Randomized controlled trial of an intervention to prevent adherence failure among HIV-infected patients initiating antiretroviral therapy.

OBJECTIVE: Compare the efficacy of a multicomponent social support intervention to standard-of-care counseling on medication adherence among HIV-infected patients initiating antiretroviral therapy. DESIGN: Randomized controlled trial. Generalized estimating equations tested for differences in the percentage of participants achieving 90% adherence. MAIN OUTCOME MEASURES: Pill-taking, electronically monitored over 6 consecutive months; plasma viral load (VL), assessed at 3 and 6 months following initiation of therapy. RESULTS: Of 226 participants who were randomized and began the trial, 87 (38%) were lost to the study by 6 months. The proportion of adherent participants declined steadily over time, with no time by group interaction. Sustained adherence was associated with increased odds of achieving an undetectable VL (OR=1.78; 95% CI=1.01, 3.13). In intention-to-treat analyses, a larger proportion of the intervention group than the control group was adherent (40.15% vs. 27.59%, p=.02) and achieved an undetectable VL p=.04). However, the majority of participants who remained on study experienced some reduction in VL (>or=1-log drop or undetectable), regardless of experimental condition. CONCLUSION: The multicomponent social support intervention significantly improved medication adherence over standard-of-care counseling; evidence for improved virologic outcomes was inconsistent. Early discontinuation of care and treatment may be a greater threat to the health of HIV patients than imperfect medication-taking.     

Complex Communication Dynamics: Exploring the Structure of an Academic Talk

Communication is a multimodal phenomenon. The cognitive mechanisms supporting it are still understudied. We explored a natural dataset of academic lectures to determine how communication modalities are used and coordinated during the presentation of complex information. Using automated and semi‐automated techniques, we extracted and analyzed, from the videos of 30 speakers, measures capturing the dynamics of their body movement, their slide change rate, and various aspects of their speech (speech rate, articulation rate, fundamental frequency, and intensity). There were consistent but statistically subtle patterns in the use of speech rate, articulation rate, intensity, and body motion across the presentation. Principal component analysis also revealed patterns of system‐like covariation among modalities. These findings, although tentative, do suggest that the cognitive system is integrating body, slides, and speech in a coordinated manner during natural language use. Further research is needed to clarify the specific coordination patterns that occur between the different modalities.     

Future‐Bias: A (Qualified) Defense

The preferences of ordinary folks typically display a future‐bias. For instance, we care more about pains and pleasures in our future than pains and pleasures in our past. Indeed, this future‐bias is so pervasive, many have taken it for granted that the preferences of rational agents will, or at least can, display this future‐bias to some degree or other. However, the rationality of future‐biased preferences has recently come in for critique. However, in this article, I offer a defense of future‐biased preferences against three recent attempts – offered by David Brink, Preston Greene and Meghan Sullivan, and Tom Dougherty – to show such preferences irrational.     

Behavioral and sociocognitive correlates of ratings of prosocial behavior and sociometric status

Although peers' and teachers' evaluations of children's prosocial behavior and peers' sociometric ratings frequently have been used in studies of social development, the validity of young children's ratings of others has been questioned, as has that for teachers' ratings of prosocial behavior. In this study, preschoolers' ratings of peers' sociometric status and prosocial behavior, as well as teachers' ratings of children's prosocial dispositions, were obtained. These were correlated with children's naturally occurring prosocial or social behavior; ratings of prosocial behavior also were correlated with children's prosocial moral reasoning and prosocial self-attributions. Peers' sociometric ratings were positively related to children's sociability whereas prosocial ratings were related to helping (but not sharing) behavior. Teachers' ratings of prosocial behavior were not related to frequency of prosocial behaviors, but were positively related to developmentally mature moral judgments and self-reported motives.     

Defensiveness in response to aid from a sibling.

Defensive reactions to aid in the context of a close relationship were studied. Young adult siblings reported on their self-esteem, the quality of the sibling relationship, relevant demographic variables, and a variety of components of defensiveness to aid. Consistent with theory, the components of defensiveness were interrelated. A large percentage (52%) of the variance in defensiveness was accounted for by conflict between siblings, dominance relative to one's sibling, low global self-esteem, high self-esteem when comparing oneself with one's sibling, and low levels of feelings of entitlement. Siblings were least defensive in reaction to aid from older and female siblings. Corroboration from a subset of benefactor siblings was obtained. The results are discussed in relation to recent thinking about the nature of receiving support in close relationships and recipients' reactions to aid.     

Parental values, reinforcement, and young children's prosocial behavior: a longitudinal study.

In this study, the authors assessed the relation of parental reinforcement and parental values to young children's prosocial behaviors. Parents' dyadic interactions with their 1- to 2-year-old children were videotaped in the home on two occasions approximately 6 months apart. The children also were videotaped playing with a peer at 3 1/2 to 4 1/2 years of age. Parental reinforcement of the children's prosocial behaviors was coded, as were the children's prosocial behaviors with the peer. The frequency of girls' spontaneous prosocial behaviors decreased in the early years; modest consistency was observed for boys (but not girls) across the two parental sessions. No relation existed between the frequency of children's prosocial behaviors with their parents and their behaviors with peers. Both maternal and paternal valuing of compliance were negatively related to the mothers' use of reinforcement for children's spontaneous prosocial behaviors. Parental reinforcement of compliant prosocial behaviors was negatively related to children's compliance with a peer's request for prosocial behavior and positively related to defensive behavior with the peer. Fathers' valuing of prosocial behavior was associated with children's compliance with the peer's requests for prosocial action. Parents who valued compliance had children who exhibited low levels of compliant prosocial behaviors with the peer, possibly because of the depressed level of peer interaction.     

Relation of sympathy and personal distress to prosocial behavior: a multimethod study

Assessed sympathy and personal distress with facial and physiological indexes (heart rate) as well as self-report indexes and examined the relations of these various indexes to prosocial behavior for children and adults in an easy escape condition. Heart rate deceleration during exposure to the needy others was associated with increased willingness to help. In addition, adults' reports of sympathy, as well as facial sadness and concerned attention, were positively related to their intention to assist. For children, there was some indication that report of positive affect and facial distress were negatively related to prosocial intentions and behavior, whereas facial concern was positively related to the indexes of prosocial behavior. These findings are interpreted as providing additional, convergent support for the notion that sympathy and personal distress are differentially related to prosocial behavior.     

The Role of Sympathy and Altruistic Personality Traits in Helping: A Reexamination

The purposes of this study were (a) to examine the role of social evaluative concerns in the self-report of sympathy and in the relation of sympathy to helping; and (b) to determine the role of "altruistic personality" traits and situationally induced vicarious emotional responses in the intention to help. Dispositional and situational self-reports of sympathy and other vicarious emotional reactions were obtained for persons who also were given the opportunity to assist a needy other. Moreover, dispositional measures of concern with social evaluation and an altruistic orientation were obtained, and a bogus pipeline manipulation was instituted for half the study participants. Both dispositional and situational self-reported sympathy were positively related to helping, as were other personality indices viewed as reflecting altruistic characteristics. The relations for the dispositional indices of sympathy were not due solely to social evaluative concerns or to other egoistic concerns. The effects on intended helping of dispositional sympathy, perspective taking, and the tendency to ascribe responsibility for others to the self appeared to be both direct and mediated by situational sympathetic responding. Finally, situational sadness did not mediate the effects of sympathetic responsiveness.     

The relations between sex-typed play and preschoolers' social behavior

For decades toy choice has been a very popular measure of children's sex-role adoption. In the present study, the relations between choice of masculine, neutral, or feminine toys and other social behaviors (sex typed and non-sex typed) were examined. The social behaviors (socializing, requesting assistance, prosocial behaviors, aggressive/defensive behaviors) and toy choices of 33 preschool children were observed in their classrooms. Only two behaviors were found to be sex typed (socializing with peers and spontaneous prosocial behavior), and both of these behaviors were related to toy choice. Toy choice was also related to helping. Among boys, masculine toy choice was associated with requesting assistance from teachers. When toy choice was classified as masculine, androgynous, and feminine, only sociability toward peers was related to toy choice. The results are discussed in terms of their implications for the continued use of toy choice as a measure of sex-role adoption.The authors wish to express their gratitude to Rene Dodez for her assistance in data analysis and to the children and teachers at the Child Study Laboratory. We also appreciate the contributions of Drs. Laurie Chassin, Jerry Harris, Susan Somerville, Sharlene Wolchik, and Antonette Zeiss. This research was completed by the first author in partial fulfillment of the masters of arts degree at Arizona State University.