Self-monitoring in behavioral medicine: Children.

Self-monitoring in children is a valuable method for collecting data, some of which may be obtained in no other way. Self-monitoring has been particularly prevalent in behavioral medicine. This article discusses children's monitoring of their own behavior and parental monitoring when the child is too young to self-monitor (e.g., an infant) and the parent is monitoring as a proxy for the child's own monitoring. Factors that influence the choice of who will perform the monitoring and the accuracy of the monitoring are considered. Monitoring may occur for assessment purposes only or may be an active part of treatment; both of these uses of self-monitoring are described. Barriers to accurate self-monitoring, as well as strategies to increase accuracy, are discussed. Self-monitoring is an integral part of disease assessment and management for many children, and the research described provides suggestions for improvements in the use of self-monitoring in children's behavioral medicine in the future. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-monitoring and cooperation as a self-presentational strategy.

Investigated the hypothesis that cooperation may occur as a result of strategic self-presentation that is instrumental for increasing personal gain. 149 undergraduates played a decomposed Prisoner's Dilemma game with a bogus partner. The prospect of future interaction with the partner and the discernment of the partner (i.e., contingency in giving approval) were manipulated, and Ss were classified as scoring high or low on a self-monitoring scale. It was hypothesized that high self-monitors would exhibit more variability in cooperative behavior across social contexts and would be more cooperative with discerning partners and partners with whom they anticipated future interaction than would low self-monitors. As predicted, the prospect of future interaction with a partner increased the cooperation of the high, but not the low, self-monitors. Cooperation was not related to attraction for the partner (Interpersonal Judgment Scale) for either high or low self-monitors. Correlates of self-monitoring did not predict cooperation. Results are discussed in terms of individual differences in motives for cooperation and strategic self-presentation. (40 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-monitoring in the assessment of eating disorders.

Self-monitoring is a key feature of cognitive behavioral therapy (CBT) for eating disorders. It provides a detailed measure of eating problems and the circumstances under which they occur, but it does not yield precise estimates of amount of caloric intake. It indexes the progress of treatment and helps guide the focus of each therapy session. Adherence to self-monitoring is good provided that therapists implement it skillfully within a collaborative therapeutic alliance. Anorexia nervosa patients may pose a particular challenge in this respect. Self-monitoring may play an important role in the rapid effects of CBT for bulimia nervosa. Preliminary data indicate that self-monitoring of binge eating and purging may provide a valid measure of treatment outcome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Exercise in behavioral medicine.

Research on the preventive and rehabilitative applications of exercise and literature on exercise adherence from the past 10 yrs are briefly reviewed. Although there is now substantial evidence that a low level of physical activity is associated with decreased life expectancy for both men and women and contributes independently to the development of many prevalent chronic diseases, most adults and children lead sedentary lives. Recent intervention studies suggest exercise adherence can be improved in a variety of populations. Researchers in the next decade should continue to elaborate the population- and disease-specific effects of physical activity and exercise and give priority to the problem of exercise adherence, which limits the effectiveness of exercise interventions and remains a significant challenge to behavioral medicine. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Self-monitoring of classroom behaviors with students exhibiting emotional and behavioral challenges.

Examined the effectiveness of a self-monitoring package (SMP) on the task engagement and disruptive behaviors of 2 elementary school children (10-yr-old female and 11-yr-old male). Ss received full-time special education services for students with severe emotional disturbance. This SMP was comprised of periodic cuing, self-recording of individually-determined target behaviors, feedback, and reinforcement for accurate self-monitoring. Results indicated that SMP was highly effective in increasing task engagement while decreasing disruptive behavior. Data add to the growing testimony regarding the utility of self-monitoring and SMPs as effective and proactive components of behavioral support for students with emotional and behavioral challenges. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sociodemographic diversity and behavioral medicine.

The broad array of economic and cultural diversity in the U.S. population correlates with and impacts on the study of behavioral aspects of health. The purpose of this article was to provide a selective overview of behavioral medicine research on sociodemographically diverse populations, with a focus on ethnicity, gender, and socioeconomic status. Suggestions are provided with regard to methodological refinement of research and insights into possible future directions in behavioral medicine research on ethnically and economically diverse populations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Role of behavior theory in behavioral medicine.

Behavioral medicine is a multidisciplinary field that combines research methods and findings from behavioral and biomedical sciences. Many investigators in the field have tended to emphasize the contribution of the biomedical more than the behavioral sciences. This is evident in the emphasis on biological rather than behavioral outcomes and on the reductionist approach within the field to reduce mechanisms responsible for behavioral effects and disease to biological influences. There has been a similar shift in psychology toward mechanistic, bottom-up approaches to understanding mechanisms responsible for integrated and dynamic behavior. These shifts in emphasis have stimulated investigators to examine the use of biomedical methods and findings as causes and explanations for behavior, rather than to utilize newer findings in behavioral sciences. New advances in basic research on learning are used to illustrate that findings from behavioral science have implications for the field of contemporary behavioral medicine. Finally, the importance of developing new technologies for measuring behavior is presented. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Reengineering in behavioral medicine

One-hundred seventy-one patients, operated for differentiated thyroid gland carcinoma, are subjected to serum thyroglobulin assessment and whole-body scanning. In twenty-nine of the total of 171 patients there is evidence of relapses and metastases, discovered by either examination. In 27/29 cases with metastases (positive scan finding) a high serum thyroglobulin level is documented. The correlation between serum thyroglobulin level and whole-body scanning finding among patients without residual normal thyroid parenchyma (status post total thyroidectomy) is much more favourable than the one in patients presenting normal residual parenchyma (status post organ-salvaging operation). The conclusion is drawn that serum thyroglobulin contributes greatly to the diagnosis of recurrences and metastases, especially in patients with normal residual parenchyma missing.     

Applications of cost-effectiveness methodologies in behavioral medicine.

In 1996, the Panel on Cost-Effectiveness in Health and Medicine developed standards for cost-effectiveness analysis. The standards include the use of a societal perspective, that treatments be evaluated in comparison with the best available alternative (rather than with no care at all), and that health benefits be expressed in standardized units. Guidelines for cost accounting were also offered. Among 24,562 references on cost-effectiveness in Medline between 1995 and 2000, only a handful were relevant to behavioral medicine. Only 19 studies published between 1983 and 2000 met criteria for further evaluation. Among analyses that were reported, only 2 studies were found consistent with the Panel's criteria for high-quality analyses, although more recent studies were more likely to meet methodological standards. There are substantial opportunities to advance behavioral medicine by performing standardized cost-effectiveness analyses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Promise-of-treatment as an opening strategy for psychotherapy.

Contends that withholding of explicit, formal treatment until after S's completion of experimental and information-gathering ordeals is an opening tactic for psychotherapy that potentiates both a course and a conclusion for the therapeutic process. The benefits of the promise-of-treatment strategy include removal of "failure" from the initial process, ability to assess and intensify client motivation, and possible eliciting of the placebo effect. Clients may be asked to delay treatment until the best one is formulated. Covertly therapeutic tasks (e.g., testing conventional cures, attempting personal solutions, rehearsing symptoms, reframing, slowly developing insight, pretending to be cured, pretending to be sick, spontaneously changing, gathering information) allow the client to do something different and to make a change for the better. Case examples of a 40-yr-old female binge eater, a 20-yr-old male with a sleep disorder, and a 15-yr-old compulsive face scratcher are presented to illustrate the promise-of-treatment strategy. (7 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-monitoring and age.

Two adult samples were surveyed to investigate the relation between individuals' levels of self-monitoring and age. A negative relation was predicted as older individuals were seen as most likely to exhibit the low self-monitoring tendency of behaving in accordance with one's own attitudes and feelings, whereas younger individuals appeared most likely to exhibit the high self-monitoring tendency of behaving according to social cues. A significant negative correlation between age and self-monitoring was found in both samples. The self-monitoring construct is discussed in relation to other social-cognitive life-span differences and the idea of critical periods throughout the life span. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Training the clinical psychology student in behavioral medicine.

The recent growth of the field of behavioral medicine is associated with an increasing interest in training issues. Research and clinical training are discussed, with a focus on what is transportable from traditional clinical psychology training, what needs to be added, and what needs to be subtracted. An example of how these issues can be handled within the context of a general clinical training program is provided. (8 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Counseling psychology in behavioral medicine and health psychology.

Counseling psychology can make a contribution to the newly emerging fields of health-related behavioral science, but the nature of that contribution will depend on counseling psychology's willingness to develop new perspectives and practices. The present authors compare 2 of these health orientations, behavioral medicine and health psychology, in an effort to establish counseling psychology's relationship with either of these approaches. Three areas of training and application are surveyed, which the current research suggests will offer opportunities for meaningful participation by counseling psychologists. Such opportunities for important work in these health-related areas will call on counseling psychology's traditional psychoeducational strategies and creative new methodologies and perspectives. (55 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-monitoring in assessing children's problems.

The techniques used in studies of self-monitoring for children's problems were examined, with an emphasis on methodology. As originally conceptualized, self-monitoring was viewed as both an assessment tool and an intervention technique. Although self-monitoring as an assessment tool is conceptually sensible, the use of self-monitoring solely for purposes of assessment with children introduces significant problems. As a result, the self-monitoring literature on children has focused not on its use as an assessment tool but primarily on its use as an intervention technique, with the exception of the assessment of internalizing disorders. The methodology of self-monitoring as it is used with children was examined in targeting internalizing problems, such as anxiety and depression, specific academic skills, broader processes of self-regulation, on-task behavior, and disruptive behavior problems of children. Conclusions and recommendations are provided for research and practice in the use of self-monitoring for children's problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-monitoring and blood pressure.

Examined the association between self-monitoring (regulation and control of nonverbal and expressive behavior) and blood pressure (BP) among 594 municipal employees. For Ss not taking antihypertensive medication, scores on an acting/extraversion scale were mildly positively associated with resting BP among Whites in general, blue collar, clerical, and professional groups. Stronger positive correlations were obtained for attorneys and customer-service representatives. Results are contrasted with slightly negative associations for Blacks in general, 1st-level supervisors, and a group of previously studied union stewards. An interactive effect was also obtained between acting/extraversion and relative participation in work vs nonwork groups and activities; acting/extraversion and systolic BP were inversely related for Ss more active in extrawork groups. Differential consequences of greater or lesser interpersonal involvement and emotional regulation in different jobs are considered. (40 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-monitoring and dating relationships.

Four investigations, with 479 university students, examined the involvement of self-monitoring propensities in dating relationships. Studies 1 and 2 examined willingness to change dating partners and form close, intimate dating relationships with other partners. Only Ss high in self-monitoring, as measured by the Self-Monitoring Scale, were willing to terminate current relationships in favor of alternative partners. In Study 3, for those involved in multiple dating relationships, high self-monitoring Ss reported having dated a greater number of partners in the preceding year than low self-monitoring Ss; for those in steady, exclusive dating relationships, low self-monitoring Ss reported having dated their current partner for considerably longer than high self-monitoring individuals. Study 4 examined growth of intimacy in dating relationships. The link between length of relationship and level of intimacy was more pronounced for low than high self-monitoring Ss. Findings suggest that high self-monitoring individuals adopt an "uncommitted" and low self-monitoring individuals a "committed" orientation toward dating relationships. Implications for understanding the evolution of intimate relationships, including marital ones, are discussed. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-monitoring and control in dyadic interactions.

Examined individual differences in the level of planning and monitoring involved in actual interpersonal interactions between pairs of friends and strangers, as measured by a self-monitoring scale (SMS) developed by M. Snyder (see record 1975-03047-001). 18 male–male, 18 male–female, and 18 female–female undergraduate dyads of friends or strangers conversed for 10 min and completed a questionnaire (rating their behavior and feelings in the interaction) and the SMS. Findings reveal that the original unitary SMS was a poor predictor of Ss' perceptions of the interaction, whereas an analysis based on 3 subscales suggested by previous research (e.g., S. R. Briggs et al [see PA, Vol 65:9212]) not only successfully predicted the Ss' perceptions but also explained the failure of the unitary scale. The subscales frequently operated in opposite directions to one another, so that although the individual subscales were able to predict aspects of Ss' perceptions quite well, when the scores were amalgamated into a single overall score this predictive power was lost. It is concluded that the subscales derived from the SMS provided a better explanation of Ss' perceptions of their interactions. (34 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Diabetes and behavioral medicine: The second decade.

Diabetes management depends almost entirely on behavioral self-regulation. Behavioral scientists have continued a collaboration with other health systems researchers to develop a holistic approach to this disease. The authors summarized the literature in 4 major areas: self-management of diabetes, psychosocial adjustment and quality of life, neuropsychological impact, and psychobehavioral intervention development. Progress made in each of these areas over the past decade is highlighted, as are important issues that have not yet received sufficient scientific attention. Emerging areas likely to become central in behavioral research, such as diabetes prevention, are introduced. The future of behavioral medicine in diabetes is also discussed, including topics such as the changing role of psychologists in diabetes care, the urgent need for more and better intervention research, the growing importance of incorporating a health system-public health perspective, and obstacles to the integration of psychobehavioral approaches into routine health care delivery. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An update on medical psychology and behavioral medicine.

Recent definitional developments have required a reevaluation of the term "medical psychology," expecially as it relates to the newly emerging interdisciplinary field of behavioral medicine. It is proposed that medical psychology should now most logically be considered as only one of many contributing specialties within the larger discipline of psychology that, along with other disciplines, converge to form behavioral medicine. A schematic representation of these relationships is proposed with special emphasis placed on the content areas (knowledge and techniques) through which the various disciplines interface. Recent organizational developments aimed at providing psychologists with more structured forums for political representation and ideal sharing are also discussed. (5 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)