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Biomedical subjects

L H Epstein

Publications and source records attributed to L H Epstein.

At least 217 records · Page 12Linked to original sources
PubMed1976

Instructional control of sleep reduction.

Nightly sleep of 8 college students was gradually reduced from baseline levels by instructions implemented in a multiple baseline, changing criterion design. The reduction phases were 5%, 15%, and 30% decreases. Performance, academic, and sleepiness measures were collected. Consistent reductions occurred for all subjects from mean daily sleep times of 7.71 to 6.20 hr. per night, a 20% decrease. No negative side-effects were observed and subjects reported they enjoyed the additional free time afforded by reducing their sleep.

Achievement↗
PubMed1975

Instructional, pacing, and feedback control of respiratory behavior.

Procedures designed to affect respiration rate and amplitude were assessed for 4 groups of 8 subjects each. The groups were exposed to combinations of procedures providing feedback for decreasing respiration amplitude, pacing respiration rate, and instructions on rate and amplitude of breathing. After an initial baseline, effects were examined during both treatment and self-management phases for respiratory activity and concurrent heart-rate and electromyogram activity. Reliable effects of pacing on respiration rate, and a slight, but non-significant effect on amplitude were observed. No effects were observed for any heart-rate or electromyogram measures.

Auditory Perception↗
PubMed1974

Generality and side effects of overcorrection.

The effects and side effects of overcorrection for self-stimulatory behaviors of two children in a specialized day-care program were evaluated. For one child, a "hand" overcorrection procedure involving arm and hand exercises was introduced contingent upon inappropriate hand movements and later contingent upon inappropriate foot movements. After "hand" overcorrection was withdrawn for inappropriate foot movements, a "foot" overcorrection procedure involving foot and leg exercises was introduced contingent upon inappropriate foot movements. For a second child, the "hand" overcorrection procedure was introduced contingent upon inappropriate hand movements during a free-play period, and later contingent upon inappropriate vocalizations at naptime. "Hand" overcorrection was withdrawn and then re-introduced sequentially for both behaviors. Several concurrent behaviors were measured to assess multiple effects of treatment. Results for both children indicated the "hand" overcorrection procedure suppressed inappropriate hand movements and inappropriate behaviors that were topographically dissimilar. In addition, inverse relationships were observed between the second child's inappropriate hand movements and appropriate toy usage during free play and between his inappropriate vocalizations and inappropriate foot movements during naptime. Results suggest that overcorrection procedures that are effective for one behavior can be used to reduce the frequency of topographically different behaviors. This finding is discussed in terms of its practical implications for therapists.

Behavior Therapy↗
PubMedDate not supplied

The effects of calories and taste on habituation of the human salivary response.

The present study examined the effects of calories on salivary habituation. The rate of habituation to lemon taste was studied over 10 trials in 24 normal weight, nondieting, 18-35-year-old females. Between each of the trials, half the subjects ate low calorie, lemon gelatin, total Kcal = 32, and the others ate high calorie, lemon gelatin, total Kcal = 320. A dishabituating, novel chocolate taste was presented on trial 11 and recovery of salivation was assessed by presenting lemon flavor on trial 12. Subjective ratings were taken before and after salivary habituation for hunger levels and hedonics for lemon taste. Results show that high- and low-calorie groups both habituated to the repeated presentation of lemon taste, but with no significant differences as a function of calories in salivation volume, rate of habituation, hunger level decreases, and hedonic decreases. Subjects in both groups perceived equal caloric intake. These results suggest that salivary habituation may be affected more by the sensory characteristics of the food than by differences in caloric intake. The generalization of these data to the development of satiety are discussed.

Adolescent↗
PubMedDate not supplied

Effects of mastery criteria and contingent reinforcement for family-based child weight control.

This study tested the effects of mastery criteria and contingent reinforcement in a family-based behavioral weight control program for obese children and their parents over two years. Families with obese children were randomized to one of two groups. The experimental group was targeted and reinforced for mastery of diet, exercise, weight loss, and parenting skills. The control group was taught behavior-change strategies and provided noncontingent reinforcement at a pace yoked to the experimental group. Both groups received the same behavioral family-based educational components over 6 months of weekly meetings and six monthly follow-up meetings. Results showed significantly better relative weight change at 6 months and 1 year for children in the experimental compared to the control group, but these effects were not maintained at 2 years. These results suggest the introduction of mastery criteria and contingent reinforcement for mastery can improve outcome during treatment in behavioral treatments for childhood obesity.

Analysis of Variance↗
PubMedDate not supplied

Psychologic stress and blood glucose levels in nondiabetic subjects.

This study analyzed the effect of a standardized psychologic stressor on blood glucose levels in nondiabetic subjects. Subjects participated in a stress and nonstress session, presented in counterbalanced order. At each session, subjects were fed a carbohydrate load and blood glucose responses were measured 0, 30, 60, 90, and 120 min after the load. On nonstress days, subjects relaxed after drinking the load, while on stress days subjects participated in 30 min of competitive tasks immediately after the drink. The stress impaired the subjects' ability to handle the carbohydrate load; whereas on nonstress days, blood glucose levels peaked at 30 min after the load, on stress days the peak blood glucose response was delayed until 60 min after the drink.

Adult↗
PubMedDate not supplied

Differences in salivation to repeated food cues in obese and nonobese women.

In a series of studies we have shown that salivation, a cephalic phase preingestive response, habituates to repeated presentations of olfactory or gustatory cues in nonobese subjects. Previous research has studied the differences in anticipatory response to food cues in obese vs. nonobese subjects. This study was designed to assess if obese and nonobese females differed in their patterns of salivary response to repeated presentation of palatable food cues. The salivary response to 10 gustatory presentations of lemon yogurt was studied in 10 obese and 10 nonobese nonrestrained women. Results showed significant differences in the pattern of salivary responding, with obese subjects showing a significantly slower decline in salivation than nonobese subjects. These results are consistent with the hypothesis that obese women differ from nonobese women in their pattern of response to repeated food cues. The results are discussed in relationship to models of intake that focus on differences in satiety or differences in the reinforcing value of food between obese and nonobese subjects.

Adolescent↗
PubMedDate not supplied

Differences in salivary habituation to palatable foods in bulimia nervosa patients and controls.

OBJECTIVE: Bulimia nervosa (BN) patients have been shown to experience anomalous responses to food and food cues. We investigated the response to food over time by presenting repeated food cues and measuring changes in physiological (ie, salivation) and subjective responses. METHOD: Subjects were 18 BN women and 18 matched control women. Two palatable food stimuli, regular or frozen yogurt, that varied in macronutrient composition but had similar sensory characteristics, were presented to subjects repeatedly during a laboratory session. After two baseline salivation measures, subjects were presented with eight trials of one of the two yogurts. On Trial 9 a lemon juice dishabituator was presented, with the yogurt stimulus presented again at Trial 10. RESULTS: We found that control subjects had decreased salivation after repeated food presentations. In comparison, BN subjects failed to show a decrease in salivation. The desire to binge increased over trials for the BN subjects, but remained stable for normals. CONCLUSIONS: These data suggest that salivary habituation may be abnormal in BN patients.

Adolescent↗
PubMedDate not supplied

Descriptive analysis of eating regulation in obese and nonobese children.

Bite rate, sip rate, and concurrent activities of six 7-yr-old children, three obese and three nonobese, were observed at lunchtime over a six-month period. A procedure for decreasing bite rate, putting eating utensils down between bites, was implemented in a multiple-baseline across-subjects design. Sip rates and concurrent activities were observed to assess behavioral covariations. In addition, bite rate and amount of food completed were computed over six food categories to analyze food preferences. Results indicated the control of bite rate acorss all subjects, with a significant reduction in amount of food consumed. Correlations between the response classes indicated they were at least partially independent. Differences in eating behavior of obese and nonobese subjects were observed for breadstuffs and milk drinking.

Behavior Therapy↗
PubMedDate not supplied

Type II diabetic subjects lose less weight than their overweight nondiabetic spouses.

To determine whether diabetic individuals have more difficulty losing weight than nondiabetic individuals, 12 overweight diabetic subjects (6 men, 6 women) and their overweight nondiabetic spouses were treated together in a behavioral weight-control program. Diabetic and nondiabetic subjects did not differ in age, weight, or percent overweight. Weight losses of nondiabetic spouses were significantly greater than those of diabetic patients (13.4 +/- 1.7 vs. 7.5 +/- 1.4 kg; P less than .01). Differences emerged by wk 5 and became greater over the 20-wk program. Nondiabetic subjects reduced their intake significantly more than diabetics, suggesting that differences in dietary adherence were responsible for the differences in weight loss.

Behavior Therapy↗
PubMedDate not supplied

Analysis of changes in eating behavior and weight loss in type II diabetic patients. Which behaviors to change.

To identify the behavior-change strategies that are most clearly related to weight loss, 106 patients with type II (non-insulin-dependent) diabetes completed the Eating Behavior Inventory (EBI) before and after participating in a behavioral weight-loss program and at 1-yr follow-up. The EBI is a standardized questionnaire that assesses behavioral strategies typically taught in a behavioral weight-loss program. Pretreatment scores on the EBI were not related to weight-loss outcome, but changes on the EBI in the direction of more frequent use of appropriate strategies were related to weight loss at both posttreatment and 1-yr follow-up. Specific strategies related to weight loss at both times were 1) eating foods that help in losing weight, 2) recording foods eaten, 3) refusing food offered by others, and 4) being able to stop eating when appropriate. However, few patients maintained frequent use of these strategies at follow-up. It is concluded that weight-loss programs should focus on the strategies most strongly related to weight loss and try to improve long-term use of these techniques.

Diabetes Mellitus, Type 2↗
PubMedDate not supplied

Measurement and modification of the accuracy of determinations of urine glucose concentration.

Studies were designed to assess the accuracy of urine glucose testing in a sample of juvenile diabetic subjects, and to determine the effects of a visual discrimination training procedure on the accuracy. In the first study, each of 81 juvenile-diabetic children was presented three prepared glucose solutions and asked to determine the glucose concentration using the 2-Drop Clinitest method. Results showed errors in 54.3% of the judgments, with greatest difficulty occurring with 1-g/dl concentrations. The majority of errors were false negatives. Study II involved similar testing accuracy on a sample of 10 nurses and 2 research technicians, before and after a visual discrimination training procedure. Results showed that the subjects were incorrect on 39% of the trials initially, with a reduction in the error rate to less than 19% after training.

Adolescent↗
PubMedDate not supplied

Effects of enhanced conventional therapy on metabolic control in children with insulin-dependent diabetes mellitus.

We implemented a three-phase, 32-wk program to improve both self-regulation of adherence behaviors and insulin delivery in children with diabetes. Twenty children, aged 8-12 yr (mean duration 3.6 yr), enrolled. Phase 1 (wk 1-12) used behavior modification to improve diet, exercise, urine testing, and insulin adjustment, targeting an increased percentage negative urines. Feedback training and parent checks were used to improve reliability; adherence was measured using Clinitest placebos. Phase 2 (wk 13-20) was a stabilization period. Phase 3 (wk 21-32) studied the effect of insulin dose adjustment, comparing once-versus twice-daily shots in 10 pairs of children matched for %GHb. GHb, fasting plasma glucose, and lipids were measured at baseline and at the end of each phase. Results revealed a significant and sustained increase in negative urine tests, but no change in % GHb or FBG. Reliability of and adherence to urine tests were 83% and 76%, respectively. During phase 3, no significant differences were noted between groups receiving once- or twice-daily insulin injections. Thus, behavior modification resulted in increased reliability and adherence to routines, associated with a reliable increase in negative urines. This did not, however, produce changes in other control measures. Furthermore, no differences between those receiving 1 or 2 daily shots were evident.

Behavior Therapy↗