Efferent projection from the rostral ventrolateral medulla to the area postrema in rats

Describes interim results of a study examining the effectiveness of parent-child interaction therapy (PCIT) with families of preschool-age children with oppositional defiant disorder. Following an initial assessment, 64 clinic-referred families were randomly assigned to an immediate treatment (i.t.) or a wait-list control (WL) condition. Results indicated that parents in the IT condition interacted more positively with their child and were more successful in gaining their child's compliance than parents in the WL condition. In addition, parents who received treatment reported decreased parenting stress and a more internal locus of control. Parents in the IT group reported statistically and clinically significant improvements in their child's behavior following PCIT. All families who received treatment reported high levels of satisfaction with both the content and process of PCIT. Preliminary 4-month follow-up data showed that parents maintained gains on all self-report measures.     

A comparison of systematic desensitization and directed masturbation in the treatment of primary orgasmic dysfunction in females.

Assigned 30 females (19–42 yrs) seeking treatment for primary inorgasmia accompanied by sexual anxiety or aversion to 1 of 3 groups: systematic desensitization (SD), directed masturbation (DM), or waiting list control (WL). Following treatment, Ss were retested, and the WL group then received directed masturbation treatment. A 3rd testing constituted a follow-up for the SD and DM groups and a posttreatment testing for the WL. Both treatments were equally effective in improving Ss' sexual self-acceptance and increasing sexual pleasure. Changes in anxiety were negligible; however, sexual arousal and orgasm for DM and WL Ss increased. The gains of the WL group not only replicated the findings of the DM group but also were of greater magnitude. (3 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A three-year follow-up on standard versus thin wall ePTFE grafts for hemodialysis

PURPOSE: Expanded polytetraflouroethylene (ePTFE) grafts are the most popular prosthetic grafts for hemodialysis patients in whom autogenous fistulas cannot be constructed. Long-term studies to study the durability and complication rate of the different wall configurations of ePTFE grafts have not been carried out. The primary, secondary, and cumulative patency and other complications between standard thickness (STD) and thin wall (THN) 6 mm stretch ePTFE grafts (WL Gore & Assoc, Flagstaff, AZ) was prospectively evaluated. METHODS: From September 1993 to August 1995, 108 patients receiving new grafts were randomized into 2 groups: those receiving STD grafts (n = 56) or those receiving THN (n = 52) grafts. Data prospectively collected included day of first access, primary patency, interventions required, and long-term results. Infections, pseudoaneurysms, and mortality were also documented. Student's unpaired t-test was used to compare the 2 groups, and log-rank life tables were constructed and compared. RESULTS: Mean follow-up examination time was 38.1 +/- 0.8 months for STD grafts and 35.1 +/- 1.0 months for THN grafts (P<.03). Longer patency was noted in the STD group of grafts (18.2 months for STD vs. 12.1 months for THN). Biographical data and complications, including pseudoaneurysm (6% vs. 5%), infection (2% vs. 3%), and mortality (22% vs. 19%), between STD and THN groups were not different statistically. Mean primary (18.2 months vs. 12.1 months), secondary (20.9 months vs. 13.7 months), and cumulative patency times (22.2 months vs. 15.2 months) for the STD group were significantly more than those for the THN group (P<.000 by log rank of life tables). Other complications were not different between groups. CONCLUSION: Standard thickness ePTFE is the graft of choice when placing ePTFE arteriovenous grafts for hemodialysis.     

A combined motivation and parent–child interaction therapy package reduces child welfare recidivism in a randomized dismantling field trial.

Objective: A package of parent–child interaction therapy (PCIT) combined with a self-motivational (SM) orientation previously was found in a laboratory trial to reduce child abuse recidivism compared with services as usual (SAU). Objectives of the present study were to test effectiveness in a field agency rather than in a laboratory setting and to dismantle the SM versus SAU orientation and PCIT versus SAU parenting component effects. Method: Participants were 192 parents in child welfare with an average of 6 prior referrals and most with all of their children removed. Following a 2 × 2 sequentially randomized experimental design, parents were randomized first to orientation condition (SM vs. SAU) and then subsequently randomized to a parenting condition (PCIT vs. SAU). Cases were followed for child welfare recidivism for a median of 904 days. An imputation-based approach was used to estimate recidivism survival complicated by significant treatment-related differences in timing and frequency of children returned home. Results: A significant orientation condition by parenting condition interaction favoring the SM + PCIT combination was found for reducing future child welfare reports, and this effect was stronger when children were returned to the home sooner rather than later. Conclusions: Findings demonstrate that previous laboratory results can be replicated in a field implementation setting and among parents with chronic and severe child welfare histories, supporting a synergistic SM + PCIT benefit. Methodological considerations for analyzing child welfare event history data complicated by differential risk deprivation are also emphasized. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parent-Child Interaction Therapy With Physically Abusive Parents: Efficacy for Reducing Future Abuse Reports.

A randomized trial was conducted to test the efficacy and sufficiency of parent-child interaction therapy (PCIT) in preventing re-reports of physical abuse among abusive parents. Physically abusive parents (N=110) were randomly assigned to one of three intervention conditions: (a) PCIT, (b) PCIT plus individualized enhanced services, or (c) a standard community-based parenting group. Participants had multiple past child welfare reports, severe parent-to-child violence, low household income, and significant levels of depression, substance abuse, and antisocial behavior. At a median follow-up of 850 days, 19% of parents assigned to PCIT had a re-report for physical abuse compared with 49% of parents assigned to the standard community group. Additional enhanced services did not improve the efficacy of PCIT. The relative superiority of PCIT was mediated by greater reduction in negative parent-child interactions, consistent with the PCIT change model. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The feasibility and outcome of clinic plus Internet delivery of cognitive-behavior therapy for childhood anxiety.

Seventy-two clinically anxious children, aged 7 to 14 years, were randomly allocated to clinic-based, cognitive-behavior therapy, the same treatment partially delivered via the Internet, or a wait-list control (WL). Children in the clinic and clinic-plus-Internet conditions showed significantly greater reductions in anxiety from pre- to posttreatment and were more likely to be free of their anxiety diagnoses, compared with the WL group. Improvements were maintained at 12-month follow-up for both therapy conditions, with minimal difference in outcomes between interventions. The Internet treatment content was highly acceptable to families, with minimal dropout and a high level of therapy compliance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Parent-child interaction therapy.

Reviews the book, Parent-child interaction therapy by Tom L. Hembree-Kigin and Cheryl Bodiford McNeil (see record 1995-98294-000). This book outlines an important, relatively new behavior therapy method with children called Parent-Child Interaction Therapy (PCIT). PCIT is a technique that explicitly aims at developing mutual parent and child skills in an affectionate relationship, while retaining the traditional emphasis upon positive social behaviors and (mostly) noncoercive disciplinary efforts. According to the reviewer, the authors have done a very sound job of producing a helpful manual that points in advance to the resolution of common problems in dealing with behaviorally disturbed children and their parents. Although there are some caveats, this book important contribution to the child treatment literature will be beneficial to psychotherapists of all persuasions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A controlled comparison of cognitive therapy and self-help support groups in the treatment of irritable bowel syndrome.

Thirty-four patients with irritable bowel syndrome were randomly assigned to 1 of 3 treatment conditions: individualized cognitive treatment (CT), self-help support group (SG), or symptom monitoring waiting-list control (WL). Each of the 3 conditions lasted approximately 8 weeks. Pre- to posttreatment analyses revealed significantly greater reductions in both individual gastrointestinal (GI) symptoms and in a composite index for GI symptom change for the CT condition than for the SG or WL conditions. When compared with the SG and WL conditions, the CT condition also showed significant improvement on psychological measures of depression and anxiety. At 3-month follow-up, the results for the CT condition were maintained and revealed further numerical improvements. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

beta-carotene 15,15'-dioxygenase activity and cellular retinol-binding protein type II level are enhanced by dietary unsaturated triacylglycerols in rat intestines

The purpose of this study was to examine effects of dietary triacylglycerols on beta-carotene 15,15'-dioxygenase (EC 1.13.11.21) activity and cellular retinol-binding protein [CRBP (II)] in rats. Six groups of eight rats (7-wk old) were fed one of the following diets: standard (STD; 2.5% soybean oil), saturated (SFA; 15% hydrogenated soybean oil), monounsaturated (MUFA; 15% olive oil), polyunsaturated (PUFA; 15% soybean oil) or clofibrate (CLF; 2.5% soybean oil + 0.2% clofibrate) for 3 wk. The dioxygenase specific activities of the intestinal homogenates in the MUFA and PUFA groups fed the high fat diets were 2.4 times that of the STD group fed a low fat diet (P < 0.01), whereas the activities of the SFA and CLF groups were not significantly different from that of the STD group. The level of CRBP (II) in the intestine of the PUFA group was 1. 3-fold that of the STD group (P < 0.05), whereas there were no significant differences among the other groups. In a second experiment, the dioxygenase activity of rat intestine was followed over 3 wk of feeding the STD and PUFA diets. After the PUFA diet was consumed for 1 d, the activity was enhanced to 2.7 times the baseline level and remained thereafter at that high level, whereas the activity of the STD group remained at the low baseline level. Thus, dietary polyunsaturated triacylglycerols enhanced both beta-carotene 15,15'-dioxygenase activity and CRBP (II) level in rat intestine. These results suggest that the dioxygenase and CRBP (II) are regulated by the same mechanism involving long-chain fatty acids and their metabolites.     

Effectiveness of behavioral therapy for chronic low back pain: A component analysis.

The effects of outpatient group behavioral therapy including aerobic exercise (BE), behavioral therapy only (B), and aerobic exercise only (E) on pain and physical and psychosocial disability were evaluated and compared in a group of mildy disabled chronic low-back-pain patients. Ninety-six Ss were randomly assigned to the 3 treatments and a waiting-list control (WL) condition and assessed on a variety of patient self-report, spouse-rated, and direct observational measures at pretreatment, posttreatment, and 6- and 12-month follow-ups. Patients in the BE condition, but not the B or E conditions, improved significantly more pretreatment to posttreatment than did WL patients on the patient self-report and observer-rated measures. At both follow-ups, all 3 treatment groups remained significantly improved from pretreatment, with no significant differences among treatments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Child Anxiety Prevention Study: Intervention model and primary outcomes.

The article presents the intervention model and primary outcomes of a preventive intervention designed to reduce anxiety symptoms and prevent the onset of anxiety disorders in the offspring of parents with anxiety disorders. Participants were 40 volunteer children (mean age = 8.94 years; 45% girls; 90% Caucasian) whose parents met criteria for a broad range of anxiety disorders. Families were randomly assigned to an 8-week cognitive–behavioral intervention, the Coping and Promoting Strength program (CAPS; n = 20) or a wait list control condition (WL; n = 20). Independent evaluators (IEs) conducted diagnostic interviews, and children and parents completed measures of anxiety symptoms. Assessments were conducted pre- and postintervention and 6 and 12 months after the postintervention assessment. On the basis of intent to treat analyses, 30% of the children in the WL group developed an anxiety disorder by the 1-year follow-up compared with 0% in the CAPS group. IE and parent-reported (but not child-reported) levels of anxiety showed significant decreases from the preintervention assessment to the 1-year follow-up assessment in the CAPS but not the WL group. Parental satisfaction with the intervention was high. Findings suggest that a family-based intervention may prevent the onset of anxiety disorders in the offspring of parents with anxiety disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reinforcing operants other than abstinence in drug abuse treatment: An effective alternative for reducing drug use.

This study examines the effectiveness of using vouchers to reinforce either the provision of urine samples testing negative for illicit drugs (UA group) or the completion of objective, individually defined, treatment-plan-related tasks (TP group). A third group was assigned to the clinic's standard treatment (STD group). Participants were randomly assigned to groups after a 6-week baseline stabilization period. Urine specimens were collected thrice weekly throughout the study. In the UA condition, participants earned $5 (U.S. dollars) in vouchers for each drug-free urine submitted. In the TP condition, participants earned up to $15 in vouchers per week for demonstrating completion of treatment plan tasks assigned by their counselors. Contingencies were in effect for 12 weeks, after which all participants received the clinic's standard treatment. Urinalysis results indicate that the TP intervention was significantly more effective in reducing illicit drug use than either the UA or STD interventions. These effects were maintained with a trend toward continuing improvement for the TP groups even after contingencies were discontinued. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of duration of treatment on treatment outcome and cost of treatment for Wilms' tumor: a report from the National Wilms' Tumor Study Group

PURPOSE: National Wilms' Tumor Study (NWTS)-4 was designed to evaluate the efficacy, toxicity, and cost of the administration of different regimens for the treatment of Wilms' tumor (WT). PATIENTS AND METHODS: Between August 6, 1986 and September 1, 1994, 905 previously untreated children aged younger than 16 years with stage II favorable histology (FH) WT (low-risk [LR]), stages III to IV FH WT, or stages I to IV clear-cell sarcoma of the kidney (high-risk[HR]) were randomized after the completion of 6 months of chemotherapy to discontinue (short) or continue for 9 additional months (long) treatment with chemotherapy regimens that included vincristine and either divided-dose (standard [STD]) courses (5 days) or single-dose (pulse-intensive [PI]) treatment with dactinomycin. HR patients also received either divided-dose (STD) courses (3 days) or single-dose (PI) treatment with doxorubicin. RESULTS: The 4-year relapse-free survival (RFS) rates after the second randomization for LR patients were 83.7% for the 190 patients treated with short and 88.2% for the 187 patients treated with long chemotherapy (P = .11). The 4-year RFS rates after the second randomization for HR FH patients were 89.7% for the 256 patients treated with short and 88.8% for the 246 patients treated with long chemotherapy (P = .87). The charge for treatment with the short PI treatment regimens for all children with stages I through IV FH WT was approximately one half of that with the long STD treatment regimens. CONCLUSION: The short administration schedule for the treatment of children with WT is no less effective than the long administration schedule and can be administered at a substantially lower total treatment cost.     

Self-help treatment for insomnia: Bibliotherapy with and without professional guidance.

Fifty-four adults with primary insomnia were randomly assigned to a self-help treatment (cognitive-behavioral bibliotherapy [BT]), BT with weekly phone consultations, or a waiting-list control (WL) group. Treated participants were mailed 6 treatment booklets at the rate of 1 booklet per week; 1/2 of them also received minimal professional guidance through a 15-min weekly phone consultation. The WL group members continued to monitor their sleep during this period. Participants in both treatment conditions improved significantly on the main outcome variables (total wake time and sleep efficiency) at posttreatment, whereas WL participants remained unchanged. The addition of weekly phone calls slightly enhanced improvements at posttreatment. However, both treatment conditions were comparable at follow-up. These results suggest that BT, with or without minimal professional guidance, is an effective approach for treating primary insomnia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Triple P-Positive Parenting Program: A comparison of enhanced, standard, and self-directed behavioral family intervention for parents of children with early onset conduct problems.

Three variants of a behavioral family intervention (BFI) program known as Triple P were compared using 305 preschoolers at high risk of developing conduct problems. Families were randomly assigned to enhanced BFI (EBFI), standard BFI (SBFI), self-directed BFI (SDBFI), or wait list (WL). At postintervention, the 2 practitioner-assisted conditions were associated with lower levels of parent-reported disruptive child behavior, lower levels of dysfunctional parenting, greater parental competence, and higher consumer satisfaction than the SDBFI and WL conditions. Overall, children in EBFI showed greater reliable improvement than children in SBFI, SDBFI, and WL. By 1-year follow-up, children in all 3 conditions achieved similar levels of clinically reliable change in observed disruptive behavior. However, the EBFI and SBFI conditions showed greater reliable improvement on parent-observed disruptive child behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Group cognitive-behavioral treatment for the nonpurging bulimic: An initial evaluation.

This study tested the initial effects of cognitive-behavioral therapy for binge eating in Ss who do not purge. Forty-four female binge eaters were randomized to either cognitive-behavioral treatment (CB) or a waiting-list (WL) control. Treatment was administered in small groups that met for 10 weekly sessions. At posttreatment a significant difference was found, with 79% of CB Ss reporting abstinence from binge eating and a 94% decrease in binge eating compared with a nonsignificant reduction (9%) in binge eating and zero abstinence rate in WL Ss. Following the posttest assessment, WL Ss were treated and evidenced an 85% reduction in binge episodes and a 73% abstinence rate. Binge eating significantly increased at 10-week follow-up for initially treated Ss; however, the frequency remained significantly improved compared with baseline levels. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-administered videotape therapy for families with conduct-problem children: Comparison with two cost-effective treatments and a control group.

Parents of 114 conduct-problem children, aged 3–8 years, were randomly assigned to one of four groups: an individually administered videotape modeling treatment (IVM), a group discussion videotape modeling treatment (GDVM), a group discussion treatment (GD), and a waiting-list control group. Compared with the control group, all three treatment groups of mothers reported significantly fewer child behavior problems, more prosocial behaviors, and less spanking. Fathers in the GDVM and IVM conditions and teachers of children whose parents were in the GDVM and GD conditions also reported significant reductions in behavior problems compared with control subjects. Home visit data indicated that all treatment groups of mothers, fathers, and children exhibited significant behavioral changes. There were relatively few differences between treatment groups on most outcome measures, although the differences found consistently favored the GDVM treatment. However, cost effectiveness was the major advantage of the IVM treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Child and parent weight loss in family-based behavior modification programs.

Overweight preadolescents and parents from 76 families were assigned to 1 of 3 behavioral treatment groups: parent/child target, child target, or nonspecific target. Percent overweight changes at the end of the 8-mo treatment and 13-mo follow-up were equivalent for children in the 3 treatment groups, but parents in the parent/child group lost more weight during treatment. Weight changes for parents and children increased through the 8-mo treatment. Patterns of maintenance showed that 40% of the children were within 20% of their ideal weight by the end of treatment, achieving nonobese status. 100% of the newly nonobese children in the parent/child group maintained nonobesity during follow-up, whereas only 30% in the child-alone group and 33% in the nonspecific group maintained nonobesity. In addition, weight losses for parents and children in the same family correlated positively at the end of treatment but not at follow-up. Results suggest that parental modeling may be important during treatment, but long-term results probably are due to parental reinforcement of child self-regulation. (30 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Acquisition and transfer of empathy by the parents of early adolescents through structured learning training.

Measured the effectiveness of A. P. Goldstein's (1973) structured learning training (modeling, role playing, and social reinforcement) in teaching parents of adolescents to respond empathically to their children; also measured was the extent to which transfer of training occurs when adolescents participate in training with their parents. 37 mothers of 6th-8th graders volunteered to attend a minicourse on communication. The mothers were divided into 4 groups, including the control group. All groups except the control group received structured learning training in empathy; in 1 group the children did not participate, in a 2nd group the children participated separately, and in the 3rd group they participated with their parents. After 3 wks (6 hrs) of training, the treatment groups showed significantly more empathy. The closeness of the mean empathy scores on the behavioral measure to the scores on the written measure suggested that all 3 treatment groups transferred the skill they had learned. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Improving quality of sexually transmitted disease case management in rural South Africa

OBJECTIVE: To measure quality of sexually transmitted disease (STD) syndromic case management and aspects of health-seeking behaviour at baseline in an intervention trial. SETTING: Ten rural primary care clinics, Hlabisa district, South Africa. DESIGN: Simulated patients (fieldworkers trained to present with STD syndromes) made a total of 44 clinic visits; 49 STD patients were interviewed when exiting clinics; facilities were assessed for availability of necessary equipment and drugs; 10 focus group discussions were held with staff; and STD syndrome surveillance was performed in all 10 clinics. RESULTS: A total of 9% of simulated patients were correctly managed (given correct drugs, plus condoms and partner notification cards), recommended drug treatment was given in only 41% of visits, and appropriate counselling was given in 48% of visits. Among patients leaving the clinic, although 39% waited over an hour to be seen and only 37% were consulted in private, all reported staff attitudes as satisfactory or good. Only six clinics had syndromic management protocols available, three reported intermittent drug shortages, and seven lacked partner notification cards. Focus group discussions revealed good staff knowledge about STD, but showed lack of training in syndromic management and low morale. Surveillance data showed that while 75% of those presenting for care did so within 1 week of symptom onset, 27% had been treated for an STD in the preceding 3 months, and only 6% of those treated were contacts. CONCLUSIONS: Quality of STD case management was poor despite good staff knowledge and availability of most essential resources. An intervention comprising staff training and STD syndrome packets has been designed to improve quality of case management.