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The impact of Magic Johnson's HIV serostatus disclosure on unmarried college students' HIV knowledge, attitudes, risk perception, and sexual behavior.

Unmarried heterosexual college students' HIV knowledge, attitudes, risk perception, and sexual behavior were assessed before and after "Magic" Johnson revealed his HIV-positive serostatus. Students examined after the disclosure showed a small, though statistically significant, increase in scores on HIV knowledge. Analyses did not reveal any other differences between the pre- and postdisclosure samples. Several differences between men's and women's scores were found, however. In addition, participants in both groups demonstrated generally positive attitudes toward HIV and people with HIV disease; rated their risk of future HIV infection as none to minimal; and reported frequently engaging in vaginal, oral, and anal intercourse without the use of condoms. These results suggest that Magic's disclosure did not significantly affect these students' attitudes, risk perception, or sexual behavior and that such students continue to engage in behaviors that may put them at risk for HIV infection.

Adolescent↗

Increasing honest responding on cognitive distortions in child molesters: the bogus pipeline procedure.

Professionals conclude that child molesters (CMs) hold offense-supportive beliefs (or cognitive distortions) from CMs'questionnaire responses. Because questionnaires are easily faked, we asked 32 CMs to complete a cognitive distortion scale under standard conditions (Time 1). A week later (Time 2), the same CMs completed the scale again. This time, approximately one half of CMs were attached to a pseudo lie detector (a bogus pipeline), and the rest completed the scale again under standard conditions (controls). At Time 1, CMs showed low cognitive distortion scores, seeming to indicate that they were faking good. At Time 2, bogus pipeline CMs seemed to believe that the apparatus could detect lies. However, this did not encourage more distorted belief disclosure compared with (a) their own previous scores and (b) controls. Furthermore, the bogus pipeline appeared to reduce cognitive distortion endorsements. The results stand in marked contrast to the common view that most CMs hold distorted beliefs.

Adult↗

The health effects of at-home written emotional disclosure in fibromyalgia: a randomized trial.

BACKGROUND: The presence and severity of the chronic pain syndrome fibromyalgia (FM) is associated with unresolved stress and emotional regulation difficulties. Written emotional disclosure is intended to reduce stress and may improve health of people with FM. PURPOSE: This study tests the effects of at-home, written emotional disclosure about stressful experiences on the health of people with FM and uses multiple follow-ups to track the time course of effects of disclosure. METHODS: Adults with FM (intention-to-treat, n=83; completers, n=72) were randomized to write for 4 days at home about either stressful experiences (disclosure group) or neutral time management (control group). Group differences in immediate mood effects and changes in health from baseline to 1-month and 3-month follow-ups were examined. RESULTS: Written disclosure led to an immediate increase in negative mood, which did not attenuate across the 4 writing days. Repeated-measures analyses from baseline to each follow-up point were conducted on both intention-to-treat and completer samples, which showed similar outcomes. At 1 month, disclosure led to few health benefits, but control writing led to less negative affect and more perceived support than did disclosure. At 3-month follow-up, these negative affect and social support effects disappeared, and written disclosure led to a greater reduction in global impact, poor sleep, health care utilization, and (marginally) physical disability than did control writing. Interpretation of these apparent benefits needs to be made cautiously, however, because the disclosure group had somewhat poorer health than controls at baseline and the control group showed some minor worsening over time. CONCLUSIONS: Written emotional disclosure can be conducted at home, and there is tentative evidence that disclosure benefits the health of people with FM. The benefits, however, may be delayed for several months after writing and may be of limited clinical significance.

Adult↗

Recanting of substance use reports in a longitudinal prevention study.

We analyzed recanting of substance use reports for lifetime use of alcohol, alcohol to get drunk, cigarettes, marijuana and cocaine in an 8-wave panel study designed to evaluate the Drug Abuse Resistance Education program in the State of Illinois. Although this phenomenon has been identified elsewhere, the current analysis of recanting is a unique attempt to track this behavior over the entire course of adolescence. Overall, rates of recanting for specific drugs were extremely high, ranging from 45% for lifetime reports of alcohol use to 81% for lifetime reports of cocaine. Most recanting occurred in the wave immediately following the wave of first disclosure. Paralleling results from other studies, race/ethnicity was an important correlate of recanting in both bivariate and multivariate analyses. African American respondents had higher rates of recanting than White subjects. Even after controlling for the number of follow-up waves, the later the wave of first disclosed lifetime drug use, the lower the probability that drug use would be recanted ever (for all substances) or in the wave immediately following first disclosure (for reports of ever having been drunk or for lifetime marijuana or cocaine use). Alternative causes for this phenomenon are discussed. Implications for the design and interpretation of multiwave school-based panel surveys targeted toward adolescents are also addressed.

Adolescent↗

Exposure to violence against a family member and internalizing symptoms in Colombian adolescents: the protective effects of family support.

Associations between exposure to serious violence against a family member and internalizing symptoms, and the protective effects of support from family versus friends, were examined in 5,775 adolescents (50% female; mean age = 15.2 years, SD = 2.0) with data from a national, random household survey of residents in Colombia, South America. After accounting for the effects of age, gender, and family life events other than violence, support from family buffered the relations between exposure to violence and adjustment; this relation was strongest for girls and younger adolescents. Disclosure to friends appeared to be protective for younger adolescents but harmful for older adolescents, and this relation was only observed for hopelessness. Results are discussed in terms of cognitive processing models of adjustment to violence.

Adaptation, Psychological↗

Mind-reading accuracy in intimate relationships: assessing the roles of the relationship, the target, and the judge.

Using a video-review procedure, multiple perceivers carried out mind-reading tasks of multiple targets at different levels of acquaintanceship (50 dating couples, friends of the dating partners, and strangers). As predicted, the authors found that mind-reading accuracy was (a). higher as a function of increased acquaintanceship, (b). relatively unaffected by target effects, (c). influenced by individual differences in perceivers' ability, and (d). higher for female than male perceivers. In addition, superior mind-reading accuracy (for dating couples and friends) was related to higher relationship satisfaction, closeness, and more prior disclosure about the problems discussed, but only under moderating conditions related to sex and relationship length. The authors conclude that the nature of the relationship between the perceiver and the target occupies a pivotal role in determining mind-reading accuracy.

Adolescent↗

Written emotional disclosure buffers the effects of social constraints on distress among cancer patients.

The aims of the present study were to examine whether written emotional disclosure would reduce distress among cancer patients and whether it would buffer the effects of high levels of social constraint (negative social responses to patients' expressions of emotion regarding their cancer) on distress. Cancer patients (N=104) were randomly assigned to write about their emotions regarding their cancer 20 min a day for 3 days or to write about a nonemotional topic. They completed questionnaires at baseline and 6 months postintervention. Results showed that written disclosure buffered the effects of social constraints on stress at the 6-month follow-up and that avoidance partly mediated these effects. The present data reinforce the notion that interventions should be tailored to patients' needs.

Adaptation, Psychological↗

Adult female victims of child sexual abuse: multitype maltreatment and disclosure characteristics related to subjective health.

This study examined the impact of child sexual abuse and disclosure characteristics on adult psychological and psychosomatic symptoms. Data on abuse characteristics, disclosure-related events, and subjective health were collected through semistructured interviews and questionnaires from 123 adult women reporting having been sexually abused in childhood by someone close. The results indicate that disclosure-related events have a stronger relation than abuse characteristics to long-term consequences of childhood sexual abuse. In particular, a positive reaction from a partner was related to fewer symptoms. Of the abuse characteristics, exposure also to physical abuse was strongly associated to psychological sequelae.

Adult↗

Disclosure of health care workers with HIV or AIDS.

Every health care organization should have clear policies about how employees with HIV/AIDS are to be accommodated under employment laws. Managers should be knowledgeable about discrimination laws in order to handle reactions of co-workers. Administrators must ensure that educational sessions are provided for all levels of staff. Informational brochures on HIV/AIDS should be available to families and to businesses and other community organizations.

HIV Infections↗

To tell or not to tell: patterns of disclosure among men with prostate cancer.

This paper draws on the results of a longitudinal, qualitative study of men with prostate cancer (treated with prostatectomy) and their spouses. Interviews were conducted separately and simultaneously with men and their spouses, at three points in time (pre-surgery, 8-10 weeks post-surgery and 11-13 months post-surgery). The primary focus in the paper is on men's responses to questions about their decisions to share information (or not) with others about their diagnosis and ongoing medical situation. Most men with prostate cancer avoided disclosure about their illness where possible, and placed great importance on sustaining a normal life. Factors related to limiting disclosure included men's low perceived need for support, fear of stigmatization, the need to minimize the threat of illness to aid coping, practical necessities in the workplace, and the desire to avoid burdening others. This study contributes to an understanding of disclosure issues related to prostate cancer, and raises issues about how best to be helpful to men, given their tendency to minimize the impact of illness, and the need for support.

Adaptation, Psychological↗

Adolescents' perceptions of their parents' disclosure to them.

This study examines 144 older adolescents' perceptions of their parents' disclosure of their own lives to them. Information was obtained about the disclosure of 209 parents of college-aged children. The adolescents indicated whether and to what depth their parents had discussed 30 topics with them, and also indicated why they believed their parents had made these disclosures. The data indicate that college-age adolescents believe that their mothers disclose more to them than their fathers, especially about their problems. Mothers were also perceived to disclose for different, more emotional reasons than fathers, and they were perceived to seek advice more often.

Adolescent↗

Changes in cognitive coping strategies predict EBV-antibody titre change following a stressor disclosure induction.

Previous research has shown that emotional disclosure of traumatic or stressful events is associated with facilitating insight into the experience, improving mood, and modulating some aspects of the immune system. The current study examined how cognitive changes and experiential involvement during an emotional disclosure induction protocol relate to immune functioning, as measured by IgG antibody titres to the Epstein-Barr virus viral capsid antigen (EBV-VCA). Seventy-six college undergraduates were randomly assigned to either a disclosure induction or an assessment-only control condition. Experimental subjects met with an experimenter for three weekly 20-min individual sessions during which time they were asked to discuss a stressful or traumatic topic which they had previously discussed only minimally with others. Blood was drawn a week prior to the first session and at one week following the third session. Subjects completed the Impact of Event Scale (IES) after session 1 and at followup, and the extent of experiential involvement in disclosure during each session was assessed by means of the Experiencing Scale. Mood was assessed before and after each disclosure using the Nowlis Mood Adjective Checklist. Although the disclosure induction did not directly affect EBV-VCA antibody titres, individual differences in subjects' ability to involve themselves in the disclosure process and abandon their avoidance of the stressful tropic during the course of the 3-wk period were predictive of antibody decrements. These associations were more pronounced for individuals who disclosed older and more troublesome events.

Adaptation, Psychological↗

Adolescents who experienced sexual abuse: fears, needs and impediments to disclosure.

OBJECTIVE: Understanding the impediments that prevented sexually abused adolescents from disclosure to their family or to professionals, and analyzing the responses they received when they did disclose. METHODS: In depth anonymous interviews were conducted in Italy through a toll-free telephone line with 36 young people who experienced sexual abuse in adolescence. A qualitative analysis was carried out of the adolescents' feelings, fears and needs, and of the help received, if any. RESULTS: The main impediments to disclose to a family member were fear of not being believed, shame, and fear of causing trouble to the family. The main impediments for not seeking services were ignorance of the existence/functioning of protective agencies, wish to keep the secret, lack of awareness of being abused, mistrust of adults and professionals, and fear of the consequences of disclosure. When they did disclose to professionals, the teens received very limited support. CONCLUSION: Adolescents need to receive proper information about the risk of being sexually abused and about the help they can receive from their social network and protective agencies. There is a crucial need for appropriate training of professionals.

Adolescent↗

Truth and consequences: ethics, confidentiality, and disclosure in adolescent longitudinal prevention research.

PURPOSE: To examine data from a natural experiment resulting from a change made in the confidentiality agreement midway through a randomized, longitudinal, controlled trial to prevent or delay adolescent alcohol use. The investigators explored the impact of the change on adolescents' rates of participation and affirmative responses to a question on suicidal thoughts. METHODS: Adolescents 12-17 years old were administered a question on suicidal thoughts as part of a confidential exit interview after a general health examination with their primary care provider. After administration to 263 adolescents, the exit interview was made conditionally confidential with the remaining 181 adolescents. The revised consent form and protocol stipulated that researchers would reveal to appropriate professionals and parents any adolescent indicating suicidal thoughts. Prevalence estimates for the suicidal thoughts question and study participation rates were computed for conditions both before and after the change. RESULTS: Fewer adolescents responded affirmatively to the suicidal thoughts question when they were recruited using the revised (1%) than the original (8%) consent form and protocol (p=.001). The revised confidentiality agreement did not affect participation rates. CONCLUSIONS: Adolescents who assent to participate in research studies may be less likely to disclose personal information regarding suicidal thoughts if they know that their disclosure may result in a break in confidentiality. Specific guidelines are needed for conditional and unconditional confidentiality agreements to study mental health in adolescent longitudinal prevention research.

Adolescent↗

Perceived professional support and the use of blocking behaviours by hospice nurses.

A prospective study of the impact of training 41 hospice nurses in assessment skills was used to test hypotheses that blocking behaviours would be used more when patients disclosed feelings and used less when nurses perceived that they had satisfactory professional support. Each nurse was asked to assess a patient's current problems before and after feedback training and 8 months later. Audiotape recordings of these interviews were rated by trained raters. They determined the frequency of nurses' responses which had the function of blocking patient disclosure and the emotional level of patient disclosure. Before each patient assessment each nurse was interviewed and questionnaires administered to measure her perceptions of the support she received. Blocking behaviours were most evident when patients disclosed their feelings (Kendalls r = 0.36, P < 0.001). In interviews containing most patient disclosure of feeling, blocking was significantly less (r = -0.24, P < 0.5) when the nurse felt that practical help would be available if needed and when the nurse felt that her direct supervisor was concerned about the nurse's own welfare (r = -0.37, P < 0.005).

Emotions↗

Social intimacy: an important moderator of stressful life events.

Two studies were conducted to explore the role of social intimacy in predicting the individual's response to stress. In the first study the experimenter reinforced the experimental subjects' verbalizations during an interview on a fixed schedule for the first 3 minutes, withdrawing reinforcement for the final 4 minutes. The control group received reinforcement on a fixed schedule for the total 7 minutes. Subjects scoring low on a measure of intimacy disclosed less personal material during the withdrawal period in the experimental condition than in the control condition in contrast to high scoring subjects who maintained their level of disclosure for both parts of the interview. In the second study, previously experienced life change events were assessed. Individuals lacking a current intimacy were found to be prone to higher levels of emotional disturbance especially when many previous negative or few positive life change events had occurred.

Adult↗

Effects of method on participants and disclosure rates in research on sensitive topics.

This study replicates and extends the research of Rosenbaum, Rabenhorst, Reddy, Fleming, and Howells, which also appears in this special issue. Responses from 398 randomly assigned participants regarding differentially sensitive topics were collected via four methods of data collection: written questionnaires, face-to-face interviews, telephone interviews, and an automated telephonic data collection system (ATDC). Several significant differences in data collection methodology and topic area were found, including greater disclosure of sensitive information via the ATDC system than via face-to-face and paper-and-pencil conditions. Participants who were assigned to the ATDC condition felt significantly more comfortable answering questions compared to those in the face-to-face interview condition. Participants in the telephone interview condition reported answering significantly more carefully than participants answering via written questionnaire. Taken together, the results of this study and the previous one it replicates suggest that the ATDC produces disclosure rates that are at least equivalent to, if not greater than, those generated using traditional methods for collecting sensitive data.

Adolescent↗