A three city comparison of the public's knowledge and attitudes about AIDS

A survey of knowledge, beliefs and attitudes about AIDS was administered simultaneously in San Francisco, New York and London to a total of 399 persons. The aim was to investigate how such knowledge and attitudes may he influenced by social and cultural contexts, as well as by disease epidemiology. Across all samples of the general public (excluding risk group members) in the three cities, general fear of AIDS and anti-gay attitudes were significantly negatively correlated with knowledge about AIDS. In the London sample, general fear of AIDS and anti-gay attitudes were significantly and positively associated with both sexual and general health behavior change. Only sexual behavior change, however, was significantly correlated with general fear of AIDS and anti-gay variables for the New York sample. Neither of these variables was significantly associated with behavior change of any kind in the San Francisco sample. We accounted for these inter-city differences by proposing a four-stage model of public response to an epidemic over time. Our data support the need for specific programs aimed at the general public that take into account sociocultural and AIDS epidemiologic differences across different sociocultural contexts.     

Coping with dental treatment correlates of dispositional and domain specific monitoring and blunting

Abstract

Relations between coping style and several variables on an intermediary level were studied in a group of dentally anxious patients (N = 68) awaiting dental treatment. Monitoring was found to be positively related to the need of information: General dispositional monitoring was the best predictor of the need of information in case of more distant threat, whereas domain specific monitoring was the best predictor in case of imminent threat. Furthermore. dental trait anxiety was strongly related to early anticipatory tension, degree of anticipatory tension at several moments in time, and tension during treatment as perceived by the dentist, thereby overshadowing the weaker effects of coping style. Domain specific blunting was negatively related to desires for informational adaptations in the waiting room, and to question proneness as perceived by the dentist during treatment. It is concluded that, in order to study further effects of coping style, a sample homogeneous with respect to domain specific anxiety is needed.     

The Miscarriage Experience: More Than Just a Trigger to Psychological Morbidity?

Most quantitative research considers miscarriage a trigger to grief, anxiety and depression. The present qualitative study involved in depth interviews with a heterogeneous sample of 13 women who had experienced a miscarriage up to five weeks previously. The women described their experiences using a range of themes which were conceptualised into three stages: turmoil, adjustment and resolution. For the majority, the turmoil stage was characterised by feelings of being unprepared and negative emotions. Some women who had had an unwanted pregnancy described their shock at the physical trauma of miscarriage but described the experience as a relief. The women then described a period of adjustment involving social comparisons, sharing and a search for meaning. The latter included a focus on causality which left a minority, particularly those who had had previous miscarriages, feeling frustrated with the absence of a satisfactory medical explanation. The final resolution stage was characterised by a decline in negative emotions, a belief by some that the miscarriage was a learning experience and the integration of the experience into their lives. This resolution seemed more positive for those with children and more negative if the miscarriage was not their first. Rather than being a trigger to psychological morbidity a miscarriage should be conceptualised as a process involving the stages of turmoil, adjustment and resolution. Miscarriage could also be considered a pivotal point in the lives of many women resulting in the reassessment of both their past and future experiences.     

Randomised trial of expressive writing for distressed metastatic breast cancer patients

Women with metastatic breast cancer and significant psychological distress (N?=?87) were assigned randomly to engage in four home-based sessions of expressive writing or neutral writing. Women in the expressive writing group wrote about their deepest thoughts and feelings regarding their cancer, whereas women in the neutral writing group wrote about their daily activities in a factual manner. No statistically significant group differences in existential and psychological well-being, fatigue and sleep quality were found at 8-weeks post-writing. However, the expressive writing group reported significantly greater use of mental health services during the study than the neutral writing group (55% vs. 26%, respectively; p?<?0.05). Findings suggest that expressive writing may improve the uptake of mental health services among distressed cancer patients, but is not broadly effective as a psychotherapeutic intervention.     

Examination stress and changes in mood and health related behaviours

Abstract

The present exploratory study evaluated the effect of stress (an examination period) on changes in mood and health related behaviours. 83 medical students completed measures of mood and health related bchaviours at baseline and four weeks later either during their examinations period (the stress condition) or after a comparative control period (the control condition). All subjects also completed ratings of stress mediating variables: social support, perceived control and coping style at baseline. The results showed deterioration in mood in terms of increases in depression and anxiety and changes in health related behaviours in terms of increased numbers of subjects who identified thcmsehes as smokers, and dcmascs in alcohol consumption, exercise and food intake in subjects in the stress condition. The results also suggest that social support moderated the effects of the examination stress and was related to greater decreases in smoking, decrcases in alcohol craving and increases in eating behaviour. In addition, an avoidance coping style (problem avoidance, wishful thinking) was related to greater decreases in eating behaviour. 'Ihe nsults an discussed in the context of the stress/illness link and the role of behavioural change.     

The Relationship Between Deployment and Turnover in Australian Navy Personnel

Increases in the frequency of operations tempo have focused attention on the relationship between deployment and separation from military service. This retrospective study explored the association between deployment and turnover over a 10-year period in Royal Australian Navy (RAN) personnel. Participants were 2355 males who served in the RAN during the period of the 1991 Gulf War (August 1990–September 1991); approximately half had been deployed to that conflict. Data were collected 10 years later as part of the Australian Gulf War Veterans' Health Study. During that 10-year period, 61% of participants left the RAN. The likelihood of separation decreased as number of deployments increased even when controlling for age, rank, and length of service. Personnel deployed to the 1991 Gulf conflict did not have a significantly higher risk of separation. The results provide evidence that deployment is not necessarily a risk factor for separation.     

Neurobiological Correlates of Autism: A Review of Recent Research

This review paper integrates recent structural and functional imaging, postmortem, animal lesion, and neurochemical research about the pathophysiology of autism. An understanding of the neurobiological correlates of autism is becoming increasingly important as more children are diagnosed with the condition and funding for well-targeted interventions increases. Converging evidence suggests that autism involves abnormalities in brain volume, neurotransmitter systems, and neuronal growth. In addition, evidence firmly links autism with abnormalities in the cerebellum, the medial temporal lobe, and the frontal lobe. Potential implications of these findings and suggestions for future research are reviewed.     

Book Review

Performance-based measures and ratings of executive functions were examined in a sample of adolescents with attention deficit/hyperactivity disorder (ADHD) and comparison controls. Performance-based measures of executive function included inhibition, working memory, set shifting, and planning, and ratings of these same executive functions were completed by parents and teachers. Adolescents with ADHD demonstrated lower executive function performance than controls and displayed elevated ratings on the executive function ratings by parents and teachers. Significant associations were obtained between the performance-based measures and the parent and teacher ratings, but each measure was not uniquely associated with its respective scale on the rating scales. When performance-based measures and ratings were examined as predictors of ADHD status, the parent and teacher ratings entered as significant predictors of ADHD status. Further commonality analyses indicated that performance-based measures accounted for little unique variance in predicting ADHD status and also displayed little overlap with the behavioral ratings. These findings highlight the diagnostic utility of behavioral ratings of executive function in predicting ADHD status; however, behavioral ratings should not be assumed to be a proxy for performance on measures of executive function in clinical practice.     

Processing Speed in Children With Attention Deficit/Hyperactivity Disorder,Inattentive Type

Attention Deficit/Hyperactivity Disorder (ADHD) is among the most common and most often reconceptualized neurobehavioral disorders of childhood. In the most recent DSM-IV, a primarily inattentive subtype of ADHD (AD) has again been identified. This study explores the neuropsychological profile of this group of children. Eighty-two children referred for school-related problems participated. Twenty-five met criteria for AD; 52 met criteria for reading disability (RD); 9 were comorbid for RD and AD. AD children performed poorly on measures of information processing speed. Children with comorbid AD/RD were distinguishable from those with RD on speed of processing measures only. Vulnerability to information processing load may be at the root of many of the behavioral manifestations of AD.     

A Practice-Based Approach to Group Identification in Nonverbal Learning Disorders

Evidence-based practice, the rigorous conduct of clinical analysis and intervention, includes practice-based evidence. Here, practice data were the source of three “clinical portraits” used for exploratory analysis of an array of cognitive and social problems in 30 children whose neurobehavioral profiles fulfilled psychometric criteria for a nonverbal learning disability (NLD). Qualitative analysis of the children's academic and adjustment difficulties revealed patterns of dissociable deficits. These findings argue for at least three groups within the NLD construct. Identifying such subgroups is of practical importance: More precise characterization of neuropsychological competencies leads to improved interventions and better outcomes.