Problems screening for HAND among the educationally disadvantaged.

Neurocognitive screeners are used to detect symptoms of HIV-Associated Neurocognitive Disorders (HAND). However, the degree to which education and socioeconomic status affect these screeners remains unclear. Neurocognitive screeners were administered to 187 socioeconomically disadvantaged HIV+ individuals upon entering treatment who had no other risk factors for HAND. The false positive rates were: 84% for the Montreal Cognitive Assessment, 59% for the International HIV Dementia Scale, and 28.3% for the Modified HIV Dementia Scale. Given these high false positive rates, the screeners may be more useful for establishing baseline functioning and sequential testing to detect deterioration.

Social Skills and School Readiness in Young Children Exposed to Violence.

Witnessing violence is associated with negative outcomes for preschool-aged children, including lowered school readiness; however, not all children evidence negative outcome, indicating the presence of protective factors. This study examined social skills as a moderator of the relation between violence exposure and school readiness in preschoolaged children. Seventy-eight children completed a measure of school readiness, and their caregiver completed measures of social skills, witnessed violence exposure, and direct victimization. Results revealed that social skills moderated the witnessed violence- school readiness association, controlling for direct victimization and family income. When children evidenced more appropriate social skills, witnessed violence and school readiness were inversely related. However, for children whose caregivers endorsed less appropriate social skills, there was no association between witnessed violence and school readiness.

Do they see dead people? Cultural factors and sensitivity in screening for schizophrenia spectrum disorders.

OBJECTIVE: Schizophrenia spectrum disorders (SSDs), are diagnosed more frequently among African-Americans (AAs) than Caucasians. It has been suggested that cultural differences in symptom presentation and endorsement (including reporting spiritual/religious experiences) may influence this disparity. The current study investigated the relationship between endorsement of spiritual auditory and visual hallucinations and subsequent diagnosis of SSD among AA patients. DESIGN: Participants (N = 471 AAs) completed the Mini International Neuropsychiatric Interview-Plus (MINI-Plus) Screening Interview as part of their intake to a HIV outpatient clinic. Endorsement of auditory or visual (A/V) hallucinations was explored with the MINI-Plus Psychotic Disorder Module and questions regarding the content of the unusual experience. RESULTS: Logistic regression indicated that endorsement of A/V hallucinations significantly predicted a SSD (OR = 41.6, 95% CI 13.7-126.0, p < .001). However, when hallucinations were spiritual in nature, odds of an SSD fell dramatically (OR = 0.22, 95% CI 0.07-0.64, p < .001). CONCLUSIONS: The current study indicates that not all visual and auditory hallucinations are symptomatic of a psychotic disorder in AA patients. Many of these experiences may be related to spirituality. Clinicians assessing AA patients need to query content of, meaning attributed to, and distress associated with A/V unusual experiences.