Background Crack cocaine use undermines adherence to highly active antiretroviral therapy (HAART). This pilot randomized clinical trial tested the feasibility and efficacy of 2 interventions based on the Information-Motivation-Behavioral Skills model to improve HAART adherence and reduce crack cocaine problems. Methods Participants were 54 adults with crack cocaine use and HIV with <90% HAART adherence. Most participants were African-American (82%) heterosexual (59%), and crack cocaine dependent (92%). Average adherence was 58% in the past 2 weeks. Average viral loads (VL) were detectable (log VL 2.97). The interventions included 6 sessions of Motivational Interviewing plus feedback and skills building (MI+), or Video information plus debriefing (Video+) over 8 weeks. Primary outcomes were adherence by 14-day timeline follow-back and Addiction Severity Index (ASI) Drug Composite Scores at 3 and 6 months. Repeated measures ANOVA assessed main effects of the interventions and interactions by condition. Results Significant increases in adherence and reductions in ASI Drug Composite Scores occurred in both conditions by 3 months and were maintained at 6 months, representing medium effect sizes. No between group differences were observed. No VL changes were observed in either group. Treatment credibility, retention, and satisfaction were high and not different by condition. Conclusions A counseling and a video intervention both improved adherence and drug problems durably among people with crack cocaine use and poor adherence in this pilot study. The interventions should be tested further among drug users with poor adherence. Video interventions may be feasible and scalable for people with HIV and drug use.

Background Indoor tanning has been found to be addictive. However, the most commonly-used tanning dependence measures have not been well-validated. Objective The study’s purpose was to explore the psychometric characteristics of and compare the mCAGE (modified Cut-down, Annoyed, Guilty, Eye-opener Scale), mDSM-IV-TR (modified Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition - Text Revised), and TAPS (Tanning Pathology Scale) measures of tanning dependence and provide recommendations for research and practice. Methods This study was a cross-sectional online survey with 18–25 year old female university students. The main outcome variable was tanning dependence measured by the mCAGE, mDSM-IV-TR, and TAPS. Results Internal consistency of the TAPS subscales was good but was poor for the mCAGE and mDSM-IV-TR, except when their items were combined. Agreement between the mCAGE and mDSM-IV-TR was fair. Factor analysis of the TAPS confirmed the current four-factor structure. All of the tanning dependence scales were significantly correlated with one another. Likewise, most of the tanning dependence scales were significantly correlated with other measures of tanning attitudes and behaviors. However, the tolerance to tanning TAPS subscale was not significantly correlated with any measure of tanning attitudes or behaviors and had the lowest subscale internal reliability and eigenvalues. Conclusion Based on the data and existing literature, we make recommendations for the continued use of tanning dependence measures. Intervention may be needed for the approximately 5% of college women who tend to be classified as tanning dependent across measures. Monitoring of individuals reporting tanning dependence symptoms is warranted.

Purpose Indoor tanning (IT) increases risk for melanoma and is particularly common among young adult women. IT has also been linked with some psychiatric symptoms, and frequent tanning may indicate tanning dependence (addiction) associated with endorphin release during ultraviolet (UV) radiation exposure. The objective of the current study was to investigate associations between IT, tanning dependence, and psychiatric and substance use symptoms in young adult women. Design Cross-sectional survey and psychiatric interview. Setting Online, except for the MINI International Neuropsychiatric Interview (MINI) that was completed over the telephone. Subjects Participants were 306 female university students aged 18–25 years. Measures MINI, Seasonal Scale Index, tanning dependence scales, reporting ever having used a tanning bed or booth with tanning lamps (single item), reporting smoking a cigarette in the last 30 days (single item). Analysis Descriptive statistics, chi square analysis, multivariate logistic regression. Results Forty-six percent of the sample reported a history of IT, and 25% were classified as tanning dependent. Multivariate logistic regression analyses showed that IT was significantly associated with symptoms of alcohol use disorders, generalized anxiety, and not having social anxiety. Tanning dependence was associated with symptoms of alcohol use disorders. Conclusion Tanning is of concern not only for its association with skin cancer but for its association with psychiatric and substance use symptoms. Young women with certain psychological problems may seek relief from their symptoms by IT. These findings suggest that indoor tanners may benefit from health behavior and other psychosocial interventions.

Since 2010, psychology leaders in education and training associated with doctoral programs in professional psychology have been monitoring court cases and state-level legislation that assert students' rights to religious freedom during professional training. Such court cases and legislative actions put at risk educators' ability to ensure the competence of graduates to effectively serve a diverse public. In response to these legal challenges, the APA Board of Educational Affairs (BEA) appointed an 11-member Virtual Working Group on Restrictions Affecting Diversity Training in Graduate Education to develop a thoughtful, proactive position. Through ongoing discussions that occurred over 18 months, members of the Working Group developed an enhanced understanding of the intersection of graduate students' First Amendment Rights with professional psychology's commitment to graduate competent psychologists who have the capacity to serve a wide and diverse clientele. The Working Group identified five core tenets that informed their development of resources to support educators and trainers of professional psychology graduate programs. This article provides a brief history of the court cases and legislative ERICA H. WISE received her PhD in clinical psychology from Southern Illinois University at Carbondale. She is clinical professor and director of the Psychology Training Clinic in the clinical psychology doctoral program at University of North Carolina, Chapel Hill. She is a member of the APA Board Educational Affairs (BEA) and co-chair of the NCPA Ethics Committee. In addition, she is past president of the Association of Psychology Training Clinics (APTC), past president of the North Carolina Psychological Association (NCPA), and a former member and chair of the APA Ethics Committee and the North Carolina Psychology Board. Her professional interests include the education and training of clinical psychologists, and the integration of ethics, diversity, and self-care into academic and professional practice settings. KATHLEEN J. BIESCHKE received her PhD in counseling psychology from Michigan State University. She is the head of the department of Educational Psychology, Counseling, and Special Education at the Pennsylvania State University. She is currently a commissioner and co-chair for Quality Assurance for the APA's Commission on Accreditation. Her research focuses on educating and training psychologists to provide competent services to sexual and gender minorities. She is also actively involved with Center for Collegiate Mental Health and the provision of services to members of under-represented populations, particularly those who identify as sexual and/or gender minorities.LINDA FORREST received her PhD from the University of Washington, Seattle. She is professor emerita in counseling psychology and human services at the University of Oregon. She serves as the chair of the BEA/BPA working group that produced this manuscript describing the evolution of the pedagogical statement and supporting products. In addition, s...

Indoor tanning (IT) has been linked with psychiatric and addictive symptoms, and frequent tanning may indicate tanning dependence (addiction). The current study evaluated the effects of an IT episode on mood states and the association of these effects with psychiatric and addictive symptoms among young adult female indoor tanners. One-hundred thirty-nine female university students aged 18-25 years who had indoor tanned completed an online survey including the Positive and Negative Affects Scales and a standardized psychiatric interview (the MINI International Neuropsychiatric Interview) via telephone. Psychiatric and addictive symptoms were relatively common among these young adult female indoor tanners. Overall, participants reported significant decreases in both negative (upset, scared, irritable, nervous, jittery, afraid) and positive (feeling interested) mood states after their most recent tanning episode. Multivariable linear regression analyses showed that more frequent indoor tanning in the past month and symptoms of illicit drug use disorders were associated with decreases in negative mood, and symptoms of generalized anxiety disorder were associated with a decrease in feeling interested. In summary, indoor tanners report relatively high rates of psychiatric and substance use symptoms, including symptoms of tanning dependence, and indoor tanning appears to alter mood. Women with certain substance use and psychiatric characteristics may be more vulnerable to such mood changes after tanning indoors. Further research is needed to clarify the relationships among these variables.