Medication beliefs and structural barriers to treatment adherence among people living with HIV infection

Background: People living in poverty face multiple structural challenges to medication adherence including lack of transportation, inadequate housing and food insecurity. The degree to which individuals’ motivations to remain adherent may overcome structural barriers has received limited attention.

Purpose: To examine whether medication necessity and concerns beliefs predict antiretroviral therapy (ART) adherence over and above structural adherence barriers associated with poverty.

Methods: People living with HIV in a southern US city (N = 942) completed computerised interviews, an objective measure of adherence and HIV viral suppression obtained from medical records. Hierarchical logistic regression models were constructed to examine demographic and illness characteristics, structural barriers, mental health, substance use and medication necessity and concerns beliefs as predictors of ART adherence.

Results: In multivariable models, current drug use and medication necessity and concerns beliefs predicted treatment adherence over and above demographic, health, mental health and structural factors.

Conclusions: Medication beliefs are proximal and powerful motivating factors that predict adherence. Adherence interventions should directly address medication beliefs in developing strategies to manage barriers facing people with HIV living in poverty.     

Philosophical Intuition Is the Capacity to Recognize one’s Epistemic Position. An Old-Fashion Approach Based on Russell,Carnap, Wittgenstein,and Husserl

Philosophical intuition has become one of the most debated problems in recent years, largely due to the rise of the movement called experimental philosophy which challenged the conviction that philosophers have some special insight into abstract ideas such as being, knowledge, good and evil, intentional action, etc. In response to the challenge, some authors claim that there is a special cognitive faculty called philosophical intuition which delivers justification to philosophical theses, while some others deny it based on experimental results. A relatively smaller group of researchers aim at clarifying what the alleged intuition is. I follow the latter path. In this paper I argue that philosophical intuition is in the first place the capacity enabling one to what I refer to as the recognition of one’s epistemic position. The latter means becoming aware of the seemingly trivial “fact” that the way in which the world manifests itself depends on the cognitive apparatus one has, thereby propelling one to draw a distinction between appearances and reality. The recognition at stake is a very specific capacity to approach the world solely as it is experienced. This capacity, I argue, is the core and the defining feature of philosophical intuition. As part of my argumentation I also distinguish between the intuition in question and its different manifestations; and then introduce a novel notion of erotetic intuition. My argument is called “old-fashion” to emphasize the fact that I draw mostly on four figures who were pivotal in the twentieth- century philosophy and whose influence on the current debate concerning philosophical intuition should be, I believe, stronger than it is; I mean Russell, Carnap, Wittgenstein, and Husserl.

     

Agoraphobia: a critical review of methodology in behavioural treatment research

This review focuses on the methodological status of the literature on behavioural treatment of agoraphobia. Thirty-three studies published between 1963 and 1979 are analysed using a methodological rating scale by which each study is assessed on the extent to which it meets eight basic criteria for outcome research. It is concluded that methodological weaknesses in these reports make questionable any general conclusions about the value of the behavioural treatment of agoraphobia, and recommendations are made concerning possible changes in the future direction of research in this area.     

Assessment of multiple implicit self‐concept dimensions using the Extrinsic Affective Simon Task (EAST)

This study explored the psychometric properties of the Extrinsic Affective Simon Task (EAST; De Houwer, 2003a ) as adapted for the measurement of the implicit self‐concept of personality. The EAST was adapted to allow the simultaneous assessment of the three traits shyness, anxiousness, and angriness. In order to test the EAST's psychometric properties, 100 participants completed a trait EAST, Implicit Association Tests (IATs), and direct self‐ratings. The EAST showed low internal consistencies and correlated neither with the IATs nor with the direct measures. The main problem of the EAST, namely its low reliability, is discussed, and general conclusions regarding the indirect assessment of the personality self‐concept by EASTs are derived. Copyright © 2004 John Wiley & Sons, Ltd.