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At least 595 records · Page 33Linked to original sources
PubMed2002

Behavioral and cognitive-behavioral treatment for chronic pain: outcome, predictors of outcome, and treatment process.

STUDY DESIGN: A literature review was conducted. OBJECTIVE: To examine the outcome of behavioral (BT) and cognitive-behavioral treatment (CBT), collectively referred to as BT-CBT, for chronic pain, to identify the predictors of treatment outcome, and to investigate the change processes associated with these treatments. SUMMARY OF BACKGROUND DATA: Numerous controlled clinical trials of BT-CBT for chronic pain, alone or more commonly in multidisciplinary treatment contexts, suggest that these treatments are effective. However, further study is needed to examine which outcome variables change, when, for whom, and how. METHODS: Published literature was gathered from Medline, PsychLit, and searches of relevant journals. RESULTS: Overall, BT-CBT for chronic pain reduces patients' pain, distress, and pain behavior, and improves their daily functioning. Differences across studies in sample characteristics, treatment features, and assessment methods seem to produce varied treatment results. Also, some patients benefit more than others. Highly distressed patients who see their pain as an uncontrollable and highly negative life event derive less benefit than other patients. Decreased negative emotional responses to pain, decreased perceptions of disability, and increased orientation toward self-management during the course of treatment predict favorable treatment outcome. CONCLUSIONS: Current BT-CBT helps many patients with chronic pain. Continuing clinical research should improve the matching of treatments with patient characteristics and refine the focus of treatments on behavior changes most associated with positive outcome. Further study of fear, attention, readiness to adopt self-management strategies, acceptance of pain, and new combinations of interdisciplinary treatments may lead to improved interventions.

Behavior Therapy↗
PubMedDate not supplied

Development of preterm infants: feeding behaviors and brazelton neonatal behavioral assessment scale at 40 and 44 weeks' postconceptional age.

The purpose of this study was twofold: (1) to explore potential changes in the Brazelton Neonatal Behavioral Assessment Scale (BNBAS) from 40 to 44 weeks postconceptional age (PCA) and (2) to determine the relationship between the BNBAS scores and feeding behaviors in preterm infants at 40 and 44 weeks PCA. The BNBAS and sucking behavior measurements were completed on 104 preterm infants at 40 and 44 weeks PCA. The Orientation (p = .001), Motor (p = .001), Range of State (p = .001), Autonomic Regulation (p = .01), and Reflexes (p = .00) clusters were significantly more mature at 44 weeks PCA than at 40 weeks. Infants that were extremely early born (n = 24) had a significantly larger change in BNBAS scores over time as compared to the more mature preterm infants (n = 77), largely catching up with their more mature preterm counterparts. At 40 and 44 weeks PCA, the BNBAS cluster scores for orientation (p = .02), motor (p = .048), range of state (p = .048), and regulation of state (p < .001) were significantly related to the average maximum pressure, adjusted for gestational age and weeks PCA. Significant neurobehavioral maturation takes place between 40 and 44 weeks PCA in preterm infants, with the greatest changes occurring in the most preterm infants. These findings highlight the relationship between neurobehavioral maturation and feeding behaviors.

Child Development↗
PubMed2003

Behavioral impulsivity paradigms: a comparison in hospitalized adolescents with disruptive behavior disorders.

BACKGROUND: Behavioral impulsivity paradigms vary widely and studies using these measures have typically relied on a single measure used in isolation. As a result, comparisons between measures are difficult, with little consensus regarding which method may be most sensitive to individual impulsivity differences of different populations. METHOD: A single testing session of each of four different impulsivity tasks was completed by two groups of adolescents aged 13-17: hospitalized inpatients with disruptive behavior disorders (DBD; n = 22) and controls (n = 22). Tasks included two rapid-decision (IMT/DMT and GoStop) and two reward-directed (TC and SKIP) impulsivity paradigms. Behavioral testing took place within 3 days of hospitalization for the adolescents with DBD. RESULTS: Compared to controls, the DBD group exhibited higher commission error rates, lower inhibited response rates after a stop-signal, and twice as many reward-directed responses even after IQ differences between the groups were taken into account. When the four paradigms were compared, effect-size calculations indicated that the two rapid-decision paradigms were more sensitive to group differences than the reward-directed tasks. CONCLUSIONS: Despite the initiation of pharmacotherapy within the first 3 days of hospitalization, in contrast to the control group, the adolescents with DBD performed consistently with what has been operationally defined as impulsivity. Based on these results, these tasks appear to measure similar, but unique components of the impulsivity construct. With further study, laboratory behavioral paradigms may prove to be useful additions to current clinical diagnostic and treatment procedures in a variety of psychiatric populations.

Adolescent↗
PubMed2000

The impact of interpersonal patient and therapist behavior on outcome in cognitive-behavior therapy. A review of empirical studies.

Empirical studies are reviewed, the aim being to investigate characteristics of the therapeutic relationship in cognitive-behavior therapy (CBT) and to identify therapist or patient interpersonal behavior that affects treatment outcome. CBT is characterized by a more active and directive stance on the part of the therapists and higher levels of emotional support than are found in insight-oriented psychotherapies. Therapists express high levels of empathy and unconditional positive regard, similar to those expressed by insight-oriented psychotherapists. Two clusters of interpersonal behavior have been identified that are clearly associated with CBT outcome: (a) the Rogerian therapist variables--empathy, nonpossessive warmth, positive regard, and genuineness; and (b) therapeutic alliance. There is some evidence for the impact on outcome of three additional clusters of patient behavior: (a) the patients' perception of the therapist as being self-confident, skillful, and active; (b) the patients' openness to discuss their problems; and (c) the patients' pretreatment predisposition to change and to accept psychological treatment as a means of achieving this. It is further concluded that relationship factors in general have a consistent but moderate impact on CBT outcome.

Behavior Therapy↗
PubMed1992

A comparison of the verbal social behavior of adolescents with behavioral disorders and regular class peers.

Improved social functioning of adolescents with behavioral disorders (BD) is of critical importance for the successful integration of these students in school, domestic, vocational, and community settings. Three comparisons were addressed in the study; overall verbal responding of BD adolescents was compared to verbal responding of their regular class peers, verbal responding of the same BD adolescents was compared across their self-contained and mainstreamed settings, and responding of the BD adolescents when in mainstreamed settings was compared to responding of regular class peers. Portable microcomputers were used to collect data across 10 categories of verbal responding for 14 BD adolescents and 14 regular class peers. Results supported several general conclusions: (a) Adolescents with behavioral disorders engaged in more negative verbal responding than their regular class peers; (b) BD adolescents exhibited less inappropriate verbal behavior when in the mainstream than when self-contained; and (c) when in the mainstream, the verbal behavior of BD students was similar to that of their regular class peers. Implications of the general and specific differences that emerged from the comparisons were presented and discussed.

Adolescent↗
PubMed1993

The role of attention in the treatment of attention-maintained self-injurious behavior: noncontingent reinforcement and differential reinforcement of other behavior.

Because there are potentially serious limitations to differential reinforcement of other behavior (DRO) (which is probably the most widely used treatment procedure for behavior problems), we examined an alternative procedure--noncontingent reinforcement (NCR). Three females with developmental disabilities, all of whom engaged in severe self-injurious behavior, participated. During a pretreatment functional analysis, each subject's self-injury was shown to be differentially sensitive to social attention as a maintaining consequence. Next, each subject was exposed to a DRO treatment and an NCR treatment. During DRO, attention was delivered contingent on the absence of self-injury for prespecified intervals. During NCR, attention was delivered on a fixed-time schedule that was not influenced by the subject's behavior. Results showed that both procedures were highly effective in reducing self-injury, probably because the functional reinforcer for self-injury was used during treatment. Furthermore, there was evidence that NCR attenuated several of the limitations of DRO. These results are particularly interesting in light of the long experimental history of NCR as a control rather than as a therapeutic procedure.

Adult↗
PubMed2002

Meta-analysis of the effects of behavioral HIV prevention interventions on the sexual risk behavior of sexually experienced adolescents in controlled studies in the United States.

To estimate the effect of behavioral and social interventions on sexual risk of HIV among sexually experienced adolescents in the United States and to assess factors associated with variation in outcomes, we selected studies from the HIV/AIDS Prevention Research Synthesis project database. Twenty studies published or reported during the years 1988 through 1998 met criteria: 16 presented sufficient data; of these, 15 evaluated behavioral interventions and 1 a social intervention. Summary odds ratios (ORs) and 95% confidence intervals (CIs), weighted by study precision, indicated significantly less sex without condoms (number of studies, k, 13; OR, 0.66; CI, 0.55-0.79) and lower behavioral risk (k, 2; OR, 0.66; CI, 0.50-0.88), but no difference in number of partners (k, 8; OR, 0.89; CI, 0.76-1.05) or STDs (k, 2; OR, 1.18; CI, 0.48-2.86). A composite sexual risk behavior variable (k, 16; 1 outcome per study; preferred order, sex without condoms, number of partners, risk index) was used for heterogeneity and publication bias tests and stratified analyses. Overall, these interventions had a significant protective effect on sexually experienced adolescents (k, 16; OR, 0.65; CI, 0.50 - 0.85), although there was a suggestion of publication bias. Study design and intervention variables did not explain outcome variation. An exploratory finding may merit investigation: interventions tested with single ethnic groups out-of-class (k, 5) had larger effects than in-class interventions with mixed ethnic groups (k, 11), whether the mixed groups were in- (k, 6) or out-of class (k, 5).

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Behavior management conference panel III report-Legal issues associated with managing children's behavior in the dental office.

Panel III reviewed the legal issues associated with managing child behavior in the dental setting. The first issue addressed was a review of the recent changes in informed consent for behavior management techniques in pediatric dentistry. Discussions focused on: (1) who should obtain informed consent; (2) who can give informed consent; and (3) what constitutes appropriate documentation. Recent legal actions related to poor outcomes and poor communication using behavior management techniques were identified and discussed. Addressed was the current movement by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) towards empowering the child-patient to be a co-decision maker at all appointments and its impact on decisions in the dental office about approaches to behavior management. Finally, liability issues accompanying increased use of sedation in the dental office were identified and discussed. The recommendations of the panel were: (1) consideration should be given to changing the language in the current American Academy of Pediatric Dentistry (AAPD) guidelines, so written consent is not required for any procedure; (2) the AAPD should create language for use in creating sample consent forms (suggestive, not prescriptive); (3) guidelines recommending the possibility of treatment deferral, when appropriate, should be strengthened; and (4) the AAPD should work with advanced education program directors to standardize the quality and number of educational experiences in the use of conscious sedation.

Anesthesia, Dental↗
PubMed2006

[Research advances in behavioral ecology of penaeid shrimps. I. Behavior of penaeid shrimps].

The behavioral ecology of penaeid shrimps has been studied extensively in many countries due to their special ecological habit and important position in sea water aquaculture. This paper reviewed the recent literatures on the behavior of penaeid shrimps, including feeding, locomotion, defense, mating, spawning, molting, burrowing and emergence, with the differences of the behavior in different habitats discussed. The existing research problems, and the study directions of penaeid shrimps in the future, e. g., the feeding strategies and mechanisms in various circumstances, the selection and adaptability to environmental factors, and the practical application of penaeid shrimps behavior theory, were put forward.

Animals↗
PubMed1989

Acceptability of behavioral interventions for self-injurious behavior.

Using a case description methodology, we examined the effects of behavior problem severity, intervention type (accelerative vs. reductive), client status (child vs. adult), and type of work setting (child vs. adult unit) on staff members' acceptability ratings of six behavioral interventions used to treat self-injurious behavior (SIB). Results indicated that (a) accelerative interventions were rated more acceptable than reductive treatments, (b) acceptability of treatments varied as a function of SIB severity, and (c) client status and type of work setting failed to significantly influence acceptability ratings. Findings were discussed in the context of the current controversy surrounding the use of aversive treatments. The implications of the results for the design of institutionally based behavioral intervention programs were examined.

Adult↗
PubMed1987

Evaluation of a residential behavioral program for behaviorally disturbed, mentally retarded young adults.

The Adaptive Behavior Scale (ABS) was used to evaluate a three-level token economy designed to modify some aspects of the behavior of behaviorally disturbed young adults of borderline intelligence. The ABS was administered to all those referred to the program. Those admitted were retested upon discharge and 6 months later. Those not admitted, or rejected, were retested 12 months later. Results showed that initially there were few significant differences in scores between the accepted and rejected groups. Following treatment, however, large improvements occurred in those areas that were logically related to target behaviors within the token economy. These gains were maintained on follow-up. The rejected group showed no improvements over the same period.

Adult↗
PubMed1993

[Evaluation of an intensive therapy program for treatment of severe behavioral disorders in mentally handicapped patients with autistic or psychotic behavior].

The development of severely disturbed and socially accepted behavior in mentally handicapped persons with autistic or psychotic symptoms is documented before, during and after an intensive therapy program conducted in a residential institution for mentally handicapped persons. Seven single case studies were made as long term observation with a duration between 18 and 33 weeks, mostly with a multiple baseline design. One or two follow ups with at least four weeks length were conducted in six out of seven cases up to four years after the end of the intensive therapy. The main results show (1) the decrease of disturbed behavior and the increase of socially accepted behavior during the therapy program, and (2) the significant reduction of the disturbed behavior patterns taking place during the baseline phase before the beginning of the therapy in all cases but one. The results are discussed under the aspects of a possible explanation for the findings and their impact on the discussion about psychotherapy research.

Adolescent↗
PubMed1993

Acceptability of behavioral treatments: influence of knowledge of behavioral principles.

The relation of staff knowledge of behavioral principles to ratings of treatment acceptability for interventions used in the management of self-injurious behavior (SIB) was examined with 57 direct-care staff members from an ICF/MR. Case descriptions of an adult with severe mental retardation who exhibited SIB were presented, followed by descriptions of six behavioral interventions rated on acceptability. Subjects also completed a 25-item measure of general knowledge of behavioral principles. Results indicated that staff age and educational attainment but not treatment acceptability ratings were significantly related to knowledge scores. Implications of the findings were discussed.

Adult↗
PubMed1996

Japanese risk behaviors and their HIV/AIDS-preventive behaviors.

This study is to identify the risk behaviors of the Japanese that may lead to HIV infection and the behaviors that prevent such infection, as well as their background factors. Two behavioral surveys were conducted for the present study. (1) For international comparison on knowledge, attitudes, beliefs, and practices (KABP) related to HIV/AIDS, we conducted a survey on a sample of 10,000 adults, randomly selected from a nationwide population in Japan; and (2) for sexual partner relation, we conducted a survey on a sample of 10,000 adults randomly selected from a population in five major cities of Japan. Our main findings include: (1) Most of the Japanese adult did not regard AIDS as a major threat in the area where they lived; (2) People in their twenties are too casual about "having sex without using a condom with someone they've met for the first time and know little about"; (3) Thirteen percent (19% male, 8% female) of those with a steady sex partner including a spouse, on average, had sex with 2.4 non-steady partners in the previous year; and (4) Only 25 percent used condoms always when they engaged in casual sex during the previous four weeks. These risk behaviors of the Japanese adults might lead to an explosive rise in the number of HIV-infected in the near future unless steps are taken immediately to prevent it.

Adult↗
PubMed1977

[Relationship between (perceived) maternal rearing behavior and personality characteristics of behaviorally disturbed children and juveniles].

A survey of the literature on methodological problems associated with, and results of, the diagnosis of parental educational attitudes and practices as viewed and experienced especially by those receiving education is followed by a report on an investigation of the maternal educational behavior perceived by behaviorally disturbed children and juveniles of male sex. Correlative results obtained from the evaluation of questionnaires confirm the interrelation of disturbed (maternal) emotional relations to children and abnormal behavior shown by children. The inclusion in the diagnostic practice of reports given by those receiving education on the educational behavior shown by parents or other persons in whom the right of education is vested is considered to be a necessary and useful supplementary method.

Adolescent↗
PubMed1997

Application of a behavioral approach to measuring dietary change: the fat- and fiber-related diet behavior questionnaire.

This study reports the validity, reliability, and responsiveness of a 33-item fat- and fiber-related behavior questionnaire (FFB) and describes how this instrument provides insight into the process of adopting healthy diets. Data are from the Eating Patterns Study, a randomized clinical trial of a physician-delivered, self-help intervention to reduce fat and increase fiber intake. Intervention (n = 850) and control participants (n = 945) completed both a food frequency questionnaire and the FFB at baseline and at 3 and 12 months postintervention. Validity, as assessed by correlation of the FFB with the food frequency questionnaire at baseline, was 0.53 for fat (fat scale with percentage energy from fat) and 0.50 for fiber (fiber scale with fiber g/1000 kcal; both P < 0.001). Reliability, as assessed by the intraclass correlation in controls across all three time points, was 0.77 for the fat scale and 0.74 for the fiber scale (both P < 0.001). The largest changes in fat-related behavior were in avoiding fat as a flavoring and in using specially manufactured low-fat foods, and the largest changes in fiber-related behavior were in substituting high-fiber versions of common foods. Overall, the FFB was a reasonably valid and reliable measure of dietary intake, which provided insight into the behavioral effects of the dietary intervention.

Behavior Therapy↗
PubMed1992

Behavior patterns in nonreferred children: replication of the factor structure of the Missouri Children's Behavior Checklist.

This study provided normative data with regard to the behavior classification system based on the Missouri Children's Behavior Checklist (MCBC) with a sample of 120 nonreferred children. The factor structure of the MCBC replicated with a high degree of congruence. Application of the MCBC behavior classification system provided information on the frequency of problem patterns and problem-free patterns by nonreferred children. Variability in MCBC factor scores and behavior patterns was examined as a function of demographic parameters of gender, race, age, and socioeconomic status.

Adolescent↗
PubMed1994

Behavioral aspects of clinical trials. An integrated framework from behavior theory.

A less-than-optimal proportion of patients with cancer are entered into National Cancer Institute-sponsored clinical trials. This article reviews the literature on accrual in oncology clinical trials to characterize the extent of the problem, identify reasons for low accrual, and suggest ways to promote accrual. Four well known theories of health behavior (the Health Belief Model, Subjective Expected Utility Theory, Protection Motivation Theory, and the Theory of Reasoned Action) point to central concepts involved in understanding patient health-related behavior: (1) the probability that an unwelcomed health event will happen to a patient, (2) the severity of that event if it does occur, (3) the effectiveness of a particular behavior (such as taking part in a clinical trial) to modify the severity, and (4) the cost of adopting that behavior. These concepts form a framework for integrating the available information about accrual to clinical oncology trials. Patient and physician factors previously related to clinical trials suggest specific recommendations for increasing accrual to clinical oncology trials.

Clinical Trials as Topic↗