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PubMed1989

Genetic correlations between morphology and antipredator behaviour in natural populations of the garter snake Thamnophis ordinoides.

The genetic coupling of morphology and behaviour means that the evolution of the two types of traits will not be independent: changes in behaviour will result in changes in morphology and vice versa. This might explain nonadaptive differences in morphology through indirect selection on correlated characters of other categories. Genetic correlations between morphology and behaviour are also the basis for some models of sympatric speciation and of the stability of polymorphisms. Morphology and behaviour are often correlated in nature and a genetic basis for such couplings has been demonstrated. I present here evidence that colour pattern and antipredator behaviour are genetically coupled in natural populations of the garter snake Thamnophis ordinoides. Similar phenotypic correlations between pattern and behaviour exist among species of North American snakes, indicating that selection for particular combinations of traits may help to maintain genetic covariances and colour polymorphism in Thamnophis ordinoides.

Animals↗

PubMed2006

Complex social behaviour derived from maternal reproductive traits.

A fundamental goal of sociobiology is to explain how complex social behaviour evolves, especially in social insects, the exemplars of social living. Although still the subject of much controversy, recent theoretical explanations have focused on the evolutionary origins of worker behaviour (assistance from daughters that remain in the nest and help their mother to reproduce) through expression of maternal care behaviour towards siblings. A key prediction of this evolutionary model is that traits involved in maternal care have been co-opted through heterochronous expression of maternal genes to result in sib-care, the hallmark of highly evolved social life in insects. A coupling of maternal behaviour to reproductive status evolved in solitary insects, and was a ready substrate for the evolution of worker-containing societies. Here we show that division of foraging labour among worker honey bees (Apis mellifera) is linked to the reproductive status of facultatively sterile females. We thereby identify the evolutionary origin of a widely expressed social-insect behavioural syndrome, and provide a direct demonstration of how variation in maternal reproductive traits gives rise to complex social behaviour in non-reproductive helpers.

Aging↗

PubMed2025

Exploring the genetics of social behaviour in C. calcarata.

Studies investigating social evolution often focus on species that are obligately eusocial, where presumably all of the adaptive genetic changes associated with sociality have already been completed. To fully understand eusociality, we must study species with facultative social behaviour. The small carpenter bee Ceratina calcarata is an ideal model for studying the genetics and molecular biology of eusocial evolution as it can exhibit both subsocial behaviour with parental care and social behaviour facilitated by the altruistic dwarf eldest daughter. Here, we sequenced the genomes of subsocial and social C. calcarata to identify mutations and genes associated with social behaviour and used these data to test several hypotheses related to the evolution of eusociality. Many single nucleotide polymorphisms that had high levels of genetic differentiation (Fst) between social and subsocial C. calcarata were in or near genes or regions important for regulating gene expression. These results are consistent with the Genetic Toolkit Hypothesis of eusocial evolution. Our findings suggest that the low behavioural complexity observed in C. calcarata may involve modulation of existing regulatory genes and gene networks to generate phenotypes associated with social behaviour.

Animals↗

PubMed2002

An investigation of paediatric dentists' attitudes towards parental accompaniment and behavioural management techniques in the UK.

OBJECTIVE: Good behavioural management techniques are essential for treating children. Recent research has investigated parental and paediatric attitudes towards various behavioural management techniques. However, in the UK, very little is known about paediatric attitudes towards such issues. Accordingly, the aim of this investigation was to conduct a survey in order to provide insight into the current thinking of paediatric dentists across the UK. STUDY DESIGN: A questionnaire was developed for this study on the basis of previous surveys investigating the attitudes of paediatric dentists towards the use of various behavioural management techniques in Australia and the USA. Areas covered in the questionnaire included: attitudes towards parental accompaniment; attitudes regarding parental expectations; and attitudes towards the use of various different child management techniques. The questionnaire was sent out to all registered members of the British Society of Paediatric Dentistry (n = 304). RESULTS: 245 responses (80.5%) were returned, of which 218 provided valid and useable information (72%). A majority of 80% of respondents supported parental accompaniment of the child during the course of treatment. Separate analysis of variance (ANOVA) procedures revealed significant differences between acceptability of parental accompaniment and the year in which dentists had qualified (P < 0.05). More recently qualified dentists were less accepting of parental accompaniment. Only a minority of dentists reported feeling pressured by parental expectations with regard to their child's treatment. However, an independent sample t-test revealed that male dentists experienced greater perceived conflict between dental and parental expectations, than female dentists (P < 0.05). In terms of specific behavioural management techniques, the most favoured was 'tell-show-do' with 87% of respondents citing this as their most commonly used method. Least acceptable were 'hand over mouth' techniques, followed closely by active restraint and papoose board. CONCLUSION: In general, paediatric dentists in the UK favoured less 'restraining' methods of behavioural management. There was widespread support for parental accompaniment in the dental operatory and a desire to work in participation with parents in order to facilitate the child's good behaviour and more effective dental treatment. Further studies comparing the effectiveness of various techniques used with regard to treatment time and clinical outcomes, are now required.

Adult↗

PubMed1999

Is dieting good for you?: Prevalence, duration and associated weight and behaviour changes for specific weight loss strategies over four years in US adults.

OBJECTIVES: This present study describes weight control strategies used by a heterogeneous sample of US adults and their associations with weight and behaviour change over time. DESIGN: A prospective cohort study. PARTICIPANTS: Participants for this study were 1120 US adults recruited from the community who enrolled in a three-year intervention study to examine methods for preventing age-related weight gain. MEASURES: Measured body weight and self-reported behaviours related to body weight (dieting practices, dietary intake and physical activity) were completed annually for four years. RESULTS: Over 70% reported using each of the following dieting strategies at least once in four years: increase exercise (82.2%); decrease fat intake (78.7%); reduce food amount (78.2%); and reduce calories (73.2%). Cumulative duration of use of these behaviours was brief (for example, even the most common behaviours were used only 20% of the time). Global reports of dieting were not predictive of weight change over time. However, a dose-response relationship was observed between reported duration of use of several specific weight loss strategies over the four years and change in behaviours and weight gain. CONCLUSIONS: These findings suggest that public health recommendations for weight control may need to place greater emphasis on persistence of weight control behaviours.

Adult↗

PubMed2000

Interventions to prevent weight gain: a systematic review of psychological models and behaviour change methods.

OBJECTIVE: To identify and review published interventions aimed at the prevention of weight gain. DESIGN: A systematic review of published interventions aimed at the prevention of weight gain. METHODS: Search strategies-we searched eight databases, manually checked reference lists and contacted authors. Inclusion and exclusion criteria-studies of any design, in which participants were selected regardless of weight or age, were included. Interventions targeting a specific subgroup, multifactorial interventions, interventions aimed at weight loss, and those with an ambiguous aim were excluded. Data extraction-data were extracted on behaviours targeted for change, psychological model, behaviour change methods and modes of delivery, methodological quality, characteristics of participants, and outcomes related to body weight and self-reported diet and physical activity. Classification and validation-a taxonomy of behaviour change programmes was developed and used for classification of underlying model, behaviour change methods, and modes of delivery. The data extraction and subsequent classification were independently validated. RESULTS: Eleven publications were included, describing five distinct interventions in schools and four in the wider community. Where diet and physical activity were described, positive effects were usually obtained, but all were measured by self-report. Effects on weight were mixed but follow-up was generally short. Smaller effects on weight gain were found among low-income participants, students and smokers. Many participants in the community-based studies were overweight or obese. Study dropout was higher among thinner and lower-income subjects. CONCLUSION: Interventions to prevent weight gain exhibited various degrees of effectiveness. Definite statements about the elements of the interventions that were associated with increased effect size cannot be made as only one of the five studies that involved an RCT design reported a significant effect on weight. This intervention involved a correspondence programme and a mix of behaviour change methods including goal setting, self-monitoring and contingencies. Future interventions might be more effective if they were explicitly based on methods of behaviour change that have been shown to work in other contexts. Effective interventions would be more easily replicated if they were explicitly described. Effectiveness might be more precisely demonstrated if more objective measures of physical activity and diet were used, and if the follow-up was over a longer period. International Journal of Obesity (2000) 24, 131-143

Behavior Therapy↗

PubMed2003

Short-term effects of sibutramine (Reductil) on appetite and eating behaviour and the long-term therapeutic outcome.

OBJECTIVE: To evaluate the short-term effects of sibutramine on appetite and eating behaviour and whether these effects are related to the long-term therapeutic outcome. STUDY DESIGN: Short-term: randomised, double-blind, placebo-controlled, within-subject design. Long-term: prospective open clinical trial. SUBJECTS: A total of 36 obese (nine men/27 women) with a body mass index of 39.3+/-4.3 (mean+/-s.d.) (range 30.2 - 45.2) kg/m(2) and age 44.4+/-12.1 y. PROCEDURE AND METHODS:: First phase-short-term effects: At baseline, the subjects were treated for 14 days with 15 mg sibutramine/placebo (period 1) followed by a 2 weeks single-blind placebo washout period, the subjects received the alternative therapy for another 14 days (period 2). At baseline, and at day 14 in each treatment period the subjects arrived fasting to the laboratory for a standardised breakfast and an ad libitum standardised lunch using the VIKTOR set-up (a universal eating monitor) to evaluate the microstructure of the eating behaviour (ie amount of food consumed and eating rate). Visual Analogue Scales were applied before and after the meals as well as every hour between the meals to monitor the appetite. During this first phase, subjects were encouraged to keep their habitual eating habits. Second phase-long-term effects: All subjects received 10 months open treatment with 15 mg sibutramine and dietary advice in monthly group sessions with a dietitian. On the last day of this treatment period, the subjects returned to repeat the measurements of appetite and eating behaviour using the same test procedure as during the first phase of the study. RESULTS: First phase: Sibutramine influenced appetite and eating behaviour that could be registered after only 14 days of treatment. The amount of food consumed at lunch on VIKTOR was reduced by 16% by sibutramine compared to placebo, 335+/-123 g vs 399+/-126 g (P<0.0001). Second phase: Responders and nonresponders were defined as those who ate less vs more food on VIKTOR when treated with sibutramine compared to the baseline food intake in the first phase of the study. The weight reduction was greater for responders 11.8+/-6.2 (mean+/-s.d.) kg compared to nonresponders 6.8+/-2.7 (mean+/-s.d.) kg (P<0.05). CONCLUSION: Short-term effects of sibutramine on appetite and eating behaviour were identified such as a reduction in food intake and in ratings of subjective motivation to eat. Short-term sibutramine effects on eating behaviour are to some extent related to the long-term therapeutic outcome in obese subjects.

Adult↗

PubMed2004

Behavioural correlates of successful weight reduction over 3 y. Results from the Lean Habits Study.

OBJECTIVE: To examine behavioural characteristics of subjects with successful long-term weight reduction. DESIGN: Prospective cohort study with 3 y follow-up. SETTING: Multicentre study of participants of a commercial weight-reduction programme (BCM-Programme). SUBJECTS: Until February 2000, 6857 voluntary study participants were included. Analyses are based on 1247 subjects with complete 3 y data. INTERVENTIONS: Open-group dietary and behavioural counselling with initial meal substitutions. RESULTS: Subjects show a number of significant behavioural improvements, for example, choice of low-fat food, flexible control of eating behaviour and coping with stress. Subjects who maintain these changes by the end of the first year have a higher probability of successful weight reduction after 3 y. CONCLUSIONS: Successful weight maintenance is associated with more pronounced improvements of health behaviours after 1 y. The likelihood of success increases with the number of behavioural patterns which are involved in the process of change.

Adaptation, Psychological↗

PubMed2004

The association between thinness and socio-economic disadvantage, health indicators, and adverse health behaviour: a study of 28 000 Finnish men and women.

OBJECTIVE: To examine how thinness is associated with indicators of socio-economic disadvantage, health-related behaviours, and health indicators including mortality. DESIGN: Independent risk factor surveys carried out in four geographic areas in Finland in 1982, 1987, 1992, and 1997, with mortality follow-up to the end of the year 2001. SUBJECTS: A total of 13 389 men and 14 770 women aged 25-64 y at baseline, and 2077 deaths during the follow-up when subjects who have died during the first 5 y were excluded. METHODS: A self-administrative questionnaire data on socio-economic status, health behaviour, and perceived health, together with measured height, weight, and metabolic indicators using standardised protocol. Mortality data by Statistics Finland were linked to the baseline surveys. RESULTS: Thin men (BMI</=20 kg/m(2)) were the socio-economically disadvantaged group engaged in adverse health behaviours. They also reported poorer perceived health despite having better metabolic indicators. Thin women reported more adverse behaviours than other women and had better metabolic profile than their obese counterparts. Thin subjects had higher mortality, but results become nonsignificant among men when first 5 y of follow-up were excluded, and nonsignificant among women when health behaviours were adjusted for. CONCLUSION: Thinness is associated with good metabolic profile but increased mortality, explained partly by underlying diseases or adverse behaviours. Thinness in men is associated with socio-economic disadvantage.

Adult↗

PubMed2002

Sexual differences in smoking behaviour and dental caries experience in young adults.

Smokers have been reported to exhibit a low awareness of their health. However, oral health awareness in smokers has not been fully studied. Having adequate oral care and high awareness of oral health from youth is necessary to prevent the deterioration of oral health in middle and old age. The aim of this study was to investigate the oral health status and oral health behaviour in young smokers. A survey composed of a questionnaire and an oral examination was administrated to adults aged 20-29 y who consulted dentists. The relationship between smoking behaviour and oral health status and oral health behaviour in subjects was analysed. In women, though no significant relationship between smoking behaviour and the number of decayed, missing, and filled teeth was seen, current smokers had significantly more decayed teeth, missing teeth and fewer filled teeth than ex-smokers and non-smokers. Current smokers tended to practice less oral health behaviour than non-smokers. In men, there was no significant relationship between smoking behaviour and each oral health status item. These findings suggested that the smoking group had lower oral health awareness than the non-smoking group in women.

Adult↗

PubMed2001

Associative effects of Pavlovian differential inhibition of behaviour.

The associative inhibitory control of behaviour is a major component of Pavlovian learning theory, but little is known about its functional neuroanatomy. The associative effects of differential inhibition of conditioned behaviour were investigated by mapping learning-related changes in brain activity of the rat with fluorodeoxyglucose autoradiography. Of interest was how a tone is processed in auditory and extra-auditory systems of the rat brain under similar behavioural, but different associative conditions. Conditioned emotional suppression to drink was used to assess training, and summation tests were used to verify that the tone became an inhibitor of conditioned behaviour. In the Inhibitor group, presentations of a tone stimulus alone were intermixed with presentations of a light stimulus followed by footshock. In the Pseudorandom group, the same numbers of tone, light and footshock presentations were used, but they were presented in a pseudorandom fashion. After training, fluorodeoxyglucose uptake was measured during tone presentations. Behavioural responding to the tone was similar during fluorodeoxyglucose uptake in the two groups, yet associative effects were found in brain activity. In the auditory system, the tone produced reduced fluorodeoxyglucose uptake in major relay nuclei (cochlear nucleus and inferior colliculus) in the Inhibitor group relative to the Pseudorandom group. The tone inhibitor produced similar decreases in the septohippocampal system and the retrosplenial cortex. In contrast, the tone inhibitor produced activity increases in somatosensory and reticulocerebellar systems. The findings provide the first detailed map of neural regions involved in the learned associations controlling differential inhibition of conditioned behaviour.

Acoustic Stimulation↗

PubMed1995

HIV risk-taking behaviour among injecting drug users currently, previously and never enrolled in methadone treatment.

This study compares the injecting and sexual risk-taking behaviour among injecting drug users (IDUs) currently, previously and never enrolled in methadone maintenance treatment (MMT). All subjects had injected during the 6 months prior to the day of interview. The current MMT group showed significantly lower injecting risk-taking behaviour subscale scores on the HIV Risk-taking Behaviour Scale (HRBS) of the Opiate Treatment Index than the previous MMT and non-MMT groups together. The current MMT group differed from the other two groups in the frequency of injecting and cleaning of injection equipment with bleach. There was no difference between the current MMT group and the other two groups combined in sexual risk-taking behaviour scores on the HRBS. There were no differences between the previous MMT and non-MMT groups in injecting and sexual risk-taking behaviour. HIV seroprevalence was low and there was no difference in seroprevalence between groups. Thus, IDUs currently enrolled in MMT are at reduced risk for HIV infection when compared with IDUs who have previously or never been enrolled in MMT. However, the absence of a difference between the current MMT and other two groups in frequency of sharing behaviours suggests the need for additional strategies among MMT clients to reduce needle-sharing. Possible strategies include the application of relapse prevention interventions and the availability of sterile injecting equipment in MMT clinics. Further research is needed to identify factors which increase attraction and retention of IDUs to MMT.

Acquired Immunodeficiency Syndrome↗

PubMed1996

Evaluation of a cognitive-behavioural intervention for pregnant injecting drug users at risk of HIV infection.

Pregnant injecting drug users were randomly assigned to: (i) individually receive a six-session cognitive-behavioural intervention in addition to their usual methadone maintenance treatment (intervention condition (I) (n = 40)); or (ii) their usual methadone maintenance treatment only (control condition (C) (n = 40)). There was no change in drug use per se in either group after the intervention. However, at 9-month follow-up the I group had significantly reduced some HIV risk-taking behaviours (in particular injecting risk behaviours). The I group reduced the needle risk associated both with "typical" use (drug use in the month before interview) and "binge" use (drug use in the month nominated as the heaviest month of drug use in the previous 6 months). The intervention had no effect on sexual risk behaviours. The finding of reduced injecting risk behaviour following the six-session intervention suggests that such an intervention may be of benefit for individuals persisting with injecting risk behaviours despite methadone maintenance treatment and the availability of sterile injection equipment.

Adult↗

PubMed1998

Patterns of sexual and injecting risk behaviours in French intravenous drug users not reporting HIV and hepatitis C virus seropositivities.

AIMS: To characterize and identify determinants of risk behaviour patterns of intravenous drug users (IDUs) independently of changes due to knowledge of HIV or hepatitis C Virus (HCV) seropositivity. DESIGN: A cross-sectional survey using a structured questionnaire concerning sexual, injecting and HIV and HCV antibody testing practices. SETTING: IDUs were interviewed in the Paris region at 10 treatment or psychosocial centres. PARTICIPANTS: Six hundred and twelve consecutive sexually active IDUs over 18 years able to answer the questionnaire. MEASUREMENTS: Five hundred and ninety-five IDUs completed the questionnaire. The risk-behaviour patterns of the 328 IDUs not reporting HIV or HCV seropositivity were analysed by phi correlation. Risk factors for each risk behaviour were determined by regression logistic models yielding odds ratios (OR) and their 95% confidence intervals (95% CI). FINDINGS: Several risk behaviour patterns were suggested: (1) lending, borrowing; (2) not or inconsistently testing HIV and HCV serology and not or inconsistently using condoms; (3) having multiple partners and prostitution; and (4) not using clean equipment. Alcohol abuse was independently and specifically associated with lending (OR = 3.8; 95% CI: 2.1-7.0) and borrowing (OR = 3.3; 95% CI: 1.8-6.1); homelessness with injecting risk behaviours and with prostitution (OR = 2.7; 95% CI: 1.2-6.1); low educational level and having children with not or inconsistently using condom and serology testing; and cocaine use with not or inconsistently using condoms (OR = 0.4; 95% CI: 0.3-0.7) and serology testing and not using clean equipment (OR = 0.4; 95% CI: 0.2-0.8). Having multiple partners and prostitution had no common risk factors. CONCLUSIONS: Identifying specific risk factors could help to target drug harm reduction programmes for each risk behaviour pattern among IDUs not reporting HIV and HCV seropositivity.

Adult↗

PubMed1999

Young, wet & wild? Associations between alcohol intoxication and violent behaviour in adolescence.

AIMS: To assess gender- and age-specific associations between alcohol intoxication and engagement in violent behaviours in young people. DESIGN, PARTICIPANTS AND MEASUREMENT: Cross-sectional study comprising a national sample of 12,000 Norwegian adolescents aged 12-20 years. Data on violent behaviour, alcohol intoxication and various confounders were obtained by self-administered questionnaires in school. FINDINGS: 2.8% had been in fight with a weapon and 32.6% had been beating or threatening to beat someone during the past year. Violent behaviours were more often reported among boys, in the younger age groups, with increasing frequency of alcohol intoxication, among users of other drugs, among those engaged in criminal activities and among those in wet environments (friends drinking regularly and parents often being intoxicated). The impact of intoxication frequency on number of times engaged in violent behaviours was of modest magnitude. It was greater in the youngest age group compared to those in the middle and late teens and greater for boys than for girls. However, when criminal activities were controlled for, the adjusted effect of intoxication on violent behaviour was significantly reduced, the effect was then of the same magnitude for both genders, whereas there was no longer any significant effect in the youngest age group. Controlling also for parents' and friends' drinking and parental monitoring did not alter these findings. CONCLUSIONS: A small direct effect of alcohol intoxication on violent behaviour appears to remain after controlling for various relevant confounders in middle and late teens. However, possible indirect effects of alcohol intoxication, mediated by own deviant life-style and wetness of environment, should also be taken into consideration.

Adolescent↗

PubMed2003

Services for pre-school children with behaviour problems in a Midlands city.

OBJECTIVES: To study the services for pre-school children with behaviour problems in a Midlands city and the level of co-ordination and co-operation between providers. SETTING: A socially and ethnically diverse Midlands city in the UK. METHODS: Survey methods were employed with city health visitors in order to determine their role and identify service providers. Service providers from different agencies were interviewed and data collected related to service offered, materials used, theoretical basis of interventions, referrals to and from the service, inclusion and exclusion criteria and co-ordination and co-operation with other providers. Themes were identified related to the content and process of the services using qualitative data analysis methods. Frequencies of themes were estimated for different provider groups. RESULTS: Health visitors and nursery nurses working in the primary care services were the primary point of contact for children with pre-school behaviour problems. Nursery nurses were one of the major sources of referral for children with pre-school behaviour problems and a significant majority of these providers had not received any specific training for this role. The majority of the providers used evidence-based programmes but few adhered strictly to a particular programme and instead used a mixture of materials drawn from different programmes. Many health service providers in particular offered interventions to parents on a one-to-one basis only. Most providers used behaviour modification approaches. While many providers claimed to have knowledge of other local providers and have good links, there was little evidence of co-ordination within and between agencies. CONCLUSIONS: While there appears to be high levels of activity by providers from both statutory and voluntary sectors in providing services for pre-school children with behaviour problems, there is evidence to suggest that some of the main providers of services are not being adequately prepared and supported in the role. There is a lack of co-ordination within and between services, and indication that evidence-based programmes are being modified and used in an ad hoc manner. It is concluded that surveys of this nature may be an important preliminary step in establishing co-ordinated services for the primary and secondary prevention of pre-school behaviour problems.

Attitude to Health↗

PubMed2000

Path analysis of efficacy expectations and exercise behaviour in older adults.

The benefits of regular exercise for older adults are well documented and include improvements in physical, functional, as well as psychological, health. The purpose of this descriptive study was to test a theoretically and empirically based model describing the factors that influence exercise behaviour of older adults in the United States of America. The hypothesized model suggested that age, gender, and mental and physical health have an effect on self-efficacy and outcome expectations, and that all these variables influence exercise behaviour. Exercise behaviour was hypothesized to have a reciprocal relationship with self-efficacy expectations and mental and physical health. The convenience sample was 187 older adults living in a continuing care retirement community (CCRC) in Baltimore, Maryland. A one-time health interview was conducted which included a measure of self-efficacy and outcome expectations related to exercise, a measure of health status (SF-12), and gathering of information from participants about their actual exercise behaviour. Of the 187, 71 (38%) reported participating in 20 minutes of continuous aerobic exercise at least three times per week over the previous 3 months. Six hypothesized paths were significant. The model fitted the data and accounted for 32% of the variance in exercise behaviour. Interventions that focus on strengthening self-efficacy and outcome expectations can improve exercise behaviour in older adults.

Aged↗

PubMed2000

British nurses in behavioural psychotherapy: a 25-year follow-up.

BACKGROUND: The National Service Framework for Mental Health has emphasized the need to prioritize the provision of cognitive behaviour therapy as the central evidence-based non-pharmacological intervention for mental health problems. For 25 years one programme (English National Board Course No. 650--Diploma in Behavioural Cognitive Therapy, formerly called Nursing in Behavioural Psychotherapy) has trained nurses in such methods. This is the only programme in nursing which qualifies graduates to be fully certified as a cognitive behaviour therapist by the British Association of Behavioural Psychotherapy and by the United Kingdom Council for Psychotherapy. The practice of these nurse therapists (most commonly known as nurse behaviour therapists, NBTs) is the most rigorously evaluated in mental health nursing, with several randomized controlled trials to testify to clinical and economic efficacy. AIM: The aim of this study is to continue the systematic follow-up of all NBT graduates previously undertaken in two earlier surveys published in 1986 and 1994. These previous surveys examined clinical practice, organizational context and career and professional development issues. This up-to-date picture of NBTs will provide useful baselines for the implementation of the National Service Framework, and may be used by the Department of Health, education providers and services. METHOD: A postal survey (using the same template for categories of information as the two earlier surveys) was used and questionnaires were sent to 237 of the 274 trained NBTs whose name appears on the Central NBT Register, maintained at the Institute of Psychiatry/Maudsley Training Centre. RESULTS: One hundred and five of 230 eligible respondents (45.6%) returned questionnaires and additional data were obtained from 27 NBTs who provided information to the Register in the year before the survey. Thus, some data were available for 57% of the sample. As in earlier surveys, it was found that the majority of therapists remain in clinical practice, undertake substantial further education and training and are involved in research and teaching as part of their overall role. The two central developments are an increasing move towards working in primary care and an increased emphasis on cognitive interventions. NBTs complete a substantial number of treatments per year and increasingly treat clients with difficulties not encountered during their basic training. NBTs now receive much more supervision than in previous surveys and continue to use valid and reliable measures of change in practice. However, the number of NBTs remains small and the impact on potential populations who would benefit from effective psychological interventions is minimal. This paper discusses the implications for service delivery.

Behavior Therapy↗