Speaker overestimation of communication effectiveness and fear of negative evaluation: being realistic is unrealistic.

Speakers systematically overestimate their communication effectiveness (Keysar & Henly, 2002). We argue that doing so is adaptive, reducing the risk of social anxiety and withdrawal from social situations. This hypothesis was tested by having speakers who scored low and high for fear of negative evaluation (FNE), a hallmark of social phobia, attempt to convey a specific meaning of ambiguous statements to a listener and then estimate their communication effectiveness. Low-FNE speakers consistently overestimated their effectiveness, expecting the listener to understand their intended meaning more often than listeners actually did. In contrast, high-FNE speakers' estimates of communication effectiveness were consistent with the listener's actual understanding. Signal detection analysis revealed that low- and high-FNE speakers were equally able to discriminate communication success from failure, but low-FNE speakers exhibited a stronger positive response bias. In conclusion, overestimating one's communication effectiveness is adaptive, and accurate estimation is associated with dysfunction.

Failure to confirm HIV infection in two end-stage HIV/AIDS patients using a popular commercial line immunoassay.

Immunoassays using either viral lysate (Western blot) or recombinant/synthetic antigen (immunoblot) for anti-HIV capture are still the preferred method to confirm HIV infection. Two cases of HIV-1-infected patients presented with acquired immunodeficiency syndrome (AIDS)-defining illnesses. Laboratory tests were performed using multiple commercial HIV test kits on multiple sera from both patients over several weeks. Both patients were strongly positive on the anti-HIV/p24 antigen combined screening assay. Yet, HIV-1 infection could not be confirmed using a popular commercial immunoassay. Eventually, HIV infection was confirmed using an alternative commercial Western blot assay as well as an HIV quantitative PCR test. In laboratories without nucleic acid testing (NAT) for HIV, indeterminate results may delay confirmation of HIV infection, if commercial line immunoassays alone are available. Some end-stage HIV/AIDS patients may not produce antibodies to specific HIV antigens and may therefore give indeterminant or negative results on some immunoassays, depending on the type of antigen used. This report highlights the utility of having NAT available when diagnosing difficult cases of HIV infection, especially in light of the recent Centers for Disease Control and Prevention move towards more universal, routine, HIV testing.