Ambulatory computer-assisted therapy for obesity: A new frontier for behavior therapy.

Implemented a behavioral treatment program for obesity and tested an interactive microcomputer system small enough to be carried by Ss throughout their normal daily routines. Treatment effects observed in 6 30–50 yr old females (at least 35% overweight) who received this experimental treatment were compared with those observed in 6 matched female controls (also at least 35% overweight) who received a similar treatment program implemented without computer assistance. The self-monitoring, goal-setting, and feedback treatment packages were computer-assisted or involved paper and pencil. Mean weight loss after the 8 postbaseline study weeks was 8.1 lb for the experimental Ss compared with 3.3 lb for the control Ss. Mean weight loss 8 mo posttreatment was 17.7 lb for the experimental Ss compared with 2.3 lb for the control Ss. It is concluded that ambulatory computer-assisted therapy provides important new opportunities for conducting behavior therapy and research in real-life settings. (5 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Weight loss and maintenance and changes in diet and exercise for behavioral counseling and nutrition education.

100 out of 112 women who initially were at least 20 lb overweight, but did not weigh over 220 lb completed a 16-wk program of either behavioral counseling or nutrition education. Initial weight losses were similar for both groups, but behavioral Ss (BEs) consumed significantly fewer calories and changed more on 2 of 4 exercise measures than did nutrition education Ss (NEs). Reviews of daily eating records indicated that BEs more often used diets that were nutritionally unsound. The exercise changes in both conditions were modest and highly variable. Seven-month follow-up indicated that BEs maintained significantly more weight loss than did NEs. Interviews with 92 Ss indicated that regular monitoring of eating, an exercise routine, and problem solving were associated with maintenance. (27 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Catecholamine secretion as a function of perceived coping self-efficacy.

Hypothesized that perceived coping self-efficacy mediates the effects of environmental events on catecholamine secretion. Differential levels of perceived self-efficacy were induced in 12 female phobic Ss, aged 19–40 yrs, through modeling. Their level of catecholamine secretion was then measured as they were presented with coping tasks in their high, medium, and low ranges of perceived self-efficacy. High perceived self-efficacy was accompanied by low levels of plasma epinephrine and norepinephrine during interaction with a phobic object, whereas moderate perceived self-inefficacy gave rise to substantial increases in plasma catecholamines. Both catecholamines dropped sharply when Ss declined tasks for which they judged themselves completely inefficacious. In contrast, dihydroxyphenyl-acetic acid was released maximally by mere apperception of task demands that Ss regarded as overwhelming their coping capabilities. After perceived self-efficacy was strengthened to the maximal level by S modeling, all of the tasks were performed without any differential catecholamine responses. (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Guided mastery and performance desensitization treatments for severe acrophobia.

Compared 2 models of phobia treatment: the desensitization model, which emphasizes extinction of conditioned anxiety responses by exposing people to feared stimuli at low levels of anxiety arousal, and the self-efficacy model, which emphasizes building a strong sense of mastery by helping people accomplish new tasks rapidly and assuredly. 38 height phobics (aged 22–68 yrs) were assigned randomly to 1 of 3 treatment conditions: guided mastery treatment based on self-efficacy theory, performance desensitization treatment, and no treatment. Although desensitization Ss received significantly longer exposure to threats than guided mastery Ss, guided mastery treatment proved to be significantly more effective than desensitization treatment in restoring Ss' behavioral functioning, in raising their perceptions of self-efficacy, and in reducing their anticipated anxiety and thoughts of danger. Results support the hypothesis that perceptions of self-efficacy are influential mediators of treatment effects. Perceived self-efficacy predicted therapeutic outcome more accurately than did anxiety arousal, anticipated anxiety, or perceived danger. (40 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A longitudinal test of the investment model: The development (and deterioration) of satisfaction and commitment in heterosexual involvements.

Used a longitudinal study of heterosexual dating relationships to test investment model predictions regarding the process by which satisfaction and commitment develop (or deteriorate) over time. Initially, 17 male and 17 female undergraduates, each of whom was involved in a heterosexual relationship of 0–8 wks duration, participated. Four Ss dropped out, and 10 Ss' relationships ended. Questionnaires were completed by Ss every 17 days. Increases over time in rewards led to corresponding increases in satisfaction, whereas variations in costs did not significantly affect satisfaction. Commitment increased because of increases in satisfaction, declines in the quality of available alternatives, and increases in investment size. Greater rewards also promoted increases in commitment to maintain relationships, whereas changes in costs generally had no impact on commitment. For stayers, rewards increased, costs rose slightly, satisfaction grew, alternative quality declined, investment size increased, and commitment grew; for leavers the reverse occurred. Ss whose partners ended their relationships evidenced entrapment: They showed relatively low increases in satisfaction, but their alternatives declined in quality and they continued to invest heavily in their relationships. (39 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anchoring, efficacy, and action: The influence of judgmental heuristics on self-efficacy judgments and behavior.

Two experiments addressed relations between judgmental processes and action by examining both the impact of the anchoring/adjustment heuristic on judgments of performance capabilities and the subsequent impact of these self-efficacy judgments on behavior. In Exp I, 62 undergraduates judged their capabilities for performance on a problem-solving task after exposure to ostensibly random anchor values representing either high or low levels of performance. Ss in a control condition received no anchor values. Anchoring biases strongly affected self-efficacy judgments. High-anchor Ss evidenced the highest judgments of their capabilities and low-anchor Ss the lowest judgments. Ss then performed the task. Differences in task persistence paralleled the differences in self-efficacy judgments, with high-anchor Ss displaying the highest level of task persistence. Exp II, with 23 high school students, replicated these results. In both studies, self-efficacy was predictive of both between-group differences and variations in performance within the anchoring conditions. (36 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Controlled trial of very low calorie diet, behavior therapy, and their combination in the treatment of obesity.

Assessed the effectiveness of a combined program of low calorie diet (400–500 kcal) and behavior therapy in treating obesity. 50 women (average age 43.9 yrs) and 9 men (average age 44.7 yrs), averaging 89% overweight, were randomly assigned to 1 of 3 conditions: (a) low calorie diet alone, (b) behavior therapy alone, or (c) low calorie diet plus behavior therapy (combined treatment). Mean weight losses for the 3 conditions at the end of treatment were 14.1, 14.3, and 19.3 kg, respectively; losses for combined treatment were significantly greater than those for the other 2 conditions. At 1-yr follow-up, mean weight losses for the diet alone, behavior therapy alone, and combined-treatment conditions were 4.6, 9.5, and 12.9 kg, respectively; and losses for combined treatment were significantly greater than for the diet alone condition. 29% of the combined-treatment and 44% of the behavior therapy alone Ss maintained weight losses within 2 kg of their end-of-treatment weight; none of the diet-alone Ss met this criterion. Ss in all 3 conditions achieved significant reductions in blood pressure at posttreatment, but only those receiving behavior therapy alone and combined treatment showed significant decreases in depression. (36 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Peer models: Influence on children's self-efficacy and achievement.

Investigated how the self-efficacy and achievement of 72 children (aged 8 yrs 6 mo to 10 yrs 10 mo) were influenced by their observing peer models learn a cognitive skill. Within this context, the effects of modeled mastery and coping behaviors were explored. Ss were children who had experienced difficulties learning subtraction with regrouping operations in their classes. Ss were pre- and posttested on measures of subtraction self-efficacy, skill, and persistence. Ss observed a same-sex peer demonstrate either rapid (mastery model) or gradual (coping model) acquisition of subtraction skills, observed a teacher model demonstrate subtraction operations, or did not observe a model. Ss then judged self-efficacy for learning to subtract and received subtraction training. Observing a peer model led to higher self-efficacy for learning, posttest self-efficacy, and achievement than did observing the teacher model or not observing a model. Ss who observed the teacher model scored higher than no-model Ss on these measures. No significant differences due to type of peer modeled behavior (mastery/coping) were obtained on any measure. (31 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

You're changed if you do and changed if you don't: Mechanisms underlying paradoxical interventions.

We examined 2 mechanisms of change under paradoxical interventions: reactance and increased sense of self-efficacy. Procrastinating college students were randomly assigned to either paradoxical or self-control interventions. Effective study time and perceived self-efficacy were measured before and after treatment. In Study 1 nonverbal measure of initial reactance was employed. In Study 2 reactance was experimentally manipulated. Under paradoxical interventions, Ss higher on initial reactance benefited more from therapy than did Ss with low reactance; nonreactant Ss did not increase their effective study time, but they did improve in perceived efficacy to control their procrastination; increased study time was negatively correlated with increased self-efficacy. In self-control treatment, increased study time was accompanied by increased self-efficacy. Paradoxical interventions seem to reduce procrastination through the mechanism of reactance in some clients, whereas in others they lead to a cognitive change, possibly mediating a subsequent behavior change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Response of obese binge eaters to treatment by behavior therapy combined with very low calorie diet.

Examined attrition and weight loss in 235 female obese binge eaters, episodic overeaters, and nonbingers treated by a 26-wk program of behavior modification and very low calorie diet. No significant differences were observed among conditions in the number of Ss who completed treatment. Episodic overeaters, however, were more likely than Ss in the other 2 conditions to drop out during the last 7 wks of treatment, when Ss resumed consumption of a conventional diet. End-of-treatment weight losses for the 3 conditions, which did not differ significantly, averaged 21.5, 19.4, and 21.7 kg, respectively. No significant differences were observed among conditions in weight regain (which averaged 8.8 kg) in the year following treatment, although small sample sizes prevented an adequate evaluation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Weight loss and behavior change 1 year after behavioral treatment for obesity.

Reports a 1-yr follow-up study of 88 of the 1st 108 clients to complete a behavioral weight reduction program at Stanford University's Eating Disorders Clinic. On the average, Ss maintained their in-treatment weight loss over the follow-up period, but there was marked variability and a low correlation between in-treatment and posttreatment performance. Ss reported significant changes in their eating behavior after treatment, but these changes were only weakly related to weight changes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Enhancing commitment improves adherence to a medical regimen.

A commitment-based intervention was evaluated for improvement of adherence to a 10-day antibiotic regimen. Experimental Ss made verbal and written commitments for adherence and completed tasks designed to increase their investment in a medication regimen. Control Ss performed similarly structured tasks unrelated to the medical regimen. Adherence, measured by unannounced pill counts, was significantly higher for experimental Ss than for control Ss. Self-reported adherence was significantly correlated with posttest self-efficacy but not with pretest self-efficacy. Adherence to a medical regimen may be improved by strategies conceptually based on the investment model of commitment, which provides a useful framework for further study of adherence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preventing weight gain in adults: A pound of prevention.

Evaluated the feasibility and effectiveness of a program for weight gain prevention (WGP) in normal adults. 219 Ss were randomized to either WGP treatment or no treatment for 12 mo. The treatment group received monthly newsletters relating to weight management, participated in a financial incentive system, and were offered an optional 4-session education course in the 6th mo of the program. Results demonstrate high interest in WGP among Ss who were not objectively overweight. Participation, as measured by return of postcards sent with each newsletter, was approximately 75%. Results after 1 yr show a net weight loss of 1.8 lb in the group receiving the program compared with controls. 82% of participants maintained or lost weight, compared with 56% of controls. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Affective, cognitive, and behavioral differences between high and low procrastinators.

Examined the relation between academic procrastination and academically related trait measures among 379 university students, including 261 females, 117 males, and 1 S who did not specify gender. 126 of the Ss participated in weekly assessment sessions. Ss completed a procrastination assessment scale, the Test Anxiety Scale, a self-control scale, and a trait measure of attributions of success and failure 3 times when midterm examinations approached. Results indicate that more than 40% of the Ss reported a high level of procrastination. Self-reported procrastination was positively correlated with delay in taking self-paced quizzes and was negatively correlated with grade point average (GPA). High procrastinators, particularly women, were significantly more likely than were low procrastinators to report more test anxiety, weekly state anxiety, and weekly anxiety-related physical symptoms. High procrastinators were significantly more likely than were low procrastinators to attribute success on examinations to external and unstable factors. As the examination deadline approached, both high and low procrastinators perceived examinations to be less difficult, less important, and less anxiety provoking; reported fewer factors to hinder study behavior; increased their study behavior; and decreased delay. Implications for anxiety reduction as a procrastination intervention are discussed. (13 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression, interpersonal standard setting, and judgments of self-efficacy.

Investigated the relationship between standard setting and judgments of self-efficacy in the domain of interpersonal functioning for depressed and nondepressed Ss. Consistent with a self-control model of depression, a large discrepancy between personal standards and judgments of personal efficacy for performance was postulated to be related to depression. Undergraduate students who scored above 13 on 2 administrations of the Beck Depression Inventory composed the depressed group. 39 depressed and 39 nondepressed students rated their minimal standards for adequate interpersonal performance, its importance to them, and their judgments of self-efficacy for the same tasks, using the Interpersonal Concerns Questionnaire. Depressed Ss showed a larger discrepancy between strength of interpersonal standards and strength of self-efficacy than did normal Ss. Depressed Ss expressed a lower strength of self-efficacy than did nondepressed Ss, but they did not differ on their interpersonal standards. Importance and the strength for standards are consistent with recent extensions of P. M. Lewinsohn's (1974) model of depression, which suggests that disruptions in self-evaluation are related to lowered judgments of self-efficacy for depressed Ss. (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-efficacy and relapse in smoking cessation: A replication and extension.

In an effort to replicate and extend findings by M. M. Condiotte and E. Lichtenstein (see record 1982-01877-001), the relationship of a measure of self-efficacy—the Confidence Questionnaire—to posttreatment smoking status was assessed. Ss were 74 smokers (mean age 37 yrs). End-of-treatment self-efficacy scores were significantly correlated with follow-up smoking status at 3-mo and 6-mo follow-up, but not at 1 yr. When only Ss who were abstinent at termination were considered, self-efficacy still correlated significantly with 3-mo follow-up but not with 6-mo or 1-yr smoking status. Smoking during treatment was associated with lower end-of-treatment efficacy scores. (3 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship of career-related self-efficacy expectations to perceived career options in college women and men.

134 female and 101 male undergraduates were asked to indicate their perceptions of their capabilities to successfully complete the educational requirements and job duties of each of 10 traditionally female and 10 traditionally male occupations. Ss also indicated their degree of interest in and extent of consideration of each occupation. Finally, American College Test Math and English subtest scores were obtained. Results indicate significant and consistent sex differences in self-efficacy with regard to traditional vs nontraditional (for females) occupations: males reported equivalent self-efficacy with regard to the 2 classes of occupations; females reported significantly higher levels of self-efficacy with regard to traditional occupations and significantly lower levels of self-efficacy with regard to nontraditional occupations. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attributions for dietary failures: Problems reported by participants in the Hypertension Prevention Trial.

Assigned 416 male and 209 female adult participants in the Hypertension Prevention Trial (HPT; HPT Research Group, in press) to 1 of 4 diets for 3 yrs. The diets were weight loss, reduced sodium, weight loss plus reduced sodium, and reduced sodium plus increased potassium. At 6-mo intervals, Ss reported problems they were having adhering to their diets. Problem attributions were coded along the dimensions of internality, stability, and controllability and were categorized as intrapersonal or extrapersonal. Ss assigned to weight-loss groups were significantly more likely than Ss assigned to non-weight-loss groups to blame themselves for their problems with adherence, making characterological as opposed to external or situational attributions. Men perceived problems to be more controllable than women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment of obesity by behavior therapy and very low calorie diet: A pilot investigation.

Treated 17 obese females (mean age 37.5 yrs) who averaged 87% overweight for 6 mo on a program of diet and behavior modification designed for weight loss maintenance. Ss, who were paid to participate, received a balanced diet of 1,000–2,200 kilocalories/day for Month 1, a low calorie protein liquid (400–500 kilocalories/day) for Month 2, low calorie protein (fish, fowl) for Month 3, and a balanced diet for Months 4–6. Results show that Ss lost an average 20.5 kg during treatment and showed significant reductions in anxiety and depression even while consuming the low calorie diet. At 1-yr follow-up, Ss had regained an average of 2.1 kg. (6 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)