Utility of the Millon Behavioral Medicine Diagnostic (MBMD) to predict adherence to highly active antiretroviral therapy (HAART) medication regimens among HIV-positive men and women

Psychosocial and behavioral factors may be strong predictors of adherence to medications in a wide variety of diseases. Newly emerging antiretroviral medications for HIV have been shown to be effective but require near perfect adherence to offer clinically significant benefits. There is currently great interest in deriving patient factors that may predict optimal medication adherence in HIV-positive persons. In this study, we examined the association of psychosocial and behavioral characteristics using the Millon Behavioral Medicine Diagnostic (MBMD; Millon, Antoni, Millon, Meagher, & Grossman, 2001) and adherence to highly active antiretroviral therapy (HAART) among 117 HIV-positive individuals on HAART regimens. Specific indexes of the MBMD were associated with HAART adherence as assessed through patient interview, at baseline assessment, and at 3-month follow-up at a point after which participants had received medication adherence training. As hypothesized, the Medication Abuse scale of the MBMD was uniquely associated with overall adherence at baseline assessment and also predictive of adherence at 3-month follow-up. Additional MBMD scales were also related to overall adherence as well as specific adherence behaviors such as missed doses, following specific instructions, and overmedicating, although the Medication Abuse scale emerged as the most consistent predictor of adherence in the study. These results suggest that the MBMD can be used to predict adherence to HAART medication in a sample of HIV-positive men and women and may subsequently be used to identify those in need of adherence counseling at the point when medications are initiated.     

Brain oscillatory activity associated with task switching and feedback processing

In this study, we sought to dissociate event-related potentials (ERPs) and the oscillatory activity associated with signals indicating feedback about performance (outcome-based behavioral adjustment) and the signals indicating the need to change or maintain a task set (rule-based behavioral adjustment). With this purpose in mind, we noninvasively recorded electroencephalographic signals, using a modified version of the Wisconsin card sorting task, in which feedback processing and task switching could be studied separately. A similar late positive component was observed for the switch and correct feedback signals on the first trials of a series, but feedback-related negativity was observed only for incorrect feedback. Moreover, whereas theta power showed a significant increase after a switch cue and after the first positive feedback of a new series, a selective frontal beta–gamma increase was observed exclusively in the first positive feedback (i.e., after the selection of the new rule). Importantly, for the switch cue, beta–alpha activity was suppressed rather than increased. This clear dissociation between the cue and feedback stimuli in task switching emphasizes the need to accurately study brain oscillatory activity to disentangle the role of different cognitive control processes.     

Neuroendocrine influences in psychoimmunology and neoplasia: A review

Much recent work has focused on the interrelationships among environmental. psychological and physiological phenomena involved in immune-related disorders. with special emphasis being given to neoplastic processes. The present review looks first at the physiological pathways involved in the body's assorted and alternating responses to stressful environmental and psychological conditions and the immune system sequelae following each of two distinct psychophysiological coping responses—active coping and passive coping/helplessness reaction. Psychoimmunological findings about stressful life events. bereavement and mental depression as stressors the integrated with current psychoneuroimmunological postulates. A framework is outlined that may have utility for understanding the relationship among chronic psychological emotional stress in its many forms, accompanying neurohormonal changes. and increased susceptibility to immune-mediated neoplastic growth. Finally, the recently evolved concepts of hyper-adaptosis and cancrophilia are employed to further integrate theoretical pathways with clinical findings in the hopes of presenting a fertile base on which others may plan and conduct empirical research and intervention strategies.     

The distribution of repressive coping styles among non-metastatic and metastatic breast cancer patients as compared to non-cancer patients

Abstract

Recent investigations have shown increased disease progression among breast cancer patients with a “repressive” coping style characterized as: passive, conforming, inclined to deny physical symptoms and emotionally unexpressive. The Millon Behavioral Health Inventory (MBHI) scales which delineate three discrete repressive coping styles include the: Introversive, Cooperative and Respectful. Forty-four women recently diagnosed (within four weeks) with non-metastatic (N=32) or metastatic (N=12) breast carcinoma, responded to the MBHI upon admission for treatment of their disease at a cancer treatment unit. All subjects received mastectomy as well as chemotherapy, radiation and/or endocrine therapy. These 44 Cancer patients were compared to 34 control subjects, comprising women who were seen at a colposcopy clinic for follow-up of a suspicious pap smear which was ultimately shown to be benign or consisted of mild dysplasia. Non-metastatic, metastatic and control subjects were compared with respect to coping style and psychological distress. The breast cancer patients were more likely to employ a repressive coping style as compared to non-cancer patients who utilized a “sensitizing” coping strategy predominantly. Cancer patients with the most severe prognosis (metastasis) were the only group within the study to attain a clinically significant mean base rate score on the respectful scale. Results suggest that the incidence of repressive coping styles may be disproportionately high among breast cancer patients.     

Exploring a new paradigm for empathy research / Explorando un nuevo paradigma para el estudio de la empatía

Abstract

The present paper proposes an alternative experimental procedure for studies on empathy. It is intended as a simple and reliable alternative to the commonly used designs, which are certainly very elegant, but costly, as they require delicate real-life experimental manipulations. We advocate that studies using simple well-formulated text stimuli can be methodologically as reliable and valid as game task approaches. To underscore our claim, we report first behavioural evidence that supports this conclusion. The clear advantage of the method we present is that it is less susceptible to bias and, more importantly, more accessible to laboratories that do not have the financial means and the spatial infrastructure to manoeuvre complex and costly experimental setups and techniques. It is an easy to use, computer-based paradigm.     

Neurophysiological differences in reward processing in anhedonics

Anhedonia is characterized by a reduced capacity to experience pleasure in response to rewarding stimuli and has been considered a possible candidate endophenotype in depression and schizophrenia. However, it is still not well understood whether these reward deficits are confined to anticipatory and/or to consummatory experiences of pleasure. In the present study, we recorded electrophysiological responses (event-related brain potentials [ERPs] and oscillatory activity) to monetary gains and losses in extreme groups of anhedonic and nonanhedonic participants. The anhedonic participants showed reduced motivation to incur risky decisions, especially after monetary rewards. These sequential behavioral effects were correlated with an increased sensitivity to punishment, which psychometrically characterized the anhedonic group. In contrast, both electrophysiological measures associated with the impacts of monetary losses and gains—the feedback-related negativity (FRN) and the beta–gamma oscillatory component—clearly revealed preserved consummatory responses in anhedonic participants. However, anhedonics showed a drastic increase in frontal medial theta power after receiving the maximum monetary gain. This increase in theta oscillatory activity could be associated with an increase in conflict and cognitive control for unexpected large positive rewards, thus indexing the violation of default negative expectations built up across the task in anhedonic participants. Thus, the present results showed that participants with elevated scores on Chapman’s Physical Anhedonia Scale were more sensitive to possible punishments, showed deficits in the correct integration of response outcomes in their actions, and evidenced deficits in sustaining positive expectations of future rewards. This overall pattern suggests an effect of anhedonia in the motivational aspects of approach behavior rather than in consummatory processes.     

Relationship between language switching experience and executive functions in bilinguals: an Internet-based study*

We examined the relationship between self-reported everyday language switching experience and the performance of early bilinguals in tasks measuring different executive functions. Our participants were Finnish–Swedish early bilinguals, aged 16–41 years (N?=?66, Experiment 1) and 18–69 years (N?=?111, Experiment 2). An earlier study using a sample from a similar population discovered a negative relationship between self-reported language switching and a mixing cost in error rates in a number–letter task. This finding was not replicated. Instead, we found that a higher rate of reported contextual language switching predicted larger switching cost reaction times in the number–letter task, and that a higher rate of reported unintended language switches predicted larger error rates in a spatial n-back task. We conclude that these results likely reflect individual differences in executive skills, and do not provide evidence for the hypothesis that language switching trains executive functions.     

Perceived partner support and psychosexual adjustment to breast cancer

Support from a partner can play a key role in a woman's emotional adjustment to breast cancer. However, little is known about the influence of partner behaviours on a woman's sexual adjustment. This study examined the prospective relationship between baseline levels of several types of perceived partner support (instrumental, informational, emotional and negative) and psychosexual adjustment (sexual functioning and relationship satisfaction) over the course of 12 months post-surgery in a sample of 130 women with breast cancer. Results indicated that perceptions of greater emotional and informational support from the partner at baseline were associated with less sexual difficulties among breast cancer patients concurrently and 6 months post-surgery. Baseline perceptions of greater emotional and instrumental support from a partner were associated with greater relationship satisfaction at all time points. Perceptions of informational support at baseline were related to greater concurrent relationship satisfaction. Baseline perceptions of negative partner support were related to less relationship satisfaction, but only concurrently. These findings suggest that the perception of a partner's provision of emotional, instrumental and informational support may each play a role in facilitating sexual adjustment and relationship satisfaction.     

Playing at Being Gods

The present article commences analyzing the origins and influences of the religious discourse on the configuration of the modern constitutional discourse and the contributions of the jus-positivism in the consolidation of this sacred-civil language. The second issue is the definition of the U.S. Constitution as a mixed and not as a democratic constitution, with regard to the influences of Plato, Aristotle, Cicero and Polybius to the Drafters of the first modern constitutional text; stability and equilibrium took preference over democracy in a wide sense. I also analyze how the Drafter’s decision has conditioned the modern constitutional system up to the present.