Feasibility of a Telephone Intervention for HIV Patients and Their Informal Caregivers

Objectives: To assess the feasibility of a telephone intervention for HIV-positive patients and their caregivers. Methods: HIV-positive participants, some co-enrolled with their informal caregiver, enrolled in this randomized study. Intervention-arm participants (124 patients and 76 caregivers; dyads assigned to same arm) received up to 12 scheduled calls from an interventionist over 6 months. Results: An average of 7.6 (SD = 3.0) calls to each participant was completed; 66.5% received at least 6 calls; 43.0% received more than 75% of the intervention (defined as ‘study adherent’). Having a higher T-cell count was associated with call adherence (p = .014); cocaine use was associated with reduced call adherence for both patients (p = .019) and caregivers (p = .083). Common telephone themes included problems with mood, relationships, finances, housing, and work; interventions (e.g., referral for mental health care) were initiated in response to these. Participant satisfaction was high, and many reported benefits from the intervention. Conclusions: Using a telephone intervention with HIV-positive patients and their caregivers is a feasible and potentially beneficial intervention.     

Clericalism: Enabler of Clergy Sexual Abuse

Sexual abuse by Catholic clergy and religious has become the greatest challenge facing Catholicism since the Reformation. Violations of clerical celibacy have occurred throughout history. The institutional church remains defensive while scholars in the behavioral and social sciences probe deeply into the nature of institutional Catholicism, searching for meaningful explanations for the dysfunctional sexual behavior. Clericalism which has traditionally led to deep-seated societal attitudes about the role of the clergy in religious and secular society, explains in part why widespread abuse has apparently been allowed. Clericalism has a profound emotional and psychological influence on victims, church leadership, and secular society. It has enabled the psychological duress experienced by victims which explains why many have remained silent for years. It has also inspired societal denial which has impeded many from accepting clergy sexual abuse as a serious and even horrific crime. Thomas P. Doyle is a Canon Lawyer and Certified Addictions Specialist.     

A developmental perspective on bullying

In this paper, we examined the forms and relationship contexts of bullying in adolescence. Using cross‐sectional data, we assessed grade and sex differences in self‐reports of bullying and sexually harassing peers, as well as reports of dating aggression from1896 students from early to late adolescence. Reports of bullying others were highest around the school transition, with lowest levels at the end of high school. Boys reported more bullying and sexual harassment than girls. Sexual harassment of same‐ and opposite‐sex peers increased over the early adolescent years and leveled off in later high‐school years. There were no sex differences in the prevalence of indirect or physical aggression with a dating partner. Adolescents who bullied were at increased risk for the other forms of relationship aggression. These data highlight bullying as a relationship problem and point to the need for prevention programs to curtail the use of power and aggression in adolescent relationships. Aggr. Behav. 32:376–384, 2006. © 2006 Wiley‐Liss, Inc.     

Agency and observation in knowledge of one's own thinking

This essay addresses the question how we know our conscious thinking. Conscious thinking typically takes the form of a series of discrete episodes that constitute a complex cognitive activity. We must distinguish the discrete episodes of thinking in which a particular content is represented in phenomenal consciousness and is present “before the mind's eye” from the extended activities of which these episodes form a part. The extended activities are themselves contentful and we have first‐person access to them. But because their content is not represented in phenomenal consciousness, this access cannot be broadly observational. Instead, I argue, it is agential. Furthermore, that extended activities are intentional explains the possibility of a nonobservational form of introspective access to the discrete episodes in consciousness.     

Parents and carers of young people with mental ill-health: What factors mediate the effect of burden on stress?

A substantial body of research has reported negative outcomes due to caregiving, however, little is known about how caring for a young person with mental ill-health impacts on parents and carers. This study aims to examine whether, like carers of older people, they experience elevated levels of caregiver burden and stress. It expands on earlier studies by examining potential mediators of burden and stress, with a specific focus on how activity restriction affects this association. There were 226 Australian parents and carers of young people (12–25 years) experiencing mental ill-health who voluntarily completed a self-report questionnaire reflecting how their young person’s ill-health had affected them over the past month. Hierarchical regression and multiple mediation analyses were conducted to examine the relationship between caregiver burden and stress, and whether adaptive coping, self-efficacy and activity restriction mediated this relationship. Caregiver burden and stress were strongly related, and both activity restriction and self-efficacy mediated their association, with activity restriction having the stronger effect. Strategies aimed at increasing awareness of the impact of activity restriction and encouraging parents and carers to find ways to maintain essential activity may reduce stress, improving mental health and well-being in parents and carers.     

Drug-associated psychoses and criminal responsibility

At present, the law draws a distinction when assigning criminal responsibility to those who commit offences while experiencing psychotic symptoms: if the symptoms are believed to arise because of ingesting drugs (an external cause), the offender is generally convicted of the offence; if the symptoms arise from a mental illness (an internal cause), the offender may be afforded a defence of insanity. In practice, drawing such a distinction can be problematic. There are difficulties for example in determining criminal responsibility when the use of drugs is followed by the emergence of a psychotic illness process that then continues to have an independent existence even in the absence of the ongoing substance use. This article analyses legal, policy, and expert witness perspectives relating to liberal, conservative, and intermediate approaches to this problematic area of jurisprudence.     

What’s in a Purse? Maybe a Woman’s Reputation

Does a woman’s reputation suffer when others discover condoms in her possession? Fifty-two male and female predominantly white undergraduates from a small, private, Catholic university in the northeast USA examined the contents of a purse to formulate an impression of its owner. Unflattering inferences were drawn about the character of the target when her purse contained condoms. A follow-up study with 55 comparable participants confirmed that these inferences were indeed uncomplimentary. The results are discussed in terms of the multi-dimensional price women pay when assuming responsibility for their sexual health.     

Roman Catholic Clericalism,Religious Duress,and Clergy Sexual Abuse

Since 1984, sexual abuse by Catholic clergy has captured public attention and resulted in a stream of criminal and civil lawsuits. The hierarchy has been defensive in the face of constant accusations and criticism. This study examines selected key aspects of the clergy sex abuse phenomenon including historical precedents and the impact of clericalism on the development of psychological and emotional duress in victims and others closely associated with sexual abuse.     

Do difficulties with emotions inhibit help-seeking in adolescence? The role of age and emotional competence in predicting help-seeking intentions

We examined whether adolescents who are poor at identifying, describing, and managing their emotions (emotional competence) have lower intentions to seek help for their personal-emotional problems and suicidal ideation, as observed in adult studies. We also examined whether age moderated the relationship between competence and help-seeking. Two hundred and seventeen adolescents completed measures of emotional competence, help-seeking, hopelessness, and social support. Results indicated that adolescents who were low in emotional competence had the lowest intentions to seek help from informal sources (i.e., family and friends) and from some formal sources (e.g., mental health professionals), and the highest intentions to seek help from no-one. There was one important age-related qualification: difficulty in identifying and describing emotions was associated with higher help-seeking intentions amongst young adolescents but lower intentions among older adolescents. Social support, hopelessness, and sex could not entirely explain these relationships. Thus, even those who had high quality social support had less intention to use it if they were low in emotional competence.