First recovery in anorexia nervosa patients in the long-term course: A discrete-time survival analysis.

The results of a 12-year follow-up study of occurrence and timing of first recovery in 69 hospitalized patients with severe anorexia nervosa (AN) are presented. For the first time discrete-time survival analysis methods were used to determine the likelihood of recovery in AN patients. Furthermore, predictors gleaned from pretreatment-posttreatment studies of long-term outcome in AN could be evaluated as to their effect on a change in the time course structure of the likelihood of first recovery. Results show that AN condition did not improve until after 6 years after the first inpatient treatment in 50% of patients. However, a restricter-type AN and low serum creatinine levels were predictors for earlier recovery. One specific effect was that AN patients who show purging behavior in combination with additional social disturbances have a lower chance of recovering. The use of discrete-time survival analysis methodology in further prospective studies will contribute to the development of more tailored treatment of AN, which also takes the individual phase of illness and specific aspects of the symptomatology into account. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Use of survival analyses to examine onset and staging of DSM-IV alcohol symptoms in women.

Despite their implications for diagnostic validity. few studies have examined patterns of alcohol symptom onset in women. Using Structured Clinical Interview for the DSM-lV (M. B. First, M. Gibbon, R. L. Spitzer, & J. B. W. Williams, 1995) data, the authors applied survival analysis to Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) alcohol symptoms in 87 women in treatment. Legal problems occurred rarely and did not fit a staging model. Compared with men previously studied, women showed a later onset of symptoms, which developed in 4 stages: abuse, consequation, accommodation to the illness, and physiological dependence. Three symptoms-hazardous use, larger/longer use than intended, and lots of time spent using-occurred early and may be useful for screening purposes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preschoolers' understanding of mental and bodily reactions to contamination: What you don't know can hurt you, but cannot sadden you.

Evidence of the operation of a biological theory might be found in children's distinction between mental (emotional) and bodily (illness) reactions to contamination. Study 1 explored whether children see emotions as voluntary but illness as outside of intentional control. Three- and 5-yr-olds judged that simple volitions were insufficient to alter either outcome. Study 2 suggested that children distinguish reactions mediated by representations from those mediated by physical interactions. Children indicated that knowledge determines mental reactions to contamination, but physical contact determines bodily reactions. Study 3 explored knowledge about particulars of emotional and illness reactions. Most preschoolers did not realize that illness takes time to develop. These data suggest that preschoolers do distinguish between physical and mental reactions to contamination but have a poor understanding of the actual bodily processes involved. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Competency and common law: Why and how decision-making capacity criteria should be drawn from the capacity-determination process.

Determining competence to request physician-assisted suicide should be no more difficult than determining competence to refuse life-prolonging treatment. In both cases, criteria and procedures should be developed out of the process of actually making capacity determinations; they should not be promulgated a priori. Because patient demeanor plays a critical role in capacity determinations, it should be made part of the record of such determinations through greater use of video- and audiotapes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Learning how to recover from job stress: Effects of a recovery training program on recovery, recovery-related self-efficacy, and well-being.

This quasi-experimental study evaluated the effects of a recovery training program on recovery experiences (psychological detachment from work, relaxation, mastery experiences, and control during off-job time), recovery-related self-efficacy, and well-being outcomes. The training comprised two sessions held one week apart. Recovery experiences, recovery-related self-efficacy, and well-being outcomes were measured before the training (T1) and one week (T2) and three weeks (T3) after the training. A training group consisting of 48 individuals and a waitlist control group of 47 individuals were compared (N = 95). Analyses of covariance revealed an increase in recovery experiences at T2 and T3 (for mastery only at T2). Recovery-related self-efficacy and sleep quality increased at T2 and T3, perceived stress and state negative affect decreased at T3. No training effects were found for emotional exhaustion. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Why, when, and how to take into account the uncertainty involved in career decisions.

Career decisions under uncertainty, when the career decision maker has to rank a number of options, rather than choose the best one, were analyzed theoretically. The analysis revealed that the way such decisions are framed affects the ranking of the options and hence the quality of the decision. Specifically, in certain cases the ranking of career options according to their expected utility does not lead to an optimal decision. In the correct framing the choice is between rankings, in which each ranking is defined as a particular rank order of the options. In this framing the ranking that maximizes the expected utility is chosen. The analysis shows that the rank order of options in the optimal ranking always coincides with the rank order of the options by their utility. The implications for career counselors who help counselees deal with the uncertainties involved in most career decisions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

What you say and how you say it: The contribution of speech content and voice quality to judgments of others.

14 groups of undergraduates (2 for each of 7 conditions) made judgments based on separated channels (speech content, voice quality, face alone, and body alone) and judgments based on combined channels (speech, face plus speech, and face plus body plus speech). Ss observed (via videotape) and heard (via audiotape) the spontaneous behavior of 15 stimulus persons in 2 types of interview situations and rated various aspects of the behavior. In Study 1, criterion judgments were based on a task similar to answering a phone. In Study 2, they were similar to watching TV. In Study 3, a complete set of behavioral clues was the basis of the criterion judgments. Results show that correlations between separated and combined channels varied significantly, depending on the kind of behavior judged. Judgments of honestly described positive feelings based on nonverbal channels were highly correlated with judgments of the whole person, while most speech-content judgments were uncorrelated. Judgments of stimulus persons' lied-about negative feelings were less influenced by nonverbal behavior. Judgments based on content of what was said were most highly correlated with how the person making the statement was judged. (11 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The long-term course of severe anorexia nervosa in adolescents: survival analysis of recovery, relapse, and outcome predictors over 10-15 years in a prospective study

OBJECTIVE: To assess the long-term course of recovery and relapse and predictors of outcome in anorexia nervosa. METHOD: A naturalistic, longitudinal prospective design was used to assess recovery and relapse in patients ascertained through a university-based specialty treatment program. Patients were assessed semiannually for 5 years and annually thereafter over 10-15 years from the time of their index admission. Recovery was defined in terms of varying levels of symptom remission maintained for no fewer than 8 consecutive weeks. RESULTS: Nearly 30% of patients had relapses following hospital discharge, prior to clinical recovery. However, most patients were weight recovered and menstruating regularly by the end of follow-up, with nearly 76% of the cohort meeting criteria for full recovery. Relapse after recovery was relatively uncommon. Of note, time to recovery was protracted, ranging from 57-79 months depending on definition of recovery. Among restrictors at intake, nearly 30% developed binge eating, occurring within 5 years of intake. A variety of predictors of chronic outcome and binge eating were identified. There were no deaths in the cohort. CONCLUSION: The course of anorexia nervosa is protracted. Predictors of outcome are surprisingly few, but those identified are in keeping with previous accounts. The intensive treatment received by these patients may account for the lower levels of morbidity and mortality when considered in relation to other reports in the follow-up literature.     

Genes, brains, and language: An epistemological examination of how genes can underlie human cognitive behavior.

How do genes encode for the formation of morphological structures such as the brain? Can genetic material also encode for behavior such as cognition, language, or culture? For many years, evolutionary biologists as well as scholars who work within extrabiological fields such as psychology, linguistics, and archaeology could only answer the above two questions in a speculative manner. This is because until recently, empirical observations on how genes underlie anatomy or behavior were generally lacking. This situation has now changed. Several genes (MCPH1-MCPH6) have been implicated in the regulation of brain size and a first gene (the FOXP2 gene) has been identified that might underlie linguistic behavior. These discoveries allow us to finally test some of the long-standing theoretical assumptions on how genes do or do not determine morphology and behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcoholic relapse, life events, and behavioral theories of choice: A prospective analysis.

This prospective study investigated the determinants of drinking in 26 alcoholic men during 6 months after treatment. Participants were interviewed while hospitalized regarding the degree to which their drinking had disrupted their functioning in 6 life–health areas. Following discharge, they self-monitored their daily alcohol consumption, event occurrences, and mood. Collaterals were interviewed regarding the alcoholic participants' life–health disruption and posttreatment drinking. Results showed that the more participants' pretreatment alcohol consumption had impaired their intimate relations, family relations, and vocational functioning, the more likely posttreatment events in these areas were to be associated with drinking episodes. Posttreatment drinking episodes preceded by events were more severe than those not preceded by events, which suggests that relapses and lapses may be differentiated by the environmental conditions that existed before and when drinking begins. These results are consistent with an analysis of relapse based on behavioral theories of choice. Negative mood states also were correlated with drinking for the majority of participants who relapsed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Drug-induced reinstatement to heroin and cocaine seeking: A rodent model of relapse in polydrug use.

The authors investigated several features of polydrug use in rats. Heroin and cocaine were self-administered following responses on different levers, with only 1 drug and 1 lever available on alternate days of training. Four doses of each drug (heroin: 25, 50, 100, and 200 μg/kg/infusion; cocaine: 0.25, 0.5, 1, and 2 mg/kg/infusion) were tested, and each rat was exposed to a single dose combination. Rats readily developed drug-specific and dose-related responding. During extinction, rats displayed a significant bias for responding on the cocaine-associated lever. Priming injections of either cocaine (20 mg/kg) or heroin (0.25 mg/kg) reinstated responding that was selective for the lever previously associated with each drug These results suggest that in this type of polydrug use, drugs have the capacity to activate drug-seeking behavior selectively oriented toward stimuli previously associated with their administration. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Counseling patients to quit smoking. What to say, when to say it, and how to use your time to advantage

Helping patients stop smoking is one of the most important--and frustrating--services primary care physicians can provide. Many physicians are reluctant to spend time talking about tobacco use with patients who show little or no interest in changing their habits. Fortunately, specific technique have been identified that can make the task easier. This article from the distinguished Nicotine Dependence Center of the Mayo Clinic looks at the "best practices" for dealing with nicotine dependence.     

Naltrexone, relapse prevention, and supportive therapy with alcoholics: An analysis of patient treatment matching.

Alcohol-dependent patients (N?=?97 ) were randomly assigned to receive either naltrexone or placebo and either relapse prevention therapy or supportive therapy. The present report explored the hypothesis that patients could be matched to the above treatments on the basis of specific pretreatment characteristics. Treatment matching variables explored included craving, alcohol dependence severity, and cognitive measures of learning and memory. Results of linear regression analyses tentatively suggest that patients experiencing higher levels of craving and poorer cognitive functioning may derive the greatest benefit from naltrexone versus placebo. For psychotherapy, lower levels of verbal learning were associated with poorer drinking outcomes for relapse prevention therapy but not for supportive therapy. Conversely, higher levels of verbal learning were associated with better outcomes for relapse prevention therapy but not for supportive therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Why we should continue to study race...but do a better job: an essay on race, racism and health

For at least a century, American medical and public health researchers have used race as a marker for biology, and have documented race-associated differences in health and illness behavior. The research has often been inappropriate and has led to abuses and erroneous conclusions about the role played by race in the production of disparities in health status. Consequently, some researchers have begun to advocate the abolition of medical and public health research using race. In this essay, I argue that, although the arguments against continuing to study race have some merit, more rather than fewer studies of race are needed. Researchers should be more careful in the use of race and more conscious of the limitations of the race concept.     

Lessons learned about service quality: What it is, how to manage it, and how to become a service quality organization.

Discusses lessons that the authors' experiences in the area of service quality have taught them about how to help a business develop into the kind of company that can deliver quality service to its customers. A theme running through the article is that becoming such a company is a multistage process that involves coordinating changes in many facets of organizational functioning. Furthermore, it is repeatedly emphasized that the design of these facets must be aligned with the market sector the organization wants to target. Lessons 1, 2, and 3 address the implications of service marketing, operations management, and human resources management for delivering quality service. The integration of what has been learned in these 1st 3 lessons is the topic of Lesson 4: creating a climate and a culture for service. Finally, some practical suggestions and guidelines are offered for beginning the process of becoming a service organization. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rowed to recovery: The use of phonological and orthographic information in reading Chinese and English.

To examine how readers of Chinese and English take advantage of orthographic and phonological features in reading, the authors investigated the effects of spelling errors on reading text in Chinese and English using the error disruption paradigm of M. Daneman and E. Reingold (1993). Skilled readers in China and the United States read passages in their native language that contained occasional spelling errors. Results showed that under some circumstances very early phonological activation can be identified in English, but no evidence for early phonology was found in Chinese. In both languages, homophone errors showed a benefit in measures of later processing, suggesting that phonology helps readers recover from the disruptive effects of errors. These results suggest that skilled readers take advantage of the special features of particular orthographies but that these orthographic effects may be most pronounced in the early stages of lexical access. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of socioeconomic group on incidence of, management of, and survival after myocardial infarction and coronary death: analysis of community coronary event register

OBJECTIVE: To investigate the effect of socioeconomic group (with reference to age and sex) on the rate of, course of, and survival after coronary events. DESIGN: Community coronary event register from 1985 to 1991. SETTING: City of Glasgow north of the River Clyde, population 196,000. SUBJECTS: 3991 men and 1551 women aged 25-64 years on the Glasgow MONICA coronary event register with definite or fatal possible or unclassifiable events according to the criteria of the World Health Organisation's MONICA project (monitoring trends and determinants in cardiovascular disease). MAIN OUTCOME MEASURES: Rate of coronary events; proportion of subjects reaching hospital alive; case fatality in admitted patients and in community overall. RESULTS: Event rates increased with age for both sexes and were greater in men than women at all ages. The rate increased 1.7-fold in men and 2.4-fold in women from the least (Q1) to the most (Q4) deprived socioeconomic quarter. The socioeconomic gradient decreased with age and was steeper for women than men. The proportion treated in hospital (66%) decreased with age, was greater in women than men, and decreased in both sexes with increasing deprivation (age standardised odds ratio 0.82 for Q4 v Q1) Case fatality in hospital (20%) increased with age, was greater for women than men when age was standardised, and showed no strong socioeconomic pattern. Overall case fatality in the community (50%) increased with age, was similar between the sexes, and increased from Q1 to Q4 (age standardised odds ratio 1.12 in men, 1.18 in women). CONCLUSIONS: Socioeconomic group affects not only death rates from myocardial infarction but also event rates and chance of admission. This should be taken into account when different groups of patients are compared. Because social deprivation is associated with so many more deaths outside hospital, primary and secondary prevention are more likely than acute hospital care to reduce the socioeconomic variation in mortality.     

Individuation, peers, and adolescent alcohol use: A latent growth analysis.

The study used latent growth modeling to investigate longitudinal relationships between individuation, peer alcohol use, and adolescent alcohol use among African American, Mexican American, and non-Hispanic White adolescents (N=6,048) from 7th, 8th, and 9th grades over a 3-year period. Initial levels of peer alcohol use were significantly related to changes in adolescents' alcohol use, whereas initial adolescent alcohol use also significantly related to changes in peers' alcohol use, suggesting a bidirectional relationship. Higher levels of intergenerational individuation were related to smaller increases in adolescent alcohol use and higher levels of separation were related to larger increases in youth drinking. The findings were similar across ethnic groups. Implications for development of prevention and intervention programs are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Longitudinal analysis of deciduous tooth emergence: II. Parametric survival analysis in Bangladeshi, Guatemalan, Japanese, and Javanese children

We present a form of parametric survival analysis that incorporates exact, interval-censored, and right-censored times to deciduous tooth emergence. The method is an extension of common cross-sectional procedures such as logit and probit analysis, so that data arising from mixed longitudinal and cross-sectional studies can be properly combined. We extended the method to incorporate and estimate a proportion of agenic teeth. While we concentrate on deciduous tooth emergence, the method is relevant to studies of permanent tooth emergence and other developmental events. Deciduous tooth emergence data were analyzed from four longitudinal studies. The samples are 1,271 rural Guatemalan children examined every three months up to age two and every six months thereafter as part of the INCAP study; 397 rural Bangladeshi children examined monthly to age one and quarterly thereafter as part of the Meheran Growth and Development Study; 468 rural Indonesian children examined monthly as part of the Ngaglik study; and 114 urban Japanese children examined monthly in studies from 1910 and 1920. Although all four studies were longitudinal, many observations from the Guatemala and Bangladesh studies were effectively cross-sectionally observed. Three different parametric forms were used to model the eruption process: a normal distribution, a lognormal distribution, and a lognormal distribution with age shifted to shortly after conception. All three distributions produced reliable estimates of central tendencies, but the shifted lognormal distribution produced the best overall estimates of shape (variance) parameters. Estimates of emergence were compared to other studies that used similar methods. Japanese children showed relatively fast emergence times for all teeth. Bangladeshi and Javanese children showed emergence times that were slower than are found in most previous studies. Estimates of agenesis were not significantly different from zero for most teeth. One or two central incisors showed significant agenesis that ranged from 0.1 to 0.8% in three of the samples; even so, failure to model the agenic proportion did not seriously bias the estimates.