Adherence to antiretroviral medications in HIV: differences in data collected via self-report and electronic monitoring.

Controversy remains regarding the reliability of methods used to determine adherence to antiretroviral medication in HIV. In this study the authors compared adherence rates of 119 HIV-positive participants during a 6-month study, as estimated via electronic monitoring (EM) and self-report (SR). Adherence for both short (4-day) and long (4-week, or intervisit) periods was examined, as well as factors that underlie discrepancies between EM and SR. Results showed that intervisit EM estimates were consistently lower than those of SR. SR estimates based on shorter periods (4 days) were closer to those of EM. Higher discrepancies between EM and SR estimates were associated with lower cognitive functioning and externalized locus of control. These findings lend support for using both EM and SR methods; however, study design (e.g., length) and other factors (e.g., cognitive status, cost) should be considered.     

The Effects of Stakes and Threat on Foreign Policy Decision-Making

Decision research demonstrates that individuals adapt decision processing strategies according to the characteristics of the decision task. Unfortunately, the literature has neglected task factors specific to foreign policy decisions. This paper presents experimental analyses of the effects of the decisional stakes (i.e., salience of the values at issue) and threat (risk of loss on those issues) on decision-makers' information acquisition patterns and choice rules with respect to one of four hypothetical foreign policy scenarios. Contrary to the notion that normative (rational) decision-making is more likely in less dramatic settings, the results indicate that elevated threat encourages rational decision processing, whereas heuristic processing was more prevalent in less threatening situations. Interestingly, the added presence of high stakes magnified both threat effects. These results, although preliminary, suggest that stakes-threat effects are not direct reflections of stress and/or complexity effects, but should be considered independently in foreign policy analyses.     

Implementing and Sustaining SHARE: An Exposure‐Based Psychotherapy Group for Incarcerated Women Survivors of Sexual Violence

Although incarcerated women are a highly victimized population, therapy for sexual violence victimization (SVV) sequela is not routinely offered in prison. SHARE is a group therapy for SVV survivors that was successfully implemented and sustained in a women’s correction center. Here, we aimed to identify implementation factors and strategies that led to SHARE’s success and describe incarcerated women’s perspectives on the program. We conducted a retrospective process evaluation using interviews structured according to EPIS, a well‐established implementation science framework. Participants (N = 22) were incarcerated women, members of the SHARE treatment team, and members of the correction center’s leadership, therapeutic team, and volunteer program. Factors that facilitated SHARE implementation varied by EPIS phase and organization. Positive inter‐organizational and interpersonal relationships were key across phases, as were the synergies between both the strengths and needs of each organization involved in implementation. Incarcerated women reported a strong need for SHARE and did not report any concerns about receiving trauma therapy in a carceral setting. Therapy for SVV sequelae, including exposure‐based therapy, is possible to implement and sustain in carceral settings. Community–academic partnerships may be a particularly feasible way to expand access to SVV therapy for incarcerated women.     

Citizenship and Community Mental Health Care

Citizenship is an approach to supporting the social inclusion and participation in society of people with mental illnesses. It is receiving greater attention in community mental health discourse and literature in parallel with increased awareness of social determinants of health and concern over the continued marginalization of persons with mental illness in the United States. In this article, we review the definition and principles of our citizenship framework with attention to social participation and access to resources as well as rights and responsibilities that society confers on its members. We then discuss our citizenship research at both individual and social‐environmental levels, including previous, current, and planned efforts. We also discuss the role of community psychology and psychologists in advancing citizenship and other themes relevant to a citizenship perspective on mental health care and persons with mental illness.     

Within-Family Effects of Smoking during Pregnancy on ADHD: the Importance of Phenotype

We sought to test within- and between- family associations of smoking during pregnancy (SDP) and attention deficit-hyperactivity disorder (ADHD) symptoms using a structured interview based on the conventional Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) symptoms and the Strengths and Weaknesses of ADHD-Symptoms and Normal-Behavior (SWAN) scale, which is a population based measure that grew out of the notion that an ADHD diagnosis exists on the extreme end of a continuum of normative behaviors and includes both above- and below- average performance on attention and activity. We used a sibling-comparison approach in a sample of 173 families including siblings aged 7–16 years (52% male) drawn from the state of Missouri, USA, wherein mothers smoked during one pregnancy but not the other. There was a within-family effect of smoking during pregnancy on SWAN hyperactivity/impulsivity and SWAN total ADHD behaviors. The associations between SDP and DSM-IV-based ADHD symptom dimensions as well as SWAN inattention were explained by familial confounds. These findings suggest that SDP exerts a potentially causal effect on increased ADHD hyperactive/impulsive behaviors and that this SDP effect is best captured when hyperactivity/impulsivity is assessed more normatively across the population, rather than specifically assessing problematic behaviors via DSM symptoms. Thus, any potentially causal effect of SDP on ADHD symptom dimensions may be restricted to hyperactive/impulsive behaviors rather than inattention, and normative, non-DSM-IV based behavioral measures may provide a more sensitive test of mechanisms of SDP-ADHD symptom associations, particularly in non-clinical samples.     

Construing action abstractly and experiencing autonomy: Implications for physical activity and diet

Mentally representing action in terms of abstract goals rather than concrete procedures has been found to facilitate self-regulation, including meeting health goals. The present research examined whether autonomous motivation mediates the association between abstract thinking and health behavior engagement. We hypothesized that abstract (vs. concrete) thinking relates to viewing oneself as behaving autonomously, which, in turn, is positively associated with engaging in health behaviors. Two studies tested whether abstract thinking is associated with greater health behavior engagement and whether autonomous motivation statistically mediates this association. In Study 1, abstract thinking was associated positively with physical activity and fruit and vegetable intake. In Study 2, supporting pre-registered hypotheses, there was a significant indirect effect of abstract thinking on vigorous physical activity and fruit and vegetable intake through autonomous motivation. Whereas past research has emphasized that abstract thinking orients attention towards the value of broader goals, this research establishes that autonomous motivation helps explain associations between abstract thinking and health behavior engagement.     

Something Old, Something New: Evidence of Self-Accommodation to Gendered Social Change

Two studies examined how individuals adapt the self to social trends—in particular, when the social roles of the gender ingroup change, do people readily leave behind traditional roles in favor of nontraditional roles? We hypothesized that self-relevant cognitions and behaviors would accommodate to societal change, and we found that this accommodation took the shape of greater acceptance of nontraditional roles alongside continued acceptance of traditional roles. Experiment 1 included 112 undergraduates from the Midwestern U.S. who learned about social change or social stability by reading articles ostensibly published in a newspaper. Individuals who learned about social change for their gender ingroup, relative to those learning about social stability, projected greater personal success in careers, particularly for gender-nontraditional careers. Experiment 2 examined behavioral responses to social change in a sample of 198 female undergraduates from the Midwestern U.S. Participants learned about social change or social stability and then chose to view either a website focused on physical appearance (i.e., traditional choice) or leadership (i.e., nontraditional choice). Behavioral responses to social change reflected accommodation to the anticipated social structure: Individuals who learned about social change chose to view information about nontraditional rather than traditional roles. These studies provide initial experimental evidence investigating how individuals adapt the self to the social structure.