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Cultural factors in the emergence of borderline pathology.

Most of the research and clinical reports concerning borderline personality disorder (BPD) come from highly developed countries. Although BPD can also be diagnosed in developing societies, it is likely that this form of pathology is more prevalent in North America and Europe. However, the personality traits and psychological risk factors underlying borderline personality may also be found in individuals from developing countries. The hypothesis of this paper is that social protective factors suppress the development of these traits into diagnosable personality disorders. This process is illustrated by cases in which borderline pathology emerged only after immigration.

Adult↗

Borderline personality disorder in cultural context: commentary on Paris.

Paris suggests that some cultures provide protective factors that can suppress the emergence of borderline personality disorder (BPD). Yet all cultures contain some individuals who perceive themselves as unable to meet what is expected of them, and the resultant distress is expressed through a variety of "ethnic" disorders such as susto or nervios. When viewed in this context, BPD is similar to these disorders, notably in the perceived sense of social failure, marginality and powerlessness.

Borderline Personality Disorder↗

The problem of antiretroviral adherence: a self-regulatory model for intervention.

Controlled trials that determine which interventions can significantly improve adherence to combination antiretroviral regimens are urgently needed. Rates of adherence to the regimens are often sub-optimal, and while a variety of factors that are predictive or associated with antiretroviral adherence have been identified, few research findings are reported of interventions that effectively promote adherence and improve health outcomes. Further, the mechanisms by which interventions promote antiretroviral adherence are not well understood. Maximizing adherence and achieving the full potential of the antiretroviral therapies demand multidimensional initiatives that address complex behavioural and biomedical issues. A model drawn from self-regulation theory and empirical data to explain antiretroviral medication adherence is proposed.

Affect↗

Micro-social structural approaches to HIV prevention: a social ecological perspective.

To be effective and sustainable, HIV-prevention interventions need to be sufficiently powerful to counteract prevailing social norms and diffuse through the targeted community to provide social reinforcement for behaviour change. Social structural and environmental factors are major influences on HIV-related behaviours yet the dearth of conceptualization and operationalization of these factors impede progress in intervention development. In this paper we propose a social ecological perspective to intervention and highlight relevant theories from social psychology and organizational behaviour literatures. We examine social networks and social settings as micro-structural and environmental influences on HIV risk behaviours, social identities and norms, and as important targets for HIV-prevention intervention. Intervention approaches are proposed that target networks and behavioural settings and provide participants with socially meaningful and rewarding behavioural options that are consistent with valued prosocial identities or roles. Examples are presented on how such an approach has been utilized in prior HIV prevention interventions, including our social network-oriented intervention that trained disadvantaged former and current illicit drug users to conduct peer outreach. We describe how behavioural interventions may enhance or introduce new prosocial identities and social roles, and that network members may confer social approval to reinforce these identities and roles, leading to sustained behavioural risk reduction and changes in risk behaviour norms.

Community Health Services↗

Biosocial models of adolescent problem behaviors.

This paper develops a biosocial model of adolescent age-graded norm violations ("problem behaviors"), combining a traditional social control model with a biological model using steroid hormones. Subjects were 101 white boys drawn from the 8th-, 9th-, and 10th-grade rosters of selected public schools, and ranging in age from 13 to 16. Subjects completed self-administered questionnaires and provided blood samples which were assayed for the behaviorally relevant hormones. Boys' problem behavior shows strong hormone effects. Social and biological variables have both additive and indirect effects. Using a biosocial model leads to conclusions which are different from those which would have been drawn from the sociological model alone.

Adolescent↗

Drinking control attempts and encouragement of alcohol use in couple relationship--a qualitative approach.

The present study addresses previously neglected research areas among couples with normal drinking habits, namely control attempts and encouragement of drinking. In this study, semistructured interviews were conducted in 2001 with 27 individuals living in steady couple relationships in Helsinki. Forms of active social control of drinking were classified into four categories and were investigated on the dimensions of indirect-direct and mild-strong. Further analysis suggests that the form of control reflects the degree of individualization in relationships, at least when drinking is concerned. Later, the exploration of encouragement of drinking shows that the culturally crucial feature of the qualified drinker is the preservation of one's own will. Then, it is concluded that in a couple relationship, social control and encouragement of drinking are, above all, complementary. Finally, the significance of drinking's social control is not restricted to alcohol use only, and it is surprisingly great in couple relationships, especially in preventing deviant drinking behavior. Several factors are presented that contribute to the increase of social control's importance.

Adult↗