Understanding the impact of HIV diagnosis amongst gay men in Scotland: An interpretative phenomenological analysis

Objectives: Although a wide literature details the psychological impact of human immunodeficiency virus (HIV) diagnosis, it predates the introduction of effective treatment for HIV (i.e. anti-retroviral therapies, ARTs). This article explores the psychological impact of HIV diagnosis in post-ART accounts. This is important, given the recent policy developments which focus upon increasing HIV testing and thus diagnoses.

Design: This study presents a qualitative exploration of the experiential accounts of HIV-positive gay men living in Scotland. A total of 14 HIV-positive gay men took part in open-ended interviews.

Methods: Interpretative phenomenological analysis was employed to identify recurrent themes across the interviews.

Results: Our analysis focuses upon the participants’ struggles in adjusting to their HIV status. Diagnosis was a deeply shocking and unexpected experience. Stigma and fear of prejudice dominated their accounts. HIV was understood, variously, as a shameful, fatal and life-changing condition. Overall, within these accounts there was little sense of HIV normalisation.

Conclusions: In Scotland, where HIV prevalence is low, and where no accessible HIV-positive sub-culture exists, there is on-going psychological distress and morbidity amongst gay men testing HIV positive. As HIV-related policy increasingly focuses on increasing rates of antibody testing, there is a need to reduce the psychosocial costs associated with HIV-positive diagnoses.     

Cognitive Discrepancy,Dissonance, and Selective Exposure

Abstract

Although cognitive dissonance is regarded as one of the most recognized causes of selective exposure [N. J. Stroud, Niche News (Oxford University Press, 2011)], the mechanism for such causation is still unclear. By inducing dissonance in a web-based experiment, this study demonstrates how cognitive dissonance relates to information preferences—the intention to seek congruent information and the intention to seek incongruent information. The findings suggest that perceived hostility with respect to one’s belief (cognitive discrepancy) can enhance the intention to seek out for attitude-consistent information. More importantly, individuals were found to have the intention to avoid counterattitudinal information, but only when they experienced some sort of psychological discomfort (dissonance). In other words, while cognitive discrepancy leads individuals to crave for confirming information, only those who encounter negative emotions are likely to employ avoidance of disconfirming information as a dissonance-reduction strategy.     

Computer-Mediated Communication Versus Vocal Communication and the Attenuation of Pre-Interaction Impressions

Conflicting theoretical approaches yield divergent predictions about the effects of telephones versus computer-mediated communication (CMC) in the persistence or dissipation of pre-interaction expectancies. Moreover, different theoretical orientations and their underlying assumptions often invoke different methodologies, which can bias the results of research. The current studies articulate and assess rival hypotheses from alternative theoretical paradigms to uncover how CMC and vocal communication affect interpersonal impressions. Methodological issues in past CMC research are evaluated that limit the generalizability of previous findings in the area. Experiments employing alternative assumptions and methods indicate that CMC is functionally equivalent to vocal communication in its ability to ameliorate expectancies and that in some cases it can be superior in transmitting positive impressions.     

The Relation Between Executive Function and Theory of Mind is More Than Skin Deep

A simple “expression” account of the relation between executive function (EF) and children's developing theory of mind (ToM) has difficulty accounting for the generality of the changes occurring in children's mental-state understanding during the preschool years. The current study of preschool children (N = 43) showed that EF—especially conflict EF—related uniformly to ToM measures that imposed either high or low executive demands, independent of verbal ability. These findings can be explained within an emergence account wherein executive skills are implicated in the acquisition of mental-state concepts as opposed to merely the expression of these concepts in task performance.     

The precuneus and the insula in self-attributional processes

Attributions are constantly assigned in everyday life. A well-known phenomenon is the self-serving bias: that is, people’s tendency to attribute positive events to internal causes (themselves) and negative events to external causes (other persons/circumstances). Here, we investigated the neural correlates of the cognitive processes implicated in self-serving attributions using social situations that differed in their emotional saliences. We administered an attributional bias task during fMRI scanning in a large sample of healthy subjects (n = 71). Eighty sentences describing positive or negative social situations were presented, and subjects decided via buttonpress whether the situation had been caused by themselves or by the other person involved. Comparing positive with negative sentences revealed activations of the bilateral posterior cingulate cortex (PCC). Self-attribution correlated with activation of the posterior portion of the precuneus. However, self-attributed positive versus negative sentences showed activation of the anterior portion of the precuneus, and self-attributed negative versus positive sentences demonstrated activation of the bilateral insular cortex. All significant activations were reported with a statistical threshold of p ≤ .001, uncorrected. In addition, a comparison of our fMRI task with data from the Internal, Personal and Situational Attributions Questionnaire, Revised German Version, demonstrated convergent validity. Our findings suggest that the precuneus and the PCC are involved in the evaluation of social events with particular regional specificities: The PCC is activated during emotional evaluation, the posterior precuneus during attributional evaluation, and the anterior precuneus during self-serving processes. Furthermore, we assume that insula activation is a correlate of awareness of personal agency in negative situations.     

Uptake of Cardiac Screening and Genetic Testing Among Hypertrophic and Dilated Cardiomyopathy Families

Cardiomyopathy is a genetically and clinically heterogeneous, life threatening disease which affects people of all ages. Recent guidelines provide recommendations for cardiac screening and genetic testing in at-risk relatives, but the uptake and impact of these measures in the United States is unknown. This is a single institution retrospective study that characterizes the uptake of cardiac screening and genetic testing for relatives of a cohort of 57 probands with hypertrophic (HCM) and dilated cardiomyopathy (DCM) who underwent both clinical evaluation and genetic testing. Cardiac screening was indicated for 302 relatives. One hundred and seventy-three (57 %) completed cardiac screening. Forty of the 57 probands were mutation positive and genetic testing was indicated for 213 relatives. Eighty-four (39 %) completed genetic testing. The uptake of cardiac surveillance was greater than the uptake of genetic testing (p?<?0.0001) among relatives of mutation positive probands. Within the group of at-risk, asymptomatic relatives of probands, cardiac screening and genetic testing were positive in 25 % and 40 % of cases, respectively. These data demonstrate the important role and utility of cascade cardiac screening and genetic testing in the care of patients and families with HCM or DCM. The approach to cardiac screening and genetic testing should be family-specific and requires expertise in the genetics of cardiomyopathy.     

Acceptance and Commitment Therapy in Genetic Counselling: A Case Study of Recurrent Worry

I present a case study where the mother of a child with 22q11 deletion disorder appeared to be experiencing recurrent, intrusive worry associated with the inherent uncertainty of this highly variable condition. Counselling sessions are summarised followed by an in-depth reflection about the case with reference to the main therapeutic tenets of Acceptance and Commitment Therapy (ACT). Specific techniques which may have been of great benefit to the client and potential application in the genetic counselling setting are explored in the context of ACT.     

Self-Construing In Former Child Soldiers

This article presents a repertory grid study of young people who had experienced civil war in Sierra Leone, some as child soldiers and others as noncombatants. Unexpected findings included that the former combatants viewed themselves more favorably than did noncombatants. The findings are discussed in terms of individual and social construing processes, drawing on narratives and interview and focus group responses obtained from the participants in the larger investigation of which this study was part. Particular consideration is given to the role of forgiveness.     

Personal Construction of Family Relationships: The Relation of Commonality and Sociality to Family Satisfaction for Parents and Adolescents

This study tested the hypothesis that family members showing greater commonality (similarity) and sociality (predictive accuracy) in their construing of family relationships would display greater satisfaction with those relationships than would individuals in families whose relational construing was more discrepant and unpredictable. Forty-seven family triads participated in the study, including a mother, father, and adolescent from each family. Measures of commonality and sociality in the construction of family relationships derived from a family relationships grid were compared to measures of family structure, including the Family Cohesion and Adaptability Evaluation Scale (FACES-II) (Olson, Portner, & Bell, 1982) and the Parent-Adolescent Communication Scale (PACS) (Barnes & Olson, 1982). The findings suggest that members' perceptions of the family as emotionally close, flexible, and communicative may not represent independent aspects of the family structure, at least within the present nonclinical sample. Comparison of the family relationship grids with the FACES-H and PACS demonstrated that commonality and sociality among family members was highly related to mothers' and adolescents' family satisfaction, but was much less predictive of that of the father.