Paranoia and self-consciousness.

A new instrument designed to assess paranoid thought in college students, together with reliability and validity data, was presented in Study 1. A single general factor accounted for a substantial portion of the variance in the full scale. Public self-consciousness was consistently and significantly correlated with the present measure of paranoia. In Study 2, both pretested paranoia and public self-consciousness were related to feelings of being watched (a classical manifestation of paranoia), although public self-consciousness had an effect only when there was a 2-way mirror present. In Study 3, self-attention, experimentally induced using a story construction task, again resulted in a heightened sense of being observed. Discussion focuses on paranoid cognition as characteristic of everyday thought and the implications of self-attention for social perception processes.     

Impact of combination therapies on HIV risk perceptions and sexual risk among HIV-positive and HIV-negative gay and bisexual men.

The availability of improved HIV treatments may prompt reduced concern about HIV and sexual risk. Gay and bisexual men (N = 554, 17% HIV-positive) completed measures of treatment attitudes, sexual risk, and assumptions regarding the infectiousness of sexual partners. A substantial minority reported reduced HIV concern related to treatment advances. Reduced HIV concern was an independent predictor of sexual risk, particularly among HIV-positive men. In response to hypothetical scenarios describing sex with an HIV-positive partner, participants rated the risk of unprotected sex to be lower if the partner was taking combination treatments and had an undetectable viral load, relative to scenarios with a seropositive partner not taking combination treatments. Prevention efforts must address attitudinal shifts prompted by recent treatment successes, stressing the continued importance of safer sex, and that an undetectable viral load does not eliminate infection risks.     

Neighborhood Stress and Life Satisfaction: Is there a Relationship for African American Adolescents?

Applied Research in Quality of Life - This study identified associations between perceived neighborhood stress and adolescents’ perceptions of life satisfaction. African American adolescents...     

Alcohol use and high-risk sexual behavior among men who have sex with men: the effects of consumption level and partner type.

Alcohol use may increase HIV sexual risk behavior, although findings have varied across study populations and methods. Using event-level data from 1,712 seronegative men who have sex with men, the authors tested the hypothesis that social context would moderate the effect of alcohol consumption on unprotected anal sex (UAS). For encounters involving a primary partner, rates of UAS did not vary as a function of alcohol use. However, consumption of 4 or more drinks tripled the likelihood of UAS for episodes involving a nonprimary partner. Thus, the effects of alcohol vary according to the context in which it is used. Interventions to reduce substance-related risk should be tailored to the demands of maintaining sexual safety with nonprimary partners.     

Effectiveness of antidepressants: an evidence myth constructed from a thousand randomized trials?

Antidepressants, in particular newer agents, are among the most widely prescribed medications worldwide with annual sales of billions of dollars. The introduction of these agents in the market has passed through seemingly strict regulatory control. Over a thousand randomized trials have been conducted with antidepressants. Statistically significant benefits have been repeatedly demonstrated and the medical literature is flooded with several hundreds of "positive" trials (both pre-approval and post-approval). However, two recent meta-analyses question this picture. The first meta-analysis used data that were submitted to FDA for the approval of 12 antidepressant drugs. While only half of these trials had formally significant effectiveness, published reports almost ubiquitously claimed significant results. "Negative" trials were either left unpublished or were distorted to present "positive" results. The average benefit of these drugs based on the FDA data was of small magnitude, while the published literature suggested larger benefits. A second meta-analysis using also FDA-submitted data examined the relationship between treatment effect and baseline severity of depression. Drug-placebo differences increased with increasing baseline severity and the difference became large enough to be clinically important only in the very small minority of patient populations with severe major depression. In severe major depression, antidepressants did not become more effective, simply placebo lost effectiveness. These data suggest that antidepressants may be less effective than their wide marketing suggests. Short-term benefits are small and long-term balance of benefits and harms is understudied. I discuss how the use of many small randomized trials with clinically non-relevant outcomes, improper interpretation of statistical significance, manipulated study design, biased selection of study populations, short follow-up, and selective and distorted reporting of results has built and nourished a seemingly evidence-based myth on antidepressant effectiveness and how higher evidence standards, with very large long-term trials and careful prospective meta-analyses of individual-level data may reach closer to the truth and clinically useful evidence.     

The 9th annual INDUS-EM 2013 Emergency Medicine Summit, “Principles,Practices, and Patients,” a level one international meeting,Kerala University of Health Sciences and Jubilee Mission Medical College and Research Institute,Thrissur, Kerala,India, October 23–27, 2013

INDUS-EM is India’s only level one conference imparting and exchanging quality knowledge in acute care. Specifically, in general and specialized emergency care and training in trauma, burns, cardiac, stroke, environmental and disaster medicine. It provides a series of exchanges regarding academic development and implementation of training tools related to developing future academic faculty and residents in Emergency Medicine in India. The INDUS-EM leadership and board of directors invited scholars from multiple institutions to participate in this advanced educational symposium that was held in Thrissur, Kerala in October 2013.     

The Effects of Assessment Mode and Privacy Level on Self‐Reports of Risky Sexual Behaviors and Substance Use Among Young Women1

This study examined differences in reported behaviors by assessment mode under differing privacy levels. Females were randomized to a computer‐administered self‐interview (CASI) or self‐administered questionnaire (SAQ) assessment of sexual risk and substance use behaviors that was completed non‐anonymously or anonymously. There were few differences in reported behaviors between assessment modes and privacy levels. However, an assessment mode by privacy‐level interaction was found for 2 outcomes (unprotected oral sex, recent sexual partner). Greater disclosure occurred in the CASI‐anonymous condition than the CASI‐non‐anonymous condition. Those in the CASI condition disclosed more instances of drinking until intoxicated than did those completing the SAQ. Overall, the findings suggest that CASI and SAQ under differing privacy levels result in comparable health behavior self‐reports.     

Computer-assisted self-interviews: A cost effectiveness analysis

Computer-assisted self-interview (CASI) questionnaires are being used with increased frequency to deliver surveys that previously were administered via self-administeredpaper-and-pencil questionnaires (SAQs).Although CASI may offer a number of advantages, an important consideration for researchers is the assessment modality's immediate and long-term costs. To facilitate researchers' choice between CASI and SAQ, this article provides theoretical cost models with specific parameters for comparing the costs for each assessment type. Utilizing these cost models, this study compared the cost effectiveness in a health behavior study in which both CASI (n = 100) and SAQ (n = 100) questionnaires were administered. Given the high initial costs, CASI was found to be less cost effective than SAQ for a single study. However, for studies with large sample sizes or when CASI software is to be used for multiple studies, CASI would be more cost effective and should be the assessment mode of choice.