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Primary prevention of coronary heart disease: a challenge for behavioral medicine.

Arteriosclerosis is importantly influenced by blood cholesterol level, blood pressure, and cigarette smoking. Each of these major risk factors is influenced by behavioral choices made by individuals and supported by societies. Behavioral medicine has a rich tradition of dealing with individuals and small groups. The public health perspective of disease challenges behavioral medicine to develop new strategies and tactics for behavioral modification for health promotion on a population-wide basis. Additional research is needed to test effective methods for influencing population behavior, population risk factors, and ultimately population morbid and mortal event rates. Several major community projects are now investigating the health promotion process targeting individuals, small groups, organizations, and the entire community. School, worksites, and churches are particularly conducive to health promotion programming. Each has unique advantages and disadvantages; each deserves careful experimentation to determine its efficacy for population-wide health promotion efforts. A public health dimension to behavioral change promises widespread impact, generalization to other health promotive behaviors, maintenance of new cultural behavioral norms, and significant reductions in the incidence of many chronic diseases.

Behavior Therapy↗

Application of the somatic marker hypothesis to individual differences in decision making.

The somatic marker hypothesis (Damasio, Tranel, & Damasio, 1991) is a controversial theory asserting that somatic activities implicitly bias human behavior. In this study, we examined the relationship between choice behaviors in the Iowa Gambling Task and patterns of skin conductance responses (SCRs) within a healthy population. Results showed that low SCRs for appraising the monetary outcome of risky decisions were related to persistence in risky choices. Such adherence to risky decisions was not related to poor explicit knowledge about the task. On the other hand, anticipatory SCRs and the effect of them on performance were not confirmed. Our findings suggest that a variation in covert physiological appraisal underlies individual differences in decision making.

Adolescent↗

Hypothalamic neuropeptides and memory.

Vasopressin and oxytocin exert pronounced effects on behavior by a direct action on the brain. A single injection of vasopressin results in a long-term inhibition of extinction of a conditioned avoidance response suggesting that vasopressin triggers a long-term effect on the maintenance of a learned response, probably by facilitation of memory processes. In addition vasopressin improves passive avoidance behavior, facilitates retention of sexually motivated T-maze choice behavior in male rats, delays extinction of an appetitive discrimination task, affects approach behavior to an imprinting stimulus in ducklings, delays the postcastration decline in copulatory behavior in male rats, prevents or reverses amnesia induced by electroconvulsive shock, CO2 inhalation, pentylenetetrazol or puromycin. The majority of these effects may be explained by stimulatory influences of vasopressin on memory processes. Generally oxytocin exerts effects which are opposite to those of vasopressin and it has been suggested that oxytocin may be an amnesic neuropeptide. Evidence has been obtained that endogenous vasopressin and oxytocin play a physiological role in brain processes related to memory. Various limbic system structures seem to act as the anatomical substrate for the behavioral effects of vasopressin and different neurotransmitter systems seem to be involved. It is postulated that in case vasopressin affects retrieval processes the site of action is located in the amygdala and the dentate gyrus of the hippocampal complex with dopamine and serotonin as the respective neurotransmitter systems involved.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Affective consciousness: Core emotional feelings in animals and humans.

The position advanced in this paper is that the bedrock of emotional feelings is contained within the evolved emotional action apparatus of mammalian brains. This dual-aspect monism approach to brain-mind functions, which asserts that emotional feelings may reflect the neurodynamics of brain systems that generate instinctual emotional behaviors, saves us from various conceptual conundrums. In coarse form, primary process affective consciousness seems to be fundamentally an unconditional "gift of nature" rather than an acquired skill, even though those systems facilitate skill acquisition via various felt reinforcements. Affective consciousness, being a comparatively intrinsic function of the brain, shared homologously by all mammalian species, should be the easiest variant of consciousness to study in animals. This is not to deny that some secondary processes (e.g., awareness of feelings in the generation of behavioral choices) cannot be evaluated in animals with sufficiently clever behavioral learning procedures, as with place-preference procedures and the analysis of changes in learned behaviors after one has induced re-valuation of incentives. Rather, the claim is that a direct neuroscientific study of primary process emotional/affective states is best achieved through the study of the intrinsic ("instinctual"), albeit experientially refined, emotional action tendencies of other animals. In this view, core emotional feelings may reflect the neurodynamic attractor landscapes of a variety of extended trans-diencephalic, limbic emotional action systems-including SEEKING, FEAR, RAGE, LUST, CARE, PANIC, and PLAY. Through a study of these brain systems, the neural infrastructure of human and animal affective consciousness may be revealed. Emotional feelings are instantiated in large-scale neurodynamics that can be most effectively monitored via the ethological analysis of emotional action tendencies and the accompanying brain neurochemical/electrical changes. The intrinsic coherence of such emotional responses is demonstrated by the fact that they can be provoked by electrical and chemical stimulation of specific brain zones-effects that are affectively laden. For substantive progress in this emerging research arena, animal brain researchers need to discuss affective brain functions more openly. Secondary awareness processes, because of their more conditional, contextually situated nature, are more difficult to understand in any neuroscientific detail. In other words, the information-processing brain functions, critical for cognitive consciousness, are harder to study in other animals than the more homologous emotional/motivational affective state functions of the brain.

Affect↗

Multi-stage mental process for economic choice in capuchins.

We studied economic choice behavior in capuchin monkeys by offering them to choose between two different foods available in variable amounts. When monkeys selected between familiar foods, their choice patterns were well-described in terms of relative value of the two foods. A leading view in economics and biology is that such behavior results from stimulus-response associations acquired through experience. According to this view, values are not psychologically real; they can only be defined a posteriori. One prediction of this associative model is that animals faced for the first time with a new pair of foods learn to choose between them gradually. We tested this prediction. Surprisingly, we find that monkeys choose as effectively between new pairs of foods as they choose between familiar pairs of foods. We therefore, propose a cognitive model in which economic choice results from a two-stage mental process of value-assignment and decision-making. In a follow-up experiment, we find that the relative value assigned to three foods in sessions in which we tested them against each other combine according to transitivity.

Analysis of Variance↗

Choice, changeover, and travel.

Since foraging in nature can be viewed as instrumental behavior, choice between sources of food, known as "patches," can be viewed as choice between instrumental response alternatives. Whereas the travel required to change alternatives deters changeover in nature, the changeover delay (COD) usually deters changeover in the laboratory. In this experiment, pigeons were exposed to laboratory choice situations, concurrent variable-interval schedules, that were standard except for the introduction of a travel requirement for changeover. As the travel requirement increased, rate of changeover decreased and preference for a favored alternative strengthened. When the travel requirement was small, the relations between choice and relative reinforcement revealed the usual tendencies toward matching and undermatching. When the travel requirement was large, strong overmatching occurred. These results, together with those from experiments in which changeover was deterred by punishment or a fixed-ratio requirement, deviate from the matching law, even when a correction is made for cost of changeover. If one accepted an argument that the COD is analogous to travel, the results suggest that the norm in choice relations would be overmatching. This overmatching, however, might only be the sign of an underlying strategy approximating optimization.

Journal Article↗

Group choice: the ideal free distribution of human social behavior.

Group choice refers to the distribution of group members between two choice alternatives over time. The ideal free distribution (IFD), an optimal foraging model from behavioral ecology, predicts that the ratio of foragers at two resource sites should equal the ratio of obtained resources, a prediction that is formally analogous to the matching law of individual choice, except that group choice is a social phenomenon. Two experiments investigated the usefulness of IFD analyses of human group choice and individual-based explanations that might account for the group-level events. Instead of nonhuman animals foraging at two sites for resources, a group of humans chose blue and red cards to receive points that could earn cash prizes. The groups chose blue and red cards in ratios in positive relation to the ratios of points associated with the cards. When group choice ratios and point ratios were plotted on logarithmic coordinates and fitted with regression lines, the slopes (i.e., sensitivity measures) approached 1.0 but tended to fall short of it (i.e., undermatching), with little bias and little unaccounted for variance. These experiments demonstrate that an IFD analysis of group choice is possible and useful, and suggest that group choice may be explained by the individual members' tendency to optimize reinforcement.

Adolescent↗

[Development of delay of gratification in preschool children].

Developmental changes in delay-choice behavior and delay-maintenance behavior were investigated in situations, in which the difference in value between immediate reward and delayed reward was set small (S situation) and large (L situation). Ninety kindergarteners aged four, five and six were assigned to either one of the two situations. (1) In S situation, the choice of immediate reward was dominant in all age groups. (2) In L situation, the choice of delayed reward was dominant in all age groups. (3) In S situation, 6-year olds maintained longer delay than 4- and 5-year olds. (4) The delay time of 4- and 5-year olds in L situation was longer than that in S situation and was not significantly different from that of 6-year olds in L situation.

Age Factors↗

Multifunctional interneurons in behavioral circuits of the medicinal leech.

We are using the medicinal leech to study the neuronal basis of behavioral choice. In particular, we are recording from neurons, both extracellularly and intracellularly, in preparations that can express three different behaviors: the shortening reflex, crawling and swimming. We have found that particular mechanosensory neurons can elicit any of the behaviors, and that the movements are produced by just four sets of muscles, each controlled by a small number of motor neurons. Hence, there must be three different pattern-generating neuronal circuits, each of which can be activated by the same set of sensory neurons. We are studying how the choice is made among the three behaviors by recording, while one behavior is being performed, from neurons known to be involved in the initiation of the other two. We have found that an interneuron, cell 204, which is known to initiate and maintain swimming, is also active during shortening and crawling. The activity level in this interneuron can influence whether a mechanosensory stimulus produces shortening or swimming. The neuronal mechanisms by which this choice is normally effected awaits further elucidation of the circuits that elicit and generate shortening and crawling.

Animals↗

[Dependence on and preference for morphine (II). Comparison among morphine, phenobarbital and diazepam].

Results of a previous experiment indicated that naive rats given a choice between morphine-admixed food (0.5 similar to 1mg/g of food) and quinine-admixed food (0.5 similar to 1 mg/g of food) for 3 weeks gradually and spontaneously preferred the morphine-admixed food, and this choice behavior revealed one of the psychological aspects of morphine dependent rats. In the present work, the ability of preference formation was detected for morphine, phenobarbital and diazepam by a defferent chioce test using drug dependent rats. Rats were pretreated with morpnine, phenobarbital, and/or diazepam by drug admixed food ingestion method for 12 similar to 15 weeks, and the choice test was practiced for one week at 3 intervals (4 similar to 5 trials). Control groups of rats were given the same choice testas the naive rats. Results indicated that (a) of all the drugs employed, morphine showed the most rapid and intensive preference formation (b) Phenobarbital and diazepam had almost the same degree of preference formation. (c) Phenobarbital showed no dose-dependent intensity of preference formation in the 50-90 mg/kg/day dose range, however, a more rapid development of preference was observed dose-dependently among the 80-120 mg/kg/day dose range of diazepam. Thus these studies utilizing a choice test provide a clear demonstration of drug-seeking behavior in rats. In addition, the present method is useful for drug screening tests involving weak psychological dependence liability, and moreover, the data could be analyzed statistically.

Animals↗

A mathematical consideration for the optimal shell change of hermit crab.

Shell of the adult hermit crab has some important roles for its fitness. In the same time, the shell size often limits the body growth of its owner. To grow the body size larger, the individual must change the shell to another larger shell. If the individual cannot get another larger one, the individual has to suppress the body size growth as the occupied shell size allows. Growth suppression would result in the lower fitness. With a simple mathematical model, we consider the criterion about whether the individual should try to change the shell or not in order to get the higher fitness. We show that the optimality of a shell change behavior has a relation with the body size and the season length for the shell change. They also affect the optimal timing for the shell change. It is implied that the probability of the success in a shell change and the cost for the shell change behavior do not affect the optimal timing for the shell change at all but significantly do the optimality of the behavioral choice.

Animals↗

Micro-effects of language on risk perception in drug prescribing behavior.

The decision to prescribe neuroleptics for the treatment of psychosis involves a potentially tragic choice between, on the one hand, a probability of psychosis and a probability of side effects, such as tardive dyskinesia, on the other. In an experimental paradigm, we examined this decision process. We hypothesized that linguistic factors considered irrelevant under classical formulations of individual choice behavior would have a significant effect on this decision. All subjects were presented with a case vignette involving a potentially psychotic patient. Subjects were then asked what probability of tardive dyskinesia they would either "accept" or "risk" in order to prevent psychotic decompensation. In addition this factor was crossed with a contextual factor that varied the patient's age. The effect of "risk" versus "accept" language was evident in significantly different patterns of decision making across age groups. The data have important implications for clinical decision making, the elicitation of informed consent, and the directions that the courts have taken in malpractice and patient's rights cases.

Adult↗

Alcohol-related and alcohol-free activity participation and enjoyment among college students: a behavioral theories of choice analysis.

College student alcohol abuse remains a significant public health problem, and there is a need for theory-driven and empirically based models to guide prevention efforts. Behavioral theories of choice assume that the decision to consume alcohol is influenced by the relative value of alcohol versus other available activities. In the present study, a sample of college student drinkers (N=108; 56% female, 44% male) who had previously completed a mandatory alcohol intervention completed a measure of alcohol-related and alcohol-free activity participation and enjoyment. The goals of the study were to examine the influence of drinking quantity and contextual variables on activity enjoyment and to identify enjoyable alcohol-free activities that take place on evenings when students might otherwise be drinking. Overall, students found alcohol-related activities more enjoyable than alcohol-free activities, and drinking quantity was positively related to enjoyment. However, alcohol-free activities such as watching movies, going to the theater or museums, going to bars or parties, hanging out with friends, eating at restaurants, and engaging in creative activity were generally as enjoyable as drinking. Alcohol-free activities that included peers or dates were more enjoyable than solitary activities. Men were less likely to engage in alcohol-free activities that included peers and reported less enjoyment related to alcohol-free activities than did women. Further research is required to identify procedures for increasing participation in alcohol-free activities and to determine whether increased alcohol-free activity participation results in decreased alcohol consumption.

Adolescent↗

Relationships between personal values and reported behavior on ethical scenarios for law students.

Lawyers' values might be considered to play some role in the decisions that are made in everyday legal practice. This study aimed to explore the effects of personal value hierarchies on ethical decision making within the context of several ethical dilemmas. A questionnaire was administered utilizing hypothetical situations presented in 11 ethical scenarios and including the Rokeach Value Survey. Logistic regression results suggested that different personal values were significant predictors of reported behavioral choices on respective ethical scenarios. However, the most important values associated with behavior consistent with ethical conduct in scenarios were 'honesty' and 'equality'. The implications of results are discussed in the contexts of ethics education in a tertiary educational environment and in relation to regulation for the professions.

Adolescent↗

Depression, guilt, and self-management of pleasant and unpleasant events.

The relation of subjects' depression and guilt to their choice to delay unpleasant and pleasant events was examined. Ninety-one college students chose to receive punishments and gratifications immediately or a week later. Depression, primarily in males, was related to a present orientation rather than a future orientation, namely, the choice of delayed punishments over immediate punishments and of immediate small rewards over large delayed rewards. This result supported the hypothesis that depressed individuals will attempt to correct a current aversive state rather than maximize long-term gains. High guilt in males was related to the choice of immediate punishment. The results are consistent with the view that behavior choices are determined in part by anticipated internal affective consequences.

Adaptation, Psychological↗

Treatment of pediatric obesity.

The primary goal of childhood obesity interventions is regulation of body weight and fat with adequate nutrition for growth and development. Ideally, these interventions are associated with positive changes in the physiologic and psychological sequelae of obesity. To contribute to long-term weight maintenance, interventions should modify eating and exercise behaviors such that new, healthier behaviors develop and replace unhealthy behaviors, thereby allowing healthier behaviors to persist throughout development and into adulthood. This overview of pediatric obesity treatment, using predominantly randomized, controlled studies, highlights important contributions and developments in primarily dietary, activity, and behavior change interventions, and identifies characteristics of successful treatment and maintenance interventions. Potential positive (eg, reduction in blood pressure, serum lipids, and insulin resistance) and negative (eg, development of disordered eating patterns) side effects of treatment also are described. Recommendations for improving implementation of childhood obesity treatments, including application of behavioral choice theory, improving knowledge of response extinction and recovery in regards to behavior relapse, individualization of treatment, and integration of basic science with clinical outcome research, are discussed.

Adolescent↗

Cardiovascular changes during social competition in a mixed-motive game.

Male and female subjects played a mixed-motive game against a male confederate under either a 20% cooperative or an 80% cooperative strategy while cardiovascular responses were computer monitored. Females had larger heart rate responses than males during play against the competitive strategy, and the opposite was true during play against the cooperative strategy. Subjects who were more competitive during the game or who scored higher on a coronary-prone (Type A) behavior scale or who reported having an action orientation toward life stress tended to have larger heart rate responses during the game than the remaining subjects. The results draw attention to the importance of covert autonomic responses for understanding overt behavioral choices in mixed-motive games and to the potential utility of this behavioral model for studying the role of psychosocial factors in psychosomatic illnesses.

Competitive Behavior↗

Using behavioral theories of choice to predict drinking outcomes following a brief intervention.

Behavioral theories of choice predict that substance use is partly a function of the relative value of drugs in relation to other available reinforcers. This study evaluated this hypothesis in the context of predicting drinking outcomes following an alcohol abuse intervention. Participants (N = 54, 69% female, 31% male) were college student heavy drinkers who completed a single-session motivational intervention. Students completed a baseline measure of substance-related and substance-free activity participation and enjoyment. Only women showed a significant reduction in drinking at the 6-month follow-up, and the ratio of substance-related to substance-free reinforcement accounted for unique variance in their drinking outcomes. Women who at baseline derived a smaller proportion of their total reinforcement from substance use showed lower levels of follow-up drinking, even after the authors controlled for baseline drinking level. Male and female participants who reduced their drinking showed increased proportional reinforcement from substance-free activities.

Adolescent↗