Editorial: Psychosocial Aspects of AIDS

This article comprises two parts.

In the first part, some general issues related to research training are discussed, including the “Scientist-Practitioner Model,” training for basic and applied research, differences between the USA and Europe at various levels of training, and types or areas of research students should be trained for.

In the second part, seven specific objectives of research training are discussed. These objective are (a) learning to write a review of the research literature, (b) learning to critically evaluate a journal article, (c) learning to plan and carry out a specific health psychology research study, (d) learning to communicate, (e) learning to enhance co-operation of professionals in the field, (f) learning to raise funds, (g) learning to respect ethical issues.     

The relationship of social support to physical and psychological aspects of AIDS

Abstract

This study explored the social support networks of 50 homosexual males with Acquired Immune Deficiency Syndrome (AIDS). Data gathered by self report questionnaires and medical records included diagnosis, number of medical symptoms, sociodemographics, extensive information about social support networks, mood state and physical health status. Variables associated with good psychological and physical adaptation included satisfaction with support, instrumental support and emotional support. Results of this study conflict with previous studies in that worse physical condition was not positively associated with satisfaction with support, was related to less instrumental support and was not associated with increased quantitative support. The measures of satisfaction with support, instrumental support and emotional support were all quite high, even though network size was small.     

Psychological models in predicting uptake of prenatal screening

Abstract

The purpose of the current study was to determine which psychological models are most useful in predicting uptake of a prenatal screening test, maternal-serum alphafetoprotein screening for spina bifida and Down's syndrome. 1000 women eligible for the test completed standardised self-report questionnaires at two routine clinic visits to an antenatal clinic prior to the time when the test could take place. 902 underwent the screening test; 51 declined the test; and 47 did not undergo the test, giving no reason for this to staff. Knowledge of the test, the subjective expected utility attached to the test, and attitudes to doctors and medicine were all significant predictors of uptake behaviour. Results of a discriminant function analysis demonstrated distinct psychological processes underlying each of these three uptake behaviours, explaining 21% of the variance in uptake of screening. If uptake of screening is examined not as a dichotomous variable but as a group of behaviours, predictive models are identified accordingly. This would lead to rnodels of health-related behaviours as a heterogeneous rather than homogeneous phenomena, predicted and influenced by different causes.     

Talking about sex after cancer: A discourse analytic study of health care professional accounts of sexual communication with patients

There is consistent evidence that health care professionals (hcps) are not addressing the sexual information and support needs of people with cancer. Thirty-eight Australian hcps across a range of professions working in cancer care were interviewed, to examine constructions of sexuality post-cancer, the subject positions adopted in relation to sexual communication, and the ways in which discourses and subject positions shape information provision and communication about sexuality. Participants constructed sexual changes post-cancer in physical, psychological and relational terms, and positioned such changes as having the potential to significantly impact on patient and partner well-being. This was associated with widespread adoption of a discourse of psychosocial support, which legitimated discussion of sexual changes within a clinical consultation, to alleviate distress, dispel myths and facilitate renegotiation of sexual practices. However, this did not necessarily translate into patient-centred practice outcomes, with the majority of participants positioning personal, patient-centred and situational factors as barriers to the discussion of sex within many clinical consultations. This included: absence of knowledge, confidence and comfort; positioning sex as irrelevant or inappropriate for some people; and limitations of the clinical context. In contrast, those who did routinely discuss sexuality adopted a subject position of agency, responsibility and confidence.     

Leading Military Teams to Think and Feel: Exploring the Relations Between Leadership,Soldiers' Cognitive and Affective Processes,and Team Effectiveness

The purpose of this study was to examine the relationships between leadership and military teams' affective and cognitive processes and the subsequent links between these processes and team effectiveness. Soldiers (N = 148) from 32 teams completed questionnaires assessing these variables. Hierarchical linear modeling was used to analyze the data. Transformational leadership was positively associated with cognitive and affective processes, but only active management-by-exception leadership was related to negative affect. Neither form of management-by-exception leadership related to cognitive processes. Positive affect, negative affect, and cognitive processes were all related to team viability. Finally, some mediation effects were observed. Implications of the results for developing leadership in military teams are drawn.     

Understanding countertransference and object relations in the process of nursing drug-dependent patients

In psychiatric nursing, transference and countertransference dynamics are generally ignored. This paper is an attempt to examine how the transference and countertransference dynamics influenced the nurse-patient relationships on an in-patient drug-dependency unit, and how an understanding of transference was found to be helpful.     

Marital Estrangement,Positive Affect,and Locus of Control Among Spouses of Workaholics and Spouses of Nonworkaholics: A National Study

This study compared a sample of spouses of workaholics and spouses of nonworkaholics on ratings of marital estrangement, positive feelings toward husband, and locus of control. A random national sample of 326 participants drawn from the membership list of the American Counseling Association was surveyed. Spouses of workaholics reported greater marital estrangement and less positive affect towards husbands and higher external locus of control than spouses of nonworkaholics. These findings were the first empirical results to corroborate clinical and case study reports. Clinical implications of these findings are also presented.     

Clinical strategies to promote compliance

Abstract

This article focuses on the need for effective client management throughout the therapeutic process. The appropriate and astute use of clinical strategies can promote client compliance with treatment and counteract the possibility of client dissatisfactions and ethical/legal complaints. This article offers a systemic explanation of compliance, identifies five major clinical strategies to foster treatment adherence, and discusses the need for clinical judgments that fulfill ethical/legal obligations while promoting quality care.     

Introducing Spirituality into Psychiatric Care

Spirituality is important to many psychiatric patients, and these patients may be moved toward recovery more effectively if their spiritual needs are addressed in treatment. This, however, is rarely given expression in the psychiatric services of teaching hospitals. In order to develop this potential area of improved care, we (1) evaluated the differential attitudes of patients and psychiatric trainees toward the value of spirituality in the recovery process, (2) established a program of group meetings conducted by psychiatric residents and staff where patients can discuss how to draw on their spirituality in coping with their problems, and (3) established related training experiences for psychiatric residents. The results and implications of these three initiatives are presented.     

Computerized adaptive assessment of personality disorder: introducing the CAT-PD project

Assessment of personality disorders (PD) has been hindered by reliance on the problematic categorical model embodied in the most recent Diagnostic and Statistical Model of Mental Disorders (DSM), lack of consensus among alternative dimensional models, and inefficient measurement methods. This article describes the rationale for and early results from a multiyear study funded by the National Institute of Mental Health that was designed to develop an integrative and comprehensive model and efficient measure of PD trait dimensions. To accomplish these goals, we are in the midst of a 5-phase project to develop and validate the model and measure. The results of Phase 1 of the project--which was focused on developing the PD traits to be assessed and the initial item pool--resulted in a candidate list of 59 PD traits and an initial item pool of 2,589 items. Data collection and structural analyses in community and patient samples will inform the ultimate structure of the measure, and computerized adaptive testing will permit efficient measurement of the resultant traits. The resultant Computerized Adaptive Test of Personality Disorder (CAT-PD) will be well positioned as a measure of the proposed DSM-5 PD traits. Implications for both applied and basic personality research are discussed.