Behavioral treatment of Raynaud's disease: Long-term follow-up.

Conducted 2- and 3-yr follow-up assessments of 13 Raynaud's disease patients who were treated with finger temperature feedback or finger temperature feedback under cold stress in a study by R. Freedman et al (see record 1983-33246-001) that reported symptom reductions of 66.8 and 92.5%, respectively, 1 yr after treatment. The present data show that these significant reductions in attack frequency were maintained for 3 yrs after treatment. The possible involvement of capillary blood flow in this phenomenon is discussed. (1 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavioral treatment of Raynaud's syndrome in peripheral vascular disease.

Raynaud's syndrome is a vasospastic phenomenon that occurs in numerous peripheral vascular diseases. Because these vasospasms are sympathetically mediated, they are, according to theory, behaviorally treatable. Research has demonstrated that biofeedback, autogenic training, and progressive relaxation can all be used to treat even severe Raynaud's syndrome. However, there is no distinct advantage of one technique over the other. These techniques can be combined with sympathetic blocking agents to produce an additive effect. It is concluded that behavioral procedures have much to add to the treatment of Raynaud's syndrome. (61 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Biofeedback treatment of Raynaud's disease.

The primary symptom in Raynaud's disease and Raynaud's phenomenon is vasospastic attacks of the extremities. The most common portions of the body affected are the fingers and toes, although the tips of the nose, ears, and other areas may also be involved. Stimuli for the attacks are cold, physical stress, emotional stress, or all of these. Clinically, Raynaud's symptomatology can be classified by history and symptoms into mild, moderate, or severe categories. Behavioral treatment with thermal biofeedback provides an efficient cost-effective treatment with little or no negative side effects. Medication and surgery are less effective and have numerous and troublesome side effects. With experienced clinicians, a good biofeedback protocol, and properly selected Raynaud's disease patients, 80-90% can have a good-to-excellent treatment result. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Individual differences in response to the behavioral treatment of Raynaud's disease.

30 23–54 yr old female patients with idiopathic Raynaud's disease were subjected to 1 of 4 behavioral treatments designed to facilitate digital vasodilation. The Ss were administered the Psychological Screening Inventory prior to treatment. All treatment conditions demonstrated significant improvement in digital skin temperature assessed during a cold stress test administered both before and after treatment. Ss with low scores on the Alienation scale of the Psychological Screening Inventory demonstrated significantly more improvement than Ss with high scores. In addition, older Ss responded better than younger Ss to these behavioral treatments. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Computerized digital thermometry in Raynaud's disease. Personal experience

BACKGROUND: Computerized digital thermometry has been used for instrumental diagnosis of Raynaud's disease, that is characterized by diminution of the cutaneous temperature of the fingers and the late delayed recovery. Thermometry permits to measure basal temperature of the ten fingers, during cooling to 10 degrees C ("cold test") and the response, measuring temperature minute by minute up to 25 degrees. METHODS: In order to assess vasospastic ischemic disease a total of 66 subjects have been examined: 19 were asymptomatic for acrolocalised pathologies (control subjects) and 47 were symptomatic. RESULTS: No close correlation was observed between clinic and instrumental data. In fact 31.5% of the asymptomatic subjects had a "non-normal" reaction to the test; on the other hand, in the group of female over-50-years-old with symptoms suggesting Raynaud's disease, 38.5% of cases revealed "normal" instrumental patterns. Therefore no discriminating parameters were identified which might have allowed the instrumental identification of subjects suffering from Raynaud's disease compared to healthy individuals. CONCLUSIONS: In conclusion, computerised digital thermometry is a technique with a good level of sensitivity, while the specificity is scarce.     

Observations on the Raynaud's disease

During the last 25 years, owing to the improvement of the diagnostic means, the cases of "Raynaud's phenomenon" with well known etiology have been increasing and according to some authors they should be considered clearly prevailing. Through a right prevention and a medical and surgical therapy it is possible to obtain significant results. Consequently it is important to carry out a diagnostic screening. A study concerns 68 cases have been carried out in the Institute of Vascular Surgery, University of Milan, during the period 1971-1974. The cases are divided in two groups: idiopathic forms (disease) and forms connected to identifiable etiologies (syndrome). Many of the clinical parameters studied are examined. The so-called idiopathic forms: 47 cases (69%) with an average age of 45 years and a clear female prevalence (33 against 14). The forms with an identifiable etiology: 21 (31%) with an average age of 31 years and a clear male prevalence (16 against 5). It is therefore observed that the idiopathic Raynaud's disease is still prevailing and particularly in women. In idiopathic forms brachial angiography shows in most of the cases X-ray evidence of digital artery occlusion.     

Familial aggregation of primary Raynaud's disease

OBJECTIVE: To determine the occurrence of familial aggregation of primary Raynaud's disease. METHODS: Twenty-three patients with primary Raynaud's disease and their first-degree relatives were assessed by questionnaire and, when possible, by physical examination. The same procedures were performed on the patients' spouses and the spouses' first-degree relatives, who served as the control group. RESULTS: The prevalence of Raynaud's disease was significantly higher in the families of the probands than in the control families when assessed by questionnaire (26.1% versus 5.5%; P < 10(-5)), and by physical examination (11.2% versus 2.8%; P = 0.015). CONCLUSION: These findings demonstrate that there is significant familial aggregation of primary Raynaud's disease.     

Behavioral treatment of childhood obesity.

[Correction Notice: An erratum for this article was reported in Vol 103(3) of Psychological Bulletin (see record 2008-10688-001). Tables 1 and 2 contain several errors. The correct data is provided in the erratum. These errors do not influence any of the main points or conclusions in this article.] Obesity is a common problem in children and is associated with an increased risk of adult obesity. Twenty-four studies on the behavioral treatment of childhood obesity are reviewed. Studies involving comparisons of behavioral treatment with no treatment or placebos have shown the superiority of behavioral treatment. In addition, the effects of a number of treatment factors on outcome are suggested. These factors include parental involvement, the arrangement of treatment contingencies, and exercise. Several directions for future research are presented, including selecting which children to treat, individualizing treatment, prevention, community programs, and the side effects of weight control. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavioral treatment of mucous colitis.

Reports the case history of a 22-yr-old female student who suffered aproximately 1 colitis attack/day who was apparently successfully treated by a procedure in which the therapist labeled antecedent stress events that appeared to be precipitating the attacks. The client was then taught a behavioral coping strategy to counter the stress events. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavioral treatment of childhood social phobia.

Sixty-seven children (ages 8 and 12) with social phobia were randomized to either a behavioral treatment program designed to enhance social skills and decrease social anxiety (Social Effectiveness Therapy for Children, SET-C) or an active, but nonspecific intervention (Testbusters). Children treated with SET-C were significantly more improved across multiple dimensions, including enhanced social skill, reduced social fear and anxiety, decreased associated psychopathology, and increased social interaction. Furthermore, 67% of the SET-C group participants did not meet diagnostic criteria for social phobia at posttreatment compared with 5% of those in the Testbusters group. Treatment gains were maintained at 6-month follow-up. The results are discussed in terms of treatment of preadolescent children with social phobia and the durability of treatment effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alzheimer disease and frontotemporal dementias. Behavioral distinctions

BACKGROUND: Frontotemporal dementia (FTD) is a syndrome produced by lobar degeneration of the temporal and/or frontal lobes. OBJECTIVES: To quantify the behavioral disturbances of FTD and compare them with behavioral changes observed in Alzheimer disease (AD). DESIGN: Cross-sectional comparison of 2 groups defined by research diagnostic criteria and single photon emission computed tomography. Behaviors were assessed using a standardized rating scale-Neuropsychiatric Inventory. Groups were matched for dementia severity. SETTING: Patients were seen at 2 university-based outpatient dementia clinics and a Veterans Affairs medical center. PARTICIPANTS: Twenty-two patients with FTD and 30 patients with AD. RESULTS: Patients with FTD had significantly greater total Neuropsychiatric Inventory scores than patients with AD and exhibited more apathy, disinhibition, euphoria, and aberrant motor behavior. The Neuropsychiatric Inventory accurately assigned 77% of patients with FTD and 77% of patients with AD to the correct diagnostic group using disinhibition, apathy, and depression. Patients with FTD had higher levels of disinhibition and apathy with relatively lower levels of depression compared with patients with AD. CONCLUSIONS: The Neuropsychiatric Inventory provides a behavioral profile that differentiates patients with FTD from patients with AD. Patients with FTD are more behaviorally disturbed but are often less depressed than patients with AD relative to their level of apathy.     

Behavioral contingencies and self-mutilation in Lesch-Nyhan disease.

Lesch-Nyhan syndrome is a rare, sex-linked, recessive disease that is accompanied by severe self-mutilation, especially finger biting. Evidence is presented suggesting that parental response patterns may contribute to the genesis of the self-injurious behavior (SIB). The therapeutic effectiveness of punishment, positive reinforcement of either SIB or non-SIB, and time-out learning paradigms were evaluated in 5 Ss aged 3–13 yrs. Electric skin shock failed to suppress the behavior. Positive reinforcement of non-self-injury and time-out from social reinforcement were consistently and rapidly effective, indicating a complex interaction of genetic and environmental factors in the production of SIB. Elimination or major reductions in incidence of SIB was maintained during follow-up periods of 2 yrs. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavioral treatment of children's fears: A review.

Reviews behavioral literature on childhood fears, including conceptual models, normative research, and fear-reduction studies. The main conclusions are as follows: (a) The information value of nearly 60 yrs of normative studies is meager, and their continuation is of doubtful value. (b) Most research has been limited to laboratory studies of mildly to moderately fearful children, and few data exist on severe fears studied in the child's natural environment or on the clinical prevalence of fear. (c) Cognitive and developmental factors have been largely ignored. (d) Modeling is the most frequently used and reliably effective fear-reduction strategy. (e) A cognitive, verbal-mediation approach is promising but is not yet sufficiently researched. (f) There is little evidence that systematic desensitization or contingency management strategies are effective. Implications for large-scale fear reduction and prevention are discussed. The need for research that recognizes the complex paradigms of children's fears is suggested. (4 p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavioral treatment of childhood neurosis

The effects of zinc sulphate pretreatment on the formation of gastric ulcers, changes in intragastric pressure and changes in the gastric mucosal mast cell count induced by electrical vagal stimulation were studied in anaesthetized rats. Vagal stimulation produced a high gastric glandular ulcer incidence and ulcer index, increased the intragastric pressure, and reduced the number of granulated mast cells in the gastric mucosa and submucosa. Pretreatment with zinc sulphate (22, 44 ot 88 mg/kg), injected i.p. 48 h beforehand, reversed the changes in these parameters in a dose-related manner. These observations suggest that the inhibitory effects of zinc sulphate on mucosal mast cell degranulation may account for its ability to antagonise vagal-induced gastric glandular ulceration. The mechanisms involved in the aetiology of this type of gastric ulcer are discussed in the light of these results.     

Therapeutic effects of prolonged normovolemic hemodilution in patients with Raynaud's disease

51 patients with Raynaud's disease has undergone prolonged normovolemic hemodilution (PNH) with a good effect. Disappearance of painful syndrome in 78.43% of cases, and a significant decrease of pains in 21.37% of cases was demonstrated. Complete healing of ulcero-necrotic defects of end phalanges of the hands was observed in 7 patients of 10 and partial--in 3. A significant remission of the disease in follow-up period was obtained. Thus, prolonged normovolemic hemodilution has resulted in significant improvement of short- and long-term results of treatment in patients with Raynaud's disease.     

Behavioral self-regulation in the treatment of patients with diabetes mellitus.

Conceptualizes the treatment regimen for patients with diabetes in terms of a behavioral self-regulation model for the control of blood sugar. The model, based on a negative feedback control system, includes 4 components: (a) behaviors related to the detection of discrepancies between actual and normal blood sugar, by urine or blood sugar monitoring; (b) corrective responses, such as the use of insulin, to normalize blood sugar; (c) minimization of disturbances to the system by such behaviors as stress reduction or dietary modification; and (d) self-reinforcement of self-regulatory behaviors. The management of Type I and Type II diabetes is discussed in terms of behavioral research related to each aspect of the model. Suggestions for further research that address monitoring and decision-making processes, the effects of various behaviors on blood sugar control, and training in self-regulation itself are derived from the self-regulation model. (70 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)