Reducing AIDS risks through community outreach interventions for drug injectors.

Provided community outreach and AIDS intervention services to 1,080 out-of-treatment injecting drug users in 5 cities. Using random assignments to experimental conditions representing alternative intervention strategies, drug use and sex risks were measured at intake and 1 and 6 mo later. Interventions resulted in significant behavioral risk reductions from intake to follow-up, but outcomes were unrelated to the completion of an interview on behavioral risk assessment at intake and to the intervention procedure Ss received. Risk reduction measures 6 mo after intake were unrelated to the receipt of a follow-up at 1 mo. Results suggest that intervention procedures and components of these community-based AIDS prevention programs need to be reconsidered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

HIV infection and AIDS among drug injectors at Rio de Janeiro: perspectives and unanswered questions

Determination of the presence and characterization of oestrogen receptors (ERs) in subcutaneous and internal fat depots were performed and compared with ERs in the uterus using ligand binding and immunological techniques. Successful and consistent measurement of ERs in ovine adipose tissue could only be accomplished in animals depleted of endogenous sex steroids by combined ovariectomy and adrenalectomy. Scatchard, sucrose gradient and Western blot analyses all confirmed the presence of ERs in the cytosolic fractions of various adipose and uterine tissues from ovariectomized-adrenalectomized ewes. The approximate Kd values of 0.1-0.4 nmol/l for oestradiol binding in cytosolic fractions of gluteal, omental and perirenal adipose tissues were similar to the expected high affinity binding of Kd 0.35 nmol/l observed in uterine tissue. The binding was specific for oestrogens, as unlabelled diethylstilboestrol and oestradiol effectively competed with labelled hormone for receptor sites and progesterone, R5020, testosterone and dexamethasone all failed to compete. Mean (+/- S.E.M.) concentrations of ERs, expressed as fmol specific binding sites per mg protein, were much lower (P < 0.05) in adipose tissues than in uterine tissue (975 +/- 33). However, the content of ERs was greater (P < 0.05) in subcutaneous gluteal fat (11.5 +/- 0.8) than in the internal omental or perirenal fat (5 +/- 0.6) depots. ERs from adipose and uterine tissues both migrated as moieties of 8S on 5-20% sucrose gradients. Western blot analysis of ERs from uterine and adipose tissues in the presence of protease inhibitors demonstrated an immunostaining band with a molecular mass of 67 kDa.(ABSTRACT TRUNCATED AT 250 WORDS)     

AIDS treatment advances and behavioral prevention setbacks: Preliminary assessment of reduced perceived threat of HIV–AIDS.

Recent advances in AIDS treatment have brought renewed optimism for prolonging the lives of those infected with HIV. This article examined beliefs about how new treatments may reduce HIV transmission risk among 298 HIV-negative gay and bisexual men attending a gay pride festival. Results from an anonymous survey showed that men who practiced unprotected anal intercourse as the receptive partner (UAR intercourse) were younger, less well educated, and more likely to believe that it is safe to have UAR intercourse with an HIV-positive man who has an undetectable viral load and that new treatments for HIV relieve their worries about unsafe sex. As HIV treatments continue to advance, new challenges for HIV prevention will likely emerge. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The HIV/AIDS epidemics among drug injectors: a study of contact structure through a mathematical model

Numerical results of a model with variable infectivity for the dynamics of HIV/AIDS (human immunodeficiency virus/acquired immune deficiency syndrome) have been compared with the data of AIDS cases among intravenous drug users in Italy, especially in the Latium region. We examined several hypotheses about the dynamics of the epidemics; for each we obtained, mainly through a least-square approach but also minimizing a different quantity, a best-fit estimate of the parameters. In the simplest model, the population is assumed to be homogeneous, and we estimate contact rate and year of start of the epidemics, obtaining a good fit up to 1989, less so after. A substantial increase in fit is obtained in assuming either a decrease of the contact rate over time or a heterogeneous population with a smaller active group. We have also compared models with different infectivity curves during the incubation period: the assumption of constant infectivity is untenable, whereas the often suggested hypothesis of a peak in infectivity shortly after infection seems to be in agreement with data.     

Cognitive and behavioral treatments of agoraphobia: Clinical, behavioral, and psychophysiological outcomes.

39 severe and chronic agoraphobics with panic attacks, diagnosed using the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) criteria, were randomly assigned to 1 of 3 cognitive-behavioral treatments: paradoxical intention (PI), graduated exposure (GE), or progressive deep muscle relaxation training (RT). Treatment consisted of 12 2-hr weekly sessions conducted by experienced therapists whose treatment integrity was objectively monitored. All 31 23–63 yr old Ss who completed the program received an extensive rationale emphasizing self-directed exposure and programmed practice in addition to their primary treatment. A comprehensive assessment battery consisting of clinical ratings of severity, phobia, anxiety, depression, and panic, as well as direct measures of behavioral, psychophysiological, and cognitive response systems was administered at pre-, mid- (6 wks), and posttreatment (12 wks) and at 3-mo follow-up. Analyses revealed significant improvement for all Ss. GE and RT tended to evoke more rapid effects. At follow-up, GE and RT evidenced the greatest potency and stability, as compared with PI. The GE condition experienced twice the drop-out rate of PI and RT. The phenomenon of synchrony appeared to be associated with overall improvement at 12 wks and follow-up. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Target groups for preventing AIDS among intravenous drug users: II. The "hard" data studies.

Studies were reviewed with respect to three different target groups for preventing AIDS among intravenous (IV) drug users by (a) providing drug abuse treatment for those who want to stop injecting drugs, (b) providing "safer" injection for those who are likely to continue injecting, and (c) preventing drug injection among those who are at high risk for beginning to inject. The studies reviewed were limited to those that include "hard" data: validated self-reports, seroprevalence outcomes, or self-reports of behavior that is opposed to any of the demand characteristics generated by the research setting. For two groups of current IV drug users—those entering drug treatment and those continuing to inject—these hard data studies show rapidly induced AIDS risk reduction but suggest a need for large-scale change maintained over long time periods. In terms of preventing initial injection, alternative forms of intense drug use have emerged but have not supplanted drug injection, and basic knowledge of AIDS does not appear to deter initial drug injection. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Gambling Craving Scale: Psychometric validation and behavioral outcomes.

[Correction Notice: An erratum for this article was reported in Vol 23(4) of Psychology of Addictive Behaviors (see record 2009-24023-002). Some data in Table 4 was inadvertently omitted. The complete Table 4 is presented in the erratum.] Although craving is an important feature of problem gambling, there is a paucity of research investigating craving to gamble. A major stumbling block for craving research in gambling has been the lack of a methodologically sound, multidimensional measure of gambling-related craving. This article reports the development of the Gambling Craving Scale (GACS). In Study 1 (N = 220), a factor analysis revealed the emergence of a 9-item scale with 3 factors: Anticipation, Desire, and Relief. An important finding was that the GACS predicted problem gambling severity, depression, and positive and negative affect. In Study 2 (N = 145), the factor structure of the GACS was confirmed using a community sample of gamblers. In Study 3 (N = 46), GACS scores significantly predicted persistence at play on a virtual slot machine in the face of continued loss. Specifically, the more participants craved to gamble, the longer they engaged in play. The implications of craving for the development and maintenance of problem gambling severity are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting outcomes in HIV-infected veterans: I. Progression to AIDS

This article (Part II) and the preceding article (Part I) report the development of two clinical staging systems for HIV-infected individuals. The objective of the research reported here (Part II) was to construct a clinical staging system to predict survival in patients with AIDS. We analyzed data from VA Cooperative Study Number 298, a multicenter, double-blind, randomized trial that compared immediate versus deferred zidovudine therapy in HIV-infected individuals. Baseline variables obtained at the onset of AIDS in 204 individuals were tested in univariate Cox regression for their relationship to survival, and those that appeared predictive were examined in multivariable analysis. Based on these analyses, we constructed a new AIDS Clinical Staging System. The system is based on age, CD4+ cell count, type of first AIDS-defining condition, and functional status. The stages of the system were significant predictors of survival (p = 0.0001, log-rank test). In conclusion, valid, simple clinical staging systems for patients with AIDS can be developed based on a few variables that are readily available in clinical settings.     

Continued risk behaviour among HIV positive drug injectors in London: implications for intervention

The increment depth discrimination function was originally described by Ogle [(1953) Journal of the Optical Society of America, 43, 906-913] as a single exponential function. In contrast, recent studies have suggested that a two-component function better describes increment depth discrimination. To determine the relative effects of stereoscopic and non-stereoscopic width cues on the form of the function, we measured increment depth discrimination under conditions where both stereoscopic and dichoptic width cues were available. We found that increment depth discrimination data were well described by two-segment functions if both stereoscopic and dichoptic width cues were available. However, when dichoptic width cues were eliminated, by randomizing the pedestal disparity (crossed or uncrossed disparity) between trials, the increment depth discrimination function was better described by a single exponential function. This result has important implications for models of stereoscopic depth processing because it shows that stereoscopic depth discrimination thresholds progressively increase as a function of distance from the horopter.     

Client Verbal Response Category System: Preliminary data.

The Client Verbal Response Category System classifies client responses into Temporal, Directional, and Experiential categories. These categories are defined with their subcategories, interjudge reliability data are presented, and the instrument's utility in psychotherapy process research is demonstrated. Initial results indicate that the instrument is reliable and that it is useful for clarifying the psychotherapeutic change process. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of simulated employment and recreation on drug taking: A behavioral economic analysis.

With a within-subject design, this study examined the effects of varying response requirement (price) to obtain puffs on a cigarette in the presence and the absence of an opportunity (a) to make money in Experiment 1 (a simulation of employment) and (b) to engage in recreational activities (a simulation of recreation) in Experiment 2. The results indicated that cigarette smoking (number of puffs) decreased and response output increased as price increased. Also, cigarette smoking and response output decreased with the introduction of competing reinforcers at all prices. Lastly, the greatest reduction in cigarette smoking resulted from the combined effects of these two factors. Overall, these data suggest that drug use can be reduced by increasing price or enriching the environment and that maximal reductions result from the simultaneous application of both factors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-generated drug outcomes in high-risk adolescents.

The perceived outcomes of drug use were studied in a sample of high-risk adolescents. Participants' self-generated responses provided the actual words they used to describe drug outcomes as well as associative frequency norms valuable for future research. The authors also compared outcomes in terms of class of outcome (positive vs. negative) and class of drug (alcohol, marijuana, cigarettes, cocaine, speed, and LSD). Although the studied drugs have divergent pharmacological effects. participants self-generated some of the same outcomes (e.g., relaxation) across some of the drugs. In addition, outcomes self-generated as positive outcomes were very rarely also self-generated as negative outcomes. Finally, regressions revealed that self-generated responses were not predicted by ethnicity, gender, or previous drug use. Many drug use outcomes thus appeared to be available in memory regardless of previous drug use or other characteristics. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ethnicity and cancer outcomes: behavioral and psychosocial considerations

Cancer has been the subject of thousands of behavioral and psychosocial studies. The literature has focused largely on non-Hispanic Whites, despite the fact that cancer outcomes vary by ethnicity. This article provides a review of those studies that do consider the relations between ethnicity and cancer-related adherence behaviors, survival, and quality of life. The authors propose a mediational framework that links ethnicity and cancer outcomes through socioeconomic status, knowledge and attitudes, and access to medical care. They use this framework to organize the literature and to develop recommendations for future research.     

Consultant and client outcomes of competency-based behavioral consultation training.

One barrier to the systematic provision of consultation services in the schools may be the lack of applied training provided to preservice individuals in graduate preparation programs. A model of behavioral consultation training which extends previous competency-based progams is presented. Five doctoral students in school psychology were trained in behavioral consultation procedures using written manuals, videotape models, behavioral rehearsal, performance feedback, self-monitoring, and generalization training. Following university-based practice with trained consultees and student teachers, consultants were assigned consultation cases with teachers who presented actual cases. Behavioral consultation services were effective at remediating behavioral and academic difficulties in 4 of 5 target clients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Juvenile drug court: Enhancing outcomes by integrating evidence-based treatments.

Evaluated the effectiveness of juvenile drug court for 161 juvenile offenders meeting diagnostic criteria for substance abuse or dependence and determined whether the integration of evidence-based practices enhanced the outcomes of juvenile drug court. Over a 1-year period, a four-condition randomized design evaluated outcomes for family court with usual community services, drug court with usual community services, drug court with multisystemic therapy, and drug court with multisystemic therapy enhanced with contingency management for adolescent substance use, criminal behavior, symptomatology, and days in out-of-home placement. In general, findings supported the view that drug court was more effective than family court services in decreasing rates of adolescent substance use and criminal behavior. Possibly due to the greatly increased surveillance of youths in drug court, however, these relative reductions in antisocial behavior did not translate to corresponding decreases in rearrest or incarceration. In addition, findings supported the view that the use of evidence-based treatments within the drug court context improved youth substance-related outcomes. Clinical and policy implications of these findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ten-year outcomes of behavioral family-based treatment for childhood obesity.

Reports 10-yr treatment outcomes for obese children in 4 randomized treatment studies. At 10 yrs, 34% decreased percentage overweight by 20% or more, and 30% were not obese. Significant effects were observed when parents and children were targeted and reinforced for weight loss in comparison with nontargeted controls and for children given lifestyle or aerobic exercise in comparison with a calisthenics control. 34% of the variance in change in percentage overweight was predicted from sex, baseline percentage overweight, self-monitoring weight, meals eaten at home, and family and friends' support for eating and exercise. Results show long-term changes in children depend on the treatment, and evidence converges on the importance of the family and other sources of support for eating and activity change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A behavioral view of paradigm debates: Let the data speak.

Because of the strong applied and empirical emphasis of the behavior analysis approach, paradigm debates are considered a waste of time. It is suggested here that the current debate by E. Locke (see record 1981-04363-001) is no exception. It is recommended that instead of engaging in data-sparse academic arguments, interested researchers should conduct experiments that test the various hypotheses and then let the data speak for themselves. (7 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hierarchical modeling of sequential behavioral data: An empirical Bayesian approach.

The authors review the common methods for measuring strength of contingency between 2 behaviors in a behavioral sequence, the binomial z score and the adjusted cell residual, and point out a number of limitations of these approaches. They present a new approach using log odds ratios and empirical Bayes estimation in the context of hierarchical modeling, an approach not constrained by these limitations. A series of hierarchical models is presented to test the stationarity of behavioral sequences, the homogeneity of sequences across a sample of episodes, and whether covariates can account for variation in sequences across the sample. These models are applied to observational data taken from a study of the behavioral interactions of 254 couples to illustrate their use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of drug and behavioral treatments of essential hypertension.

Studied 36 hypertensives (aged 35–60 yrs) twice/wk for 8 wks under 1 of the 4 following conditions: blood pressure (BP) biofeedback, Benson's relaxation response, drug treatment, and a control procedure consisting of the home self-monitoring of BP. Extensive baseline, treatment, and follow-up assessments were obtained of home BP recordings and psychophysiological variables in the laboratory (heart rate, BP, skin conductance, breathing rate, and frontalis muscle tension). Ss also completed psychological tests that included the MMPI and Jenkins Activity Survey. Drug treatment (main diuretics) was found to be markedly superior to all of the behavioral procedures in the regulation of BP in home recordings. With regard to laboratory measures of BP, biofeedback was as effective as drugs and more effective than relaxation or the self-monitoring control procedure in lowering diastolic but not systolic BP. In addition, neither the relaxation response nor the control procedure had any effect on the regulation of BP. (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Matching training procedures to outcomes. A behavioral and quantitative analysis

To analyze the effects of matching the prompting procedure used in training to the specific behavior chain to be taught, 3 students with mild to moderate retardation were taught four independent tasks: making a bagged lunch, playing a matching game with a peer, ordering food at a restaurant, and participating in a social conversation. Following baseline, all 3 students were exposed to one of two types of training procedures for each task: a least-to-most prompting procedure or a most-to-least prompting procedure. The type of training procedure was counter-balanced across students and tasks, whereas performance on the tasks was evaluated within a combination of a multiple-baseline design across participants and multiple-probe design across tasks. When the method of prompting was matched to the naturally occurring discriminative stimulus (SD) of the training stimulus, it greatly affected acquisition and maintenance of the skill in terms of differences in levels of and variability of performance. The most-to-least method of prompting, the matched method in these cases, was more efficient and effective for acquisition and generalization of the bagged-lunch and matching-game skills. The least-to-most method, the matched method in these cases, was more efficient and effective for social questions and ordering-food skills.