Effective strategies to control disturbing behavior.
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Risperidone is an atypical antipsychotic agent with dopamine and serotonin antagonistic effects. It is an effective treatment for reducing aggressive behavior in adults with mental retardation. The use of risperidone in a severely mental retarded child with aggression is described. Risperidone was able to reduce the aggressive behavior in this patient. No serious side effect was found. This case illustrated that risperidone is effective and well tolerated in treating aggressive behavior in children with severe mental retardation. However, the anti-aggressive effect of risperidone in mentally retarded children remains to be seen in a larger sample-size study.
Application of the theory of planned behavior (TPB) to healthy eating in 144 health promotion clinic attendees is reported. Respondents completed self-report TPB measures after the clinic (Time 1) and 6 months later (Time 2) with a measure of perceived past behavior. Intention stability was assessed on Time 1-2 differences. Six years later (Time 3), respondents completed measures of healthy eating intentions and behavior. Intentions were predicted by attitudes, perceived behavioral control, and perceived past behavior (cross-sectionally). Healthy eating behavior (Time 3) was predicted from intentions (Time 2). As intention stability increased, intentions and perceived past behavior became stronger and weaker predictors of behavior, respectively. Implications for understanding health cognitions in long-term performance of health behavior are discussed.
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Acute psychosis is a true emergency and is a manifestation of multiple organic and functional disorders. The emergency medicine physician's role in dealing with the acutely psychotic patient is to control the patient's behavior, to delineate the etiology of the psychosis, and to provide appropriate initial treatment and disposition. When making initial contact with the psychotic patient, behavioral control can be accomplished through supportive, physical, or pharmacologic interventions. Judicious use of rapid tranquilization permits rapid control of these patients when supportive and other nonpharmacologic therapies fail. Initial examination is directed at identifying immediate life-threatening organic disorders and promptly treating them. Historical data, mental status examination, physical examination, and appropriate radiologic and laboratory investigations give information that assist in delineating functional from organic psychosis. Most acute organic psychoses, with the exception of some drug intoxications that clear in the Emergency Department, require medical or surgical admission. Acute functional psychotic patients who are a danger to themselves or others, who are without a reliable social support system, or who present with their first psychotic episode require admission to the psychiatric service for further evaluation and treatment.
Behavioral outcomes of a behavioral-chemical intervention procedure on stereotypic and non-compliant behavior were evaluated. One group (n = 22) of community-based mentally retarded clients was initially on psychotropic medication (major tranquilizers). Their dosage was either increased, decreased, or kept the same following behavioral intervention. A second group (n = 19) was placed on psychotropic medication following behavioral intervention. A nonequivalent between-groups design was employed that permitted 36 outcome combinations involving Conditions X Subject X Group. The effects of behavioral intervention, the validity of drug-intervention decision rules, drug-intervention effects, and the validity of the behavioral-chemical intervention model were evaluated. Results indicated that the behavioral-chemical intervention produced expected and desirable behavioral change as well as reduced levels of psychotropic drug usage.
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H-2+ and H-2- cells of B16 melanoma were established by repeated fluorescence-activated cell sorting. The H-2- line formed no metastasis in untreated C57BL/6 mice, whereas the H-2+ cells showed evidence of metastatic development. This difference was ascribed mainly to the increased susceptibility of H-2- cells to attack by natural effector mechanisms, particularly asialo GM1+ NK cells. After treatment with both anti-asialo GM1 serum and whole body irradiation (400 rad), numerous colonies of H-2- cells formed in the lung, whereas the metastasis was only marginally enhanced by irradiation and moderately by treatment with anti-asialo GM1 serum. With the H-2+ cells, treatment with each modality significantly increased the number of metastatic colonies. Therefore collaboration of asialo GM1+ NK cells and radiosensitive natural effectors seems to be the main mechanism involved in the synergistic effects on defense against H-2- cell metastasis, and to a lesser extent against H-2+ cell metastasis. Irradiation (1000 rad) to the right lung to abrogate the organ-associated defense increased the colonies, particularly in the H-2+ cells. On the other hand, treatment with anti-asialo GM1 serum increased colonization in the early phase of metastasis with H-2- cells and may have abolished asialo GM1+ NK cells capable of recognizing the reduced expression of H-2 antigens and eliminating H-2- cells in the blood-born phase. Natural defense mechanisms probably exert suppressive effects on the metastasis of H-2+ cells, mainly in the organ-associated phase after extravasation.