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Biomedical subjects

J W Finney

Publications and source records attributed to J W Finney.

At least 55 records · Page 3Linked to original sources

Entering treatment for alcohol abuse: a stress and coping model.

This study used a stress and coping model to examine the process of entering treatment among 515 problem drinkers without prior formal treatment for alcohol abuse who were recruited at alcoholism information/referral (I&R) and detoxification centers. Over a 1-year follow-up period, 76% of the individuals in the sample entered some form of treatment, including Alcoholics Anonymous. People were more likely to enter treatment if they perceived their drinking problem as more severe, had more dependence symptoms, experienced more adverse consequences as a result of drinking, had more symptoms of depression, were more self-derogating, experienced more negative life events in the past year, and/or experienced more stressors in various life domains. Facilitative factors also related positively to treatment entry: people who had sought help from non-formal treatment sources before, who recalled being referred to treatment programs by an I&R center, and/or who received detoxification at a center that had treatment services available on-site, also were more likely to enter treatment. For people with greater resources in multiple life domains the positive effects of days intoxicated, dependence symptoms and stressors on help-seeking were intensified. Overall, the findings suggest that perceived severity of drinking problem plays a central role in the treatment entry process and mediates the effects of many other intrapersonal and environmental variables in generating an impetus or readiness to seek treatment.

Adaptation, Psychological↗

Short-term treatment careers and outcomes of previously untreated alcoholics.

OBJECTIVE: To describe treatment selection and outcomes over a 3-year follow-up period for 439 individuals who had drinking problems and had not yet received formal treatment at baseline. METHOD: By the 3-year follow-up, individuals had self-selected into one of four groups: no-treatment (n = 70), completed treatment (i.e., help was received only in Year 1 of follow-up: n = 109), additional treatment (i.e., help was received in Year 1, with more help in Years 2 and 3; n = 233), and delayed treatment (i.e., no help was received until Years 2 and 3 of follow-up; n = 27). RESULTS: Compared with individuals who remained untreated, individuals who sought help during Year 1 had more severe drinking problems, poorer psychosocial functioning and more negative life events at baseline; however, treated individuals had better drinking outcomes than untreated persons at the 1- and 3-year follow-ups. Compared to individuals who completed treatment in Year 1, additional treatment group members had more severe drinking problems at baseline and 1 year later, but better drinking outcomes at the 3-year follow-up. Formal treatment in conjunction with Alcoholics Anonymous (AA) was associated with better drinking outcomes than formal treatment alone. In addition, more involvement with formal inpatient or outpatient treatment, or AA, was associated with more improvement on drinking indices. CONCLUSION: Overall, the findings suggest a reciprocal relationship between individuals' functioning and their participation in alcohol abuse interventions.

Adult↗

Evaluation of two health education strategies for testicular self-examination.

We evaluated the effects of two health education teaching methods, a pamphlet based on a task-analyzed checklist and two professionally developed films, on the completeness, accuracy, and maintenance of testicular self-examinations (TSE). Subjects (N = 48) were videotaped while performing a TSE after training and at a follow-up visit. Direct observation of the tapes showed that checklist-based training resulted in more complete and longer TSEs (p < .05). Social validation ratings, however, suggested that physicians were unable to discriminate reliably the performances of subjects taught using the two methods. Accuracy of detection of simulated lesions on plastic models was also similar for the two groups. Adherence to TSE recommendations was high during the study, but declined across the follow-up period. Further study is needed to promote adherence to TSE and to document the effects of early detection on morbidity and mortality of testicular cancer.

Adolescent↗

The use of transcutaneous electrical nerve stimulation (TENS) in the treatment of facial pain.

The purpose of this article is to provide guidelines for the use of transcutaneous electrical nerve stimulation (TENS) in the differential diagnosis and treatment of facial pain. Most practitioners familiar with electrical modalities are aware that TENS is a physiologically-specific therapy for treating and resolving facial pain related to various neurological and/or myofascial conditions. This article proposes the added use of TENS as a diagnostic tool. The effect on the patient's pain level from the trials of various combinations of rate and width settings provides the practitioner specific information to aid in a diagnosis. Guidelines to differential diagnosis as well as protocols for office and home use of this non-invasive, non-addictive and effective modality will be presented.

Facial Pain↗

Outcome of treatment for alcohol abuse and involvement in Alcoholics Anonymous among previously untreated problem drinkers.

A sample of 515 initially untreated problem drinkers was followed for one year after contacting alcohol information and referral or detoxification services. At a one-year follow-up, participants had self-selected into one of four groups: no treatment (24%), Alcoholics Anonymous (AA) only (18%), outpatient treatment (25%), and residential or inpatient treatment (32%); some outpatients also attended AA, and some inpatients also attended AA and/or outpatient programs. These four groups were compared on changes in drinking-related variables, other aspects of functioning, and stressors and resources over the follow-up year. Also examined were associations between amount of treatment and outcomes at one year. All four groups improved on drinking and functioning outcomes but changed less on stressors and resources. Although individuals who received no help improved, persons in the two treatment and the AA-only groups improved more, particularly on drinking-related outcomes. Inpatients were more likely than outpatients or AA-only participants to be abstinent; otherwise, type of intervention had few differential effects. More AA attendance was associated with abstinence among AA-only, outpatient, and inpatient group members. Among outpatients and inpatients, more formal treatment was associated with abstinence and improvement on other drinking-related outcomes.

Alcoholics Anonymous↗

Enhancing commitment improves adherence to a medical regimen.

A commitment-based intervention was evaluated for improvement of adherence to a 10-day antibiotic regimen. Experimental Ss made verbal and written commitments for adherence and completed tasks designed to increase their investment in a medication regimen. Control Ss performed similarly structured tasks unrelated to the medical regimen. Adherence, measured by unannounced pill counts, was significantly higher for experimental subjects than for control Ss. Self-reported adherence was significantly correlated with posttest self-efficacy but not with pretest self-efficacy. Adherence to a medical regimen may be improved by strategies conceptually based on the investment model of commitment, which provides a useful framework for further study of adherence.

Adolescent↗

Previous injuries and behavior problems predict children's injuries.

Investigated factors related to unintentional injuries in 50 children from summer day camps for economically underprivileged youth. Data were collected on parent reports of children's previous medically treated injuries, Eyberg Child Behavior Inventory (ECBI) scores, and the day camp's incident reports of injuries. One year later, parents completed a second questionnaire about medically and home-treated injuries. Multiple linear regression indicated that previous medically treated injury, ECBI opposition score, and injury at camp accounted for 50% of the variance of medically treated injuries in the year after camp. Previous medically treated injury accounted for 21% of the variance in frequent home-treated injuries during the year after camp. Children who have behavior problems may behave in ways that predispose them to common injuries. Conceptualizing injury as a behavioral process suggests behavior change strategies to reduce injury risk and ways to target children for injury prevention efforts.

Accident Proneness↗

Exploring the relationship between thumb-sucking and psychopathology.

Studied the relationship between chronic thumb-sucking and behavior problems reflective of psychopathology. Compared scores on the Child Behavior Checklist (CBCL) and Eyberg Child Behavior Inventory (ECBI) for matched samples of thumb-sucking, referred, and nonreferred children. Mean scores for the thumb-sucking and nonreferred samples were equivalent and were significantly lower than scores for the referred sample. Comparing scores for older children (8-14 years) and younger children (4-7 years) did not produce a significant interaction. Correlating measures of thumb-sucking severity with ECBI and CBCL scores produced only 8 (of 42) significant correlations and a mean correlation of only .09. Collectively our results provide little support for the theoretically derived notion that thumb-sucking is necessarily a symptom of psychopathology.

Adolescent↗

The process of treatment selection among previously untreated help-seeking problem drinkers.

A sample of 515 untreated problem drinkers was followed up for 1 year after contacting alcohol information and referral or detoxification services. At the 1-year follow-up, participants were placed into one of four treatment status groups: no treatment (24%), Alcoholics Anonymous only (18%), outpatient (25%), and inpatient or residential (32%). Participants with fewer financial resources, more serious drinking problems, and poorer functioning at baseline were more likely to enter inpatient or residential programs than outpatient treatment. Persons who selected AA only for treatment were of lower socioeconomic status than outpatients, and were functioning better than those who opted for treatment in inpatient or residential settings. In general, individuals who entered treatment received a considerable amount of treatment. Poorer baseline functioning was related to attending more AA meetings or outpatient sessions, and to staying longer in inpatient or residential treatment. The results are discussed in the context of a conceptual model of selection into alcoholism treatment.

Adult↗

Empirical selection of psychosocial treatment targets for children and adolescents with diabetes.

Used an empirical approach to determine psychosocial variables related to optimal metabolic control of diabetes in two samples (total n = 56) of children and their families. Children and adolescents classified as either in optimal or nonoptimal control of diabetes (based on glycosylated hemoglobin results) completed self-report measures on variables of anxiety, coping, family environment and health locus of control, and a structured interview. Parents completed parallel self-report measures and a child behavior checklist. Children in optimal control of diabetes had more structured and controlling family environments, and more frequently believed that "powerful others" were responsible for their health. There was a marginally significant difference in knowledge, with children in poorer metabolic control showing better knowledge about diabetes and its management than children in optimal control. The study illustrates an empirical approach to the selection of psychosocial treatment targets for children with diabetes, and underscores the importance of parental involvement with the diabetes regimen to ensure optimal control of diabetes in both children and adolescents.

Adaptation, Psychological↗

Society of Pediatric Psychology Task Force Report: pediatric psychology and injury control.

Injuries are the major causes of death for children. Pediatric psychology offers significant contributions to the multidisciplinary efforts necessary to prevent injuries and reduce harm to children. This Task Force Report reviews epidemiological data, characteristics of children's injuries, passive and active interventions for reducing injuries, and research, policy, and evaluation issues for individual and community injury control efforts. Directions for future pediatric psychology efforts are identified and placed in a context of collaborative efforts required to advance the control of children's injuries.

Adolescent↗

Determinants of children's health care use: an investigation of psychosocial factors.

Factors related to the amount of health care used by 5- to 11-year-old children in a health maintenance organization (HMO) were investigated using a comprehensive multivariate model that assessed the contribution of child health need, mental health, and social functioning; maternal mental health, social support and health care utilization; and family functioning and life events. Mothers reported on the 450 participating children. Health care visits for a two-year retrospective period were obtained from the computerized encounter system. Child health need and maternal patterns of health care use were powerful predictors of the overall amount of health care used, and these factors discriminated high users from low users of care. Family conflict was associated with a higher volume of care, while children's depressive symptoms and non-white race were related to lower use. Maternal social support, mental health, and life events were not predictive of use in either full multivariate model. Enabling factors were held relatively constant by participation of all families in a prepaid HMO. The multiple regression model explained 33% of the variance in use, slightly more than in previous studies of children's health care use. When included in a comprehensive analysis, child and family psychosocial characteristics help to explain children's health care use beyond what is possible using simple health and illness variables. The implications of these findings in the development of further research and to the practice of routine pediatric care are discussed.

Adult↗

The overestimation of adherence to pediatric medical regimens.

We evaluated the accuracy of primary health care providers' predictions of parents' adherence to their children's short-term antibiotic regimen and a scheduled follow-up appointment. Adherence predictions were compared with objective measures of the parents' adherence. Providers were poor predictors of nonadherence, greatly overestimating the percentage of parents who would be adherent. Nonadherence is typically addressed by applying adherence improvement strategies to all patients. Recent pediatric research, however, suggests that applying contingency-based interventions for adherent patients can result in later nonadherence if the strategies are withdrawn. Inaccurate predictions of adherence will result in many nonadherent patients not receiving a needed intervention. The results indicate the need for strong behavioral predictors that result in more accurate identification of patient nonadherence to guide further applications of adherence improvement strategies.

Anti-Bacterial Agents↗

Changing protective and risky behaviors to prevent child-to-parent transmission of cytomegalovirus.

Child-to-parent transmission of cytomegalovirus may be reduced by increasing protective behaviors (handwashing and glove use) and decreasing risky behaviors (intimate contact between child and parent). This study showed that an educational intervention resulted in increases in reported and objective measures of protective behaviors and decreases in reported risky behaviors. Further study must determine if changes in protective and risky behavior are maintained and prevent cytomegalovirus transmission.

Behavior Therapy↗

New directions in substance abuse services: programmatic innovations in the Veterans Administration.

The purpose of this paper to describe the Department of Veterans Affairs' (VA) recent expansion and enhancement of its substance abuse treatment services. Several treatment innovations are considered from both clinical and administrative perspectives. These services include extended care programs for multiply impaired patients, programs for substance abuse patients with comorbid psychiatry conditions and services designed to improve continuity of care and community re-entry. Emergent themes include a broadening of services to meet the needs of a changing substance abuse population and an emphasis on providing more cost-efficient treatment.

Comorbidity↗

Behavioral assessment of children and adolescents.

Primary care visits provide opportunities for behavioral assessment of children and adolescents. Screening checklists, interviewing, behavioral observations, and parent and child monitoring of behavior are feasible assessment techniques for ongoing assessment of the child's behavioral and developmental status. The incorporation of behavioral assessment in primary care will result in better identification of children's behavioral and developmental problems and an improved health care system that is responsive to all aspects of children's health.

Adolescent↗

Behavior of injured and uninjured children and their parents in a simulated hazardous setting.

Compared the behavior of parents and their previously injured children with parents and their uninjured children in unstructured play and distracted parent conditions. Injured children were more disruptive, more active, and had more contacts with hazards, whereas uninjured children had more appropriate behavior. Parents of injured children had lower rates of play activities. Observable classes of parent and child behaviors amenable to change were associated with a history of child injury. Further study is needed to assess the use of safe and unsafe behavior as proxy measures for injuries and to identify functional classes of safe and unsafe behavior for which active strategies can be developed to prevent children's injuries.

Accident Proneness↗