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.     

Propension à discriminer à l’égard du genre et dominance sociale

This work aims to study the propensity to discriminate (PTD) (Dovidio & Helb, 2005 ; Tisserant, Wagner & Barth, 2010) against gender and other salient criteria in the working place, such as ethnic origin and religious background. More precisely, we investigated the link between PTD and the social dominance orientation (Sidanius & Pratto, 1999). 119 counsellors from French employment services answered a questionnaire dealing on concepts and attitudes towards social groups. Results show that social dominance, as a system of belief justifying social inequalities, generally predict the PTD of individuals, whatever the criterion of discrimination considered. The sex of counsellors can be considered as a moderating variable since females are less likely to accept inequalities than males do. We discuss the need for work and organizational psychologists to invest, alongside the managers, this field of research on equality, non-discrimination and diversity (ENDD).     

The incremental validity of the MMPI-2: when does therapist access not enhance treatment outcome?

The present study examined whether therapist access to the Minnesota Multiphasic Personality Inventory (MMPI-2) predicted favorable treatment outcome, above and beyond other assessment measures. A manipulated assessment design was used, in which patients were randomly assigned either to a group in which therapists had access to their MMPI-2 data or to a group without therapist access to such information. Illness severity, improvement ratings, number of sessions attended, and premature termination were indicators of therapy outcome. Results indicated that therapist access to the MMPI-2 data did not add to the prediction of positive treatment outcome beyond that predicted by other measures in this setting. Findings from this initial study suggest that, compared with other resources, perhaps in clinical settings with an emphasis on diagnosis-based and evidence-based treatment, the MMPI-2 may not provide incrementally valid information. However, these effects warrant replication across different settings and samples. Guidelines for future studies are discussed.     

The development of infant learning about specific face-voice relations

This study examined the development of infants' ability to perceive, learn, and remember the unique face-voice relations of unfamiliar adults. Infants of 2, 4, and 6 months were habituated to the faces and voices of 2 same-gender adults speaking and then received test trials where the faces and voices were synchronized yet mismatched. Results indicated that 4- and 6-month-olds, but not 2-month-olds, detected the change in face-voice pairings. Two-month-olds did, however, discriminate among the faces and voices in a control study. Results of a subsequent intermodal matching procedure indicated that only the 6-month-olds showed matching and memory for the face-voice relations. These findings suggest that infants' ability to detect the arbitrary relations between specific faces and voices of unfamiliar adults emerges between 2 and 4 months of age, whereas matching and memory for these relations emerges somewhat later, perhaps between 4 and 6 months of age.     

Psychopathic-like traits in childhood: conceptual and measurement concerns

Can psychopathy be identified in pre-adolescent children? This question has both theoretical and practical implications. So far, attempts to answer this question have been made by making downward extensions of symptoms of the disorder as found in adults. We argue that for the construct of psychopathy to be viable as a construct in childhood it is necessary to demonstrate that a coherent syndrome of symptoms can be identified during childhood. To achieve this it is necessary first to use a strong measurement model, and second to use developmentally informed conceptualizations of key constructs. In order to progress from the measurement perspective, it is necessary to demonstrate (i) configural invariance of symptoms across key ages, (ii) similar performance of age cognate symptoms across key ages, and (iii) stability of relative standing on the latent trait across age. Novel techniques including item response methods and structural equation modelling techniques are required. In this paper, we review the relevant literature and evaluate the strength, or otherwise, of the evidence that key traits of psychopathy can be observed in childhood.     

The 1996 Mount Everest tragedy: contemplation on group process and group dynamics

In May 1996, one of the most tragic Mt. Everest climbing seasons was about to unfold, and five climbers would perish in the "Death Zone" miles above the earth's surface. This article considers the events from a group dynamic and group process perspective in an attempt to understand what might have been happening to the group members. We summarize the events through the writings of two chroniclers. We then discuss creating the group, leadership, diversity and subgrouping, scapegoating, and multiple interpretations through an interpersonalist/psychodynamic framework.     

Changes in behavior and behavioral intentions among middle-age women: results from an osteoporosis prevention program

The purpose of this study was to evaluate changes in behaviors and behavioral intentions that occurred among 342 middle-age women (M age 49.5 yr.) after participating in an Osteoporosis Prevention Program. The valid and reliable Osteoporosis Preventing Behaviors Survey (developed by Doheny and Sedlak) and a survey developed for this work were measures. Significant changes in behaviors were reported, especially increases in weight-bearing physical activity, dairy product intake, and decreases in consumption of caffeine-containing beverages. Many subjects reported intentions to increase physical activity and calcium intake. An Osteoporosis Prevention Program may help promote osteoporosis prevention behaviors, but intents must be followed up to check actual change.     

Using Media to Create Experiential Learning in Multicultural and Diversity Issues

The authors present a framework for using media to create experiential learning in multicultural and diversity issues based on cognitive-experiential self-theory. They offer several lessons and a media resource list that are helpful in training counseling students in multicultural and diversity issues.     

An audit of a school-based counselling provision for emotional and behavioural difficulties in primary school children

The presence and prevalence of mental health problems in young children ad well as therapeutic interventions is less well understood than the same problems in adults, Long-term consequences of childhood mental health problems have been noted, yet provision of services at the age appropriate level is ofter limited. This sudy presents a case note audit of 540 children attending an innovative programme for counselling and therapy in school-based centres based in 8 inner London Primary schools. This represented 22.4% of all children attending the schools, with an overage age at referral of 8.1 Years. 53.8% of boys compared to 46.2% girls ew referred emanating from varied backgrounds. The majority of the children spoke English at home (86%) and the only significant differences according to home language related to concern over social interactions. Comparisons between children cared for by both parents(48%) and those cardd for by a single parent (37.3%) showed the latter group to have higher distress and concerns affection school work, home situation, stress for significant life events and lowered coping. Atendance and defaulting rates were good, with no significant differences among those who attended regularly. Many of the conderns surrounded self-esteem and social/family factors. The level of distress was significantly lowered after counselling (t = 17.5 p_.001) 51.45 of the children experienced significant life events which preceded their referral, 30.9% triggered the referral and 45.6% during the course of counselling. Distress caused by life events was generally high with coping levels moving down after multiple exposure. The data is discussed in the light of future provision of care for children.     

Women's Descriptions of Drinking in Bars: Reasons and Risks

Fifty-two women bar drinkers participated infocus group discussions about women's reasons fordrinking, victimization experiences, and behaviors thatinfluence risk for victimization, in bars. The majority of the participants were White (67.3%),one-third were Black (30.8%), and one was NativeAmerican. Qualitative data analytic techniques were usedto assess the content of these discussions. Womendescribed distinct reasons for going to bars and providednumerous accounts of aggression they had witnessed orexperienced associated with this setting. Depictions ofphysical violence ranged from having an object thrown at them or being pushed, to accounts ofrape and attempted murder. These women also describedobservable changes in other women's behavior followingalcohol consumption, and how these behaviors increase risk for victimization in bars. The qualitativefindings are discussed in terms of what they tell usabout women bar drinkers and the insight theyprovide fordesigning future studies and interventions that focus on education and prevention.