Motivational interviewing or reminders for glaucoma medication adherence: Results of a multi-site randomised controlled trial

Objective: Nonadherence reduces glaucoma treatment efficacy. Motivational interviewing (MI) is a well-studied adherence intervention, but has not been tested in glaucoma. Reminder interventions also may improve adherence.

Design: 201 patients with glaucoma or ocular hypertension were urn-randomised to receive MI delivered by an ophthalmic technician (OT), usual care or a minimal behavioural intervention (reminder calls).

Main Outcome Measures: Outcomes included electronic monitoring with Medication Event Monitoring System (MEMS) bottles, two self-report adherence measures, patient satisfaction and clinical outcomes. Multilevel modelling was used to test differences in MEMS results by group over time; ANCOVA was used to compare groups on other measures.

Results: Reminder calls increased adherence compared to usual care based on MEMS, p = .005, and self-report, p = .04. MI had a nonsignificant effect but produced higher satisfaction than reminder calls, p = .007. Treatment fidelity was high on most measures, with observable differences in behaviour between groups. All groups had high baseline adherence that limited opportunities for change.

Conclusion: Reminder calls, but not MI, led to better adherence than usual care. Although a large literature supports MI, reminder calls might be a cost-effective intervention for patients with high baseline adherence. Replication is needed with less adherent participants.     

Conscious Motivations of Adolescent Visual Artists and Creative Writers: Similarities and Differences

This exploratory study was designed to expand the field’s understanding of talented adolescent visual artists and creative writers and their conscious motivations for engaging in these creative activities. Accordingly, 233 talented high school visual arts (n = 151) and creative writing (n = 82) students were asked to rate the degree to which they believed their creative activities were motivated by each of a wide range of possible motivations. The students in both fields reported being very strongly motivated by the opportunities their activities provided them to use their imaginations, feel free, sense that they were being their “true” selves, regulate their emotions, capture moments in time, deepen their self-understanding, express themselves, improve their skills, and enhance their self-esteem. Some of these motivations correspond closely to those highlighted by theories of intrinsic motivation, competence motivation, and self-actualization, several are similar to those which have been reported by professional artists and writers, and some suggest that the students may have derived important psychological benefits from their creative activities. Theoretically plausible differences between the motivational profiles of the visual and creative writing students were identified and discussed.     

Blaming the Victim: University Student Attitudes Toward Bullying

Numerous studies have examined adolescent attitudes toward bullying, but limited research has explored college students’ attitudes toward victims of bullying. Using data collected from three southern universities (n = 1,135), the current research investigates demographic, experiential, and behavioral factors that are likely to influence whether university students attribute blame to bullying victims. Findings indicate that most university students report prosocial attitudes toward bullying. Victim blaming and minimizing attitudes were most common among males, heterosexuals, and those with a history of prior bullying perpetration during junior high or high school. Individuals reporting a higher frequency of drug use were significantly more likely to support victim blaming attitudes, and those who engaged in more frequent alcohol use were significantly more likely to minimize bullying.     

Investigating the outcome of the initial assessment at a national transgender health service: Time to review the process?

Background: Globally, there is a lack of a standardized assessment process prior to the initiation of gender affirming medical interventions and consequently there is a discrepancy in this process among different transgender health services.

Aim: The main objective of this study is to investigate the outcome of the initial assessment process at a national transgender health service.

Method: The outcome of people over the age of 17 years, assessed at a large national transgender health service in the United Kingdom during a 2-year period was categorized into: (1) recommendation for cross-sex hormone treatment, or (2) no recommendation for cross-sex hormone treatment. In addition, 200 case notes were reviewed in order to investigate the level of agreement between the two clinicians involved in the assessment process.

Results: During the study period, a total number of 617 people completed their assessment at the service. Following assessment 380 (61.6%) patients were recommended for cross-sex hormone treatment, leaving 237 (38.4%) patients who required a longer assessment period or were discharged. The factors associated with being recommended for cross-sex hormone treatment were having socially transitioned, not smoking, having initiated cross-sex hormones prior to assessment, being older, and assigned male at birth. Out of the 200 case notes reviewed, agreement between assessor 1 and 2 (3 months apart) was found in 88% (n = 176) of the cases.

Discussion: Although the results of the study may not be generalizable to other international centers, questioning the assessment process and the role of the assessors is important to ensure treatment is offered in a timely and efficient manner. The findings from this study suggest that the routine inclusion of two assessors needs to be reviewed.     

Religiosity and Spiritual Engagement in Two American Indian Populations

Social scientific investigation into the religiospiritual characteristics of American Indians rarely includes analysis of quantitative data. After reviewing information from ethnographic and autobiographical sources, we present analyses of data from a large, population-based sample of two tribes (n = 3,084). We examine salience of belief in three traditions: aboriginal, Christian, and Native American Church. We then investigate patterns in sociodemographic subgroups, determining the significant correlates of salience with other variables controlled. Finally, we examine frequency with which respondents assign high salience to only one tradition (exclusivity) or multiple traditions (nonexclusivity), again investigating subgroup variations. This first detailed, statistical portrait of American Indian religious and spiritual lives links work on tribal ethnic identity to theoretical work on America's "religious marketplace." Results may also inform social/behavioral interventions that incorporate religiospiritual elements.     

“She is not actually bullied.” the discourse of harassment in student groups

Bullying is a considerable problem in schools. It has various negative effects on the children involved. The purpose of this qualitative study was to explore how children themselves interpret and construct bullying. Three elementary school classes with a high number of victim nominations were chosen among the 48 classes taking part in a larger study. The pupils from selected classes were interviewed in small groups. The interviews were tape‐recorded, transcribed and analyzed using the discourse analytical methodology described by Potter and Wetherell [1987]. Various recurrently used systems of terms (e.g., interpretative repertoires) were found. The results suggest that bullying can be construed as unproblematic and justified among children. For example, the ‘interpretative repertoire of underestimation’ constructs bullying as a game or some other harmless action, the ‘odd student repertoire’ describes the victim as a negatively deviant student who cannot behave as he/she should and the ‘interpretative repertoire of deserving’ constructs meaningful reasons for hostility towards the victim. These and other interpretative repertoires are described and discussed. Aggr. Behav. 29:134–154. © 2003 Wiley‐Liss, Inc.     

Dueling Experiences and Dual Ambivalences: Emotional and Motivational Ambivalence of Women in High Status Positions

A laboratory study demonstrates that women in high status positions experience emotional ambivalence (simultaneous experience of positive and negative affect) and motivational ambivalence (simultaneous desires to build relationships and display power). These effects were found with 2 different measures of ambivalence, 1 derived from the attitudinal ambivalence literature and the other from the structure of affect literature. These findings have implications about the experience of women in the workplace, as well as the current debates concerning structure of affect.     

Video-based assessment of interpersonal problem solving skills in patients with schizophrenia, their siblings and non-psychiatric controls

The aim of this study was to analyze social functioning in patients with schizophrenia and their biological relatives with a Swedish version of the video-based vignette test Assessment of Interpersonal Problem Solving Skills (AIPSS). In a new video production with simulated "real life" situations we tested the ability to receive, process and send social information in 25 individuals with a DSM-IV diagnosis of schizophrenia, 20 siblings to patients with schizophrenia and 25 randomly selected non-psychiatric controls. The test proved to have good validity and interrater reliability. After controlling for positive or negative symptoms, patients had poor performance especially in acting out solutions leading to effective problem solving. Siblings generally did not differ from controls, but showed some deficiencies in non-verbal language. To conclude, AIPSS is appropriate for use in a Swedish-speaking context and might be useful in research on vulnerability indicators and in assessment of treatment interventions.     

A randomized control trial to investigate the impact of the Lidcombe Program on early stuttering in German-speaking preschoolers

In order to investigate whether the Lidcombe Program effects a short-term reduction of stuttered speech beyond natural recovery, 46 German preschool children were randomly assigned to a wait-contrast group or to an experimental group which received the Lidcombe Program for 16 weeks. The children were between 3;0 and 5;11 years old, their and both of their parents’ native language was German, stuttering onset had been at least 6 months before, and their stuttering frequency was higher than 3% stuttered syllables. Spontaneous speech samples were recorded at home and in the clinic prior to treatment and after 4 months. Compared to the wait-contrast group, the treatment group showed a significantly higher decrease in stuttered syllables in home-measurements (6.9%SS vs. 1.6%SS) and clinic-measurements (6.8%SS vs. 3.6%SS), and the same increase in articulation rate. The program is considered an enrichment of currently applied early stuttering interventions in Germany.

Educational objectives: Readers will discuss and evaluate: (1) the short-term effects of the Lidcombe Program in comparison to natural recovery on stuttering; (2) the impact of the Lidcombe Program on early stuttering in German-speaking preschool children.     

Decline in life satisfaction in old age: longitudinal evidence for links to distance-to-death

Using 12-year longitudinal data from deceased participants of the Berlin Aging Study (N = 414; age 70-103 years, at first occasion; M = 87 years, SD = 8.13), the authors examined whether and how old and very old individuals exhibit terminal decline in reported life satisfaction at the end of life. Relative to age-related decline, mortality-related decline (i.e., distance-to-death) accounted for more variance in interindividual differences in life satisfaction change and revealed steeper average rates of decline, by a factor of 2. By applying change-point growth models, the authors identified a point, about 4 years before death, at which decline showed a two-fold increase in steepness relative to the preterminal phase. For the oldest old (85+ years), a threefold increase was observed. Established mortality predictors, including sex, comorbidities, dementia, and cognition, accounted for only small portions of interindividual differences in mortality-related change in life satisfaction. The authors conclude that late-life changes in subjective well-being are related to mechanisms predicting death and suggest routes for further inquiry.