Der Facharzt für Psychotherapeutische Medizin

Ohne Zusammenfassung     

Ethnic pride and self-control related to protective and risk factors: test of the theoretical model for the strong African American families program.

OBJECTIVE: To test a theoretical model of how ethnic pride and self-control are related to risk and protective factors. DESIGN: A community sample of 670 African American youth (mean age = 11.2 years) were interviewed in households. MAIN OUTCOME MEASURES: Measures of cigarette smoking, alcohol use, and sexual behavior (lifetime to past month). RESULTS: Structural modeling analyses indicated parenting was related to self-control and self-esteem, and racial socialization was related to ethnic pride. Self-control and self-esteem variables were related to levels of deviance-prone attitudes and to perceptions of engagers in, or abstainers from, substance use and sexual behavior. The proximal factors (behavioral willingness, resistance efficacy, and peer behavior) had substantial relations to the criterion variables. Participant gender and parental education also had several paths in the model. Results were generally similar for the 2 outcome behaviors. CONCLUSIONS: In this population, self-esteem and self-control are related to parenting approaches and have pathways to attitudes and social perceptions that are significant factors for predisposing to, or protecting against, early involvement in substance use and sexual behavior.     

Positive Emotions Speed Recovery from the Cardiovascular Sequelae of Negative Emotions

Two studies tested the hypothesis that certain positive emotions speed recovery from the cardiovascular sequelae of negative emotions. In Study 1, 60 subjects (Ss) viewed an initial fear-eliciting film, and were randomly assigned to view a secondary film that elicited: (a) contentment; (b) amusement; (c) neutrality; or (d) sadness. Compared to Ss who viewed the neutral and sad secondary films, those who viewed the positive films exhibited more rapid returns to pre-film levels of cardiovascular activation. In Study 2, 72 Ss viewed a film known to elicit sadness. Fifty Ss spontaneously smiled at least once while viewing this film. Compared to Ss who did not smile, those who smiled exhibited more rapid returns to pre-film levels of cardiovascular activation. We discuss these findings in terms of emotion theory and possible health-promoting functions of positive emotions.     

Selective attention and stimulus-reinforcer interactions in the pigeon

The study supplies further evidence that non-associative effects and temporal-spatial similarities between certain combinations of cue and consequence cannot explain all instances of stimulus-reinforcer interactions. Pigeons were trained to press a treadle in the presence of a discriminative compound stimulus either to avoid shock or to obtain a food reinforcer. The compound stimulus was composed of diffuse tone and light cues which had identical temporal patterns of onset, duration and offset. With the avoidance schedule the auditory cue acquired more control than the visual cue; however, when food was the reinforcer, the visual cue exerted more control. This pattern of stimulus control on the appetitive schedule did not change if random shocks were also added, even though these shocks were equal in density to the food presentations and equal in magnitude to those used for the avoidance schedule. Other changes in the appetitive procedure, such as making the tone spatially contiguous with food and removing the light in the food hopper, also failed to alter the relative control by the different cues. Prior training with a food reinforcer did not produce any change in the relative control by the two cues when the birds were retrained on the shock-avoidance schedule. The results suggest that some frequently stated alternatives to selective associability are not adequate explanations of this instance of a stimulus-reinforcer interaction.     

Book reviews

Arnold, M. Memory and the brain. Hillsdale, N. J.: Lawrence Erlbaum Associates. 1984. Pp. 532. ISBN 0-89859-290-9. £47.90.

Green, T. R. G., Payne, S. P. and van der Veer, G. C. (Eds.). The psychology of computer use.. London: Academic Press. 1983. Pp. 225. ISBN 0-12-2974204. $9.50.

Stunkard, A. J. and Stellar, E. (Eds.). Eating and its disorders. New York: Raven Press. 1984. Pp. 302. ISBN 0-89004-891-6. $58.50.

Spillmann, L. and Wooten, B. R. (Eds.) Sensory experience, adaptation, and perception: Festschrift for Zero Kohler. Hillsdale, N. J.: Lawrence Erlbaum Associates. 1984. Pp. xxvii + 748. ISBN 0 8985-3-218-6. £70.85.

Geschwind, N. and Galaburda, A. M. (Eds.)Cerebral dominance: The biological foundations. Cambridge, Mass.: Harvard University Press. 1984. Pp. 232. ISBN 0-674-10658-X. £24.35.

Annett, M. Left, right, hand and brain: The right shift theory. 1985. London and Hillsdale, N. J.: Lawrence Erlbaum Associates. Pp. xiii + 474. ISBN 0-86377418-5 £29.95.

Ericsson, K. A. and Simon, H. A. Protocol analysis: Verbal reports as data. Cambridge, Mass.: The M.I.T. Press. 1984. Pp. 426. ISBN 0-262-05029-3. £28.95.     

Randomized controlled trial of an intervention to prevent adherence failure among HIV-infected patients initiating antiretroviral therapy.

OBJECTIVE: Compare the efficacy of a multicomponent social support intervention to standard-of-care counseling on medication adherence among HIV-infected patients initiating antiretroviral therapy. DESIGN: Randomized controlled trial. Generalized estimating equations tested for differences in the percentage of participants achieving 90% adherence. MAIN OUTCOME MEASURES: Pill-taking, electronically monitored over 6 consecutive months; plasma viral load (VL), assessed at 3 and 6 months following initiation of therapy. RESULTS: Of 226 participants who were randomized and began the trial, 87 (38%) were lost to the study by 6 months. The proportion of adherent participants declined steadily over time, with no time by group interaction. Sustained adherence was associated with increased odds of achieving an undetectable VL (OR=1.78; 95% CI=1.01, 3.13). In intention-to-treat analyses, a larger proportion of the intervention group than the control group was adherent (40.15% vs. 27.59%, p=.02) and achieved an undetectable VL p=.04). However, the majority of participants who remained on study experienced some reduction in VL (>or=1-log drop or undetectable), regardless of experimental condition. CONCLUSION: The multicomponent social support intervention significantly improved medication adherence over standard-of-care counseling; evidence for improved virologic outcomes was inconsistent. Early discontinuation of care and treatment may be a greater threat to the health of HIV patients than imperfect medication-taking.