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.     

Physical self-efficacy and actualization

In his theorizing about self-actualization, Maslow speculated that physical ability and physical self-confidence were two aspects of cooperative dominance which were associated positively with actualization. These aspects of dominance bear close resemblance to the Perceived Physical Ability (PPA) and the Physical Self-Presentation Confidence (PSPC) dimensions of the Physical Self-Efficacy (PSE) Inventory. Accordingly, the PPA and PSPC scores of undergraduate men and women were correlated with their scores on the Personal Orientation Inventory (POI), a popular measure of actualization, to test Maslow's hypotheses. The results showed that, contrary to Maslow's claims, PPA is not a positive correlate of self-actualization. However, strong support was found for Maslow's contention that high-PSPC individuals are more likely to be actualizing than low-PSPC people. Also, Maslow's hypothesis that actualizers are high in global sensation seeking (SS) was tested. The data indicated that only male actualizers were high in various aspects of SS, but female actualizers were not. Multiple regression analyses revealed further that both SS and PSPC are primary contributors to POI for men, but only PSPC contributes significantly to POI for women. Discussion focused on the reasons why research findings showing that increases in physical fitness lead to increases in self-esteem cannot be used to support the view that physical fitness and actualization are linked positively.     

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.     

Looking time: Experimenter and instruction effects

A 2 by 3 factorial design was used to investigate the effects of the instructions and the presence of E on looking time. Two hundred thirty-nine college students viewed 30 colored stimuli of landscapes, single objects, and arrays of objects under three different sets of instructions, with E either present or absent while S viewed the stimuli. The results demonstrated that E’s presence depressed the time spent looking at the stimuli Evidence was also found suggesting that ambiguity in the typical instructions given Ss in looking-time experiments may result in artifactually long looking times. It was concluded that a more appropriate situation to investigate looking time would (1) utilize sham GSR instructions to reduce S’s uncertainty concerning the experiment’s purpose, and (2) arrange for E’s absence while S is viewing the stimuli