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.     

Demoralization and living alone: outcome from an urban community study.

The purpose of the present study was to investigate differences in demoralization between those who live in single-person households and those who live in households with others in a random sample of 8,634 urban adults. Responses to the 26-item Psychiatric Epidemiologic Research Interview did not substantiate that adults who live alone are more likely to be demoralized than those who live with others, until age and gender are considered. Men who live alone scored higher on demoralization than men who live with others, yet women who live with others scored higher on demoralization than those who live alone. An interaction for living arrangement and age group on demoralization was also observed.     

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.     

Physical fitness, body image, and locus of control in college freshman men and women

This study examined the relations among physical fitness, body image, and locus of control. The Hall-Physical Fitness Test Profile, the Winstead and Cash Body Self-relations Questionnaire (BSRQ) and the Nowicki-Strickland Locus of Control Scale were administered to 243 freshmen. Women were significantly more positive about their physical appearance than men. Men were more positive about their physical fitness than women. Men were more physically fit than women. Men and women scoring in the internal direction viewed the physical fitness domain of their body image positively. Unlike men, internally oriented women had more positive perceptions of the health aspect of their body image. Physically fit men and women had positive attitudes toward the physical fitness component of their body image. Physically fit men differed from physically fit women in that men were more internal and held more positive attitudes toward the physical health dimension of their body images.     

Motivation and performance: Two consequences of winning and losing in competition

The present study examined the effects of competitive outcome—either a win or a loss—on intrinsic motivation. Winning was hypothesized to facilitate both performance and intrinsic motivation. Fifty-four participants, 29 females and 25 males, competed against a same-gender confederate in a puzzle-solving contest. Following the competition, participants' intrinsic motivation was surreptitiously measured by the amount of time spent playing with the puzzle while alone. Results showed that winning facilitated both actual competitive performance and intrinsic motivation relative to losing. The importance of considering the outcome when predicting intrinsic motivation after competition is discussed.     

The Zeigarnik effect and intrinsic motivation: Are they the same?

The present study focused on delineating the parameters under which intrinsic motivation leads an individual to reengage an activity from those that result in the Zeigarnik effect. In a posttask free-choice period, participants not completing the experimental task displayed more reengagement behavior than participants completing the task (the Zeigarnik effect). When participants were also provided self-efficacious performance feedback via a prearranged competitive outcome manipulation, there was no evidence of the Zeigarnik effect, while there was support for intrinsic motivation from competent self-efficacious performance feedback. Results were discussed in terms of distinguishing between intrinsic motivation and the Zeigarnik effect as sources of reengagement motivation. It was concluded that, in the presence of self-efficacious performance feedback, the competent-incompetent impression was more salient than task-completion feedback.Preparation of this article was supported by Texas Christian University grant TCU/RF 5-23757.     

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.     

Some Preliminary Notes on the Objectivity of Mathematics

Topoi - I respond to a challenge by Dieterle (Philos Math 18:311–328, 2010) that requires mathematical social constructivists to complete two tasks: (i) counter the myth that socially...