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PubMed2005

Is cognitive behaviour therapy effective for changing health behaviours? Commentary on Hobbis and Sutton.

Although Cognitive Behaviour Therapy (CBT) has successfully combined procedures based on behavioural and cognitive theories to reduce emotional problems, there is limited research into the efficacy of CBT in changing health behaviours. Of the studies cited by Hobbis and Sutton (this issue), only one measured health behaviours. In order to evaluate the effectiveness of behaviour change techniques, it is essential that the endpoints are behaviours, rather than health or emotional outcomes. There are both theoretical and circumstantial reasons for believing that CBT may be effective for changing health behaviours. Hobbis and Sutton have considered CBT as an addition to the Theory of Planned Behaviour-based interventions. It may be even more effective as an alternative.

Cognitive Behavioral Therapy↗
PubMed1983

Agoraphobia, compulsive behaviours and behaviour completion mechanisms.

Anxiety is identified with a state of high arousal. Agoraphobia is differentiated from specific phobias which are inherent responses to situations which threatened primitive man. In agoraphobia, attacks of high arousal are produced by situations which delay ongoing activity. It is hypothesised that such delays produce arousal by activating behaviour completion mechanisms. Evidence is reviewed which indicates desensitization has a lasting effect in agoraphobia but not in specific phobias. It is suggested that desensitization reduces the arousal produced by behaviour completion mechanisms. Aversive therapy in homosexuality reduces the subjects' drive to carry out compulsive sexual behaviours but does not alter sexual orientation. It is suggested that compulsive sexual behaviours are not activated by primary sexual drives but by behaviour completion mechanisms which are also responsible for other compulsive behaviours. Aversive therapy acts by reducing the arousal produced by the behaviour completion mechanisms. As both aversive therapy and desensitization reduce such arousal, desensitization should be able to replace aversive therapy in the treatment of compulsive behaviours.

Agoraphobia↗
PubMed2000

Knowledge, self-efficacy and behavioural intent towards AIDS prevention behaviours among culturally diverse secondary school pupils in South Africa.

OBJECTIVE: To investigate knowledge, self-efficacy, and behavioural intent towards AIDS prevention behaviours among culturally diverse secondary school pupils in South Africa. DESIGN: Randomised study. SETTING: Three urban secondary schools in Pietersburg, South Africa. PARTICIPANTS: Three hundred and sixty six Grade 11 secondary school pupils, comprising 150 (41%) males, and 216 (59%) females, aged 17 to 24 years (mean age 19.3 years, SD=2.6). The three cultural groups were 142 Blacks, 112 Whites and 112 Asians. MAIN OUTCOME MEASURES: The questionnaire included items on socio-economic and family background, knowledge about HIV, perceived self-efficacy and behavioural intent regarding AIDS preventive behaviours. RESULTS: Overall, the participants showed an adequate level of AIDS knowledge. However, there was considerable inaccuracy regarding AIDS transmission myths or how AIDS cannot be transmitted. The different cultural groups generally felt most self-efficacious regarding how to protect themselves from becoming infected (75-90%) and least self-efficacious on knowing where to go for information on AIDS (72-74%). Generally, participants reported a high behavioural intent. The Whites stand second in knowledge and more or less second in self-efficacy and behaviour intent. The Blacks stand third in knowledge and more or less second in self-efficacy and behaviour intent. CONCLUSION: Culturally diverse knowledge, self-efficacy and behavioural intent towards AIDS prevention was found among White, Black and Asian pupils, which should inform a culturally sensitive and appropriate AIDS health promotion programme in South Africa.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Behavioural and cognitive behavioural therapy for obsessive compulsive disorder in children and adolescents.

BACKGROUND: While behavioural or cognitive-behavioural therapy (BT/CBT) is recommended as the psychotherapeutic treatment of choice for children and adolescents with obsessive-compulsive disorder (OCD), the application of BT/CBT to paediatric OCD may not be straightforward. OBJECTIVES: This review examines the overall efficacy of BT/CBT for paediatric OCD, its relative efficacy against psychopharmacology and whether there are benefits in using BT/CBT combined with medication. SEARCH STRATEGY: We searched CCDANCTR-Studies and CCDANCTR-References (searched on 5/8/2005), MEDLINE, EMBASE, PsycINFO, the reference lists of all selected studies and handsearched journals specifically related to behavioural treatment of OCD. SELECTION CRITERIA: Included studies were randomised controlled trials or quasi-randomised trials with participants who were 18 years of age or younger and had a diagnosis of OCD, established by clinical assessment or standardised diagnostic interview. Reviewed studies included the standard behavioural or cognitive-behavioural techniques, either alone or in combination, compared with wait-list or pill placebo. DATA COLLECTION AND ANALYSIS: The quality of selected studies was assessed by two independent reviewers. The primary outcomes comprised of endpoint scores on the gold standard clinical outcome measure of OCD symptoms, distress and interference (CY-BOCS) and endpoint OCD status. MAIN RESULTS: Four studies with 222 participants were considered eligible for inclusion and for data extraction. Two studies showed significantly better post-treatment functioning and reduced risk of continuing with OCD at post-treatment for the BT/CBT group compared to placebo or wait-list comparisons. We suggested that the POTS 2004 result, equal to a difference of about eight points on the CY-BOCS, represented the best available estimate for the efficacy of BT/CBT relative to no treatment. (WMD -7.50; 95% CI -11.55, -3.45). Pooled evidence from two trials indicated that the efficacy of BT/CBT and medication did not differ significantly (WMD -3.87; 95% CI -8.15, 0.41). There was evidence of the benefit of combined BT/CBT and medication compared to medication alone (WMD -4.55; 95% CI -7.40, -1.70), but not relative to BT/CBT alone (WMD -2.80; 95% CI -7.55, 1.95). The rates of drop out suggested BT/CBT is an acceptable treatment to child and adolescent patients and their families. AUTHORS' CONCLUSIONS: Although only based on a small number of studies, behavioural or cognitive-behaviour therapy appears to be a promising treatment for OCD in children and adolescents. It can lead to better outcomes when combined with medication compared to medication alone. Additional trials are needed to confirm these findings. In the interim, consideration should be given to the ways in which BT/CBT might be made more widely available as a treatment for OCD in children and adolescents.

Adolescent↗
PubMed2006

Validation of the Chinese Challenging Behaviour Scale: clinical correlates of challenging behaviours in nursing home residents with dementia.

BACKGROUND: Behavioural and psychological symptoms of dementia (BPSD) are associated with considerable burden to patients with dementia and their caregivers. Formal caregivers in residential care settings face different challenges when delivering care. OBJECTIVE: This study aimed at assessing the clinical correlates of challenging BPSD using the Chinese version of the Challenging Behaviour Scale (CCBS) designed for residential care settings. METHODS: One hundred and twenty-five participants were recruited from three care-and-attention homes in Hong Kong. The CCBS was administered together with the Cantonese version of Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), Disability Assessment for Dementia (DAD) and Neuropsychiatric Inventory (NPI) to explore the relationships between challenging behaviour and important clinical correlates. RESULTS: The CCBS had good internal consistency (alpha = 0.86), inter-rater (ICC = 0.79) and test-retest reliability (ICC = 0.98). A four-factor structure is demonstrated by factor analysis: hyperactivity behaviours, hypoactivity behaviours, verbally aggressive and aberrant behaviours. Challenging behaviours were associated with male gender, cognitive impairment, functional disability, neuropsychiatric symptoms, and higher caregiver's workload. CONCLUSIONS: The CCBS is a valid and reliable measure to assess BPSD in residential care settings in local Chinese community. It is useful in evaluating the challenges faced by formal caregivers during daily care of the dementia patients.

Aged↗
PubMed1989

The putatively antipsychotic agent amperozide produces behavioural stimulation in the rat. A behavioural and biochemical characterization.

Amperozide (FG 5606; N-ethyl-4-[4',4'-bis(p-fluorophenyl)butyl]-1-piperazinecarboximide ) is a new putatively antipsychotic compound with a postulated 5-HT2 antagonistic profile. Somewhat surprisingly amperozide dose dependently induced a behavioural stimulation in reserpinized and in nonpretreated rats. The behaviour consisted of both forward and backward locomotion as well as forepaw circling and a grooming like behaviour. Since the behavioural pattern clearly differ from that produced by classical dopaminergic or serotonergic agonists (e.g. apomorphine or 8-hydroxy-2-(di-n-propylamino)tetralin, 8-OH-DPAT), and has not been previously reported, we decided to investigate the origin of this effect. In the behavioural paradigms it was not possible to antagonize the amperozide stimulation in reserpinized rats with the dopamine receptor blockers haloperidol, raclopride or R(+)-7-chloro-8-hydroxy-3-methyl-1-phenyl-2,3,4,5-tetrahydro-1 H-3-benzazepine, SCH 23390. Neither the 5-HT2 receptor blocking agent ritanserin nor the tryptophan and tyrosine hydroxylase inhibitor DL-3,4-dihydroxy-phenyl-alpha-propylacetamide, H22/54, could block the motoric stimulation or the forepaw circling behaviour produced by amperozide. However, the noradrenaline synthesis inhibitor bis-(4-methyl-1-homopiperazinylthiocarbonyl)-disulfide, FLA 63, as well as the alpha-adrenoceptor antagonist phenoxybenzamine, could partly inhibit the locomotor stimulation. Hence, noradrenaline seems to be, at least in part, involved in the behavioural stimulatory effect of amperozide. Biochemically amperozide had no effect on the dopamine synthesis rate (DOPA formation) in normal or reserpinized animals in the striatal or the limbic brain regions. In reserpinized animals amperozide also failed to antagonize the decrease in DOPA formation after apomorphine and 3-hydroxy-benzylhydrazine HCl, NSD 1015, in these regions.(ABSTRACT TRUNCATED AT 250 WORDS)

5-Hydroxytryptophan↗
PubMed1979

Registration of feeding behaviour in rats by recording food approach behaviour.

A method is described in which food approach behaviour of rats is recorded to study feeding behaviour. Between rats, differences in food approach behaviour were observed. For each rat, food approach behaviour was constant over a long period of time. This allows conversion of approach behaviour data into quantified feeding behaviour. Examples of long-term feeding behaviour and of reproducibility of food intake are given.

Animals↗
PubMed1997

A behavioural analysis of the delayed non-matching to position task: the effects of scopolamine, lesions of the fornix and of the prelimbic region on mediating behaviours by rats.

The delayed non-matching to position task (DNMP) is a widely used automated test of spatial memory, yet its validity has been challenged by suggestions that animals use motor mediating behaviours which facilitate correct responding. This possibility was systematically studied by analysing video recordings of rats displaying delay-dependent and delay-independent deficits following lesions or drug manipulations. Rats were first trained to perform the DNMP task and whilst untreated, a number of potential mediating behaviours were identified from the video recorded behaviour. Two independent raters recorded any apparent motor strategies and attempted to predict the response the animals made during the choice phase of the task by viewing only behaviour during the delay periods. Subsequently, the behaviour of the same animals was examined following scopolamine treatment and following lesions of the prelimbic cortex or of the fornix. The experiment confirmed previous reports of delay-dependent and delay-independent deficits under the varying conditions (drug, lesions), but also revealed that rats use clearly identifiable mediating behaviours that appear to facilitate correct responding in the DNMP task. Consequently, apparent "memory" impairments in the DNMP task, may reflect a disruption of behavioural strategies used by the animal to assist in performing the task.

Animals↗
PubMed1986

Effects of rapid urbanization on child behaviour and health in a part of Khartoum, Sudan--II. Psycho-social influences on behaviour.

A study of child behaviour and health in a newly urbanized part of Khartoum, Sudan, was carried out in 1980 on 245 children aged 3-15 years. The same area, then rural, had been investigated in 1965. Compared to 1965, the 1980 study showed an increase of behaviour problems of boys aged 7-15. In both studies the levels of most behaviour problems were below the figures from comparable studies from developed countries. Contrary to this the physical health and nutrition had improved between 1965 and 1980. The older children of newcomers, especially blue-collar, wage-earners with low incomes showed the highest frequencies of behaviour deviances. Children who had dropped out of school had higher rates while those belonging to the best third of their grades had less behaviour problems. While polygamy did not influence the rates of behaviour problems maternal anxiety/depression and harsh corporal punishment did so. Children of school-age (7-15) showed a strong connection between poor somatic health and high rates of behaviour deviances. The impact of various cultural changes on the families and the psychological well-being of the children is discussed.

Adolescent↗
PubMed2005

The association between bullying behaviour, arousal levels and behaviour problems.

Research into bullying behaviour has identified two main categories of bullying behaviour, direct bullying and relational bullying, within which different profiles are evident, namely 'pure' bullies, 'pure' victims, bully/victims and neutral children. The current study examined the relationship between direct and relational bullying profiles, arousal levels, and behaviour problems. 242 (males: 121, females: 121) Secondary school pupils (mean age 13.5 years) completed three questionnaires; the Arousal Predisposition Scale (APS) (Behav. Res. Therapy 26 (1988) 415); the School Relationships Questionnaire (SRQ) (detailed in J. Child Psychol. Psychiatry 41(8) (2000) 989; Br. J. Psychol. 92 (2001) 673); the Strengths and Difficulties Questionnaire (SDQ) (J. Child Psychol. Psychiatry 38(5) (1997) 581). Results revealed that the bully/victim profile for direct and relational bullying had the highest levels of arousal compared to other bullying profiles. Conversely, direct 'pure' bullies had low levels of arousal. Clinical behaviour problems as measured by the SDQ were associated with high levels of arousal. Clinically low arousal was not related to either bullying profiles, or behaviour problems. These findings were largely consistent with the arousal theory of behaviour (Crime and personality, 1964), which indicates that arousal levels are differentially associated with distinct behaviour patterns. The results provide implications for bullying intervention strategies, and methods to manage the school environment in relation to arousal levels.

Adolescent↗
PubMed2006

Measuring behavioural susceptibility to obesity: validation of the child eating behaviour questionnaire.

The Child Eating Behaviour Questionnaire (CEBQ; [Wardle, J., Guthrie, C.A., Sanderson, S., & Rapoport, L. (2001). Development of the children's eating behaviour questionnaire. Journal of Child Psychology and Psychiatry, 42, 963-970]) is a parent-report questionnaire designed to assess eating styles related to obesity risk. It has been shown to have a robust factor structure and good internal reliability, but has not been validated against behavioural measures of eating. In the present study, associations were examined between three CEBQ scales (Satiety Responsiveness, SR; Food Responsiveness, FR; Enjoyment of Food, EF) and four aspects of eating behaviour (eating without hunger, caloric compensation, eating rate and energy intake at a meal) aggregated across up to five occasions, in a sample of 4-5-year olds. In multiple regression, the aggregated behavioural measures of eating explained 56% of the variance in SR, 33% of the variance in FR and 40% of the variance in EF. These findings support the validity of the CEBQ as a parent-report instrument to assess 'obesogenic' eating behaviours in children. An easily-administered measure such as the CEBQ will be valuable in gathering data on the scale required to study the behavioural phenotype associated with obesity risk.

Child, Preschool↗
PubMed2004

Attitudes, subjective norms and perception of behavioural control as predictors of sun-related behaviour in Swedish adults.

BACKGROUND: Exposure to ultraviolet (UV) radiation is the major preventable cause of skin cancer. The aim of this study was to investigate the explanatory value of attitudes, subjective norms and perceived behavioural control on behaviours related to UV exposure. METHOD: A random population-based sample (n = 1752, 18-37 years of age) in the Stockholm County, Sweden, answered a questionnaire with items on sun related behaviours and beliefs. The items concerned issues influenced by the Theory of Planned Behaviour, that is, attitudes, subjective norms and perceived behavioural control. Logistic regression analysis was used to examine the associations between behaviours and beliefs. RESULTS: Positive attitudes towards being tanned and being in the sun were both strongly associated with time spent in the sun, intentional tanning, sunbed use, going on vacation to a sunny resort, intention to decrease sunbathing and use of protection against the sun. Perceiving sunbathing as risky was associated with using different ways to protect and intending to reduce sun exposure. Having people around oneself who frequently sunbathe was related to intentional tanning and vacations to sunny resorts. Finally, perceived behavioural control was associated with use of sunscreen and use of other ways to protect from the sun among women. CONCLUSION: The study identified factors on which primary preventive interventions towards decreasing sun exposure should be focused.

Adolescent↗
PubMed1998

Behavioural profiles of two Wistar rat lines selectively bred for high or low anxiety-related behaviour.

Over the past years, two breeding lines, derived originally from outbred Wistar rats, have been established that differ markedly and consistently in their anxiety-related behaviour in the elevated plus-maze. At the age of ten weeks, rats were tested once on the elevated plus-maze and the males and females displaying the most anxious and the least anxious behaviour were sib-mated to start a new generation of the high anxiety-related behaviour (HAB) and the low anxiety-related behaviour (LAB) lines, respectively. The resulting difference in emotionality between these two lines was also evident in an open field test and correlated with differences in the forced swim test. In the open field, the HAB rats tended to be less active and explored the central zone of the open field much less than the LAB animals. In the forced swim test, HAB rats started floating earlier, spent significantly more time in this immobile posture and struggled less than LAB rats. However, in an olfactory-cued social discrimination task there was no difference between male and female animals from either line. The overall performance in these various behavioural tests suggests that selective breeding has resulted in rat lines not only differing markedly in their innate anxiety-related behaviour in the plus-maze, but also in other stress-related behavioural performances, suggesting a close link between the emotional evaluation of a novel and stressful situation and an individual's coping strategy.

Animals↗
PubMed2005

Endurance training adherence in elite junior netball athletes: a test of the theory of planned behaviour and a revised theory of planned behaviour.

This study examined the utility of Ajzen's (1985) theory of planned behaviour and Maddux's (1993) revised theory of planned behaviour to predict endurance training intentions and adherence of elite junior netball athletes. One hundred and fifteen athletes from the England Netball World Class Start Programme were assessed on constructs central to the predictions of the two theories. Adherence to a recommended endurance training programme was recorded in self-report diaries across a 9-week period. Validity for the diaries was supported by significant correlations (P < 0.001) with recalls across 7 days and 9 weeks. Adherence was moderate and variable between athletes (mean = 66.05, s = 25.75%). Two separate path analyses were conducted to examine the predictions of the theories. Goodness-of-fit indices suggested acceptable fit of the data to the models. Analyses showed that attitude towards the new behaviour, subjective norms and perceived behavioural control predicted training intentions. The relationship between intention and adherence was weak. The present results suggest that the constructs of the theory of planned behaviour offer some insight into the explanation of intentions to follow an endurance training programme. Constructs unique to the revised theory of planned behaviour did not significantly predict training intentions or behaviour. Implications for practitioners working with team sport performers are provided.

Adolescent↗
PubMed2005

Staff responses to challenging behaviour shown by people with dementia: an application of an attributional-emotional model of helping behaviour.

There is some evidence to suggest that staff beliefs and emotional responses to challenging behaviour shown by clients are critical factors in guiding their responses to such behaviour. The purpose of this paper was to apply Weiner's cognitive-emotional model of helping behaviour to staff working with people with dementia who exhibit challenging behaviour. The paper also aimed to explore the impact of staff burnout and professional group upon participants' responses to real-life experiences of challenging behaviour. The participants were 25 nurses and 26 psychologists. Methods included questionnaire measures and coding of spoken attributions using the Leeds Attributional Coding System. Non-parametric tests measured between-group differences and correlations between the key variables. There were few differences between the two professional groups for the key variables. Optimism and sympathy were generally associated with willingness to help, and burnout was associated with less willingness to help, low optimism and negative emotional responses to clients' behaviour. No consistent or robust role was found for attributions. The results are discussed in relation to alternative factors, which may promote or reduce staff helping behaviour in the context of services for people with dementia.

Adult↗
PubMed1996

Knowledge, attitudes and perception of AIDS in rural Senegal: relationship to sexual behaviour and behaviour change.

OBJECTIVES: To describe the determinants of 'at risk' sexual behaviour and perception of AIDS-related prevention messages in rural Africa. SETTING: A rural area in Southern Senegal. DESIGN: Cross-sectional study using a standardized questionnaire administered by local interviewers to 240 men and 242 women aged 15-59 years, randomly selected among the general population. RESULTS: Twenty-eight per cent of the sexually active men and 27% of the sexually active women declared at least one casual sexual partner in the 12 months preceding the interview. Among these, 27% of men and 30% of women declared having used a condom in most acts of casual intercourse. Seasonal migrants and divorced or widowed women were more likely to declare casual sex. Causal sex was motivated by material needs for 66% of the women who experienced it, and those of the women who reported casual sexual intercourse were less likely to feel at risk of AIDS [odds ratio (OR), 3.9; P = 0.01] and were more optimistic about their future (OR, 3.6; P = 0.03). For men, the motivations explaining a change in sexual behaviour in order to avoid HIV infection included the perception of AIDS as a health problem (OR, 11; P = 0.004), the perception of the disease as serious (OR, 5.4; P = 0.001) and the feeling of personal risk of becoming HIV-infected (OR, 3.2; P = 0.02). Perceived skill in changing one's behaviour was strongly associated with declaration of past behaviour change for both men and women (men: OR, 3.4; P = 0.02; women: OR, 6.3; P = 0.0001). CONCLUSION: Men and women exhibit two different patterns regarding their behaviour and perception towards AIDS. Material needs appear to be of importance for women, whereas perception of a real threat lead men to adopt protective behaviours. In the very area of this study, widowed and divorced women as well as male seasonal migrants are particularly exposed to HIV infection. They are characterized by a higher risk behaviour, a low rate of condom use and seldom declared any protective measures to avoid HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Issues of reliability and validity in the measurement of challenging behaviour (behavioural difficulties) in learning disability: a discussion of implications for nursing research and practice.

The purpose of this paper is to contribute to the debate on issues related to the reliability and validity of measurement of challenging behaviour (behavioural difficulties) in learning disability. A number of practical, theoretical and methodological issues are discussed that have significance for the nurse both as practitioner and/or researcher in learning disability. These issues are equally important to both provider and purchaser of health care in order that resources can be most effectively targeted. The term 'challenging behaviour' would appear to be used both in literature and research synonymously with behavioural difficulties, this has implications for nurses in both their clinical practice and/or research. The author concludes by identifying a need to replace the term challenging behaviour, with 'behavioural difficulties'. It is argued that such a term is much more explicit in meaning and amenable to operational definition, thus enabling empirical study. Such a proposal will not be accepted by all as justifiable; this is because some might argue that adopting the term behavioural difficulties may be a retrograde step that perpetuates negative imagery and inappropriate labelling of people with a learning disability.

Humans↗
PubMed2004

Picking behaviour in cognitively impaired residents in geriatric settings: prevalence of the behaviour and characteristics of the residents.

This paper presents the findings of a point prevalence study performed at all geriatric settings within a county in Northern Sweden. The aims of the study were twofold: to investigate the prevalence of picking behaviour in cognitively impaired residents in various kinds of geriatric care settings and describe the characteristics of the residents, and to investigate how the residents who exhibit picking behaviour are experienced by their care providers. The study comprises 1928 cognitively impaired residents. The prevalence of picking behaviour was found to be 17%. Multivariate analyses showed that behavioural and psychiatric symptoms such as 'often stands at the outer door and wants to go out', 'wanders alone or with other patients back and forth', 'aggressive threats to patients and staff' and being 'manic' and 'fearful' were associated with picking behaviour. Other factors associated with picking behaviour were 'taking part in daily tasks', 'can walk without assistance' and imposing a high psychological workload. Furthermore, residents who exhibited picking behaviour were experienced by care providers as more uncertain and unhappier than residents who did not behave in this way.

Activities of Daily Living↗