A problem-posing educational methodology for the prevention of HIV / AIDS

The problem-posing methodology of Brazilian educator Paulo Freire, using the reading circle approach previously deployed in successful literacy campaigns in developing countries, is introduced for application in AIDS information programs. The basis of this educational process is the dialogue where those to be educated resolve their problems by evaluating information critically, capturing concepts by codification and decodification, and transmitting information by creating relevant educational materials. Health circles are organized with women as educators to impart knowledge about AIDS and HIV: definitions, epidemiological components (sex, age, and risk behavior), means of transmission, stages of the progression of AIDS, prevention of HIV infection, and tests for detecting HIV antibodies. The dialogue explores knowledge and feelings about AIDS and how it affects life in the community reveals personal experiences and accounts of knowing someone who was HIV-positive, and develops action plans to minimize AIDS cases in the community. The Latin population of California, mainly of Mexican origin, with low levels of education, income, and acculturation and a high incidence of AIDS, is an appropriate target of such intervention. In 1980, there were 12.3 million people of Hispanic origin in the US. In August 1990, there were 143,280 persons diagnoses with AIDS according to the Centers for Disease Control. 78,878 of these (55%) were Anglos, and 21,752 (15%) were Hispanics. Among the Anglos, the incidence was 300/million inhabitants, while among Hispanics, it was 1059/million, a 3-field higher rate.     

Subjective assessment of sleep by Sleep Questionnaire

A 55-item Sleep Questionnaire is presented for possible use as a standardized instrument in psychological studies of sleep. A factor analysis of responses from 145 adults to the questionnaire indicated 7 factors accounted for 71.7% of the total variance. These factors are congruent with sleep dimensions discussed in the literature and with other factor analytic investigations. A set of 11 clinical judgment scales are also presented. The reliabilities of both factor and clinical scales are adequate as judged by test-retest, internal consistency, and comparisons of self vs spouse ratings. The construct validity is supported by three studies showing significant differences between (a) medical patients with and without sleep disturbances, (b) psychiatric patients with and without symptoms of depression, and (c) short and long sleepers.     

Integrating Exposure and Response Prevention With a Mobile App to Treat Obsessive-Compulsive Disorder: Feasibility,Acceptability, and Preliminary Effects

Many individuals with obsessive-compulsive disorder (OCD) do not receive evidence-based care (specifically exposure and ritual prevention; EX/RP) due to barriers such as a lack of EX/RP-trained clinicians, geographic obstacles, and the cost and time associated with the treatment. Offering an integrated treatment model consisting of brief in-person therapy coupled with a mobile application (app) might be one way to increase access to and reduce the time burden (to clinicians and patients) of EX/RP. This pilot trial evaluated the feasibility, acceptability, and clinical effects of such a treatment program for adults with OCD. Thirty-three participants enrolled in the 8-week open trial. The integrated treatment program consisted of 3 to 5 in-person sessions followed by weekly phone calls supported by a mobile app (nOCD). Participants were evaluated by trained raters and completed self-report measures at baseline, midtreatment, posttreatment and 2-month follow-up; the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was the primary outcome. This integrated treatment program was feasible and acceptable to participants. Of the 33 study entrants, 14 (42%) responded to treatment (Y-BOCS decrease ≥ 35% with CGI- of 1 or 2), and 8 (24%) achieved minimal symptoms (i.e., Y-BOCS ≤ 12). At 2-month follow-up (n = 20), 7/20 (35%) met criteria for treatment response, and 3/20 (15.0%) met criteria for treatment remission. Although preliminary, this model warrants further study as an efficacious and resource-efficient way to deliver EX/RP for some patients with OCD.     

Adding motivational interviewing to exposure and ritual prevention for obsessive-compulsive disorder: an open pilot trial

Exposure and ritual prevention (EX/RP) is an efficacious treatment for obsessive-compulsive disorder (OCD), but high dropout rates and variable treatment adherence limit its effectiveness. Motivational interviewing (MI) has shown promise as an adjunct to symptom-focused treatments for improving treatment adherence and outcomes. The authors developed a manual integrating MI with EX/RP, consisting of three information-gathering/motivational enhancement sessions and 15 EX/RP sessions with an optional MI module to be used as needed. Six patients with moderate to severe OCD symptoms (Yale-Brown Obsessive Compulsive Scale [Y-BOCS] score> or =16) underwent treatment. Five showed a decrease in their baseline Y-BOCS scores and an increase in their quality of life, with three achieving an excellent response (i.e. Y-BOCS< or =12 at Session 18). The authors briefly describe the motivational strategies used in the six cases and suggest that integrating MI with standard EX/RP is a promising method to increase and sustain patient engagement with EX/RP. Challenges in combining these treatments and maintaining the integrity of each as well as limitations of the study are discussed.     

Cumulating Evidence about the Social Animal: Meta‐Analysis in Social‐Personality Psychology

Like most scientific fields, social‐personality psychology has experienced an explosion of research related to such central topics as aggression, attraction, gender, group processes, motivation, personality, and persuasion, to name a few. The proliferation of research can be a monster unless it is tamed with the scientific review strategy of meta‐analysis, literally analyses of past analyses that produce a quantitative and empirical history of research on a particular phenomenon. The purpose of this article is to outline the basic process and statistics of meta‐analysis, as they pertain to social‐personality psychology. Meta‐analysis involves: (i) defining the problem under review; (ii) gathering qualified reports and putting their findings and methods into a database, (iii) analyzing that database, and (iv) interpreting the results and reporting them. Use of meta‐analytic strategies has paralleled the knowledge explosion in social‐personality psychology, but must be used and consumed with careful discernment if the cumulated evidence about the social animal, Homo sapiens, is to have maximal value.     

Somatic Markers and Response Reversal: Is There Orbitofrontal Cortex Dysfunction in Boys with Psychopathic Tendencies?

This study investigated the performance of boys with psychopathic tendencies and comparison boys, aged 9 to 17 years, on two tasks believed to be sensitive to amygdala and orbitofrontal cortex functioning. Fifty-one boys were divided into two groups according to the Psychopathy Screening Device (PSD, P. J. Frick & R. D. Hare, in press) and presented with two tasks. The tasks were the gambling task (A. Bechara, A. R. Damasio, H. Damasio, & S. W. Anderson, 1994) and the Intradimensional/Extradimensional (ID/ED) shift task (R. Dias, T. W. Robbins, & A. C. Roberts, 1996). The boys with psychopathic tendencies showed impaired performance on the gambling task. However, there were no group differences on the ID/ED task either for response reversal or extradimensional set shifting. The implications of these results for models of psychopathy are discussed.     

The importance of differentiation in young children’s acquisition of expertise

In a short-term longitudinal study, stories told about novel creatures conveyed information varying in its capability for differentiating. Depending on the context, a bodily feature could be functionally undifferentiated (FUF), meaning that its subtypes (e.g., eyes of two forms) shared a generic function (“seeing”), or functionally differentiated (FDF), meaning that each subtype’s function was unique to it (e.g., only a “hooded eye” could “see in a sandstorm”). 5- to 6-year-olds who heard 8 stories, but not those who heard only 4, cited FDFs more than FUFs in a pair-justification test of judged similarity; and their delayed recall of specific story events was greater when FDFs rather than FUFs were involved. In the absence of direct instruction, young children show sensitivity to the degree of differentiation afforded by feature-function relations.