Adolescent beliefs about AIDS prevention

Abstract

Four hundred and ten school children, aged between 13 and 16 years, were administered a questionnaire to investigate (a) their perceptions of AIDS and implications of the disease for the victim; (b) beliefs about how best to prevent the spread of disease; (c) sources of information and (d) AIDS relevant topics they would like to learn in school. The results suggested that there were few differences in knowledge or attitude as a function of age, but some significant differences due to sex. Boys were more likely to derogate the AIDS victim compared with girls. In terms of different strategies for prevention, boys were more in favour of “scare” approaches, and girls of information-giving. The success of any AIDS education package may be at least partly determined by individual beliefs about the disease, and preferences for different educational strategies.     

Personality predictors of smoking behavior in a sample of physicians

Abstract

The smoking status of 239 physicians was obtained from a mail survey in 1981. MMPI data, which had been obtained from these men 25 years earlier, was used to prospectively predict smoking status at follow-up. Those who never smoked had scores indicative of social conventionality (low scores on L, Pd, and Schubert scales; high scores on Ego-control). A similar pattern was found among smokers who quit after a relatively short smoking history. Compared to ex-smokers, those who continued to smoke at the time of follow-up were characterized by high scores on the Pd and Ma scales. These results were discussed in terms of a multi-stage conceptualization of the smoking cessation process.     

Skin cancer: Assessing perceived risk and behavioural attitudes

Abstract

Measures of attitude concerning exposure to the sun, and judgements of risk and other beliefs concerning skin cancer and four other problems (stomach cancer, deafness, AIDS and sunstroke) were obtained from a questionnaire completed by 176 university students. Subjects also estimated the incidence of each problem using one of three response formats. The highest incidence estimates were obtained when subjects were asked to guess at an absolute number, and the lowest when they used a scale which differentiated between lower frequencies, while grouping higher frequencies into a single response category. The effect of the response scale format, however, did not generalize to other ratings of personal risk. Subjects' ratings of their personal risk, compared with their peers, showed an optimistic bias over the five problems as a whole, particularly for AIDS, but not reliably so in the case of skin cancer. Optimism was inversely related to the amount of thought given to each problem. Men and women did not differ overall in their optimism regarding their own risk of skin cancer. However, differences as a function of gender and optimism were found on various behavioural attitudes. The results are discussed in relation to a tendency of disregard base-rates in subjective risk judgements, unrealistic optimism, and implications for health education.     

Mental Imagery and Post-Event Processing in Anticipation of a Speech Performance Among Socially Anxious Individuals

The present study investigated whether post-event processing (PEP) involving mental imagery about a past speech is particularly detrimental for socially anxious individuals who are currently anticipating giving a speech. One hundred fourteen high and low socially anxious participants were told they would give a 5 min impromptu speech at the end of the experimental session. They were randomly assigned to one of three manipulation conditions: post-event processing about a past speech incorporating imagery (PEP-Imagery), semantic post-event processing about a past speech (PEP-Semantic), or a control condition, (n = 19 per experimental group, per condition [high vs low socially anxious]). After the condition inductions, individuals’ anxiety, their predictions of performance in the anticipated speech, and their interpretations of other ambiguous social events were measured. Consistent with predictions, high socially anxious individuals in the PEP-Imagery condition displayed greater anxiety than individuals in the other conditions immediately following the induction and before the anticipated speech task. They also interpreted ambiguous social scenarios in a more socially anxious manner than socially anxious individuals in the control condition. High socially anxious individuals made more negative predictions about their upcoming speech performance than low anxious participants in all conditions. The impact of imagery during post-event processing in social anxiety and its implications are discussed.     

Enhancing recovery rates: Lessons from year one of IAPT

BackgroundThe English Improving Access to Psychological Therapies (IAPT) initiative aims to make evidence-based psychological therapies for depression and anxiety disorder more widely available in the National Health Service (NHS). 32 IAPT services based on a stepped care model were established in the first year of the programme. We report on the reliable recovery rates achieved by patients treated in the services and identify predictors of recovery at patient level, service level, and as a function of compliance with National Institute of Health and Care Excellence (NICE) Treatment Guidelines.MethodData from 19,395 patients who were clinical cases at intake, attended at least two sessions, had at least two outcomes scores and had completed their treatment during the period were analysed. Outcome was assessed with the patient health questionnaire depression scale (PHQ-9) and the anxiety scale (GAD-7).ResultsData completeness was high for a routine cohort study. Over 91% of treated patients had paired (pre-post) outcome scores. Overall, 40.3% of patients were reliably recovered at post-treatment, 63.7% showed reliable improvement and 6.6% showed reliable deterioration. Most patients received treatments that were recommended by NICE. When a treatment not recommended by NICE was provided, recovery rates were reduced. Service characteristics that predicted higher reliable recovery rates were: high average number of therapy sessions; higher step-up rates among individuals who started with low intensity treatment; larger services; and a larger proportion of experienced staff.ConclusionsCompliance with the IAPT clinical model is associated with enhanced rates of reliable recovery.     

Implementation of Cognitive Therapy for PTSD in routine clinical care: Effectiveness and moderators of outcome in a consecutive sample

ObjectiveTrauma-focused psychological treatments are recommended as first-line treatments for Posttraumatic Stress Disorder (PTSD), but clinicians may be concerned that the good outcomes observed in randomized controlled trials (RCTs) may not generalize to the wide range of traumas and presentations seen in clinical practice. This study investigated whether Cognitive Therapy for PTSD (CT-PTSD) can be effectively implemented into a UK National Health Service Outpatient Clinic serving a defined ethnically mixed urban catchment area.MethodA consecutive sample of 330 patients with PTSD (age 17–83) following a wide range of traumas were treated by 34 therapists, who received training and supervision in CT-PTSD. Pre and post treatment data (PTSD symptoms, anxiety, depression) were collected for all patients, including dropouts. Hierarchical linear modeling investigated candidate moderators of outcome and therapist effects.ResultsCT-PTSD was well tolerated and led to very large improvement in PTSD symptoms, depression and anxiety. The majority of patients showed reliable improvement/clinically significant change: intent-to-treat: 78.8%/57.3%; completer: 84.5%/65.1%. Dropouts and unreliable attenders had worse outcome. Statistically reliable symptom exacerbation with treatment was observed in only 1.2% of patients. Treatment gains were maintained during follow-up (M = 280 days, n = 220). Few of the selection criteria used in some RCTs, demographic, diagnostic and trauma characteristics moderated treatment outcome, and only social problems and needing treatment for multiple traumas showed unique moderation effects. There were no random effects of therapist on symptom improvement, but therapists who were inexperienced in CT-PTSD had more dropouts than those with greater experience.ConclusionsThe results support the effectiveness of CT-PTSD and suggest that trauma-focused cognitive behavior therapy can be successfully implemented in routine clinical services treating patients with a wide range of traumas.     

Anxiety in Swedish School Children: Situational Specificity,Informant Variability and Coping Strategies

In a school sample, 463 Swedish children aged between 8 and 12 years reported their experience of anxiety during 11 "typical" home and school setting activities. In addition to rating the frequency and type of anxiety experienced, the children reported whether they used coping strategies to reduce their anxiety. Parents and teachers also rated the anxiety levels in the same children. Nine percent of the children reported that they experienced anxiety "often" during at least 1 of the 11 home and school activities and 1.5% reported an anxiety level of "often" averaged across all of the 11 activities. The parents reported that 9% of the children experienced "moderate" to "very much" anxiety levels averaged across the home-related activities, whereas the teachers reported that 38.5% of the children had such anxiety levels at school. Overall, the children's ratings of their frequency levels of anxiety were found to depend more on age than on gender. The children and their parents both regarded anxiety to be most common during "leaving home for school" and "going to bed at night" activities. The correspondence between child, parent and teacher reports of overall anxiety in the children was low; similar findings were obtained for anxiety among children in the various setting activities. The 8-year-old children reported a higher use of various coping strategies than did the 12-year-olds. The results are discussed in view of the current literature on anxiety and fears in children.     

Diabetes Self-Management Profile Short Form: A Preliminary Report

Effective family management of type 1 diabetes in childhood is critical to maintaining optimal glycemic control. The purpose of this study was to provide preliminary evidence for a reduced form of the Diabetes Self-Management Profile (DSMP) using Rasch modeling techniques. The study was a secondary analysis of DSMP data drawn from a previous study on patterns of self-management from 239 preadolescents with type 1 diabetes. Rasch modeling strategies were used to identify the most informative items and then a reduced score composite was correlated with hemoglobin A1c (A1c) and blood glucose monitoring (BGM) frequency. A short form of the DSMP was obtained using seven items that comprised all five subscales of the DSMP. The DSMP Short-Form (DSMP-SF) composite score correlated significantly with child’s HbA1c and BGM frequency. The DSMP-SF may be considered a valid and effective screening interview alternative to the longer, original, DSMP, particularly when attempting to identify high-risk patients.