Demonstration of an Integrated Treatment for Smoking Cessation and Anxiety Symptoms in People With HIV: A Clinical Case Study

Despite high rates of co-occurring tobacco use and anxiety symptoms and disorders among persons with HIV, evidence-based interventions for these individuals are not yet available. The present study sought to evaluate an integrated treatment model addressing smoking cessation and anxiety sypmtoms among HIV-positive smokers. Treatment was an 8-week intervention integrating a standard smoking cessation protocol (i.e., cognitive-behavioral therapy [CBT], nicotine replacement therapy) with CBT for anxiety. Inclusion criteria were 18–65 years of age, ≥ 10 cigarettes/day, State–Trait Anxiety Inventory [STAI-T] score of > 39, and moderate motivation (i.e., ≥ 5 out of 10 on a 10-point Likert scale) to quit smoking. Primary outcomes included scores on the Anxiety Sensitivity Index (ASI) and cigarettes smoked per day. Self-reported abstinence was biochemically verified by carbon monoxide breath analysis. Three male participants (mean age 49.3, SD = 9.1) completed through 2-month follow-up. At baseline all participants reported smoking an average of 20 cigarettes per day. Two participants quit smoking and maintained abstinence by the 2-month follow-up, and demonstrated a reduction in ASI scores. Participant 3 continued to smoke but at a reduced rate. Participants’ response to cognitive and behavioral strategies (e.g., creating balanced thoughts, interoceptive exposures) will be discussed. Clinical lessons learned include use of a flexible approach to cognitive restructuring, use of imaginal and in vivo exposures in session to better prepare patients for homework practice, and flexibility in delivering the treatment in an individual or group format. This clinical presentation provides preliminary support for the feasibility and initial effectiveness of an integrated treatment to reduce anxiety symptoms and aid in smoking cessation in anxious, HIV-positive smokers.     

The role of the Five Factor Model of personality in the perceptions of negative and positive forms of work–nonwork spillover: A meta-analytic review

The present meta-analysis examines the relationships between the Five Factor Model (FFM) of personality and negative and positive forms of work–nonwork spillover (e.g., work-family conflict and facilitation). Results, based on aggregated correlations drawn from 66 studies and 72 independent samples (Total N = 28,127), reveal that the FFM is predictive of work–nonwork spillover. More specifically, meta-analytic structural equation modeling indicated that extraversion (β = −.08), agreeableness (β = −.06), conscientiousness (β = −.13), and neuroticism (β = .29) are related to negative work–nonwork spillover, while extraversion (β = .27), agreeableness (β = .11), conscientiousness (β = .12), and openness to experience (β = .20) are related to positive work–nonwork spillover. FFM personality variables were equally predictive of both directions of spillover (i.e., work-to-nonwork and nonwork-to-work). Collectively these results suggest a moderate amount of variance in negative (R² = .15) and positive (R² = .18) work–nonwork spillover is accounted for by personality.     

Judging a book by its cover and its contents: the representation of polysemous and homophonous meanings in four-year-old children

Unlike homophonous meanings, which are semantically unrelated (e.g., the use of bat to refer to a baseball bat and a flying rodent), polysemous meanings are systematically related to one another (e.g., the use of book, CD, and video to refer to physical objects, as in ‘the leather book’, or to the intellectual content they contain, as in ‘the profound book’). But do perceived relations among polysemous meanings reflect the presence of generative lexical or conceptual structures that permit the meanings of these words to shift? If so, these structures may also support children’s early representations of polysemous meanings. In four studies, we demonstrate (1) that four-year-old children can understand both the concrete and abstract meanings of words like book, (2) that when taught a novel label for one of these meanings, children can readily understand an extension of that label to the other meaning, and (3) that extension does not occur between two homophonous meanings, which share a common phonological form but are otherwise unrelated. We conclude that the polysemous meanings of words like book rely on a common representational base early in development, and suggest that this may be the result of foundational, generative properties of the lexicon or conceptual system.     

Client and therapist variability in clients' perceptions of their therapists' multicultural competencies

This study examined therapist differences in their clients' ratings of their therapists' multicultural competencies (MCCs) as well as tested whether therapists' who were rated as exhibiting more MCCs also had clients who had better therapy outcomes (N = 143 clients and 31 therapists). All clients completed at least 3 sessions. Results demonstrated that therapists accounted for less than 1% of the variance in their clients' Cross-Cultural Counseling Inventory–Revised (CCCI-R; T. D. LaFromboise, H. L. K. Coleman, & A. Hernandez, 1991) scores, suggesting that therapists did not differ in terms of how clients rated their MCCs. Therapists accounted for approximately 8.5% of the variance in therapy outcomes. For each therapist, their clients' CCCI-R scores were aggregated to provide an estimate of therapists' MCCs. Therapists' MCCs, based on aggregate CCCI-R scores, did not account for the variability in therapy outcomes that were attributed to them. Additionally, clients' race/ethnicity, therapists' race/ethnicity, or the interaction of clients'–therapists' race/ethnicity were not significantly associated with clients' perceptions of their therapists' MCCs.     

Mapping the moral domain

The moral domain is broader than the empathy and justice concerns assessed by existing measures of moral competence, and it is not just a subset of the values assessed by value inventories. To fill the need for reliable and theoretically grounded measurement of the full range of moral concerns, we developed the Moral Foundations Questionnaire on the basis of a theoretical model of 5 universally available (but variably developed) sets of moral intuitions: Harm/Care, Fairness/Reciprocity, Ingroup/Loyalty, Authority/Respect, and Purity/Sanctity. We present evidence for the internal and external validity of the scale and the model, and in doing so we present new findings about morality: (a) Comparative model fitting of confirmatory factor analyses provides empirical justification for a 5-factor structure of moral concerns; (b) convergent/discriminant validity evidence suggests that moral concerns predict personality features and social group attitudes not previously considered morally relevant; and (c) we establish pragmatic validity of the measure in providing new knowledge and research opportunities concerning demographic and cultural differences in moral intuitions. These analyses provide evidence for the usefulness of Moral Foundations Theory in simultaneously increasing the scope and sharpening the resolution of psychological views of morality.     

A bad taste in the mouth: gustatory disgust influences moral judgment

Can sweet-tasting substances trigger kind, favorable judgments about other people? What about substances that are disgusting and bitter? Various studies have linked physical disgust to moral disgust, but despite the rich and sometimes striking findings these studies have yielded, no research has explored morality in conjunction with taste, which can vary greatly and may differentially affect cognition. The research reported here tested the effects of taste perception on moral judgments. After consuming a sweet beverage, a bitter beverage, or water, participants rated a variety of moral transgressions. Results showed that taste perception significantly affected moral judgments, such that physical disgust (induced via a bitter taste) elicited feelings of moral disgust. Further, this effect was more pronounced in participants with politically conservative views than in participants with politically liberal views. Taken together, these differential findings suggest that embodied gustatory experiences may affect moral processing more than previously thought.     

Measurement of Religiosity/Spirituality in Adolescent Health Outcomes Research: Trends and Recommendations

The relationship between religious/spiritual (R/S) factors and adolescent health outcomes has been studied for decades; however, the R/S measurement tools used may not be developmentally relevant for adolescents. A systematic literature review was conducted to review and evaluate trends in measuring R/S in adolescent health outcomes research. In this review a total of 100 articles met criteria for inclusion. Relatively few (n = 15) included adolescent-specific R/S measures or items accounting for developmentally relevant issues such as parental religiosity or age-appropriate language. Future R/S and health research with adolescents would be strengthened by incorporating developmentally relevant R/S measurement tools, psychometrics, and multidimensional measures.     

UNDERSTANDING WOMEN'S RISK FOR HIV INFECTION USING SOCIAL DOMINANCE THEORY AND THE FOUR BASES OF GENDERED POWER

Theoretical models to date have fallen short of accounting for the alarming worldwide rates of HIV infection in women through heterosexual contact. In this article, social dominance theory and the four bases of gendered power—force, resource control, social obligations, and consensual ideologies—are used to organize and explain international research findings on women's risk of contracting HIV from male sexual partners. Research suggests that the four bases of gendered power contribute to women having less power than men in heterosexual relationships, resulting in challenges to preventing HIV transmission from male partners. Social dominance theory also recognizes the intersections among various group-based hierarchies, such as race and class, thereby helping explain why women of color and low-income women are disproportionately affected by HIV. The intergroup focus of social dominance theory points to gender inequality as increasing men's risk of HIV infection as well, and the construct of social dominance orientation helps to explain individual differences in HIV risk behavior. We discuss the ways the current theoretical framework can prove useful in helping to guide future research addressing the connections between power and HIV risk, including exploring mediators and links to other theoretical models. We also discuss the implications the framework has for intervention efforts aimed at reducing HIV rates worldwide, such as supporting efforts at increasing women's representation in hierarchy-enhancing positions, incorporating empowerment issues into current interventions, promoting use of female condoms, and targeting heterosexual men for interventions.     

Correlation versus causation in multisensory perception

Events are often perceived in multiple modalities. The co-occurring proximal visual and auditory stimuli events are mostly also causally linked to the distal event, which makes it difficult to evaluate whether learned correlation or perceived causation guides binding in multisensory perception. Piano tones are an interesting exception: They are associated with the act of the pianist striking keys, an event that is visible to the perceiver, but directly results from hammers hitting strings, an event that typically is not visible to the perceiver. We examined the influence of seeing the hammer or the keystroke on auditory temporal order judgments (TOJs). Participants judged the temporal order of a dog bark and a piano tone, while seeing the piano stroke shifted temporally relative to its audio signal. Visual lead increased “piano-first” responses in auditory TOJ, but more so if the associated keystroke was visible than if the sound-producing hammer was visible, even though both were equally visually salient. This provides evidence for a learning account of audiovisual perception.     

Expressions of emotional distress in active duty military personnel with mild traumatic brain injury: A qualitative content analysis

Service members (SMs) who sustain traumatic brain injury (TBI) during deployment have increased risk for mental health issues. Mental health treatment can be challenging in military settings where treatment seeking is often stigmatized. Adequate care relies on accurate interpretations of SMs’ verbal accounts of distress, but little is known about how SMs, embedded in a culture that values resilience and self-reliance, relay emotional distress. We performed qualitative analyses of recordings from a telephone-based intervention with 25 SMs who sustained deployment-related mild TBI (mTBI) to elucidate thematic and dialectal patterns. Consistent with our expectations, SMs rarely used explicit depressive terms while discussing their emotional distress. More prevalent was language suggestive of an overarching theme of loss of control, whereby SMs’ stress, anxiety, and anger were often attributable to SMs’ perceptions that they had incomplete jurisdiction over their own lives. This study may help mental health providers improve engagements with SMs and Veterans, preventing misunderstandings and even improper diagnoses or referrals that could result from a strict reliance on the more customary expressions of distress.