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Response of patients to participation in psychiatry board examinations.

The patient who volunteers to be a subject for Part II of the certifying examination in psychiatry and neurology is an indispensable but surprisingly invisible participant in a highly controversial process. A survey of the attitudes of 78 patients toward this experience revealed that although they experienced a significant degree of stress, the overwhelming majority viewed their participation in strongly positive terms. The patient's loyalty to the host institution and the manner in which the patient is prepared for the experience appear to be the major factors in determining a positive outcome.

Adult

Facilitating diabetes self-management.

The purpose of this study was to enhance sensitivity to and understanding of the perceptions of persons with diabetes by analyzing these individuals' unsolicited comments on structured questionnaires. Twenty of 66 adults with non-insulin-dependent diabetes mellitus (NIDDM) who participated in a study to modify their eating habits wrote a total of 122 unsolicited comments on three different questionnaires. A systematic analysis of the content of these comments resulted in seven coding categories: personal philosophy; knowledge deficit; weight or blood sugar problems; diet, exercise, or medication problems; self-care activity; stress; and success. Further analysis resulted in a trilevel schema (survival, regulation, success) depicting how individuals learn to manage their diabetes. The problem-identification and seeking-help behaviors identified in the survival level gradually changed to learning to live with the regimen in the regulation level. Respondents whose activities were in the success level demonstrated more autonomy than persons in the other two levels. A health orientation rather than a problem orientation also was seen in the success level. Consequently, teaching strategies should be tailored to the client's level of self-care, with an emphasis on assisting them toward the success level.

Adult

Friendship patterns among older women.

This study examined the friendship patterns of older women. The participants in the study were white, middle-class, urban women, sixty-five years of age or older. Results indicated the older widowed women received more help from their friends than did married older women. In addition, significant differences in the morale of the older women were found according to the equity of helping behaviors with friends. Specifically, those equitably benefited women had a higher mean morale score than over benefited women. The under benefited women also had a higher mean morale score than the over benefited women. Discussion centered on the importance of friends in the lives of older women as well as on implications for friendship support systems in late life.

Aged

Intimacy: factors affecting its development among members of a home for the aged.

The purpose of this research was to explore the extent and nature of intimate interaction in an unGoffmanesque home for the aged. Interviews with all elderly residents and the staff who served them revealed that the residents' intimate relationships were primarily with others outside the home and never with staff members. Moreover, the residents and, more particularly, the staff viewed the residents in negative ways and reported more negative than positive affectivity within the home. Factors impeding intimate interactions were related to the widely shared negative stereotype of the aged residents, the manner in which staff perceived their role, and the absence of mutual aid or helping behaviors among the residents.

Aged

Rural/urban elderly and siblings: their value consensus.

Consensus is the level of agreement about life felt among kin and has been identified as a dimension of family solidarity with important implications for the family network. This investigation studied the factors contributing to the consensus between older adults (age sixty-five and older) and the sibling with whom they had the most contact. Respondents (N = 275) lived in a rural/urban area. Seven independent variables were entered into a multiple-regression model to determine their relative importance to consensus of the sibling relationship. Results showed that 7 percent of the variance in consensus could be explained. Filial expectations, educational disparity, and the brother/sister link were the only variables of relative importance to older adult/sibling consensus. There was greater consensus when there were fewer expectations of the sibling, similarity of educational backgrounds, and when the respondent was male and his sibling was female. Brother/sister and brother/brother links, residential proximity, communication by mail or telephone, helping behaviors, and marital status were of no relative importance to consensus. The results suggest that factors previously found to be associated with intergenerational consensus may vary in their importance to intragenerational consensus.

Aged

Asthma mortality: another opinion--is it a matter of life and ... bread?

There is a general consensus that the mortality rates for asthma in much of the developed world have been increasing for the past 10-15 years. This has occurred despite an improved information base regarding diagnosis and management as well as the development of novel and more effective therapeutic modalities. Several explanations have been proposed for this increase, including a statistical artifact based on a change in the coding criteria for asthma from the International Classification of Diseases Version 8 (ICD-8) to ICD-9, worsened pollution, delays in seeking medical help, behavioral changes, deficits in asthma education of both patients and primary care providers, toxicity of beta agonists, and noncompliance with medications. We suggest that although all of these are potential etiological factors, there may exist still another major etiological risk. There have been dramatic changes in our eating habits and food preparation. In general, we eat less total calories, more meals outside the home, and more refined or prepared foods. With the emphasis on reducing the intake of saturated fats and cholesterol, we eat more polyunsaturated fats both by choice and secondary to manufacturers' attempts to improve the appeal of foods to health-conscious government and the public. The drive to remove animal fats and cholesterol from our diet has resulted in the replacement of animal fats with vegetable oil in food manufacture, fast-food frying, and even home preparation. One result of these dietary habits has been a doubling from 8 to 15% of the percentage of the polyunsaturated linoleic acid in body fat. We postulate that this, and other nutritional changes, will render asthma a more difficult syndrome to manage and will contribute adversely to the inflammatory abnormalities in airways.

Adrenergic beta-Agonists

Staff skills in patient/family relations grow.

Short but cogent course on communication, attitudes, and behaviors helps staff members from many departments relate more effectively with patients, their families, and visitors.

Communication

A typology of AIDS volunteers.

Based on our research of volunteers at Gay Men's Health Crisis (GMHC) in New York City, we developed a typology of AIDS volunteers derived from their responses to our Reasons for Volunteering scale. The scale included six basic reasons, three of which were AIDS-specific and three of which represented more general reasons for doing volunteer work. Cluster analysis was used to identify sub-groups in this sample, from which we identified seven distinct and meaningful types of volunteers. One type, which we labeled Self-Sacrificers, is the closest we could find to a group of altruists-volunteers who indicated that self-gain was unimportant to them. While the volunteers who endorsed AIDS-related reasons for volunteering were most likely to be gay men and to have had significant prior AIDS-related experiences, each cluster was markedly heterogeneous in terms of demographic characteristics. Implications are drawn for the management of volunteers in community-based AIDS organizations and for further research on helping behavior and altruism.

Acquired Immunodeficiency Syndrome

A cognitive-behavioral self-help educational program for patients with COPD. A pilot study.

BACKGROUND: The purpose of this pilot study was to evaluate the impact of an 8-week cognitive-behavioral self-help educational program for individuals with COPD on level of disability. METHODS: Eight adults ranging in age from 58 to 83 years attended a program that included a cognitive-behavioral intervention strategy. Levels of disability, cognitive distortion, anxiety, depression, somatic symptoms, and hostility were measured pre- and posttreatment using the Sickness Impact Profile, two Cognitive Error Questionnaires and the Symptom Questionnaire. RESULTS: Significant decreases were found in the Psychosocial and Total Sickness Impact Profile Scores (p value = 0.02 and p value = 0.03, respectively). On the General-Cognitive Error Questionnaire, the personalization subscale decreased significantly (p value = 0.04). On the COPD-Cognitive Error Questionnaire, the selective abstraction subscale decreased significantly (p value = 0.02). CONCLUSION: Findings suggest a positive treatment response to the program.

Adolescent

Setting phenotypes in a mutual help organization: expanding behavior setting theory.

Expands Barker's theory of behavior settings by proposing an additional method of classifying settings based on their functional/behavioral aspects--the setting phenotype. Although behavior setting theory has been widely hailed as a revolutionary contribution to behavioral science, it has had limited impact on general psychology. This may be due in part to a reliance on a purely structural method of classifying behavior settings--the setting genotype. Behavioral data were collected from 510 meetings of 13 self-help groups from a mutual help organization for persons with problems in living. A cluster analysis was performed to uncover meaningful behavioral patterns among the groups. Four phenotypes were identified: personal, impersonal, small talk, and advising. Mutual help group phenotype was found to be related to a set of setting characteristics as well as to overall rated change of group members. The results are discussed in light of the significance of the phenotype construct for making behavior setting theory more relevant for social scientists.

Activities of Daily Living

Changes in appetitive behavior in weanling-age rats: transitions from suckling to feeding behavior.

To help identify determinants of rat appetitive behavior during the weanling period, rat pups 17-32 days of age were studied in a Y-maze. One arm of the maze provided pups with the opportunity to suckle a lactating or nonlactating anesthetized female. The other arm always contained a familiar food, either liquid diet or ground laboratory chow. In some experiments the dam was separated from the food compartment by a thin gauze screen. In other tests maternal contact could be maintained in the feeding goal but suckling in that compartment was prevented by nipple involution. Age was the major determinant of choice, with more older animals choosing the food arm. Availability of maternal contact in the feeding compartment increased the percentage of rats that chose to feed by about 20% at all ages studied. Food quality, but not quantity, affected choice at each age, as did lactational status. Prior food, water, and maternal deprivation (2 or 24 hr) did not affect choice behavior at any age but did influence behavior in the goal box. These findings are discussed within the context of the changing demands faced by the rats during the weaning period.

Aging

Charting uncharted terrain: a behavioral observation system for mutual help groups.

Describes the development of a behavioral observation system for mutual help meetings and presents evidence supporting its reliability, validity, and utility. The MHOS-BIC (Mutual Help Observation System-Behavioral Interaction Codes) was used by 10 observers to record the sequential flow of group interaction in 527 meetings. Psychometric analyses indicate that the system performed consistently with measurement objectives. Mean kappas for each of the 12 coding categories ranged from .62 to .87; the system demonstrated sensitivity to setting and time differences; and a predictable pattern of correlations was found among BIC categories and conceptually related participant and observer ratings. Studies using the BIC to address substantive questions about mutual help are reviewed, providing further evidence for its validity and utility. An empirical description of mutual help is presented using BIC data, and the promises and limitations of the system are discussed.

Affective Symptoms

Utility of behavioral self-help manuals in a minimal-contact smoking cessation program.

The effectiveness of two commercially available smoking cessation manuals was evaluated under minimal therapist contact conditions. Forty cigarette smokers who volunteered to participate in a self-help quit smoking program were randomly assigned to one of three conditions: 18 to Pomerleau and Pomerleau's 1977 manual, 13 to Danaher and Lichtenstein's 1978 manual, and nine to a waiting-list control. Six-month follow-ups indicate that the former manual offers a useful treatment approach, while no firm conclusions can be made regarding the latter manual. Utility of self-help manuals in multilevel treatment programs is discussed.

Adolescent

Durations of unitary synaptic potentials help time a behavioral sequence.

Recordings in identified neurons and muscles that mediate crayfish tailflips reveal inhibitory postsynaptic potentials of two distinct durations. Those of long duration are recorded in five classes of cells in the flexion circuit, while those of short duration are recorded in three classes of cells in the extension circuit. The durations of the inhibitory postsynaptic potentials are matched to the durations of inhibition required by the different phases of the behavior.

Animals