HIV infection associated post-traumatic stress disorder and post-traumatic growth--a systematic review

The phenomenon of post-traumatic stress has been well documented in the literature as a lasting mental health condition associated with exposure to traumatic life events. The diagnosis and experience of human immunodeficiency virus (HIV) disease may be such a trauma. On the other hand, the phenomenon of post-traumatic growth (PTG) has been described, whereby people show positive mental health growth in the face of such trauma. This systematic review was set out to explore post-traumatic stress disorder (PTSD) and PTG in people with HIV to monitor prevalence, measurement and efficacy of interventions to reduce stress and/or promote growth. Standardised review techniques were used to track reports on both PTSD and PTG. A total of 206 papers were retrieved from the PTSD and HIV searches, and 13 from the PTG and HIV searches. After reviewing the papers for inclusion according to adequacy and relevance criteria and to remove duplicates, 33 PTSD papers and three PTG were available for full coding. Prevalence of PTSD in HIV ranged from 5% to 74%, which were much greater than the 7-10% in the general population. Seven studies showed a relation between trauma and PTSD, while six showed a link between PTSD diagnosis and reduced antiretroviral treatment adherence. Women were more likely to be diagnosed with PTSD. Only three intervention reports were identified that fitted our inclusion criteria. All of these reported on psychological interventions for HIV+?individuals with trauma. The interventions utilised HIV education, training in coping techniques and support groups. Only coping interventions were shown to be effective. PTG was under researched but showed a promising avenue of study. There needs to be harmonised measurement and the evidence base would need strengthening in order to build on the understanding of the impact of PTSD and PTG over the course of HIV disease. There is good evidence to associate HIV diagnosis and experiences during the course of illness as traumatic. PTSD has been shown to be prevalent and there seems to be good evidence to incorporate standardised measures to track the course of the disorder. There is extremely limited evidence that interventions may affect the course of symptom experience. The evidence and insight into PTG show promise but is currently inadequate.     

A systematic review of interventions for anxiety in people with HIV

People with human immunodeficiency virus (HIV) show elevated anxiety levels compared to the general population. Anxiety can predate HIV infection or be triggered by HIV diagnosis and the many stresses that emerge during the course of HIV disease. Many psychological and pharmacological therapies have been shown to treat anxiety in the general population but a systematic understanding of which interventions have been tested in and are effective with HIV-seropositive individuals is needed. This review examines all published intervention studies on anxiety and HIV from 1980 to 2009 covered by the databases MedLine (1980-2009) and PsycINFO (1980-2009) for a definitive account of effectiveness of interventions and an indication of prevalence of HIV-related anxiety and measurement within studies. Standard systematic research methods were used to gather quality published papers on HIV and anxiety, searching published data bases according to quality inclusion criteria. From the search, 492 papers were generated and hand searched resulting in 39 studies meeting adequacy inclusion criteria for analysis. Of these, 30 (76.9%) were implemented in North America (the USA and Canada), with little representation from developing countries. Thirty-three (84.6%) studies recruited only men or mostly men. A total of 50 interventions were investigated by the 39 studies; 13 targeted HIV, symptoms or associated outcomes/conditions, 20 directly targeted anxiety and another 17 indirectly targeted anxiety. Twenty-four (48%) interventions were effective in reducing anxiety (including 11 indirect interventions), 16 (32%) were ineffective and 10 (20%) had an unknown effect on anxiety. Sixty-five percent of interventions directly targeting anxiety were effective. Psychological interventions (especially cognitive behavioural stress management interventions and cognitive behavioural therapy) were generally more effective than pharmacological interventions. Only three studies provided prevalence rates - these ranged from 13% to 80%. Anxiety was measured using 16 different instruments. Our detailed data suggest that interventions are both effective and available, although further research into enhancing efficacy would be valuable. Also, the vast majority of studies were Western-based, no studies looked at children or adolescents and few looked specifically at women. An international effort to harmonise measurement of anxiety is also missing. There is a need to routinely log anxiety in those with HIV infection during the course of their disease, to provide specific data on women, young people and those in diverse geographic areas and incorporate management into care protocols.     

Time-based prospective remembering: Interference and facilitation in a dual task

The aim of this study was to analyse prospective memory behaviour when people have to fulfil two different intentions whose retention intervals partially overlapped. More specifically, the purpose of the study was to explore the effects of a secondary PM task (either time-based or event-based) on performance of a main time-based PM task. Four embedded conditions were tested: two event-based ones and two time-based ones. The time- and event-based interpolated tasks differed in how closely their target time was to the 20-minute response required by the main time-based task (16th and 19th min., respectively). The results indicated that when a main time-based prospective memory task shares a portion of the retention interval with a second time-based prospective task, this overlapping facilitated performance on the main task. However, the interpolated tasks appeared to be affected by the moment in which they were administered during the execution of the main time-based task. More specifically, a decrease in the interpolated task performance was observed when this was time-based and had to be executed very closely to the target time of the main task. On the contrary, when the two tasks were different (event-based vs. time-based), there was neither interference, nor facilitation.     

The use of superficial and meaning-based representations in interpreting pronouns: Evidence from Spanish

Abstract

In this paper, we address the question of whether a representation of the surface form of a text is directly implicated in the interpretation of definite pronouns in that text. According to an influential theory proposed by Sag and Hankamer (1984), it should not be, because definite pronouns are model-interpretive anaphors that take their meaning from elements in a representation of content. We report three experiments in Spanish, a language with non-semantic gender, in which pronouns can match their antecedents on the basis of morphosyntactic properties alone. The first experiment suggested that a surface representation might not be implicated in the interpretation of pronouns, since a gender match speeded only the interpretation of pronouns referring to people and not those referring to things. However, a questionnaire study (Experiment 2) confirmed that our strategy of modelling the Spanish sentences in Experiment 1 on sentences used in English studies had affected the results, and a further on-line experiment provided evidence that the interpretation of pronouns referring to things can be speeded by a gender match (Experiment 3). We discuss the implication of these findings for theories of text comprehension.     

Updating mental models in predictive reasoning

Abstract

A mental model account for predictive judgement is proposed. According to this view, solving a predictive task involves the foundation ad updating of a mental he work as the relevant data are provided. The final model state determines the subject's predictive outcome. Two experiments examine the temporal course of reasoning in novices (Experiment 1) and experts (Experiment 2). Each task provided in succession a quantitative source (e.g. “Last year, of the vehidts that stopped at the cafe, 80% were cars and 20% were trucks”), a diagnostic source (e.g. “This vehide is mksy”) and a categorical choice (e.g. “What kind of vehicle was it?”). Two factors were manipulated: The order of sources aimed at analysing the contextual dependence of the updating processes, and the between-sources congruence (congruent or incongruent) in order to explore the integrative processes in model building. The pattern of the sources reading times, the choice times and the categorical choices suggested that: (1) the processing of a source depends on the previous one, (2) subjects try to integrste both sources into a single mental framework, and (3) experts and novices have a similar performance, although experts give more importance to the quantitative source in the diagnostic-quantitative order. These results are better accounted for by the mental model framework than both the heuristic and the formal view of prediction.     

Repetition and form priming interact with neighborhood density at a brief stimulus onset asynchrony

The relationships between repetition- and form-priming effects and neighborhood density were analyzed in two masked priming experiments with the lexical decision task. Given that form-priming effects appear to be influenced by a word’s orthographic neighborhood, it is theoretically important to find out whether repetition priming also differs as a function of the word’s orthographic neighborhood. Within an activation framework, repetition- and form-priming effects are just quantitatively different phenomena, whereas the two effects are qualitatively different in a serial-ordered model of lexical access (theentry-opening model). The results show that repetition- and form-priming effects were stronger forhermit words than for words with many neighbors. These results pose some problems for both activation and serial-ordered models. The implications of these results for determining how neighbors affect the identification of a word are discussed.     

ROC and z-ROC parameters in word memory: experimental and pre-experimental effects

In this study, ROC and z-ROC parameters are applied in word recognition memory, with words classified according to frequency and class. In doing so, unbiased techniques can be used to assess hits and false alarms and to obtain standardized distributions for each experimental condition. Our results confirm the existence of differences in word recognition memory for experimental exposition time, type of words and other pre-experimental effects. These data are consistent with familiarity and recollection models when words' frequency is used, and with familiarity, recollection and dual-route models when words are organized according to class. Finally, we argue in favour of an interactive processing model (words organized according to frequency) versus a processing model nearer to modularity (words organized according to class).     

Affective priming with pictures of emotional scenes: the role of perceptual similarity and category relatedness

Prime pictures portraying pleasant or unpleasant scenes were briefly presented (150-ms display; SOAs of 300 or 800 ms), followed by probe pictures either congruent or incongruent in emotional valence. In an evaluative decision task, participants responded whether the probe was emotionally positive or negative. Affective priming was reflected in shorter response latencies for congruent than for incongruent prime-probe pairs. Although this effect was enhanced by perceptual similarity between the prime and the probe, it also occurred for probes that were physically different, and the effect generalized across semantic categories (animals vs. people). It is concluded that affective priming is a genuine phenomenon, in that it occurs as a function of stimulus emotional content, in the absence of both perceptual similarity and semantic category relatedness between the prime and the probe.     

Parafoveal semantic processing of emotional visual scenes

The authors investigated whether emotional pictorial stimuli are especially likely to be processed in parafoveal vision. Pairs of emotional and neutral visual scenes were presented parafoveally (2.1 degrees or 2.5 degrees of visual angle from a central fixation point) for 150-3,000 ms, followed by an immediate recognition test (500-ms delay). Results indicated that (a) the first fixation was more likely to be placed onto the emotional than the neutral scene; (b) recognition sensitivity (A') was generally higher for the emotional than for the neutral scene when the scenes were paired, but there were no differences when presented individually; and (c) the superior sensitivity for emotional scenes survived changes in size, color, and spatial orientation, but not in meaning. The data suggest that semantic analysis of emotional scenes can begin in parafoveal vision in advance of foveal fixation.     

Perceptions of and satisfaction with retirement: a comparison of six European union countries

The main aim of this study was to assess perceptions of and satisfaction with retirement among 1,686 recently retired people from 6 European Union countries. The authors compared their responses to a set of questions taken from the Retirement Satisfaction Inventory (F. J. Floyd et al., 1992). The first significant result was that Belgian, British, Finnish, French, and Spanish retirees all expressed very similar assessments of life satisfaction, whereas Portuguese retirees expressed a lower level of satisfaction. The 2nd result was that the major determinants of overall satisfaction in the 6 countries were (a) health and resources and (b) anticipated satisfaction. Finally, the data revealed that cultural background only accounted for a limited amount of variance in overall satisfaction with retirement.