Neuropsychopharmacologic treatment of depression and other neuropsychiatric disorders in HIV-infected individuals

How can neuropsychiatric disorders and syndromes be underdiagnosed and inadequately treated in individuals infected with human immunodeficiency virus? Depression in particular is among the most prevalent diagnoses and there is a solid foundation of data from controlled clinical studies that has begun to examine the efficacy of various antidepressants in HIV-infected persons. This article summarizes essential findings pertaining to the use of psychotropic medications to treat depression and other neuropsychiatric disorders in the context of immunodeficiency. This includes discussion of clinically significant treatment considerations (eg, efficacy, side effects, drug-drug interactions) derived from the existing literature. Taken together, there is compelling evidence that psychopharmacologic intervention can improve the quality of life of mentally ill HIV-infected individuals.     

Acquired equivalence and distinctiveness in human discrimination learning: evidence for associative mediation

In the first stage of Experiments 1-3, subjects learned to associate different geometrical figures with colors or with verbal labels. Performance in Stage 2, in which the figures signaled which of 2 motor responses should be performed, was superior in subjects required to make the same response to figures that had shared the same Stage 1 associate. A third stage of testing showed that the events used as associates in Stage 1 were capable of evoking the motor response trained in Stage 2, an outcome predicted by an associative interpretation of such transfer effects. Experiment 4 provided evidence that the relevant associations can be effective in controlling motor responding even when subjects report an antagonistic relationship between events.     

Evaluating NEO Personality Inventory-Revised profiles in veterans with personality disorders

Fifty-one psychiatric, veteran outpatients were assessed for personality disorders on the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II; First, Gibbon, Spitzer, Williams, & Benjamin, 1997a) and were also administered the NEO Personality Inventory-Revised (NEO-PI-R; Costa & McCrae, 1992). Results were compared to Trull and Widiger's (1997) hypotheses about the profiles of such patients and similar past studies. Correlations between NEO-PI-R facets and SCID-II personality disorder symptom clusters generally occurred in the expected direction. Facets hypothesized to be associated with a given personality disorder were able to predict variance in their respective SCID-II personality disorder scores for seven of ten personality disorders. In general, results support the facet-level conceptualizations of these disorders, except for Obsessive-Compulsive Personality Disorder.     

Introduction to the special section on Resources for Enhancing Alzheimer's Caregiver Health (REACH)

This article provides background information and an overview on Resources for Enhancing Alzheimer's Caregiver Health (REACH) a multisite intervention trial for caregivers of persons with Alzheimer's disease designed to reduce caregiver burden and depression. REACH is the largest randomized controlled clinical trial to date, involving 1,222 caregiver and care recipient dyads recruited from 6 different sites in the United States. The authors describe the design of the study, summarize the interventions implemented at each site, and provide an overview of the 4 articles in this special section.     

The Resources for Enhancing Alzheimer's Caregiver Health (REACH): project design and baseline characteristics

The Resources for Enhancing Alzheimer's Cargiver Health (REACH) project was designed to test promising interventions for enhancing family caregiving for persons with dementia. The purpose of this article is to describe the research design, interventions, and outcome measures used in REACH and to characterize the sample recruited for the study. Nine interventions and 2 control conditions were implemented at 6 sites; 1,222 dyads were randomly assigned to an intervention or a control condition. The caregiver sample was 18.6% male with an average age of 62.3 years (56% Caucasian, 24% Black, and 19% Hispanic). Caregivers reported high levels of depressive symptoms and moderate burden. Care recipients were older, with a mean age of 79, and were moderately to severely impaired with mean Mini-Mental State Exam scores of 13/30.     

Psychometric analysis of the Revised Memory and Behavior Problems Checklist: factor structure of occurrence and reaction ratings

A modified version of the Revised Memory and Behavior Problems Checklist (RMBPC; L. Teri et al., 1992) was administered across 6 different sites to 1,229 family caregivers of community-dwelling adults with dementia. The total sample was divided randomly into 2 subsamples. Principal components analyses on occurrence responses and reaction ratings from the first subsample resulted in a 3-factor solution that closely resembled the originally proposed dimensions (memory-related problems, disruptive behaviors, and depression). Confirmatory factor analyses on data from the second subsample indicated adequate fit for the 3-factor model. Correlations with other caregiver and care-recipient measures supported the convergent and discriminant validity of the RMBPC measures. In addition, female caregivers and White caregivers reported more problems, on average, than male caregivers and African American caregivers, respectively.     

Sources of individual differences in fraction skills

The purpose of this investigation was to evaluate a conceptual model of relations between two kinds of mathematical knowledge (simple arithmetic and conceptual knowledge), two kinds of child characteristics (working memory and on-task related classroom behavior), and individual differences in three kinds of fraction outcomes (fraction computation, estimation, and word problems) in 105 fifth grade students. Structural equation modeling provided consistent evidence that conceptual knowledge independently contributes to individual differences in the three fraction outcomes. Simple arithmetic knowledge was uniquely related only to variability in fraction computation skills. Mathematical knowledge was found to mediate some of the contributions of both working memory and classroom behavior on variability in fraction outcomes. These supported mediating processes extend the current literature by explication of the pathways via which characteristics of children may affect individual differences in fraction outcomes.     

Time and resource limits on working memory: cross-age consistency in counting span performance

This longitudinal study separated resource demand effects from those of retention interval in a counting span task among 100 children tested in grade 2 and again in grades 3 and 4. A last card large counting span condition had an equivalent memory load to a last card small, but the last card large required holding the count over a longer retention interval. In all three waves of assessment, the last card large condition was found to be less accurate than the last card small. A model predicting reading comprehension showed that age was a significant predictor when entered first accounting for 26% of the variance, but counting span accounted for a further 22% of the variance. Span at Wave 1 accounted for significant unique variance at Wave 2 and at Wave 3. Results were similar for math calculation with age accounting for 31% of the variance and counting span accounting for a further 34% of the variance. Span at Wave 1 explained unique variance in math at Wave 2 and at Wave 3.     

An evaluation of Woodard's theory of perceptually oriented hypnosis

This article evaluates Woodard's theory of Perceptually Oriented Hypnosis, a welcome addition to theories of hypnosis that emphasize the centrality of subjective experiences in understanding and studying hypnosis. With a focus on subjective experience. Woodard's account of perceptually oriented hypnosis is based on elements of humanistic, client-centered, and perceptual psychology. However, we contend that improvements in the operational clarity and coverage of the theory are necessary to optimize its utility and heuristic value. We also argue that it is important for Perceptually Oriented Hypnosis to address hypnotic phenomena, e.g., individual differences in suggestibility, involuntary responding to suggestions, stability of responding over time, widely recognized as essential to understanding hypnotic experience and responding. With these refinements, we believe that Woodard's theory would have a greater potential to enrich our understanding of both the unique experiences of individuals who undergo hypnosis and of hypnosis in general.