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.     

Cocaine-induced brainstem seizures and behavior.

A variety of abnormal sensory/motor behaviors associated with electrical discharges recorded from the bilateral brainstem were induced in adult WKY rats by mechanical (electrode implants) and DC electrical current stimulations and by acute and chronic administration of cocaine. The electrode implant implicated one side or the other of the reticular system of the brainstem but subjects were not incapacitated by the stimulations. Cocaine (40 mg/kg) was injected subcutaneously for an acute experiment and subsequent 20 mg/kg doses twice daily for 3 days in a chronic study. Cocaine generated more abnormal behaviors in the brainstem perturbation group, especially the electrically perturbated subjects. The abnormal behaviors were yawning, retrocollis, hyperactivity, hypersensitivity, "beating drum" behavior, squealing, head bobbing, circling, sniffing, abnormal posturing, and facial twitching. Shifts in the power frequency spectra of the discharge patterns were noted between quiet and pacing behavioral states. Hypersensitivity to various auditory, tactile, and visual stimulation was present and shifts in the brainstem ambient power spectral frequency occurred in response to tactile stimulation. These findings suggest that the brainstem generates and propagates pathological discharges that can be elicited by mechanical and DC electrical perturbation. Cocaine was found to activate the discharge system and thus induce abnormal behaviors that are generated at the discharge site and at distant sites to which the discharge propagates. Cognitive functions may also be involved since dopaminergic and serotonergic cellular elements at the brainstem level are also implicated.     

Development of perceived adolescent relationship scale

The purpose of the present study was to develop an easily administered scale to assess adolescents' perceptions of both their own social competence and social participation in relationships. Six items were used to generate two factors that accounted for about 68% of the variance.     

Interhemispheric transfer in schizophrenics, depressives, and normals with schizoid tendencies

Although several studies suggest that schizophrenics suffer from an impairment in the interhemispheric transfer (IHT) of information, methodological weaknesses in these studies preclude clear interpretation of their results. This study addresses these criticisms in order to provide a clearer test of the IHT theory. Schizophrenics, depressives, normal controls, and normals with schizoid tendencies were assessed on five measures of IHT (verbal and nonverbal dichotic listening, intermanual transfer, bimanual block design, finger sequence repetition) and two measures of unilateral hemispheric processing (lateral eye movements, auditory thresholds). Results consistently failed to support an IHT deficit interpretation of schizophrenia. Schizoid normals had a significantly greater right-ear advantage on verbal dichotic listening than both psychiatric groups, a result suggesting enhanced left-hemisphere activation in schizoid normals. It is concluded that the IHT theory requires stronger empirical substantiation than has been obtained to date to warrant further consideration as a central theory of schizophrenia.     

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.