Adherence to HAART: perspectives from clients in treatment support programs

The development of highly active antiretroviral therapy (HAART) has resulted in dramatic decreases in morbidity and mortality for HIV-infected individuals. Because the long-term efficacy of HAART is dependent on near perfect adherence, many providers offer services to support adherence, including education, regimen review, counseling, and reminder tools. Little is known regarding the utilization or efficacy of these services. In this paper, we report on data collected during 32 open-ended interviews conducted with individuals receiving services through the New York State Treatment Adherence Demonstration Project. Participants in the project reported deriving benefits from a broad range of project activities. Educational efforts helped clients to recognize HIV as a manageable, rather than terminal, illness. Information and tools focused on specific regimens provided clients with concrete knowledge and skills. Effective communication with medical providers and pharmacists was facilitated by adherence staff who proactively advocated for client needs. Program-based social support was particularly valuable for many participants, helping them to retain needed motivation and strength. Educational, practical, and supportive services were all considered valuable to clients participating in adherence support programs. A mix of services may best meet the range of needs found among persons taking HAART.     

Unitary vs multiple semantics: PET studies of word and picture processing

In this paper we examine a central issue in cognitive neuroscience: are there separate conceptual representations associated with different input modalities (e.g., Paivio, 1971, 1986; Warrington & Shallice, 1984) or do inputs from different modalities converge on to the same set of representations (e.g., Caramazza, Hillis, Rapp, & Romani, 1990; Lambon Ralph, Graham, Patterson, & Hodges, 1999; Rapp, Hillis, & Caramazza, 1993)? We present an analysis of four PET studies (three semantic categorisation tasks and one lexical decision task), two of which employ words as stimuli and two of which employ pictures. Using conjunction analyses, we found robust semantic activation, common to both input modalities in anterior and medial aspects of the left fusiform gyrus, left parahippocampal and perirhinal cortices, and left inferior frontal gyrus (BA 47). There were modality-specific activations in both temporal poles (words) and occipitotemporal cortices (pictures). We propose that the temporal poles are involved in processing both words and pictures, but their engagement might be primarily determined by the level of specificity at which an object is processed. Activation in posterior temporal regions associated with picture processing most likely reflects intermediate, pre-semantic stages of visual processing. Our data are most consistent with a hierarchically structured, unitary system of semantic representations for both verbal and visual modalities, subserved by anterior regions of the inferior temporal cortex.     

A four-component model of procedural justice: defining the meaning of a "fair" process

Two studies test the prediction of the four-component model of procedural justice that people evaluate the fairness of group procedures using four distinct types of judgment. The model hypothesizes that people are influenced by two aspects of the formal procedures of the group: those aspects that relate to decision making and those that relate to the quality of treatment that group members are entitled to receive under the rules. In addition, people are hypothesized to be separately influenced by two aspects of the authorities with whom they personally deal: the quality of decision making by those authorities and the quality of the treatment that they receive from them. The results of two studies support the hypothesis of the four-component model by finding that all four of the procedural judgments identified by the model contribute to overall evaluations of the fairness of group procedures.     

Using Media to Create Experiential Learning in Multicultural and Diversity Issues

The authors present a framework for using media to create experiential learning in multicultural and diversity issues based on cognitive-experiential self-theory. They offer several lessons and a media resource list that are helpful in training counseling students in multicultural and diversity issues.     

Self-serving bias in the attribution of responsibility: Cognitive versus motivational explanations

The purpose of this study is to compare the cognitive and motivational explanations of differences in the responsibility assigned to the victim of a crime. It has generally been found that the victim of a crime is assigned more responsibility for that crime by similar others if its consequences are severe. The motivational explanation for this finding is that subjects are threatened by the idea that a serious crime can happen by chance. The cognitive explanation is that serious crimes are rarer and subjects attribute more of the responsibility for rarer events to those who experience them. This study tested these two explanations by independently varying the severity and the likelihood of a crime and examining attributions of responsibility to its victim. The results of the study support the cognitive explanation. Similar others were found to attribute more responsibility for a crime to the victim when that crime was presented as rare, irrespective of whether its consequences were mild or severe. In addition, when likelihood was controlled experimentally no effect of severity upon attributions of responsibility was found. These results suggest that, within the context of attributions of responsibility to victims, patterns of attribution consistent with those predicted by theories suggesting motivational influences upon attribution may actually represent the operation of cognitive processes.     

Bi-directional relations between behavioral problems and executive function: Assessing the longitudinal development of self-regulation

During childhood, the ability to limit problem behaviors (i.e., externalizing) and the capacity for cognitive regulation (i.e., executive function) are often understood to develop in tandem, and together constitute two major components of self-regulation research. The current study examines bi-directional relations between behavioral problems and executive function over the course of childhood and adolescence. Relying on a diverse sample of children growing up in low-income neighborhoods, we applied a random intercept cross-lagged panel model to longitudinally test associations between behavioral problems and executive function from age 4 through age 16. With this approach, which disaggregated between- and within-child variation, we did not observe significant cross-lagged paths, suggesting that within-child development in one domain did not strongly relate to development in the other. We also observed a moderate correlation between the stable between-child components of behavioral problems and executive function over time in our preferred model, suggesting that these two domains may be relatively distinct when modeled from early childhood through adolescence.