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PubMed1990

Assessment of the components of observed chronic pain behavior: the Checklist for Interpersonal Pain Behavior (CHIP).

This article describes the development of the Checklist for Interpersonal Pain Behavior (CHIP), an observation scale which assesses overt pain behavior. The study is an extension of an earlier study in which the dimensions and components of observed chronic pain behavior were examined. A broad definition of pain behavior is chosen (interpersonal pain behavior), namely the interaction between the pain patient and his/her direct environment. The list of pain behaviors, taken from the earlier study, has been transformed into a 78-item global rating scale to be used by nurses to quantify observed pain behavior in a clinical setting. Six studies examine the factor structure and the psychometric properties of this behavioral observation method. In the first study, 6 internally reliable factors are derived using factor analytic techniques from a sample of 152 chronic pain patients. They are labeled as: 'distorted mobility,' 'verbal complaints,' 'non-verbal complaints,' 'nervousness,' 'depression' and 'day sleeping.' Internal consistency of all factors, except 'day sleeping' was excellent. The following studies show that the CHIP is sufficiently reliable and valid. After a discussion on the advantages of this observation scale, the conclusion seems justified that the CHIP is a useful tool in pain assessment that can easily be used by nurses.

Adult↗

PubMed1991

Self-injurious behavior: a review of the behavior and biology of self-mutilation.

OBJECTIVE: The authors describe the clinical characteristics of self-injurious behavior, giving special emphasis to self-injurious behavior occurring among individuals with character disorders. DATA COLLECTION: They review data suggesting the involvement of serotonergic, dopaminergic, and opiate neurotransmitter systems in the expression of self-injurious behavior. FINDINGS: Self-injurious behavior occurs among mentally retarded individuals, psychotic patients, prison populations, and individuals with severe character disorders. Although theoretical psychological models of self-injurious behavior are helpful in understanding the patient's experience of self-injury, no generally useful therapeutic approach has yet evolved from these models. Data derived from animal models and treatment studies suggest the involvement of opiatergic and dopaminergic mechanisms in self-injury among the mentally retarded. Serotonergic influences on self-injurious behavior may be present in varying forms of this behavior. The scientific literature on the benefits of pharmacological agents for mentally retarded individuals is beset with a number of problems. Support is emerging, however, for the use of lithium and carbamazepine with self-injuring mentally retarded patients, and some behavioral interventions appear to be successful for mentally retarded individuals. Self-injuring patients with borderline personality disorder may benefit from milieu treatment. CONCLUSIONS: Although no form of treatment has yet been demonstrated to be of general benefit, the literature suggests that therapeutic trials with dopamine antagonists, serotonin reuptake inhibitors, and opiate antagonists may be of value.

Adolescent↗

PubMed1990

Prolactin (PRL) regulation of maternal behavior in rats: bromocriptine treatment delays and PRL promotes the rapid onset of behavior.

Recent findings indicate that PRL helps stimulate the onset of maternal behavior in inexperienced hypophysectomized steroid-treated female rats. In a series of five experiments we have further examined the involvement of PRL in maternal behavior using nonhypophysectomized ovariectomized rats treated concurrently (type I) or sequentially (type II) with progesterone (P) and estradiol (E2) and administered either bromocriptine (to suppress endogenous PRL secretion) or bromocriptine plus ovine PRL. In Exp 1 plasma PRL concentrations were measured in ovariectomized rats treated for 2 weeks with a combination of E2 and P Silastic implants. Type I steroid-treated (2mm E2, days 1-24; three 30 mm P, days 3-13) rats exhibited elevated plasma PRL levels throughout the sampling period compared with nonsteroid-treated controls. In contrast, PRL concentrations in type II steroid-treated (P, days 3-13; E2, days 13-24) females were low (similar to controls) from days 3-13 when the type II steroid-treated females were exposed to P only. Like type I treated rats, PRL levels in type II steroid-treated rats were elevated from day 13 onward after E2 capsule insertion. In Exp 2, treatment of both type I and type II steroid-treated rats with bromocriptine (2 mg/kg, sc) twice daily beginning on treatment day 13 suppressed basal PRL concentrations and prevented the estrogen-induced diurnal PRL surge. Whereas PRL was effectively suppressed by bromocriptine in both steroid-treated groups, the absolute levels of PRL were lower in rats treated with the type II steroid regimen. Behavioral analyses in Exp 3, 4, and 5 revealed that bromocriptine administration, while failing to interfere with the onset of maternal behavior in rats treated with the type I concurrent steroid regimen, disrupted the onset of maternal care in rats treated with the type II sequential steroid regimen. When a separate set of type II steroid-treated rats was given both bromocriptine (2 mg/kg) plus ovine PRL (0.5 mg, sc) twice daily, maternal behavior rapidly appeared. Thus, suppression of endogenous PRL secretion delays the onset of maternal behavior in nonhypophysectomized steroid-primed rats, an effect prevented by concurrent administration of ovine PRL. In addition to providing further experimental support for PRL's role in maternal behavior, the development of this endocrine regimen provides researchers with a potentially fruitful model to examine neural sites and mechanisms of PRL regulation of maternal behavior in mammals.

Animals↗

PubMed1992

Behavioral science education in family medicine: a survey of behavioral science educators and family physicians.

A mailed questionnaire was used to provide a profile of behavioral science educators in family practice residency programs, to examine some aspects of behavioral science curriculum development, and to compare the attitudes of behavioral science educators and family physicians regarding the proper level of involvement of family physicians in a variety of psychosocial problems. The study populations consisted of all 383 behavioral science coordinators of US family practice programs and a national sample of 400 residency-trained family physicians. Eighty percent of the behavioral science educators were familiar with the Core Competency Objectives in Behavioral Science Education, published by the Society of Teachers of Family Medicine, and 61% had used this document to aid in curriculum development. Both behavioral science educators and family physicians perceived that the training provided in the areas of physician-patient relationships, family awareness, and personal and professional relationships was quite effective. The physicians felt significantly less effectively trained in the areas of biopsychosocial assessment and management. A high level of concordance was found between the responses of physicians and educators regarding the appropriate level of involvement of family physicians in various psychosocial problems. One exception between the two groups involved the problems of family and social functioning, for which family physicians advocated a more active level of involvement than did behavioral science educators.

Adult↗

PubMed1992

[Behavior therapy as a new procedure in health education--recommendation for introducing behavior science into personal health services].

Recent efforts to integrate biomedical and behavioral science perspectives and techniques have revealed the creativity and efficacy of behavioral health approaches to health enhancement and disease prevention. There are expectations that behavioral medicine and behavioral health will be significant in approaches toward changing life style, improving patient's compliance with medical advice, and in rehabilitation. Three examples of actual practice of behavioral procedures in a public health center are studied-behavior therapies for obesity and hypercholesterolemia, and prompting of patient clinic utilization behavior by a letter of introduction. The importance of proper selection of target problems, staff training is emphasized. In conclusion, it is recommended that behavioral science and its techniques of assessment and treatment are incorporated into public health activities, especially in the field of health education.

Behavior Therapy↗

PubMedDate not supplied

Association between children's dental behavior and play behavior.

The results of this study showed that clinical distinctions can be made regarding the behavior of children in the dental setting and that these distinctions are reflected in the behavior of these children in an easily-arranged play situation. The existence of such associations of behavior presents the possibility that play behavior may be a reliable predictor of maladaptive dental behavior. If so, the incorporation of a play dental area into a dental office would be an inexpensive and convenient method of intercepting potential problem dental patients. If the results of this study can be replicated, they would support the initiation of a study to predict the behavior of children in the dental setting by means of easily scorable aspects of their play behavior in a simulated dental environment. Special management considerations could then be made to prevent disruptive behavior at subsequent appointments. The results also point up the tendency of problem patients to avoid certain aspects of the play dental experience. This suggests a possible treatment potential for the dental play area, using it as an instrument to desensitize appropriate patients to those aspects of dental treatment which distress them, and thereby reduce their anxieties, prior to actual dental treatment.

Child Behavior↗

PubMed1978

The application of behavior modification to behavior management: guidelines for the family physician.

Treatment in ambulatory care settings depends on the patient's behavior to implement the regimen prescribed by the family physician. Behavior modification offers a means for developing behavioral programs that will improve the physician's ability to effectively influence the patient's behavior. This article outlines some of the principles of behavior modification as they can be applied in office settings to diverse behavioral problems. Some specific suggestions are made for identifying behaviors, setting goals, delineating the steps to reach these goals, monitoring progress, and developing treatment contracts that will aid the physician in the management of the behavioral aspects of treatment.

Behavior Therapy↗

PubMed1986

The propensity for nonregulatory ingestive behavior is related to differences in dopamine systems: behavioral and biochemical evidence.

Previous research has shown that animals predisposed to eat and drink in response to electrical stimulation of the lateral hypothalamus (ESLH) are similarly predisposed to drink excessively when tested for schedule-induced polydipsia. The eating and drinking elicited by both experimental paradigms appears to be unrelated to homeostatic need and has been called nonregulatory ingestive behavior. In this study, the relation between properties of dopaminergic neural systems and the predisposition to exhibit nonregulatory ingestive behavior was investigated. It was found that rats that eat and drink during ESLH show greater behavioral sensitization to a series of amphetamine injections that those that do not exhibit ingestive behavior during ESLH. In addition, footshock stress produced a greater increase in forebrain dopamine utilization in rats that engaged in nonregulatory ingestive behavior. This evidence is consistent with the hypothesis that there are individual differences in the responsiveness of forebrain dopamine systems that are related to the behavioral predisposition to exhibit nonregulatory ingestive behavior.

Animals↗

PubMed1987

Effect of discontinuance of type A behavioral counseling on type A behavior and cardiac recurrence rate of post myocardial infarction patients.

Three hundred post infarction participants who had received type A behavioral counseling in the Recurrent Coronary Prevention Project, (RCPP) agreed to be followed for 1 additional year after stopping 4.5 years of continuous type A behavioral counseling. One hundred fourteen participants who had served for 4.5 years as controls in the RCPP Study, thus receiving no type A behavioral counseling, volunteered to receive such counseling for 1 year. Eleven of the 300 previously type A counseled RCPP participants were lost to follow-up at the end of the additional year. The remaining 289 subjects at risk were found to have maintained their previously reduced intensity of type A behavior. Their previously observed relatively low cardiac recurrence rate during the additional year also did not significantly change. Ten of the 114 previous control RCPP participants were lost to follow-up at the end of the additional year. The remaining 104 subjects who had received a year's type A behavioral counseling showed a significantly reduced intensity of type A behavior and a similar significant decrease in both the cardiac mortality and morbidity rate. These results suggest that the decline in the intensity of type A behavior and also in the cardiac recurrence rate previously observed in post infarction subjects exposed to type A behavioral counseling persists for at least 1 year after cessation of such counseling.

Counseling↗

PubMed1986

Illness behavior as a predictor of pain and overt behavior patterns in chronic low back pain patients.

This study examined the relationship of self-reports of illness behavior to pain ratings and overt pain behaviors in a group of chronic low back pain patients referred for pain management. Illness behavior was measured using the Pilowsky and Spence Illness Behavior Questionnaire (IBQ) and pain behavior was recorded using a standard behavioral observation method. Multivariate regression analyses revealed that scores on the IBQ were highly predictive of a variety of indices of pain and pain behavior. These results were obtained even after controlling for significant demographic and medical status variables. The findings of this study support the utility of the IBQ in the behavioral assessment of chronic pain patients.

Back Pain↗

PubMed1976

[Conditioning of emotional behavior caused by hypothalamic stimulation (4). Effects of drugs on conditioned avoidance and escape behavior].

In the present study, effects of psychotropic drugs were analyzed by observing avoidance and escape behavior or rabbits under hypothalamic electrical stimulation. In avoidance behavior, chlorpromazine (CPZ) and diazepam (DZP) depressed avoidance response and extended avoidance response latency and head movement latency. Autonomic behavior such as opening of palpebral fissure and pupil size were also delayed. The locus of movement and count of head movement were depressed by the administration of each drug. On the other hand, unlike CPZ, DZP extended escape response latency. On escape behavior, effects of CPZ and DZP were apparently different. Unlike CPZ, DZP induced avoidance behavior and increased locus of movement. With methamphetamine, no avoidance behavior was observed, but under conditional stimulation, the behavior and the escape response latency were decreased. Chlordiazepoxide induced avoidance behavior.

Animals↗

PubMed1990

The relationship of attitude, subjective norm, and behavioral intent to the documentation behavior of nurses.

Ajzen and Fishbein's theory of reasoned action was used to assess the relationship of nurses' attitude, subjective norm, and behavioral intention to their documentation behavior. Attitudes, subjective norms, and behavioral intentions toward documentation were elicited from 108 staff nurses. Documentation behavior was based on what should be documented in any hospitalized patient's chart during a shift. This exploratory model was analyzed with LISREL VI. The overall fit of the final model to the data was good, as judged by a chi-square (df = 7, p = .845). The total coefficient of determination for the structural equation was .461. Attitude toward documentation did not relate significantly to intention to document optimally. Subjective norm did have a significant effect on behavioral intent. Attitude and subjective norm accounted for 46.1% of the variance in behavioral intent. Behavioral intent had a significant effect on documentation behavior, accounting for 15.2% of the variance. It appears that subjective norm, which is the influence of others, is what directs the intention to document and thus relates to subsequent documentation. Recommendations for practice include the communication of high ideals and expectations of important others to the staff nurse in order to improve the quality of documentation.

Attitude of Health Personnel↗

PubMed1992

The effects of a positive behavioral context on the social impact of aggressive behavior.

The hypothesis is experimentally examined that a positive behavioral repertoire can ameliorate the negative social impact of aggressive behavior. Sixty-six fourth- through sixth-grade girls viewed and rated a series of videotaped interactions between two female confederates. The proportion of positive to aggressive behavior viewed by each subject was manipulated across six experimental conditions by varying the number of positive behaviors exhibited by one of the confederates (target) while the number of aggressive behaviors displayed by her remained constant (i.e., 0%, 20%, 43%, 60%, 80%, and 100% positive). Each subject provided sociometric ratings of the target and selected trait descriptors that best described her from a checklist. The results indicated that positive behavior exhibited in high rates (80% or more, compared to aggressive behavior) offset the negative effects of aggression on both sociometric ratings and positive and negative descriptors.

Adolescent↗

PubMed1989

Cognitive-behavioral therapy and relationship therapy in the treatment of children referred for antisocial behavior.

The present study evaluated alternative treatments for children (N = 112, ages 7-13) referred for severe antisocial behavior. Children were randomly assigned to one of three treatments: problem-solving skills training (PSST), problem-solving skills training with in vivo practice (PSST-P), which included therapeutically planned activities to extend training to settings outside of treatment, or client-centered relationship therapy (RT). PSST and PSST-P children showed significantly greater reductions in antisocial behavior and overall behavior problems, and greater increases in prosocial behavior than RT children. These effects were evident on measures obtained immediately after treatment and at a 1-year follow-up, and on measures of child performance at home and at school. PSST-P children showed greater changes than PSST children on measures of functioning at school at posttreatment, but these differences were no longer evident at follow-up. Children in both PSST conditions showed significant reductions in deviant behavior and improvements in prosocial behavior from pretreatment to follow-up, whereas RT children tended to remain at their pretreatment level of functioning. Notwithstanding the significant improvements, comparisons with nonclinic (normative) samples revealed that the majority of youth remained outside of the normal range of deviant behavior. Possible directions for improving treatment for antisocial youth are highlighted.

Adolescent↗

PubMed1977

What types of sex-role behavior should behavior modifiers promote?

Rekers and Lovaas (1974) reported a study using reinforcement procedures aimed at modifying the behavior of a 5-yr-old who engaged in cross-gender behavior. The use of traditional sex-role concepts in forming target behaviors is criticized and androgynous behavior is suggested as an empirically based alternative. The pathological nature of the behavior that the study was designed to prevent is also questioned, as is the ability to predict sex-role behavior from a 5-yr-old child's current behavior. These issues are raised in the context of the more general question, whom should the therapist serve?

Adaptation, Psychological↗

PubMed1991

Thyrotropin-releasing hormone facilitates display of reproductive behavior and locomotor behavior in an amphibian.

In the amphibian brain, thyrotropin-releasing hormone (TRH) is present in many regions outside the hypothalamus. The functions of this extrahypothalamic TRH however are unknown. We sought to determine whether TRH or its metabolites altered reproductive behaviors (amplectic clasping behavior) or locomotor behaviors of the male South African clawed frog, Xenopus laevis. TRH-injected (100 micrograms; dorsal lymph sac injection) male Xenopus displayed significantly fewer amplectic clasp attempts and longer clasp durations than saline-injected controls. The TRH metabolites, TRH acid and histidylproline diketopiperazine, similarly altered clasping behavior. Several hormones released by TRH, including thyroid-stimulating hormone, melanocyte-stimulating hormone, prolactin, and dopamine, had no significant effect on clasp frequency or duration. Locomotor activity in Xenopus males was increased significantly after 15 min following TRH injection (150 micrograms); this effect persisted for at least 1 hr. The metabolites did not alter locomotion. These studies indicate that TRH can facilitate the display of two behaviors in the South African clawed frog. Effects of TRH on locomotor and reproductive behaviors thus appear in several vertebrate classes. These behavioral actions of TRH likely occur through different mechanisms or at different sites.

Animals↗

PubMed1988

Methoxychlor induces estrogen-like alterations of behavior and the reproductive tract in the female rat and hamster: effects on sex behavior, running wheel activity, and uterine morphology.

The current investigation was designed to determine if the pesticide methoxychlor (M) mimicked the effects of estrogen in the brain and on behavior. Running wheel activity (RWA) and sex behaviors were evaluated in this study because the role of estrogen in the regulation of these behaviors has been thoroughly established. M exposure at 400 mg/kg/day (90% pure) induced high levels of acyclic RWA and persistent vaginal estrus in the female rats. Following ovariectomy (ovx), RWA declined precipitously in controls but remained at high levels in M-treated-ovx females. M also produced estrogen-like alterations of the uterine endometrial epithelium, the ovary, and growth after ovx. In another study, ovx female rats were dosed with M at 200 mg/kg/day and then with progesterone (P). P acts as an antiestrogen and specifically suppresses estrogen-induced RWA. P blocks the synthesis of estrogen receptors in the CNS and reproductive tract but does not lower RWA induced by nonestrogenic mechanisms. After 14 days of M administration RWA was increased fourfold over the ovx-oil-treated females. Subsequently, P injections reduced RWA levels far below those seen when the ovx-M-treated rats were injected with oil. The P-induced decline represents a 95% inhibition of the M-induced increase in RWA. Subsequently, M-treated-ovx rats and hamsters were injected with P and tested for their ability to display reproductive behaviors when paired with a stud male. Female sexual behaviors are induced by the administration of estrogen followed by progesterone. In this study the M-treated females displayed reproductive behaviors, in contrast to the oil-treated rats and hamsters. The observation that the high levels of RWA induced by methoxychlor treatment in ovx rats can be suppressed by concurrent progesterone injections demonstrates that the increase in RWA is due to the estrogenic effects of methoxychlor on the CNS. The fact that methoxychlor, followed by P injections, induces behavioral estrus in the rat and hamster extends this estrogenicity to other areas in the CNS.

Animals↗

PubMed1986

Prevalence of behavior problems and mental health utilization among encopretic children: implications for behavioral pediatrics.

The psychiatric literature traditionally has viewed encopretic children as having severe and characteristic behavior problems. Current psychiatric views as expressed in the Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition (DSM-III), and in the pediatric literature, however, tend to regard the behavior problems of encopretic children as being rather mild or secondary to the consequences of the encopresis itself. Using a behavioral checklist with empirically derived factors (the Child Behavior Checklist), 55 children presenting for medical treatment of their encopresis have been assessed. Numerous behavior problems are reported on parental ratings, but the overall severity of behavior problems in this group of children falls below that found in children with behavior problems who are referred for mental health services. Most children presenting for medical management of encopresis have not been seen or evaluated by mental health services. Encopresis is a disorder in which psychological evaluation and intervention by the pediatrician may be advisable.

Adolescent↗