The meaning of bad news in HIV disease: Counselling about dreaded issues revisited

HIV disease is a slow, progressive immunological disorder. As there is neither a cure nor a vaccine, morbidity and mortality arising from HIV infection will continue to challenge health care providers, including those who counsel these patients. Psychological preparation for ‘bad news’ and support for those whose health is deteriorating is an important task in HIV counselling. This paper describes what may be considered bad news for people living with HIV, how to prepare them for unwelcome changes in their medical condition and how to give bad news, should the need arise.     

Affective interactions using virtual reality: the link between presence and emotions.

Many studies showed the ability of movies and imagery techniques to elicit emotions. Nevertheless, it is less clear how to manipulate the content of interactive media to induce specific emotional responses. In particular, this is true for the emerging medium virtual reality (VR), whose main feature is the ability to induce a feeling of "presence" in the computer-generated world experienced by the user. The main goal of this study was to analyze the possible use of VR as an affective medium. Within this general goal, the study also analyzed the relationship between presence and emotions. The results confirmed the efficacy of VR as affective medium: the interaction with "anxious" and "relaxing" virtual environments produced anxiety and relaxation. The data also showed a circular interaction between presence and emotions: on one side, the feeling of presence was greater in the "emotional" environments; on the other side, the emotional state was influenced by the level of presence. The significance of these results for the assessment of affective interaction is discussed.     

Effects of group experiential cognitive therapy for the treatment of panic disorder with agoraphobia.

A treatment protocol, called experiential cognitive therapy (ExCT), was developed. It integrated traditional cognitive behavior therapy (CBT) with virtual reality exposure for the treatment of panic disorder with agoraphobia (PDA). The objective of this study was to test the efficacy of short-term (four sessions) ExCT compared with a traditional 12-session panic control program (PCP) for the treatment of PDA. Forty patients diagnosed as having PDA by the diagnostic criteria of DSM-IV were randomly assigned to ExCT and PCP groups of 20 patients each. The treatment effects were measured with self-report questionnaires, including the BDI, STAI, ASI, PBQ, ACQ, and BSQ. The authors also assessed high end-state functioning (HES), including the success rate of stopping or reducing medication at post-treatment and 6-month follow-up. In all ratings, both ExCT and PCP groups showed significant improvement post-treatment compared with pre-treatment scores. There were no significant differences between the two treatment groups in HES and medication discontinuation at post-treatment, but there was a significant difference in medication discontinuation at 6-month follow-up. These results suggested that although short-term effectiveness of ExCT might be comparable to the effectiveness of PCP, long-term effectiveness of ExCT might be relatively inferior to the effectiveness of PCP.     

Who Are the Children Most Vulnerable to Social Exclusion? The Moderating Role of Self-Esteem,Popularity, and Nonverbal Intelligence on Cognitive Performance Following Social Exclusion

Social exclusion has a profound emotional impact on children. However, there is still limited and partly conflicting experimental evidence for the possible effect of social exclusion on children’s cognitive performance. In the present study, we tested the possibility that some children are more vulnerable than others to the negative effects of social exclusion on cognitive performance. We selected 4 potential candidates that could moderate the effects of social exclusion: relational self-esteem, peer ratings of popularity, rejection sensitivity and nonverbal intelligence. Individual differences in these 4 potential moderating factors were first assessed in a sample of 318 children (45.6 % females; mean age = 9.92 years). Then, in a subsequent experimental session, the participants were either socially included or excluded using a typical manipulation (i.e., the Cyberball paradigm). Following the manipulation, the children’s cognitive performance was assessed using a logical reasoning test. The results showed that the children with lower scores for relational self-esteem (the bottom 37.46 % of the sample), lower popularity (43.49 %) or weaker nonverbal intelligence (37.80 %) performed worse on the logical reasoning test following social exclusion. Moreover, children with combined low self-esteem, popularity and nonverbal intelligence were the most affected by social exclusion. This study identified factors that make some children more vulnerable to the negative effects of social exclusion. Overall, the present work underscores the value of considering basic cognitive and relational individual differences when developing interventions aimed at preventing the negative effects of social exclusion among children.     

Can the chronic exclusion-resignation link be broken? An analysis of support groups within prisons

Social exclusion, especially when prolonged over time––has a strong impact on the individuals’ health and wellbeing. According to the Temporal Need-Threat Model (Williams, 2009), the experience of chronic social exclusion inescapably leads to a condition of resignation, characterized by feelings of alienation, depression, helplessness, and unworthiness. However, few empirical studies have tested this prediction and its potential moderating factors. In this research, we identified the prison as a prototypical condition of chronic social exclusion, and aimed at (a) empirically testing the link between chronic exclusion and the resignation stage, (b) investigating whether situational factors—such as attending a support group in prison—can reduce the adverse outcomes of the resignation, and (c) exploring the role of individual differences (e.g., psychological flexibility) in mediating the effect of the support group on the resignation. The study involved 136 participants—68 detainees (31 of them participated in a support group) and 68 free citizens. Results showed that prisoners without the support group showed the highest levels of feelings of resignation. By contrast, prisoners in the support group were no different from nonprisoners in terms of resignation stage outcomes, and this beneficial effect of the support group was mediated by higher levels of perceived social support and psychological flexibility. Overall, this study suggests that the link between chronic exclusion and the resignation stage could be moderated by intervening social factors, highlighting the potential benefits of group-based interventions to tackle the negative consequences of chronic exclusion in chronically excluded populations.     

The lone gamer: Social exclusion predicts violent video game preferences and fuels aggressive inclinations in adolescent players

Violent video game playing has been linked to a wide range of negative outcomes, especially in adolescents. In the present research, we focused on a potential determinant of adolescents’ willingness to play violent video games: social exclusion. We also tested whether exclusion can predict increased aggressiveness following violent video game playing. In two experiments, we predicted that exclusion could increase adolescents’ preferences for violent video games and interact with violent game playing fostering adolescents’ aggressive inclinations. In Study 1, 121 adolescents (aged 10–18 years) were randomly assigned to a manipulation of social exclusion. Then, they evaluated the violent content of nine different video games (violent, nonviolent, or prosocial) and reported their willingness to play each presented video game. The results showed that excluded participants expressed a greater willingness to play violent games than nonviolent or prosocial games. No such effect was found for included participants. In Study 2, both inclusionary status and video game contents were manipulated. After a manipulation of inclusionary status, 113 adolescents (aged 11–16 years) were randomly assigned to play either a violent or a nonviolent video game. Then, they were given an opportunity to express their aggressive inclinations toward the excluders. Results showed that excluded participants who played a violent game displayed the highest level of aggressive inclinations than participants who were assigned to the other experimental conditions. Overall, these findings suggest that exclusion increases preferences for violent games and that the combination of exclusion and violent game playing fuels aggressive inclinations.

     

“Everybody feels a broken bone,but only we can feel a broken heart”: Group membership influences the perception of targets' suffering

There is surmounting evidence in the literature demonstrating that social pain (e.g. rejection, humiliation, and isolation) and physical pain (e.g. injury or assault) overlap in personal experiences. The present investigation focuses on second‐hand perceptions of social and physical pain. We argue that judgments of others' pain may vary as a function of group membership. By integrating research on intergroup bias in pain judgment with intergroup attributions of humanity, we predicted that observers tend to underestimate social pain more than physical pain in out‐groups compared with in‐groups. Across two studies that considered different scenarios, we found that Italian participants attributed less severe social pain when considering an out‐group (Chinese and Ecuadorian) than an in‐group member. No such effect was found for physical pain. Overall, the current work suggests an additional way through which people preserve a privileged human status to in‐group members while denying out‐group members' humanness. Copyright © 2012 John Wiley & Sons, Ltd.     

When the solution becomes a part of the problem in the psychosocial management of an AIDS patient

This paper describes the important role a professional has in defining the nature of psychosocial problems with patients. An example is described in which a patient with AIDS was referred to a psychiatrist. The effect of this on the patient was that he believed that his problems were more serious than how he usually viewed them. This created a new problem in the management of the patient. The authors stress the importance of counsellors and their referrers discussing patient management issues in advance, so that different views do not impede the care of patients.     

Addressing ‘Dreaded issues’: A Description of a unique counselling intervention with patients with AIDS/HIV

The authors describe an approach to counselling patients with AIDS/HIV in which the patients main anxieties can be addressed. A definition of ‘AIDS Counselling’ and ‘Dreaded issues’ is offered. The choice of method is derived from experience with over 1,000 patients. A therapeutic strategy is used in which hypothetical and future-orientated questions asked by the counsellor can help to sidestep denial and resistance with patients. Clinical case examples are described in order to illustrate the approach. Some of the advantages as well as the limitations of the approach, for patients and staff, are considered.