Nature, decay, and spiraling of the effects of fear-inducing arguments and HIV counseling and testing: A meta-analysis of the short- and long-term outcomes of HIV-prevention interventions.

[Correction Notice: An erratum for this article was reported in Vol 26(6) of Health Psychology (see record 2007-16656-022). Several corrections that were omitted are found in this erratum.] Objective: To examine the long-term efficacy of both fear-inducing arguments and HIV counseling and testing at encouraging and maintaining knowledge about HIV transmission and prevention, as well as condom use. Design: Analyses were conducted with a sample of 150 treatment groups and 34 controls and included measures of change at an immediate follow-up and a delayed follow-up. Main outcome measures: The main outcome measures were perceived risk of HIV infection, knowledge about HIV, and condom use. Results: Results indicated that receiving fear-inducing arguments increased perceptions of risk at the immediate follow-up but decreased knowledge and condom use, whereas resolving fear via HIV counseling and testing decreased perceptions of risk and increased knowledge and condom use at both the immediate and delayed follow-ups. The effects on perceived risk and knowledge decreased over time, but the effects on condom use became more pronounced. Conclusion: Inducing fear is not an effective way to promote HIV-relevant learning or condom use either immediately following the intervention or later on. However, HIV counseling and testing can provide an outlet for HIV-related anxiety and, subsequently, gains in both knowledge and behavior change immediately and longitudinally. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correction to Earl and Albarracín (2007).

Reports an error in "Nature, decay, and spiraling of the effects of fear-inducing arguments and HIV counseling and testing: A meta-analysis of the short- and long-term outcomes of HIV-prevention interventions" by Allison Earl and Dolores Albarracín (Health Psychology, 2007[Jul], Vol 26[4], 496-506). Several corrections that were omitted are found in this erratum. (The following abstract of the original article appeared in record 2007-09406-014.) Objective: To examine the long-term efficacy of both fear-inducing arguments and HIV counseling and testing at encouraging and maintaining knowledge about HIV transmission and prevention, as well as condom use. Design: Analyses were conducted with a sample of 150 treatment groups and 34 controls and included measures of change at an immediate follow-up and a delayed follow-up. Main outcome measures: The main outcome measures were perceived risk of HIV infection, knowledge about HIV, and condom use. Results: Results indicated that receiving fear-inducing arguments increased perceptions of risk at the immediate follow-up but decreased knowledge and condom use, whereas resolving fear via HIV counseling and testing decreased perceptions of risk and increased knowledge and condom use at both the immediate and delayed follow-ups. The effects on perceived risk and knowledge decreased over time, but the effects on condom use became more pronounced. Conclusion: Inducing fear is not an effective way to promote HIV-relevant learning or condom use either immediately following the intervention or later on. However, HIV counseling and testing can provide an outlet for HIV-related anxiety and, subsequently, gains in both knowledge and behavior change immediately and longitudinally. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differential effects of emotion-focused therapy and psychoeducation in facilitating forgiveness and letting go of emotional injuries.

This study compared the effectiveness of emotion-focused therapy (EFT) involving gestalt empty-chair dialogue in the treatment of individuals who were emotionally injured by a significant other with therapy in a psychoeducation group designed to deal with these injuries. In addition, this study examined aspects of the emotional process of forgiveness in resolving interpersonal injuries and investigated the relationship between letting go of distressing feelings and forgiveness. A total of 46 clients assessed as having unresolved, interpersonal, emotional injuries were randomly assigned to an individual therapy treatment of EFT or a psychoeducation group. Clients were assessed at pretreatment, posttreatment, and 3-month follow-up on measures of forgiveness, letting go, depression, global symptoms, and key target complaints. Results indicated that clients in EFT using empty-chair dialogue showed significantly more improvement than the psychoeducation treatment on all measures of forgiveness and letting go, as well as global symptoms and key target complaints. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impact of a social influence intervention on condom use and sexually transmitted infections among establishment-based female sex workers in the Philippines: A multilevel analysis.

The authors assessed the relative impact of structural and social influence interventions on reducing sexually transmitted infections (STIs) and HIV risk behavior among female sex workers in the Philippines (N = 897). Four conditions included manager influence, peer influence, combined manager-peer influence, and control. Intervention effects were assessed at the establishment level in multilevel models because of statistical dependencies among women employed within the same establishments. Control group membership predicted greater perceived risk, less condom use, less HIV/AIDS knowledge, and more negative condom attitudes. Combination participants reported more positive condom attitudes, more establishment policies favoring condom use, and fewer STIs. Manager-only participants reported fewer STIs, lower condom attitudes, less knowledge, and higher perceived risk than peer-only participants. Because interventions were implemented at the city level, baseline and follow-up city differences were analyzed to rule out intervention effects due to preexisting differences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A preliminary test of the Addiction-to-Near-Death construct.

The diagnostic concept of Addiction to Near Death (ATND) is a construct with strong face validity. The purpose of this study was to empirically test the ATND construct in the context of a substance abusing population who were at high risk of contracting HIV. Interviews of female clients were conducted 30 days postdischarge from a residential therapeutic community. Clients were interviewed about their sexual activity and their condom use while they were in treatment. Results preliminarily support the ATND construct. The limitations were: data were from retrospective self-reports; the original study contained no baseline measures of sexual activity, safe-sex knowledge, condom use, HIV status; it had no male participants, no specific questions about near-death behavior, nor whether alternative safe-sex activities were practiced. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A case of linear IgA bullous dermatosis with atypical clinical and ultrastructural manifestations

The purpose of this study was to evaluate the effects of a brief intervention programme on STD knowledge, condom use and gonorrhoea incidence among sex workers in Singapore. A controlled before-and-after study design with non-random assignment of sex workers was used, supplemented by multivariate analysis to adjust for baseline differences. Control (n = 221, denoted C1) and experimental (n = 221, denoted E1) groups were interviewed on 2 occasions 3 months apart. Two supplementary groups were interviewed once each at the end of the 3-month period (n = 145 who had received the intervention and n = 151 who had not). Basic knowledge of STD symptoms and HIV transmission was high in all groups. There were misconceptions about casual transmission of HIV which improved dramatically at the second interview for group E1 (from 37-56% correct responses to 82-90%). Overall condom use was high (about 75%) and did not change after the intervention. Gonorrhoea rates were correspondingly low (0.4 episodes/worker/year) and also did not change. This brief intervention improved the STD knowledge of sex workers. However, behaviour as measured by reported condom use and gonorrhoea incidence did not change. Implications for future intervention programmes are discussed.     

Using information, motivational enhancement, and skills training to reduce the risk of HIV infection for low-income urban women: A second randomized clinical trial.

This randomized clinical trial evaluated an HIV-risk reduction (HIV-RR) intervention based on the information–motivation–behavioral skills model. At baseline, 102 women (M age?=?29 years; 88% African American) completed a survey regarding HIV-related knowledge, risk perceptions, behavioral intentions, and risk behavior. Participants were then assigned to either the HIV-RR intervention or a health-promotion control group. Postintervention and follow-up data indicated that women in the HIV-RR program enhanced their knowledge and strengthened their risk reduction intentions relative to controls. Moreover, HIV-RR women who expressed "imperfect" intentions also increased their condom use, talked more with partners about condom use and HIV testing, and were more likely to have refused unprotected sex. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interpersonal skill training in groups.

Evaluated the relative effectiveness of 2 group counseling programs, one using primarily behavioral rehearsal and contingency contracting and the other using behavioral discussion. 36 18-38 yr old self-referred male and female clients were randomly assigned to 2 treatment conditions. Four rehearsal-contracting and 3 discussion groups, with 5-6 members in each, met for 6 weekly 2-hr sessions. Assessment was based on (a) 2 self-report inventories, administered at pretreatment, posttreatment, and at a 3-mo follow-up and (b) a behavioral role-play test administered at posttreatment and follow-up periods for both conditions, with the behavioral role-play test showing significant gains in favor of the rehearsal-contracting conditions. (32 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factors influencing service utilization and mood symptom severity in children with mood disorders: Effects of multifamily psychoeducation groups (MFPGs).

This study investigated the impact of psychoeducation on service utilization and mood symptom severity in children with mood disorders. Parents’ knowledge of mood disorders, beliefs about treatment, and perceptions of children’s need for treatment were hypothesized to mediate the relationship between psychoeducation and service utilization and between psychoeducation and mood symptom severity. Linear mixed effects modeling and joint significance test for mediation were used in secondary data analyses of the multifamily psychoeducation group (MFPG) study, a randomized controlled trial of 165 children ages 8 to 12 years with mood disorders. A majority of those sampled were male (73%) and White, non-Hispanic (90%), and the median range of family income was $40,000–$59,000. Participation in MFPG significantly improved quality of services utilized, mediated by parents’ beliefs about treatment. Participation in MFPG also significantly improved severity of child’s mood symptoms, mediated by quality of services utilized. MFPG appears to be a psychoeducational intervention that helps parents to become better consumers of the mental health system who access higher quality services. Children’s symptom severity decreases as a result. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treating comorbid panic disorder in veterans with posttraumatic stress disorder.

This study compares the effectiveness of panic control treatment (PCT) with that of a psychoeducational supportive treatment (PE-SUP) in treating panic disorder among a veteran sample with a primary diagnosis of chronic posttraumatic stress disorder (PTSD). Thirty-five patients randomized to receive 10 individual sessions of either PCT or PE-SUP underwent assessments at pretreatment, at 1-week posttreatment, and at a 3-month follow-up. Intent-to-treat analyses of covariance showed that PCT participants significantly improved on panic severity at posttreatment and panic fear at the 3-month follow-up. The PCT group also showed significant reductions in anxiety sensitivity at posttreatment and follow-up compared with that of the PE-SUP group. A significantly higher proportion of persons (63%) in the PCT group was panic free by the follow-up period compared with that of the PE-SUP group (19%). Patient self-report and clinician ratings showed no changes in general anxiety, depression, and PTSD symptoms in either group. These findings indicated that PCT was superior to an active control therapy in reducing the frequency, severity, and distress associated with panic disorder and suggested that brief cognitive-behavioral therapy for panic is effective for persons with chronic PTSD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effectiveness of a video-based motivational skills-building HIV risk-reduction intervention for inner-city African American men.

Interventions to reduce HIV risk behavior have shown promise but have demonstrated inconsistent effects with heterosexual men. This article reports a cognitive-behavioral HIV risk reduction intervention designed for heterosexually active African American men. Men (N?=?117) recruited from a public clinic were randomly assigned to either (a) a 6-hr video-based small group motivational-skills intervention, or (b) a 6-hr video-based contact-matched HIV education comparison group. Results showed men in the motivational-skills intervention reported lower rates of unprotected vaginal intercourse and higher rates of condom use at the 3-month follow-up. However, because of increased condom use in the comparison condition, differences between groups dissipated 6 months following the intervention. These findings are among the first to demonstrate effects from a motivational-skills intervention for reducing HIV risk in men who have sex with women using a model designed to facilitate transferring prevention technology to community settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological treatment of chronic posttraumatic stress disorder in victims of sexual aggression

The aim of this research was to test the comparative effectiveness of two therapeutic modalities in the treatment of chronic posttraumatic stress disorder in victims of sexual aggression: (a) self-exposure and cognitive restructuring and (b) progressive relaxation training. The sample consisted of 20 patients (victims of rape in adulthood or adult victims of childhood sexual abuse) selected according to DSM-III-R criteria. A multigroup experimental design with repeated measures (pretreatment, posttreatment, and 1-, 3-, 6-, and 12-month follow-up) was used. Most treated patients improved, but the success rate was higher in all measures in the exposure and cognitive restructuring group immediately on posttreatment and at follow-up. Implications of this study for clinical practice and future research in this field are commented on.     

Exposure plus response-prevention treatment of bulimia nervosa.

A controlled study evaluating the effectiveness of exposure plus response-prevention treatment of bulimia nervosa was conducted in a sample of 47 women. This was a four-group comparison involving three treatment conditions and a waiting-list control group. The three treatment conditions were (a) exposure plus response prevention conducted in a single setting (clinic), (b) exposure plus response prevention conducted in multiple settings (clinic, patients' homes, and restaurants), and (c) cognitive–behavioral therapy without exposure plus response prevention. All treatment was provided to groups of 3 patients at a time. Outcome was evaluated at posttreatment and at a 6-month follow-up. The three treatment groups improved significantly on most outcome measures, whereas the waiting-list control group showed little change. At follow-up, there was a slightly better outcome on vomiting behavior and amount of food consumed in one of the test meals for the exposure plus response-prevention groups relative to the no-exposure group. However, on all other measures, the degree of improvement from pretreatment to follow-up was the same for all three treatment groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pretreatment and process predictors of outcome in interpersonal and cognitive behavioral psychotherapy for binge eating disorder.

The present study examined pretreatment and process predictors of individual nonresponse to psychological group treatment of binge eating disorder (BED). In a randomized trial, 162 overweight patients with BED were treated with either group cognitive-behavioral therapy or group interpersonal psychotherapy. Treatment nonresponse, which was defined as nonabstinence from binge eating, was assessed at posttreatment and at 1 year following treatment completion. Using 4 signal detection analyses, greater extent of interpersonal problems prior to treatment or at midtreatment were identified as predictors of nonresponse, both at posttreatment and at 1-year follow-up. Greater pretreatment and midtreatment concerns about shape and weight, among those patients with low interpersonal problems, were predictive of posttreatment nonresponse. Lower group cohesion during the early treatment phase predicted nonresponse at 1-year follow-up. Attention to specific pre- or intreatment predictors could allow for targeted selection into differential or augmented care and could thus improve response to group psychotherapy for BED. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Discontinuation of treatment with IFN-beta leads to exacerbation of experimental autoimmune encephalomyelitis in Lewis rats. Rapid reversal of the antiproliferative activity of IFN-beta and excessive expansion of autoreactive T cells as disease promoting mechanisms

BACKGROUND: It is important for HIV/AIDS control programmes to determine population knowledge on AIDS in order to develop appropriate Information, Education and Communication (IEC) messages. The objectives of our study were to determine the seroprevalence of HIV and syphilis among pregnant women, female prostitutes and long-distance truck drivers and to evaluate knowledge, attitudes, beliefs, and practice (KABP) with respect to the HIV/AIDS epidemic in these three groups in Burkina Faso. METHODS: We performed three cross-sectional serosurveys including face-to-face interviews on KABP between October 1994 and February 1995 in three population groups. RESULTS: Overall, 1,294 pregnant women, 236 long-distance truck drivers and 426 female prostitutes were recruited. HIV seroprevalence was 8% (95% Confidence Interval (CI): 6.6-9.6) among pregnant women, 18.6% (95% CI: 13.9-24.2) among long-distance truck drivers and 58.2% (95% CI: 53.4-62.9) in female prostitutes. The prevalence of syphilis was 2.5%, 9.3% and 15%, respectively. Most pregnant women (98%), long-distance truck drivers (96%) and female prostitutes (98%) had already heard of AIDS. However, the level of knowledge of HIV transmission routes, of risk factors for HIV transmission and of available preventive measures was very low. Consequently, 41% of pregnant women, 40% of long-distance truck drivers and an alarming 61% of female prostitutes reported that they did not feel themselves at risk for HIV. In each group, high levels of knowledge on AIDS were associated with increased awareness of AIDS risk and the adoption of preventive behaviours. Level of education was associated with knowledge of AIDS and condom use. However, in the 12 months preceding the surveys, condom use was very low among pregnant women (0.1%), long-distance truck drivers (18%) and among female prostitutes (42%). CONCLUSIONS: These results indicate that HIV is widespread in Burkina Faso and that there is an urgent need to develop and evaluate HIV prevention strategies in the general population and among core groups such as female prostitutes and long-distance truck drivers. Interventions must include information campaigns, condom promotion and distribution, and sexually transmitted diseases control.     

Condom use: A self-efficacy model.

A survey of heterosexually active college students gathered information about condom use, self-efficacy (SE), outcome expectancies, sexual attitudes, peer group influences, AIDS knowledge, and a perceived vulnerability to AIDS. On the basis of A. Bandura's (1986) social-cognitive theory, a structural model with SE as the central mediator was formulated and evaluated with LISREL. This model explained 46% of the variance in condom use from judgments of SE and effects attributable to peers and 53% of the variance in SE from outcome expectancies and peer group influences. Sexual attitudes, AIDS knowledge, and perceived vulnerability did not predict condom use. Most students were well-informed about HIV transmission but reported not feeling at risk, even though many engaged in risky sexual behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An Interactive Psychoeducational Intervention for Women at Risk of Developing an Eating Disorder.

This study evaluated a synchronous Internet-delivered intervention (chat room) for improving eating habits and body image in college-age women at risk for developing an eating disorder. Sixty at-risk women (mean age = 18.9, SD = 2.4; 65.0% Caucasian, 19% Latino/Hispanic, 8% Asian/Pacific Islander, 3% African American, 5% other; mean body mass index = 25.6, SD = 5.7) were randomly assigned to intervention (n = 30) or control (n = 30) groups. Once a week for 8 weeks, participants used a private chat room for a 1-hr moderated discussion focused on improving body image and eating behaviors. Additional treatment components included psychoeducation, asynchronous support, homework, and summaries. Assessments were conducted at baseline, posttreatment, and 10 weeks after posttreatment. Participants indicated high satisfaction with the intervention mode. Intervention participants significantly reduced eating pathology and improved self-esteem over controls at follow-up. These findings suggest that synchronous, Internet-delivered programs are efficacious and have potential to reduce problematic attitudes and behaviors that may lead to eating disorders among college-age women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of planning and self-efficacy in condom use among men who have sex with men: An application of the Health Action Process Approach model.

Objective: In Hong Kong, men who have sex with men (MSM) remain a high risk group for HIV infection. This study applied the Health Action Process Approach (HAPA) to study the motivational and behavioral patterns of local MSM in condom use. Design: Four hundred ten sexually active MSM completed the questionnaire on site at Time 1; 217 who remained sexually active were interviewed during a 1-month follow-up. Main Outcome Measures: Risk perception, outcome expectancy, action self-efficacy, intention, planning, maintenance self-efficacy, and recovery self-efficacy were measured at Time 1. Actual condom use was measured at both time points. Results: The HAPA model had a good fit to the data (χ2 = 300.71, df = 111, p     

HIV prevention interventions: The effects of role-play and behavioural commitment on knowledge and attitudes.

Investigated the effects of active versus passive participation, as well as behavioral commitment, on the knowledge and attitudes of adolescents in an HIV-prevention intervention. Following completion of an HIV attitudes and knowledge test, a group of 144 9th grade students were randomly assigned to 1 of 4 treatment conditions that included either role-play, video, lecture, or no treatment. Half the participants in each condition were required to commit to attend to HIV-prevention information and educate another student about such issues. A post-test conducted at 4-wk follow-up indicated that students in the active participation condition (i.e., role-play) demonstrated increased knowledge about AIDS and HIV. Behavioral commitment to further HIV-prevention information did not moderate (i.e., enhance) the effects of active participation; however, commitment did lead to more positive attitudes toward HIV-prevention. The findings suggest that a role-play intervention may be a viable alternative to traditional lecture and video methods for enhancing knowledge towards HIV-prevention in adolescents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A randomized clinical trial of acceptance and commitment therapy versus progressive relaxation training for obsessive-compulsive disorder.

Objective: Effective treatments for obsessive-compulsive disorder (OCD) exist, but additional treatment options are needed. The effectiveness of 8 sessions of acceptance and commitment therapy (ACT) for adult OCD was compared with progressive relaxation training (PRT). Method: Seventy-nine adults (61% female) diagnosed with OCD (mean age = 37 years; 89% Caucasian) participated in a randomized clinical trial of 8 sessions of ACT or PRT with no in-session exposure. The following assessments were completed at pretreatment, posttreatment, and 3-month follow-up by an assessor who was unaware of treatment conditions: Yale–Brown Obsessive Compulsive Scale (Y-BOCS), Beck Depression Inventory–II, Quality of Life Scale, Acceptance and Action Questionnaire, Thought Action Fusion Scale, and Thought Control Questionnaire. Treatment Evaluation Inventory was completed at posttreatment. Results: ACT produced greater changes at posttreatment and follow-up over PRT on OCD severity (Y-BOCS: ACT pretreatment = 24.22, posttreatment = 12.76, follow-up = 11.79; PRT pretreatment = 25.4, posttreatment = 18.67, follow-up = 16.23) and produced greater change on depression among those reporting at least mild depression before treatment. Clinically significant change in OCD severity occurred more in the ACT condition than PRT (clinical response rates: ACT posttreatment = 46%–56%, follow-up = 46%–66%; PRT posttreatment = 13%–18%, follow-up = 16%–18%). Quality of life improved in both conditions but was marginally in favor of ACT at posttreatment. Treatment refusal (2.4% ACT, 7.8% PRT) and dropout (9.8% ACT, 13.2% PRT) were low in both conditions. Conclusions: ACT is worth exploring as a treatment for OCD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)