Adherence to HAART: perspectives from clients in treatment support programs

The development of highly active antiretroviral therapy (HAART) has resulted in dramatic decreases in morbidity and mortality for HIV-infected individuals. Because the long-term efficacy of HAART is dependent on near perfect adherence, many providers offer services to support adherence, including education, regimen review, counseling, and reminder tools. Little is known regarding the utilization or efficacy of these services. In this paper, we report on data collected during 32 open-ended interviews conducted with individuals receiving services through the New York State Treatment Adherence Demonstration Project. Participants in the project reported deriving benefits from a broad range of project activities. Educational efforts helped clients to recognize HIV as a manageable, rather than terminal, illness. Information and tools focused on specific regimens provided clients with concrete knowledge and skills. Effective communication with medical providers and pharmacists was facilitated by adherence staff who proactively advocated for client needs. Program-based social support was particularly valuable for many participants, helping them to retain needed motivation and strength. Educational, practical, and supportive services were all considered valuable to clients participating in adherence support programs. A mix of services may best meet the range of needs found among persons taking HAART.     

Eye remember you two: gaze direction modulates face recognition in a developmental study

The effects of gaze direction on memory for faces were studied in children from three different age groups (6-7, 8-9, and 10-11 years old) using a computerized version of a task devised by Hood, Macrae, Cole-Davies and Dias (2003). Participants were presented with a sequence of faces in an encoding phase, and were then required to judge which faces they had previously encountered in a surprise two-alternative forced-choice recognition test. In one condition, stimulus eye gaze was either direct or deviated at the viewing phase, and eyes were closed at the test phase. In another condition, stimulus eyes were closed at the viewing phase, with either direct or deviated gaze at the test phase. Modulation of gaze direction affected hit rates, with participants demonstrating greater accuracy for direct gaze targets compared to deviated gaze targets in both conditions. Reaction times (RT) to correctly recognized stimuli were faster for direct gaze stimuli at the viewing phase, but not at the test phase. The age group of participants differentially affected these measures: there was a greater hit rate advantage for direct gaze stimuli in older children, although RTs were less affected by age. These findings suggest that while the facilitation of face recognition by gaze direction is robust across encoding and recognition stages, the efficiency of the process is affected by the stage at which gaze is modulated.     

Clustering, seriation, and subset extraction of confusion data

The study of confusion data is a well established practice in psychology. Although many types of analytical approaches for confusion data are available, among the most common methods are the extraction of 1 or more subsets of stimuli, the partitioning of the complete stimulus set into distinct groups, and the ordering of the stimulus set. Although standard commercial software packages can sometimes facilitate these types of analyses, they are not guaranteed to produce optimal solutions. The authors present a MATLAB *.m file for preprocessing confusion matrices, which includes fitting of the similarity-choice model. Two additional MATLAB programs are available for optimally clustering stimuli on the basis of confusion data. The authors also developed programs for optimally ordering stimuli and extracting subsets of stimuli using information from confusion matrices. Together, these programs provide several pragmatic alternatives for the applied researcher when analyzing confusion data. Although the programs are described within the context of confusion data, they are also amenable to other types of proximity data.     

Assessing family-of-origin functioning in Mexican American adults: retrospective application of the family environment scale

Although both theoretical and empirical literature suggests that individuals' family-of-origin experiences affect subsequent relationship functioning as adults, few studies have examined the appropriateness of family assessment techniques when applied retrospectively for use in either theory development or clinical applications. This study examined psycho-metric characteristics of the Family Environment Scale (FES) when used retrospectively with Mexican Americans to assess their families-of-origin. Findings provided qualified support for the internal consistency of the FES and showed significant mean profile differences for this population across gender and when compared to the normative sample for this measure. Retrospective reports on the FES related to independent measures of family history of distress and, to a lesser extent, with current relationship functioning, providing preliminary support for the criterion-related validity of the FES when adapted for retrospective assessment. Limitations and implications of findings for further research are discussed.     

Incremental validity analyses of the violence risk appraisal guide and the psychopathy checklist: screening version in a civil psychiatric sample

This study compares two instruments frequently used to assess risk for violence, the Violence Risk Appraisal Guide (VRAG) and the Psychopathy Checklist: Screening Version (PCL:SV), in a large sample of civil psychiatric patients. Despite a strong bivariate relationship with community violence, the VRAG could not improve on the predictive validity of the PCL:SV alone, even though the VRAG includes several ostensible violence risk factors other than psychopathy. Moreover, incremental validity analyses indicated that the remaining VRAG items accounted for little or no variance in violent outcomes once psychopathy scores were controlled. Conversely, the PCL:SV continued to account for considerable variance after controlling for the VRAG. These results reflect the limited validity of the VRAG items in civil psychiatric samples beyond the variance that is explained by the PCL:SV alone.     

Spiritual care as eHealth: a systematic review

A systematic review was undertaken of the literature on the use of the Internet and other information and communication technologies (ICT's) in the provision and support of religious and spiritual care in healthcare. Indexes such as Medline, PsychoINFO and Proquest Religion were searched. The review found little systematic study of the effectiveness of the Internet and other ICT's in religious and spiritual care. It is believed that the results of this review provide a basis for promise spiri care in the further explora of the potential and of ICT's for tual healthcare.     

Observing attachment behavior in couples: the Adult Attachment Behavior Q-Set (AABQ)

Knowledge as to how attachment behavior is observable in couple interaction can be very useful to clinicians who use attachment theory or related theories to guide their work with couples. The development of the Adult Attachment Behavior Q-Set (AABQ), a 100-item Q-sort designed to be consistent with Main's Adult Attachment Interview (AAI) coding system, is described. Videotaped discussions were coded for a sample of 28 couples. The majority of the couples were married and had sought therapy for couple problems. Reliability of coding was adequate. Evidence for validity was promising, with a match of 84% between the AAI and AABQ for secure versus insecure, and 70% for the three categories of secure, dismissing, and preoccupied. Even though additional reliability and validity information are needed for the AABQ, it holds promise for providing insights into couple dynamics that could be useful in guiding interventions and in evaluating the outcome of couple therapy.     

Considering rational self-interest as a disposition: organizational implications of other orientation

In contrast with major theories of attitudes and behavior, the authors propose that individuals are not equally motivated to pursue their self-interests. The authors show that differences in other orientation affect the extent to which actions and attitudes reflect self-interested calculation (instrumental rationality) and the extent to which beliefs represent their external environment (epistemic rationality). These differences have consequences for processes underlying a wide range of attitudes and behavior typically assumed to be rationally self-interested. Thus, the authors' model exposes a common explanation for diverse organizational phenomena. It also clarifies inconsistencies surrounding the validity of certain attitudinal and motivational models, the relationship between job attitudes and actions, cross-cultural differences in attitudes and behavior, escalation of commitment, and the relationship between chief executive officer characteristics and organizational performance.     

The end of the world as we know it (and I feel fine): comment on Erard

We review Erard's (this issue) article. We laud him for the measured tone and carefully reasoned position that is taken. Although his main point that The Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the new American Psychological Association (APA) Ethics Code (2002) need not be seen as disasters for the practice of assessment, we pose several problems with his analysis. In particular, we argue that although his point that test security is not airtight at present is well taken, nonetheless, it is important to set the bar as high as possible to limit breaches in security. Although Erard is correct that more complex instruments may withstand attempts to manipulate the results, many smaller or more focused instruments may be irrevocably damaged. Furthermore, the release of raw test data can have a deleterious effect in the clinical arena, especially in instances in which it could be subject to misinterpretation and misuse. Finally, we criticize the APA for subjugating the interests of the profession to political expediency.     

Time perception with and without a concurrent nontemporal task

Prospective time estimates were obtained from human subjects for stimulus durations ranging from 2 to 23 sec. Presence and absence of a concurrent nontemporal task was manipulated within subjects in three experiments. In addition, location of the task within temporal reproduction trials and psychophysical method were varied between groups in Experiments 2 and 3, respectively. For long-duration stimuli, the results of all three experiments conformed to results in the literature, showing a decrease in perceived duration under concurrent task conditions, in accord with attentional resource allocation models of timing. The effects of task location and psychophysical method on time estimates were also compatible with this analysis. However, psychophysical functions obtained under task conditions were fit well by power functions, an outcome that would not be anticipated on the basis of attention theory. The slopes of the functions under no-task conditions were steeper than those under task conditions. The data support the perceptual hypothesis that different sources of sensory input mediate timing under task and no-task conditions.