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This study examined coping behaviors of people with AIDS, using a large sample (N = 736) that was both geographically and sociodemographically diverse. In-person interviews were conducted with people receiving AIDS-related medical or social services; follow-up interviews were conducted approximately 11 months later. Factor analyses of 16 coping behaviors revealed three factors: Positive Coping, Seeking Social Support, and Avoidance Coping. Respondents with a history of injected drug use, as compared with gay or bisexual men, had higher scores for Avoidance Coping and lower scores for Positive Coping. Each coping scale was significantly related to depressive symptoms in cross-sectional analyses. In longitudinal analyses that controlled for prior depressive symptoms, Positive Coping was significantly related to decreases in symptoms.

SUMMARYThe presence of' depression was evaluated in a cross-section of 50 outpatients with dementia using the self-rated Geriatric Depression Scale and the clinician-rated Cornell Depression Scale. Impaired insight, as manifested by unawareness of dementia, correlated with dementia severity and discriminated a group of patients in whom the self-rated scale failed to show evidence of depression. Discrepancy between the two types of scales occurred among mildly as well as moderately demented patients when insight was impaired. Recognition of this discrepancy suggests that reliance on self-ratings may underestimate the presence and degree of depression among patients with dementia.

The purposes of this article are (1) to identify resident and facility risk factors for the use of physical restraints since the implementation of the Nursing Home Reform Act (NHRA), and (2) to compare these results with resident and facility risk factors for the use of physical restraints prior to the implementation of the NHRA. Data were collected in 1990 and 1993, and represent residents drawn from 268 facilities in 10 states. In the 1993 cohort activities of daily living (ADL) scores, cognitive performance scale (CPS) scores, age, taking antipsychotic medications, a history of falls, and mobility problems were resident-level variables significantly associated with the use of restraints. Full-time-equivalent (FTE) nurse aides per resident, FTE RNs per resident, average occupancy, Herfindahl index, Alzheimer's special care unit, and Medicaid reimbursement policy were facility-level variables significantly associated with the use of restraints. When the 1990 cohort was compared to the 1993 cohort (pre- and post-NHRA), however, only three risk factors for the use of restraints were significant. We propose that, to date, the NHRA may have been successful in reducing the use of physical restraints, but it appears to have had less impact on the types of residents who are restrained.