Metacognitive Interpersonal Therapy Improves Adherence to Antiretroviral Therapies in a Man with a Severe Personality Disorder: A Case Report

Treatment adherence by patients with HIV ensures they gain the full benefit of antiretroviral medications and extend their lives. One problem which may contribute to poor adherence is deficits in metacognition or the capacity to make sense of mental states. In particular, persons who struggle to notice and think about their thoughts and feelings may be less able to direct their own recovery by taking advantage of effective treatments. This raises the possibility that treatments which lead to improved metacognitive function may enhance treatment adherence. We describe the case of a man in an advanced stage of AIDS with Kaposi’s sarcoma. The patient was treated with Metacognitive Interpersonal Therapy combined with psychoeducation about pharmacological treatment for HIV. Primary medical outcomes were suppression of viral load, increase of CD4 count and control of AIDS related conditions such as Kaposi’s sarcoma. The primary psychological outcome was reduction of personality disorders criteria. The patient was able to understand what led him to discontinue medication and then later regain full adherence. He achieved suppression of viral load and restore of CD4 count. As regard severity of personality disorder, he achieved reliable change. Interventions such as Metacognitive Interpersonal Therapy may assist patients with HIV to gain the metacognitive capacities to make sense of their medical and psychological challenges and adhere to antiretroviral therapies leading to enhanced levels of health. Future studies are needed to explore these findings in larger controlled studies.     

A Guide for Assessing Clients’ Attachment to the Sacred: The Spiritual Attachment History

Current research supports that many people relate to God or a higher power in ways consistent with attachment theory, yet nothing exists assisting therapists in gathering attachment-focused background information regarding their clients’ spiritual lives. This paper fills that gap with the Spiritual Attachment History (SAH), a semi-structured interview guide adapted from an ICEEFT Training in Emotionally Focused Couple Therapy attachment history handout, to help the authors meet their clients’ spiritual and relational clinical concerns. We describe how we developed the SAH and provide a case study of its incorporation into two treatment plans. We also discuss implications for training, for use by marriage and family therapists, for cross-cultural research, and the ethics of addressing spirituality as a cultural issue.     

The Associations between Perceived Maternal Psychological Control and Academic Performance and Academic Self-Concept in Chinese Adolescents: The Mediating Role of Basic Psychological Needs

This study examined the associations between perceived maternal psychological control and adolescent academic functioning in terms of academic performance and academic self-concept. The study also tested the possible mediating role of basic psychological needs to investigate how parental psychological control is related to child academic functioning. A sample of Chinese adolescents (N?=?338) completed a self-administered questionnaire on maternal psychological control, academic self-concept, academic performance and basic psychological needs satisfaction. Structural equation modeling was used for data analyses. Findings of this study revealed that Chinese adolescents’ perceptions of maternal psychological control were associated with their academic self-concept, and furthermore this association was mediated by adolescents’ basic psychological needs satisfaction on autonomy, relatedness and competence. Theoretical and practical implications, as well as future research directions were discussed.     

Comparing single‐ and dual‐process models of memory development

This experiment examined single‐process and dual‐process accounts of the development of visual recognition memory. The participants, 6–7‐year‐olds, 9–10‐year‐olds and adults, were presented with a list of pictures which they encoded under shallow or deep conditions. They then made recognition and confidence judgments about a list containing old and new items. We replicated the main trends reported by Ghetti and Angelini ( 2008 ) in that recognition hit rates increased from 6 to 9 years of age, with larger age changes following deep than shallow encoding. Formal versions of the dual‐process high threshold signal detection model and several single‐process models (equal variance signal detection, unequal variance signal detection, mixture signal detection) were fit to the developmental data. The unequal variance and mixture signal detection models gave a better account of the data than either of the other models. A state‐trace analysis found evidence for only one underlying memory process across the age range tested. These results suggest that single‐process memory models based on memory strength are a viable alternative to dual‐process models for explaining memory development.     

Happiness and health behaviours among university students from 24 low,middle and high income countries

The aim of this study was to examine health behaviours and happiness and associated factors in low, middle and high income countries. In a cross-sectional survey, 17 508 undergraduate university students (mean age 20.9, SD = 2. 8) from 25 universities in 24 countries across Asia, Africa and the Americas self-completed anonymous questionnaires. Results indicate that the overall happiness mean score among university students across 24 countries was 13.7 (range 4–20). Generally, the study found that university students from countries of the Caribbean, South America and sub-Saharan Africa had greater happiness scores than students from countries in North Africa and Asia. In multivariate linear regression analysis, better subjective socio-economic status, coming from an higher income country, higher social support, higher intrinsic religiosity, higher personal mastery, positive health behaviours (regular breakfast, adequate physical activity, habitual seatbelt use, regular dental check-ups, not having had an injury, not drinking and driving) and negative health behaviours (not having three or more servings of vegetables and eating red meat daily) were correlated with happiness. Improvement to the happiness of university students should consider regional differences in socio-economic environment.     

Beyond the double-jeopardy hypothesis: Assessing emotion on the faces of multiply-categorizable targets of prejudice

Prior research has shown that race influences perceptions of facial expressions, with hostility detected earlier on young male Black than White faces. This study examined whether the interplay of race and age would moderate perceptions of hostility by having participants evaluate facial expressions of multiply-categorizable targets. Using a facial emotion change-detection task, we assessed evaluations of onset/offset of anger and happiness on faces of young and old Black and White men. Significant age by race interactions were observed: while participants perceived anger as lasting longer and appearing sooner on old compared to young White faces, this relationship was reversed for Black faces, with participants perceiving anger lasting longer and appearing sooner on young compared to old Black faces. Similar results were found for perceived happiness. These results suggest that perception during cross-categorization may be more complex than the simple additive function proposed by the double-jeopardy hypothesis, such that co-activation of other stereotypes may sometimes confer a protective benefit against bias.     

Induction with uncertain categories: When do people consider the category alternatives?

These three experiments examined how people make property inferences about exemplars whose category membership is uncertain. Participants were shown two categories and a novel exemplar with a feature that indicated that the exemplar was more likely to belong to one category (target) than to the other (nontarget). Participants then made categorization decisions and property inferences about the novel exemplar. In some conditions, property inferences could be made only by considering both target and nontarget categories. In other conditions, predictions could be based on both categories or on the target category alone. Consistent with previous studies (e.g., Murphy & Ross, 1994, 2005), we found that many people made predictions based only on consideration of the target category. However, the prevalence of such single-category reasoning was greatly reduced by highlighting the costs of neglecting nontarget alternatives and by asking for inferences before categorization decisions. The results suggest that previous work may have exaggerated the prevalence of single-category reasoning and that people may be more flexible in their use of multiple categories in property inference than has been previously recognized.     

Maternal Attributions Related to Compliance with Cystic Fibrosis Treatment

This study examined mothers' attributions related to their children's compliance with various components of medical treatment for cystic fibrosis (CF). Mothers of children with CF were queried regarding adherence rates and reasons for child compliance with chest physiotherapy, inhalation therapy, exercise, medication, and dietary treatments. Maternal attributions for compliance were assessed on the dimensions of parental locus, stability, and controllability. Mothers reported significantly less compliance with diet than with other CF treatments; they also perceived the reasons for compliance with diet and exercise as more external and less under their control. These findings are discussed in relation to parent–child interactions that may be critical to improving treatment adherence, particularly in the context of nutritional interventions.