Behavior modification for obesity: The evaluation of exercise, contingency management, and program adherence.

Investigated crucial aspects of behavioral programs for obesity including (a) the assumption that Ss actually engage in requested behaviors and that these behaviors mediate weight loss, (b) the effect of exercise on weight loss, and (c) the problem of long-term maintenance and generalization to the clinically obese. Exercise and self-managed contingency components were compared in a 2?×?2 factorial design on 44 obese Ss and were evaluated after 10 wks of treatment and 3-mo and 1-yr follow-ups. Significant weight loss was observed for all groups at program termination and the 3-mo follow-up, with only those exposed to exercise and/or contingency management maintaining weight loss after 1 yr. There were no main effects or interactions at program termination or at the 3-mo follow-up. However, the influence of exercise at the 1-yr follow-up was noticeable. Assessment of program adherence indicated that Ss engaged in program behaviors, yet only 1 of 10 such behaviors was related to weight loss. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of participant modeling on information acquisition and skill utilization.

Assessed the contribution of active participant modeling in coping skills training by evaluating 2 critical process variables: the retention of information about the threatening events and how to cope with them, and the visceral component of imaginal rehearsal. 38 8–13 yr old children, highly fearful of dentists (the Dental subscale of the Children's Fear Survey Schedule), were shown a videotape of 2 children practicing controlled respiration and imagery techniques while undergoing dental treatment. The participant modeling group was encouraged to practice these as they watched the film, whereas the symbolic modeling group was told that this might help them during their own dental treatment, which immediately followed videotape preparation. Ss who had the active participant instructions obtained more information from the videotape, reported greater reduction in dental anxiety, and showed lower respiratory rates as they watched the videotape. They reported greater use of imagery techniques and enhanced self-control. The degree of disruptiveness was significantly lower during subsequent actual dental treatment in Ss from the active practice group. (33 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sequencing of behavior therapy and pharmacotherapy for obesity.

Investigated 2 sequences of combining behavior therapy and pharmacotherapy to determine if anorexic medication could be used effectively to facilitate initial weight loss without compromising the long-term effects of behavior therapy. 91 18–30 yr old women, averaging 31% overweight, participated in a 16-wk treatment program with follow-up assessments scheduled 4 mo and 1 yr later. Anorexic medication, fenfluramine HCl, enhanced weight loss whenever it was introduced, but it was more effective when introduced 8 wks into the behavior therapy program rather than initially. Ss in this sequence (later medication) had lost the most weight (9.3 kg) by the end of treatment, significantly more than those receiving either medication or behavior therapy only. These Ss, however, regained weight once treatment was terminated so that by the 1-yr follow-up, the conditions were not significantly different. Ss in the other sequence (initial medication) maintained their weight loss after medication was terminated as long as they continued to receive behavior therapy; however, they too regained weight once all treatment was terminated. Thus, anorexic medication demonstrated a surprisingly strong effect when introduced midway through a behavior therapy program, when the rate of loss typically slows, but this initially beneficial effect was not maintained during the follow-up period. A post hoc exploration of the data indicates that medication was particularly helpful to Ss who did not initially respond well to behavior therapy. (13 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment of childhood migraine using autogenic feedback training.

Assigned 28 7–16 yr olds who suffered from migraine headaches to 1 of 2 conditions (treatment group or waiting-list control group). All Ss recorded at breakfast, lunch, dinner, and bedtime whether they had a headache and its intensity. The records of headache index, frequency, duration, intensity, average intensity, and medication generated weekly scores. Analysis showed that Ss in the treatment condition were significantly improved at the end of treatment (7 wks) and at 1-mo follow-up. No improvement was found for control Ss. 93% of Ss in the autogenic feedback condition were clinically improved, using a criterion of 50% reduction of headache activity. Six months after treatment, Ss were asked to complete headache recordings. 13 Ss responded (8 Ss from the treatment groups and 5 from the control group). Treated Ss maintained significant improvement. Findings are important in light of the need for effective nonpharmacological treatment procedures for childhood migraine. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-administered masturbation training in the treatment of primary orgasmic dysfunction.

30 married and 30 single nonorgasmic women (mean age 29 yrs) participated in a clinical outcome study of sexual dysfunction. Ss were randomly divided into 3 groups: videotape modeling, written instructions, and waiting-list control. Both treatment procedures involved a 6-wk, self-administered masturbation-training program. After the pretest interview, treatment was carried out without direct contact with the experimenter. Of the Ss receiving treatment, 60% became orgasmic by the end of the treatment period. Four additional married Ss became orgasmic by the time of the 1-yr follow-up. For those Ss who failed to transfer orgasmic capacity to coital intercourse, the role of partner dysfunction is discussed. Although no significant differences were found between the videotaped modeling condition and the written instructions group, the overall effectiveness of the treatment compares favorably with other treatment programs. With respect to cost–benefit assessment, however, the self-administered treatment is clearly superior. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Borderline personality organization and prognosis in eating disorders.

Used interview-based assessment of level of personality organization and confirmed the finding of C. Johnson et al (see record 1991-13161-001) that borderline bulimics had a markedly worse prognosis over 1 yr than bulimics without borderline features. Ss in the present study were 31 eating disorder female patients at 1-yr follow-up. However, after 2 and 3 yrs, no such indications were evident. Instead, the borderline patients (9 Ss) unexpectedly caught up, eliminating the initial advantage held by the neurotics (7 Ss), and after 3 yrs, there were no differences in outcome between the groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Exposure-based integrated vs. pure psychodynamic treatment of agoraphobic inpatients.

Compared treatment outcomes for 19 agoraphobic inpatients who received either integrated, exposure-based, behavioral-psychodynamic treatment (IT) or general psychodynamic therapy (PT). All Ss completed an agoraphobic cognitions scale, the Multidimensional Health Locus of Control Scale, the Beck Depression Inventory, and a phobic avoidance rating scale after admission to the hospital and 11 wks later at discharge. Both IT and PT Ss improved significantly on almost all measures. Changes in IT Ss were relatively stable at a 1-yr follow-up, while PT Ss showed significant relapse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Improving the social skills of males in a maximum security psychiatric setting.

34 male patients (mean age 26 yrs) in a maximum security psychiatric hospital, selected on the basis of their low ratings on role-play situations, the Communication and Social Contact subscales of the MACC Behavior Adjustment Scale, and the Social Adjustment Rating Scale, were assigned to either social skills training (SST) or client-centered therapy (CCT) and were given either contingent or noncontingent reinforcement for social behavior. Ss in the SST condition received 10 wks of SST; Ss in the CCT condition participated in 2 90-min nondirective group psychotherapy sessions per week for 10 wks. Ss in all conditions showed dramatic improvements on the assessment battery when tested postintervention. Consistent with other studies of SST, Ss in the SST condition showed significant improvements in role-play measures of social skills during treatment, while Ss given CCT did not. However, there was no evidence of transfer of training onto the ward nor evidence that the effects persisted at 1-mo follow-up. Thus, the data question the application of SST in maximum security settings. (French abstract) (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Covert and overt rehearsal and homework practice in developing assertiveness.

Evaluated the effects of overt rehearsal and homework practice on covert modeling treatment of social skills. 79 18–73 yr old nonassertive clients received 1 of 4 variations of covert modeling that resulted from a 2?×?2 combination of overt rehearsal and homework practice. Ss who received overt rehearsal engaged in overt enactments (role playing) within the treatment sessions; Ss who received homework practice engaged in extra treatment activities to develop their social skills. A delayed-treatment control group was also included to serve as a no-treatment condition before Ss were randomly assigned to 1 of the 4 treatments. Findings indicate that treatments led to significant improvements on self-report inventories, global ratings, and behavioral measures of assertiveness (the Conflict Resolution Inventory and the Wolpe-Lazarus Assertiveness Questionnaire). Ss who engaged in homework practice and/or overt rehearsal of assertive behavior within the treatment sessions made consistently greater improvements at posttreatment and at an 8-mo follow-up than Ss who did not receive the procedures. Treatment effects extended to novel assessment situations and brought Ss to the level of 45 16–41 yr olds who regarded themselves as adept in social situations. (28 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparative study of feminist and traditional group assertiveness training with women.

Tested the effectiveness of feminist group therapy within the context of group assertiveness training for women. Two types of group were organized: One emphasized female role modeling, identity formation, and awareness of sex roles; and one had a traditional approach. Two female group leaders were trained and conducted one of each type group with all-female group members. The 40 adult Ss were interviewed, and 5 outcome measures were taken pre- and posttherapy and at follow-up 6 wks later. Both groups made significant gains on all measures, but the feminist groups did not make greater gains than the traditional groups. Ss who described themselves as feminists at the outset generally showed elevated scores throughout, more commitment to remain in treatment, and greater initial gains in self-reported assertiveness than did Ss who endorsed a more conservative position. It is concluded that the success of feminist therapy groups may not be attributable to their consciousness-raising style but perhaps to the single-sex composition of such groups and to the feminist orientation of clients who seek this form of psychotherapy. (30 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Feminist therapy with chronically and profoundly disturbed women.

28 18–55 yr old females judged to be either high risk, chronic, or potentially chronic with regard to psychiatric illness by staff at a community mental health center were assigned to a women's awareness (WA) group and tested. While they waited for the WA group to begin, they participated in an "adult daycare" program for a mean of 8.7 wks. The WA groups lasted 14–26 wks, before and after which Ss were again tested. Significant improvement in self-esteem, as measured by the Tennessee Self-Concept Scale, and significant increase in sexual knowledge, as measured by a sexual information questionnaire, were produced for Ss in the feminist therapy groups. No changes were produced on the Attitudes Toward Women Scale. No effects were noted for Ss in the control comparison on any of the measures. Results are compared with other findings on the effects of feminist therapy. It is concluded that feminist therapy can be effective for women from the chronically and profoundly disturbed population. (36 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Developmental differences in responses to a television character's appearance and behavior.

In a 2?×?2?×?3 design, 52 3–5 yr olds, 58 6–7 yr olds, and 59 9–10 yr olds viewed a videotape in which a female protagonist's appearance (attractive, ugly) was factorially varied with her behavior (kind, cruel). Perceptions of the protagonist and predictions of the story's outcome were assessed. Based on theoretical and empirical evidence of a developmental decrease in perceptual dependence, the influence of the woman's appearance was expected to decrease with age, and the influence of her behavior was expected to increase with age. These expectations were confirmed. A 2nd study was conducted with 40 4–5 yr olds, 41 6–7 yr olds, and 34 9–21 yr olds to rule out the alternative explanation that younger children possess stronger physical appearance stereotypes than do older children. In this study, Ss did not have information about the woman's behavior. It was found that Ss at all 3 age levels demonstrated appearance stereotyping. (36 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive-behavioral self-control therapy for children: A components analysis.

27 non-self-controlled 8–12 yr olds (as measured by the Self-Control Rating Scale) were randomly assigned to a cognitive-behavioral treatment, a behavioral treatment, or an attention-control condition. Ss were administered the Peabody Picture Vocabulary Test, Matching Familiar Figures Test, Piers-Harris Children's Self-Concept Scale, and Wide Range Achievement Test. All Ss received 12 sessions of individual therapist contact focusing on psychoeducational, play, and interpersonal tasks and situations, with the cognitive-behavioral treatment including self-instructional training via modeling and behavioral contingencies and the behavioral treatment involving modeling and contingencies. The cognitive-behavioral intervention improved teachers' blind ratings of self-control, and both the cognitive-behavioral and behavioral treatments improved teachers' blind ratings of hyperactivity. Several performance measures (cognitive style, academic achievement) showed improvements for the cognitive-behavioral and behavioral conditions, whereas only the cognitive-behavioral treatment improved children's self-concept. Normative comparisons and 10-wk follow-up provided additional support for the efficacy of the cognitive-behavioral treatment; 1-yr follow-up did not show significant differences across conditions. (35 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Group psychotherapy with mastectomy patients.

Compared 20 women who participated in 10 weekly sessions of group psychotherapy with 20 women placed on a waiting list after they had mastectomies. Ss were matched on age (33–65 yrs old), marital status, time since surgery, prognosis, and SES. A structured, scaled interview was used to assess maladjustment, and 2 inventories were used to assess therapy outcome; all Ss were administered all measures before the treatment program began, when it finished 10 wks later, and 4 wks after the end of treatment. Results show that over the course of the therapy period, both groups showed changes in a positive direction; however, Ss in the treatment group showed significantly greater improvement. In the 4-wk follow-up period Ss in the treatment group continued to show significant positive change. (13 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

One-year follow-up of concrete versus conceptual cognitive-behavioral self-control training.

Examined 1-yr follow-up data on the cognitive–behavioral treatment reported by P. C. Kendall and L. E. Wilcox (see PA, Vols 63:2414 and 63:5970). 17 of the 33 children (mean age 11.1 yrs) were located and given the Matching Familiar Figures Test. Numerous improvements were found for Ss in all treatment groups, and these effects were attributed to increased age. It was found that conceptually trained Ss showed significantly better recall of the material they had learned than either concrete-trained or control group Ss, and they were rated blindly by new classroom teachers as not sufficiently lacking in self-control to warrant referral. A suggestive pattern of relationships between age and long-term effects was noted. (6 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment of female sexual dysfunction through symbolic modeling.

Presents an evaluation of treatment programs for women suffering from debilitating sexual anxiety. Attitudinal and behavioral indices of sexual adjustment and sexual anxiety, including a card sort, a sexual semantic differential, and the Bantler Heterosexual Behavior Hierarchy, were obtained from 22 21–39 yr old inorgasmic women to assess effects of individual and group graduated symbolic modeling through videotapes, with concurrent behavioral tasks as treatment procedures. All Ss had reported severe anxiety that precluded sexual enjoyment or activity. 16 Ss were randomly assigned to 2 groups receiving either individual or group treatment, which consisted of relaxation training followed by viewing 45 videotaped vignettes depicting graduated sexual behaviors. Five sessions were held twice weekly. The other Ss were subjected to identical measurement without treatment. Results show that significant decreases in anxiety and increases in behavioral and attitudinal measures were evidenced for both treatment groups; however, a trend toward greater improvement was observed for those receiving group treatment. Improvement remained stable through a 1-yr follow-up. Control Ss showed no improvement and trends toward deterioration. The treatment regimen appeared to produce positive changes in attitudinal, behavioral, and anxiety indices simultaneously. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of cognitive and behavioral group treatment on the depressive symptomatology of Puerto Rican women.

Compared a control, a cognitive, and a behavior therapy group in the reduction of depression in 26 low-income Puerto Rican women (mean age 38 yrs). Ss were identified as depressed by self-report (Beck Depression Inventory), clinical ratings (a revised version of the Hamilton Rating Scale for Depression), and depression behavior rating scales and were randomly assigned to 3 treatment conditions. Five treatment sessions of 1? hrs each were conducted over 4 wks. Results show a significant reduction in depression for therapy groups and no significant differences between the behavior and cognitive approaches. A 5-wk follow-up assessment revealed that the alleviation of depression had generally been maintained, with a slight advantage for the behavioral approach. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Communication patterns and response to treatment among depressed and nondepressed maritally distressed couples.

Compared 35 maritally distressed couples assigned to 1 of 3 cognitive behavioral marital therapy (BMT) groups. Groups represented (1) couples in which 1 spouse was depressed at pretest, (2) couples in which 1 spouse showed psychopathology other than depression, and (3) couples who showed no symptoms of individual psychopathology. Ss were administered, pre- and posttreatment, the Dyadic Adjustment Scale and the Minnesota Multiphasic Personality Inventory (MMPI). Pretreatment couples in Group 1 were the oldest and the least maritally satisfied, and expressed the most negative communication. 12 wks of BMT was an effective treatment modality for all groups when compared with a group of 12 couples on a wait list. BMT significantly increased marital adjustment for all 3 treatment groups and decreased the rates of negative communication. BMT significantly decreased the level of depression in Group 1 and the level of psychopathology in Group 2. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Enhancing treatment gains in a school-based intervention for children of divorce through skill training, parental involvement, and transfer procedures.

The school-based Children's Support Group procedure teaches skills to cope with divorce-related events and provides strategies for mastering disrupted developmental tasks. Ss were 103 3rd–5th grade children of separated or divorced parents who were assigned to 1 of 3 treatment groups: (1) support, (2) support and skill building, or (3) support, skill building, transfer, and parent training procedures. 26 children from intact homes served as non-stressed controls. The 2 skill-building conditions yielded durable improvements in adjustive behaviors in the home. Transfer components yielded additional improvements in affect, but the absence of substantial increments in benefits suggests the need for a closer look at the format and expectations of the transfer vehicle. The benefits of the support-alone condition were experienced most by children who entered the intervention with significant problems, with the greatest reductions in clinical symptomatology at follow-up being found in this group. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment of nightmares via relaxation and desensitization: A controlled evaluation.

32 self-referred nightmare sufferers (mean age 36 yrs) were randomly assigned to relaxation training, systematic desensitization, or a waiting-list control. Ss on the average had been having 9 nightmares/mo and reported mean problem duration of 12 yrs prior to treatment. After the intervention phase, both treated groups showed significant decreases in nightmare frequency relative to controls. After subsequent treatment, the waiting-list group showed similarly decreased frequency but remained unimproved on nightmare intensity relative to prior treated groups. Hierarchical desensitization did not increase efficacy at 15 wks beyond benefits associated with relaxation alone. At 25 wks, however, desensitized Ss showed significantly greater reduction in nightmare intensity. Overall, at least 80% reduction in nightmares was reported by 20 Ss, of whom 12 reported total elimination of symptoms at 25-wk follow-up. Some Ss experienced fewer but more intense nightmares, others maintained frequency of previously disturbing dreams but were no longer awakened or distressed by them, and 2 reported substantial worsening of symptoms. Unfavorable outcome was associated with personality disorder profiles on the MMPI. Findings are discussed in relation to a conceptualization of nightmares as a symptom of a more generalized arousal disorder. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)