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.     

The valuing process: A study of favorite songs and the inner experience of persons diagnosed with schizophrenia

Since valuing is a process grounded in the organizational tendency of human behavior, the characteristics of a highly valued object should reflect the experience of the individual who selects it. This research compared the favorite songs of fourteen individuals diagnosed with schizophrenia to their inner experience as assessed in a standard interview. Many relationships were revealed between the two, often pertaining to important issues identified in theories of schizophrenia. Results may have therapeutic applications and shed light on processes through which psychological difficulties persist.     

As If Your Life Depended on It: Promoting Cognitive Development to Promote Wellness

In this article the authors discuss key elements of the cognitive-developmental perspective and the need to integrate it as an important component of the wellness model. Each speaks to the personal empowerment of every person to live a rewarding and responsible life. Each also emphasizes the ongoing promotion of growth rather than secondary prevention or remediation.     

Locus of control,choice, and satisfaction with an assigned task

P. E. Spector's (1982, Psychological Bulletin, 91, 482–497) hypothesis that under conditions of freedom of choice persons characterized by an internal locus of control will experience greater satisfaction with an undesirable task than persons characterized by an external locus of control is considered in light of distinctions between perceived control and perceived choice. Perceived choice is proposed as an intervening variable implicit in Spector's argument. This reasoning was tested with 46 male and female college student participants in a 2 (Choice) × 2 (Locus of Control) factorial design experiment. An interaction of Choice × Locus of Control on task satisfaction was obtained such that internals tended to be more satisfied when given a choice while externals experienced greater satisfaction when not given a choice. The implications of this result for Spector' hypothesis and for the manner in which undesirable work is assigned are discussed.     

The power within: Mass media,scientific entertainment,and the introduction of psychical research into China, 1900–1920

How did a new science initially promoted by only a few individuals eventually become a widespread cultural phenomenon practiced and known by thousands of people? Following a transnational approach, this article traces the introduction of psychical research into China during the first two decades of the 20th century. Known in the Republican period (1912–1949) as Spiritual Science (xinling kexue or xinling yanjiu), psychical research flourished between the 1920s and 1930s, playing a key role in the popularization of applied psychology and mind-cure across China. This article takes a step back from the heyday of Spiritual Science by looking at the period that immediately preceded and helped define it. Focused on wide-circulation newspapers, popular manuals, and stage performances, it teases out the ways in which Chinese popular culture translated European, American, and Japanese psychical research to local Chinese audiences in the midst of China's search for modernity. By naturalizing the reality of psychic powers, spiritual scientists blurred the boundaries between science and superstition in a period when these were posited as diametrically opposed.     

Susceptibility to prosocial and antisocial influence in adolescence following mindfulness training

Mindfulness training programmes have shown to encourage prosocial behaviours and reduce antisocial tendencies in adolescents. However, less is known about whether training affects susceptibility to prosocial and antisocial influence. The current study investigated the effect of mindfulness training (compared with an active control) on self-reported prosocial and antisocial tendencies and susceptibility to prosocial and antisocial influence. 465 adolescents aged 11–16 years were randomly allocated to one of two training programmes. Pre- and post-training, participants completed a social influence task. Self-reported likelihood of engaging in prosocial and antisocial behaviours did not change post-training, and regardless of training group, participants showed a higher propensity for prosocial influence than for antisocial influence. Finally, participants were less influenced by antisocial ratings following both training programmes.     

Distress,wellbeing, and growth amidst COVID-19: Considering the dynamic interplay between positive and negative anticipatory emotions

Although negative anticipatory emotions are typically seen as risk factors for poorer psychological outcomes over COVID-19, emotion theorists suggest that this risk may be attenuated if balanced by the experience of positive emotion. Thus, the current study examined whether interactions between positive and negative anticipatory emotions were concurrently associated with psychological distress and greater personal wellbeing/posttraumatic growth (PTG) at three distinct periods (i.e., pre-lockdown, during lockdown, post-lockdown), and whether associations varied by these three COVID-19 time periods. The study utilizes two large longitudinal Australian samples, surveyed in 2020 prior to, during, and after a strict 4-month lockdown that occurred in Australia. Overall, positive emotions attenuated the adverse psychological outcomes arising from higher levels of negative emotion (i.e., higher psychological distress and lower personal wellbeing). Observed effects varied according to COVID-19 threat exposure. Specifically, the interaction was significantly associated with psychological distress prior to the lockdown for Sample 2, and during the lockdown for both samples. The interaction was significantly associated with wellbeing (Sample 2) prior to, and during, the lockdown but only marginally associated post-lockdown. The interaction, however, was not significantly associated with PTG (Sample 1). The results suggest that it is valuable for future research to consider greater emotional complexity (i.e., mixed emotions) over COVID-19, and other stressors more generally, to encompass a more nuanced understanding of resilience.     

SLOTE'S SATISFICING CONSEQUENTIALISM

The article discusses Michael Slote's Satisficing Consequentialism, which is the view that moral agents are not required to maximise the good, but merely to produce a sufficient amount of good. It is argued that Satisficing Consequentialism is not an acceptable alternative to Maximising Consequentialism. In particular, it is argued that Satisficing Consequentialism cannot be less demanding in practice than Maximising Consequentialism without also endorsing a wide range of clearly unacceptable actions. It is then argued that Slote's inability to provide adequate reasons for moral satisficing stems from a mistaken analogy between rationality and morals. The sense of ‘good enough’ which is relevant to morality is one which focusses on the effort an agent puts in, rather than on the outcome she produces. However, replacing outcomes with efforts would undermine Slote's Consequentialist project. Finally, it is suggested that similar problems will be faced by others who seek to construct essentially Consequentialist theories which are not unduly demanding.     

Promoting the Culturally Sensitive Diagnosis of Mexican Americans: Some Personal Insights

This article presents a series of personal guidelines for promoting the culturally sensitive psychiatric diagnosis of Mexican American/Chicano clients. These guidelines are primarily based on the authors' collective experiences in diagnosing and treating this population.