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Dating violence against adolescent girls and associated substance use, unhealthy weight control, sexual risk behavior, pregnancy, and suicidality.

CONTEXT: Intimate partner violence against women is a major public health concern. Research among adults has shown that younger age is a consistent risk factor for experiencing and perpetrating intimate partner violence. However, no representative epidemiologic studies of lifetime prevalence of dating violence among adolescents have been conducted. OBJECTIVE: To assess lifetime prevalence of physical and sexual violence from dating partners among adolescent girls and associations of these forms of violence with specific health risks. DESIGN, SETTING, AND PARTICIPANTS: Female 9th through 12th-grade students who participated in the 1997 and 1999 Massachusetts Youth Risk Behavior Surveys (n = 1977 and 2186, respectively). MAIN OUTCOME MEASURES: Lifetime prevalence rates of physical and sexual dating violence and whether such violence is independently associated with substance use, unhealthy weight control, sexual risk behavior, pregnancy, and suicidality. RESULTS: Approximately 1 in 5 female students (20.2% in 1997 and 18.0% in 1999) reported being physically and/or sexually abused by a dating partner. After controlling for the effects of potentially confounding demographics and risk behaviors, data from both surveys indicate that physical and sexual dating violence against adolescent girls is associated with increased risk of substance use (eg, cocaine use for 1997, odds ratio [OR], 4.7; 95% confidence interval [CI], 2.3-9.6; for 1999, OR, 3.4; 95% CI, 1.7-6.7), unhealthy weight control behaviors (eg, use of laxatives and/or vomiting [for 1997, OR, 3.2; 95% CI, 1.8-5.5; for 1999, OR, 3.7; 95% CI, 2.2-6.5]), sexual risk behaviors (eg, first intercourse before age 15 years [for 1997, OR, 8.2; 95% CI, 5.1-13.4; for 1999, OR, 2.4; 95% CI, 1.4-4.2]), pregnancy (for 1997, OR, 6.3; 95% CI, 3.4-11.7; for 1999, OR, 3.9; 95% CI, 1.9-7.8), and suicidality (eg, attempted suicide [for 1997, OR, 7.6; 95% CI, 4.7-12.3; for 1999, OR, 8.6; 95% CI, 5.2-14.4]). CONCLUSION: Dating violence is extremely prevalent among this population, and adolescent girls who report a history of experiencing dating violence are more likely to exhibit other serious health risk behaviors.

Adolescent↗

Benzodiazepine-GABAA receptor complex ligands in two models of anxiety.

In the present study, the actions of several compounds with different intrinsic activities and BDZ receptor selectivity were examined in two well established animal models of anxiety: the open field test (OFT) and Vogel's punished drinking text (VT). Full agonists at the BDZ GABAA receptor (midazolam and diazepam) showed anxiolytic-like effects in both tests; however, the doses necessary to disinhibit animal behavior controlled by fear were higher in the VT than in the OFT. None of the partial BDZ receptor agonists studied (bretazenil, Ro 19-8022 and abecarnil) diminished neophobia-like behavior of rats in the OFT, and their sedative influence on gross behavior prevailed. On the other hand, all three drugs produced a clear-cut anxiolytic effect in the VT. A selective BDZ, receptor subtype full agonist (zolpidem) had a similar profile of action to that of partial agonists with an even stronger sedative effect in the OFT. Alpidem (a selective BDZ1 receptor partial agonist) did not reveal any anxiolytic action in either test. Flumazenil (an antagonist at the BDZ-GABAA receptors) also produced no effect in the OFT, or the VT. An inverse BDZ receptor agonist, beta-carboline-3-carboxylate methyl ester (beta-CCM), evoked an anxiogenic-like response in the OFT, but not in the VT. In summary, it appeared that partial agonists and selective ligands at BDZ1 receptors revealed less advantageous anxiolytic-like action than did full allosteric GABAA receptor modulators. This study also indicates the test dependent profiles of action of BDZ-GABAA receptor ligands. It also indirectly suggests a different neurobiological background underlying the applied tests.

Analysis of Variance↗

Self-perception of weight appropriateness in the United States.

UNLABELLED: BACKGROUND; The self-perception of weight appropriateness is an important component of eating and weight-loss behaviors. Self-perceived weight status, however, is not fully explained by objective weight status. OBJECTIVE: To examine the influence of sociodemographic factors on Americans' perceptions of their weight appropriateness, controlling for objective weight status. DESIGN: In the Third National Health and Nutrition Examination Survey, respondents were asked, "Do you consider yourself now to be overweight, underweight, or about the right weight?" Responses to this question were compared with how respondents (n=15,593) would be classified by medical standards given their body mass index (BMI). A proportional odds logistic regression model was used to assess the predictive effects of various sociodemographic factors on weight self-perception. RESULTS: Overall, 27.5% of women and 29.8% of men misclassified their own weight status by medical standards. Of particular note, 38.3% of normal weight women thought they were "overweight," while 32.8% of overweight men thought they were "about the right weight" or "underweight." Multivariate regression analysis revealed that, controlling for BMI, numerous factors-including gender, age, marital status, race, income, and education-were independently associated with the self-evaluation of weight status. CONCLUSIONS: The self-perceived appropriateness of weight status varies in highly predictable ways among population-level subgroups, likely reflecting differences in the normative evaluation of bodily weight standards. Such evaluations may assist in the explanation of discrepancies between clinical recommendations based on weight status and actual weight control behaviors, discrepancies that are socially patterned along some of the same subgroupings.

Adult↗

Gender differences in drinking restraint.

OBJECTIVE: This study examines the factor structure and the predictive power of drinking restraint for men and women as measured by the Temptation and Restraint Inventory (TRI). The TRI assesses two factors: Cognitive-Emotional Preoccupation (CEP) and Cognitive-Behavioral Control (CBC). METHOD: A group of 418 drinkers was drawn from a university sample and divided by gender into two groups. Men (n = 122) were of a mean age (+/-SD) of 23 +/- 7 years; women (n = 296) were of a mean age of 22.5 +/- 8 years. Subjects completed the TRI and the Alcohol Dependence Scale (ADS) and validated quantity and frequency of drinking indices. RESULTS: Drinking restraint for the men was found to better predict alcohol dependence, quantity of drinking and frequency of drinking. Moreover, two factors confirming the TRI's CEP and CBC model were extracted for the men, but only one factor was extracted for the women. CONCLUSIONS: It was proposed that, as men tend to drink greater amounts of alcohol more often, they have learned to distinguish more clearly the conflicts in their personal control over drinking. If the TRI is to be used as a diagnostic and treatment tool, it is recommended that clinicians be cognizant of possible gender differences in restrained drinking behavior.

Adolescent↗

The unauthorized biography of pharmacologic behavior management.

Behavior management in pediatric dentistry is taught as a clinical science and few dentists learn the historical basis of the techniques in use today. The use of sedative medications to control behavior, though popular, has only a limited scientific basis. The drugs, regimens and methods of administration used today often have curious and anecdotal origins. Today's practice climate demands that the dentist using sedative medications be aware of their risks and benefits, but also the often limited scientific rationale for their use. A generation of research provides insight into the evolution of today's practice of pharmacologic behavior management.

Child↗

Functional neurotoxicity of drugs of abuse.

The epidemic growth of the use of controlled substances has brought their toxic effects to clinical attention. Several drugs of abuse are known to induce nerve cell toxicity after acute and chronic administration. In addition, it has been suggested that the three main classes of abused substances, namely psychostimulants, ethanol and opiates, also induce changes in the function of discrete neural pathways. These alterations may eventually be responsible for the loss of behavioral control often observed during the natural history of the addiction process. Therefore, biochemical and behavioral toxicity deserve equal attention. A complex neural network within the forebrain limbic system which has been characterized over the past few years seems to mediate drug-seeking behavior and maintain drug self-administration in rodents. A striking similarity has been observed between this circuit and the neural substrates of motivated behavior. This review focuses on the possibility that drugs of abuse may acquire significance as reinforcers by usurping the physiological role of this circuit which normally operates to ensure survival of the individual. This may represent a subtle mechanism through which drugs of abuse may induce behavioral toxicity even in the absence of nerve cell loss.

Animals↗

Cardiac changes during behavioral stress in dogs.

Alterations in heart rate (HR), left ventricular systolic pressure (LVP), and maximum rate of left ventricular pressure development (LV dP/dtmax) during a Sidman avoidance task were studied in eight chronically prepared dogs. Four of these animals comprised a nonstressed control group. In the experimental group, in addition to phasic increases in HR, LVP, and LV dP/dtmax during the avoidance period of each day, tonic increases in these measures were also observed over the 13 days of the experiment. Left ventricular systolic pressure was found to be least sensitive to the stress procedure inasmuch as the phasic changes were no longer present after the 10th day and tonic levels were within base-line values by the 13th day. When alterations in cardiac activity were observed in the nonstressed animals, there were decreases in function. It was concluded that controlled behavioral stress produces increased cardiac performance without increased bodily activity. It was also hypothesized that preavoidance increases in heart rate in experimental animals were the result of vagal influences on the heart, whereas avoidance increases in HR, LV dP/dtmax, and LVP were functions of increased beta-sympathetic activity on the heart and adaptive peripheral vascular changes.

Animals↗

Evaluation of a Health Promoting Schools program to reduce smoking in Australian secondary schools.

This randomized controlled trial evaluated the effectiveness of a multicomponent Health Promoting Schools (HPS) intervention program in improving self-reported smoking outcomes among a cohort of adolescents in 22 public secondary schools in the Hunter Region of New South Wales, Australia. Pre-test surveys were completed by students in the first 2 years of secondary school, with a 2-year post-test survey. Multivariate analyses examined intervention effect for the main outcome, post-test smoking behavior, controlling for pre-test smoking status, school and other confounders. The sample comprised the cohort of 1852 students who completed both surveys. The results demonstrated that the HPS program failed to improve smoking behavior over the 2 years (equal increase of 10% in both groups). The program was successful in improving smoking knowledge, but not attitudes, in intervention versus control group (P < 0.001). Independent predictors of post-test smoking included: pre-test smoking [odds ratio (OR) = 5.44; 95% confidence interval (CI) = 3.20-9.28], being female (OR = 0.55; CI = 0.35-0.87), having more close friends who smoked (OR = 1.42; CI = 1.33-1.52), peer group having no clear opinion about smoking (OR = 3.23; CI = 1.27-8.27), having more positive and less negative attitudes towards smoking, and being less involved in school activities. We discuss methodological issues in multicomponent community-based interventions, and highlight the strengths and limitations of this study.

Adolescent↗

Neocortical representational dynamics in adult primates: implications for neuropsychology.

Some evidence for functional reorganization of cortical somatosensory representations in adult primates is reviewed. These examples include representation remodeling in cortical area 3b following digit amputation, digit fusion, local intracortical microstimulation, restricted cortical lesions, or as a consequence of behaviorally controlled stimulation of restricted hand surfaces. We suggest that the profound changes in the cortical representations that have been observed after these and other manipulations must bear consequences for the specific behaviors that depend on the operation of this neural machinery. Furthermore, this lifelong dynamic cortical capacity for neuronal response adaptation by use almost certainly also underlies the progressive representational remodeling that we have recorded following brain lesions.

Afferent Pathways↗

Nucleus tractus solitarius lesions block the behavioral actions of cholecystokinin.

Cholecystokinin (CCK) has been implicated as a signal for the syndrome of satiety in a variety of species. Several lines of evidence point to a peripheral site of action for the behavioral effects of CCK. Peripheral CCK receptors appear to activate a gut-brain pathway involving the sensory fibers of the vagus nerve. To investigate the central anatomical substrate of this visceral-behavioral control system, the terminal regions of the sensory tract of the vagus were lesioned. Radiofrequency lesions of the nucleus tractus solitarius abolished the effects of acute doses of CCK on exploratory behaviors. Sham lesions had no effect on baseline exploratory behaviors and did not influence the ability of CCK to decrease spontaneous exploratory behaviors. These findings delineate the first central site along the ascending sensory pathway which appears to mediate the satiety-related behavioral effects of CCK.

Animals↗

Functional anatomy of top-down visuospatial processing in the human brain: evidence from rTMS.

The hypothesis was tested that visuospatial mental imagery relies on processing in the posterior parietal lobe. Using repetitive transcranial magnetic stimulation (rTMS) in a cross-over, sham-controlled design, we compared involvement of right posterior parietal cortex with primary visual cortex. Subjects received rTMS over the parietal and occipital cortices during 20 min, after which they performed a behaviorally controlled visuospatial mental imagery task. Performance deteriorated significantly after rTMS over the parietal, but not occipital, cortex. These data support a causal link between parietal activation and top-down spatial processing.

Adult↗

An analysis of interpersonal manipulation.

The term 'manipulation' is frequently employed but rarely discussed or defined in psychiatric circles. This paper reviews previous conceptual analyses of the term by philosophers and psychiatrists, and examines its use in ordinary discourse. A series of characteristics which comprise the conceptual core of the term when it is unambiguously applied in interpersonal settings are proposed. Manipulation is contrasted with other behavior control methods such as rational persuasion and coercion, with emphasis on the role played by deception and the communicative context in which the manipulative transaction occurs. It is argued that manipulative behavior is fundamentally intentional, and the usefulness of the concept of 'unconscious manipulation' is questioned. Though the proposal that Manipulative Personality Disorder be formally recognized as a new diagnostic category is rejected, it is urged that the concept of manipulation receive wider attention and discussion within the mental health community.

Attitude of Health Personnel↗

Preoptic-hypothalamic periventricular lesions: thirst deficits and hypernatremia.

To assess the significance of stimulation studies suggesting an anteroventral third ventricle (AV3V) dipsogenic site of action for hyperosmotic and angiotensin thirst stimuli, electrolytic lesions of periventricular tissue surrounding AV3V were produced under ether anesthesia in rats preselected for responsiveness to subcutaneous angiotensin and hypertonic NaCl thirst challenges. Lesions limited to preoptic-anterior hypothalamic periventricular substrates resulted in adipsia; those rats resuming ad lib. drinking after a period of adipsia exhibited persistent drinking deficits to angiotensin and hypertonic NaCl thirst challenges, reduced drinking after water deprivation, and increased plasma osmolality and sodium. Drinking to polyethylene glycol-induced hypovolemia and feeding after food deprivation did not differ between lesioned and sham-lesioned animals. The disturbances in behavioral control of fluid balance imply that AV3V periventricular tissue normally plays a key role in mediating regulatory drinking. It is proposed that these AV3V periventricular lesion-induced effects on drinking behavior are due to destruction of receptors and/or integrative systems monitoring fluid-borne angiotensin and hyperosmotic stimuli.

Angiotensin II↗

Sexually dimorphic behavioral and brain asymmetries in neonatal rats: effects of prenatal alcohol exposure.

Behavioral and neuroanatomical asymmetries were assessed in 3-day-old male and female rat pups chosen from litters whose dams had received one of 3 prenatal treatments: 35% ethanol-derived calories, pair-fed control, or lab chow control. Behavioral laterality was assessed by observing the preferred tail bias on postnatal (PN) day 1. On PN day 3, brains were sectioned and morphometric analyses conducted for total brain volume, left and right neocortical volumes, and left and right hippocampal volumes. Prenatal alcohol exposure altered the population proportions of left, right and neutral tail biases in male pups on PN day 1. Female pups were affected by both prenatal alcohol exposure and maternal undernutrition/stress of pair-feeding. Prenatal alcohol exposure decreased body weight and total brain volume, but increased the brain volume/body weight ratio compared to both control groups. Prenatal alcohol exposure also reduced the volumes of the hippocampus and neocortex, with the greatest proportional reduction found in the volume of the anterior neocortex. A left-right anterior neocortical asymmetry was observed, with tail bias, prenatal treatment and sex all significant factors. Alcohol-exposed males showed a 'feminized' asymmetry. These results demonstrate that a sexually dimorphic cerebral asymmetry can be detected at birth in rats; this asymmetry appears to be related to a postural position bias. The reversal of normal interhemispheric relations by prenatal alcohol exposure in male offspring suggested that the in utero hormonal milieu modulates the development of cerebral lateralization.

Animals↗

Serotonin and dopamine in the parabrachial nucleus of rats during conditioned taste aversion learning.

A microdialysis technique was used to monitor changes in serotonin (5-HT), 5-hydroxyindole acetic acid (5-HIAA) and dopamine (DA) in the extracellular space of the parabrachial nucleus (PBN) of rats to estimate the contribution of these neurotransmitter systems to the acquisition of conditioned taste aversion (CTA). A significant (280%) enhancement of 5-HT was found immediately after saccharin drinking (CS). I.p. injection of unconditioned stimulus LiCl alone (after water drinking) also increased level of 5-HT (200%). However, when saccharin intake was followed by injection of LiCl (CS-US pairing), no change in 5-HT was observed. 5-HIAA and DA were unaffected by any of the above treatments. Thus in spite of elevation of 5-HT in PBN following saccharin consumption alone (CS) or LiCl administration alone (US) no changes in 5-HT occurred after pairing of both stimuli (CS-US). Our work demonstrates that participation of 5-HT in acquisition of CTA appears to be unlikely, and also DA appears not to be engaged in this acquisition at all. At the level of the PBN 5-HT participates mainly in CS and/or US stimuli processing, where this phenomenon has close relationship to other important physiological mechanisms, involved in behavioral control. Such as anxiety, alimentation intake.

Animals↗

Successful operant conditioning procedures with an institutionalized aggressive geriatric patient.

The present investigation utilized a modified differential reinforcement of other behaviors (DRO) schedule with an exclusionary time-out procedure to treat a sixty-nine year-old aggressive male. Dependent measures included confirmed incidents of physical and verbal aggressive behavior monitored across an ABAB design with a four month follow-up. During the experimental conditions, contingent tangible reinforcers were provided for non-aggressive behavior. Such rewards were progressively diminished over the course of treatment utilizing a systematic fading scheme. Results indicated a clear demonstration of behavioral control and clinically significant treatment effects during both experimental periods. Implications for future research are discussed.

Aged↗

The effects of prenatal morphine on the responsiveness to morphine and amphetamine.

The effects of morphine administered to pregnant Sprague-Dawley rats on the schedule-controlled behavior of the offspring were examined. It was observed that both male and female adult rats exposed prenatally to morphine were tolerant to the disruptive effects of morphine on fixed-interval responding compared to age-matched controls. These morphine-treated rats, however, were neither tolerant nor supersensitive to the disruptive effects of the catecholaminergic agonist, amphetamine, and did not exhibit any alteration in their steady state levels of central monoamines. These observations are discussed in relation to the effects of prenatal morphine exposure on unconditioned behaviors.

Amphetamine↗

Alcohol dependence and gene x environment interaction in emotion regulation: Is serotonin the link?

Alcohol dependence is characterized by frequent, compulsive and uncontrolled consumption of alcohol associated with behavior of maladaption and destruction. It is an etiologically and clinically heterogeneous syndrome, moderately to highly heritable, and caused by interaction of genes and environment. Alcohol dependence is related to other psychiatric diseases by common neurobiological pathways, including those that modulate reward, behavioral control as well as anxiety and stress response. Alcohol induces adaptive changes in brain function providing the basis for tolerance, craving, withdrawal, and emotional disturbance. The differentiation of psychobiological traits of addictive behavior reflecting neurobiological processes is therefore of particular importance for the dissection of the complex genetic susceptibility to alcohol dependence. A central serotonin (5-HT) deficit is thought to be involved in the pathogenesis of alcohol dependence by modulating motivational behavior, neuroadaptive processes, and resulting emotional disturbance. 5-HT-related impulsive, aggressive, and suicidal behavior has been linked to a primordial personality that is susceptible to alcohol dependence. Although variations in many of the genes that encode receptors, enzymes, and transporters of the 5-HT system have been tested as risk factors for alcohol dependence, genetic analyses of 5-HT signaling in alcohol dependence have mainly been focused on the 5-HT transporter (5-HTT) gene. Due to its central role in the fine-tuning serotonergic neurotransmission, a regulatory variant of the 5-HTT, which is associated with anxiety related traits, is not only a key player in the neurobiological mechanism of gene x environment interaction in the etiology of depression, but also contributes to the risk to develop alcohol dependence with antisocial behavior and suicidality. Evidence for a modulatory effect of allelic variation of 5-HTT function on limbic circuit responses to emotional stimuli suggests that genotype-endophenotype correlations may be accessible to molecular functional imaging of the brain. These new developments have broad implications for our understanding how genetic vulnerability to alcohol dependence is manifested in the brain's response to emotional stimuli.

Alcoholism↗