Informal Caregiving to Persons with AIDS in the United States: Caregiver Burden Among Central Cities Residents Eighteen to Forty-Nine Years Old

Characteristics and caregiving experiences of friends and family members caring for people with AIDS (PWAs) were examined. Based on a probability sample of informal AIDS caregivers ages 18–49 living in central cities of the United States (n = 260), analyses were conducted to (a) identify the sociodemographic characteristics of young central city caregivers; and (b) examine the effects of caregiver characteristics (relationship to PWA, gender, race/ethnicity, income, sexual orientation, HIV status, perceived susceptibility), and level of objective caregiving demands, on subjective caregiver burden. Results indicate that the largest group of caregivers in this age category are male friends of the PWA—a group not typically found among caregivers to persons with other types of illnesses. In general, gay or bisexual caregivers, caregivers who have traditional family ties to the PWA, men relative to women, and lower income caregivers, report the greatest burden. While level of caregiving demands represents the most influential predictor of caregiver burden, white and male caregivers experience greater burden, independent of level of involvement and other caregiver characteristics. Receiving instrumental support with caregiving buffers the impact of high objective demands on subjective burden.     

Cognitive sequelae of repeated head injury in a population of intravenous drug users

The relationship between closed head injury and performance on neuropsychological (NP) tests was investigated in a group of intravenous drug users (IVDUs). Subjects with repeated head traumas involving loss of consciousness (LOC) performed worse than both a control group without LOC and reference group with only a single episode of LOC. There were no significant differences between the last two groups. Performance on tests of memory, attention, and motor performance was significantly worse in the group with repeated head injury. The average time since the last episode of LOC was more than 11 years. We conclude from these findings that a single episode of LOC does not result in significant cognitive impairment in this population. Two or more episodes, however, are more likely to produce chronic cognitive impairment.     

A preventive,psychoeducational approach to increase perceived social support

Investigated the effects of a 13-week preventive, psychoeducational intervention program to improve perceived social support. Fifty-one, low-perceived support, community residents were randomly assigned to an intervention or wait-list control condition. Intervention subjects received training in social skills and cognitive reframing regarding the self and social relations. The intervention led to increased perceived social support from family, but not from friends. As hypothesized by social cognition models, increases in perceived support appeared to be mediated by changes in self-esteem and frequency of self-reinforcement. Further, such changes in cognition about the self were larger than the changes observed for perceived support, suggesting that it may be easier to change cognition about the self than perceptions of support.     

Woman and the gift of reason

An incidental extension of the central domain of argumentation theory with non-classical ways of constructing arguments seems to automatically raise a question that is otherwise rarely posed, namely whether or not it is useful to consider the sex of the arguer. This question is usually posed with regard to argumentation by women in particular. Do women rely more, or differently than men do on non-canonical modes of reasoning stemming from the realm of the emotional, physical and intuitive, instead of the logical? One may simply refer this question to folk-linguistics. One may also take the question seriously, given the findings on women's linguistic behaviour, and for various other reasons that will be explained below.Section 1 sums up the most frequently quoted differences in language use between women and men. This is followed by a non-exhaustive, interdisciplinary review of studies on male/female differences in verbal and written argumentation.Section 2 discusses the role of language and texts in generating and maintaining ideas on gender. These gender messages not only influence the actual argumentation behaviour of women and men, but also the way such behaviour is valued.Section 3 subsequently shows that our ideas on rationality are gendered, and therefore also our ideas on the proper central domain of argumentation theory.Section 4 briefly reflects on why this kind of wrong question about the reasoning of women should sometimes be addressed seriously anyway.     

Developing the matrix representation grid (MRG): A method for observing group processes. Findings from time-limited group psychotherapy for alcohol-dependent patients

The MRG was published 1988 in order to support developments in group psychotherapy methods as one of the all too few process observation research methods for studying group-as-a-whole. After 9 years of what pilot studies have labeled successful clinical trials, this study aims at validating the MRG against the established SAVI: Structural Analysis of Verbal Interaction (Agazarian & Simon 1989). Videotaped group sessions from short-term groups for alcohol dependent patients conducted along two therapy methods, one behaviorally oriented and the other group analytic, are used as material. The MRG is validated in the study, confirmed to be clinically valuable, and some interesting comparisons between the two treatment modalities are also made.     

Group climate in an open-ended cancer support group

A number of well-described, controlled studies assessing cancer support group intervention support their effectiveness. All of these experimental groups have been close-ended and typically involve six to eight weekly sessions. Because many cancer patients are unable or unwilling to participate in closed, extended-session groups, there is particular need for analysis of the effectiveness of short-term, open-ended groups. Additionally, objective measures are needed to delineate the factors contributing to a successful outcome in cancer support groups. We used the Short Form of the Group Climate Questionnaire (GCQ-S) to characterize 23 sessions in an open-ended, short-term, Veterans Hospital based cancer support group. The cancer group scored significantly lower on the Avoiding and Conflict dimensions (p<.001) compared to a normative psychotherapy group sample. There was no difference on the Engaged dimension. This pilot study suggests that a cancer support group in this setting can create an environment where members are cohesive and take responsibility for their own change process, while keeping interpersonal conflict to a minimum. Based on these preliminary findings, we encourage controlled clinical trials examining the efficacy of open-ended cancer support groups.At the time of this study, Dr. Daroff was a resident in Psychiatry, University of California, San Francisco.     

Cultural specificity of support sources,correlates and contexts: Three studies of African-American and Caucasian youth

Levels and correlates of parental support, peer support, partner support, and/or spiritual support among African American and Caucasian youth were examined in three contexts: adolescent pregnancy (Study 1), first year of college (Study 2), and adolescence and young adulthood (ages 15–29; Study 3). Partially consistent with a cultural specificity perspective, in different contexts different support sources were higher in level and/or more strongly related to adjustment for one ethnic group than the other. Among pregnant adolescents, levels of spiritual support were higher for African Americans than Caucasians; additionally, peer support was positively related to well-being only for African Americans whereas partner support was positively related to well-being only for Caucasians. Among college freshmen, family support was more strongly related to institutional and goal commitment for African Americans than Caucasians; conversely, peer support was more strongly related to institutional and goal commitment among Caucasians. Among 15 to 29-year-olds, levels of parental support and spiritual support were higher among African Americans than Caucasians; additionally, spiritual support was positively related to self-esteem for African Americans but not for Caucasians. Implications and limitations of the research are discussed. The third study was supported by National Institute of Mental Health Grant RO1 MH40963. We thank Monica Greene, Shea Lyda, Wendy Stevenson, and the many undergraduate students who contributed to the three research projects. We also acknowledge the very thoughtful and helpful comments of the anonymous reviewers and the editor, Edison Trickett.     

Social desirability,perceived stress,and PACT ratings in lung transplant candidates: A preliminary investigation

Some aspect of psychosocial criteria is commonly utilized by most transplant programs in assessing candidates' acceptability for transplantation. However, regardless of the assessment methodology, information obtained in pretransplant assessments may be limited given the evaluative nature of the assessment as well as the sensitive nature of the contents. Indeed, transplant candidates may present themselves in a favorable fashion, minimizing any negative traits or psychological dysfunction which they perceive might prevent transplantation. Unfortunately, there are limited data addressing the extent to which transplant candidates may present themselves in an overly positive light. This investigation surveys the prevalence of social desirability in lung transplant candidates as well as its association with self-reports of perceived stress. Further, the relationship between social desirability and interviewer ratings of transplant candidacy is examined. Subjects included 24 patients in end-stage organ failure being evaluated for lung transplant candidacy. Subjects completed the Perceived Stress Scale and a brief version of the Marlowe-Crowne Social Desirability Scale. Additionally, subjects were interviewer-rated on the Psychosocial Assessment of Candidates for Transplantation. Results indicate social desirability is a prevalent phenomenon in lung transplant candidates, with more than half of the sample scoring at or above the 84th percentile on the social desirability measure. Further, self-reports of perceived stress are moderately and inversely associated with social desirability (r=–.55,p .01). Social desirability was unrelated to interviewer-ratings of transplant candidates acceptability (r=.13,p .56). Future research might include larger samples of subjects, other organ transplant candidates, and more detailed assessments of symptom distress.     

Realism,instrumentalism, and the intentional stance

One of Dennett's principal arguments for an instrumentalistic construal of intentional attributions (e.g., attributions of belief, etc.) is that such attributions are environment relative. I argue that one can and should adopt a realist perspective toward such attributions, but accommodate their environmental relativity by treating intentional properties as relational properties. By doing so one acquires a useful perspective on experimental cognitive psychology; in particular, one can overcome the temptation to treat ecological accounts and information processing accounts as incompatible alternatives and come to see them as mutually supportive. Treating intentional properties as relational may be counter-intuitive, but I provide examples of how other sciences have had to treat what seem to be intrinsic properties as relational.