Medication beliefs and structural barriers to treatment adherence among people living with HIV infection

Background: People living in poverty face multiple structural challenges to medication adherence including lack of transportation, inadequate housing and food insecurity. The degree to which individuals’ motivations to remain adherent may overcome structural barriers has received limited attention.

Purpose: To examine whether medication necessity and concerns beliefs predict antiretroviral therapy (ART) adherence over and above structural adherence barriers associated with poverty.

Methods: People living with HIV in a southern US city (N = 942) completed computerised interviews, an objective measure of adherence and HIV viral suppression obtained from medical records. Hierarchical logistic regression models were constructed to examine demographic and illness characteristics, structural barriers, mental health, substance use and medication necessity and concerns beliefs as predictors of ART adherence.

Results: In multivariable models, current drug use and medication necessity and concerns beliefs predicted treatment adherence over and above demographic, health, mental health and structural factors.

Conclusions: Medication beliefs are proximal and powerful motivating factors that predict adherence. Adherence interventions should directly address medication beliefs in developing strategies to manage barriers facing people with HIV living in poverty.     

Bystander Responses to Risk for Rape Perpetrated by a Friend,Acquaintance, or Stranger

This study explored bystander responses to risk for an alcohol-facilitated rape perpetrated by a friend, acquaintance, or stranger. Undergraduates (N = 331) were randomly assigned to read 1 of 3 scenarios in which an apparently sober male friend, acquaintance, or stranger leads an intoxicated woman into a bedroom. Participants completed self-report measures of intent to directly intervene and barriers to intervention. Compared to men, women reported greater intent to help the potential victim and fewer barriers to intervention. Participant gender moderated the effect of the bystander’s relationship with the potential perpetrator on intent to confront and responsibility to intervene. Men reported more confrontation and more responsibility to intervene when perpetrators were identified as either friends or acquaintances than strangers. In contrast, women reported more confrontation when perpetrators were identified as friends than either strangers or acquaintances. Bystander education programs that address specific barriers to intervening with strangers and acquaintances could promote more frequent bystander behavior.     

Evaluating the role of anxiety sensitivity in barriers to cessation and reasons for quitting among smokers with asthma

The aim of the present study was to examine the unique predictive ability of anxiety sensitivity (AS) in terms of perceived barriers to cessation and smoking cessation motives among daily smokers with asthma (n = 125, 54% male, M_age = 37.7 years, SD = 12.1). As hypothesized, after controlling for the effects of race, asthma control, negative affect, and smoking rate, AS significantly predicted greater barriers to cessation, and reasons for quitting related to health concerns and self-control. Contrary to hypotheses, AS did not significantly predict external reasons for quitting. These findings suggest that smokers with asthma who are fearful of physiological arousal may be a particularly ‘at-risk’ population for smoking cessation difficulties due, in part, to greater perceived barriers to cessation. Interventions focused on enhancing intrinsic motivation for quitting and reducing AS may be most effective for this population.     

Perceptions of Prolonged Occupation as Barriers to Conflict Resolution

The goal of this research was to examine whether a denial of a prolonged occupation by the occupying society constitutes a meaningful sociopsychological barrier to resolving the conflict peacefully. We hypothesized that this perception will be associated with objections both to conflict resolution processes and to specific compromises intended to end the occupation. Furthermore, we hypothesized that the association between denial of the occupation and compromises will be partially mediated by denial of its costs, low levels of moral emotions, and closure to new information about the conflict. Taking the prolonged Israeli occupation as our case study, we used three nationwide representative polls of Jewish Israelis to test our hypotheses. The studies supported our hypotheses, pointing to the distinct role that the perception of prolonged occupation by the occupying society plays in peacefully ending this situation, and the psychological mechanisms underlying occupation denial as a barrier to conflict resolution.     

THE PRIMORDIAL ROOTS OF BEING

Abstract. Suffering, alongside the feeling of sanctity of life, pervades human experience, generating primal anxiety, which humans learn to shore up with social solidarity and with the practice of communication in religious rituals. The roots of social belonging spring from the primordial sentiments toward ethnicity, race, language, religion, customs and traditions, and region. Self–identity, mediated by mental formations derived from social relations, is composed of thinking and values. Daily experience reveals that cultural differences produce blind spots in thinking and barriers in values—-governing areas of activity, social relations, the world, and identity of being—-that impedes cross—-cultural understanding.     

Gender Differences in STEM Students' Perfectionism,Career Search Self‐Efficacy,and Perception of Career Barriers

The purpose of this study was to explore potential gender differences in the mediating effect of career search self‐efficacy between 2 dimensions of perfectionism (adaptive and maladaptive) and the perception of career barriers. A total of 279 science, technology, engineering, and mathematics undergraduate students participated in the study. Among men, but not women, career search self‐efficacy mediated the relationships between both dimensions of perfectionism and the perception of career barriers. Implications for counselors and future research directions are discussed.     

On the determination of autistoid organizations in non-autistic adults

Psychogenic autistic phenomena occurring in non-autistic adults are being increasingly discussed in the psychoanalytical literature. The author endeavours to determine autistoid organizations, which are understood to be a particular form of pathological retreat. Together with the use of autistic objects, two-dimensional levelling out, the failure of unconscious communication, and of projective identification, a characteristic of these retreats is that they are meant to afford protection against paranoid-schizoid fears of the external and unintegrated states of the internal world. The formation of such autistic reactions should be sought not only in traumatic separations and the inadequate containment of primary objects, but also in constitutional weakening. Intolerance accompanying projective identification and damage to primal fantasies/preconceptions are discussed. In conclusion, a clinical illustration with autistoid and hypochondriacal retreats clarifies some of the aspects discussed.     

Chapter 2. Single Mothers' Transition to Self-Sufficiency

SUMMARY

In this chapter, I review the literature in four sections central to my research questions. First, I review the socio-historical context of trends that have had an impact on single mothers in transition from economic assistance to self-sufficiency. Next, I present research that focuses on poor women's interactions with barriers to work versus self-sufficiency. Then I examine the reported interactions between work, family role strain, and the psychological well-being of low-income women during their transition to work. Finally, I introduce related literature that reflects studies and reports on the outcomes of TANF after 1996.     

Health and Social Service Needs of Transgender People in Chicago

SUMMARY

A needs assessment of transgender people was conducted in Chicago in 2001 to assess their HIV risks, health and social service needs, and barriers to care. One hundred and eleven transgender individuals, 78 male-to-females (MTFs) and 33 female-to-males (FTMs), participated in the study. Fourteen percent of respondents reported being HIV-positive; they were all male-to-female and the majority was of color. Risk factors for HIV included unprotected sex and willingness to have high-risk sex in the future. Respondents experienced high levels of violence. Two-thirds of respondents had thought of attempting suicide. Respondents reported a high need for health and social services, particularly MTFs and people of color.