Effects of alcohol cues and alcohol intoxication on drug use expectancies among men who have sex with men.

Although alcohol and drug use have been identified as HIV-risk factors for men who have sex with men (MSM), little is known about how they interact. An alcohol administration paradigm was used to examine alcohol's cue and pharmacological effects on perceived drug use benefits and consequences in 117 MSM. Planned contrasts indicated that those in the alcohol cue (i.e., placebo) condition reported lower perceived drug consequences compared to controls. No cue effects were found for drug benefits. There was no pharmacological effect of alcohol as compared to alcohol cue on either outcome. Findings suggest that alcohol cues may influence the perception of consequences related to drug use, which has implications for health interventions targeting substance use and HIV risk.

Life goal appraisal and marijuana use among college students.

The current study was designed to examine the motivational context of marijuana use among college students using idiographic and nomothetic goal assessment approaches. One hundred and ninety-eight introductory psychology students completed a questionnaire that included measures of life goals and marijuana use behavior. Forty-three percent of students surveyed reported the use of marijuana in the past 90 days. Students rated a set of five personally salient, self-generated and five normative life goals on a series of dimensions using the personal projects methodology (Little, 1983). Goal meaning and goal efficacy ratings for each type of assessment were studied in relation to the likelihood of marijuana use and the frequency of use among current users. Logistic regression analyses showed that levels of meaning for self-generated life goals and normative academic life goals were independent predictors of whether students used marijuana in the past 90 days. Students who reported high levels of meaning were less likely to have used marijuana in the past 90 days. For students who used marijuana, higher meaning ratings related to involvement in groups/organizations and fitness were correlated with decreased frequency of use. Moreover, ratings of efficacy related to self-generated goals were associated with less frequent use among smokers. These results suggest that meaning related to life goal pursuit may be associated with students' decisions to use marijuana. Potential implications for interventions are discussed.

Discrediting the notion "working with 'crazies' will make you 'crazy'": addressing stigma and enhancing empathy in medical student education.

People with mental illness around the world continue to suffer from stigmatization and limited care. Previous studies utilizing self-report questionnaires indicate that many medical students regard clinical work with psychiatric patients as unappealing, while the professionalism literature has documented a general decline in students' capacity for empathy over the course of medical school. Through in-depth interviews, this study attempts to better understand the formation of medical students' perceptions of psychiatry and the implications of that process for a more general understanding of the impact of emotionally-laden experiences on medical students' capacity for empathy. Forty-seven fourth-year medical students who had expressed interest or performed well in psychiatry were asked a series of questions to elicit their perceptions of the field of psychiatry. Interview transcripts were systematically coded using content analysis and principles of grounded theory. Stigma, stereotypes, and stressfully intense emotional reactions seemed to adversely affect the students' expected satisfaction from and willingness to care for the mentally ill, despite enjoying psychiatry's intellectual content and the opportunity to develop in-depth relationships with patients. Teaching faculty need to directly address the stigma and stereotypes that surround mental illness and actively help medical students cope with the stress that they report experiencing during their psychiatry clerkship in order to improve the recognition and treatment of psychiatric illness by newly graduating physicians. More generally, the relationships that we identify among stress, stigmatization, and stereotyping along an empathic spectrum suggest that increased attention should be paid to the stress that empathy can entail. This perspective may allow for the creation of similarly targeted interventions throughout the medical school curriculum to counteract the decline in empathy, the so-called "hardening of the heart," associated with physician-training worldwide.

Medical students' perceptions of psychiatry as a career choice.

OBJECTIVE: This study describes medical students' perceptions of the field of psychiatry and identifies the impact of those perceptions on their career choices in order to explore the questions: Are we as a field doing all that we can to enhance the educational experience of all medical students, regardless of their career preferences? What are the most appropriate ways to encourage interested medical students that would allow for more targeted recruitment efforts toward the most receptive students? METHODS: Third-year (n=131) and fourth-year medical students (n=117) at a northeastern, urban, private university medical school completed anonymous self-report questionnaires. Students rated the impact of intellectual interest, status, earning potential, healthcare reform, quality of life, satisfaction, and stress of working with psychiatric patients on their consideration of a psychiatric career. Respondents were then systematically divided into two groups: 1) those who considered psychiatry as a possible career choice and 2) those who did not. RESULTS: When compared to students who had been coded as "not seriously considering" a career in psychiatry, students coded as "seriously considering" gave significantly higher positive ratings to the field's intellectual content and quality of life. There were also significant differences between the groups regarding the satisfaction involved in working with psychiatric patients. Students from both groups were equally concerned about stress levels in the field. CONCLUSIONS: Acknowledging, discussing, and providing a context for stressful experiences during the psychiatry clerkship are likely to bring about productive approaches to improve recruitment into the field as well as to improve all students' psychiatric education.