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.     

Personality traits,money attitudes and consumer decision-making styles as predictors of investment products choice in South Africa

This study examines how personality traits and money attitudes influence consumers' decision-making styles when purchasing investment products in South Africa. A sample of 269 South Africans completed the research questionnaire, which assessed their extraversion, conscientiousness, openness, money power/prestige, money retention/time, money quality, info-mising, extending, and tax-free investment purchase decision. Also, confirmatory factor analysis and structural equation modelling approaches were used to analyze the survey data. The results suggest that personality traits and money attitudes significantly impact consumer decision-making regarding tax-free investment products. However, the relationships between extraversion and money power/prestige and between info-mising decision styles and tax-tree investment purchase decisions were found to be negative. Cluster analysis revealed three distinct segments based on the characteristics of respondents and their drive for investment: strong conscientiousness investors, status-driven investors, and introverted investors. Marketing professionals and investment firms can use the study findings on consumer traits and money attitudes to improve marketing effectiveness in an organisation. Practically, extensive information processing has a fundamental bearing on investment decision-making in emerging markets. Extraversion and conscientiousness personality traits and money attitudes must be taken into consideration by investment products marketers and practitioners in marketing practice.     

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.     

Childhood fantasy play relates to adult socio-emotional competence

Childhood fantasy play and creation of imaginary companions are thought to confer socio-emotional benefits in children, but little is known about how they relate to socio-emotional competence in adulthood. A total of 341 adults (81 males) aged 18 and above (M = 31.47, SD = 12.62) completed an online survey examining their fantasy play as a child, their childhood imaginary companion status, and their adult socio-emotional competence. Adults who reported higher levels of childhood fantasy play were found to be significantly more prosocial, empathetic, and emotionally intelligent than their counterparts after controlling for demographic factors. Recall of a childhood imaginary companion, however, was significantly related only to higher scores for perspective-taking and did not explain unique variance in any adult competence measure. Findings suggest that engagement in fantasy play during childhood may be a precursor to later socio-emotional competence, while benefits previously associated with imaginary companions specifically may not extend into adulthood.     

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.     

Moving the debate forward in small steps: A reply to Morrison

Morrison (1996) criticised the authors' 1995 evaluation on three main grounds: that it was too narrow, that it was circular, and that the model evaluated was contradictory. It is argued that the narrow focus was deliberate, that the methodology was standard and logical, and that the framework evaluated was coherent. Although the authors agree with Morrison in some respects, e.g. on the value of variety of methodology, there seems to be a basic difference in view on scientific method. The authors see research as (mainly) small steps which are erratic but generally cumulative; Morrison appears to favour grand-scale, multi-purpose research.