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Case study: behavioral treatment of obsessive-compulsive disorder in a boy with comorbid disruptive behavior problems.

Comorbid psychiatric conditions often complicate the treatment of childhood obsessive-compulsive disorder (OCD). Behavioral treatment of OCD using exposure plus response prevention for a boy with disruptive behavior disorders and two previous unsuccessful medication trials is described. Treatment was adapted to his developmental level, his mother was highly involved in treatment, and a contingency management program contained his disruptive behavior so that he could participate in therapy. Posttreatment and 2- and 6-month follow-up measures indicated marked improvement in OCD symptoms. The possibility of successful behavioral treatment of OCD in medication-free children with disruptive behavior problems is highlighted.

Attention Deficit and Disruptive Behavior Disorder↗

Stability and social-behavioral consequences of toddlers' inhibited temperament and parenting behaviors.

A prospective longitudinal design was employed to ascertain whether different types of behavioral inhibition (i.e., traditional, peer-social) were stable from toddler to preschool age, and whether inhibited temperament and/or parenting style would predict children's subsequent social and behavioral problems. At Time 1, 108 toddlers (54 males, 54 females) and their mothers were observed in the Traditional Inhibition Paradigm and in a toddler-peer session; then at age 4 years, 88 children were observed with unfamiliar peers, and maternal ratings of psychological functioning were obtained. How mothers and their toddlers interacted was also observed. Results revealed meaningful connections between toddler inhibition, maternal intrusive control and derision, and nonsocial behaviors at age 4. Both forms of toddler inhibition predicted socially reticent behavior during free play at 4 years. If mothers demonstrated relatively high frequencies of intrusive control and/or derisive comments, then the association between their toddlers' peer inhibition and 4-year social reticence was significant and positive; whereas if mothers were neither intrusive nor derisive, then toddlers' peer inhibition and 4-year reticence were not significantly associated. Thus, maternal behaviors moderated the relation between toddlers' peer inhibition and preschoolers' social reticence.

Child Behavior Disorders↗

Maternal sensitivity behavior and infant crying, fussing and contented behavior: the effects of mother's experienced social support.

Maternal sensitivity behavior, mother's experienced difficulties, experienced social support, and the amount of infant's crying, fussing and contented behavior were studied when the infants were 3 and 12 months of age. Fifty-seven Finnish low-risk mothers' sensitivity behavior was assessed by the Parent-Child Early Relational Assessment method. Infant's crying behavior was assessed by the Baby's Day Record and by the Crying Patterns Questionnaire. The Social Support Questionnaires (SSQ 1 and 2) were used to evaluate mother's experienced difficulties and support. The infants of More Sensitive (MS) mothers were more contented than those with Less Sensitive (LS) mothers. The MS mothers experienced fewer difficulties with their infants and experienced more support from their best friend and their husband than LS mothers. In addition, some gender differences were found concerning infant behavior.

Crying↗

Interrelationships between hormones, behavior, and affect during adolescence: complex relationships exist between reproductive hormones, stress-related hormones, and the activity of neural systems that regulate behavioral affect. Comments on part III.

Adolescence is a period in life marked by change, encompassing physiological changes associated with pubertal development, changes in social status and the social stresses that an individual faces, and changes in behavioral affect regulation. The interactions between activity in the reproductive axis, the neural systems that regulate stress, hormones produced in response to stress, and neural systems governing behavioral affect regulation are complex and multifaceted. Although our understanding of these interactions remains rudimentary, we do know that stress can suppress activity of the reproductive axis, that reproductive hormones can modulate the activity of neural systems that govern the body's responses to stress, that both reproductive function and stress responsiveness can be altered in depressed individuals, and that the function of some of the key neural systems regulating behavioral affect (i.e., serotonergic, noradrenergic, dopaminergic systems) are modulated by both gonadal steroid hormones and adrenal steroid hormones. This summary reviews the central interactions discussed in this session on the interrelationships between hormones, behavior, and affect during adolescence and identifies key topics that require further investigation in order to understand the role that pubertal changes in reproductive function, interacting with increased exposure to life stresses, play in modulating behavioral affect regulation during the adolescent period.

Adolescent↗

Effects of diet and behavior therapy on social and motor behavior of retarded phenylketonuric adults: an experimental analysis.

The effects of a low phenylalanine diet on six retarded phenylketonuric adults were assessed. An ABA individual-subject design was used in experiment I to assess the effects of a low phenylalanine diet on social and motor behavior. Following a baseline during which the subjects ingested a normal phenylalanine diet (phase A), a low phenylalanine diet (phase B) was administered in a double blind fashion. Finally, the baseline condition (phase A) was reinstated (normal diet). The low phenylalanine diet resulted in few significant behavioral changes for those subjects with which proper methodologic controls were employed. However, for two of six subjects motor behavior, including stereotypy and tremor, seem to have ameliorated. In experiment II, applied behavior analysis techniques, including differential reinforcement of other behavior and time out, were combined to radically reduce the frequency of stereotypy and self-abuse exhibited by one of the six subjects of experiment I.

Adult↗

Behavioral technology and behavioral ecology.

Applied behavior analysis, as a special case of behavioral technology, is discussed from the standpoint of behavioral ecology. The ecological orientation and its emphasis upon system-like interdependencies among environment, organism, and behavior are presented. The widespread possibilities for unintended effects of simple interventions provide the context for evaluating effective behavioral technology and calling for cooperation between the technologist and ecologist. Such cooperation, in the form of mutual and cooperative research efforts, should come naturally for the technologist and ecologist, because they share some fundamental values and assumptions, and each has much to offer the other. Several areas of such cooperative effort are spelled out.

Behavior↗

Translating what we know about the context of antisocial behavior into a lower prevalence of such behavior.

Although we have identified many variables that affect antisocial behavior, there is no evidence that we have learned how to reduce the incidence of such behavior or the proportion of young people who repeatedly engage in antisocial behavior. It is appropriate, therefore, for behavioral scientists to turn some of their energies to research on reducing the incidence and prevalence of antisocial behavior. Small communities may be a particularly useful social unit in which to conduct experimental research. The interventions to be tested include advocacy and community organizing to influence communities to make validated school and clinical interventions widely available and to assist them in increasing other forms of supervision of young people and social and material support of families. Key components of advocacy and community organizing are suggested, and possibilities for research are described.

Adolescent↗

Adolescents engaging in unhealthy weight control behaviors: are they at risk for other health-compromising behaviors?

OBJECTIVES: This study sought to determine whether adolescents engaging in weight control behaviors are at increased risk for tobacco, alcohol, and marijuana use; suicide ideation and attempts; and unprotected sexual activity. METHODS: Data were collected on a nationally representative sample of 16,296 adolescents taking part in the 1993 Youth Risk Behavior Survey. RESULTS: Adolescents using extreme weight control behaviors were at increased risk for health-compromising behaviors, while associations with other weight control behaviors were weak and inconsistent. CONCLUSIONS: The findings have relevance to clinical work with youth, provide a better understanding of disordered eating, and open up a number of opportunities for future research.

Adolescent↗

Effective behavioral interventions for decreasing dementia-related challenging behavior in nursing homes.

This paper provides a selective review of behavioral intervention research aimed at successfully decreasing dementia-related challenging behaviors in nursing homes. The authors include separate discussions of behavioral excesses (disruptive vocalization, wandering, physical and verbal aggression) and deficits (excess dependency, therapeutic activities, social interaction/communication). Descriptions of interventions used to address each behavior problem are followed by methodological evaluations of the research. Discussions are augmented by inclusion of the authors' ongoing intervention research. The paper concludes with a description of a comprehensive program for teaching behavior management skills to nurse aides and a motivational system for maintaining the performance of these skills over the long term.

Aged↗

Effects of antisense to the (alpha)2A-adrenoceptors administered into the region of the locus ceruleus on behaviors in plus-maze and sexual behavior tests in sham-operated and castrated male rats.

Clinical and experimental findings have implicated brain alpha2-adrenoceptors in the regulation of many physiological functions, including sexual activity and stress-related behavior. However, which subtypes of the three alpha2-adrenoceptors that have now been cloned (alpha2A, alpha2B, and alpha2C) are involved in these controls have yet to be established. Here, we investigated the contribution of alpha2A-adrenoceptors of the locus ceruleus, the principal source of brain noradrenaline, to exploratory and sexual behaviors. Using administration of antisense oligodeoxynucleotide to inhibit the receptor expression, we found that reductions in brainstem alpha2A-adrenoceptor mRNA levels and alpha2-adrenoceptor densities induced by antisense treatment were not accompanied by any changes in the major characteristics of male sexual activity, such as mount latencies and numbers of mounts. However, in sexual behavior tests, antisense-treated male rats had decreased numbers of rearings and thus have higher percentages of behaviors positively correlated with sexual activity. Besides, antisense-treated animals had decreased anxiety in plus-maze tests. The data demonstrate that inhibition of alpha2A-adrenoceptor expression in the region of the locus ceruleus has an anxiolytic-like effect and facilitates male's attention to female in sexual behavior test.

Adrenergic alpha-2 Receptor Antagonists↗

[An epidemiological study of health behavior and health consciousness in smoking behavior modification].

Among health enhancement activities which have been promoted at various worksites smoking cessation is the most common but is seldom very successful. Smoking cessation programs have almost always neglected individual background factors. The main purpose of this study is to evaluate the factors critical to behavior modification with respect to smoking cessation at worksites. Five hundred and sixty-five chemical factory workers responded to questionnaires on their smoking behavior lifestyle, drinking habits, opinions on smoking, opinions on quitting smoking, knowledge about the effects of smoking on health, and type A behavior pattern. Two hundred thirty two male smokers (age 20-58) were chosen for the smoking cessation program, which was administered during the periodical health examinations. One year after receiving the anti-smoking education their smoking behaviors were again surveyed. Fifteen employees had quit smoking and 79 had reduced consumption by more than 10 cigarettes per day. A principal component analysis was performed in order to extract factors from the numerous items on the questionnaire. Principal component scores were compared between the group that had stopped smoking or had cut back by more than 10 cigarettes per day (Responsive Group) and the rest of the smokers (Unresponsive Group). Principal component scores, which appear to be related to levels of individual health consciousness and levels of regular exercise, were significantly higher in the responsive group than in the unresponsive group. No significant differences were noted between the two groups for principal component scores for knowledge of effects of smoking on health, drinking habits, opinions on smoking, opinions on quitting smoking, and type A behavior.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

AIDS-related health behavior: coping, protection motivation, and previous behavior.

The purpose of this study was to examine Rogers' protection motivation theory and aspects of Janis and Mann's conflict theory in the context of AIDS-related health behavior. Subjects were 84 heterosexual men and women and 147 homosexual men with multiple sexual partners; LISREL's path-analysis techniques were used to evaluate the goodness of fit of the structural equation models. Protection motivation theory did fit the data but had considerably more explanatory power for heterosexual than for homosexual subjects (49 vs. 22%, respectively). When coping styles were added, different patterns of findings were found among both groups. Adding variables such as social norms and previous behavior increased the explained variance to 73% for heterosexual subjects and to 44% for homosexual subjects. It was concluded that although protection motivation theory did fit the data fairly adequately, expanding the theory with other variables--especially those related to previous behavior--could improve our understanding of AIDS-related health behavior.

Acquired Immunodeficiency Syndrome↗

A behavior analytic interpretation of attributions in the context of behavior therapy.

Clients often provide reasons, justifications, and explanations (i.e., attributions) about the causes of their problems and what they believe needs to be done to ameliorate them. Behavior therapists also frequently generate hypotheses about causal factors contributing to client behavior problems. We discuss the function of attributing in the context of behavior therapy and interpret the cognitive construct of attributions from a behavior analytic perspective as a verbal act of relating otherwise arbitrary events with origins in a social-verbal community. The applied implications of our interpretive analysis of attributions and their role in client problems suggest different therapeutic strategies.

Behavior Therapy↗

Sexual behavior of young men in Thailand: regional differences and evidence of behavior change.

An anonymous, self-administered behavioral survey was conducted in Royal Thai Army (RTA) conscripts from 19 provinces throughout Thailand in May 1996. All (to a maximum of 350) Thai men who entered the RTA in each province were selected. Data from 5474 men were included in this analysis. High-risk behaviors were reported nationwide; however, some regional differences were found. Men from the upper North were more likely to have had a commercial sex worker (CSW) as their first sexual partner (42%) than men from any other region. However, in the past year, reported sex with CSWs in the upper North (41%) was similar to or lower than those in other regions. Consistent condom use with CSWs was higher in the North than in any other region. Condom use at first sex with CSWs increased with later years at first sex in all regions. These data suggest that past higher-risk behavior among young men in the upper northern part of Thailand may have contributed to the concentration of the HIV epidemic in that region. Risk behaviors, particularly unprotected sex, appear to be decreasing nationwide.

Adult↗

Comparison of hyperactive and emotionally-behaviorally disturbed children on the Devereux Child Behavior Rating Scale: a potential aid in diagnosis.

Comparison was made between Devereux Child Behavior Rating Scale (DCB) ratings of matched groups of hyperactive and emotionally-behaviorally disturbed children. The emotionally behaviorally disturbed group was chosen to represent a population with presenting symptoms similar to hyperactivity. Ratings of the two groups exceeded the normative population on all DCB factors. The hyperactive group received higher scores on 16 factors and was significantly higher than the emotionally-behaviorally disturbed group on 8 factors. The hyperactive group received the most extreme scores on behavioral dimensions generally described as characteristic of the hyperactive syndrome. The results suggested that the DCB can assist in differentiating hyperactive children from children with presenting symptoms similar to those of hyperactivity.

Child↗

Behavioral sensitization: characterization of enduring changes in rotational behavior produced by intermittent injections of amphetamine in male and female rats.

Factors influencing the behavioral sensitization ("reverse tolerance") produced by intermittent amphetamine (AMPH) injections were studied by quantifying rotational behavior in rats that had a unilateral 6-hydroxy-dopamine lesion of the substantia nigra. The results indicate that: a single injection of a low dose of AMPH enhances rotational behavior induced by a second injection of AMPH for up to 12 weeks; multiple, weekly injections of AMPH produce a progressive enhancement in rotational behavior, over-and-above that produced by a single injection; female rats show more robust sensitization than males following single or multiple injections of AMPH; this sex difference may be due to the suppression of sensitization by an androgen, because removal of testicular hormones potentiates sensitization; the long-lasting sensitization of rotational behavior produced by infrequent injections of AMPH is not due to drug-environment conditioning effects, but perhaps to a persistent AMPH-induced change(s) in brain catecholamine systems; and a simple change in DA receptors is probably not involved, because the sensitization produced by infrequent injections of AMPH does not influence the rotation produced by a subsequent injection of apomorphine. The results illustrate an intriguing example of neuroplasticity that may have clinical relevance.

Amphetamine↗

Understanding childhood (problem) behaviors from a cultural perspective: comparison of problem behaviors and competencies in Turkish immigrant, Turkish and Dutch children.

Parents' reports of problem behaviors in 2,081 Dutch children, 3,127 Turkish children in Ankara and 833 Turkish immigrant children living in The Netherlands, aged 4-18 years, were compared. Dutch and Turkish versions of the Child Behavior Checklist (CBCL) were used. Immigrant children were scored higher than Dutch children on 6 of the 11 CBCL scales, most markedly on the Anxious/Depressed scale. Immigrant children were scored higher than Ankara children on five CBCL scales. However, these differences were much smaller than those found between immigrant and Dutch children. Furthermore, immigrant children's Total Problem scores did not differ from those for Ankara children. Turkish immigrant children have very similar patterns of parent-reported problem behaviors to children living in Turkey, although both groups of Turkish children showed higher levels of parent-reported problem behaviors than Dutch children. The higher scores for Turkish children on the Anxious/Depressed scale compared with their Dutch peers may be explained by cultural differences in parental perception of children's problem behaviors, as well as the threshold for reporting them, or by cultural differences in the prevalence of problems, for instance as the result of cross-cultural differences in child-rearing practice. More research is needed to test the degree to which Turkish immigrant parents tend to preserve their cultural characteristics and child-rearing practices in Dutch society.

Achievement↗

Personality organization and language behavior: the imprint of psychological differentiation on language behavior in varying communication conditions.

The language behavior of field-independent (F-D) clinically normal, verbally resourceful femal college students was examined in three different communication conditions: Dialogue, Warm (vissually supportive) monologue, and Cold (visually nonsupportive and stressful) Monologue. F-I and F-D Ss produced similar amounts of the different types of language behavior evaluated in each of the three communicative conditions. However, they differed with respect to verbal output and length of sentence "packaging" unit in Monologue conditions. F-D Ss talked considerably less but at the same time produced different types of grammatically more elaborate language behavior in Warm and Cold Monologue compared to their Dialogue language behavior. F-I Ss talked considerably more but also showed a type of language autonomy. The pattern of language behavior which characterized F-I speech in Dialogue remained the same in both Monologue conditions.

Adolescent↗