Biomedical subjects

W H O'Brien

Publications and source records attributed to W H O'Brien.

13 recordsLinked to original sources

PubMed2001

Ecological momentary assessment of temptation and lapse in dieting.

Although some research attention has been given to the factors associated with temptation and lapse in dieting, the majority of research has focused on individuals in weight loss clinical trials and relied heavily on retrospective self-report data. The present study sought to overcome these limitations by using ecological momentary assessment (EMA) techniques to examine situations of dietary temptation, lapse, and minimal dietary consequence with a sample of overweight dieters (N=30) attempting to lose weight on their own. Results support and extend previous research findings on dietary temptation and lapse. In general, results indicate that recent consumptive activity, location, mood state, type of activity, and abstinence violation effects were related to moments of temptation and/or lapse. Education on the factors associated with dietary temptation and lapse and strategies for addressing these factors is imperative for both dieters in formal programs and those attempting to lose or maintain weight on their own.

Journal Article↗

PubMed2001

Pediatric impedance cardiography: temporal stability and intertask consistency.

The pathogenic processes responsible for cardiovascular disease have their origins in childhood. Although children's measures of heart rate and blood pressure have been found to be reliable, the reliability of impedance cardiography derived measures have not been evaluated. Thirty-three children, ages 8-11 participated in two sessions. Stressors included serial subtraction, isometric handgrip, and mirror-image tracing. Results indicated the impedance measures showed moderately high temporal stability (average scores r(avg) = .74; difference scores r(avg) = .53) and intertask consistency (average scores r(avg)= .78; difference scores r(avg)= .53). Blood pressure demonstrated the lowest reliability; Heather index, preejection period, and stroke volume demonstrated the highest. These findings suggest children's cardiovascular reactivity to laboratory stressors can be reliably and consistently assessed using impedance cardiography.

Cardiography, Impedance↗

PubMed2000

The economics of managed care in behavioral health. Basic concepts and incentives.

Psychiatrists and other behavioral health clinicians must accept managed care philosophy because it is not going to disappear. A keen understanding of the specific issues that are pertinent to the managed care contracts that are signed is important if the clinician is to serve as an effective advocate for his or her patients on a case by case basis. Managed care in behavioral health services is now preparing to enter a new phase in development in which there will be reduced competition amongst the BHMCOs because the number of managed care organizations are decreasing with mergers and acquisitions. These adjustments in the market will leave the clinician and the provider organization potentially less able to make changes in their own delivery systems unless the discussions and strategies for change are structured in such a way that the incentives for all involved parties are aligned. Stakeholders in the process of managing care for behavioral health will need to come together to educate all parties about the value of necessary behavioral health treatment at the point of need. Appropriate access to all necessary behavioral health services could create additional short-term costs, but with reasonable management of the services, these costs could be kept in line.

Behavior Therapy↗

PubMed1999

Appraisal and coping responses to pain and stress in migraine headache sufferers.

The purpose of this study was to investigate how migraine headache sufferers and headache-free controls differ in their appraisal and coping responses to a cognitive (mental arithmetic) and a physical (cold pressor) laboratory stressor. Fifty-two women (26 migraine headache and 26 controls) completed the study. Results indicated that migraine sufferers rated the cold pressor task as significantly more painful compared to headache-free participants. Migraine headache sufferers also reported more wishful thinking and self-criticism in managing the mental arithmetic stressor. In addition, migraine participants reported the use of more social withdrawal and catastrophizing in managing stress and pain outside of the laboratory.

Adaptation, Psychological↗

PubMed1999

Cardiovascular responses to pain and stress in migraine.

OBJECTIVE: The purpose of this study was to investigate how migrainous subjects and controls differ in their cardiovascular reactivity and recovery to a cognitive and an acute pain laboratory stressor. BACKGROUND: Prior research suggests that individuals subject to migraine may respond physiologically to pain and stress differently than controls. METHODS: Fifty-two women (26 with migraine and 26 controls) participated in a single laboratory session. Multiple cardiovascular responses to a cognitive (mental arithmetic) and an acute pain (cold pressor task) stressor were recorded with cardiac impedance methods. The cardiovascular responses measured included systolic and diastolic blood pressure, heart rate, cardiac output, stroke volume, and total peripheral resistance. RESULTS: Results indicated that the migrainous participants displayed different cardiovascular recovery patterns for total peripheral resistance, cardiac output, and stroke volume following the termination of the mental arithmetic task. CONCLUSIONS: These results support the hypothesis that individuals with migraine respond physiologically to stress differently than control individuals.

Adolescent↗

PubMed1999

An evaluation of the impact of social support manipulations on cardiovascular reactivity to laboratory stressors.

Research findings have suggested that social support decreases cardiovascular reactivity and reduces the incidence of cardiovascular disease. The authors describe 2 studies evaluating the association between social support and cardiovascular reactivity to a stressor. In both studies, it was predicted that the presence of a supportive person would exert a buffering effect on cardiovascular reactivity. In Study 1, 68 participants were randomly assigned to 1 of 3 conditions: alone, supportive, and nonsupportive. In Study 2, 60 participants were randomly assigned to 1 of 3 conditions: highly supportive, supportive, and nonsupportive. In both studies, a speech was the stressor. Results in both studies showed no significant differences in cardiovascular reactivity between supportive and nonsupportive conditions. The results failed to support the reactivity buffering effects of social support. Findings are explained in terms of evaluation apprehension theory, familiarity of support provider, and level of social support.

Adolescent↗

PubMed1998

Differences in heartbeat awareness among males with higher and lower levels of systolic blood pressure.

Recent empirical findings related to the baroreceptor hypothesis indicate that elevated heart rate, pulse pressure, and blood pressure may dampen exteroception and interoception. We thus predicted that persons with elevated systolic blood pressure would be less able to accurately perceive their heartbeats and profit from feedback training. This study examined the plausibility of this hypothesis by exposing 57 male students (11 with elevated SBP levels and 46 with normotensive SBP levels) to the Whitehead heartbeat perception task with, and without, feedback training. Results indicated that participants with elevated SBP levels were more able to accurately perceive their heartbeats prior to, and after, feedback training. Participants with elevated SBP levels also showed a significant increase in heartbeat perception accuracy when they were provided with feedback training while participants with normotensive blood pressure levels did not show a significant response to feedback training. These findings are interpreted in terms of the ballistic perception model of cardiac awareness.

Adult↗

PubMed1998

Clinical psychology students' self-reported willingness to interact with persons living with HIV.

Previous research has indicated that health care workers, including those in mental health, have negative attitudes toward people living with HIV and AIDS and may be unwilling to work with them in a professional capacity. Ajzen's theory of planned behavior (1985) was used as a model for better understanding the specific components of these attitudes. In this project doctoral students in clinical psychology read a vignette describing a person who is HIV positive and then completed a set of measures regarding willingness to interact professionally, level of knowledge and attitudes toward HIV and AIDS, and attitudes regarding drug abusers and promiscuity. Results indicated that participants were generally willing to provide therapy for an HIV positive client, although some participants indicated that they would experience some anxiety in doing so. Level of anxiety could be predicted by attitudes toward AIDS and whether the participants believed that accepting an infected client would have negative effects for them personally or professionally.

Adult↗

PubMed1997

Meta-analysis of cognitive-behavioral treatment studies for bulimia.

A meta-analysis was performed to systematically assess the effect of cognitive-behavioral treatments for bulimia. To protect against past criticisms of meta-analyses, this study focused on well-defined hypotheses with clearly articulated conceptual foundations. Twenty-six studies of the cognitive-behavioral treatment of bulimia were selected through computer searches. Effect sizes were calculated for changes in behavioral outcome measures (25 independent hypothesis tests) and cognitive-attitudinal outcome measures (17 independent hypothesis tests). Additionally, two effect sizes were generated for within and between group comparisons. The analysis revealed an effect size of average r = 0.69 for behavioral outcome measures (average r = 0.64 for between group and average r = 0.74 for within group) and average r = 0.67 for cognitive-attitudinal outcome measures (average r = 0.64 for between group and average r = 0.69 for within group). Follow-up effect sizes were less favorable; however, the diversity of time spans and outcome measures used to calculate follow-up effect sizes limit their utility. Overall, results suggest that the use of a cognitive-behavioral therapy will result in favorable treatment outcomes and implications for future research are discussed.

Adolescent↗

PubMed1997

A meta-analysis of the effect of hormone replacement therapy upon depressed mood.

This meta-analysis had two objectives: (a) to aggregate data from studies that used hormone replacement therapy (HRT) and a quantitative measure of depressed mood in order to examine the effectiveness of HRT upon menopausal depressed mood; and (b) to review the methodologies of this literature base. The overall effect size for HRT was 0.68. This indicated that the average treatment patient had lower levels of depressed mood than 76% of the control patients. Analyses of specific hormone treatments suggested that (a) estrogen significantly reduced depressed mood (ES = 0.69); (b) progesterone alone, and in combination with estrogen, was associated with smaller reductions in depressed mood (ES = 0.39, ES = 0.45, respectively); and (c) androgen alone and in combination with estrogen was associated with greater reductions in depressed mood (ES = 1.37; ES = 0.90, respectively). In summary, HRT appeared to be effective in reducing depressed mood among menopausal women. The methodological review indicated that most studies used adequate sample sizes, controlled research designs, random assignment, double-blind treatment manipulations, and valid and reliable measures of depression. Limitations in the interpretation of these results are discussed and recommendations for improved methodology are provided.

Climacteric↗

PubMed1997

Cardiovascular recovery from stress and hypertension risk factors: a meta-analytic review.

Recent research has suggested that cardiovascular recovery from stress can play a potential role in hypertension pathogenesis. Sixty-nine studies were included in a meta-analytic review to evaluate the effect of various hypertension risk factors (e.g., race, lack of exercise) on cardiovascular recovery from stress. Small mean effect sizes were observed for studies examining hypertension status and race as risk factors associated with delayed diastolic blood pressure recovery. Lack of fitness was also associated with delayed heart rate recovery. These results revealed that, for the specified risk factors and cardiovascular variables, high-risk individuals exhibited delayed cardiovascular recovery as compared with low-risk individuals. Further, the relationships between hypertension status, race, and cardiovascular recovery were typically associated with the use of "active" laboratory stressors. The relationship between lack of fitness and cardiovascular recovery was also associated with the use of "active" and exercise laboratory stressors.

Hemodynamics↗

PubMed1995

Inaccuracies in the estimation of functional relationships using self-monitoring data.

When evaluating self-monitoring data, most behavior therapists form subjective estimates of the magnitude of the functional relationships between controlling factors and target behaviors. These estimates are, however, subject to correlation misestimation. In this study, upper-level clinical psychology graduate students were asked to estimate the magnitude of correlations between a set of controlling variables and target behaviors for a hypothetical client. The findings suggested that intuitive correlation estimates among controlling factors and target behaviors are generally inaccurate.

Behavior↗

PubMedDate not supplied

Perceived susceptibility to heart disease and preventive health behavior among Type A and Type B individuals.

Although the Type A behavior pattern has been the subject of extensive research, surprisingly little information is available about the preventive health behavior of this population. Measures of perceived susceptibility, preventive health behavior, current stress, and risk for cardiovascular disease were obtained from 37 Type A and 37 Type B college students. Results indicated that the Type A students generated susceptibility judgments that covaried significantly with perceived stress. Susceptibility judgments for the Type B group, however, covaried significantly with nonbehavioral cardiovascular risk-factor status. Correlations between perceived susceptibility and preventive health behavior also differed between the two groups. For the Type A group, increments in perceived susceptibility were associated with decrements in preventive behavior. For the Type B group, however, increments in perceived susceptibility were associated with increments in preventive behavior. Between-group comparisons of preventive health behavior indicated that Type A participants were less likely to use relaxation and avoidance of overwork but were more likely than those who were Type B to regulate their diets.

Adult↗