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.     

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.     

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.     

THE SIMILARITY OF BRAIN ACTIVITY ASSOCIATED WITH TRUE AND FALSE RECOGNITION MEMORY DEPENDS ON TEST FORMAT

Abstract— Event-related potentials (ERPs) were compared for correct recognitions of previously presented words and false recognitions of associatively related, nonpresented words (lures). When the test items were presented blocked by test type (old, new, lure), waveforms for old and lure items were different, especially at frontal and left parietal electrode sites, consistent with previous positron emission tomography (PET) data (Schacter, Reiman, et. al., 1996). When the test format randomly intermixed the types of items, waveforms for old and lure items were more similar. We suggest that test format affects the type of processing subjects engage in, consistent with expectations from the source-monitoring framework (Johnson, Hashtroudi, & Lindsay, 1993). These results also indicate that brain activity as assessed by neuroimaging designs requiring blocked presentation of trials (e g, PET) do not necessarily reflect the brain activity that occurs in cognitive-behavioral paradigms, in which types of test trials are typically intermixed.     

Computerized fuzzy ratings: The concept of a fuzzy class

In this paper, we outline the concept of a fuzzy class used in programs for eliciting computerized fuzzy ratings. Fuzzy ratings allow respondents to provide symmetrical or asymmetrical latitudes of acceptance around a preferred point. These ratings have been used in research testing career theories and person-environment fit models. The variables defining the fuzzy class and the various functions that can be performed by it are described in the paper. The idea of a fuzzy class may be of interest to those involved in expert systems, knowledge engineering, or in fuzzy classification and measurement in general. A program, FUZRATE, written in object-oriented C++ code that uses the concept of a fuzzy class, is available on request. Both source code and a binary (executable) file are available.     

Teaching peer reinforcement and grocery words: An investigation of observational learning and instructive feedback

A multiple probe across behaviors design, replicated across participants, assessed the effectiveness of constant time delay in teaching appropriate peer reinforcement and grocery words to 3 elementary students with moderate intellectual disabilities. Additionally, pretests and posttests assessed the acquisition of the participants' observational learning (acquisition of peers' grocery words) and instructive feedback (related information supplied by the teacher in the consequent event). Results indicate that the participants learned (a) how to appropriately reinforce peers, (b) to read their grocery words, (c) some of the targeted stimuli of their peers, and (d) much of the instructive feedback that was associated with each of the grocery words. Maintenance data indicate that the participants maintained their target grocery words at high levels of accuracy.