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A preliminary investigation into the feasibility and efficacy of a CD-ROM-based cognitive-behavioral self-help intervention for bulimia nervosa.

OBJECTIVE: Many patients with bulimia nervosa find it hard to access evidence-based treatment such as cognitive-behavioral therapy (CBT). The aim of the current study was to evaluate the feasibility and efficacy of a novel CD-ROM-based cognitive-behavioral multimedia self-help intervention for the treatment of bulimia nervosa. METHOD: Patients with bulimia nervosa referred to a catchment area-based eating disorder service were offered eight sessions of a novel CD-ROM cognitive-behavioral self-help treatment without any added therapist input. We report here the take-up and drop-out rates and efficacy of this intervention. RESULTS: Of 60 participants who were offered the intervention, 47 took it up. At follow-up, there were significant reductions in binging and compensatory behaviors, most clearly in self-induced vomiting. DISCUSSION: This intervention has potential as a first step in the treatment of bulimia nervosa and for dissemination to nonspecialist settings.

Adult↗

The spectrum of behavioral responses to cholinesterase inhibitor therapy in Alzheimer disease.

BACKGROUND: Behavioral abnormalities are common in Alzheimer disease (AD); cholinergic treatment reduces the behavioral disturbances of some patients with AD. Characterizing the pretreatment profile of patients who are likely to respond to cholinergic therapy will aid the efficient use of clinical resources. OBJECTIVE: To determine the baseline behavioral profile for 86 patients with AD treated with the cholinesterase inhibitor donepezil hydrochloride. METHODS: Open-label retrospective study of treatment-related behavioral assessments. Based on previous double-blind placebo-controlled experience using the Neuropsychiatric Inventory (NPI), patients were divided into responder (> or =4-point total NPI score decrease, indicating improvement), unchanged (+/-3-point total NPI score change), or nonresponder (> or =4-point total NPI score increase, indicating worsening) groups. The Mini-Mental State Examination assessed cognitive response. RESULTS: Behavioral improvement was seen in 35 patients (41%), worsening in 24 (28%), and no change in 27 (31%). Comparison of profiles in behavioral responders vs nonresponders revealed significantly worse delusions (P = .04), agitation (P = .04), depression (P = .006), anxiety (P = .02), apathy (P = .003), disinhibition (P = .02), and irritability (P<.001) at baseline in responders. Five behaviors changed significantly from baseline, improving for the responders and worsening for the nonresponders: delusions (P = .003 for nonresponders, P = .004 for responders), agitation (P = .01), anxiety (P = .006 for nonresponders, P = .004 for responders), disinhibition (P = .02 for nonresponders, P = .05 for responders), and irritability (P = .003 for nonresponders, P = .001 for responders). The behavioral changes were dose dependent. Cognition did not change significantly with donepezil treatment within any group. CONCLUSIONS: Donepezil has psychotropic properties, and pretreatment behaviors help predict patients' responses to treatment.

Aged↗

Phylogenetic analysis of twinning in callitrichinae.

The callitrichines are known for twinning and for a communal rearing system in which all or most group members help care for the offspring. The origin of twinning has been the subject of much speculation. In this study predictions from earlier hypotheses are tested on the basis of two alternative phylogenetic trees. From this analysis we infer that helping behavior and male care preceded the origin of twinning, and that these traits did not coevolve with, but might have been important prerequisites for twinning in callitrichines. Small body size does not necessarily result in twinning, although it might still have been a prerequisite for its evolution. Gum feeding was an ecological change which evolved along with twinning. If nutrition was a limiting factor in the number of off-spring produced, then the use of a new feeding resource could have been crucial for the origin of twinning in callitrichines. According to one of the two alternative solutions inferred by the total evidence tree, and in accordance with the morphological tree, semi-annual breeding appears in the marmosets together with specialization in gum feeding. The fact that gums are available for these monkeys all year may have facilitated semiannual breeding. We suggest that the exploitation of gums as a feeding resource could have been the decisive factor in the increase of the reproductive rate by twinning and by semi-annual breeding.

Animals↗

Evaluation of two strategies for heart health promotion by direct mail in a low-income urban community.

BACKGROUND: The objective of this study was to evaluate the reach of mass mailings of heart health education print materials in a low-income, urban community. Materials included a monthly newsletter and a self-help behavior change kit, both distributed to all 12,789 households in the study community. METHODS: Recall, use, and self-reported impact of the materials were measured in a cross-sectional survey of a random sample of 345 adults conducted 2 weeks after distribution of the kit and 18 months after delivery of the first newsletter. RESULTS: Over one-third of the subjects (38.6%) recalled the newsletter and 27.9% had read one or more newsletters; 21.7% recalled the kit and 10.8% had read it. Few subjects had read both materials. Female gender and older age were independent correlates of having seen and read the newsletters. Older age, being widowed/separated/divorced, and infrequent physical activity were correlates of having seen and read the kit. CONCLUSIONS: Although the newsletter and kit formats might appeal to different segments of the population, mass mailings of heart health education print materials in a low-income urban community can reach large numbers of individuals. The cost effectiveness of repeated mailings of short, simple newsletters might be higher than a single mailing of a more complex behavior change kit.

Adolescent↗

Relationships among experience level and value orientation and the performance of paraprofessional telephone counselors.

The effectiveness of indigenous paraprofessional helpers is thought to be partially due to the similarity in style and values between then and their clients. However, there is a concern that as they gain experience in an agency, their identification may shift from the clients to the agency. Also, there is a question as to how effective paraprofessionals (selected due to their shared values with a target population) are with value-dissimilar clients. Truax and Carkhuff's scales of facilitative conditions as well as a technique functioning scale were used to assess the helping behavior of paraprofessional telephone counselors at three levels of experience in response to value-similar and value-dissimilar simulated calls. The results indicate that performance generally improved with training and experience and that instead of a uniform deterioration with dissimilar value calls, a complex relationship existed between performance, values, and experience level.

Adolescent↗

[Basic principles in rheumatologic patient education. Theoretical principles and didactic aspects].

Nowadays, the handling of a chronic disease is seen as a process, influenced by a variety of factors. Case studies, taken from health behavior, help to illustrate the conduct of patients suffering from chronic diseases and develop strategies of how to increase a patient's skills in coping with his illness. The concept of self-efficacy beliefs is of great importance and will be discussed in detail. In addition, possible effects of patient education in the comprehensive treatment of rheumatic diseases will be presented. In teaching methods, equal emphasis is placed on the transmission of information as on the development of practical know-how. They are on a par with emotional support, motivation, assistance in accepting the disease and coping with fear. The special methods and media required will be discussed, along with the framework for training methods and qualification required of the staff in charge of training.

Adaptation, Psychological↗

Diversity of patterns of improvement in confrontation naming rehabilitation: some tentative hypotheses.

A previous group analysis of the effects of a computerized written naming rehabilitation program revealed global improvement with generalization of benefits to untrained items and to untreated oral naming (Deloche et al., 1992). The present multiple single-case analysis of the data indicates a variety of patterns of improvement and of generalization effects among individual patients. Patterns of relationships between written and oral naming behaviors help to explain the type of improvement that was observed.

Adult↗

Child sexual abuse and gender differences: attitudes and prevalence.

A great deal of attention has been focused on child sexual abuse in recent years. The present study reports attitudes and beliefs of 824 male and female college students concerning sexual abuse, and the participants' own experience with such abuse. Results indicate that women have much stronger pro-social beliefs, attitudes, and emotional reactions to sexual abuse and to abusers and victims than men do. In addition, 6% of men and 13% of women participants reported that they had been sexually abused as children or adolescents, while equal proportions of males and females reported that they were sexually approached by a potential perpetrator. These results are discussed in terms of socialization experiences of males and females in our society, and the literature regarding helping behaviors and compassion for others perceived as helpless and in need of aid. In particular, females may be abused more often than males, even though both sexes are approached in equal frequency, because females have been socialized to be more compliant and responsive to the needs of others, while males are perpetrators more often than females because males have been socialized to be more aggressive, powerful, and dominant.

Adult↗

Public reactions towards people with AIDS: an attributional analysis.

This article addresses the issue of stigmatization and discrimination towards people with AIDS (PWAs) using Weiner's attributional theory of motivation and emotion. In a field experiment, subjects responded to vignettes describing patients with AIDS, syphilis, lung cancer or tuberculosis. In these vignettes, the onset of the diseases was either described as personally controllable or as uncontrollable. Results show that although attributional variables do account for a significant amount of variance in helping behavior and emotions towards PWAs, other variables such as the incurability of the disease, the risk of infection and associations with (homo)sexuality, may be more useful in explaining reactions to PWAs. Implications for education tailored at the prevention of the stigmatization of PWAs are discussed.

Acquired Immunodeficiency Syndrome↗

Illness behavior, affective disturbance and intestinal transit time in idiopathic constipation.

Patients with constipation differ not only from healthy subjects but can also be categorized into two groups: slow transit constipation (STC) and normal transit constipation (NTC) using measures of total intestinal transit time (TITT). We investigated the role of illness behavior and affective state in 45 NTC and 29 STC patients as compared with 20 healthy subjects. All subjects completed the Illness Behavior Questionnaire (IBQ), the Symptom Questionnaire (SQ), and the CES-D to assess illness behavior, psychological distress, and depression. The constipated patients reported more psychological distress than healthy subjects. Within the constipated group, the NTC subjects had significantly higher scores on the IBQ dimensions of hypochondriasis and disease affirmation. Our results suggest that even among constipated patients psychological distress is prominent and that measures of illness behavior help to discriminate among different pathophysiological groups.

Adult↗

A tale of two defectors: the importance of standing for evolution of indirect reciprocity.

Indirect reciprocity occurs when the cooperative behavior between two individuals is contingent on their previous behavior toward others. Previous theoretical analysis indicates that indirect reciprocity can evolve if individuals use an image-scoring strategy. In this paper, we show that, when errors are added, indirect reciprocity cannot be based on an image-scoring strategy. However, if individuals use a standing strategy, then cooperation through indirect reciprocity is evolutionarily stable. These two strategies differ with respect to the information to which they attend. While image-scoring strategies only need attend to the actions of others, standing strategies also require information about intent. We speculate that this difference may shed light on the evolvability of indirect reciprocity. Additionally, we show that systems of indirect reciprocity are highly sensitive to the availability of information. Finally, we present a model which shows that if indirect reciprocity were to evolve, selection should also favor trusting behavior in relations between strangers.

Altruism↗

Opportunities for using Navy marine mammals to explore associations between organochlorine contaminants and unfavorable effects on reproduction.

The Department of Defense (DoD) has a unique marine mammal program maintained by the US Navy that includes the largest force of bottlenose dolphins, Tursiops truncatus, worldwide. In recent years, this population of cetaceans that lives in netted open water enclosures in San Diego Bay has been monitored for levels of organochlorine (OC) contaminants in blubber, blood and milk. Data generated from these studies have afforded insight into the fate and possible effects of OC contaminants in marine mammals. We now report preliminary findings on the effects of maternal OC exposure on pregnancy outcome. Blubber OC levels were compared between females whose calves survived beyond 6 months and females whose calves were stillborn or died within 12 days of birth. The mean concentration of SigmaDDT was more than 3 times as high among dolphins whose calves died as that among dolphins whose calves survived beyond 6 months (P = 0.002). Mean SigmaPCB was more than 2.5 times higher in females whose calves did not survive (P= 0.076). This population is a logical sentinel for the assessment of environmentally mediated disease. Biological tissues and fluids can be sampled on a regular basis from the dolphins for accumulation of tissue residues, facilitated by conditioned husbandry behaviors. These trained behaviors help preclude possible alterations in health measures resulting from capture stress. Animals' diets can be monitored for contaminant levels. With these data, the expertise and facilities available at the Navy laboratory and in collaboration with other experts in the field, controlled studies can be designed to monitor and assess dietary exposure, measurable immune and neurologic responses and assess reproductive and transgenerational effects of contaminants. Biomarkers can be developed to relate the health of individual animals relative to contaminant exposures. Such investigations of natural exposure and response scenarios are a logical adjunct to traditional laboratory toxicity studies.

Adipose Tissue↗

Cluster subtypes within stage of change in a representative sample of smokers.

In this paper a three-level conceptualization of approaches to matching self-help behavior change strategies to individuals is presented based on the Transtheoretical Model of Change. Two of the model's intervention approaches, tailoring to Stage-of-Change and creating completely individualized interventions, have already been developed and implemented in previous research. A third intervention approach, in between stage-tailored and individualized, is targeting subtype groups within each Stage of Change. The subtype targeted intervention approach is in the initial development stage of empirically determining and validating the stage subtypes. Three studies are presented which investigate stage subtypes within a representative sample of 4,144 smokers in the Precontemplation, Contemplation, and Preparation Stages of Change. Within each Stage-of-Change study, two cluster analyses were performed using the Pros, Cons, and Situational Temptations from the Transtheoretical Model to establish cluster replicability. Cluster solutions were externally validated using the 10 Processes of Change and 2 smoking behavior variables. Four distinct subtypes were found in Precontemplation and Contemplation, and five subtypes were found in Preparation. These subtypes closely replicate subtypes previously found in a convenience sample of smokers and provide strong evidence for the existence of subtypes within the first three Stages of Change.

Adaptation, Psychological↗

The social construction of co-dependency in the treatment of substance abuse.

Co-dependency has become an important concept in the treatment of substance abuse, yet there is still disagreement about what it means. The meaning of co-dependency is important because it shapes public perceptions of helping behavior and affects the treatment that persons with addictions receive. However, some observers have criticized co-dependency, arguing that the concept is gender-biased, denigrates women, and blames innocent victims of substance abuse. This investigation examined the social construction of co-dependency in the treatment of substance abuse by asking substance-abuse counselors three questions: (a) what do they mean by co-dependency, (b) to what extent does co-dependency mean women, and (c) to what extent do they agree. The findings suggest that co-dependency is a reliable social construction that substance-abuse counselors use to describe persons of both genders.

Attitude of Health Personnel↗

Wheel-shaped polyoxotungstate [Cu20Cl(OH)24(H2O)12(P8W48O184)]25- macroanions form supramolecular "blackberry" structure in aqueous solution.

The hydrophilic polyoxotungstate [Cu20Cl(OH)24(H2O)12(P8W48O184)]25- ({Cu20P8W48}) self-assembles into single-layer, hollow, spherical "blackberry"-type structures in aqueous solutions, as studied by dynamic light scattering (DLS), static light scattering (SLS), zeta potential analysis, and scanning electron microscopy (SEM) techniques. This represents the first report of blackberry formation for a non-Mo-containing polyoxometalate. There is no obvious change in the shape and size of the blackberries during the slow blackberry formation process, neither with macroionic concentration nor with temperature. Our results suggest that the blackberry-type structure formation is most likely a general phenomenon for hydrophilic macroions with suitable size and charge in a polar solvent, and not a specific property of polyoxomolybdates and their derivatives. The {Cu20P8W48} macroions are thus far the smallest type of macroions to date (equivalent radius < 2 nm) showing the unique self-assembly behavior, helping us to move one step closer toward identifying the transition point from simple ions (can be described by the Debye-Hückel theory) to macroions in very dilute solutions. Moreover, by using {Cu20P8W48} blackberry-type structures as the model system, the electrophoretic properties of macroionic supramolecular structures are studied for the first time via zeta-potential analysis. The mobility of blackberry-type structures is determined and used for understanding the state of small cations in solution. We notice that the average charge density on each {Cu20P8W48} macroanion in a blackberry is much lower than that of discrete "free" {Cu20P8W48} macroions. This result suggests that some small alkali counterions are closely associated with, or even incorporated into, the blackberry-type structures and thus do not contribute to solution conductivity. This model is fully consistent with our speculation that monovalent counterions play an important role in the self-assembly of macroions, possibly providing an attractive force contributing to blackberry formation.

Journal Article↗

On the dimensionality of organizational justice: a construct validation of a measure.

This study explores the dimensionality of organizational justice and provides evidence of construct validity for a new justice measure. Items for this measure were generated by strictly following the seminal works in the justice literature. The measure was then validated in 2 separate studies. Study 1 occurred in a university setting, and Study 2 occurred in a field setting using employees in an automobile parts manufacturing company. Confirmatory factor analyses supported a 4-factor structure to the measure, with distributive, procedural, interpersonal, and informational justice as distinct dimensions. This solution fit the data significantly better than a 2- or 3-factor solution using larger interactional or procedural dimensions. Structural equation modeling also demonstrated predictive validity for the justice dimensions on important outcomes, including leader evaluation, rule compliance, commitment, and helping behavior.

Adult↗

Evolution of eusociality in termites.

A model is presented that demonstrates that asymmetries in relatedness such that individuals are more closely related to siblings than to offspring develop in diploid pedigrees under conditions of inbreeding. Given also certain incestuous conditions, the model predicts that eusocial-type helping behavior can be favored by natural selection. Three cases of the model are discussed along with implications for termite eusociality. Several aspects of termite biology, particularly the existence of replacement reproductives, are interpreted as evidence that termite eusociality may have arisen under the special conditions specified in the models.

Journal Article↗