Stability and Change in Type A Components and Cardiovascular Reactivity in Medical Students During Periods of Academic Stress1

This study examined the effects of academic stress upon components of Type A behavior and cardiovascular reactivity. In a longitudinal design, heart rate and blood pressure responses to the Type A Structured Interview (SI) and additional laboratory challenges were measured in medical students at three points during an academic semester. Sessions 1 and 3 were scheduled during vacation periods; Session 2 took place during an intensive examination week. Results indicated that three “stylistic” components of Pattern A derived from the SI—loud and explosive speech, short response latency, and potential for hostility—increased significantly during the exam period. Similar increases achieved marginal significance for another stylistic component, rapid and accelerated speech. By contrast, global Type A assessments did not increase with academic demands. Cardiovascular reactivity was significantly but only moderately stable across the three sessions, showing less consistency than has been reported in previous research. In addition, there was little evidence in this study that cardiovascular reactivity was potentiated by academic stress or by Type A behavior. These results demonstrate the influence of naturalistic environmental factors on overt behavioral components that have recently been suggested as coronary risk factors. Therefore, it is advisable for future experimental and epidemiological research to examine the social and environmental context in which these behaviors occur.     

Target Groups for Preventing AIDS Among Intravenous Drug Users

The acquired immune deficiency syndrome (AIDS) has rapidly become the most serious medical consequence of injecting illicit drugs. Its potential impact on intravenous (IV) drug use is enormous. Human immunodeficiency virus (HIV, also known as HTLV-III and LAV), the virus that causes AIDS, appears, usually, to lead to lifelong infection. At present there is no effective treatment, and the treatments under development may require lifelong antiviral therapy. Since most of the antibody produced in response to HIV infection does not neutralize the virus, and since there is substantial genetic variation in the virus, it will be difficult to develop a vaccine. Even after vaccines are developed, testing their safety and efficacy will be formidable problems. Until either effective treatment or vaccines are developed, control of the epidemic among IV drug users must be attempted through behavior change/prevention efforts. In this paper we will review the epidemiology of AIDS among IV drug users and characteristics of the IV drug-use subculture relevant to prevention efforts. We will then identify different target groups for these prevention efforts, present available evidence about behavior change in these groups, and then briefly discuss how to prevent transmission of HIV to heterosexual partners who are not themselves IV drug users and to the children of IV drug users.     

Book Reviews

The Psychological Record -     

The interaction of stressful life events and chronic strains on community mental health

One of the possible adaptive costs of coping with stress is diminished capacity to respond to subsequent adaptive demands. This paper examined the complex interplay between major life events and one source of chronic strain. Residents of the greater Los Angeles metropolitan area exposed to higher levels of smog, who had also experienced a recent stressful life event, exhibited poorer mental health than those exposed to pollution who had not experienced a recent stressful life event. There were, however, no direct effects of smog levels on mental health. These patterns of results were replicated in both a cross-sectional and a longitudinal study. The interplay of psychosocial vulnerability and environmental conditions is discussed.     

The principle of charity and the problem of irrationality (translation and the problem of irrationality)

Common formulations of the principle of charity in translation seem to undermine attributions of irrationality in social scientific accounts that are otherwise unexceptionable. This I call the problem of irrationality. Here I resolve the problem of irrationality by developing two complementary views of the principle of charity. First, I develop the view (ill-developed in the literature at present) that the principle of charity is preparatory, being needed in the construction of provisional first-approximation translation manuals. These serve as the basis for explanatory accounts and associated refinements in the translation manual. In developing such explanatory accounts, the principle of charity is no longer constraining. Thus, the principle of charity applies only in the early stages of constructing translation manuals, and there is no problem of irrationality in the later stages of constructing translation manuals. Second, I reduce the principle of charity, where it does apply, to a special case of what I call the principle of explicability: so translate as to attribute explicable beliefs and practices to the speakers of the source-language. I show that the appropriate formulation of the principle of charity counsels just what the principle of explicability requires in the early stages of social scientific investigation.I am grateful to Robert Barrett, Roger Gibson, and Paul Roth for their generous assistance.     

Psychotropic drug treatment among learning-disabled,educable mentally retarded,and seriously emotionally disturbed students

Psychotropic drug treatment in learning-disabled (LD), educable mentally retarded (EMR), and seriously emotionally disturbed (ED) children and adolescents receiving public school special education services was examined. The findings indicated that while treatment prevalence rates for EMR and ED groups were comparable, the rate for LD students was much lower. In the LD sample, pharmacotherapy was associated with higher ratings of behavioral deviance, longer placement in special education, less social integration, and greater peer rejection, which suggests that symptom severity is an important determiner of pharmacotherapy in this population.