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PubMed2006

Compelled to consume: the Implicit Association Test and automatic alcohol motivation.

The Implicit Association Test (IAT; A. G. Greenwald, D. E. McGhee, & J. L. K. Schwartz, 1998) has recently been used to assess the role of alcohol-affect associations in drinking behavior. The current study examined the validity of an alcohol IAT with 88 hazardous-drinking college students who completed measures of drinking behavior, an explicit measure of alcohol motivation, and an IAT that assessed alcohol-motivation associations. Regression analyses indicated that IAT scores correlated with binge drinking and cue reactivity, replicating T. P. Palfai and B. D. Ostafin's (2003) results. Results also indicated convergent validity (the IAT was related to an explicit measure of alcohol motivation) and incremental validity (IAT scores were correlated with alcohol behavior after controlling for the explicit measure). Implications for understanding the self-regulation of drinking are discussed.

Adolescent↗
PubMed1995

[Ambulatory behavior therapy in obsessive-compulsive disorders].

The term Obsessive Compulsive Disorder (OCD) is a label for a variety of syndromes with changing symptom configurations and different intraindividual as well as interactional functions. They are among the most difficult to treat psychiatric disorders. Heterogeneous variables affecting personal development in family, school, and peer-group, as well as genetic or brain organic variables contribute to the development of obsessions and compulsions. In more than 50% of patients with OCD we find one or more of the following disturbances before the outbreak of the disorder: low self-esteem; social deficits; increased anxiety level with increased, latent aggressiveness; striving for 100% security. Behaviour therapy today is the "treatment of choice" for OCD--both in respect of direct symptom reduction as well as the treatment of "causes", co-morbidity and risk factors. Additionally to the use of highly standardised "symptom techniques" individualized, multimodal treatment is necessary in the more severely disturbed patients. Long-term follow-up results show 50-80% success--probably depending on variations in the study samples regarding the type of obsessions and compulsions, the degree of developmental deficits before the occurrence of OCD, actual co-morbidity, and professional as well as private life conditions. Whether and to what degree additional psychotropic medication can enhance the efficacy of behaviour therapy, and whether the high relapse rates of 70% after discontinuation of previously successful drug treatment can be reduced by concomitant or subsequent behaviour therapy, cannot be safely concluded from the currently available studies. Are the non-responders in each of these treatments the responders of the non-responders in the alternative treatment mode?

Ambulatory Care↗
PubMed1983

Psychological and behavioral characteristics of normal-weight bulimics and normal-weight controls.

This study compares psychological traits, physical traits, behavior, demographic data, incidence of family pathology, incidence of life stress, and scores on eating disorder scales in a sample of normal-weight female bulimics with a sample of normal-weight female controls. The groups, matched for age, socioeconomic status, and I.Q. were found to have comparable physical traits, family demographics, incidence of family pathology, and incidence of life stress. However, bulimics demonstrated significantly higher levels of psychological pathology and impulsive behavior. There were significantly more suicide attempts, psychiatric hospitalizations, episodes of stealing, use of drugs, and menstrual disturbances among the bulimics than the controls. The bulimics consistently rated themselves sicker than the controls on all psychometric scales. Most notable were the depression, anxiety, obsessive-compulsive, and interpersonal sensitivity factors on the Symptom Checklist 90, and the internal control score on the Nowicki-Strickland Locus of Control Scale. The discussion includes a brief description of weight set-point theory and its role in the maintenance of bulimia.

Adult↗
PubMed1992

Neuroendocrine and behavioral responses to challenge with the indirect serotonin agonist dl-fenfluramine in adults with obsessive-compulsive disorder.

Neuroendocrine and behavioral responses to a single 60-mg oral dose of the indirect serotonin agonist dl-fenfluramine were assessed in unmedicated adults with obsessive-compulsive disorder (OCD) and neuroendocrine results contrasted with those in normal control subjects. Net fenfluramine-induced prolactin release did not differ significantly between OCD patients and normal controls. Prolactin responses in the OCD group were not significantly correlated with baseline Yale-Brown Obsessive Compulsive Scale scores for either obsessions or compulsions, but were positively correlated with the baseline Hamilton Depression Scale score and Hamilton Anxiety Scale score. No clear difference in the severity of patients' obsessions or compulsions was found following challenge with fenfluramine versus placebo. Although the present study does not demonstrate a serotonergic abnormality in OCD, this may be more a reflection of limitations of the test procedures than evidence that central nervous system (CNS) serotonergic function is normal in the disorder.

Adult↗
PubMed2004

Hyperactivity in anorexia nervosa: a case study using experience sampling methodology.

Hyperactivity is frequently observed in eating disorders, and several biopsychological mechanisms have been proposed to explain its pathogenetic role. In view of the lack of a reliable method to study hyperactive behavior, we did an experiment with experience sampling methodology (ESM). During 1 week, an anorexia nervosa (AN) patient was asked at nine random times a day to report her momentary tendency to be physically active, her emotions and several other variables including calorie expenditure, drive for thinness, attractiveness, obsessions, compulsions, and attitudes towards hyperactivity. Results indicate that the patient's tendency to be hyperactive was (a) positively related to her weight preoccupation and her negative emotions, and (b) negatively related to her positive emotions and the absence of depression. In this patient, obsessions and compulsions were not related to hyperactivity. The usefulness of ESM for studying the role of hyperactivity in AN is discussed.

Adolescent↗
PubMed2002

Relationship among sex, imagery, and exercise dependence symptoms.

There is limited research examining the physical (e.g., sex) and psychological correlates (e.g., imagery) of exercise dependence despite its harmful effects. The purposes of this study were to examine sex differences and the predictive ability of exercise imagery for exercise dependence symptoms. Participants were 408 university students who completed measures of exercise imagery, exercise behavior, and exercise dependence. The results indicated that men reported more exercise dependence symptoms than women. For the women, exercise behavior, appearance imagery, and energy imagery were positive predictors of exercise dependence symptoms. In contrast, for the men, exercise behavior and energy imagery positively predicted exercise dependence symptoms. Consistent with suggestions by C. Hall (1995), exercise imagery may be related to exercise dependence symptoms.

Adult↗
PubMed1999

Family accommodation of obsessive-compulsive symptoms: instrument development and assessment of family behavior.

Relatives frequently accommodate patients' obsessive-compulsive symptoms and clinicians hypothesize that such accommodations adversely affect patient outcome. This study's purpose was to develop a valid and reliable measure, the Family Accommodation Scale for Obsessive-Compulsive Disorder (FAS), and to investigate the family accommodation construct. We administered the FAS and additional family and patient measures to 36 adult obsessive-compulsive patients and their primary caregivers. The FAS demonstrated excellent interrater reliability and good internal consistency and performed well on assessment of its convergent and discriminant validity. Family accommodation was significantly associated with patient symptom severity and functioning, and with relatives' own obsessive-compulsive symptoms. Although most relatives accommodated patient symptoms, many did not believe that such accommodations improved the patient's clinical status. The FAS will provide researchers and clinicians with a useful tool for assessing family accommodation and for identifying families who may benefit from interventions aimed at developing more adaptive coping strategies.

Adaptation, Psychological↗
PubMed2005

How effective are cognitive and behavioral treatments for obsessive-compulsive disorder? A clinical significance analysis.

Controlled outcome studies investigating the efficacy of psychological treatments for obsessive-compulsive disorder (OCD) have employed different methods of determining the clinical significance of treatment effects. This makes it difficult to draw conclusions regarding the absolute and relative efficacy of psychological treatments for OCD. To address this issue, standardized Jacobson methodology for defining clinically significant change was applied to recent psychological outcome trials for OCD. The proportion of asymptomatic patients following treatment was also calculated. When recovery is defined by Jacobson methodology, exposure and response prevention (ERP) appears the most effective treatment currently available (50-60% recovered). However, when the asymptomatic criterion is used as the index of outcome, ERP and cognitive therapy have low and equivalent recovery rates (approximately 25%).

Behavior Therapy↗
PubMed1996

Course of behavioral change in autism: a retrospective study of high-IQ adolescents and adults.

OBJECTIVE: The course of behavioral change in autistic behaviors has received little attention in previous research but is a potentially important parameter for study in autism. METHOD: Autistic behaviors were systematically examined in 38 high-IQ adolescent and adult autistic individuals at their current age (13 through 28 years) and retrospectively at age 5 years using a standardized interview for autism. RESULTS: Significant change over time in autistic behaviors, generally in the direction of improvement, was detected. The proportion of subjects showing improvement in communication and social behaviors was found to be significantly higher than the proportion showing improvement in ritualistic/repetitive behaviors. Five of 38 subjects who met DSM-IV criteria for autistic disorder at age 5 years no longer met criteria at their current age, although all five continued to have substantial impairment. CONCLUSIONS: The study of patterns of behavioral change over time in autism has practical implications for both diagnosis and prognosis as well as potential importance in defining biologically meaningful subgroups and clarifying fundamental mechanisms underlying this disorder.

Adolescent↗
PubMed1989

From one addiction to another: life after alcohol and drug abuse.

Once the alcoholic or drug addict has stopped drinking or using drugs, other addictive behaviors are frequently adopted. These factors must be considered in planning the overall recovery program. Substances likely to be used to excess include nicotine, caffeine, sugar, chocolate, nutritional supplements and medicinal herbs. Addictive behaviors adopted by recovering persons include eating disorders, exercise and body building, workaholism, and dependency on one's own adrenalin. Breaking the cycle of addiction requires commitment to a program of self-growth and becoming responsible for one's actions.

Compulsive Behavior↗
PubMed2005

Impulse control disorders in adult psychiatric inpatients.

OBJECTIVE: The authors' goal was to examine the prevalence of impulse control disorders in psychiatric inpatients. METHOD: They used the Minnesota Impulsive Disorders Interview, a semistructured clinical interview assessing pathological gambling, trichotillomania, kleptomania, pyromania, intermittent explosive disorder, compulsive buying, and compulsive sexual behavior, to screen 204 consecutively admitted psychiatric inpatients. One hundred twelve of the inpatients were women (54.9%), and the mean age of the 204 inpatients was 40.5 years (SD=13.2, range=18-83). Patients whose screen was positive for an impulse control disorder were evaluated with structured clinical interviews. RESULTS: Sixty-three patients (30.9%) were diagnosed with at least one current impulse control disorder. The most common impulse control disorders were compulsive buying (N=19 [9.3%]), kleptomania (N=16 [7.8%]), and pathological gambling (N=14 [6.9%]). Patients with and without co-occurring impulse control disorders did not differ significantly from each other on demographic measures or number or type of psychiatric diagnoses other than impulse control disorders. CONCLUSIONS: Impulse control disorders appear common among psychiatric inpatients. Additional, larger studies are needed to examine the prevalence of impulse control disorders in the general population and specific psychiatric groups.

Adolescent↗
PubMed1981

Review of behavioral psychotherapy, I: Obsessive-compulsive disorders.

Obsessive-compulsive ritualizers have maintained their improvement after exposure in vivo for up to 3 years' follow-up in the United States, Britain, Greece, and Australia. Unlike exposure in vivo, relaxation is of little value. Early gains in treatment predict long-term outcome. Exposure therapy is usually on an outpatient basis and takes 1-30 sessions. Self-exposure homework is critical. Sessions at home are also required, together with relatives cooperating as exposure cotherapists. Some patients can treat themselves almost unaided, while others need extensive assistance. Clomipramine is helpful for ritualizers with coexisting depression, but depression tends to recur when clomipramine therapy is stopped.

Behavior Therapy↗
PubMed2000

Thalamic volume in pediatric obsessive-compulsive disorder patients before and after cognitive behavioral therapy.

BACKGROUND: Neurobiologic abnormalities in the thalamus have been implicated in the pathophysiology of obsessive-compulsive disorder. We recently reported increased thalamic volume in treatment-naive pediatric obsessive-compulsive disorder patients versus case-matched healthy comparison subjects that decreased to levels comparable to control subjects after effective paroxetine therapy. To our knowledge, no prior study has measured neuroanatomic changes in the thalamus of obsessive-compulsive disorder patients near illness onset before and after cognitive behavioral therapy. METHODS: Volumetric magnetic resonance imaging studies were conducted in 11 psychotropic drug-naive 8-17-year-old children with obsessive-compulsive disorder before and after 12 weeks of effective cognitive behavioral therapy monotherapy (> or =30% reduction in obsessive-compulsive disorder symptom severity). RESULTS: No significant change in thalamic volume was observed in obsessive-compulsive disorder patients before and after cognitive behavioral therapy. CONCLUSIONS: Our findings suggest that reduction in thalamic volume after paroxetine therapy may be specific to paroxetine treatment and not the result of a general treatment response or spontaneous improvement. These results are preliminary in view of the small sample studied.

Adolescent↗
PubMed1990

Depression, episodic behavioral dyscontrol, and polydipsia following right temporal lobe damage.

A patient referred to the authors for evaluation and treatment of depression, behavioral dyscontrol syndrome, and polydipsia is described. The authors reviewed his medical status and, finding damage to his right temporal lobe, conceptualized his symptom constellation as representing interictal syndrome and treated him with carbamazepine. His affective symptoms, but not the polydipsia, improved following treatment with carbamazepine.

Adult↗
PubMed2001

Chronic inositol increases striatal D(2) receptors but does not modify dexamphetamine-induced motor behavior. Relevance to obsessive-compulsive disorder.

A large body of evidence suggests that the neuropathology of obsessive-compulsive disorder (OCD) lies in the complex neurotransmitter network of the cortico-striatal-thalamo-cortical (CSTC) circuit, where dopamine (DA), serotonin (5HT), glutamate (Glu), and gamma-amino butyric acid (GABA) dysfunction have been implicated in the disorder. Chronic inositol has been found to be effective in specific disorders that respond to selective serotonin reuptake inhibitors (SSRIs), including OCD, panic, and depression. This selective mechanism of action is obscure. Since nigro-striatal DA tracts are subject to 5HT(2) heteroreceptor regulation, one possible mechanism of inositol in OCD may involve its effects on inositol-dependent receptors, especially the 5HT(2) receptor, and a resulting effect on DA pathways in the striatum. In order to investigate this possible interaction, we exposed guinea pigs to oral inositol (1.2 g/kg) for 12 weeks. Subsequently, effects on locomotor behavior (LB) and stereotype behavior (SB), together with possible changes to striatal 5HT(2) and D(2) receptor function, were determined. In addition, the effects of chronic inositol on dexamphetamine (DEX)-induced motor behavior were evaluated. Acute DEX (3 mg/kg, ip) induced a significant increase in both SB and LB, while chronic inositol alone did not modify LA or SB. The behavioral response to DEX was also not modified by chronic inositol pretreatment. However, chronic inositol induced a significant increase in striatal D(2) receptor density (B(max)) with a slight, albeit insignificant, increase in 5HT(2) receptor density. This suggests that D(2) receptor upregulation may play an important role in the behavioral effects of inositol although the role of the 5HT(2) receptor in this response is questionable.

Animals↗
PubMed1979

FI schedules and persistence at gambling in the U.K. betting office.

This study reports on the direct observations of customers in two U.K. betting offices gambling on horse and dog races. These observations revealed that bets were more frequently placed in the last minutes just prior to the start (the OFF), and that this was caused by high-frequency gamblers (customers who had eight or more bets in a session) consistently placing their bets in the last two minutes prior to the OFF. Low-frequency gamblers (three or fewer bets/session) avoided this time period placing their bets earlier, or after the OFF, i.e., on a later race. It was argued that the betting behavior of the "gamblers" could not be explained either in terms of "skillful betting" or solely in terms of variable ratio schedules but was more adequately accounted for in terms of an interval schedule. It was further suggested that time-based schedules might be of heuristic value in generally understanding persistence at gambling while losing.

Adult↗