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Difficult dementia: six steps to control problem behaviors.

For patients with a confirmed diagnosis of dementia, your challenge is to promote a quality life during their remaining years. This task often includes managing problem behaviors. A systematic approach starts with pinpointing the nature of the specific behavior, reviewing possible physical and emotional stressors, and checking for coexisting affective or psychotic disorders. It often helps to reduce environmental stimulation and to simplify the patient's tasks. Drug therapy with an antipsychotic or benzodiazepine is indicated if a clear-cut behavioral strategy has not proven fully effective, the behavior has been well documented, and the behavior presents a clear danger to the patient or others or prevents necessary care from occurring.

Adaptation, Psychological↗

60 Hz electric fields and incandescent light as aversive stimuli controlling the behavior of rats responding under concurrent schedules of reinforcement.

Several reports have shown that animals will sometimes engage in behaviors that reduce their exposure to a 60 Hz electric field (E-field). The field, therefore, can function as an aversive stimulus. In other studies, the E-field at equivalent strengths failed to function as an aversive stimulus. The present experiment, using rats, demonstrates how factors other than field strength can influence whether a subject engages in behavior that reduces field exposure. The general design consisted of giving the rat a choice between two alternatives, one of which sometimes included an added stimulus. Each subject was trained to press each of two levers to obtain food. Pressing one lever was reinforced intermittently under a variable interval 2 min schedule (VI 2); pressing the other lever was reinforced by a second VI 2 schedule operating independently of the first. Under this concurrent schedule the rat spent 50% of the daily 50 min session responding to each of the levers, indicating that they were equally "valued." Next, while the schedules remained in effect, the first response to one of the levers turned on a 100 kV/m E-field which remained on until the rat pressed the other lever. The time spent responding under the schedule associated with the field was reduced by about 5-10%. When the procedure was changed so that no lever presses produced food, i.e., extinction, but the added stimulus contingency remained, the rats spent even less time in the presence of the field. Similar outcomes were observed during both the concurrent food or extinction schedules when incandescent light was used. Thus, both an E-field and incandescent light functioned as aversive stimuli, but the magnitude of the aversiveness was small. Aversiveness depended not only on stimulus intensity, but also on behavioral factors.

Animals↗

Timing of omitted events: an analysis of temporal control of inhibitory behavior.

This paper reviews research designed to investigate the temporal control of inhibitory responding using rats as subjects. One area of investigation has focused on the role of temporal variables in conditioned inhibition produced using Pavlov's [Pavlov, I.P., 1927. Conditioned Reflexes. Oxford University Press, London, 430 pp.] procedure. These studies have found that evidence of conditioned inhibition obtained by negative summation testing is strongest when the conditioned inhibitor signals the omission of the unconditioned stimulus (US) at the same temporal location as a transfer excitor signals presentation of the US [e.g., Barnet, R.C., Miller, R.R., 1996. Temporal encoding as a determinant of inhibitory control. Learn. Motiv. 27, 73-91]. Similarly, retardation of acquisition of behavioral control by a previously inhibitory conditioned stimulus (CS) is maximal when the inhibitory CS is paired with the US at the same temporal location as the inhibitor had previously signaled US omission [Burger, D., Denniston, J.C., Miller, R.R., 2001. Temporal coding in condition inhibition: retardation tests. Anim. Learn. Behav. 29, 281-290]. Other lines of research designed to assess the associative structure of temporal control of inhibition [e.g., Denniston, J.C., Blaisdell, A.P., Miller, R.R., 2004. Temporal control in conditioned inhibition: analysis of associative structure of inhibition. J. Exp. Psychol. Anim. Behav. Process. 30, 190-202] are reviewed, as is the assessment of temporal control of inhibition produced through extinction [Denniston, J.C., Miller, R.R., 2003. The role of temporal variables in inhibition produced through extinction. Learn. Behav. 31, 35-48]. These collective observations are discussed in terms of the temporal coding hypothesis [Matzel, L.D., Held, F.P., Miller, R.R., 1988. Reexamination of simultaneous and backward conditioning: Implications for contiguity theory. Learn. Motiv. 19, 317-344].

Animals↗

Evaluation of a theoretically based AIDS/STD peer education program on postponing sexual intercourse and on condom use among adolescents attending high school.

The effectiveness of an intervention based upon the theories of Ajzen and Triandis was evaluated among 698 junior and 306 senior high school students. The intervention to juniors was offered by senior students who were trained during a course integrated into the school curriculum. Respondents in the control and experimental groups completed a questionnaire at baseline and 9 months after the program. Compared to junior respondents in the control group, those in the experimental group positively modified their attitude, perceived behavioral control, personal normative beliefs, perceived role beliefs, anticipated regret and intention with respect to postponing sexual intercourse and with respect to condom use, as well as perceived self-efficacy to negotiate both behaviors. Compared to senior respondents in the control group, those in the experimental group showed a significant positive modification of all the above variables except perceived behavioral control (indirect measure), anticipated regret and intention with respect to postponing sexual intercourse. At post-test, seniors in the experimental group were more likely to use condoms on a regular basis than those in the control group. Program effects occurred among both sexes, but a few differences in response were observed among males and females. Results suggest this type of theory-based program is effective in modifying psychosocial variables related to postponing sexual intercourse and related to condom use among adolescents. Personal involvement in designing intervention appears to be effective in modifying the behavior of peer educators.

Adolescent↗

Separation of drug effects on timing and behavioral inhibition by increased stimulus control.

Impulsive behavior may represent, in part, a failure of behavioral inhibition (the ability to delay or inhibit a response). In this study, use of a multiple signaled-unsignaled differential-reinforcement-of-low-rates (DRL) 15-s schedule allowed examination of drug effects in conditions in which level of stimulus control differed. Results showed that whereas diazepam increased premature responding during signaled and unsignaled DRL components, amphetamine and delta9-tetrahydrocannabinol increased premature responding primarily during unsignaled components when timing was necessary for efficient performance on the task. In contrast, pimozide and desipramine increased long-delay responses across both components, resulting in longer mean interresponse times. Collectively, these results suggest that the use of different levels of stimulus control may aid in separation of drug effects on timing and other behavioral processes, including behavioral inhibition.

Amphetamine↗

Being a self: considerations from functional imaging.

Having a self is associated with important advantages for an organism. These advantages have been suggested to include mechanisms supporting elaborate capacities for planning, decision-making, and behavioral control. Acknowledging such functionality offers possibilities for obtaining traction on investigation of neural correlates of self-hood. A method that has potential for investigating some of the brain-based properties of self arising in behavioral contexts varying in requirements for such behavioral guidance and control is functional brain imaging. Data obtained with this method are beginning to converge on a set of brain areas that appear to play a significant role in permitting conscious access to representational content having reference to self as an embodied and independent experiencer and agent. These areas have been identified in a variety of imaging contexts ranging from passive state conditions in which they appear to manifest ongoing activity associated with spontaneous and typically 'self-related' cognition, to tasks targeting explicitly experienced properties of self, to demanding task conditions where activity within them is attenuated in apparent redirection of cognitive resources in the service of task guidance and control. In this paper, these data will be reviewed and a hypothesis presented regarding a significant role for these areas in enabling degrees of self-awareness and participating in the management of such behavioral control.

Awareness↗

Mastery motivation and self-evaluative affect in toddlers: longitudinal relations with maternal behavior.

This study examined relations between maternal control and evaluative feedback during the second year of life and children's mastery motivation and expressions of self-evaluative affect a year later. Participants were 75 toddlers (35 girls, 40 boys) and their mothers. Maternal controlling behavior and evaluative feedback were examined while mothers taught their 24-month-olds a challenging task. Children's mastery motivation and expressions of self-evaluative affect were assessed during easy and difficult achievement-like tasks when they were 36 months old. Maternal evaluative feedback and control style at 24 months predicted children's shame, persistence, and avoidance of mastery activities at 36 months. Specifically, negative maternal evaluations at age two related to children's later shame, especially when feedback was linked to children's actions or products; positive maternal feedback overall, as well as corrective feedback, related to children's later persistence; mothers who engaged in more autonomy-supporting control with their 2-year-olds had children who were less likely to avoid challenging activities at age 3. Children's pride at 36 months was not predicted by mothers' behavior at 24 months.

Affect↗

Predicting children's sunscreen use: application of the theories of reasoned action and planned behavior.

BACKGROUND: Skin cancer remains the most common form of cancer in the United States despite the fact that most cases can be prevented by limiting sun exposure. Childhood and adolescence are periods of life during which prolonged sun exposure is particularly common. Accordingly, promoting sun-protective behaviors during these formative years can be of critical importance in preventing skin cancer. The present study applied the theories of reasoned action and planned behavior to the understanding of children's sunscreen use. Based on these theories, it was hypothesized that attitudes, subjective norms, and perceived behavioral control would be related to intentions to use sunscreen, which, in turn, would be related to actual sunscreen use. METHODS: Questionnaires measuring sun-related attitudes, beliefs, perceived control, and intentions were administered to 199 fourth graders (ages 9 to 13, mean = 10.3) attending public schools in Florida. Self-report measures of sun-related behavior were administered to the same subjects 1 month later. RESULTS: Results of correlational analyses were consistent with study hypotheses. Higher rates of sunscreen use at follow-up were predicted by stronger intentions to use sunscreen assessed 1 month previously. In addition, stronger intentions to use sunscreen were found to be related to more favorable attitudes toward sunscreen use, stronger beliefs that peers and parents favored sunscreen use, and greater perceptions of personal control in using sunscreen. Path and multiple regression analyses identified direct and indirect relationships among study variables that partially confirmed those predicted by the theories and provided support for the use of an expanded model that included perceived behavioral control. CONCLUSIONS: The present study confirmed hypotheses derived from the theories of reasoned action and planned behavior regarding the relation of attitudes, subjective norms, and perceived behavioral control to sunscreen use among fourth graders. In addition to their theoretical significance, these findings suggest ways to intervene at the individual, classroom, and family levels to promote greater sunscreen use in this age group.

Adolescent↗

Behavioral, physiological, and self-evaluative effects of anxiety on the self-control of pain.

This study examined the impact of trait anxiety on self-control behavior using the cold pressor task. In addition to cold pressor tolerance, effects were measured in terms of physiological arousal and self-evaluations. Forty-six female subjects screened for high and low trait anxiety were given two trials of the cold pressor task, and between trials, they were given either self-control or non-self-control training. As expected, self-control training resulted in increased pain tolerance and decreased physiological arousal. Although anxiety did not influence behavioral tolerance, high trait anxious subjects receiving self-control training made more negative self-evaluations and had higher levels of physiological arousal. These results suggest that anxiety may disrupt the use of self-control strategies in coping with pain.

Adaptation, Psychological↗

Behavioral effects mediated by the modulatory glycine site of the NMDA receptor in the anterodorsal striatum and nucleus accumbens.

The striatum and the nucleus accumbens are the main input structures of the basal ganglia (BG). They contribute differently to motor behavior controlled by the BG in rats, e.g., stereo-typed behavior, catalepsy, and locomotion. Whereas the striatum is predominantly involved in the control of sniffing behavior and catalepsy, the nucleus accumbens contributes to control of locomotion. To test whether the allosteric glycine site of the NMDA receptor complex modulates these behavioral variables, we injected the glycine-site antagonist 7-chlorokynurenate and the glycine-site agonist D-serine into the anterodorsal striatum and the nucleus accumbens and studied their influence on stereotypical snout contacts and locomotion. Additionally, the effects of intrastriatal injections of 7-chlorokynurenate on haloperidol- and SCH 23390-induced catalepsy were investigated. 7-Chlorokynurenate enhanced stereotypical snout contacts in the anterodorsal striatum and in the nucleus accumbens but did not change spontaneous locomotion in either of these structures. Haloperidol- but not SCH 23390-induced catalepsy was attenuated by intrastriatally administered 7-chlorokynurenate. The glycine-site agonist D-serine had no effect on stereotypical snout contacts and locomotion. The results suggest that motor behavior mediated by the striatopallidal output pathway is modulated by the glycine site, whereas motor behavior mediated by the accumbopallidal and striatonigral output pathway is not.

Animals↗

Anxious solitude across contexts: girls' interactions with familiar and unfamiliar peers.

Cross-situational continuity and change in anxious solitary girls' behavior and peer relations were examined in interactions with familiar versus unfamiliar playmates. Fourth-grade girls (N=209, M age=9.77 years, half African American, half European American) were identified as anxious solitary or behaviorally normative using observed and teacher-reported behavior among classmates. Subsequently, girls participated in 1-hr play groups containing 5 same-race familiar or unfamiliar girls for 5 consecutive days. Results support both cross-situational continuity and change in anxious solitary girls' behavior and peer relations. Although anxious solitary girls exhibited difficulty interacting with both familiar and unfamiliar playmates relative to behaviorally normative girls, elements of their behavior improved in unfamiliar play groups, a context in which they received less peer mistreatment.

Anxiety↗

Post-ingestive positive controls of ingestive behavior.

Post-ingestive negative controls of ingestive behavior are well characterized. Nutrients act in the gut to inhibit meal size by direct actions on feeding and by conditioning a satiation response to orosensory (flavor) stimuli. Accumulating evidence indicates that there are also post-ingestive positive controls of ingestion that operate by conditioning flavor preference and increased acceptance. In several experiments rats trained to consume a flavored solution paired with intragastric carbohydrate infusions significantly increased their solution intake. Drinking bout size and number, and lick rates and burst size were also increased by carbohydrate infusions. Whether intake is stimulated or inhibited by post-ingestive nutrient actions depends upon several factors, including most notably nutrient concentration. Post-ingestive positive controls need to be incorporated into theoretical models of ingestive behavior.

Animals↗

Behaviorism: part of the problem or part of the solution.

The form frequently taken by behavior-modification programs is analyzed in terms of the parent science, Behaviorism. Whereas Behaviorism assumes that behavior is the result of contingencies, and that lasting behavior change involves changing the contingencies that give rise to and support the behavior, most behavior-modification programs merely arrange special contingencies in a special environment to eliminate the "problem" behavior. Even when the problem behavior is as widespread as alcoholism and crime, behavior modifiers focus on "fixing" the alcoholic and the criminal, not on changing the societal contingencies that prevail outside the therapeutic environment and continue to produce alcoholics and criminals. The contingencies that shape this method of dealing with behavioral problems are also analyzed, and this analysis leads to a criticism of the current social structure as a behavior control system. Although applied behaviorists have frequently focused on fixing individuals, the science of Behaviorism provides the means to analyze the structures, the system, and the forms of societal control that produce the "problems".

Alcoholism↗

Domain-specific antecedents of parental psychological control and monitoring: the role of parenting beliefs and practices.

This research examined the effects of domain-differentiated beliefs about legitimate parental authority and ratings of restrictive parental control on adolescent- and mother-reported psychological and behavioral control. The influence of parenting beliefs and practices regarding socially regulated (moral and conventional) and ambiguously personal (multifaceted and personal) issues was examined in 93 middle-class African American early adolescents (M = 13.11 years, SD = 1.29) and their mothers, who were followed longitudinally for 2 years. Domain-specific parenting beliefs and ratings predicted adolescent-reported maternal psychological control and parental monitoring, but the nature and direction of the relations differed. Adolescents who rated parents as more restrictive in their control of personal issues and who believed that parents should have less legitimate authority over these issues rated their mothers as higher in psychological control. In contrast, more adolescent-reported parental monitoring was associated with gender (being female) and adolescents' beliefs that parents have more legitimate authority to regulate personal issues. As expected, adolescent age and gender influenced mother-reported monitoring and psychological control; in addition, the effects of mothers' ratings of restrictive control on both psychological control and monitoring were moderated by gender. The results indicate that psychological control and monitoring can be understood in terms of the particular behaviors that are controlled, as well as the style in which control is exercised.

Adolescent↗

The ethics of practice in adolescent psychiatry.

The author discusses ethical problems specific to practice with adolescents, a patient group which has special requirements in terms of their relations with authority figures and the kind and degree of external control they need. The psychiatrist who works with adolescents must be aware that his or her actions, attitudes, and personality can be crucial influences in the young person's development. Particular attention is needed in the areas of confidentiality, informed consent, and the impact of behavior control and other treatment techniques on adolescents.

Adolescent↗

Neural substrate for an integrated metabolic control of feeding behavior.

Evidence indicates that feeding behavior in rats is controlled by a mechanism that integrates information about different aspects of fuel metabolism. We investigated the neural substrate for this integrated control by measuring the effect of metabolic inhibitors given alone and in combination on food intake and neuronal activity as reflected by the expression of c-Fos protein. Combined administration of methyl palmoxirate (5 mg/kg po), an inhibitor of fatty acid oxidation, and 2,5-anhydro-D-mannitol (150 mg/kg ip), which decreases liver ATP content, increased feeding in rats more than expected on the basis of eating responses after treatment with either inhibitor given alone. Combined treatment also produced a synergistic increase in Fos-like immunoreactivity in several brain areas, including the nucleus of the solitary tract, area postrema, and parvocellular portion of the hypothalamic paraventricular nucleus. These findings provide strong evidence for the involvement of selected brain regions in the metabolic control of food intake and suggest that metabolic information used to control feeding behavior is integrated in the periphery or at the level of the brain stem.

Animals↗