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A randomized controlled study of cognitive behavior therapy and behavioral family therapy for anorexia nervosa patients.

Very few studies have examined the role of cognitive behavior therapy (CBT) in the outpatient treatment of anorexia nervosa. This study used a randomized, controlled design to evaluate a 12-month, manual based program of CBT, with behavioral family therapy as the comparison group. Twenty-five adolescents and young adults with anorexia nervosa, currently living with their families, were recruited into the study with both treatment groups receiving 21-25 sessions of therapy. Outcome measures included nutritional status, eating behaviors, mood, self-esteem, and family communication. Sixty percent of the total sample and 72% of treatment completers had "good" outcome (defined as maintaining weight within 10% of average body weight and regular menstrual cycles) at post-treatment and at six months follow-up. No significant differences between treatment groups were found and the majority of patients did not reach symptomatic recovery. While limited by the small sample size, the findings compliment and extend previous research.

Journal Article↗

The Significant-other Behavior Questionnaire (SBQ): an instrument for measuring the behavior of significant others towards a person's drinking and abstinence.

The psychometric properties of the Significant-other Behavior Questionnaire (SBQ), an instrument measuring the specific social support in terms of the patient's drinking. Assessments of the significant other's behavior in the presence of the patient drinking is provided by both the patient and significant other. Data from the two SBQ forms were analyzed with a principal axis factor analytic procedure with varimax rotation. The scales were similar for the two forms with four behavioral reactions, withdraw from the patient, support drinking, support sobriety, and punish drinking. Correlations between the two forms on the same four scales were higher than correlations within groups on three of four scales and differed from measures of general social support. Applications of the SBQ are discussed.

Adult↗

Initiation of behavior by single neurons: the role of behavioral context.

Flying crickets avoid sources of ultrasound, possibly echolocating bats, by making rapid steering movements that turn them away from the stimulus. Electrical stimulation of a single, identified sensory interneuron (Int-1) elicits avoidance steering; depressing its response to ultrasound abolishes avoidance steering. Int-1 is necessary and sufficient for this behavior but only while the cricket is in flight. Thus, the sufficiency of Int-1 for eliciting this behavior is contingent on behavioral context.

Acoustic Stimulation↗

The Behavior Rating Scale for Dementia of the Consortium to Establish a Registry for Alzheimer's Disease. The Behavioral Pathology Committee of the Consortium to Establish a Registry for Alzheimer's Disease.

OBJECTIVE: The purpose of the study was to develop a standardized instrument, the Behavior Rating Scale for Dementia, for rating psychopathology in patients with probable Alzheimer's disease and to conduct a multicenter pilot study of this instrument. METHOD: The rating scale was developed collaboratively on the basis of clinical experience and existing instruments. Items were scaled according to frequency of psychopathology and were administered to an informant who was familiar with the subject. The scale was administered in a standardized manner by trained examiners who had met predetermined certification standards. The study group consisted of 303 subjects with probable Alzheimer's disease who had undergone standardized clinical evaluations by the Consortium to Establish a Registry for Alzheimer's Disease. RESULTS: Subjects had an average of 15 problems rated as present in the preceding month. Wide variability in the nature of disturbances was found, with a number of items rated as present since the illness began but not in the past month. Interrater agreement was high. Factor analysis suggested eight preliminary factors that mapped onto clinically relevant domains: depressive features, psychotic features, defective self-regulation, irritability/agitation, vegetative features, apathy, aggression, and affective lability. CONCLUSIONS: The Behavior Rating Scale for Dementia provides a standardized, reliable measure that can be administered to caregivers of demented subjects. On the basis of the present study, the scale has been revised slightly. After additional studies in progress, the Behavior Rating Scale for Dementia will be available for general use in assessing a wide range of psychopathology in dementia.

Aged↗

The epidemiology of drinking and driving: results from the Behavioral Risk Factor Surveillance System, 1986. Behavioral Risk Factor Surveillance Group.

Alcohol-related motor vehicle crashes result in thousands of deaths and serious injuries each year. For effective intervention in this problem, it is important to understand the epidemiology of "drinking and driving." To study this behavior, we analyzed the self-reports of 34,395 respondents in the 26 states conducting behavioral risk factor surveillance during 1986. An estimated 4.1% of the survey population and 7.2% of drinkers reported drinking and driving at least once in the month before the survey. In general, the prevalence of drinking and driving was highest among men, young adults, and divorced or separated persons. States with the highest prevalence of drinking and driving tended to cluster in the north-central region of the United States. In 15 states conducting surveillance from 1984 to 1986, the overall prevalence of drinking and driving changed little during this period. However, among persons less than 25-years old, the prevalence decreased. Efforts to deter drinking and driving are likely to reduce the number of motor vehicle crashes and should include both legal sanctions and greater public education about the dangers of this behavior.

Adolescent↗

Central control of electric signaling behavior in the mormyrid Brienomyrus brachyistius: segregation of behavior-specific inputs and the role of modifiable recurrent inhibition.

Like all mormyrid fish, Brienomyrus brachyistius produces an electric organ discharge (EOD) with a constant waveform and variable sequence of pulse intervals (SPI). Periodic bursts fall into two display categories termed 'scallops' and 'accelerations', with a third category termed 'rasps' that appears to combine the two. The medullary EOD command nucleus (CN) receives excitatory input from the midbrain precommand nucleus (PCN) and the thalamic dorsal posterior nucleus (DP), both of which are regulated by a recurrent inhibitory projection from the ventroposterior nucleus of the torus semicircularis (VP). We tested the following hypotheses: (1) PCN and DP are responsible for generating different burst types (scallops and accelerations, respectively), (2) differences in the strength of recurrent inhibition are related to physiological differences between PCN and DP and (3) recurrent inhibition regulates the resting electromotor rhythm, while disinhibition releases PCN and DP, allowing them to generate bursts. Iontophoresis of the excitatory neurotransmitter L-glutamate (L-Glu) into DP led to acceleration-like output patterns, while in PCN it led to scallop-like output patterns. Iontophoresis of the inhibitory neurotransmitter gamma-amino-butyric acid (GABA) into DP and PCN led to an elongation of intervals, as did iontophoresis of L-Glu into VP. Iontophoresis of the GABA(A) receptor blocker bicuculline methiodide (BMI) into DP and PCN induced repetitive bursting behavior and eliminated differences in the effects of L-Glu iontophoresis in the two nuclei. These results support our three hypotheses, suggesting that production of different communication behaviors may be regulated by spatially distinct groups of neurons, and recurrent inhibition and disinhibition may play an active role in driving and shaping such behaviors.

Animal Communication↗

Behavioral economics: areas of cooperative research between economics and applied behavioral analysis.

The current research methods of behavioral economics are characterized by inadequate empirical foundations. Psychologists involved in the experimental analysis of behavior with their research strategies and their experimental technology, particularly that of the Token Economy, can assist in providing empirical foundations for behavioral economics. Cooperative research between economists and psychologists to this end should be immediately fruitful and mutually beneficial.

Journal Article↗

The Generic Work Behavior Questionnaire (GWBQ): assessment of core dimensions of generic work behavior of people with severe mental illnesses in vocational rehabilitation.

The purpose of this study was the development of a short self-reporting and supervisor-reporting questionnaire to assess generic work behavior of people with severe mental illnesses participating in psychiatric vocational rehabilitation. An 18-item generic work behavior questionnaire (GWBQ) was developed, which contains core dimensions derived from both supervisor scores and self-report scores. The factor structure of the GWBQ was replicated for both versions (supervisor and self reports). The GWBQ was very reliable for supervisor reports and moderately so for self-reports. Although self-report scores and supervisor scores correlated significantly, participants rated their own work behavior consistently higher than supervisors did.

Adult↗

Documenting productive behaviors. Using the functional behavior profile to plan discharge following stroke.

The Functional Behavior Profile (FBP) is presented as a clinically useful measurement tool to guide placement decisions following stroke. The measure provides the practitioner with a tool to identify the nature and extent of the behavioral capabilities and problems caregivers will face if they choose to manage their loved ones at home. The FBP yields information for planning treatment. Individuals with scores of 84 or lower were five times more likely to need supervision after discharge than those with scores of 85 or higher. The FBP was able to correctly classify 69% of the 45 patients in this study. Additionally, the FBP identified key behaviors that discriminated between patients who go home compared to those who require supervised care.

Activities of Daily Living↗

Behavioral healthcare report card indicators: AMBHA (American Managed Behavioral Healthcare Association) begins to define standards for accountability.

AMBHA--The American Managed Behavioral Healthcare Association--was formed by a number of the country's leading national behavioral health managed care firms in order to influence the national reform debate and document the cost effectiveness of managed care techniques in this setting. Recently, AMBHA undertook the challenge of setting standardized quality assessment measures and methods and related benchmarks. The author describes the association's beginning efforts to develop a behavioral healthcare "report card" addressing basic elements of access, client satisfaction, quality and outcomes.

Health Services Accessibility↗

[Conditioning of emotional behavior caused by hypothalamic stimulation (3): The learned behavior caused by hypothalamic stimulation in rabbits].

In the present study, the learned behavior caused by hypothalamic electrical stimulation was examined in order to determine the effects of psychotropic drugs. Subjects were albino male rabbits with electrodes chronically implanted in the hypothalamic area. A shuttle box, which was adjusted for behavioral pharmacological estimation of drugs in rabbits, was used. A buzzer sound (85dB) and electrical stimulation of hypothalamus (100 HZ, 1 msec, 1.2-2.0V) were used as the conditional stimulation (CS) and unconditional stimulation (UCS), respectively. The same animal was trained in habituation to a buzzer sound as the CS. For avoidance conditioning in a two-compartment situation, the animal was placed in a shuttle box divided by a hurdle situated at the middle of two-compartments. After the CS was presented for 10 sec, the UCS was given. The animals were subjected to 15 conditioning trials per day. The avoidance and escape behavior model became as distinct by hypothalamic stimulation as by UCS. After termination of the experiments, extinction trials were carried out after which the animals were sacrificed, and localization of the stimulating electrodes was determined histologically.

Animals↗

Information-motivation-behavioral skills model-based HIV risk behavior change intervention for inner-city high school youth.

This study assessed the effects of 3 theoretically grounded, school-based HIV prevention interventions on inner-city minority high school students' levels of HIV prevention information, motivation, behavioral skills, and behavior. It involved a quasi-experimental controlled trial comparing classroom-based, peer-based, and combined classroom- and peer-based HIV prevention interventions with a standard-of-care control condition in 4 urban high schools (N = 1,532, primarily 9th-grade students). At 12 months postintervention, the classroom-based intervention resulted in sustained changes in HIV prevention behavior. This article discusses why both of the interventions involving peers were less effective than the classroom-based intervention at the 12-month follow-up and, more generally, suggests a set of possible limiting conditions for the efficacy of peer-based interventions.

Adolescent↗

Does a behavioral science rotation change residents' self-assessed psychosocial attitudes and behavior?

The purpose of this study was to determine changes in self-assessed resident psychosocial attitudes and behavior after participation in a month-long behavioral science rotation. The four areas specifically investigated were 1) Personal Attributes, 2) Attitudes toward the Practice of Medicine, 3) Basic Psychosocial Skills of interviewing and assessment, and 4) Complex Psychosocial Skills, including counseling and brief psychological intervention. A total of 17 male and 9 female residents participated sequentially in 4-6 consecutive weeks of a specially designed behavioral science curriculum. Results demonstrated change in the positive direction in only two of the four areas, Personal Attributes (p. less than .05), and Psychosocial Assessment Skills (p. less than 000). Findings suggest that certain basic psychosocial assessment skills, especially those in which residents initially evaluate themselves as lacking mastery, can be successfully taught through a structured format. However, overall lack of clinically relevant improvement points to significant limitations in using structured coursework to address issues of values and attitudinal change. Further, such a structured approach does not seem to have been effective in teaching the skills requiring actual patient intervention.

Attitude of Health Personnel↗

Convergent and discriminant validities of the Scales of Independent Behavior and the revised Vineland Adaptive Behavior Scales.

The relation between the Scales of Independent Behavior (SIB) and the revised Vineland Adaptive Behavior Scales (VABS) was examined. Subjects were 53 children ages 3 through 7. A correlation of .83 was found between the SIB Broad Independence Score and the VABS Adaptive Behavior Composite. Campbell and Fiske's criteria for convergent and discriminant validity were applied to six of the scales that were common to both instruments. Results indicated that the most valid subscales were Personal Living Skills, Communication Skills, and Community Living Skills.

Activities of Daily Living↗

Externalizing behavior disorders, situational generality, and the type A behavior pattern.

Measures of the Type A Behavior Pattern (TABP) in children have demonstrated good sensitivity but problematic specificity. Using the most popular measure of childhood TABP, a teacher rating scale called the MYTH, we sought to (a) replicate earlier findings of extensive overlap between TABP and externalizing behavior problems, (b) further distinguish between and extend the empirical networks for the positive (Competition) and negative (Impatience-Aggression) components of TABP, and (c) explore cross-situational generality. Normal boys and those with attention-deficit hyperactivity disorder (ADHD) were assessed on multiple instruments in diverse contexts. ADHD boys obtained higher TABP Total and Impatience-Aggression scores than normal boys, and these scores were associated with a wide array of behavior problems and peer difficulties. In contrast, the Competition subscale was related to popularity and athleticism and, inversely, to internalizing problems. Discussion focused on the construct validity of the MYTH, the heterogeneity of boys identified by the MYTH as showing the TABP, and the need for distinguishing research uses of the measure from applications of the TABP concept.

Aggression↗

Behavioral studies with anxiolytic drugs. IV. Serotonergic involvement in the effects of buspirone on punished behavior of pigeons.

Interactions of the nonbenzodiazepine anxiolytic, buspirone, with serotonin (5-HT) were studied using behavioral and neurochemical procedures. Punished responding was studied in pigeons as this behavior is a generally acknowledged preclinical predictor of anxiolytic activity and because buspirone increases punished responding of pigeons with greater potency and efficacy than in other species. Keypeck responses were maintained under either fixed-interval or fixed-ratio schedules of food presentation; every 30th response produced a brief electric shock and suppressed responding (punishment). Buspirone (0.1-5.6 mg/kg i.m.) produced dose-related increases in punished responding which reached a maximum at 1 mg/kg. A serotonin agonist, MK-212 (0.01 mg/kg), antagonized whereas the 5-HT antagonist, cyproheptadine (0.01 mg/kg), potentiated the effects of buspirone without having behavioral effects of their own. The characteristics of [3H]-5-HT binding in pigeon brain membranes were similar to results reported in mammalian brain. Neither buspirone, MJ-13805 (gepirone, a related analog), nor MJ-13653 (a buspirone metabolite), significantly affected [3H]-5-HT binding and none of the compounds appreciably inhibited uptake of [3H]-5-HT into pigeon cerebral synaptosomes. Hill coefficients significantly less than unity for all drugs except 5-HT suggested multiple serotonergic binding sites for buspirone and analogs. Buspirone and MJ-13805 (1 nM) inhibited [3H]ketanserin binding (a measure of 5-HT2 binding sites) in pigeon cerebrum with Ki values above 10(-6) M. The number of [3H]ketanserin binding sites was estimated to be 109 fmol/mg of protein in pigeon cerebrum compared to 400 fmol/mg of protein in rat cerebrum.(ABSTRACT TRUNCATED AT 250 WORDS)

8-Hydroxy-2-(di-n-propylamino)tetralin↗

Privacy and behavioral research. Preliminary summary of the report of the panel on privacy and behavioral research.

From our examination of the relation of behavioral science research to the right to privacy, we have been led to the following conclusions. 1) While most current practices in the field pose no significant threat to the privacy of research subjects, a sufficient number of exceptions have been noted to warrant a sharp increase in attention to procedures that will assure protection of this right. The increasing scale of behavioral research is itself an additional reason for focusing attention in this area. 2) Participation by subjects must be voluntary and based on informed consent to the extent that this is consistent with the objectives of the research. It is fully consistent with the protection of privacy that, in the absence of full information, consent be based on trust in the qualified investigator and the integrity of his institution. 3) The scientist has an obligation to insure that no permanent physical or psychological harm will ensue from the research procedures, and that temporary discomfort or loss of privacy will be remedied in an appropriate way during the course of the research or at its completion. To merit trust, the scientist must design his research with a view to protecting, to the fullest extent possible, the privacy of the subjects. If intrusion on privacy proves essential to the research, he should not proceed with his proposed experiment until he and his colleagues have considered all of the relevant facts and he has determined, with support from them, that the benefits outweigh the costs. 4) The scientist has the same responsibility to protect the privacy of the individual in published reports and in research records that he has in the conduct of the research itself. 5) The primary responsibility for the use of ethical procedures must rest with the individual investigator, but government agencies that support behavioral research should satisfy themselves that the institution which employs the investigator has effectively accepted its responsibility to require that he meet proper ethical standards. 6) Legislation to assure appropriate recognition of the rights of human subjects is neither necessary nor desirable if the scientists and sponsoring institutions fully discharge their responsibilities in accommodating to the claim of privacy. Because of its relative inflexibility, legislation cannot meet the challenge of the subtle and sensitive conflict of values under consideration, nor can it aid in the wise decision making by individuals which is required to assure optimum protection of subjects, together with the fullest effectiveness of research.

Ethics↗

[Epidemiologic research, disorders of eating behavior and addictive behavior].

The tremendous increase in interest in eating disorders, and especially in bulimia nervosa, that has occurred since the last 1970s has resulted in a large and contradictory literature about the relationships between eating disorders and addictive disorders, especially alcohol and drug abuse. At first sight, according to the differences observed between these disorders in most of their phenomenological characteristics (age, sex, socio-cultural factors), it may seem difficult to draw a parallel between them. However, studies showed that eating behavior problems, alcohol and drug abuse nowadays shared some common features in adolescents and young people. However that may be, epidemiological studies demonstrated a high prevalence of substance abuse among patients with bulimia. In anorexia nervosa, this prevalence seemed to be lower. However, significant differences have been observed between bulimic and restricting anorexics: substance abuse occurred significantly more frequently in bulimic anorexics than in restricting anorexics and this characteristic was associated with a higher prevalence of impulsive behaviors (i.e. stealing, self-mutilation and suicide attempt), laxative or diuretic use and impairments in social relationships. These clinical features are quite similar to those observed in bulimic patients with substance abuse problems. Follow-up studies also showed that substance abuse problems in anorexia nervosa were associated with the occurrence of bulimic behaviors. On the other hand, family studies reported that a high prevalence of patients with bulimia had at least one first degree relatives with substance abuse problems or an affective disorder. In anorexia nervosa, the prevalence of substance abuse or depression among the family members seemed to be higher in bulimic anorexics than in restricting anorexics.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗