Psychological factors in hiv testing among sexually transmitted disease clinic patients: An exploratory study

Abstract

Substantial numbers of persons at risk for HIV infection do not seek HIV testing and factors influencing testing decisions are not well understood. To identify psychological characteristics of persons who remain unwilling to receive HIV testing, we surveyed patients of an inner-city sexually transmitted disease (STD) clinic (n = 181). Participants completed an anonymous survey and were grouped on the basis of HIV testing history and compared on measures of testing perceptions, attitudes, and decision making influences. Results showed that untested participants feared testing and had a sense of not knowing if they needed to be tested. In contrast, participants who were getting tested believed that testing would help them feel better about their health. Results also showed that participants lacked accurate information about some HIV testing procedures. We conclude that identifying concerns which inhibit seeking HIV testing can be useful in developing effective methods of promoting HIV testing.     

Health-related quality of life among people living with hiv disease in small communities and rural areas

Abstract

While many studies have examined the life quality of HIV-infected persons in large metropolitan areas, few studies have investigated quality of life issues among persons living with HIV disease in America's small and rural communities. In the present study, 78 people living with HIV/AIDS in small and rural communities (i.e., populations <25,000) reported on their health-related quality of life. Many respondents reported decreased social, emotional, functional, and physical well-being. Results revealed that participants' emotional well-being and the quality of their relationship with their doctor were related to their overall quality of life. The majority of participants (73%) expressed interest in participating in a telephone-linked support group involving other people living with HIV designed to improve quality of life.     

Event countertransference and vicarious traumatization: Theoretically valid and clinically useful concepts?

The event countertransference and vicarious traumatization concepts have been introduced in the 1990s to describe the adverse emotional impacts that working with severely traumatized patients may have for the helping professional. These concepts are increasingly popular among trauma therapists. The present paper critically discusses the empirical evidence, theoretical validity and clinical utility of both concepts. Vulnerable trauma therapists may too eagerly embrace the event countertransference and vicarious traumatization perspectives as a cover up for their own failures. Interpersonal communication theory is suggested as a more useful conceptual framework for the analysis of countertransference reactions in therapies with severely traumatized patients.     

Neurotic Nucleus and Test Anxiety

Undergraduate university students (N = 103) participated in a study of the relationship between test anxiety and the variables of trait anxiety, self-esteem, locus of control, mental ability, and gender. Results indicated bivariate associations between total test anxiety and the other measures except for mental ability. Further analyses revealed independent relationships between the “worry” component of test anxiety and the variables of trait anxiety, intemality, chance, and mental ability. We also found independent associations between the “emotionality” aspect of test anxiety and the measures of trait anxiety and chance.     

Patients’ Perceptions of Risky Developments During Psychotherapy

Research on risks and unwanted effects is largely missing in psychotherapy. Using exploratory factor analysis six dimensions of personal therapy situation were identified in a preliminary study, three of them were associated with risky developments during the psychotherapeutic process: (1) (poor) quality of therapeutic relationship, (2) burden caused by psychotherapy, and (3) dependency/isolation. Based on the finding of this study an online survey was performed to examine these three dimensions. Aside from these three factors another variable was associated with risky therapy developments: the online questionnaire also asked for premature terminations of psychotherapy as a consequence of risky conditions for the therapeutic development. Risky conditions were found to be associated with the following variables: (1) the combination of female patient–male therapist, (2) the therapeutic orientation (particularly with the psychodynamic approaches) and (3) the duration of therapy. Fewer humanistic and systemic psychotherapies were found among the high risk-prone group of patients who were at risk in at least three of the four variables which were associated with risky developments. Differences in the findings of the study regarding the four therapeutic orientations stress the importance of an extensive differential indication and a cooperative partnership between patient and therapist, in order to facilitate a positive patient participation towards the choice of therapy method and subsequent successful participation throughout the course of treatment. Further studies should also focus on female patient and male therapist psychotherapies.     

Factor Analysis of a French-Canadian Form of the Parental Attitude Research Instrument

We analyzed the factorial structure of a French version of the Parental Attitude Research Instrument (PARI), a questionnaire designed to measure parental attitudes toward child rearing and family life. Principal component analysis with varimax rotation of data of a sample of 98 French-Canadian mothers revealed three factors: Authoritarian-Control, Hostility-Rejection, and Democratic Attitudes. Results were compared with the findings of Schaefer and Bell (1958), and of Zuckerman, Barrett-Ribback, Monashkin, and Norton (1958). We determined that a French translation of this questionnaire had the same factorial structure as the English original.     

Death,meaning and tragedy

In this article, the author submits Zygmunt Bauman's analysis of post-modernity as a life strategy entailing the 'deconstruction of immortality' to critical scrutiny. ‘Deconstructing’ the striving for immortality suggests the transformation of life into a continual rehearsal of the transcience and demise of all things, the celebration of moments or instances of short-lived fame or notoriety, and the effacement of the opposition between the transient and the durable. This idea—with its implicated suggestion that everything, including life itself, loses meaning and importance, and that the striving for durable effect becomes obsolete—is found to be both logically and morally incoherent. The author suggests and develops the idea of life as tragedy within the spectre of death as key to developing a more cogent life strategy, drawing on insights from Aristotle and Nietzsche, and countering the pessimism of Schopenhauer in this regard.     

Biomedical enhancement and the pursuit of mastery and perfection: a critique of the views of Michael Sandel

This article is a comprehensive critical analysis of the objections of Michael Sandel to the possibilities of human enhancement as foreseen by recent developments in new (particularly genetic) biotechnologies. It is shown that enhancement has always been a feature of human development. The nature and possibilities of these new technologies are briefly discussed, followed by an explanation of Sandel's views. In critical response to Sandel, the author raises three arguments that are discussed in detail, followed by a conclusion that contains wrap-up arguments. The three main arguments relate, first, to Sandel's rejection of enhancement tout court, second to the (in)consistency of his argument about the ‘gifted’ nature of reality, and third to the problems raised by his idea that the striving for mastery is the main problem with enhancement. On the basis of an extensive analysis, the author finds Sandel's position untenable. It is shown that Sandel espouses the ‘simple conservative argument’ (Buchanan). The author concludes that science and technology are not value free, and that the critical evaluation of enhancements cannot lead to an overall judgment, but has to progress in a piecemeal manner. The author also concludes that the notion of ‘human nature’ cannot be regarded as a moral desideratum.     

Responsivity to stress in chronic posttraumatic stress disorder due to childhood sexual abuse

The purpose of this study was to investigate psychological, cardiovascular, and neuroendocrine reactivity to standardized stress tests (orthostatic challenge, Stroop Color Word Test) in drug-free adult women with chronic PTSD due to repetitive childhood sexual abuse. At baseline, the 11 patients showed significantly higher mean scores on the Symptom Check List-90 and the Profile of Mood States than 13 healthy female controls, whereas baseline cardiovascular or hormonal parameters showed no differences between the groups. Also, no significant differences were found between the two groups in cardiovascular and hormonal responsivity to the stress tests. Thus, in the presence of robust psychological differences, the patients with chronic PTSD due to childhood sexual abuse did not show alterations in baseline values of neurobiological parameters, nor did they react differently to a physical and mental stress test when compared to healthy controls.     

Nociceptive sensitivity and control: hypo- and hyperalgesia under two different modes of coping

Effects of perceived control on nociceptive sensitivity were investigated in an experimental arrangement with N = 40 healthy volunteers in which the duration of painful pressure stimuli was made contingent on success in a tracking task. Perceived control over the pain duration was manipulated through varying the frequency of success in the tracking task. The amount of painful stimulation applied in the high and low control conditions was balanced by a yoked-control design. Pain sensitivity was measured before and after the tracking task by means of a thermal sensory analyzer. Pain sensitivity was found to decrease in the low control condition (hypoalgesia), and to increase slightly in the high control condition (hyperalgesia). These effects are explained with reference to a dual process model of coping.