Book reviews

Arnold, M. Memory and the brain. Hillsdale, N. J.: Lawrence Erlbaum Associates. 1984. Pp. 532. ISBN 0-89859-290-9. £47.90.

Green, T. R. G., Payne, S. P. and van der Veer, G. C. (Eds.). The psychology of computer use.. London: Academic Press. 1983. Pp. 225. ISBN 0-12-2974204. $9.50.

Stunkard, A. J. and Stellar, E. (Eds.). Eating and its disorders. New York: Raven Press. 1984. Pp. 302. ISBN 0-89004-891-6. $58.50.

Spillmann, L. and Wooten, B. R. (Eds.) Sensory experience, adaptation, and perception: Festschrift for Zero Kohler. Hillsdale, N. J.: Lawrence Erlbaum Associates. 1984. Pp. xxvii + 748. ISBN 0 8985-3-218-6. £70.85.

Geschwind, N. and Galaburda, A. M. (Eds.)Cerebral dominance: The biological foundations. Cambridge, Mass.: Harvard University Press. 1984. Pp. 232. ISBN 0-674-10658-X. £24.35.

Annett, M. Left, right, hand and brain: The right shift theory. 1985. London and Hillsdale, N. J.: Lawrence Erlbaum Associates. Pp. xiii + 474. ISBN 0-86377418-5 £29.95.

Ericsson, K. A. and Simon, H. A. Protocol analysis: Verbal reports as data. Cambridge, Mass.: The M.I.T. Press. 1984. Pp. 426. ISBN 0-262-05029-3. £28.95.     

Instrumental responding following reinforcer devaluation

In two experiments, hungry rats were given instrumental lever-press training for an appetitive reinforcer and, in addition, were exposed to another type of food which was not contingent on lever pressing. In the first experiment, exposure to each type of food was on separate days, whereas in the second experiment rats were exposed to each type of food in strict alternation within each session. Subsequently, a food aversion was conditioned to the reinforcer for the experimental group and to the non-contingent food for the control group. In both experiments, animals with an aversion to the reinforcer responded less in an extinction test than animals with an aversion to the non-contingent food. Subsequent reacquisition tests confirmed that the aversion to the non-contingent food in the control group was of comparable strength with that to the reinforcer in the experimental group. The results were discussed in terms of whether the reinforcer is encoded in the associative structure set up by exposure to an instrumental contingency.     

Randomized controlled trial of an intervention to prevent adherence failure among HIV-infected patients initiating antiretroviral therapy.

OBJECTIVE: Compare the efficacy of a multicomponent social support intervention to standard-of-care counseling on medication adherence among HIV-infected patients initiating antiretroviral therapy. DESIGN: Randomized controlled trial. Generalized estimating equations tested for differences in the percentage of participants achieving 90% adherence. MAIN OUTCOME MEASURES: Pill-taking, electronically monitored over 6 consecutive months; plasma viral load (VL), assessed at 3 and 6 months following initiation of therapy. RESULTS: Of 226 participants who were randomized and began the trial, 87 (38%) were lost to the study by 6 months. The proportion of adherent participants declined steadily over time, with no time by group interaction. Sustained adherence was associated with increased odds of achieving an undetectable VL (OR=1.78; 95% CI=1.01, 3.13). In intention-to-treat analyses, a larger proportion of the intervention group than the control group was adherent (40.15% vs. 27.59%, p=.02) and achieved an undetectable VL p=.04). However, the majority of participants who remained on study experienced some reduction in VL (>or=1-log drop or undetectable), regardless of experimental condition. CONCLUSION: The multicomponent social support intervention significantly improved medication adherence over standard-of-care counseling; evidence for improved virologic outcomes was inconsistent. Early discontinuation of care and treatment may be a greater threat to the health of HIV patients than imperfect medication-taking.