Perceived discrimination and mental health symptoms among Black men with HIV

People living with HIV (PLWH) exhibit more severe mental health symptoms, including depression and posttraumatic stress disorder (PTSD) symptoms, than do members of the general public. We examined whether perceived discrimination, which has been associated with poor mental health in prior research, contributes to greater depression and PTSD symptoms among HIV-positive Black men who have sex with men (MSM), who are at high risk for discrimination from multiple stigmatized characteristics (HIV-serostatus, race/ethnicity, sexual orientation). A total of 181 Black MSM living with HIV completed audio computer-assisted self-interviews (ACASI) that included measures of mental health symptoms (depression, PTSD) and scales assessing perceived discrimination due to HIV-serostatus, race/ethnicity, and sexual orientation. In bivariate tests, all three perceived discrimination scales were significantly associated with greater symptoms of depression and PTSD (i.e., reexperiencing, avoidance, and arousal subscales; all p values < .05). The multivariate model for depression yielded a three-way interaction among all three discrimination types (p < .01), indicating that perceived racial discrimination was negatively associated with depression symptoms when considered in isolation from other forms of discrimination, but positively associated when all three types of discrimination were present. In multivariate tests, only perceived HIV-related discrimination was associated with PTSD symptoms (p < .05). Findings suggest that some types of perceived discrimination contribute to poor mental health among PLWH. Researchers need to take into account intersecting stigmata when developing interventions to improve mental health among PLWH.     

An Examination of the Association between Difficulties with Emotion Regulation and Dating Violence Perpetration

The perpetration of aggression in dating relationships is a prevalent problem among college students. Research that examines factors related to perpetrating dating violence is needed, as this could help guide prevention programming. This study examined how emotion regulation is related to dating violence perpetration among male and female college students (N = 440). Findings showed that the association between broad difficulties with emotion regulation, as well as more specific emotion regulation problems, were associated with dating violence perpetration and could differentiate individuals who had perpetrated and not perpetrated aggression. These findings varied slightly depending on the gender of the perpetrator and the type of aggression examined. Implications of these findings for prevention programs and future research are discussed.     

LGB-Affirmative Cognitive Behavioral Treatment for Social Anxiety: A Case Study Applying Evidence-Based Practice Principles

Guided by the American Psychological Association's principles of evidence-based practice, this article reviews a single-case treatment outcome study whereby a client characteristic, sexual identity, was integrated into the assessment and treatment of social anxiety symptoms. The case involved a young adult European-American male who presented to a training clinic with a primary diagnosis of social anxiety disorder as well as secondary symptoms of excessive worry and concerns of sexual identity confusion. Recent evidence suggests that gay men report more symptoms of social anxiety when compared to heterosexual men, and those who make more efforts to conceal their sexual identity experience increased anxiety and have greater difficulty committing to a personal identity. Further, it has been hypothesized that fear of rejection from heterosexual individuals underlies this anxiety. The client attended 50 sessions over the course of 18 months. Treatment progress was assessed via self-report questionnaires assessing social anxiety and worry. Consistent with principles of evidence-based practice, a cognitive behavioral treatment protocol was employed at the outset of therapy and resulted in a decline in the client's social anxiety scores. However, once the case conceptualization and treatment focus shifted to focus on sexual identity, his scores continued to decline at an even steeper rate. He ultimately came to identify himself as having a same-sex sexual orientation, began living his life in a manner consistent with that identification, and reported a number of positive outcomes at termination of therapy. Implications for treatment of social anxiety in sexual minorities are discussed.     

The pattern of subjective anxiety during in-session exposures over the course of cognitive-behavioral therapy for clients with social anxiety disorder

Exposure-based therapies are efficacious treatments for social anxiety disorder (i.e., Gould et al., 1997). Much of the theory behind these treatments is derived from Foa and colleagues' (Foa, Huppert, & Cahill, 2005; Foa & Kozak, 1986) work on emotional processing. However, there has been little research examining individual differences in emotional processing patterns within and between treatment sessions among clients with social anxiety disorder. This study utilized longitudinal data analytic methods to examine changes in subjective anxiety during the first 3 exposure sessions in group and individual cognitive-behavioral therapy for social anxiety disorder. The results of this study provide preliminary evidence that, although anxiety generally decreases across exposures, some individuals experience considerable fluctuations in anxiety during a single exposure. Although anxiety during the first exposure was not significantly related to outcome, the relationship between anxiety during exposure and outcome became stronger during subsequent exposures. Overall, this study highlights the need to conduct more fine-grained analyses to better understand the mechanisms underlying exposure-based therapies for social anxiety disorder.     

Shifting attention into and out of objects: evaluating the processes underlying the object advantage

Visual cuing studies have been widely used to demonstrate and explore contributions from both object- and location-based attention systems. A common finding has been a response advantage for shifts of attention occurring within an object, relative to shifts of an equal distance between objects. The present study examined this advantage for within-object shifts in terms of engage and disengage operations within the object- and location-based attention systems. The rationale was that shifts of attention between objects require object-based attention to disengage from one object before shifting to another, something that is not required for shifts of attention within an object or away from a location. One- and two-object displays were used to assess object-based contributions related to disengaging and engaging attention within, between, into, and out of objects. The results suggest that the "object advantage" commonly found in visual cuing experiments in which shifts of attention are required is primarily due to disengage operations associated with object-based attention.     

DEVELOPMENT AND EVALUATION OF AN INFANT-CARE TRAINING PROGRAM WITH FIRST-TIME FATHERS

We evaluated the effectiveness of a multicomponent package in training infant-care skills to first-time fathers. After developing and socially validating a set of infant-care skills, we assessed the effects of training in a hospital-based program with expectant fathers (Experiment 1) and in a home-based program with fathers having varied degrees of experience with their infants (Experiment 2). In both experiments, a multiple probe design demonstrated that the training package was responsible for producing criterion performance by the expectant and first-time fathers. A 1-month generalization probe in Experiment 1 showed that the effects transferred across training conditions (training doll to human infant) and settings (hospital to home). An increase in the number of infant-stimulation activities performed by fathers was also observed in both experiments.     

Exposure to community violence and social support as predictors of anxiety and social and emotional behavior among African American children

We examined the effects of exposure to violence and social support on self-reported state and trait anxiety and parental rated problem behaviors among school-aged African-American children in low and high violence areas. Ninety-seven (97) fourth through sixth graders and their parents were interviewed about exposure to community violence, social support, and state and trait anxiety. Results indicate that trait anxiety was correlated positively with exposure to violence and negatively with social support. State anxiety was correlated negatively with family social support. Problem behaviors were correlated negatively with family support and income. Hierarchial multiple regression analyses indicated that children's reports of their exposure to community violence continued to explain significant variability in trait anxiety, and problem behavior after controlling for both income and social support measures. Social support from peers, family and teachers played differential roles in predicting problem behaviors among children from high and lower violence areas. These findings suggest that in planning intervention programs for children exposed to violence, greater attention to empowering parents to support their children, to fostering peer group support, and to bolstering teacher support may be useful, but attention to the underlying socio-political causes of violence exposure is essential.     

PHYSICAL AND PSYCHIATRIC CORRELATES OF GENDER DISCRIMINATION

We tested the model that sexist discrimination, measured by the Schedule of Sexist Events (SSE), would account for additional variance in women's physical and psychiatric symptoms, above and beyond that accounted for by generic stressors. A series of hierarchical regression analyses, predicting symptoms on 10 different symptom outcome measures from generic stress and sexist stress (discrimination) were conducted, with the generic stressors entered on the first step and sexist discrimination on the second. Results revealed that sexist discrimination contributed significantly to the variance in women's symptoms, accounting for additional variance in those symptoms. Furthermore, sexist discrimination accounted for more of the variance than did generic stressors in premenstrual, depressive, obsessive-compulsive, somatic, and total psychiatric and physical symptoms. These findings varied with the age and ethnicity of the women and with the symptom measure used, but nonetheless suggest that sexist discrimination plays a significant role in women's most prevalent symptoms.     

Using Social Cognition and Persuasion to Promote Energy Conservation: A Quasi-Experiment1

A quasi-experiment was conducted to determine if the effectiveness of the R.C.S. Home Energy Audit Program could be improved by training auditors to use social-psychological principles during the audit procedure. Nine experienced home energy auditors attended two 1-day workshops in which they were trained to: (a) communicate vividly; (b) personalize their recommendations to homeowners; (c) induce commitment; and (d) frame their recommendations in terms of “loss” rather than “gain”. The effectiveness of the trained auditors was compared with a control group of experienced auditors who did not receive specific training. Both telephone interview data and utility company records pointed to the success of the auditor training. In interviews, customers served by the trained auditors reported a greater likelihood of acting on the auditors' recommendations, and a large number of these customers reported applying for utility programs to finance retrofits. Utility records validated these customer claims: A significantly larger number of customers served by trained auditors actually did apply for retrofit finance programs. A longitudinal measure of actual energy consumption showed no difference between experimental and control households. Taken as a whole, these findings demonstrate the potential for using principles uncovered in the social psychological laboratory to design applied interventions.