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Biomedical subjects

D S Kirschenbaum

Publications and source records attributed to D S Kirschenbaum.

17 recordsLinked to original sources
PubMed1993

Obese people who seek treatment have different characteristics than those who do not seek treatment.

A group of obese people who had not sought treatment, an obese group who had sought treatment in a professional, hospital-based program, and normal-weight controls (N = 547) were compared in regard to level of psychopathology, binge eating, and negative emotional eating. Because the groups differed significantly on several demographic variables, 3 demographically matched groups were created and compared (n = 177, 59 per group). In the matched subgroups, obese people who had sought treatment reported greater psychopathology and more binge eating than did those who had not sought treatment or did normal-weight controls. Both obese groups (including those who had not sought treatment) endorsed more symptoms of distress, negative emotional eating, overeating, difficulty resisting temptation, and less exercise than did normal-weight controls.

Adaptation, Psychological↗
PubMed1992

Evaluation of an intensive weight control program using a priori criteria to determine outcome.

This study evaluated the effectiveness of a comprehensive obesity treatment program which incorporated open-ended treatment duration, pre-treatment assessments, protein-sparing modified fasts (PSMFs), and the use of six a priori outcome categories to analyse outcomes. Subjects were the first 291 obese individuals (mean weight = 235 lb, 66% overweight) to participate in the program's intake procedures. Data obtained after 55 weeks of treatment (on average) showed that the program seemed quite effective for 65% of those who participated for at least 12 weeks (mean = 62 and 30 lb lost in the two successful groups). Analyses supported the continued use of pre-treatment assessments, extended treatment times, and a priori categorizations of outcomes. In addition, correlational analyses showed that binge eating, high levels of psychological distress, and low income levels were associated with poorer outcomes.

Adult↗
PubMed1991

Distressed binge eaters as a distinct subgroup among obese individuals.

This study was conducted to examine the degree to which binge eating and psychological distress among obese adults are associated with a variety of behavioral patterns and competencies that could substantially affect weight control. Subjects were 167 obese people who sought help in a long-term cognitive behavioral treatment program. Subjects were divided into three groups depending on their level of psychological distress and severity of binge eating. Subjects were also assessed on coping style, subjective distress, weight history, and exercising and eating patterns. Results demonstrated substantial differences between those reporting relatively few problems with binge eating or psychological distress as opposed to those with noteworthy problems in both. The presence of either severe binge eating or psychological distress was associated with problems in regulating food-related behavior and, more generally, to problematic coping styles. These findings support the importance of in-depth assessment when treating obesity, more intensive treatment for some subgroupings, and long-term studies that incorporate comprehensive pretreatment process measure of eating style and psychological distress.

Adaptation, Psychological↗
PubMed1991

Disinhibited eating by resourceful restrained eaters.

Restrained eaters who reported consistent use of a variety of self-control skills were expected to avoid disinhibited eating in a high-risk situation better than were restrained eaters, who reportedly used fewer self-control skills. Eighty women were selected as subjects on the basis of their scores on the Revised Restraint Scale and the Self-Control Schedule. A 2 x 2 design was used: Restraint (high, low) x Self-Control (high, low). Subjects participated in the usual "preload + taste-test" restraint paradigm. Restrained eaters who reported high self-control skills disinhibited their eating significantly more (not less, as expected) than all other groups.

Body Weight↗
PubMed1990

Heterogeneity of clinical presentation among obese individuals seeking treatment.

This study provides a test for the assumption of psychological homogeneity among 60 individuals who sought treatment for obesity and were referred for cognitive-behavioral group treatment. Subjects were divided along the dimension of severity of psychopathology and were assessed on subjective distress, binge eating, coping ability, and a variety of historical and demographic dimensions. Twenty-three percent of the sample scored in a range indicative of significant personality disturbance on the Borderline Syndrome Index. This distressed group did not differ from the less distressed cohort in weight, but reported more extensive symptoms of psychopathology, more chaotic eating patterns, more binge eating, and evidenced less effective coping skills. These findings provide support for the importance of a thorough assessment prior to initiating treatment for obesity.

Adult↗
PubMed1987

Promoting self-directed hemodialysis: measurement and cognitive-behavioral intervention.

Approximately 98% of hemodialysis patients who are treated in hemodialysis units currently use staff-directed treatment. This may well be the most expensive and most dependent mode of hemodialysis treatment. If an effective strategy were developed to enhance degree of self-directed care, millions of public health dollars might be saved while patients reap potentially substantial psychological benefits. The present research took two steps in the direction of promoting increased self-directed treatment of hemodialysis. First, a reliable and easily used behavioral observation system was developed to define and measure degree of self-directed treatment of hemodialysis. Second, a five-step cognitive-behavioral strategy to improve degree of self-directed treatment was developed and tested preliminarily. The strategy includes an initial rationale, decisional counseling, behavioral contracting, self-monitoring, and staff support/problem solving. Four nurses used this approach with 4 elderly patients (mean age = 70.5 years). A multiple-baseline-across-subjects design revealed substantial and relatively rapid improvements in degree of self-directedness associated with the intervention for the 3 patients who remained healthy throughout the study. The discussion focuses on the implications of the results for future research.

Aged↗
PubMed1987

Self-regulation of sport performance.

All serious sport participants must engage in goal-directed behaviors in the relative absence of immediate external constraints (i.e., self-regulation). Psychologists have developed theoretical models of self-regulation and produced principles of self-regulation that are summarized by the models. These concepts apply directly to sport performance. The purpose of this paper is to review the most relevant concepts in self-regulation and show how they impact on sport psychology. Several studies are reviewed which have used self-regulatory concepts to help both elite and ordinary athletes improve their performance. For example, the research indicates that when performance is difficult (e.g., at low and moderate skill levels), performance can be improved by keeping track of successes while performing or while viewing videotapes of one's own performance. Keeping track of instances of inadequate performance may prove detrimental except if the tasks being monitored are extremely easy or routine. How to apply this principle and others to sport performance is discussed.

Educational Measurement↗
PubMed1986

Dispositional and situational correlates of long-term weight reduction in obese children.

Two samples of obese children were studied in order to investigate the extent to which four classes of variables were associated with weight reduction outcomes: use of self-control techniques, degree of social support, attributional style, and self-reinforcement style. One sample participated in a program in Wisconsin (n = 22) 1-2 years before assessment, whereas the second sample completed a similar program in Pittsburgh (n = 17) 3 months prior to assessment. Children and parents were individually interviewed using structured protocols, and children also completed a block design task. Children's self-reinforcement and attributional styles, motivation to change, problem-solving style, family environment, and intellectual skills were assessed. Regression analyses selected a subset of variables which were clearly associated with change in percent overweight and Feinstein indices, computed from pretreatment and from posttreatment to time of assessment. Substantial proportions of outcome variance were accounted for in the Wisconsin sample but not in the Pittsburgh sample. The results suggest that obese children who terminate ineffective problem-solving efforts quickly and who make more adaptive weight reduction attributions may be more likely to succeed in long-term weight reduction. The differential results in the two samples suggest that variables investigated in this study may play a greater role in maintenance than in initial behavior change.

Adolescent↗
PubMed1986

Coping skills training for children: effects on distress before, during, and after hospitalization for surgery.

Thirty-three parent-child dyads (children's mean age = 7.2 years, SD = 1.2) were randomly assigned to information, anxiety reduction, or coping skills presurgical preparatory interventions. All groups received the "information" procedure that described typical hospitalization and surgery experiences via a puppetry film viewed 1 week prior to hospital admission. In the anxiety reduction group, parents also learned procedures (e.g., relaxation) to help them reduce their own distress. Parents in the coping skills group learned how to help their children use coping self-talk and related techniques. The coping skills intervention was expected to assist children most effectively, although the anxiety reduction procedure was also expected to improve adaptation relative to the information condition. These hypotheses were generally supported. Anxiety reduction and coping skills groups, compared to the information group, reduced children's self-reported fearfulness and parents' reported distress. Furthermore, only the coping skills group, compared to the information group, exhibited fewer maladaptive behaviors during hospitalization (ratings by observers) and less problematic behavior in the preadmission week and second postdischarge week (daily parental diaries). Theoretical explanations for these results are discussed in light of the similar findings obtained by Peterson and Shigetomi (1981).

Adaptation, Psychological↗
PubMed1980

Multimodal evaluation of therapy versus consultation components in a large inner-city early intervention program.

Cincinnati's Social Skills Development Program (SSDP) used a social competence model to direct its interventions for children. Systematic screening identified 15-25% of the primary grade children who showed behavioral problems and deficits in social skills at seven elementary schools. Multimodal evaluations comparing therapy and consultation interventions included three types of assessments over a 1 year period. Tests of social skills revealed that children who received both therapy and consultation services, compared to those who received only consultation, improved in a basic empathy skill and increased their externality in locus of control. School record data showed that therapy and consultation children improved in grades; but, consultation children improved most. Finally, trained observers found that therapy children, compared to children in consultation only, increased cooperative interactions with teachers and maintained appropriate solitary behaviors. The data are discussed as providing some support for the hypothesis that therapy produced increased benefits for children compared to the less costly consultation intervention. However, since therapy and consultation conditions were not differentiated on many assessments (e.g., tests of interpersonal problem-solving and advanced empathy skills; lateness; achievement), more intense behaviorally oriented interventions may be warranted.

Child↗