Early Childhood Trauma, Posttraumatic Stress Disorder, and Non-Adherence in Persons with AIDS: A Psychodynamic Perspective
Bibliographic record
Abstract
Non-adherence to treatment and risk-reduction measures not only leads to increased morbidity and mortality in patients with HIV/AIDS but is also a major public health hazard. While there are multiple determinants of non-adherence, one that is particularly complex and refractory to intervention appears to be the history of childhood trauma and the development of post-traumatic stress disorder (PTSD). While behavioral intervention is occasionally helpful in increasing a patient's commitment to self-care, it is our view that the use of a more psychoanalytic framework, as well as the development of a psychodynamic understanding of the patient's history and struggles, may provide both patient and clinician with a more profound understanding of the forces that perpetuate non-adherence, thus facilitating a more cohesive and empathic approach to treatment. It is the aim of this article to explore, from a psychodynamic perspective, the possible connections between early childhood trauma resulting in PTSD and non-adherence to risk reduction and HIV treatment.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.007 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.002 | 0.004 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".