N170 component for faces versus tables, was significantly smaller in the EIUs than in normal subjects. However, the N170 inversion effect, or difference in amplitude of the N170 component elicited by upright versus inverted faces, was similar in the EIUs and normal subjects. These data indicate that EIUs have deficits in the early stage of face-perception processing but may have intact holistic/configural processing of faces. Whether some deeper processes of face perception, such as face memory and face identification, are affected in EIUs needs to be investigated further with more specific procedures.     

Applying the expectancy disconfirmation and regret theories to online consumer behavior

This study synthesizes the expectancy disconfirmation theory with empirical theories pertaining to customer regret in an e-commerce environment. The study begins by examining the roles that information quality (IQ), system quality (SYQ), and service quality (SEQ) play in determining customer regret and satisfaction. Then the consequences of regret and satisfaction on reuse intention are examined. Survey data collected from 445 respondents are analyzed using structural equation modeling with partial least squares (PLS-Graph 3.0) to provide support for the hypothesized links. Results show that IQ disconfirmation, SYQ disconfirmation and SEQ disconfirmation are related to regret and satisfaction. Both regret and satisfaction are related to reuse intention. In addition, satisfaction mediates the effect of regret on reuse intention. Based on these results, implications for theory and practice are discussed.     

Multidimensional processing of dynamic sounds: more than meets the ear

Strong cross-modal interactions exist between visual and auditory processing. The relative contributions of perceptual versus decision-related processes to such interactions are only beginning to be understood. We used methodological and statistical approaches to control for potential decision-related contributions such as response interference, decisional criterion shift, and strategy selection. Participants were presented with rising-, falling-, and constant-amplitude sounds and were asked to detect change (increase or decrease) in sound amplitude while ignoring an irrelevant visual cue of a disk that grew, shrank, or stayed constant in size. Across two experiments, testing context was manipulated by varying the grouping of visual cues during testing, and cross-modal congruency showed independent perceptual and decision-related effects. Whereas a change in testing context greatly affected criterion shifts, cross-modal effects on perceptual sensitivity remained relatively consistent. In general, participants were more sensitive to increases in sound amplitude and less sensitive to sounds paired with dynamic visual cues. As compared with incongruent visual cues, congruent cues enhanced detection of amplitude decreases, but not increases. These findings suggest that the relative contributions of perceptual and decisional processing and the impacts of these processes on cross-modal interactions can vary significantly depending on asymmetries in within-modal processing, as well as consistencies in cross-modal dynamics.     

The effects of spatial frequency overlap on face recognition

The effects of spatial frequency overlap between pairs of low-pass versus high-pass images on face recognition and matching were examined in 6 experiments. Overlap was defined as the range of spatial frequencies shared by a pair of filtered images. This factor was manipulated by processing image pairs with high-pass/low-pass filter pairs whose 50% cutoff points varied in their separation from one another. The effects of the center frequency of filter pairs were also investigated. In general, performance improved with greater overlap and higher center frequency. In control conditions, the image pairs were processed with identical filters and thus had complete overlap. Even severely filtered low-pass or high-pass images in these conditions produced superior performance. These results suggest that face recognition is more strongly affected by spatial frequency overlap than by the frequency content of the images.     

The development and initial validation of the Multicultural Environmental Inventory: a preliminary investigation

This article describes the development and initial validation of the Multicultural Environmental Inventory (MEI). The MEI is an instrument designed to measure an individual's perceptions about the degree to which graduate counseling programs address multicultural issues within curriculum, supervision, climate, and research. This investigation was conducted using the data from 208 students and faculty from counseling psychology graduate programs across the United States approved by the American Psychological Association. By using techniques of exploratory factor analysis, a 4-factor solution was determined to account for the relationships among the items on the MEI. The instrument was modified from 53 to 27 items on the basis of the items' effectiveness in measuring the underlying constructs of interest, and internal consistency information is provided on the final revised instrument (MEI-R). The factors underlying the MEI-R are discussed within the context of a multicultural environment in graduate counseling programs, and directions for future research are considered.     

The glare effect does not give rise to a longer-lasting afterimage

The glare effect is an illusion in which a region appears self-luminous when flanked by gradients that decrease in luminance with distance from the region (Zavagno, 1999 Perception 28 835-838). This region also appears brighter than a surface of the same luminance. We investigated, using the paradigm of afterimages, whether a low-level mechanism at the level of the retina or LGN could account for this apparent brighter sensation. We first replicated the result from the literature that brighter and longer-lasting physical stimuli generate longer-lasting afterimages. We then compared the glare-effect stimuli with their counterpart controls, and found that the glare-effect stimuli did not give rise to longer-lasting afterimages. This suggests that the apparent brighter sensation of the glare effect is not due to a retinal or LGN mechanism, but must have a cortical origin.     

Attention alters the appearance of motion coherence

Selective attention enhances visual information processing, as measured by behavioral performance and neural activity. However, little is known about its effects on subjective experience. Here, we investigated the effect of transient (exogenous) attention on the appearance of visual motion, using a psychophysical procedure that directly measures appearance and controls for response bias. Observers viewed pairs of moving dot patterns and reported the motion direction of the more coherent pattern. Directing attention (via a peripheral precue) to a stimulus location increased its perceived coherence level and improved performance on a direction discrimination task. In a control experiment, we ruled out response bias by lengthening the time interval between the cue and the stimuli, so that the effect of transient attention could no longer be exerted. Our results are consistent with those of neurophysiological studies showing that attention modulates motion processing and provide evidence of a subjective perceptual correlate of attention, with a concomitant effect on performance.     

Pilocarpine seizures cause age-dependent impairment in auditory location discrimination

Children who have status epilepticus have continuous or rapidly repeating seizures that may be life-threatening and may cause life-long changes in brain and behavior. The extent to which status epilepticus causes deficits in auditory discrimination is unknown. A naturalistic auditory location discrimination method was used to evaluate this question using an animal model of status epilepticus. Male Sprague-Dawley rats were injected with saline on postnatal day (P) 20, or a convulsant dose of pilocarpine on P20 or P45. Pilocarpine on either day induced status epilepticus; status epilepticus at P45 resulted in CA3 cell loss and spontaneous seizures, whereas P20 rats had no cell loss or spontaneous seizures. Mature rats were trained with sound-source location and sound-silence discriminations. Control (saline P20) rats acquired both discriminations immediately. In status epilepticus (P20) rats, acquisition of the sound-source location discrimination was moderately impaired. Status epilepticus (P45) rats failed to acquire either sound-source location or sound-silence discriminations. Status epilepticus in rat causes an age-dependent, long-term impairment in auditory discrimination. This impairment may explain one cause of impaired auditory location discrimination in humans.