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Tonic regulation of satiety by 5-HT receptors in the mouse: converging evidence from behavioural and c-fos immunoreactivity studies?

Activation of 5-HT(1B) receptors is thought to play an important role in the inhibitory influence of serotonin on feeding behaviour and body weight in mammals. Earlier studies have shown that 5-HT(1B)-knockout (KO) mice eat more and are heavier than wild-type (WT) controls and that the selective 5-HT(1B) receptor agonist CP-94,253 reduces food intake in food-deprived mice. Here we characterize the behavioural effects of both CP-94,253 and the selective 5-HT(1B) receptor antagonist SB224289 on feeding and other behaviours within the behavioural satiety sequence, and also report a c-fos mapping study using CP-94,253. CP-94,253 produced a dose-dependent suppression of food intake with a profile consistent with a selective effect on feeding behaviour. These effects were absent or reduced in 5-HT(1B)-KO mice and in WT mice pretreated with SB224289. SB224289 administered alone enhanced food intake consistent with impaired satiation; a similar effect was apparent in 5-HT(1B)-KO mice compared to WT. CP-94,253 induced c-fos in a range of structures previously implicated in the expression of feeding behaviour. These results suggest that the activation of 5-HT(1B) receptors is an important component of endogenous satiation mechanisms in the mouse.

Animals↗

Behavioural addictions: common features and treatment implications.

Marks' editorial is welcome in that is suggests common treatment approaches for chemical and behavioural addictions, namely, exposure and relapse prevention. There are other common features of addictive substances or activities which may explain their addictive potential: they act as operant reinforcers and as Pavlovian unconditioned stimuli, tolerance develops, an initial positive mood is followed by dysphoria and addictions are stimulated by common states (arousal, stress, pain). Most of Marks' features are not unique to addictions but apply to primary drive states (normal eating, sleeping, elimination, sex) and many apply to normal goal-orientated behaviour. Normal repetitive behaviour is more flexible than addictive behaviour, in allowing satisfactory substitution of alternatives. The restrictive range of activities which are satisfactory for the addict suggest that building up the behavioural repertoire may help in prevention and rehabilitation. Tics and Tourette's syndrome should not be regarded as addictions, since they involve simple, involuntary and non-goal-directed behavioural sequences. Considering addictions as goal-directed is important: addicts are often ambivalent about whether they want to give up or continue. This often underlies dropout and relapse. Treatment must address this issue.

Drive↗

The structure of problem behaviours among Irish adolescents.

Problem behaviour theory proposes that adolescent substance use and other problem behaviours comprise a single dimension reflecting a general underlying tendency towards deviance. This general deviance hypothesis was tested with survey data obtained from 2731 adolescents from Dublin, Ireland. A series of hierarchical maximum likelihood factor analyses indicated that three specific factors were necessary to account for the covariation among problem behaviour measures. These factors corresponded to substance use (drinking, smoking, marijuana use, and other drug use), relatively minor problem behaviours (swearing, lying), and relatively serious problem behaviours (stealing, vandalism). Contrary to the general deviance hypothesis, a second order factor representing general deviance accounted for only 14% of the variance in substance use, on the average, as opposed to 74% of the variance in minor and serious problem behaviours. These findings thus indicate that substance use among these Irish adolescents is relatively independent of a general tendency toward deviance. They also suggest that the general deviance hypothesis, as it usually is applied, may be culturally specific and relevant only for adolescents from the United States and similar cultural contexts.

Adolescent↗

Like parent like child? Associations between drinking and smoking behaviour of parents and their children.

This paper examines the association between the smoking and drinking behaviours of parents and their adolescent children, and the effect of gender and social class upon this association. It is based on data collected from a cohort of young people and their parents, resident in the west of Scotland. Both social class and parental smoking behaviour were independently associated with young people's smoking, with young people from lower social class households or whose parents smoked being most likely to smoke. Social class and gender were independently associated with young people's drinking, with males and young people from non-manual households being most likely to drink. Parental drinking behaviour was associated positively with young people's drinking only in non-manual classes and among daughters. We conclude that it is important to take social class and gender into account since it may influence whether or not there is an association between the behaviour of young people and that of their parents, and it may influence young people's behaviour in addition to influences from parental behaviour.

Adolescent↗

Highly active antiretroviral therapy (HAART) among HIV-infected drug users: a prospective cohort study of sexual risk and injecting behaviour.

AIMS: To study sexual risk and injecting behaviour among HIV-infected drug users (DU) receiving highly active antiretroviral therapy (HAART). DESIGN AND SETTING: As part of an ongoing prospective cohort study, HIV-infected DU who commenced HAART (n=67) were matched with those not starting HAART (n=130) on CD4 cell counts, duration of cohort participation, age and calendar year of visit. Immunological and virological responses of the HAART-treated DU were compared with the HAART-treated homosexual men from the same cohort (n=212). MEASUREMENTS: Trends in behaviour and therapeutic response were tested with a logistic regression model adjusted for repeated measurements and a piecewise random effects model, respectively. FINDINGS: Non-HAART users reported more episodes of injecting than HAART users. In both groups injecting declined over time with no effect of HAART initiation. Before HAART initiation an increase in sexual risk behaviour was observed among those who had been assigned to receive HAART; their sexual risk behaviour declined thereafter. No change in sexual risk behaviour was found among non-HAART users. Relative to homosexual men, DU had a similar initial therapeutic response, but DU started HAART at lower CD4 cell counts and higher viral load levels. Conclusion DU who are treated with HAART are not increasing their risk behaviour, and their early response to HAART is similar to homosexual men. However, before the treated DU received HAART they were seen to inject less often than those not treated with HAART. This suggests that selection of potential HAART starters is based on limited drug use. Although the DU who commence HAART are a selected group, our results show that HIV-infected DU can be treated effectively.

Adult↗

Health and behaviour in preschool children.

This study reviews the relationship between the health and behaviour of 870 preschool children reviewed over a 5-year period. Detailed information was collected at regular intervals on rates of upper and lower respiratory tract infections, ear infections, and other illnesses. The children were examined, and their behaviour was assessed using questionnaires. In addition, the mothers of the children were interviewed, and assessment was made of levels of maternal stress. Relationships are demonstrated between episodes of illness and different behaviour problems. Night waking, poor appetite, temper tantrums, difficulty in management, and the doctor's and mother's overall assessment of behaviour were all found to be correlated with recurrent minor illnesses. Relationships were also found between maternal stress and some of the behaviour variables. Attention is drawn to the well known association of stress with physical illness, and the importance of this relationship in the management of both infections and behaviour problems in the young child is discussed.

Anorexia↗

How do Turkish mothers discipline children? An analysis from a behavioural perspective.

A descriptive study was conducted to assess the disciplinary practices of Turkish mothers for increasing appropriate and decreasing inappropriate behaviours of their children. The participants were 50 mothers of 4- to 6-year-old children receiving preschool education. The data were collected via a questionnaire consisting of open-ended questions. The results revealed that the most frequently used disciplinary technique for strengthening desirable behaviours of children was presenting verbal praise, followed by presenting activity, edible, and social reinforcers whereas the favourite disciplinary technique for overcoming behaviour problems was providing verbal explanations. These findings show that the participants seem to be benefiting from a variety of behavioural techniques for supporting their children's appropriate behaviours. However, they look less competent when it comes to discouraging inappropriate behaviours. These findings are expected to (a) offer an alternative data collection model for assessing parental disciplinary practices, and (b) contribute to designing parent training and family-focused early intervention programmes.

Attention↗

Behaviour modification in nursing practice and research: a case study.

Using a behaviour modification programme, an attempt was made to teach a 39-year-old dependent patient with a medical diagnosis of schizophrenia to reacquire and maintain self-care behaviours. Dependence in this project was limited to morning care behaviours, i.e. mouth-washing, face-washing, shaving and bathing. Praise and a token economy programme were used to reduce the number of prompts (help and reminders) the patient needed to accomplish the targeted behaviours. Although the treatment programme ran for only 4 weeks because the patient was prematurely transferred to another ward, an evaluation of the programme shows that nursing staff in psychiatric hospitals can facilitate healthy behaviours in schizophrenic patients through behaviour management skills.

Activities of Daily Living↗

The meaning of living with dementia and disturbing behaviour as narrated by three persons admitted to a residential home.

AIM: The aim of our study was to illuminate the meaning of living with dementia and disturbing behaviour, as narrated by three persons admitted to a residential home. BACKGROUND: Living with dementia and so-called disturbing behaviour in an institution involves interaction with care providers and fellow residents and poses a challenge to all who are involved. METHODS: We asked the head nurses at a residential home to select persons with dementia and disturbing behaviour who were willing to be interviewed and able to communicate verbally. We performed 10 informal conversational interviews with three persons. The interviews were transcribed into text and interpreted using a phenomenological hermeneutic method inspired by Ricoeur's philosophy. RESULTS: The findings indicate that the meaning of living with dementia and disturbing behaviour, as narrated by three persons admitted to a residential home, is about being surrounded by disorder, being trapped by restriction and being set aside, as well as about being included. The findings are interpreted as a collapse of relations to self and others intertwined with occasional episodes of togetherness. This is reflected on in relation to the literature on homelessness and at-homeness and loss and maintenance of personal and social selves. RELEVANCE TO CLINICAL PRACTICE: The view others have of the person with dementia and of disturbing behaviour determines the nursing care given. Taking the residents' personal history and actual context into account, disturbing behaviour may be seen as a way persons with dementia express their story and maintain their self.

Dementia↗

A signal detection approach to patient-doctor communication and doctor-shopping behaviour among Japanese patients.

OBJECTIVES: As one of the factors related to doctor-shopping behaviour (i.e. consulting multiple doctors with regard to the same illness episode), very little has been revealed about the role of doctor explanation. We examined therefore the association between doctor explanation and doctor-shopping behaviour. METHODS: The subjects were internist-patient pairs in Japan. Signal detection analysis (SDA) was used for the data analysis. RESULTS: Of the 303 patients, 84 patients engaged in doctor shopping (27.7%). The following results were obtained: (1) of the 19 relevant variables, the 'level of doctor explanation: treatment' was the most significant predictor of doctor-shopping behaviour (P < 0.01), and (2) with regard to their subjective evaluations of the sufficiency of their explanations about treatment or testing, the evaluations of the doctors, rather than those of the patient, were significant predictors of doctor-shopping behaviour. CONCLUSIONS: These results imply the following: (1) a patient's inability to understand a doctor's explanation about treatment, which results from a large gap between the perceptions of the patient and those of the doctor, is the most significant predictor of doctor-shopping behaviour, and (2) in the context of favourable patient-doctor interactions, when doctors feel their explanations are insufficient, they may be able to prevent doctor-shopping behaviour by providing relatively thorough explanations about treatment.

Adolescent↗

Behaviour problems in Angelman syndrome.

Angelman syndrome (AS) is a genetic disorder that is associated with a deletion on chromosome 15, and is characterized by abnormalities or impairments in neurological, motor and intellectual functioning. While behaviour problems have been reported in clients with AS, relatively little is known about their developmental course and outcome. In this study, data on the nature and prevalence of behaviour problems among clients with AS were gathered from two sources: (1) a review of published case reports; and (2) parent responses to a survey of behaviour problems in a small (n = 11) sample of children with AS. Data from both sources showed that behaviour problems were present in males and females of all ages, and included language deficits, excessive laughter, hyperactivity, short attention span, problems with eating and sleeping, aggression, noncompliance, mouthing of objects, tantrums, and repetitive and stereotyped behaviour. Identification and treatment of severe behaviour problems in clients with AS may improve their adaptive functioning.

Adolescent↗

Emotional and behavioural needs of children and adolescents with intellectual disabilities in an urban conurbation.

BACKGROUND: Over the past decade, increased attention has been paid to identifying and responding to the emotional and behavioural needs of children and adolescents with intellectual disability (ID). The aims of the present study were to add to this body of knowledge by identifying factors associated with emotional and behavioural needs among a sample of children with ID drawn from a large urban conurbation. METHOD: Information was collected by postal questionnaire (or interview for family carers who did not have English as their first language) from teachers and from family carers of 615 children administratively identified as having ID (47% of all children with ID). RESULTS: Results indicated that: (1) the administrative prevalence of moderate but not severe ID was associated with social deprivation whereas the prevalence of severe but not moderate ID appeared to be associated with ethnicity; (2) 54% of children scored above the threshold on the Developmental Behaviour Checklist (DBC)-primary family carer, and 37% of children scored above the threshold on the DBC-teacher; (3) social deprivation, male gender, less severe ID and having fewer physical or sensory impairments were associated with antisocial and disruptive behaviour; and (4) more severe ID and additional impairments were associated with anxiety, communication disturbance, social relating and self-absorbed behaviours. CONCLUSIONS: These results identify a range of risk factors associated with behavioural and emotional problems experienced by children with ID.

Adolescent↗

Self-reported anti-social behaviour: prevalence and risk factors amongst adolescents with and without intellectual disability.

BACKGROUND: Research has suggested increased risk of anti-social behaviour amongst individuals with intellectual disability (ID). METHODS: This study reports the results of a secondary analysis of data relating to self-reported anti-social behaviour, obtained from the 1999 Office for National Statistics (ONS) study of the mental health of children and adolescents in Great Britain. Self-report data from 4174 adolescents was available. Within this group, a sub-group of 98 adolescents with ID was identified. Data covered a variety of sub-types of anti-social behaviour. RESULTS: Comparisons of individuals with ID and those without ID indicated a significantly higher prevalence of a number of types of self-reported anti-social behaviour in the ID sample. Further analyses indicated however, that these between group differences were accounted for by the higher rates of social deprivation and child mental health problems among the ID sample. CONCLUSIONS: Rather than ID per se being associated with increased rates of anti-social behaviour, adolescents with ID may be more likely to experience risk factors (lower socio-economic status and mental health problems) known to be associated with anti-social behaviour. The clinical implications of this and possible future directions for research are discussed.

Adolescent↗

Staff in services for people with intellectual disabilities: the impact of stress on attributions of challenging behaviour.

BACKGROUND: There is a lack of a conceptual framework as to how stress and attribution variables interact and influence staff behaviour in response to challenging behaviour. To address this, a model is tested examining the impact of stress on attributions of challenging behaviour within Weiner's model of helping. METHOD: A total of 107 staff working in community homes for people with intellectual disabilities completed a self-report questionnaire that measured stress, burnout, attributions, emotions, optimism and helping behaviour in response to challenging behaviour. RESULTS: Partial support was found for the role of attributions and emotions. However, although staff reported high stress levels and moderate burnout, this did not appear to relate to their reporting of thoughts and feelings regarding challenging behaviour predicted by Weiner's helping model. It was not possible to fully test the helping model, as the 'help' variable was not normally distributed. CONCLUSIONS: There was little evidence to suggest that stress has a primary role in determining staff responses when examined within Weiner's model of helping. Limited support in general was offered for Weiner's helping model. Potential conceptual difficulties and clinical implications are explored and alternative models for future research are discussed.

Adult↗

The behavioural profile of psychiatric disorders in persons with intellectual disability.

BACKGROUND: Problems associated with psychiatric diagnoses could be minimized by identifying behavioural clusters of specific psychiatric disorders. METHODS: Sixty persons with intellectual disability (ID) and behavioural problems, aged 12-55 years, were assessed with standardized Indian tools for intelligence and adaptive behaviour. Clinical diagnoses were conferred as per International Classification of Diseases - 10th Revision (ICD-10) criteria. Subsequently Reiss Screen for Maladaptive Behaviors (RSMB) and AAMD Adaptive Behavior Scale-Part II were administered independently. RESULTS: Aggression and rebellious behaviours were more common in affective disorders and personality disorders. Psychotic and paranoid features were significantly more in psychosis group. Those with behavioural problems had significantly low scores on the sub-scales of RSMB. CONCLUSION: RSMB and AAMD Adaptive Behavior Scale-Part II will be useful to identify behavioural clusters, which will complement clinical psychiatric diagnoses in individuals with ID.

Adolescent↗

Do social information-processing models explain aggressive behaviour by children with mild intellectual disabilities in residential care?

BACKGROUND: This study aimed to examine whether the social information-processing model (SIP model) applies to aggressive behaviour by children with mild intellectual disabilities (MID). The response-decision element of SIP was expected to be unnecessary to explain aggressive behaviour in these children, and SIP was expected to mediate the relation between social schemata and aggressive behaviour. METHOD: SIP and aggressive behaviour of 130 10- to 14-year-old children with MID in residential care were assessed. The fit of various SIP models was tested with structural equation modelling. RESULTS: The response-decision process was found not to be necessary to explain aggressive behaviour. Social schemata were indirectly related to aggressive behaviour with aggressive response generation as mediating variable. CONCLUSIONS: Implications for SIP theory and intervention are discussed.

Adolescent↗

Temperament and social behaviour at home and school among typically developing children and children with an intellectually disability.

BACKGROUND: There has been limited research on differences in temperament between typically developing children and children with an intellectual disability (ID). Individual differences have generally been neglected in previous investigations of children with an ID. The present research investigated differences in temperament and social behaviour between typically developing children and children with an ID, in both home and school settings. METHODS: Participants were 100 children (M = 10.7 years, SD = 0.88) from both regular and special education schools. Temperament was measured using the Emotionality, Activity, Sociability (EAS) Temperament Survey for Children (parental and teacher ratings), while social behaviour was measured using the School Social Behaviour Scales, Second Edition (SSBS-2) and the Home and Community Social Behaviour Scales (HCSBS). RESULTS: There were minimal significant differences in temperament between the regular and special education groups. Children who attended regular schools had a significantly higher level of social competence and significantly lower level of antisocial behaviour both at home and school, when compared with children who attended special schools. CONCLUSIONS: The difference in social behaviour between children attending regular and special schools was attributed to the difference in intellectual ability of the two groups, as well as contextual influences of regular or special school environments.

Antisocial Personality Disorder↗

Psychiatric symptoms and problem behaviours in people with intellectual disabilities.

BACKGROUND: Previous studies have suggested different patterns of associations between psychiatric symptoms and problem behaviours in people with intellectual disabilities (ID). The aim of this study was to investigate which problem behaviours are associated with specific psychiatric symptoms and the relative strength of these specific associations. METHOD: A cross sectional survey using the Psychiatric Assessment Schedule for Adults with Developmental Disabilities Checklist and the Disability Assessment Schedule was carried out in a sample of 214 adults with ID. RESULTS: Self-injurious and, to a lesser extent, aggressive problem behaviours were most associated with affective type symptoms. Screaming and destructive behaviours tended to be more associated with autism-related social impairment rather than conventional psychiatric symptoms. CONCLUSIONS: This study gives further evidence of associations between psychiatric symptoms and specific problem behaviours in people with ID. It may be particularly useful to consider the diagnosis of affective disorders if a person with ID shows self-injurious or aggressive behaviours.

Adult↗