A longitudinal evaluation of a social support model of medication adherence among HIV-positive men and women on antiretroviral therapy.

Nonadherence in the management of chronic illness is a pervasive clinical challenge. Although researchers have identified multiple correlates of adherence, the field remains relatively atheoretical. The authors propose a cognitive-affective model of medication adherence based on social support theory and research. Structural equation modeling of longitudinal survey data from 136 mainly African American and Puerto Rican men and women with HIV/AIDS provided preliminary support for a modified model. Specifically, baseline data indicated social support was associated with less negative affect and greater spirituality, which, in turn, were associated with self-efficacy to adhere. Self-efficacy to adhere at baseline predicted self-reported adherence at 3 months, which predicted chart-extracted viral load at 6 months. The findings have relevance for theory building, intervention development, and clinical practice.     

Destructive Criticism Revisited: Appraisals,Task Outcomes,and the Moderating Role of Competitiveness

Destructive criticism is negative feedback that is inconsiderate in style and content, which exists at the intersection of performance feedback and interpersonal mistreatment. The current research integrates these literatures with an investigation of the effects of destructive versus constructive criticism from a co‐worker on recipients' relational appraisals, emotions, and task outcomes. Drawing from theorising about cognitive appraisals after personal affronts, we first propose that those who experience destructive criticism are more likely than those who experience constructive criticism to (a) perceive that the feedback‐giver intended to harm them, (b) blame the feedback‐giver, (c) distrust the feedback‐giver, and (d) feel anger. Second, with regard to task‐related outcomes, we extend research on trait moderators of feedback responses to the study of destructive criticism. We draw from feedback intervention theory ( Kluger & DeNisi, 1996 ) regarding how feedback may alter the locus of attention to be either self‐ or task‐focused, and investigate a trait that may shift one's attention to the self after destructive criticism. Specifically, we proposed that trait competitiveness—i.e. a desire to win over others—interacts with type of criticism to predict task‐related outcomes. The results of two experiments—a scenario study and a behavioral experiment—provide support for our arguments.     

Abuse, health locus of control, and perceived health among HIV-positive women.

This study of 230 predominantly poor Hispanic and African American women aged 25 to 61 years living with HIV/AIDS in New York City revealed high levels of both sexual (39%) and physical (44%) trauma before the age of 16. Both types of early trauma were correlated with later trauma, and all forms of trauma were significantly associated with current perceived health. In multivariate analyses controlling for relevant covariates, the Powerful Others and Internal Control subscales of the Multidimensional Health Locus of Control Scales (K. A. Wallston, B. S. Wallston, & R. DeVellis, 1978) acted as independent predictors of perceived health rather than (as hypothesized) mediators of the association between trauma and perceived health. Findings underscore the importance of addressing trauma and perceptions of control over one's physical health in the provision of health services to HIV-positive women.     

Racism and Feminism: Is Women's Liberation for Whites Only?

The women's movement is often described as „white middle-class” despite the fact that black women not only are more oppressed than whites, but are more favorable to the goals of the women's movement. Black women, especially those identified with the black rights movement, fear that feminism will split their ranks and divert public attention. Black women's problems also differ from those of whites in other ways, mostly related to the fact that their economic position is much worse than that of either white women or black men. Moreover, blacks hesitate to join organizations they perceive as white dominated. It is argued that both black and women's rights movements need each others' support and that black women cannot achieve equality unless both movements succeed     

Attachment theory and systemic practice: research update

Attachment theory offers a way of thinking about the dyadic relationships within the family system. Family systems theory and therapy can contribute to attachment theory, as dyadic relationships do not exist in isolation but within the context of other relationships. Research at the interface between systemic practice and attachment theory is reviewed with examination of the central role they may play together in the developing understanding of family relationships.