HIV and depression--a systematic review of interventions

HIV-positive individuals are more likely to be diagnosed with major depressive disorder than HIV-negative individuals. Depression can precede diagnosis and be associated with risk factors for infection. The experience of illness can also exacerbate depressive episodes and depression can be a side effect to treatment. A systematic understanding of which interventions have been tested in and are effective with HIV-seropositive individuals is needed. This review aims to provide a comprehensive understanding of evaluated interventions related to HIV and depression and provide some insight on questions of prevalence and measurement. Standard systematic research methods were used to gather quality published papers on HIV and depression. From the search, 1015 articles were generated and hand searched resulting in 90 studies meeting adequacy inclusion criteria for analysis. Of these, 67 (74.4%) were implemented in North America (the US and Canada) and 14 (15.5%) in Europe, with little representation from Africa, Asia and South America. Sixty-five (65.5%) studies recruited only men or mostly men, of which 31 (35%) recruited gay or bisexual men. Prevalence rates of depression ranged from 0 to 80%; measures were diverse and rarely adopted the same cut-off points. Twenty-one standardized instruments were used to measure depression. Ninety-nine interventions were investigated. The interventions were diverse and could broadly be categorized into psychological, psychotropic, psychosocial, physical, HIV-specific health psychology interventions and HIV treatment-related interventions. Psychological interventions were particularly effective and in particular interventions that incorporated a cognitive-behavioural component. Psychotropic and HIV-specific health psychology interventions were generally effective. Evidence is not clear-cut regarding the effectiveness of physical therapies and psychosocial interventions were generally ineffective. Interventions that investigated the effects of treatments for HIV and HIV-associated conditions on depression generally found that these treatments did not increase but often decreased depression. Interventions are both effective and available, although further research into enhancing efficacy would be valuable. Depression needs to be routinely logged in those with HIV infection during the course of their disease. Specific data on women, young people, heterosexual men, drug users and those indiverse geographic areas are needed. Measurement of depression needs to be harmonized and management into care protocols incorporated.     

Inner Subjective Experiences and Social Constructionism: A Response to Rudes and Guterman (2007)

In an earlier article, the author argued that there had been a devaluation of inner subjective experiences by the counseling profession over the last several decades (J. T. Hansen, 2005). In their reply to this article, J. Rudes and J. T. Guterman (2007) advocated for a social constructionist position for the counseling profession. In the current article, 2 fundamental premises that are inherent in the reply of J. Rudes and J. T. Guterman are examined. Disagreements with 1 of these premises are elaborated, and implications for the counseling profession are discussed.     

Counseling and Psychoanalysis: Advancing the Value of Diversity

Arguably, the defining feature of the counseling profession is an appreciation for human diversity. Early counseling movements emphasized individual diversity, while multiculturalism and social justice highlighted cultural diversity. The author maintains that contemporary psychoanalytic thought can supply a needed intraindividual diversity perspective, which has been suppressed by dominant ideologies. Podría decirse que el rasgo definitorio de la profesión de la consejería es la apreciación por la diversidad humana. Los movimientos iniciales en el campo de la consejería enfatizaron la diversidad individual, mientras que el multiculturalismo y la justicia social pusieron de relieve la diversidad cultural. El autor sostiene que el pensamiento psicoanalítico contemporáneo puede proporcionar una perspectiva necesaria sobre la diversidad intraindividual, que ha sido suprimida hasta ahora por las ideologías dominantes.     

The role of higher order image statistics in masking scene gist recognition

In the present article, we investigated whether higher order image statistics, which are known to be carried by the Fourier phase spectrum, are sufficient to affect scene gist recognition. In Experiment 1, we compared the scene gist masking strength of four masking image types that varied in their degrees of second- and higher order relationships: normal scene images, scene textures, phase-randomized scene images, and white noise. Masking effects were the largest for masking images that possessed significant higher order image statistics (scene images and scene textures) as compared with masking images that did not (phase-randomized scenes and white noise), with scene image masks yielding the largest masking effects. In a control study, we eliminated all differences in the second-order statistics of the masks, while maintaining differences in their higher order statistics by comparing masking by scene textures rather than by their phase-randomized versions, and showed that the former produced significantly stronger gist masking. Experiments 2 and 3 were designed to test whether conceptual masking could account for the differences in the strength of the scene texture and phase-randomized masks used in Experiment 1, and revealed that the recognizability of scene texture masks explained just 1% of their masking variance. Together, the results suggest that (1) masks containing the higher order statistical structure of scenes are more effective at masking scene gist processing than are masks lacking such structure, and (2) much of the disruption of scene gist recognition that one might be tempted to attribute to conceptual masking is due to spatial masking.     

The Swedish National Adult Reading Test (NART-SWE): a test of premorbid IQ

The purpose of this study was to construct a Swedish version of the National Adult Reading Test (NART-SWE), a test for assessment of premorbid IQ, and to investigate its validity and reliability on healthy controls and patients with mild Alzheimer's disease. As Swedish pronunciation rules are fixed, NART-SWE was constructed using loan words. NART-SWE has satisfactory psychometric properties: Inter-rater and retest reliability as well as internal consistency are very high. The NART-SWE demonstrates face validity. In addition, high correlation with IQ was obtained. A significant model emerged when using NART-SWE to predict IQ. Furthermore, no significant differences were observed when comparing performance for healthy controls' with that of patients with Alzheimer's disease on NART-SWE. It does appear that reading of irregular words is intact in mild Alzheimer's disease.     

Measuring Latinos' perceptions of depression: a confirmatory factor analysis of the Illness Perception Questionnaire

This study examined the psychometric properties of the Revised Illness Perception Questionnaire adapted for a clinical sample of low-income Latinos suffering from depression. Participants (N = 339) were recruited from public primary care centers. Their average age was 49.73 years and the majority was foreign born females of either Mexican or Central American descent. Confirmatory factor analysis was used to test the factor structure of this measure. Construct and discriminant validity and internal consistency were evaluated. After the elimination of three items because of low factor loadings (< .40) and the specification of seven error covariances, a revised model composed of 24 items had adequate goodness-of-fit indices and factor loadings, supporting construct validity. Each of the subscales reported satisfactory internal consistency. Intercorrelations between the 5 illness perception factors provided initial support for the discriminant validity of these factors in the context of depression. The establishment of the psychometric properties of this adapted measure will pave the way for future studies examining the role illness perceptions play in the help seeking and management of depression among Latinos.     

Bonus of rebate?: the impact of income framing on spending and saving

All income increases a person's absolute wealth, but consumption decisions may be based more heavily on perceived changes in wealth. Change is computed by comparing a current state with a former state, and we predicted that people would be more likely to spend income framed as a gain from a current wealth state than income framed as a return to a prior state. Four experiments confirmed this prediction on people's memory for spending of a government tax rebate (Experiment 1), on unobtrusive self‐report measures of spending an unexpected windfall (Experiments 2 and 3), and on actual spending on items for sale in a laboratory experiment (Experiment 4). These results can be explained, at least in part, by the reference points implied in the framing of income (follow‐ups to Experiments 1 and 4). Discussion focuses on implications for the consumption of other commodities, assessments of risk, and government tax policies. Copyright © 2006 John Wiley & Sons, Ltd.     

What Renders a Witness Trustworthy? Ethical and Curricular Notes on a Mode of Educational Inquiry

Studies in Philosophy and Education - Bearing witness is a familiar if diversely employed concept. On the one hand, it concerns the accuracy and validity of practical affairs, for example in a...