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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↗

PubMed1994

Pain behavior in industrial subacute low back pain. Part I. Reliability: concurrent and predictive validity of pain behavior assessments.

The reproducibility of overt pain behavior ratings was shown to be reliable between independent observers. In the clinical evaluation of 103 blue collar workers with subacute low back pain (LBP), concurrent validity was high between Behavioural Signs (Waddell et al. 1980) and UAB Pain Behavior Rating scale (Richards et al. 1982). Correlations with pain rated on visual analogue scales (Scott and Huskisson 1976) were generally lower. Behavioural Signs correlated separately with covert pain behavior (general convictions concerning back strength and general health). It seems that subacute LBP patients do not behave as a homogenous group since pain behaviors predicted occupational handicap (absenteeism) in a non-linear fashion. Return to work was best predicted by UAB and covert pain behavior, absenteeism up to 2 years by covert pain behavior. The findings emphasize the potential social implications of overt pain behaviors and the importance of covert pain behavior in maintaining the sick role. The conclusion is that, in secondary prevention, where the main targets are to interfere with somatic deconditioning and sick-role development, a more diversified primary approach may be possible, based on supplementary use of relatively easy observational tests and quick self-reports.

Absenteeism↗

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↗

PubMed1994

Generating hypotheses about the function of student problem behavior by observing teacher behavior.

We examined whether, as predicted by research on child effects, we could generate hypotheses about the function of student problem behavior by observing the amount of attention teachers provided to students. In the first phase of the study, we observed the amount of attention teachers distributed among small groups of students who exhibited problem behavior in individual or small-group instructional settings (problem behavior presumably maintained by attention or escape). Based on the amount of attention each student received, we generated hypotheses about the function of his or her problem behavior. In the second phase of the study, we determined the accuracy of these predictions by conducting a brief functional assessment with each student. Results confirmed that, for 14 of the 15 students, we were able to generate accurate hypotheses about the function of their problem behavior. These results suggest the potential efficacy of using the amount of attention teachers distribute among groups of students to generate empirically based hypotheses about the function of student problem behavior maintained by attention and/or escape. These results also illustrate the efficiency of this procedure; by observing teacher behavior, we were able to generate hypotheses about the function of problem behavior for several students at one time.

Attention↗

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↗

PubMed1994

[Health behavior model based analysis of factors affecting alcohol behavior of company employees].

Factors affecting alcohol behavior were studied using, as a conceptual framework, a Health Behavior Model on Alcohol (Alcohol Behavior Model), adapted from Munakata's Health Behavior Model. Under this model alcohol behavior is restricted or promoted by the levels of self-initiative ability, which influences both health promotion factors and health hindrance factors. How these factors influence alcoholic behavior in company employees was studied. Employees were asked to complete questionnaires when they came to health centers for their regular health examination between August to September 1990. Two hundred and ninety-two of the three hundred subjects answered the questionnaire. Results indicate that the major factor for restricting alcoholic behavior was self-efficacy regarding drinking alcohol. The self-efficacy level was increased by the persons' perceived vulnerability to alcohol and was decreased when alcohol functioned as an aid to recover from fatigue or to lower stress. As a conclusion, empowering clients to enhance self-efficacy appears to be effective as a health objective for coping with alcoholic behavior.

Adult↗

PubMed1980

Behavioral effects of hashish in mice. I. Social interactions and nest-building behavior of males.

The acute and subchronic effects of hashish extract (20 mg delta 9-THC/kg) on the behavior of male mice encountering a control partner was studied by ethological methods. A single administration of the extract resulted in general sedation, suppressing all the individual and social activities with the exception of some submissive elements. The locomotive and the overall activity of drugged males was drastically reduced and immobility occurred frequently. After four applications, tolerance to the sedative effects had developed and behavioral drug effects were recognizable. Drugged males showed an increase in nonsocial activities as well as in submissive behavior and flight, whereas social investigation was less frequent. Sexual and aggressive behavior was not significantly affected by the drug and immobility no longer occurred. In spite of behavioral changes after a single or repeated drug treatment, drugged males became dominant in about half the experiments. The nest-building behavior of males was disturbed in the same way after one or four drug applications. Drugged males generally refrained from carrying and working up the nesting material. The acute behavioral effects of hashish extract are compared to those described in previous papers and the difference between acute and subchronic drug effects is discussed.

Aggression↗

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↗

PubMed1981

Compliance training and behavioral covariation in the treatment of multiple behavior problems.

The present study investigated the use of a compliance-training procedure and its effect on untreated deviant child behaviors. Three children, each generally noncompliant to adult requests and with several additional problems, such as crying, aggression, and self-injurious behavior, were trained in the compliance procedure under a multiple-baseline design across therapists. Compliance was defined as the correct response to prespecified requests. Other classes of deviant child behavior were measured continuously throughout the study but not directly reinforced. The results of the study showed that (a) increases in compliance to requests were directly related to the contingencies employed; (b) decreases in untreated deviant behaviors occurred when compliance increased, even though no direct contingencies had been placed on these behaviors; and (c) the relationship between untreated deviant behaviors and compliance appeared to be maintained by a different set of events in each of the three children. The results are discussed in terms of behavioral covariation and generalization.

Aggression↗

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↗

PubMed1997

Coronary disease-prone behavior among Japanese men: job-centered lifestyle and social dominance. Type A Behavior Pattern Conference.

In Japan the type A behavior pattern, particularly its component of hostility, is known to have less value as a risk for coronary artery disease (CAD) than in the United States. We developed a questionnaire (Japanese Coronary-prone Behavior Scale [JCBS]) to investigate the behavioral correlates with CAD among contemporary Japanese persons. The JCBS was administered to 419 Japanese men undergoing coronary angiography; 310 of them had angiographic or clinical evidence or both of CAD, and 109 had no evidence of CAD. The group with CAD had more coronary risk factors than the group without CAD, but the two groups did not differ in type A behavior pattern as assessed with the Jenkins Activity Survey. Stepwise discriminant analysis, in which standard coronary risk factors were forced into the model, revealed that inclusion of nine JCBS items (scale C) in the model resulted in the best discrimination between the two groups. Cross-validation results showed that the error-rate estimates for the discriminant models that consisted only of standard coronary risk factors, only of scale C items, and of their combination were 34.7, 32.4, and 27.0%, respectively. The scale C items represented a job-centered lifestyle, social dominance, and suppressed overt type A behaviors. These results indicate that an independent behavior pattern prone to CAD is discernible among Japanese men and suggest that the behavior pattern may contain characteristics that can be differentiated from those that constitute the type A behavior pattern.

Aged↗

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↗