The Multilevel Relationships of HIV‐Related Stigma to Child and Caregiver Mental Health among HIV‐Affected Households in South Africa

HIV/AIDS‐related (HAR) stigma is still a prevalent problem in Sub‐Saharan Africa, and has been found to be related to mental health of HIV‐positive individuals. However, no studies in the Sub‐Saharan African context have yet examined the relationship between HAR stigma and mental health among HIV‐negative, HIV‐affected adults and families; nor have any studies in this context yet examined stigma as an ecological construct predicting mental health outcomes through supra‐individual (setting level) and individual levels of influence. Multilevel modeling was used to examine multilevel, ecological relationships between HAR stigma and mental health among child and caregiver pairs from a systematic, community‐representative sample of 508 HIV‐affected households nested within 24 communities in KwaZulu‐Natal, South Africa. Two distinct dimensions of HAR stigma were measured: individual stigmatizing attitudes, and perceptions of community normative stigma. Findings suggest that individual‐level HAR stigma significantly predicts individual mental health (depression and anxiety) among HIV‐affected adults; and that community‐level HAR stigma significantly predicts both individual‐level mental health outcomes (anxiety) among HIV‐affected adults, and mental health outcomes (PTSD and externalizing behavior scores) among HIV‐affected children. Differentiated patterns of relationships were found using the two different stigma measures. These findings of unique relationships identified when utilizing two conceptually distinct stigma measures, at two levels of analysis (individual and community) suggest that HAR stigma in this context should be conceptualized as a multilevel, multidimensional construct. These findings have important implications both for mental health interventions and for interventions to reduce HAR stigma in this context.     

Anticipatory postural adjustments during a Fitts’ task: Comparing young versus older adults and the effects of different foci of attention

Anticipatory postural adjustments (APAs) are an integral part of standing balance. Previous research with balance control has shown that adopting an external focus of attention, compared to an internal focus of attention, yields better performance during motor skills. Despite the importance of APAs, especially among older adults, and the potential benefits of adopting an external focus of attention, studies investigating methods for improving APAs are limited. The aim of this study was to compare behavioral, kinematic and APAs measures while adopting different foci of attention among young and older adults when performing a lower extremity Fitts’ task. Ten young adults (mean age 24 years ± 4.37) and ten older adults (mean age 75 years ± 5.85) performed a lower-extremity reaching task (Fitts’ task) while adopting an external focus (focus on target) and an internal focus (focus on limb) in a within-subject design. A motion capture system was used to record participants’ movement data. Custom software derived movement time (MT), peak velocity (PV), time to peak velocity (ttPV) and variability at target (SD_T). Electromyography (EMG) was used to determine APAs onset and magnitude. The findings showed that an external focus of attention led to significantly shorter MT, higher PV, shorter ttPV and more accuracy when reaching the target (SD_T) for both age groups. Also, EMG results showed that, with an external focus, APAs onset occurred earlier and APAs magnitude was more efficient. As predicted by Fitts’ Law, participants spent more time executing movements to targets with higher indices of difficulty. Older adults compared to young adults were more adversely affected by the increase of difficulty of the Fitts’ task, specifically, on measures of APAs. In conclusion, adopting an external focus of attention led to better overall movement performance when performing a lower extremity Fitts’ task. The task used in the present study can distinguish between APAs for older and young adults. We recommend that future studies expand on our findings in order to establish a performance-based objective measure of APAs to assess clinical interventions for postural control impairment.     

Similarity to prototypical heavy drinkers and non-drinkers predicts AUDIT-C and risky drinking in young adults: prospective study

Objective: The aim of the present study was to explore whether constructs within the Prototype Willingness Model (PWM) predicted risky drinking as measured by AUDIT-C, drinking harms and unplanned drunkenness in a sample of UK young adults. Previous studies exploring the PWM often do not use validated measures of alcohol consumption, and the outcomes of risky drinking are underexplored. Design: An online prospective study design with 4 week follow-up was employed and 385 young adults completed the study (M age?=?21.76, SD?=?3.39, 69.6% female; 85.2% students). Main outcome measures: Intentions to get drunk, AUDIT-C, drinking harms experienced in the last 4 weeks, and unplanned drunkenness in the last 4 weeks. Results: Heavy and non-drinker prototype similarity predicted AUDIT-C, drinking harms and unplanned drunkenness when controlling for past behaviour and reasoned action pathway constructs. Intentions and willingness both mediated the relationship between prototype perceptions and AUDIT-C. Conclusion: This study supports the use of the PWM in the prediction of AUDIT-C, drinking harms and unplanned drinking in a UK sample. Prototype perceptions influenced behaviour via both reasoned and reactive cognitions. Targeting similarity to heavy and non-drinker prototypes should be the focus of future interventions in this population.     

Time for change: using implementation intentions to promote physical activity in a randomised pilot trial

Objective: A common barrier to exercise is a perceived lack of time. The current pilot study examined the effects of an implementation intention intervention to enhance exercise self-efficacy, increase confidence to exercise when facing time constraints, and increase physical activity in middle-aged adults (n?=?63, aged 35–69). Design: Participants received a pedometer (Fitbit) to objectively measure activity and were randomly assigned to either a control or intervention condition. After a 1-week baseline, the intervention condition received instructions to plan how, where, and when they would add steps to their daily routine to meet their step goal, using personalised schedules and maps. Both groups were contacted nightly via email. Main Outcome Measures: Physical activity (steps and time spent in moderate-to-vigorous activity), goal achievement, exercise self-efficacy, time-relevant exercise self-efficacy and affect. Results: Compared to the control, the intervention condition significantly increased in steps, time spent in moderate-to-vigorous activity, and time-relevant exercise self-efficacy. Goal achievement was related to greater time-relevant exercise self-efficacy and more positive affect at the daily level. Conclusion: Findings suggest that the personalised planning intervention increased physical activity and confidence in achieving physical activity goals under time constraints. Avenues for future directions, especially for producing more sustained effects, are discussed.     

Application of Problem Solving Therapy for Late-Life Anxiety

Cognitive behavioral therapy for anxiety has demonstrated lower efficacy in older compared with younger adults. Yet, few other evidence-based options for late-life anxiety have been examined. This case series aimed to demonstrate the application of Problem Solving Therapy (PST) to older adults with anxiety disorders building on PST’s strong empirical support for treating late-life depression. PST was implemented to treat three older primary-care patients diagnosed with anxiety disorders. We present treatment outcomes and discuss the feasibility and acceptability of using PST to treat these patients. Implications and lessons learned from these patients are discussed to inform further development of PST to better meet the needs of older patients suffering from late-life anxiety.     

Romantic relationship commitment and the threat of alternatives on social media

Although previous findings suggest a link between adults' use of social networking sites (SNS) and relationship commitment, research has been lacking. This study of 427 emerging and young adults (aged 18–32 years, 71.20% female) indicated that exposure to alternative partners on SNS was indirectly related to relationship commitment through the pursuing of alternative partners on SNS. The more frequently they were exposed to alternative partners on SNS, the more they engaged in pursuing these alternative partners, which negatively affected their relationship commitment. Furthermore, a positive relation between exposure and romantic comparison to alternative partners was found. Gender did not moderate these relations. The discussion focuses on the implications of the findings for relationship development.     

Setting the stage for children’s participation in worship practices

How children participate in worship practices is largely determined by adults. Adults set the stage; they shape the physical environment and determine the subject matter. Adults design the format for children’s participation in various forms of worship and the roles adults perform influence the interactions with children. Many different intentions inform these design choices and roles: Intentions revolving around faith, liturgy, community, and experience. The way adults shape worship with children points to the significance of spirituality. When adults perform directing roles, children’s spirituality can find a point of reference in stories and traditions while adults themselves gain from the process of translation this involves. When adults facilitate exploration, this nourishes both children’s and adults’ spirituality. Finally, when adults and children participate in worship practices together, it may contribute to a sense of community in which faith can be lived and shared.     

Grit Applied Within: Identity and Well-being

This study investigates how grit, perseverance in the face of challenges and focus on achieving goals, relates to identity development and how identity development mediates the relationship between grit and well-being. Emerging adult college students (N = 232) indicated their grit, identity status, and well-being by completing an online questionnaire. Grit-perseverance of effort was associated with all identity statuses. Grit-consistency of interest was associated most identity statuses. Commitment and ruminative exploration mediated the relationship between grit and happiness and self-esteem, respectively.     

越老越风险规避吗？——年龄对冲动性预测决策行为的调节效应

年老化伴随着风险承担倾向的改变,而决策行为受冲动性的影响是否受到年龄的调节尚不清楚。研究采用两种不同类型的决策任务以及Barratt冲动性量表,考察老年人风险承担在自我报告和决策行为上的改变。结果显示老年人在剑桥博弈任务中更加风险寻求而在模拟充气球任务中更加风险规避。同时冲动性可以显著预测模拟充气球的行为,且该预测受到年龄的调节。研究结果提示,老年人并不是单一的更加风险规避或者风险寻求,而是与任务特异性相关。同时,冲动性可以较好的预测年轻人的决策行为,而对老年人的决策行为没有预测作用。