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PubMed2005

Cognitive-behaviour therapy for schizophrenia: a review.

PURPOSE OF REVIEW: Most studies demonstrating the benefits of cognitive-behaviour therapy for schizophrenia were carried out in the 1990s. The majority targeted treatment resistant positive symptoms. Recent research is now focussing on the impact of cognitive-behaviour therapy on prodromal states, acute schizophrenia, negative symptoms, loss of insight and relapse prevention. RECENT FINDINGS: There is mounting evidence to suggest that cognitive-behaviour therapy is an effective adjunct to antipsychotic medication in the management of positive symptoms of acute schizophrenia as well as negative and residual symptoms of chronic schizophrenia. The effect size at the end of therapy is strong, with durability at short-term follow up. There is also evidence that cognitive-behaviour therapy can be combined with family therapy and assertive community treatment programs targeted to reduce relapse. Cognitive-behaviour therapy improves the prognosis of patients with schizophrenia through improved adherence and symptom management leading to reduced relapse. It may prevent transition to psychosis in high-risk prodromal states. SUMMARY: In conclusion, recent literature provides fairly strong evidence that cognitive-behaviour therapy in addition to antipsychotic medication is effective in the management of acute as well as chronic schizophrenia, However, despite its proven efficacy, it remains a rare commodity, especially outside the United Kingdom.

Journal Article↗
PubMed1991

The reliability and validity of a scale to measure HIV risk-taking behaviour among intravenous drug users.

The initiation and maintenance of substantial behaviour change is required to reduce the spread of HIV infection among the intravenous drug-using population. In order to ascertain the efficacy of interventions aimed at reducing HIV-related risk-taking behaviour among this population, valid and reliable (yet preferably short) instruments for measuring such behaviour are required. The HIV risk-taking behaviour scale (HRBS) is a brief 11-item interviewer-administered scale which examines the behaviour of intravenous drug users in relation to both injecting and sexual behaviour. This paper describes the construction of the scale, in addition to data evaluating its reliability and validity. Initial analyses indicate that the scale has satisfactory psychometric properties.

Adolescent↗
PubMed1994

Knowledge, attitudes and behaviour among HIV-positive and HIV-negative clients of a confidential HIV counselling and testing centre in Thailand.

OBJECTIVE: To describe the clients, operation and impact of an Asian public HIV counselling and testing centre. DESIGN AND SETTING: Analysis of samples from clients attending the Thai Red Cross Anonymous Clinic (TRC-AC) in Bangkok, Thailand in 1993. SUBJECTS: HIV-positive and HIV-negative consecutive clients (250 of each). MAIN OUTCOME MEASURES: HIV seroprevalence rates, knowledge, attitudes and behaviour. RESULTS: Overall HIV-1 prevalence was 16%; 13% in men and 24% in women. Reasons for requesting an HIV test were high-risk behaviour (21%), feeling unwell (20%), checking a previous HIV test result (18%), a planned marriage or new relationship (10%), and planning a baby (5%). Heterosexual risk behaviour was reported by 85% of clients, while in each case only 1% reported male homosexual or intravenous drug use risk behaviour. Factors associated with HIV infection on univariate analysis included a history of sexually transmitted disease, not using condoms, a low level of education and salary, and being female. Knowledge about HIV transmission risks and AIDS prevention measures was good, and most clients expressed a caring attitude towards people with HIV and AIDS. A former negative HIV test result was associated with higher levels of condom use, and most clients expressed the intention to reduce their HIV risk behaviour in response to a positive or negative HIV test result (more so if positive). CONCLUSIONS: Our study demonstrates the demand for and the feasibility of confidential HIV counseling and testing services in Thailand and illustrates the value of these services in achieving behaviour changes. Such services should be considered as an additional approach for reducing HIV transmission in Asia, especially in areas with high HIV seroprevalence rates.

Adult↗
PubMed1996

New developments in behaviour therapy for obsessive-compulsive disorder.

Effective behaviour therapy techniques of exposure and response (or ritual) prevention for obsessive-compulsive disorder (OCD) are based on the principle of habituation. This is a common-sense approach that is simple in conception but not easy to implement and maintain. Controlled trials have proven the short- and long-term effectiveness of behaviour therapies in OCD and meta-analyses suggest that behaviour therapy is at least as effective as potent serotonin reuptake inhibitors (SRIs). A combination of these behavioural and psychopharmacological modalities might represent the optimal treatment for OCD. Here I review behaviour therapy techniques for OCD, the studies supporting its effectiveness and acceptability and problems limiting its wider dissemination. The preliminary results of a computer-administered behaviour therapy programme for OCD, BT STEPS, are also presented.

Behavior Therapy↗
PubMed2002

Treatment of compulsive sexual behaviour with naltrexone and serotonin reuptake inhibitors: two case studies.

Although there is no universally accepted definition of compulsive sexual behaviour (CSB), the term is generally used to indicate excessive sexual behaviour or sexual cognitions that lead to subjective distress, social or occupational impairment, or legal and financial consequences. Similar to impulse control disorders, CSB is characterized by a failure to resist the impulse for sex. Opioid antagonists have been effective in treating urge-driven disorders, such as pathological gambling disorder, alcoholism, borderline personality disorder with self-injurious behaviour, cocaine abuse, mental retardation with self-injurious behaviour and eating disorders. Based upon the efficacy of opioid antagonists in treating disorders associated with urges, we hypothesized that naltrexone would reduce both the urges associated with CSB and therefore reduce the sexual behaviour. We present two case reports of individuals with CSB treated successfully with naltrexone, a novel treatment for CSB. In both cases, symptoms dramatically decreased and psychosocial functioning improved with the use of naltrexone. Although more research is needed to determine the mechanism that leads to the excessive sexual behaviour in individuals with CSB, the present case reports suggest that naltrexone may be effective in treating some cases of CSB.

Adult↗
PubMed1997

Ethopharmacological analysis of behaviour of rats using variations of the elevated plus-maze.

Besides allowing better observation and recording of the behaviour of rodents, we have shown that the elevated plus-maze with transparent walls is as sensitive to anxiolytic and anxiogenic drug effects as a traditional apparatus with opaque walls. In this study we extend these observations with an ethopharmacological analysis of the behaviour of rats in the elevated plus-maze with transparent walls. A factor analysis of the behaviour of control (saline-treated) rats on the modified maze and on a standard maze revealed a characteristic distribution of the behavioural categories in six factors. For the modified maze, the first three factors, representing standard indices of anxiety, locomotion and risk assessment, were similar to the factor distribution reported by this and other studies using the standard elevated plus-maze test. Distinct features appeared on Factor 4, with the loading of rears in the modified maze together with the occurrence of the percentage of centre time and flat-back approach common to both mazes. Scanning and grooming, which are generally grouped on Factor 5 in the standard maze, appeared as isolated behavioural elements loading on Factors 5 and 6, respectively, in the modified maze. An ethopharmacological analysis of behaviour in the modified maze showed that midazolam (1 and 2 mg/kg) produced an anxioselective profile, whereas pentylenetetrazol (5 and 10 mg/kg) produced an anxiogenic-like profile. These results point to the distinct features of the elevated plus-maze with transparent walls, which may be beneficial in the study of the different facets of anxiety and the mode of action of anxiolytic drugs in rats.

Animals↗
PubMed2000

Behavioural effects of a benzodiazepine receptor partial agonist, Ro 19-8022, in the social conflict test in mice.

The study examined the effects of the benzodiazepine receptor partial agonist, Ro 19-8022, on anxiety-like, aggressive, social and locomotor behaviours in timid ('anxious') and aggressive mice in the social conflict test. To test the hypothesis that Ro 19-8022 acts as a partial agonist in this model, i.e. it reduces anxiety-like and aggressive behaviours without affecting motor coordination, its effects were compared to those of the full agonist, nitrazepam. Both Ro 19-8022 and nitrazepam decreased anxiety-like behaviour in timid mice and aggressive behaviour in aggressive mice. The effect of the full agonist, nitrazepam, was dose-dependent while the effect of the partial agonist, Ro 19-8022, was lower in magnitude and reflected its partial agonistic properties. Both drugs stimulated social behaviour in both groups of mice, presumably due to disinhibition of anxiety or aggression. The marked difference was in their effects on motor coordination, as nitrazepam, but not Ro 19-8022, produced motor impairment at higher doses. Thus, Ro 19-8022 produces anxiolytic-like and potent anti-aggressive effects without causing muscle relaxation or ataxia in the present model. Our data confirm that the main behavioural differences between partial and full benzodiazepine receptor agonists are in their side-effect profiles.

Aggression↗
PubMed2000

Acute effects of cocaine on play behaviour of rats.

Play behaviours are exhibited by many mammalian species. The similarity of such behaviour across children, non-human primates and rats makes it an especially appropriate target for the investigation of drug- or toxicant-induced disruption. In this study the acute effects of cocaine on play behaviour in male and female Sprague-Dawley rats was assessed. Same-sex dyads of rats (postnatal day 35-36) were separated 24 h prior to testing. On the following day, one or both rats of the dyad were injected with the same dose of cocaine (0, 2.5, 5.0 or 20.00 mg/kg). Thirty minutes later the rats were placed together and, after 5 min of habituation, the frequency of pins and crawl-overs were measured for each subject. In dyads in which both rats were treated, crawl-overs and pinning behaviour were decreased by 20 mg/kg cocaine. In dyads in which only one rat was treated, there was marginal effect of cocaine treatment on pinning frequency, while crawl-overs were unaffected. Pinning frequency was not sexually dimorphic in either type of dyad; however, crawl-overs were more frequently exhibited by females in dyads in which only one rat was treated. Thus, pinning behaviour in juvenile rats appears somewhat more sensitive to cocaine-induced disruption than crawl-over behaviours. Additionally, the presence of an untreated rat appears to attenuate the play-disrupting effects of cocaine on pinning frequency.

Animals↗
PubMed2002

Behavioural and pharmacological relevance of stroke-prone spontaneously hypertensive rats as an animal model of a developmental disorder.

The present study evaluates juvenile stroke-prone spontaneously hypertensive rats (SHRSP) as an animal model of a developmental disorder, which is diagnosed according to hyperactivity-impulsivity and/or inattention. To characterize behavioural alterations, we studied motor activity, as well as emotional and cognitive behaviours in juvenile SHRSP, with and without methylphenidate, a psychostimulant. Ambulatory and rearing activities in the open-field environment were significantly higher in SHRSP than in Wistar-Kyoto rats (WKY). In the elevated plus maze task, the entries into open arms, as an index of impulsivity, were significantly increased in SHRSP. In the Y-maze task, spontaneous alternation behaviour, as an index of attention, was significantly lowered in the male SHRSP, but not in the female SHRSP, indicating that spontaneous alternation deficit is gender specific. Methylphenidate (0.01-1 mg/kg, i.p.) significantly attenuated locomotor hyperactivity at low doses and dose-dependently improved the spontaneous alternation deficit in SHRSP. Our findings reveal that juvenile SHRSP manifest problematic behaviours resembling a developmental disorder, attention-deficit/hyperactivity disorder (ADHD), namely hyperactivity-impulsivity and/or inattention. Methylphenidate alleviated the behavioural symptoms of hyperactivity and inattention. We propose that juvenile SHRSP are an appropriate animal model of a developmental disorder resembling ADHD, from behavioural and pharmacological perspectives.

Animals↗
PubMed2002

Emotions, behaviours and mood changes in stroke.

The brain mediates and integrates all cognitive activities, emotional experiences and finally behaviours. Stroke is undoubtedly a privileged disease for human behavioural studies, because of its high incidence. Recent advances in high-resolution magnetic resonance imaging techniques and functional neuroimaging allow both the precise localization of lesions and on-line visualization of the activity of cerebral areas and networks. Nevertheless, the neuropsychiatry of stroke remains uncertain in its relationship with brain dysfunction. Clinical studies on registry populations, single case studies, and functional neuroimaging data provide interesting findings, but differences in methods and great individual intervariability still prevent a complete understanding of emotional perception and behavioural responses in stroke. We adopted an anatomical-functional model as an operational framework in order to systematize the recent literature on emotional, behavioural and mood changes after stroke. The dysfunction of the areas subserving fundamental and executive functions induces behavioural and affective changes (such as depression, anxiety, apathy) that reflect the dysfunction of the whole system. Conversely, lesions in the system of instrumental functions induce signature syndromes (aphasia, anosognosia). At any delay from stroke, the diagnosis and treatment of mood and behavioural changes are a priority for clinicians and healthcare professionals to improve the quality of life of patients.

Behavior↗
PubMed2006

Do prevention interventions reduce HIV risk behaviours among people living with HIV? A meta-analytic review of controlled trials.

OBJECTIVE: To conduct a meta-analytic review of HIV interventions for people living with HIV (PLWH) to determine their overall efficacy in reducing HIV risk behaviours and identify intervention characteristics associated with efficacy. METHODS: Comprehensive searches included electronic databases from 1988 to 2004, hand searches of journals, reference lists of articles, and contacts with researchers. Twelve trials met the stringent selection criteria: randomization or assignment with minimal bias, use of statistical analysis, and assessment of HIV-related behavioural or biologic outcomes at least 3 months after the intervention. Random-effects models were used to aggregate data. RESULTS: Interventions significantly reduced unprotected sex [odds ratio (OR), 0.57; 95% confidence interval (CI) 0.40-0.82] and decreased acquisition of sexually transmitted diseases (OR, 0.20; 95% CI, 0.05-0.73). Non-significant intervention effects were observed for needle sharing (OR, 0.47, 95% CI, 0.13-1.71). As a whole, interventions with the following characteristics significantly reduced sexual risk behaviours: (1) based on behavioural theory; (2) designed to change specifically HIV transmission risk behaviours; (3) delivered by health-care providers or counsellors; (4) delivered to individuals; (5) delivered in an intensive manner; (6) delivered in settings where PLWH receive routine services or medical care; (7) provided skills building, or (8) addressed a myriad of issues related to mental health, medication adherence, and HIV risk behaviour. CONCLUSION: Interventions targeting PWLH are efficacious in reducing unprotected sex and acquisition of sexually transmitted diseases. Efficacious strategies identified in this review should be incorporated into community HIV prevention efforts and further evaluated for effectiveness.

Adult↗
PubMed2006

Long-term influence of a health education programme on knowledge and health behaviour in children.

BACKGROUND: Aiming at an active lifestyle, healthy food habits and non-smoking among Swedish children, the Swedish Heart Lung Foundation initiated the health educational programme 'An adventure with Pelle Pump'. A study kit, including theoretical and practical material on heart-lung function and healthy behaviour, was offered to all fourth graders in Sweden. The impact of the programme was examined by studying health behaviours and health knowledge among programme participants using non-participants as a control population. METHODS: A questionnaire on health behaviour and health knowledge was answered by a random sample of 1369 children from different social classes and living conditions. Children subjected to the programme formed the programme group (n=523) and those without exposure served as a control group (n=846). RESULTS: Children in the programme group had a significantly higher level of knowledge (P<0.001) on questions relating to health behaviour and bodily functions. The actual health behaviour was, however, not affected by the programme. CONCLUSION: Children exposed to a health education programme had, compared with a control population, 2 years after completing the programme, an increased level of knowledge; however, no difference was found in health behaviour.

Child↗
PubMed2000

Signals and behavioural responses are not coupled in males: aggression affected by replacement of an evolutionarily lost colour signal.

Male Sceloporus virgatus lack the blue abdominal patches which are used during aggressive encounters in other Sceloporus lizards. Herein we report that, despite having lost this signal, males have retained a behavioural response to experimentally restored blue abdominal patches. We tested two adaptive hypotheses: selection acted primarily upon signallers or selection acted upon both signallers and receivers. The first predicts that only the signal is lost and that male interactions should be affected by the restoration of blue patches. The latter predicts that both the signal and behavioural response are lost and the display of the restored blue patches should have no effect on male-male interactions. We compared the behaviour of receivers in paired encounters where one male (signaller) had blue-painted abdominal patches to a set of trials where both males had white-painted abdomens, unmanipulated abdomens or a novel-painted pattern. The receivers of the blue-painted signal were more likely to display submissive behaviour. The receivers in either the unmanipulated, white-painted or novel-painted signal trials were more likely to display neutral behaviour. These results support the hypothesis that receivers have retained a behavioural response and selection has acted primarily on the signaller. We believe this is the first documentation of males responding to an evolutionarily lost signal in conspecific males.

Aggression↗
PubMed2001

Territorial intrusion risk and antipredator behaviour: a mathematical model.

In territorial animals that hide to avoid predators, a predatory attack creates a conflict because a hiding animal cannot defend its territory from conspecific intruders. When intruders are persistent, a past conspecific intrusion informs a territorial resident that future intrusions by the same animal are likely. Using a mathematical model, I examine the effects that past territorial intrusions can have on antipredator behaviour. Past territorial intrusions rarely affect a resident animal's time to hide (the optimal behaviour is to hide as soon as the predator initiates its attack). In contrast, past intrusions should shorten the length of time during which territory holders remain in hiding, with the magnitude of this effect depending on the time of the predator's attack, the re-intruder's pattern of return, and the intrusion rates of other conspecifics. The results of the model show that we need more information on patterns of re-intruders' behaviour, and emphasize that a similar functional explanation could underlie other behavioural changes following territorial and/or aggressive encounters (such as winner/loser effects or changes in display frequency and territorial vigilance). Differences between my findings and those from previous studies suggest that the trade-off between antipredator behaviour and territorial defence can involve different costs from the trade-off between antipredator behaviour and foraging.

Animals↗
PubMed2005

Environmental variability in the early rearing environment generates behaviourally flexible cod: implications for rehabilitating wild populations.

The release of hatchery-reared fishes for restoring threatened and endangered populations is one of the most controversial issues in applied ecology. A central issue has been to determine whether releases cause extinction of local wild populations. This may arise either through domesticated or non-local fishes hybridizing with wild fishes, or through inappropriate behavioural interactions; for example, many hatchery fishes show exaggerated aggressive and competitive behaviour and out-compete wild counterparts. The impact of the impoverished hatchery environment in shaping behaviour is only now receiving attention. Attempts to counteract hatchery-related behavioural deficiencies have utilized intensive training programmes shortly before the fishes are released. However, we show here that simple exposure to variable spatial and foraging cues in the standard hatchery environment generates fishes with enhanced behavioural traits that are probably associated with improved survival in the wild. It appears that fishes need to experience a varying and changeable environment to learn and develop flexible behaviour. Using variable hatchery rearing environments to generate suitable phenotypes in combination with a knowledge of appropriate local genotypes, rehabilitation of wild fishes is likely to succeed, where to date it has largely failed.

Analysis of Variance↗
PubMed2002

Associations between behaviour problems and verbal and nonverbal cognitive abilities and disabilities in early childhood.

BACKGROUND: We investigated associations between behaviour problems and verbal and nonverbal cognitive abilities at 2, 3 and 4 years of age both for the entire distribution and for the lowest 5% and 10% of the verbal and nonverbal cognitive disabilities. METHODS: A community sample of 4,000 pairs of twins born in England and Wales in 1994 and 1995 was assessed by their parents at 2, 3 and 4 years using the Revised Rutter Parent Scale for Preschool Children (RRPSPC, behaviour problems), the MacArthur Communicative Development Inventory (MCDI, verbal development), and the Parent Report of Children's Abilities (PARCA, nonverbal cognitive development). RESULTS: For the entire sample, behaviour problem scores were modestly associated with lower MCDI and PARCA scores - correlations were less than .30. Similarly modest effect sizes were found for relationships between behaviour problem scores and the lowest 5% and 10% of the MCDI and of the PARCA distributions. Associations were stronger for nonverbal than for verbal development, increased from 2 to 3 to 4 years, and, at the extremes of the distributions, were stronger for boys than for girls. Multivariate genetic analyses indicated that both genetic and shared environmental factors mediate the links between behaviour problems and cognitive development both for the total distribution and for the extremes. Genetic links may be stronger for the extremes than for the total sample. CONCLUSIONS: We conclude that, in this community sample of young children, associations between behaviour problems and verbal and nonverbal cognitive development are generally modest for the entire distribution and are no greater at the extremes than expected on the basis of the associations for the entire distribution.

Aptitude Tests↗
PubMed2003

Expressed emotion, attributions and depression in mothers of children with problem behaviour.

BACKGROUND: This was an initial study seeking to examine the relationship between Expressed Emotion (EE), spontaneous causal attributions and depression in mothers of children referred for problem behaviour. METHOD: Sixty-one mothers were interviewed using the Camberwell Family Interview (CFI). The CFI was coded for maternal EE and spontaneous causal attributions regarding the child's behaviour. Self-report measures of child problem behaviour and maternal depressive symptoms were also completed. RESULTS: Consistent with previous research, high EE mothers, compared to low EE mothers, were more likely to make attributions thatjudged the cause of problem behaviour to be personal to and controllable by the child and also made more 'child-blaming' attributions than low EE mothers. Mothers' scores on the Beck Depression Inventory were found to be associated with 'child-blaming' attributions and higher levels of EE. Regression analyses did not support the hypothesised role of attributions as a mediator between depression and EE but did identify EE as a potential mediator in the relationship between maternal depressed mood and ratings of child problem behaviour. CONCLUSIONS: These results indicate the relevance of both EE and attributions in mothers of children with problem behaviour and suggest that maternal depressed mood is an important factor which is related to both of these.

Adult↗
PubMed2003

Classes of disruptive behaviour in a sample of young elementary school children.

BACKGROUND: The objectives were to (1) classify young children to groups differing in disruptive behaviour, (2) determine whether the patterns of disruptive behaviour in these groups are in accordance with the conceptualisation of disruptive disorders as described in DSM-IV, and (3) optimise the classification of children in groups. METHODS: Disruptive behaviour of 636 seven-year-old elementary schoolchildren was assessed with the CBCL/4-18. Using CBCL items rated as very consistent with DSM-IV categories Conduct Disorder, Oppositional Defiant Disorder and Attention-Deficit/Hyperactivity Disorder, latent class analyses were applied to identify classes of children differing in patterns of disruptive behaviour. RESULTS: Three classes were identified: (1) high levels of oppositional defiant problems (ODD problems) and attention-deficit/hyperactivity problems (ADH problems) and intermediate levels of Conduct problems; (2) intermediate ODD problems and ADH problems and low levels of Conduct problems; (3) low levels on all disruptive behaviours. CONCLUSIONS: No classes were identified in which children had symptoms of only Conduct problems, only ODD problems or only ADH problems. Covariates (socio-economic status, gender, parenting stress) improved the classification of children. The findings are discussed in terms of implications for classification, identification of children at risk, prevention and treatment of disruptive behaviour in young children.

Attention Deficit and Disruptive Behavior Disorder↗