Depression is not an inevitable outcome of disclosure avoidance: HIV stigma and mental health in a cohort of HIV-infected individuals from Southern India

Previous research has shown that HIV stigma in India can be characterized by a framework dividing manifestations into enacted (discrimination), vicarious (hearing stories of discrimination), felt normative (perceptions of stigma's prevalence), and internalized stigma (personal endorsement of stigma beliefs). We examined whether this framework could explain associations among stigma, efforts to avoid HIV serostatus disclosure, and depression symptoms in a cohort of 198 HIV-infected individuals from Southern India who were followed up for one year as part of a study of antiretroviral adherence. Prior studies had suggested that disclosure avoidance was a primary outcome of stigma and that impaired well-being was a primary outcome of disclosure avoidance. Analyses from our longitudinal research revealed that the pattern of associations among stigma, disclosure avoidance, and depression symptoms remained consistent over time. Enacted and vicarious stigmas were correlated with felt normative stigma beliefs. In turn, felt normative stigma was correlated with disclosure avoidance. And, enacted stigma, internalized stigma, and disclosure avoidance were all associated with depression symptoms. However, even though the overall framework held together, internalized stigma and depression symptoms dropped significantly over time while other components remained unchanged. These findings suggest that, although HIV stigma may limit disclosure, it does not invariably lead to psychological maladjustment. Amidst ongoing perceptions and experiences of stigma, HIV-positive individuals can achieve significant improvements in their acceptance of the disease and in mental well-being.     

生活医学化与健康恐慌的关系及其反思*--论Michael Fitzpatrick《健康的暴政：医生及生活方式的控制》

迈克尔·菲茨帕特里克的《健康的暴政：医生及生活方式的控制》一书,以健康干预为主线,以健康政治化、生活医学化、疾病道德化为主题,论述了生活医学化的不同方面和形成过程,并力图揭示医学化背后隐含着的医学对社会的干预和控制。其中作者关于生活医学化和健康恐慌的一些哲学思考,尤其是生活医学化与健康恐慌的内涵及特点、生活医学化与健康恐慌的关系以及对生活医学化的审视与反思,在一定程度上蕴涵着对当今社会发展的启示。     

Situation awareness as a function of frame of reference, computer-graphics eyepoint elevation, and geometric field of view

The purpose of this study was to determine how 3 variables for the design of a "heads-down" spatial display--the frame of reference (pilot's eye vs. God's eye), geometric field of view, and elevation of the computer graphics eyepoint--influenced situation awareness. Thirteen flight-naive subjects each flew a simulated F-16 over a computer-generated flight environment to lock onto and intercept a series of sequentially appearing targets. The flight scene consisted of both an "out-the-window" view and a computer-generated heads-down spatial display showing an airplane symbol superimposed on a perspective view of the flight environment. During the interactive phase of the experiment, root mean square flight-path error, target lock-on time, and target acquisition time were measured. After the interactive phase of the study was completed, subjects were required to mark the location of the targets from memory on a computer-generated top-down view of the flight scene in an attempt to reconstruct the spatial mental model which subjects formed of the flight environment. The results for the interactive phase of the study indicated that performance was superior using the pilot's-eye display. However, for the spatial reconstruction task, performance was better using the God's-eye display. It was also shown that the ability to maintain the optimal flight-path using the more top-down view of the scene (600 eyepoint) was superior to the 300 eyepoint elevation. Implications of the results for the design of spatial instruments are discussed.