Evaluating treatment effectiveness by monitoring changes in problematic behaviors.

Suggests the use of a problem-oriented approach for the measurement of change in patient status, using an ordinal scale format. Correlational data and findings from the use of this approach with spouses and patients receiving conjoint family therapy are presented to illustrate the advantages of the method. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prevalence and effectiveness of self-regulatory techniques used to avoid drunk driving

Research suggests that drinkers often use personal self-regulatory techniques to avoid drunk driving. A population-representative sample of 427 people at high risk of drunk driving were interviewed to examine the extent to which they used self-regulatory techniques. Most popular techniques were limiting drinks to a predetermined number, organizing another driver, catching a taxi, and spontaneously delaying or avoiding driving after alcohol has been consumed. After controlling exposure to demographic and drinking behavior variables, limiting drinks to a predetermined number was the only technique associated with a reduced likelihood of drunk driving. Respondents who used taxis and drank low-alcohol beer were more likely to report drunk driving, as were those who spontaneously decided to delay or avoid driving after drinking. Although interpretation of the findings is constrained by the cross-sectional survey methodology, further investigations may lead to the development of countermeasures which promote the use of appropriate techniques.     

Efficacy of self-administered treatment programs: Meta-analytic review.

Using meta-analysis, we examined the efficacy of self-administered treatments. Self-administered treatments were compared with no treatment and with therapist-administered treatments. Results indicated that self-administered treatments were reliably more effective than no treatment and that differences between self-administered and therapist-administered treatments were nonsignificant. Effect sizes for type of target problem (e.g., phobias, affective disturbances) were comparable. These results suggest that self-administered treatments in general are effective in comparison with no treatment. The limitations of this review are noted, including those that preclude the conclusion that self-administered treatments are as effective as therapist-administered programs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Managing problem behaviors of elderly patients

Professional as well as nonprofessional staff who work with the elderly in nursing homes must be reminded repeatedly that most problem behaviors are symptoms of such underlying problems as unresolved conflicts, the loss of normal, appropriate life roles, and the anticipation of illness and death. The author describes how those problems are reflected in such "senile" behaviors as incoherence, incontinence, ritualism, and inappropriate sexual behaviors. She believes the concept of personality regression under stress is a useful framework for helping staff understand and manage such behaviors. She illustrates how nonprofessional staff can help patients achieve a more satisfactory adjustment by using certain behavior modification techniques, by roleplaying, and by identifying feelings responsible for porblem behaviors and helping patients ventilate them.     

Nonverbal and verbal content behaviors in the prediction of interviewer effectiveness.

Assessed the ecological validity of previous research (e.g., M. B. LaCrosse, 1975; J. R. Graves and J. D. Robinson, 1976) that has suggested that an interviewer's nonverbal behaviors predominate over verbal content in the prediction of interviewer effectiveness ratings. In contrast to earlier investigations, the current study assessed naturally occurring rather than manipulated interviewer behavior and used "client" ratings of effectiveness rather than observer ratings. Data were collected from analog interviews conducted by 40 counseling students with 80 undergraduates. Results indicate that nonverbal interviewer behaviors do not clearly predominate over verbal content behaviors in the prediction of effectiveness ratings. It is suggested that earlier findings of nonverbal superiority are not generalizable to more ecologically valid interview settings. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mothers' scaffolding of children's problem solving: Establishing a foundation of academic self-regulatory competence.

The study examined relations between dimensions of mothers' scaffolding and children's academic self-regulatory behaviors in school. Mothers and their preschool children (68 dyads) were visited in their homes the summer before the child entered kindergarten. Mothers' metacognitive content and manner of instruction, emotional support, and transfer of responsibility were coded as mothers provided assistance to their children during 4 problem-solving tasks. Children's self-regulatory behaviors were assessed the following school year. Metacognitive content and manner of instruction were predictors of child behaviors related to cognitive awareness and management: metacognitive talk, monitoring, and help seeking. Emotional support and transfer of responsibility were related to children's task persistence and behavior control in school. Mothers' scaffolding appears to lay the foundation for children's subsequent academic self-regulatory competence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Benchmarking the effectiveness of psychotherapy treatment for adult depression in a managed care environment: A preliminary study.

This preliminary study evaluated the effectiveness of psychotherapy treatment for adult clinical depression provided in a natural setting by benchmarking the clinical outcomes in a managed care environment against effect size estimates observed in published clinical trials. Overall results suggest that effect size estimates of effectiveness in a managed care context were comparable to effect size estimates of efficacy observed in clinical trials. Relative to the 1-tailed 95th-percentile critical effect size estimates, effectiveness of treatment provided in this setting was observed to be between 80% (patients with comorbidity and without antidepressants) and 112% (patients without comorbidity concurrently on antidepressants) as compared to the benchmarks. Because the nature of the treatments delivered in the managed care environment were unknown, it was not possible to make conclusions about treatments. However, while replications are warranted, concerns that psychotherapy delivered in a naturalistic setting is inferior to treatments delivered in clinical trials appear unjustified. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Two-, three-, and four-year follow-up on the self-regulatory treatment of chronic headache.

Chronic tension and vascular headache patients, initially treated with relaxation and biofeedback, were prospectively followed-up on an annual basis at 2-, 3-, and 4-years posttreatment. Although there was a fair degree of variability, tension headache patients generally showed good maintenance of initial headache reduction at Year 4. Vascular patients showed a nonsignificant trend for gradual deterioration of treatment effects over the 4 years of follow-up. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family-based treatment for adolescent problem behaviors: Overview of contemporary developments and introduction to the special section.

The contemporary adolescent treatment field encompasses a remarkable diversity of ideas, treatment contexts, practice models, and treatment providers. Recently, there have been significant changes in how we conceptualize adolescent problems, the knowledge bases we draw on to craft such understanding, the interventions we use to treat adolescent dysfunction, the contexts in which they are treated, the amount and quality of research on adolescent problems generally, and interventions for adolescent problems in particular. The specialty is more complex and varied than ever before with subspecialties addressing scientific, clinical, public health, and social policy concerns. This work is pursued in a wide variety of research and clinical contexts supported by a diverse group of federal, state, and local agencies and by private foundations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Agreeableness and activeness as components of conflict behaviors.

Handling social conflict is usually described in terms of 2 dimensions that either cause the behavior (concern for one's own and others' goals) or that result from it (integration and distribution). In contrast, agreeableness and activeness are common factors of modes and taxonomies of conflict behavior that do not confound independent and dependent variables. This article specifies the extent to which avoiding, accommodating, compromising, problem solving, indirect fighting, and 2 forms of direct fighting—issue fighting and outcome fighting—each positively or negatively relate to agreeableness and activeness. Systematic observations of videotaped simulations by 82 male police sergeants handling a standardized conflict with either a subordinate or a superior supported and refined this metataxonomy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Bidirectional long-term modification of synaptic effectiveness in the adult and immature hippocampus

Previously we showed that delivering 900 pulses to the Schaffer collateral-CA1 pathway at 1-3 Hz causes a lasting depression of synaptic effectiveness that is input specific and dependent on NMDA receptor activation (Dudek and Bear, 1992a). Here we describe experiments aimed at further characterizing this homosynaptic long-term depression (LTD) and comparing it with long-term potentiation (LTP). To address the question of whether depressed synapses can still be potentiated and vice versa, LTP was saturated with repeated high-frequency tetani, and then LTD was induced with low-frequency stimulation (LFS). A second strong tetanus then restored the potentiation, indicating that the same synapses whose transmission had been depressed by LFS were capable of subsequently supporting potentiation. In a complementary experiment, LTD was induced first and then a strong high-frequency tetanus was delivered. We found that the resulting LTP achieved the same absolute magnitude as that observed in control slices that had received the high-frequency stimulation alone. Next, the postnatal development of LTD was investigated in slices prepared from rats at 6-35 d of age. The consequences of LFS were far more pronounced in slices from young rats. LTD following 900 pulses at 1 Hz measured -45 +/- 4% in CA1 of rats less than 2 weeks old as compared with -20 +/- 4 in animals at 5 weeks postnatal. It was also found that LTD precedes the developmental onset of LTP in CA1. Finally, we addressed the question of whether LTD could be saturated by repeated episodes of LFS in slices prepared from 3-week-old rats.(ABSTRACT TRUNCATED AT 250 WORDS)     

Field investigation of influenza vaccine effectiveness on morbidity

Our objective was to evaluate influenza vaccine effectiveness during an influenza epidemic by means of a matched case-control study. The study was performed by 35 general practitioners who collected specimens for influenza virus testing from 610 patients who consulted for infectious syndrome: 168 (28%) were influenza-positive. Two designs were used for selecting controls to take into account the high incidence-rate of influenza-like illness and the various possible protective effects of the vaccine. A first disease-free control matched for age and sex was selected during the same week as the case. A second control matched for age and sex was selected at the end of the epidemic period, irrespective of disease history during the epidemic period. Upper and lower bounds of vaccine effectiveness can be derived from these case-control designs. After adjustment for chronic conditions and exposure to an index case, analysis of the matched-pairs whose case was influenza-positive showed, with the first group of controls, an influenza vaccine effectiveness of 68% (95% CI, 10% to 88%) and, in the second group, 53% (95% CI, -19% to 82%). Among the pairs whose case was negative for influenza, vaccine effectiveness was, respectively, 31% (95% CI, -17% to 59%) and 12% (95% CI, -47% to 47%). Vaccine effectiveness was highest for the H3N2 subtype whose vaccine strain was identical to that of the wild-type strain. The results suggest that influenza vaccine is effective in the field in preventing influenza morbidity.     

Morphological investigation on phenylhydrazine-induced erythropoiesis in the adult mouse liver

In adult mice suffering from a phenylhydrazine (PHZ)-induced hemolytic anemia, erythropoietic islands were observed in the liver. These islands were studied with the light and electron microscope. Within two days after the beginning of four daily injections of PHZ, erythoid elements appeared in the sinusoids and central veins. A maximum number of erythroblasts was found on day 7. Light and electron microscopic observations revealed that the erythropoietic islands consisted of centrally located macrophages(CM) with a Kupffer cell-like morphology, surrounded by erythroblasts, which were often of the same maturation stage. CM in central veins (CM-V) and in sinusoids (CM-S) were found to have a different morphology. The CM-V phagocytized less circulating red blood cells and were in contact with a smaller number of erythroblasts. Furthermore, the contact areas between erythroblasts and CM-S extended for a much longer distance than those between erythroblasts and CM-V. The progenitor cell for the CM-V is most likely a monocyte, since cells which were morphologically determined as monocytes were found to appear on the first day of the PHZ treatment and differentiated into macrophages within about 2 days. The origin of the CM-S population was less clear, but could be monocytic as well. These data are tentatively explained as a migration of a progenitor of a cellular component of the erythroid micro-environment into the liver after appropriate stimuli. In contrast to fetal liver erythropoiesis, erythroblasts in the adult liver occurred only incidentally extrasinusoidally. Furthermore, specialized membrane contacts between erythroblasts and CM or hepatocytes could not be observed in adult liver. Ferritin could not be detected on the erythroid cell membrane or located in coated vesicles. Also, no ferritin could be observed within or attached to the finger-like processes of CM. The observations suggest that the coated vesicles in erythoid elements are partly exocytotic vesicles and are not specific for ferritin transport. The morphological aspects of PHZ-induced extramedullary erythropoiesis is discussed in relation to the hemopoietic microenvironment.     

Meta-analytic review of sex differences in group performance.

To examine the impact of sex composition of groups on productivity, a meta-analytic review was conducted on the findings of past laboratory research. Two classes of factors were distinguished to account for any performance differences obtained: (a) task contents or settings that favor the interests and abilities of one sex over the other and (b) group-level factors, such as men's and women's interaction, in particular, the tendency for men in groups to offer opinions and suggestions and the tendency for women to act friendly and agree with others. Overall, all-male groups were found to perform better than all-female ones. This appeared due to tasks or settings that favored men's interests and abilities over women's. The effects of group-level factors, such as interaction style, became apparent when tasks were classified in terms of the type of interaction required for completion. Female group members' interaction apparently facilitated performance at tasks requiring positive social activities, including friendliness and agreement with others. Men's interaction style slightly, although not reliably, facilitated performance on tasks requiring task-oriented behavior, such as giving opinions and suggestions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Early temperamental antecedents of adult Type A behaviors.

Examined the role of early childhood temperament in the development of adult Type A (coronary prone) behaviors, using data on 108 young adults from the ongoing New York Longitudinal Study (begun by A. Thomas and S. Chess in 1956). The data included measures of temperament derived from interviews conducted with the children's mothers when the youngsters were 3 and 4 yrs of age and measures of Type A behaviors derived from interviews conducted with the participants during young adulthood (mean age 21 yrs). Correlational and regression analyses indicated that early childhood temperament accounted for approximately 20% of the variance in achievement-striving, 13% of the variance in impatience-anger, and 15–25% of the variance in overall Type A behavior scores. Achievement-striving in young adulthood was associated with high adaptability and negative mood during early childhood, whereas impatience-anger had as its antecedents low sensory threshold, low persistence, and low adaptability. Findings suggest that certain temperamental attributes, visible early in childhood, may predispose individuals toward the development of the Type A behavior pattern. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Structure of problem and positive behaviors in African American youths.

Explored the association of 21 problem and positive behaviors in a sample of 283 inner-city, African American youths (8–12 yrs old). Data reduction yielded 4 factors, 3 representing different types or levels of problem behavior, labeled Interpersonal-Minor Deviance, School Problems, and Covert-High Deviance, and 1 representing positive behaviors. The 3 problem behavior factors, although not the positive behavior factor, were significantly correlated with an underlying second-order general deviance factor. The problem behavior clusters identified differed by the settings in which they occur as well as their inherent magnitude of deviance. Discriminant validity analyses confirmed that deviance was not a unitary phenomenon. Limitations as well as other implications of the data are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Classroom context and teachers' perceptions of problem behaviors.

73 teachers of kindergarten to 8th grade viewed disruptive- or nondisruptive-context videotaped vignettes and rated each portrayal in terms of severity, manageability, tolerance, and contagion to investigate the effects of context on Ss' perceptions of 5 problem behaviors (blaming, poor peer cooperation, negative aggression, inattention, and failure anxiety). ANCOVA showed that contagion yielded significant differences (stronger within the disruptive context), suggesting that the target child was held responsible for the classroom disorder. Correlational data explained the relationship between the 4 areas, suggesting a dichotomy between quality (type of behavior) and quantity (degree or severity of behavior) for interpreting perceptions. Low tolerance was associated with higher levels of severity and more outer-directed behaviors. Contagion had more active, observable components and was related more to the qualitative dimension. Manageability (also active, observable, and teacher centered) was strongly influenced by quantitative factors (greater extremes of atypical behavior). (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessment of interpersonal negotiation strategies in youth engaged in problem behaviors.

Explored relations among developmental levels and styles of interpersonal negotiation strategies (INS) and competence in social problem-solving skills (SPS-skills). Also assessed relations among levels and styles of INS and self-reported engagement in problem behaviors, including hard and soft drug use, delinquent acts, official criminal status, running away, and unprotected sexual activity. For both males and females (M age?=?16.7 years), a moderate positive correlation was found between level of INS and SPS-skills. Older males with lower INS scores who used a more other-transforming (assertive) style reported greater involvement in problem behaviors. For females, no significant relations between levels and styles of INS and involvement in problem behaviors were found. Advantages of a developmental model for the evaluation of deficits and changes in interpersonal negotiation strategies are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)