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Linda J Koenig Sherri L Pals Tim Bush Melody Pratt Palmore Dale Stratford Tedd V Ellerbrock 《Health psychology》2008,27(2):159-169
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. 相似文献
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This study examined the role of illness uncertainty in pain coping among women with fibromyalgia (FM), a chronic pain condition of unknown origin. Fifty-one FM participants completed initial demographic and illness uncertainty questionnaires and underwent 10-12 weekly interviews regarding pain, coping difficulty, and coping efficacy. Main outcome measures included weekly levels of difficulty coping with FM symptoms and coping efficacy. Multilevel analyses indicated that pain elevations for those high in illness uncertainty predicted increases in coping difficulty. Furthermore, when participants had more difficulty coping, they reported lower levels of coping efficacy. Results were consistent with hypothesized effects. Illness uncertainty accompanied by episodic pain negatively influenced coping efficacy, an important resource in adaptation to FM. 相似文献
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Marcellus M Merritt Gary G Bennett Redford B Williams Christopher L Edwards John J Sollers 《Health psychology》2006,25(3):364-369
This study evaluated cardiovascular responses (CVR) to an active speech task with blatantly discriminatory (BRC) versus neutral (NRC) stimuli and an anger recall task in a sample of Black men (N = 73; age 18 to 47). Diastolic blood pressure scores were higher for NRC versus BRC stimuli during anger recall (p = .05). Moreover, persons in the NRC group who perceived high levels of racism (vs. no racism or BRC group) during active speech showed larger increases in blood pressure across postspeech rest, anger recall, and subsequent rest (p = .03). The notable elevation in CVR in response to an ambiguous event extends current models of racism suggesting that subtle racism is a psychosocial stressor that erodes health through chronically elevated CVR. 相似文献
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Sara J. Shettleworth 《The Quarterly Journal of Experimental Psychology Section B: Comparative and Physiological Psychology》1981,33(4):241-255
Are different responses differentially associable with their consequences? An overshadowing design was used to try to answer this question for three responses previously studied in golden hamsters. In Experiment I, scrabbling was rapidly suppressed by electric shock punishment, and it overshadowed a tone which occurred between scrabbling and shock. In Experiment II, no evidence of response-shock association was obtained when open rearing was the punished response, and open rearing did not overshadow the tone. Punishment had some effect on face washing, but there was no statistically significant overshadowing with this response. These results are consistent with the idea that differences in punishment suppression among these three responses have an associative basis. They also demonstrate the usefulness of a novel paradigm for studying “preparedness” of response-reinforcer associations. 相似文献
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Reducing STD/HIV Stigmatizing Attitudes Through Community Popular Opinion Leaders in Chinese Markets
Reducing STDs and HIV/AIDS incidence requires campaigns designed to change knowledge, attitudes, and practices of risky sexual behavior. In China, a significant obstacle to such changes is the stigma associated with these diseases. Thus 1 campaign intervention strategy is to train credible community leaders to discuss these issues in everyday social venues. This study tested the effectiveness of such an approach on reducing HIV/AIDS stigma, across 2 years, from a sample of over 4,500 market vendors, in 3 conditions. Results showed an increasing growth in market communication about intervention messages, and concomitant declines in stigmatizing attitudes, across time, with the greatest changes in community popular opinion leaders, significant changes in intervention nonopinion leaders, and little change in the control markets. 相似文献
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Susan S Girdler Jane Leserman Robertas Bunevicius Rebecca Klatzkin Cort A Pedersen Kathleen C Light 《Health psychology》2007,26(2):201-213
OBJECTIVE: To examine dysregulation in biological measures associated with histories of abuse in women and whether women with premenstrual dysphoric disorder (PMDD) differ in their dysregulation. DESIGN: Twenty-five women meeting prospective criteria for PMDD and 42 non-PMDD controls underwent structured interview to determine abuse histories and lifetime Axis I diagnoses, excluding those with current Axis I disorders or using medications. MAJOR OUTCOME MEASURES: Plasma cortisol and norepinephrine (NE), heart rate (HR), blood pressure (BP), and vascular resistance index (VRI) were assessed at rest and in response to mental stress. RESULTS: A greater proportion of PMDD women had prior abuse compared with non-PMDD women. Regardless of PMDD status, all abused women had lower plasma NE and higher HRs and tended to have lower plasma cortisol at rest and during stress. Abused women also reported more severe daily emotional and physical symptoms. Greater VRI and BP at rest and during stress were seen only in PMDD women with abuse. CONCLUSION: There is persistent dysregulation in stress-responsive systems in all abused women that cannot be accounted for by current psychiatric illness or medications, and PMDD women may be differentially more vulnerable to the impact of abuse on measures reflecting alpha-adrenergic receptor function. 相似文献