HIV infection and mental health: suicidal behaviour--systematic review

Suicide has long been associated with serious illness generally and HIV specifically. New treatments have affected prognosis in HIV positively, but it is unclear how they impact on suicidal burden (thoughts, self-harm and completions). This review examines all published suicide and HIV data for a definitive account of (1) prevalence of HIV-related suicidality, (2) measurement within studies and (3) effectiveness of interventions. Standard systematic research methods were used to gather quality published papers on HIV and suicide, searching published databases according to quality inclusion criteria. From the search, 332 papers were generated and hand searched resulting in 66 studies for analysis. Of these, 75% were American/European, but there was representation from developing countries. The breakdown of papers provided 12, which measured completed suicides (death records), five reporting suicide as a cause of attrition. Deliberate self-harm was measured in 21, using 22 instruments; 16 studies measured suicidal ideation using 14 instruments, suicidal thoughts were measured in 17, using 15 instruments. Navigating the diverse range of studies clearly points to a high-suicidal burden among people with HIV. The overview shows that autopsy studies reveal 9.4% of deceased HIV+?individuals had committed suicide; 2.4% HIV+?study participants commit suicide; approximately 20% of HIV+?people studied had deliberately harmed themselves; 26.9% reported suicidal ideation, 28.5% during the past week and 6.5% reported ideation as a side effect to medication; 22.2% had a suicide plan; 19.7% were generally "suicidal" (11.7% of people with AIDS, 15.3% at other stages of HIV); 23.1% reported thoughts of ending their own life; and 14.4% expressed a desire for death. Only three studies recruited over 70% female participants (39 studies recruited over 70% men), and six focussed on injecting drug users. Only three studies looked at interventions - predominantly indirect. Our detailed data suggest that all aspects of suicide are elevated and urgently require routine monitoring and tracking as a standard component of clinical care. There is scant evidence of direct interventions to reduce any aspect of suicidality, which needs urgent redress.     

Neural temporal dynamics of contingency judgement

The present study captures the dynamics of neural processing across positively contingent, negatively contingent, and noncontingent relations. In the setting of a hypothetical chat room conversation, participants rated the contingency of emotional response between two individuals. Event-related potentials (ERPs) were time-locked to the onset of each emotional event. Although each event alone was ambiguous regarding contingency, its neural response was characteristic of the overall contingent relation and the subsequent contingency rating. Very early displays of contingency modified the ERP anterior N1 (AN1) component amplitude. In contrast, the ERP selection negativity (SN) component amplitude seemed to be more sensitive to display properties than contingency. Our results point to the recruitment of early attentional processes for contingency judgement and highlight the efficiency of statistical information processing.     

An Ecological Process Model of Systems Change

In June 2007 the American Journal of Community Psychology published a special issue focused on theories, methods and interventions for systems change which included calls from the editors and authors for theoretical advancement in this field. We propose a conceptual model of systems change that integrates familiar and fundamental community psychology principles (succession, interdependence, cycling of resources, adaptation) and accentuates a process orientation. To situate our framework we offer a definition of systems change and a brief review of the ecological perspective and principles. The Ecological Process Model of Systems Change is depicted, described and applied to a case example of policy driven systems level change in publicly funded social programs. We conclude by identifying salient implications for thinking and action which flow from the Model.     

What propositional structure could not be

Synthese - The dominant account of propositions holds that they are structured entities that have, as constituents, the semantic values of the constituents of the sentences that express them. Since...     

Social cure and social curse: Social identity resources and adjustment to acquired brain injury

There is increasing evidence that identification with social groups can protect and enhance health, establishing a kind of ‘social cure’. However, for those affected by chronic or disabling conditions such as acquired brain injury (ABI), their identity may also represent a burden, a form of ‘social curse’. The present study explored the identity benefits and burdens available to 15 participants living with ABI using semi-structured interviews. The qualitative data was then analysed systematically using thematic analysis. The findings highlight social identity changes as central to the experience of brain injury. Participants reported changes in their social networks and social group memberships after injury. Identity loss and reduced social support were described as disabling. Engagement in meaningful group activity with others affected by ABI and access to affected peers enabled new group-based resources such as social support. In this way, group activity can be seen as a form of identity enactment that can drive social cure effects. Similarly, adaptation to life after injury was demonstrably linked to social identity processes pointing to the importance of a social cure approach to rehabilitation.     

Phonological effects in visual word recognition: investigating the impact of feedback activation

P. M. Pexman, S. J. Lupker, and D. Jared (2001) reported longer response latencies in lexical decision tasks (LDTs) for homophones (e.g., maid) than for nonhomophones, and attributed this homophone effect to orthographic competition created by feedback activation from phonology. In the current study, two predictions of this feedback account were tested: (a) In LDT, observe homophone effects should be observed but not regularity or homograph effects because most exception words (e.g., pint) and homographs (e.g., wind) have different feedback characteristics than homophones do, and (b) in a phonological LDT ("does it sound like a word?"), regularity and homograph effects should be observed but not homophone effects. Both predictions were confirmed. These results support the claim that feedback activation from phonology plays a significant role in visual word recognition.     

Imagining how you'd feel: the role of motivational experiences from regulatory fit

The authors propose that how people imagine they would feel about making a choice is affected not only by the outcome's anticipated pleasure or pain but also by regulatory fit. Regulatory fit occurs when people pursue a goal in a manner that sustains their regulatory state and it intensifies the motivation to pursue that goal. Considering positive outcomes fits a promotion focus more than a prevention focus, whereas the reverse is true for negative outcomes. Thus, it is proposed that anticipating a desirable choice is more intensely positive for promotion than prevention, and anticipating an undesirable choice is more intensely negative for prevention than promotion. The results of three studies support these predictions. Studies 2 and 3 also demonstrate that motivational intensity underlies the stronger responses. Thus, to understand fully what it means to feel good or bad about a prospective choice, motivational experiences from regulatory fit must be considered.     

The interaction of meaning and sound in spoken word recognition

Models of spoken word recognition vary in the ways in which they capture the relationship between speech input and meaning. Modular accounts prohibit a word’s meaning from affecting the computation of its form-based representation, whereas interactive models allow activation at the semantic level to affect phonological processing. We tested these competing hypotheses by manipulating word familiarity and imageability, using lexical decision and repetition tasks. Responses to high-imageability words were significantly faster than those to low-imageability words. Repetition latencies were also analyzed as a function of cohort variables, revealing a significant imageability effect only for words that were members of large cohorts, suggesting that when the mapping from phonology to semantics is difficult, semantic information can help the discrimination process. Thus, these data support interactive models of spoken word recognition.     

Temporal contiguity and contingency judgments: A Pavlovian analogue

The two experiments reported examine the role of temporal contiguity on judgments of contingency in a human analogue of the Pavlovian task. The data show that the effect of the actual delay on contingency judgment depends on the observer’s expectation regarding the delay. for a fixed contingency between the cue and the outcome, ratings of the contingency are higher when the actual delay is congruent with the observer’s expectation than when it is incongruent. We argue that our data can be understood within the context of the temporal coding hypothesis.