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The effect of central and systemic injection of the 5-HT1A receptor agonist 8-OHDPAT and the 5-HT1A receptor antagonist WAY100635 on periaqueductal grey-induced defence behaviour.

The effects of the selective 5-HT(1A) agonist, 8-hydroxy-2-(di-n-propylamino)-tetralin (8-OHDPAT) and the selective 5-HT(1A) antagonist, N-[2-[4-(2-methoxyphenyl)-1-piperzinyl]ethyl]-N-(pyridinyl) cyclohexanecarboxamide trichloride (WAY100635) on periaqueductal grey (PAG)-stimulated defence behaviour were tested in the rat. Microinjection of the excitatory amino acid, D, L-homocysteic acid (DLH) into the dorsal region of the PAG produced overt aversive behaviour characteristic of the defence response, consisting of explosive motor behaviours which were quantified in terms of their duration and the number of arena revolutions and jumps made by the animal. Intra-PAG pre-treatment with 8-OHDPAT (3, 10 and 25 nmol in 250 nl) 10 min before DLH stimulation significantly attenuated the defence behaviour. This could be reversed by peripheral application of WAY100635 (0.1 mg/kg). In contrast, peripheral 8-OHDPAT (0.03, 0.1 and 0.3mg/kg) produced a significant potentiation of the DLH response which could also be blocked by peripheral WAY100635. When WAY100635 (10 nmol in 250 nl) alone was given into the PAG a significant increase in DLH induced behaviours was observed whereas peripherally applied WAY100635 (0.1 mg/kg) was without effect. These data support previous findings which indicate that serotonergic modulation of aversive behaviours such as defence can be mediated by 5-HT(1A) receptors. Furthermore there is evidence to indicate a differential involvement of pre- and postsynaptic 5-HT(1A) receptors.

Animals↗

Frequency of mental health disorders in a sample of elementary school students receiving special educational services for behavioural difficulties.

OBJECTIVE: Despite being essential for defining and planning special educational services, very few data are available in Quebec regarding the nature and extent of behavioural difficulties presented by children who receive special educational services at school. This study provides a picture of the frequency of disruptive behaviour disorders (that is, attention-deficit hyperactivity disorder [ADHD], oppositional defiant disorder [ODD], and conduct disorder [CD]) and internalized disorders (including generalized anxiety disorder [GAD] and major depressive episode [MDE]) in a sample of elementary school students receiving special educational services for behavioural difficulties (n = 324). METHOD: In this descriptive study, we established the presence of mental health disorders according to teacher-, parent-, and child-reported data that were obtained using structured diagnostic interviews based on DSM-IV criteria. We also examined prevalence rates by sex and age group. RESULTS: Three-quarters of the students met the criteria for ADHD, one-half for ODD, and one-third for CD. About 14% of the students presented with a GAD or met the criteria for an MDE in the past year. Only 2% of the students presented with an internalized disorder without a comorbid disruptive behaviour disorder. CONCLUSIONS: Our results suggest that among students receiving special educational services for behavioural difficulties, a large proportion may have difficulties severe enough to meet the criteria for at least one DSM-IV disruptive behaviour disorder. Such findings may underscore the need to develop more collaboration between the mental health and education sectors in rehabilitating these children.

Anxiety Disorders↗

Relationship between attachment-felt security and history of suicidal behaviours in clinical adolescents.

OBJECTIVE: This study was designed to test the hypothesis that adolescents who perceive their attachment figures as unavailable (low felt security) would be overrepresented in the case group of adolescents with a history of suicidal behaviours. METHOD: One hundred and eighty-seven adolescents in psychiatric treatment participated in this retrospective case-comparison study of attachment-felt security and history of suicidal behaviours. All participants completed the following measures: Adolescent Attachment Questionnaire, Perceived Social Support From Friends Scale, Rosenberg Self-Esteem Scale, Beck Hopelessness Scale, the depression syndrome scale of the Youth Self Report, and Adam's Suicidal Ideation and Behavior protocol. RESULTS: The comparison group comprised 101 adolescents who had never experienced suicidal ideation or behaviour; the case group included 86 adolescents with a history of suicidal behaviour. We found that perceived unavailability and high levels of depressive symptomatology were predictive of suicidal behaviours. We also found a strong association between being older and having high levels of angry distress in adolescents with a history of suicidal behaviours. CONCLUSION: The advantage of including an assessment of parent-adolescent attachment with clinical adolescents is noted.

Adolescent↗

Premeditated assaults on young boys by a man with spina bifida and hydrocephalus--a cognitive-behavioural approach to treatment.

This paper describes the case of a 25-year-old man with spina bifida and hydrocephalus, who had at least a ten-year history of physically assaulting young boys. Anti-social behaviour is reported as comparatively rare in people with this disability, and the case study illustrates how psychological assessment and treatment techniques were successfully applied. Information from his personal history plus a functional analysis of the assaults suggested that a combination of existing psychological difficulties and learning experiences contributed to the development of his behaviour. A behavioural model of the psychological mechanisms underlying the behaviour was suggested and treatment objectives defined. Cognitive and behavioural treatment techniques were adapted where necessary, with a good outcome. A gap in services for physically handicapped people with behavioural problems is noted and briefly discussed.

Adult↗

Impact of a sun awareness curriculum on medical students' knowledge, attitudes, and behaviour.

BACKGROUND: Physicians teach sun awareness to their patients, but frequently have no formal training in this area. A week-long dermatology curriculum during Sun Awareness Week that included skin cancer and sun awareness education to first-year medical students was introduced in May 1998 at the University of Western Ontario, London, Canada. OBJECTIVE: The purpose of this study was to determine the baseline knowledge, attitudes, and behaviour of the first-year medical students towards sun awareness before and after the new curriculum. METHOD: This study used a pre- and post-test design to determine the impact of the curriculum on the medical students' knowledge, attitudes, and intent to change behaviour. It also reports any influence of demographic variables on these parameters. RESULTS: The students demonstrated a substantial improvement in their knowledge of sun-related topics despite some baseline knowledge. Many students reported unhealthy behaviour prior to the curriculum, but demonstrated an intent to adopt more healthy behaviour after the curriculum. Minor differences in knowledge and behaviour due to demographic characteristics disappeared upon completion of the curriculum. CONCLUSIONS: An undergraduate medical curriculum with skin cancer and sun awareness education can improve the medical students' knowledge, attitudes, and behaviour towards sun awareness.

Adult↗

Mister in-between: a case study of masculine identity and health-related behaviour.

The study of young men's health-related behaviour offers an opportunity to examine the links between masculine identity and social behaviour. This article presents a case study of a 19-year-old man living in London, who describes himself as different to his peers on several important dimensions, including his engagement in health-related behaviours. The case study demonstrates the importance of health-related social behaviours such as drinking, drug use, physical activity, sport and sexual behaviour in the construction of a masculine identity. This case study also reveals that the way in which men position themselves in relation to different discourses of masculinity can have important implications not only for their masculine identities, but also for their health-related behaviour.

Adult↗

Predictors of smoking behaviour among indigenous sami adolescents and non-indigenous peers in north Norway.

AIMS: A study was undertaken to examine predictors of smoking behaviour among indigenous Sami adolescents and non-indigenous peers in North Norway, and to examine for ethnic-specific predictors. METHODS: This is a cross-sectional and longitudinal school-based and postal questionnaire study initially including 2,718 10th to 12th grade students (response rate (RR): 85%) in 1994-95 (T1). At the three-year follow-up (T2), in 1997-98, 1,405 were included (RR: 57%). Indigenous Sami contributed 23% (599/324) of the total samples. Logistic regression was used to examine the influence of sociodemographic and psychosocial predictors on smoking behaviour. RESULTS: The proportions of regular smokers were 33% (729) and 35% (401) at T1 and T2, respectively, while 19% (153) had initiated current smoking during the study period. Substance use, externalizing problems, sexual activity and vocational training (p </= 0.01) predicted regular smoking both cross-sectionally and prospectively. Among non-smokers at T1, age and frequent alcohol intoxication predicted current smoking prospectively (p </= 0.01). Frequent intoxication predicted all stages of smoking (p </= 0.001). Ethnicity did not predict smoking in this study. Laestadian Christian affiliation increased the prevalence of experimental smoking at T1 but only for Sami students. CONCLUSIONS: Youth smoking behaviour was strongly associated with risk-taking behaviours, indicating that a broader focus on health-compromising behaviours in anti-smoking campaigns is needed. The findings indicate little need for culturally sensitive anti-smoking campaigns specially designed for indigenous Sami youth, as the main predictors (risk-taking behaviours) were similar across ethnic groups.

Adolescent↗

Testing the effectiveness of an innovative information package on practitioner reported behaviour and beliefs: the UK Chiropractors, Osteopaths and Musculoskeletal Physiotherapists Low back pain ManagemENT (COMPLeMENT) trial [ISRCTN77245761].

BACKGROUND: Low back pain (LBP) is a common and costly problem. Initiatives designed to assist practitioner and patient decisions about appropriate healthcare for LBP include printed evidence-based clinical guidelines. The three professional groups of chiropractic, osteopathy and musculoskeletal physiotherapy in the UK share common ground with their approaches to managing LBP and are amongst those targeted by LBP guidelines. Even so, many seem unaware that such guidelines exist. Furthermore, the behaviour of at least some of these practitioners differs from that recommended in these guidelines. Few randomised controlled trials evaluating printed information as an intervention to change practitioner behaviour have utilised a no-intervention control. All these trials have used a cluster design and most have methodological flaws. None specifically focus upon practitioner behaviour towards LBP patients. Studies that have investigated other strategies to change practitioner behaviour with LBP patients have produced conflicting results. Although numerous LBP guidelines have been developed worldwide, there is a paucity of data on whether their dissemination actually changes practitioner behaviour. Primarily because of its low unit cost, sending printed information to large numbers of practitioners is an attractive dissemination and implementation strategy. The effect size of such a strategy, at an individual practitioner level, is likely to be small. However, if large numbers of practitioners are targeted, this strategy might achieve meaningful changes at a population level. METHODS: The primary aim of this prospective, pragmatic randomised controlled trial is to test the short-term effectiveness (six-months following intervention) of a directly-posted information package on the reported clinical behaviour (primary outcome), attitudes and beliefs of UK chiropractors, osteopaths and musculoskeletal physiotherapists. We sought to randomly allocate a combined sample of 1,800 consenting practitioners to receive either the information package (intervention arm) or no information above that gained during normal practice (control arm). We collected questionnaire data at baseline and six-months post-intervention. The analysis of the primary outcome will assess between-arm differences of proportions of responses to questions on recommendations about activity, work and bed-rest, that fall within categories previously defined by an expert consensus exercise as either 'guideline-consistent' and 'guideline-inconsistent'.

Chiropractic↗

Way-marking behaviour: an aid to spatial navigation in the wood mouse (Apodemus sylvaticus).

BACKGROUND: During their movements in the wild, wood mice (Apodemus sylvaticus) distribute small objects, such as leaves or twigs, which are often visually conspicuous. Our experiments demonstrate that these marks serve as points of reference during exploration. Way-marking, as we call it, may diminish the likelihood of losing an "interesting" location, perhaps following disturbance by, for example, a predator or conspecific. Way-marks, being readily portable, may be a less confusing method of marking ephemeral sites than scent marks. They may also be a safer option for local navigation insofar as scent marks can easily be detected by a predator. RESULTS: In an experiment, conspicuous natural candidate way-marks were removed from a simple arena and wood mice were given white plastic discs instead. The wood mice picked up these discs and re-distributed them about their arena; as the mice moved, they repeatedly re-positioned the discs and usually spent a considerable time near recently repositioned discs. Analysis revealed a statistically significant association between the location of places in which the mice had positioned way-marks and the subsequent pattern of their movements. In a separate analysis, based on the context in which each behaviour occurred, we used the components and sequences of wood mouse behaviour to deduce the motivation behind each activity. One set of behaviour patterns, the elements of which were closely linked by the high transition probabilities amongst them, were interpreted as linked elements of exploration; whenever the mice transported a disc it was in association with these exploratory behaviours. This evidence that transporting discs is set in the motivational context of exploratory behaviour supports the conclusion that way-marking is part of the wood mouse's system of spatial orientation. CONCLUSION: We conclude that way-marking - a behaviour not previously described in mammals other than humans - serves solely as an aid to spatial navigation during exploration.

Animals↗

Moment-to-moment dynamics of ADHD behaviour in South African children.

BACKGROUND: The behaviour of children with Attention-Deficit/Hyperactivity Disorder is characterized by low predictability of responding. Low behavioural predictability is one way of operationalizing intra-individual ADHD-related variability. ADHD-related variability may be caused by inefficient behavioural selection mechanisms linked to reinforcement and extinction, as suggested by the recently published dynamic developmental theory (DDT) of ADHD. DDT argues that ADHD is a basic neurobehavioural disorder, caused by dysfunctioning dopamine systems. For establishing ADHD as a neurobehavioural disorder, findings from studies conducted in Western countries should be replicated in other cultural populations. The present study replicated the study conducted in Norway, with children from the Limpopo province in the Republic of South Africa. METHODS: Boys and girls, aged 6-9 yr, from seven ethnic groups participated. Scores by teachers on the Disruptive Behavior Disorders rating scale defined participation in either ADHD-hyperactive/impulsive (-HI), ADHD-predominantly inattentive (-PI), or ADHD-combined (-C) groups. Children below the 86th percentile were matched on gender and age and comprised the non-ADHD group. The children completed a computerized game-like task where mouse clicks on one of two squares on the screen resulted in delivery of a reinforcer according to a variable interval schedule of reinforcement. Reinforcers were cartoon pictures presented on the screen together with a sound. Predictability of response location and timing were measured in terms of explained variance. RESULTS: Overall, the results replicated findings from Norway. Specifically, the ADHD-C group showed significantly lower predictability of responding than the non-ADHD group, while the ADHD-HI and the ADHD-PI groups were in-between. In accordance with the previous study, response location, but not response timing, was a sensitive behavioural measure. There were no significant gender differences. Cartoon pictures were effective reinforcers as the non-ADHD group showed learning of the task. There was no relation between behavioural predictability and motor functions. CONCLUSION: The present study makes a strong case for ADHD as a basic, neurobehavioural disorder, not a cultural phenomenon, by replicating findings from a wealthy Western country in a poor province of a developing country. The results were, generally, in line with predictions from the dynamic developmental theory of ADHD by indicating that reinforcers were less efficient in the ADHD group than in the non-ADHD group. Finally, the results substantiated ADHD-related variability as an etiologically important characteristic of ADHD behaviour.

Journal Article↗

The community management of schizophrenia. A controlled trial of a behavioural intervention with families to reduce relapse.

Schizophrenic patients were recruited into a trial of a prophylactic behavioural intervention with families. Families with at least one high Expressed Emotion (EE) relative were randomly allocated to one of four intervention groups: Behavioural Intervention Enactive; Behavioural Intervention Symbolic; Education Only; Routine Treatment. Patients from low-EE families were randomly allocated to two groups: Education Only or Routine Treatment. Relapse rates over nine months after discharge were significantly lower for patients in the two Behavioural Intervention, compared with Education Only and Routine Treatment groups. There was little difference between the two low-EE groups. Patients returning to high-EE relatives showed significantly higher relapse rates than those returning to low-EE relatives, in groups not receiving active intervention. Changes from high to low EE occurred in the Behavioural Intervention groups, and similar although less extensive changes occurred in the Education Only and Routine Treatment groups. Changes in criticism and marked emotional over-involvement (EOI) occurred generally in high-EE groups but were larger in magnitude in the Enactive and Symbolic groups. Reduction of hostility only occurred in the Behavioural Intervention groups. These results give partial support for the causal role of EE in relapse. There were no significant differences between the groups with respect to contact with the psychiatric services or medication.

Adult↗

Behaviour phenotype for Down's syndrome.

BACKGROUND: For more than a century, the idea of particular personality/behavioural characteristics being associated with people with Down's syndrome has been explored, but with inconclusive results. METHOD: The Disability Assessment Schedule was used to ascertain the behavioural profiles of 360 adults with Down's syndrome and 1829 adults with learning disabilities of other aetiologies, who were the whole identified population within a defined geographical area. Comparison was made between the two total groups and additionally for the subgroups aged < 35 years and aged > or = 35 years. Comparison was also made with regards to cluster analysis findings. RESULTS: Despite an equal age and developmental quotient, the Down's syndrome group were less likely to demonstrate maladaptive behaviours. The behaviour characteristics of the adults with Down's syndrome remained constant in the younger and older age groups. Cluster analysis demonstrated adults with Down's syndrome to have an increased prevalence in cluster groupings with lower rates of maladaptive behaviours. CONCLUSIONS: This study confirms there to be a behaviour phenotype among adults with Down's syndrome. The reasons for this (e.g. genetic/psychological/social) require further research. Such research may establish a better understanding of the aetiologies of maladaptive behaviours among people with learning disabilities in general.

Adult↗

Self-injurious behaviour as part of genetic syndromes.

BACKGROUND: The purpose of this paper is to review the association between genetic syndromes and self-injurious behaviour. METHOD: The information available from the literature on the subject of self-injurious behaviours and genetic syndromes was collated and presented with a critical appraisal. RESULTS: Self-injurious behaviours are associated with some genetic syndromes. However, the causal relationship between the genetic syndromes and the self-injurious behaviour remains far from clear. CONCLUSIONS: Although self-injurious behaviour has been shown to be the part of a broader phenotype in many genetic disorders, the specificity and sensitivity of these behaviours in this context remain unclear.

Brain Damage, Chronic↗

Suicidal behaviour in psychosis: prevalence and predictors from a randomised controlled trial of case management: report from the UK700 trial.

BACKGROUND: It is unclear whether intensive case management influences the prevalence of suicidal behaviour in patients with psychosis. AIMS: To compare the effect of intensive case management and standard care on prevalence of suicidal behaviour in patients with chronic psychosis. METHOD: Patients with established psychosis (n = 708) were randomised either to intensive case management or to standard care. The prevalence of suicidal behaviour was estimated at 2-year follow-up and compared between treatment groups. Suicide attempters and non-attempters were compared on multiple socio-demographic and clinical variables to identify predictors of suicidal behaviour. RESULTS: There was no significant difference in prevalence of suicidal behaviour between treatment groups. Recent attempts at suicide and multiple recent hospital admissions best predicted future attempts. CONCLUSIONS: Intensive case management does not appear to influence the prevalence of suicidal behaviour in chronic psychosis. Predictors identified in this study confirm some previous findings.

Adolescent↗

Dialectical behaviour therapy for women with borderline personality disorder: 12-month, randomised clinical trial in The Netherlands.

BACKGROUND: Dialectical behaviour therapy (DBT) is widely considered to be a promising treatment for borderline personality disorder (BPD). However, the evidence for its efficacy published thus far should be regarded as preliminary. AIMS: To compare the effectiveness of DBT with treatment as usual for patients with BPD and to examine the impact of baseline severity on effectiveness. METHOD: Fifty-eight women with BPD were randomly assigned to either 12 months of DBT or usual treatment in a randomised controlled study. Participants were recruited through clinical referrals from both addiction treatment and psychiatric services. Outcome measures included treatment retention and the course of suicidal, self-mutilating and self-damaging impulsive behaviours. RESULTS: Dialectical behaviour therapy resulted in better retention rates and greater reductions of self-mutilating and self-damaging impulsive behaviours compared with usual treatment, especially among those with a history of frequent self-mutilation. CONCLUSIONS: Dialectical behaviour therapy is superior to usual treatment in reducing high-risk behaviours in patients with BPD.

Adult↗

Group cognitive-behavioural therapy for schizophrenia. Randomised controlled trial.

BACKGROUND: The efficacy of cognitive-behavioural therapy for schizophrenia is established, but there is less evidence for a group format. AIMS: To evaluate the effectiveness of group cognitive-behavioural therapy for schizophrenia. METHOD: In all, 113 people with persistent positive symptoms of schizophrenia were assigned to receive group cognitive-behavioural therapy or treatment as usual. The primary outcome was positive symptom improvement on the Positive and Negative Syndrome Scales. Secondary outcome measures included symptoms, functioning, relapses, hopelessness and self-esteem. RESULTS: There were no significant differences between the cognitive-behavioural therapy and treatment as usual on measures of symptoms or functioning or relapse, but group cognitive-behavioural therapy treatment resulted in reductions in feelings of hopelessness and in low self-esteem. CONCLUSIONS: Although group cognitive-behavioural therapy may not be the optimum treatment method for reducing hallucinations and delusions, it may have important benefits, including feeling less negative about oneself and less hopeless for the future.

Adult↗

Physiological control of diving behaviour in the Weddell seal Leptonychotes weddelli: a model based on cardiorespiratory control theory.

Despite being obligate air breathers, many species of marine mammal are capable of spending most of their lives submerged in water. How they do this has been a subject of intense interest to physiologists for over a century, yet we still do not have a detailed understanding of the physiological mechanisms underlying this behaviour. What are the proximate mechanisms that trigger the 'decisions' to submerge and return to the surface? The present study proposes a model intended to address this question, based on fundamental concepts of cardiorespiratory control. Two basic hypotheses are examined by computer simulation, using a mathematical model of the mammalian cardiorespiratory control system with parameter values for an adult Weddell seal: (1) that the control of diving can be considered to be a respiratory control problem, and (2) that dives are initiated and maintained by disfacilitation of respiratory drive, not inhibition. Computer simulations confirmed the plausibility of these hypotheses. Simulated diving behaviour and physiological responses (ventilation, cardiac output, blood and tissue gas tensions) were consistent with published data from freely diving Weddell seals. Dives up to the estimated aerobic dive limit (ADL, 18-25 min) could be simulated without the need for active inhibition of breathing in this model. This theoretical analysis suggests that the most important physiological adjustments occur during the surface interval phase of the dive cycle and include hyperventilation accompanied by high cardiac output, appropriate regulation of cerebral blood flow and central chemoreceptor threshold shifts. During dives, cardiac output, distribution of peripheral blood flow, splenic contraction and peripheral chemoreflex drives were found to modulate physiological and behavioural responses, but were not essential for simulated dives to occur. The main conclusion from this study is that the central chemoreceptor may be an important mechanism involved in the regulation of diving behaviour, implying that CO2, not O2, is the key regulatory variable in this model. This model includes and extends the ADL concept and suggests an explicit mechanism by which the respiratory control system may play a central role in the regulation of diving behaviour. It is likely that respiratory mechanisms are an important component of a hierarchical behavioural control system and further studies are required to test the qualitative and quantitative validity of the model.

Animals↗

Head waving in Aplysia californica. I. Behavioural characterization of searching movements.

Searching is an important component of several types of goal-directed behaviour. In soft-bodied animals, searching behaviour can appear quite complex because the range of body movement is not constrained by joints, limbs or muscles with discrete areas of origin and insertion. In addition, animals exhibiting this type of behaviour utilize their maximum freedom of movement. In this paper, we describe the head-waving searching behaviour of the sea hare Aplysia californica by characterizing patterns of movements and the changes in body shape that underlie these movements. A bout of head waving consists of a series of discrete movements separated by pauses. Each discrete movement lasts 4-10s and is directed either horizontally or vertically with respect to stationary part of the animal. Large movements, such as bending from the extreme right to the extreme left, consist of a series of these shorter movements separated by pauses lasting 1-2s. In all head-waving movements, the transverse axis of the head is kept relatively parallel with the substratum. Thus, vertical movements require only bending of the body, whereas horizontal movements require twisting of the body, particularly when the posture is more erect. During head waving, the anterior two-thirds of the body is free to move, but most of the bending occurs immediately posterior to the head region. There is no periodicity of movements within a bout of head waving, although isolated instances of repeated movements are sometimes observed. Therefore, although the individual movements during head waving are relatively simple, the absence of a patterned sequence accounts for the complexity of the overall behaviour. These observations both constrain models of the neural organization of head waving and provide criteria for categorizing head-waving movements in further behavioural and physiological studies.

Animals↗