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Basic empathy in older adults: conceptualization, measurement, and application.

Older adults comprise the most rapidly increasing age group in America. In addition, an increasing number of older adults are involved in helping behaviors or volunteering. Although empathy has been identified as a critical component of a helping relationship, few studies concerning empathy have been conducted with older adults and few instruments have been developed that can be used with this population. The purpose of this study was to explore the relationship between two measures of empathy in older adults. The Hogan Empathy Scale and an Adjective Check List Empathy Scale were used to assess basic empathy in 43 older adults between the ages of 63 and 96. Results indicated that the mean scores of older adults were lower than mean scores in younger populations. Scores on both measures were comparable suggesting that both instruments could be used to measure basic empathy in older adults.

Aged↗

Comparison of operant- and independence-training procedures for mentally retarded adults.

Seventy-five moderatley to profoundly retarded adults in an exit unit of a large state institution were randomly assigned to one of three groups: standard treatment, independence training, and no treatment control. Pre- and posttreatment measures, with progress being defined as an increase in the percentage of operationally defined steps completed for one behavior, were taken for all three groups on one of two types of targeted self-help behavior. A significant increase in correctly completed steps of the target behavior from pre- to posttreatment, as well as from pretreatment to follow-up assessment, was noted for the independence-training group. Independence training proved to be significantly more effective, and staff members preferred it over both standard treatment and no-treatment control at the postassessment.

Activities of Daily Living↗

Behavioral self-help materials as an adjunct to nicotine gum.

The present study assessed the incremental effectiveness of behavioral self-help materials specifically written to accompany nicotine gum. Subjects (187 women and 117 men) were randomly assigned either behavioral self-help booklets or a factual information pamphlet. All subjects received prescriptions for Nicorette from study physicians. Contrary to prediction, subjects provided self-help booklets fared no better than did subjects provided comparison pamphlets. Overall abstinence levels were encouraging, however. Nicotine gum users were far more likely than nonusers to maintain abstinence through 6-month follow-up. Perhaps self-help materials could be improved by condensing and simplifying content and by adopting a more attractive multicolored pictorial format.

Adult↗

From behavior theory to behavior therapy: the contributions of behavioral theories and research to the advancement of behavior therapy.

As we approach the latter years of the twentieth century, a century that witnessed the birth of the behavior therapy movement, it becomes increasingly important to understand the forces that shaped the development, advancement, and success of behavior therapy. This paper is an introduction to a series of articles analyzing how major behavioral theories and research have contributed to the advancement of behavior therapy. In view of the fact that many behavior therapists have lost touch with the relation between behavior theory and behavior therapy and the challenges of the "cognitive revolution", we argue that the field would benefit conceptually and practically from integrating and utilizing the resources provided by recent advances in basic behavioral theory and research. The articles in this symposium attempt to build conceptual, methodological, and practical bridges to help behavior therapists recognize and utilize basic behavioral research and concepts.

Behavior Therapy↗

Intergenerational solidarity: an examination of a theoretical model.

This study provided an empirical test of a widely cited proposed model of intergenerational solidarity. The model emphasizes that association, affect, and consensus are interdependent dimensions of solidarity and offers an explanatory rationale for parent-child solidarity. Path analysis techniques were used with a sample of 279 older rural-transitional parents. The results showed little support for the model, but the data indicated that residential propinquity and mutual helping behavior were strong predictors of intergenerational association. The importance of the indirect effect of sex linkage via mutual help to associational solidarity also received strong support. The results showed that the proposed model was useful in explaining objective solidarity (association) but not subjective solidarity (consensus and affection) and that these variables were not dimensions of one construct.

Adult↗

Help-seeking for behavior problems by parents of preschool children: a community study.

OBJECTIVE: To identify barriers to seeking help for preschool behavior problems and understand the pattern of service utilization. METHOD: Altogether, 320 preschool children from eight preschool centers were studied using a two-stage design. After the initial screening, a more detailed assessment was carried out in the second stage involving semistructured interviews with parents and children. Parents also completed a service utilization questionnaire during the first stage and General Health Questionnaire, Family Assessment Device, and life events questions during the second stage. RESULTS: Only 19% of those with preschool behavior disorder crossed all the filters in reaching for help. The most common perceived barriers to help-seeking were that problems would get better by themselves or that parents should be strong enough to handle them. The major blocks to help-seeking were at two levels, in parents recognizing the presence of a problem and in overcoming the perceived barriers by the parents. Parents sought help from the informal agencies more often than from the formal. Help was sought significantly less often by those who had parental separation, low income, or multiple adversities, all of which were known to be significantly associated with behavior disorder. CONCLUSION: These findings indicate the need to educate and influence the parents' attitude to help-seeking, target those at risk to develop behavior disorder, and develop better consultation-liaison service with the informal agencies.

Child Behavior Disorders↗

Pain and depression.

This paper explores the relationship between depression and chronic intractable pain in which somatic pathology is playing a minor role. In this study, 114 patients with chronic pain were compared with 53 patients with depression. Patients with chronic pain were older, more likely to be married, more frequently attributed difficulties in activity and sleep to pain, and reported greater impairment of motor functions. They had less dysphoria and an illness behaviour profile (on the Illness Behaviour Questionnaire) suggestive of a conversion reaction. Depressed patients recalled more life events in the year prior to presentation, whilst pain patients recalled more events of nine and ten years earlier. It is concluded that the two patient groups cannot be considered identical. It is argued that the concept of abnormal illness behavior helps to distinguish the two groups.

Attitude to Health↗

[Higher forms of brain activity and psychology].

On the examples of comparison of the evoked potentials with a theory of signal identification (A. M. Ivanitsky) and need-informational theory of emotions (P. V. Simonov) with the "general law of human emotions" (D. Price, J. Barrell) the efficiency is demonstrated of the simultaneous study of the higher brain functions by neurophysiological and psychological methods. Recent experimental data are given on the natural-scientific bases of consciousness. Human personality is considered as an individual unique composition and internal hierarchy of his vital, social and individual needs. Acknowledgement of the supplementary nature of the objective and subjective analysis of the human behavior helps eliminate the contradiction between the determinism and subjectively sensed freedom of choice.

Animals↗

Alcohol and social behavior II: the helpful drunkard.

Can alcohol make people more helpful, and if so, how? We hypothesized that alcohol would increase helping when, if the person were sober, the helping response would be under high inhibitory conflict--that is, when it would be affected by strong instigating and inhibiting pressures. Alcohol's damage to inhibitory processing should then allow instigating pressures to have more influence on the response, increasing helping. We expected that under low inhibitory conflict, when either or both of these response pressures would be weak under sobriety, alcohol would have little effect on helping. In two experiments we examined this reasoning. In Study 1, a mild dose of alcohol increased helping among high-conflict subjects pressured to help with a task they did not like, but did not increase helping among low-conflict subjects who either liked the task or were weakly pressured to help. In Study 2, a somewhat stronger dose of alcohol increased helping among all high-conflict subjects pressured to help with an undesirable task, yet again had no effect among low-conflict subjects weakly pressured to help. These studies provided an experimental demonstration of the role of inhibitory response conflict in mediating alcohol's social effects, and show that this process generalizes to prosocial behavior. Additional evidence from both experiments helped to rule out alternative explanations concerning drinking expectancies, alcohol's ability to enhance mood, and its ability to make the task more bearable.

Conflict, Psychological↗

The relation of client behavior and therapist helping skills to reduced aggression of boys in individual and group treatment.

In this study behavioral processes in the individual and group therapies of aggressive boys were compared and the relationship between these variables and treatment outcome was examined. Level of aggression was the outcome variable, measured by both self-report and teacher-report instruments. Hill's Client Behavior System (CBS; Hill, 1986) with our own ad hoc categories of Reference to Literary Figures and Response to Another, and therapist Helping Skills System (HSS; Hill & O'Brien, 1999) were the behavioral process measures. In terms of the boys' behaviors, discriminant function analyses revealed that Reference to Literary Figures and Response to Another differentiated the treatment formats; with regard to therapists' behaviors, Questions and Challenge differentiated the modalities. Results offered partial support for the greater effectiveness of group, compared to individual, therapy in reducing aggression. Outcome, however, as measured by teacher reports of aggression, was adversely affected in group therapy by the presence of specific behaviors in the boys. Implications of the findings for modifying the group therapy program as well as for the search for process variables appropriate to the treatment of aggressive children are discussed.

Aggression↗

Toward an improved behavioral medicine.

Never before have the challenges for behavioral medicine been more exciting or more urgent. Because most health problems have their roots in behavioral causes, the role of behavioral medicine is paramount in public health. The challenges focus both on issues related to the way researchers interact, set priorities, and conduct research, as well as priority areas for future research. The principles include a need for more theoretical diversity and critique of theory, more inclusiveness, more cost-consciousness, an acceptance of failure as a fundamental part of behavioral science, and a greater commitment to international health. The priorities encompass a greater focus on basic behavioral science, more attention to the study of risk perception, more study of the problems of children and aging populations, and an urgent need for proven, proactive interventions. Actualization of these principles could help behavioral medicine researchers and practitioners to achieve a much greater impact in improving the public's health both in the U.S. and abroad.

Behavioral Medicine↗

Intergenerational family support among blacks and whites: response to culture or to socioeconomic differences.

Factors that influence family helping behavior are examined and comparisons are made between black and white families. The question of whether family differences are due to culture or socioeconomic reasons is asked. In the analysis, tests are made for the main and interactive effects of race. Black elderly parents give and receive more help than white elderly parents after controlling for age and sex; however the greater amount of help that is received by older blacks is, to a large extent, the result of socioeconomic factors. The increased amount of help that they give to the middle and younger generations appears to be a combination of cultural and socioeconomic factors. Among black families, attitudes of respect for each generation play a part in determining family support behavior.

Black or African American↗

What do men want? Gender differences and two spheres of belongingness: comment on Cross and Madson (1997)

In response to S. E. Cross and L. Madson's (1997) suggestion that men's behaviors reflect a desire for independence and separateness, the authors propose that those same behaviors are designed to form connections with other people but in a broader social sphere. Women's sociality is oriented toward dyadic close relationships, whereas men's sociality is oriented toward a larger group. Gender differences in aggression, helping behavior, desire for power, uniqueness, self-representations, interpersonal behavior, and intimacy fit this view.

Adult↗

[Rectal self-mutilation, rectal bleeding and Prader-Willi syndrome].

UNLABELLED: Prader-Willi syndrome is a genetic disorder characterized by infantile hypotonia, obesity, hypogonadism and mental retardation. Individuals with Prader-Willi syndrome manifest a severe skin picking behavior, including rectal picking. CASE REPORT: We report the case of a girl (12 years old) with this syndrome in whom rectal picking resulted in rectal bleeding and solitary rectal ulcer. CONCLUSION: Caregivers of children with Prader-Willi syndrome should be aware of a potential rectal picking behavior, which results in significant bleeding. Early recognition of such a behavior helps to avoid misdiagnosis.

Child↗

What do parents of children with learning disabilities, ADHD, and related disorders deal with?

Children with learning disabilities, attention deficit/hyperactivity disorder (ADHD), and related disorders puzzle parents because of their many abilities and disabilities. It can also be difficult to understand how much of their behavior is the nature of the condition and how much is oppositional. It is all too easy for parents to "catch" a child's feelings of inadequacy and then feel bad as a parent. Parenting approaches that include clear, concise instructions; structure without rigidity; nurturing a child's gifts and interests; and constant approval of positive behavior help parents feel better and help children feel safe. It takes time for both children and parents to embrace the concept that being different does not mean being inferior and, in fact, can be a good thing. Parents need to be nurtured and praised to help them nurture and praise their children. Most parents use almost every resource they have to help their children flourish, and still, they worry they are not doing a good enough job. Usually they are!

Adaptation, Psychological↗

An evaluation of the efficacy of supervised cognitive behavioral self-help bulimia nervosa.

Eighty two patients with bulimia nervosa were managed by providing them with supervision in the use of a highly structured cognitive behavioral self-help manual. Their progress was assessed in an open clinical trial. The 67 patients who completed the course of self-help experienced considerable benefit; the frequency of bulimic episodes and self-induced vomiting decreasing by 80% and 79%, respectively. Compared to those who benefited, those who had a poor outcome or dropped out of treatment were more than twice as likely to have had anorexia nervosa in the past and were somewhat more likely to have a personality disorder. Three-quarters of those who persisted with the programme of supervised self-help were followed up a year after commencing treatment. Clinical gains were well maintained: almost two thirds were abstinent with respect to both bulimic episodes and self-induced vomiting. It would seem appropriate that, as part of a stepped care approach to the management of bulimia nervosa, supervised cognitive behavioral self-help should routinely be the first line treatment.

Adolescent↗

Response of faculty members to medical students' personal problems.

In the study reported here, the authors examined the interpersonal helping behaviors of medical educators. Ninety-six faculty members from 12 randomly selected medical schools completed a detailed questionnaire providing data on the nature and frequency of their interpersonal behaviors with students experiencing personal problems. The faculty members reported spending an average of 48.6 minutes a week discussing personal problems with students. Student problems reported most frequently pertained to financial concerns, emotional health, and interactions with faculty members. Medical educators used various techniques to offer help; the most commonly reported techniques were listening, asking questions to draw the student out, offering support and sympathy, and offering empathy. Most medical faculty members felt positive about their role as "helper" and rated that component of their job as extremely important. The implications of these findings, especially for staffing and personnel policy, are discussed.

Education, Medical↗

The use of telemarketing in the community-wide prevention of heart disease: the Pawtucket Heart Health Program.

The marketing of preventive health behaviors is typically accomplished through various broadcast, print, and other mass media channels. By making randomly-dialed telephone calls to 4,000 residents of Pawtucket, RI, volunteers of the Pawtucket Heart Health Program succeeded in registering nearly 400 individuals for risk factor reduction groups or self-help behavior change kits. Additionally, community awareness of the program was an indirect benefit of this "telemarketing." Telemarketing is an interactive and inexpensive approach to marketing preventive health behaviors.

Heart Diseases↗