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PubMed1990

Conditioned learning in alcohol dependence: implications for cue exposure treatment.

A review of the literature pertinent to cue exposure treatment in alcohol dependence is presented. Psychological models of relapse, based on conditioning and social learning theories, are critically evaluated. In particular, attention is drawn to the potential implications for cue exposure research and treatment of an interaction between Pavlovian and operant conditioning, problems with the application of the concepts of arousal and craving and the importance of a systems model to understand physiological responses. It is concluded that no study has so far demonstrated a link between conditioned responses to alcohol-related cues and relapse, an assumption on which cue exposure treatment is based. Further, the evidence for the effectiveness of cue exposure as a treatment is lacking. Promising research directions are identified.

Alcohol Drinking↗
PubMed2006

Flux and stability: individual fluctuations, regression towards the mean and collective changes in alcohol consumption.

AIM: First, to extend the predictions of the collectivity theory of drinking cultures to contexts of ordinary panel data, thereby integrating collective change and individual fluctuations in consumption. Secondly, to develop a technique for controlling the regression towards the mean effect, in order to estimate the pattern of individual change, net of this effect. DESIGN: The task is, first and foremost, to develop a theoretical model, guided by earlier contributions and empirical results. The applicability of the model is illustrated through re-analyses of panel data on annual intake of alcoholic beverages from the Finnish alcohol reform in 1968-69, and Norwegian panel data from 1975 to 1976. FINDINGS: The model offers a reasonable fit to the data. It is demonstrated that a previous attempt at controlling the regression effect has overlooked a methodological complication, and therefore underestimates the real change. CONCLUSION: Analysis of the Finnish data demonstrates that the large increase in average consumption was due to approximately the same percentage-wise increase in the consumption level of drinkers at all levels, when the regression effect was controlled for. Thus, in absolute terms the increase was largest among the heavier drinkers.

Alcohol Drinking↗
PubMed1987

Problematic situations in nursing: analysis of Orlando's theory based on Dewey's theory of inquiry.

Orlando's theory, proposed as a framework to use in problematic situations, was analysed using Dewey's theory of inquiry. This analysis revealed that Orlando's concepts are remarkably similar to those of Dewey. Each used an organizing principle that was derived from the meaning of experience and both view investigation as a serial process using facts and ideas to determine the problem and its solution. Several areas in Orlando's work could be enhanced and extended through the formulations of Dewey. The analysis supports the use of Orlando's theory in problematic situations.

Humans↗
PubMed1990

Aspects of communication with people who have attempted suicide.

This paper addresses some potential difficulties in communication which may occur between health-care professionals and those who are being assessed following an unsuccessful suicide attempt. Attitudes towards suicide and attempted suicide which may be held by the patient and carer are reviewed and the effects that these may have on communication, particularly at the assessment stage, are considered. Some techniques to enhance communication and assessment are proposed.

Attitude of Health Personnel↗
PubMed1992

AIDS, nursing and occupational risk: an ethical analysis.

This paper examines the notion of risk assessment in relation to nursing patients with HIV infection or AIDS. Risk assessment consists in examining three features of a given hazard; its magnitude, its probability, and its acceptability. In relation to the last of these, an 'acceptability threshold' can be identified. If contact with HIV-infected patients is perceived to pass this threshold, nurses may seek to abrogate the usual 'duty to treat'. Rather than endeavour to pinpoint this threshold, the paper explores some of the factors which may either raise or lower it, and their ethical implications. In particular, the consequences of setting a high threshold, and thereby limiting or avoiding contact with patients infected with HIV, are examined. In this debate, the burden of proof is seen as resting firmly on nurses themselves, not on the patients at risk of being deprived of care.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Parental violence and the occurrence of severe and acute malnutrition in childhood.

Evidence from developed countries has linked family violence with severe acute malnutrition (SAM), yet no similar studies have been conducted in developing countries where the risk of SAM is higher. To redress this gap, the objective of this study was to explore the role of intimate partner violence (IPV) among caregivers as an independent risk factor for SAM. A hospital-based case-control (n = 172 : 345) study was carried out in six paediatric hospitals of Rio de Janeiro (1995-99). Cases comprised children (1-24 months) admitted with SAM (weight-for-height z-score < -2 SD). Controls were children of the same age admitted for non-traumatic surgery. Couple violence was gauged through the Conflict Tactics Scales from two perspectives: (a) two ordinal variables characterising the intensity of verbal and physical aggression based on scores, and (b) a four-level variable representing a pattern of increasing violence seriousness. Unconditional logistic regression analysis was performed to control for confounding factors. Parents of SAM cases had higher Conflict Tactics scores than parents of controls, indicating more severe partner violence. The adjusted odds ratio for the comparison of the highest to the lowest scores (10 vs. 0) was 4.15 (95% confidence interval 1.55, 11.15). Using the four-level variable for violence seriousness, a threefold SAM risk was found for children with parents reporting severe physical abuse, but not for those with parents reporting verbal aggression or more minor physical assaults. In addition to traditionally studied risk factors, the findings suggest that family violence may also play an important role in SAM among children. Moreover, these findings indicate that the risk for SAM is not associated with all types of IPV, but that children exposed to severe and recurrent events are more likely to be admitted for SAM. For the prevention or early detection of SAM, this result points to a specific population group requiring rigorous public health targeting, especially in terms of accurate detection of both SAM and IPV, as well as appropriate handling and follow-up of violent families.

Acute Disease↗
PubMed1988

Self-discrepancies as predictors of vulnerability to distinct syndromes of chronic emotional distress.

Two types of self-discrepancy differing in both domain and standpoint of self-guide were examined as predictors of vulnerability to chronic emotional syndromes. Study 1 assessed discrepancy between the actual/own self-state and the ideal/own self-guide and between the actual/own self-state and the ought/other self-guide in predicting syndromes of dejection and agitation as well as different types of anger. Actual/own: ideal/own discrepancy (AI) was uniquely related to dejection, frustration, and anger at self as measured 2 months later; actual/own:ought/other discrepancy (AOO) was uniquely related to agitation and to anger at others and resentment. Study 2 used structural equation modeling of the relations between AI and AOO discrepancy and social anxiety versus depression as measured weeks later. A model in which AOO was more strongly associated with social anxiety and AI was more strongly associated with depressive symptoms provided the best fit. The results support the convergent and discriminant validity of a self-discrepancy model of vulnerability to chronic emotional syndromes.

Affective Symptoms↗
PubMed1992

An introduction to the five-factor model and its applications.

The five-factor model of personality is a hierarchical organization of personality traits in terms of five basic dimensions: Extraversion, Agreeableness, Conscientiousness, Neuroticism, and Openness to Experience. Research using both natural language adjectives and theoretically based personality questionnaires supports the comprehensiveness of the model and its applicability across observers and cultures. This article summarizes the history of the model and its supporting evidence; discusses conceptions of the nature of the factors; and outlines an agenda for theorizing about the origins and operation of the factors. We argue that the model should prove useful both for individual assessment and for the elucidation of a number of topics of interest to personality psychologists.

Humans↗
PubMed1992

Assessing the five-factor model of personality description.

Several approaches to assessing the dimensions of the five-factor model are reviewed and evaluated. The items in the assessment instrument may be adjectives or phrases, and the instrument itself may have been developed specifically to measure the five factors or may have been reinterpreted in terms of the five-factor model. Data are presented comparing an adjective-based measure of the model (Goldberg, 1990) with two phrase-based measures (Costa & McCrae, 1985; Hogan, 1986), and recommendations are made for the choice of an instrument in different research contexts. Allport's (1937) distinctions between the structure of the trait lexicon and the structure of personality in individuals are reiterated.

Humans↗
PubMed2004

Task orientation, parental warmth and SES account for a significant proportion of the shared environmental variance in general cognitive ability in early childhood: evidence from a twin study.

Prior research suggests shared environmental influences on cognitive performance are important in early childhood. However, few studies have attempted to identify the factors comprising this shared environmental variance. To address this issue, we examined the covariance between task orientation, parental warmth, socioeconomic status and general cognitive ability in a British twin study of 125 pairs of identical and same-sex fraternal twins. Task orientation correlated r =.41 with general cognitive ability Bivariate genetic analyses suggested that this correlation was mediated by shared environmental influences. Additional analyses suggested that SES and parental warmth mediated about two-thirds of the shared environmental covariance between task engagement and cognitive skills.

Chi-Square Distribution↗
PubMed1994

First diagnosis of severe mental and physical disability: a study of doctor-parent communication.

This study investigates factors associated with satisfaction with medical communication at the time of diagnosis of a child's severe mental or physical disability. Two competing social psychological models that have been used to account for parent patient satisfaction are tested: Korsch's (1968) affective model and Ley's (1977) cognitive model. One hundred and sixty six mothers of children with severe learning disabilities were questioned about the time when their child's disability was first diagnosed. Measures included the child's age when diagnosis was made, the length of time parents had been anxious, and how satisfied they were with the way they were told the diagnosis. They were asked to rate the doctor's affective behaviour and their understanding and memory of the information they received. Fifty-eight per cent of parents reported dissatisfaction with the communication. Stepwise multiple regression analysis showed that Korsch's affective scale was much the strongest predictor, entering the equation first, and explaining 35.7% of the variance in satisfaction. Ley's cognitive scale entered second, explaining a further 1.4% of the variance. Further analysis including the other predictors found that six predictors explained 40% of the variance. The implications of the findings for the training of medical staff are discussed.

Activities of Daily Living↗
PubMed2006

An integrated physical dispersion and behavioral response model for risk assessment of radiological dispersion device (RDD) events.

A radiological dispersion device (RDD) or "dirty" bomb is a conventional explosive wrapped in radiological material. Terrorists may use an RDD to disperse radioactive material across a populated area, causing casualties and/or economic damage. Nearly all risk assessment models for RDDs make unrealistic assumptions about public behavior in their health assessments, including assumptions that the public would stand outside in a single location indefinitely. In this article, we describe an approach for assessing the risks of RDD events incorporating both physical dispersion and behavioral response variables. The general approach is tested using the City of Pittsburgh, Pennsylvania as a case study. Atmospheric models simulate an RDD attack and its likely fallout, while radiation exposure models assess fatal cancer risk. We model different geographical distributions of the population based on time of day. We evaluate aggregate health impacts for different public responses (i.e., sheltering-in-place, evacuating). We find that current RDD models in use can be improved with the integration of behavioral components. Using the results from the model, we show how risk varies across several behavioral and physical variables. We show that the best policy to recommend to the public depends on many different variables, such as the amount of trauma at ground zero, the capability of emergency responders to get trauma victims to local hospitals quickly and efficiently, how quickly evacuations can take place in the city, and the amount of shielding available for shelterers. Using a parametric analysis, we develop behaviorally realistic risk assessments, we identify variables that can affect an optimal risk reduction policy, and we find that decision making can be improved by evaluating the tradeoff between trauma and cancer fatalities for various RDD scenarios before they occur.

Humans↗
PubMed1989

Models for moral response in care of seriously ill children.

This paper presents a discussion of three models for provision of care to seriously ill infants and their families. The statistical, the wait until near-certainty and the individual models are defined and compared. Comparisons were based on quality of life, legality, responsibility, withdrawing/withholding treatment and potential injury. The individual model offers the most humane and legally sound basis for care. Suggestions to redefine the model of care in the United States are offered with nursing leading the way.

Child Abuse↗
PubMed1990

Anorexia nervosa and bulimia nervosa. Perspectives on etiology and cognitive behavior therapy.

This article gives a brief historical introduction to the field of eating disorders. Anorexia Nervosa (AN) and Bulimia Nervosa (BN) are seen from a sociocultural point of view, and the current emphasis on slimness is regarded as an important factor in the etiology of eating disorders. A short description of the central features of BN is given, and some important explanatory psychological models are described with the emphasis on the cognitive-behavioral model. Recent controlled treatment studies are cited.

Anorexia Nervosa↗