Determinants of Relapse and the Rule Violation Effect in Predicting Safer Sex Goal Violations1

Knowledge of the determinants of lapses into unsafe sex are important parts of HIV prevention interventions. The present study examines the determinants of lapses into unsafe sex, and the role of attribution in predicting lapses into unsafe sex within an HIV prevention treatment program for homosexual men based on the relapse prevention (RP) model (Marlatt & Gordon, 1985). Self-reported negative emotional states and general urges to engage in sex were perceived to precede violations of safer sex goals. Stable and global attributions for a goal violation related to the probability of a second concurrently assessed violation. Prospective analyses indicated that future unprotected oral and anal sex was predicted by current unprotected oral and anal sex. In addition, more stable and external attributions for previous goal violations added to the prediction of future unprotected anal sex. Results are discussed in relation to the RP model, the role of attributions in safer sex goal violations, and treatments to reduce unsafe sexual behavior.     

MOTHERS' DEVELOPMENTAL TIMETABLES IN TWO CULTURAL GROUPS*

To explore differences in concepts about development, mothers in two cultural groups were interviewed to determine: (a) their developmental timetables (the ages at which they expected various skills to appear); (b) the extent to which they taught various skills before school; and (c) the extent to which they perceived several qualities, once established, as stable over time. Variables were the child's gender, the child's birth order (first or not first to begin school), and the mother's ethnic background (Australian-born or Lebanese-born). Gender and birth order showed minimal effects; ethnicity had a strong effect in areas (a) and (b) but not (c). The results bring out the content of mothers' ideas, raise questions about factors affecting this content, and point to some aspects of mothers' ideas as inter-related.     

The minister as healer,the healer as minister

A major task of the minister is that of healer, and with the healing task come some special opportunities. These relate to the therapy of the word, awakening in all the tragic sense of life, an identity with the wounded healer, distinguishing between healing and curing, and accepting the medical education enterprise as a patient. The healer as minister broadens the healing community into a priesthood of all believers. Further, our rich heritage of healing is anchored in the biblical tradition, and a study of this will show a similarity between ancient and modern healing.This article is based on a paper presented at the Annual Conference of the Ministers in Medical Education of the Society for Health and Human Values, Washington, D.C., October 23–26, 1980.     

Paradoxical Sadness

Three experiments were conducted to examine the theoretical prediction that the intensity of sadness is determined not only by the instigating event but also by factors that impede or deter the function or purpose of sadness. In the first two experiments, participants were asked to read a story designed to induce sadness, and were then given a $1, $2, or $3 gift. In both, reported sadness was higher for persons receiving a $2 gift than for those receiving either a $1 or $3 gift. However, the increase in sadness from the $1 to $2 group failed to reach an acceptable level of significance. In the second experiment, as expected, a $1 gift produced less sadness than did the story by itself, and as in the first experiment, a $2 gift resulted in more sadness than either a $1 or $3 gift. The third experiment replicated the $1 and $2 conditions and obtained a highly reliable effect; sadness was greater among those who received the $2 gift. Measures of positive affect suggested that participants experienced either sadness or positive feelings, not both.     

Proximal Impact of Two First-Grade Preventive Interventions on the Early Risk Behaviors for Later Substance Abuse, Depression, and Antisocial Behavior

We assessed the immediate effects of two universal, first-grade preventive interventions on the proximal targets of poor achievement, concentration problems, aggression, and shy behaviors, known early risk behaviors for later substance use/abuse, affective disorder, and conduct disorder. The classroom-centered (CC) intervention was designed to reduce these early risk behaviors by enhancing teachers' behavior management and instructional skills, whereas the family-school partnership (FSP) intervention was aimed at improving parent-teacher communication and parental teaching and child behavior management strategies. Over the course of first and second grades, the CC intervention yielded the greatest degree of impact on its proximal targets, whereas the FSP's impact was somewhat less. The effects were influenced by gender and by preintervention levels of risk. Analyses of implementation measures demonstrated that greater fidelity to the intervention protocols was associated with greater impact on behavior ratings and on achievement scores, thus providing some evidence of specificity in the effect of the interventions.     

Effects of physical fatigue and cognitive challenges on the potential for low back injury

There is no question that the motor control system will adapt under fatiguing conditions; however, there is documented evidence showing that when fatigued or challenged, the motor control system will, on occasion, perform inappropriate muscle sequencing, increasing the risk of injury, or directly causing injury. Knowing that inappropriate muscle activations can lead to injury, the purpose of this study was to investigate motor patterns during cognitive and physical challenges. Rather than ensure change with severe challenges, milder challenges were purposefully chosen. Eight male subjects performed a low external load task performed near end ROM while in an unchallenged state, and while in three challenged states: passive tissue creep, muscle fatigue and cognitive distraction. Data were collected using EMG of the trunk muscles and angular displacement of the lumbar spine. Comparison of motor control patterns between the unchallenged state and each of the three challenged conditions showed no systematic differences. However, several random anomalies were observed. A case study of a single subject was chosen to show inappropriate motor control during one trial under the cognitive distraction conditions. The response of the motor control system is very individualized and does on occasion produce inappropriate motor patterns. This supports the notion that injury may also occur as the result of random motor control errors as well as predictable, systematic changes.     

Lending a Helping Hand: The Effects of Gender Stereotypes and Gender on Likelihood of Helping1

The purpose of this study was to investigate the effects of gender and gender-role stereotypes on judgments of help-giving. As part of a 2 × 2 within-subjects design, 40 undergraduates read 4 different scenarios that described either a man or a woman needing help in either a stereotypically masculine or a stereotypically feminine situation. Although male participants felt more sympathy for men in stereotypically feminine situations and for women in stereotypically masculine situations, they were no more likely to help these individuals than they were to help those in gender-consistent situations. By contrast, women were more likely to help people in gender-inconsistent situations, despite feeling the most sympathy for people needing help in masculine situations. Implications for Weiner's (1980) attribution model of help-giving and Nadler & Fisher's (1986) threat-to-self-esteem model are discussed.     

CONTINGENT REINFORCEMENT OF ABSTINENCE WITH INDIVIDUALS ABUSING COCAINE AND MARIJUANA

Two males diagnosed with cocaine dependence received a behavioral intervention comprised of contingency management and the community reinforcement approach. During the initial phase of treatment, reinforcement was delivered contingent on submitting cocaine-free urine specimens. The community reinforcement approach involved two behavior therapy sessions each week. Almost complete cocaine abstinence was achieved, but regular marijuana use continued. During a second phase, reinforcement magnitude was reduced, but remained contingent on submitting cocaine-free specimens. Behavior therapy was reduced to once per week. Cocaine abstinence and regular marijuana use continued. Next, reinforcement was delivered contingent on submitting cocaine- and marijuana-free specimens. This modified contingency resulted in an abrupt increase in marijuana abstinence and maintenance of cocaine abstinence. One- and 5-month follow-ups indicated that cocaine abstinence continued, but marijuana smoking resumed. These results indicate that the behavioral intervention was efficacious in achieving abstinence from cocaine and marijuana; maintenance, however, was achieved for cocaine only.     

Developmental epidemiologically based preventive trials: Baseline modeling of early target behaviors and depressive symptoms

Describes a conceptual framework for identifying and targeting developmental antecedents in early childhood that have been shown in previous work to predict delinquency and violent behavior, heavy drug use, depression, and other psychiatric symptoms and possibly disorders in late adolescence and into adulthood. Criteria are described that guided choices of targets for two epidemiologically based, randomized preventive trials carried out in 19 elementary schools in the eastern half of Baltimore, involving more than 2,400 first-grade children over the course of first and second grades. Baseline models derived from the first of two cohorts show the evolving patterns of concurrence among the target antecedents. The central role of concentration problems emerged. From Fall to Spring in first grade, concentration problems led to shy and aggressive behavior and poor achievement in both genders and to depressive symptoms among girls. There was evidence for reciprocal relationships in girls. For example, depressive symptoms led to poor achievement in both girls and boys, whereas poor achievement led to depressive symptoms in girls but not boys, at least over the first-grade year. These results provide important epidemiological data relevant to the developmental paths leading to the problem outcomes and suggest preventive trials.