Showing papers in "Journal of Behavioral Medicine in 1981"
TL;DR: It was found that the Hassles Scale was a better predictor of concurrent and subsequent psychological symptoms than were the life events scores, and that the scale shared most of the variance in symptoms accounted for by life events.
Abstract: The standard life events methodology for the prediction of psychological symptoms was compared with one focusing on relatively minor events, namely, the hassles and uplifts of everyday life Hassles and Uplifts Scales were constructed and administered once a month for 10 consecutive months to a community sample of middle-aged adults It was found that the Hassles Scale was a better predictor of concurrent and subsequent psychological symptoms than were the life events scores, and that the scale shared most of the variance in symptoms accounted for by life events When the effects of life events scores were removed, hassles and symptoms remained significantly correlated Uplifts were positively related to symptoms for women but not for men Hassles and uplifts were also shown to be related, although only modestly so, to positive and negative affect, thus providing discriminate validation for hassles and uplifts in comparison to measures of emotion It was concluded that the assessment of daily hassles and uplifts may be a better approach to the prediction of adaptational outcomes than the usual life events approach
3,045 citations
TL;DR: Mood and symptom levels were related to coping responses and to quantitative and qualitative measures of social resources, which attenuated the relationship between undesirable life events and personal functioning.
Abstract: The nature of individual coping responses to stressful life events was explored in a representative adult community sample. Two approaches to the classification of coping strategies were operationalized. Using these measures, small but significant gender and contextual differences in coping were identified. Mood and symptom levels were related to coping responses and to quantitative and qualitative measures of social resources. Measures of coping and social resources attenuated the relationship between undesirable life events and personal functioning.
1,997 citations
TL;DR: It was concluded that social support research would benefit from attention to the multidimensionality ofSupport and greater specificity in hypotheses about the relationship between types of support and adaptational outcomes.
Abstract: Social support research has been hampered by a lack of clarity both in the definitions of social support and in the conceptualization of its effects on health outcomes. The present study compared social network size and three types of perceived social support—tangible, emotional, and informational —in relation to stressful life events, psychological symptoms and morale, and physical health status in a sample of 100 persons 45–64 years old. Social network size was empirically separable from, though correlated with, perceived social support and had a weaker overall relationship to outcomes than did support. Low tangible support and emotional support, in addition to certain life events, were independently related to depression and negative morale; informational support was associated with positive morale. Neither social support nor stressful life events were associated with physical health. It was concluded that social support research would benefit from attention to the multidimensionality of support and greater specificity in hypotheses about the relationship between types of support and adaptational outcomes.
1,219 citations
TL;DR: Findings provide considerable support for the valid and reliable assessment of self-motivation and for its distinctive utility in enhancing the prediction of perseverant behavior, specifically, adherence to therapeutic exercise.
Abstract: Behavioral compliance or adherence is a fundamental problem in health care, and diagnosis of dropout proneness represents a first step in adherence facilitation. A paper-and-pencil scale was developed to assess self-motivation, conceptualized as a behavioral tendency to persevere independent of situational reinforcements. Scale refinement (N=401) yielded a logically valid and reliable measure with a high internal consistency (α=0.91). Repeated measurements (1 to 5 months) indicated a high degree of scale stability (r'sranged from 0.86 to 0.92), reinforcing the conception of self-motivation as relatively enduring and trait-like. Convergent evidence for construct validity was provided by the Self-Motivation Inventory's (SMI) relationship with the Thomas-Zander Ego-Strength Scale (r=0.63) and other more behaviorally specific attitudes (r'sranged from 0.47 to 0.58). Discriminant validity was evidenced by minimal overlap with motivational measures of social desirability, health locus of control, and achievement tendency; in each case, less than 10% of the variance in self-motivation was explained. Predictive validity was demonstrated in a variety of naturalistic settings in which perseverant behavior was easily quantified. These included habitual exercise programs for exercise training (N=64), preventive medicine (N=66), and acute exercise (N=48). The diversity of these settings supported the situational invariance of self-motivation. Collectively, these findings provide considerable support for the valid and reliable assessment of sel-fmotivation and for its distinctive utility in enhancing the prediction of perseverant behavior, specifically, adherence to therapeutic exercise.
241 citations
TL;DR: Patients in the relaxation training condition reported feeling less emotionally distressed and nauseated, and showed less physiological arousal following the chemotherapy infusion, than patients in the no relaxationTraining condition.
Abstract: Cancer patients who had developed negative conditioned responses to their chemotherapy either did (relaxation training) or did not (no relaxation training) receive progressive muscle relaxation training and guided relaxation imagery instructions immediately before and during their chemotherapy treatments. Physiological (blood pressure and pulse rate) measures of arousal, frequency of vomiting, and patient-reported and nurse-reported indices of negative affect and nausea were collected during pretraining, training and posttraining chemotherapy sessions. Results indicated that during both the training and the posttraining sessions, patients in the relaxation training condition reported feeling less emotionally distressed and nauseated, and showed less physiological arousal following the chemotherapy infusion, than patients in the no relaxation training condition. The attending nurses' observations confirmed the patients' self-reports. No differences were found in frequency of vomiting between conditions. These data clearly suggest that the use of relaxation procedures may be an effective means of reducing several of the adverse side effects of cancer chemotherapy.
180 citations
TL;DR: It is suggested that behavioral preparation benefits even frightened, aggressive, or denying elective surgical patients, and an active coping model is proposed to explain the benefits of relaxation.
Abstract: Elective surgery patients were prepared for surgery with training in muscle relaxation or with information about sensations they would experience. Relaxation reduced hospital stay, pain, and medication for pain and increased strength, energy, and postoperative epinephrine levels. Information reduced hospital stay. Personality variables (denial, fear, aggressiveness) were associated with recovery and influenced patients' responses to preparation. Less frightened patients benefited more from relaxation than did very frightened patients. Nonaggressive patients reacted to information with decreased hospital stay along with increased pain, medication, and epinephrine. Aggressive patients responded to information with decreased hospital stay along with decreased pain, medication, and epinephrine. Patients using denial were not harmed by preparation. A catharsis/moderation model is proposed to explain how information benefits patients. An active coping model is proposed to explain the benefits of relaxation. This study suggests that behavioral preparation benefits even frightened, aggressive, or denying elective surgical patients.
173 citations
TL;DR: Correlations between the various Type A questionnaire scales and the structured interview were found to be notably low and the use of Type A questionnaires and implications for Type A interventions are discussed.
Abstract: Psychological characteristics of 384 adult males classified as Type A or Type B by the structured interview were examined. Subjects classified Type A differed significantly from subjects classified Type B on a number of psychological scales including measures of aggression, autonomy, extroversion, and impulsiveness but not on measures of psychological distress. The extent to which pencil and paper questionnaire assessments of Type A differ from structured interview ratings was also studied. Correlations between the various Type A questionnaire scales and the structured interview were found to be notably low. The use of Type A questionnaires and implications for Type A interventions are discussed.
171 citations
TL;DR: Evaluating group studies that reported weight data at least 1 year posttreatment concluded that although changes in weight do occur, these changes are almost always clinically small, variability among patients is large, and further weight losses do not occur following the end of formal treatment.
Abstract: Over 200 articles have been published describing behavior modification programs for weight reduction. We reviewed the group studies that reported weight data at least 1 year posttreatment. Evaluating these studies, we concluded that although changes in weight do occur, these changes are almost always clinically small, variability among patients is large, and further weight losses do not occur following the end of formal treatment. The weight lost during treatment may be explained by changes in specific eating behaviors caused by therapist contact rather than the effect of self-applied behavioral techniques on eating. Support for the effectiveness of each of the specific techniques to produce lasting weight loss or behavioral change was also lacking. Suggestions for future research in this area are given.
122 citations
TL;DR: Results showed that the interventions achieved substantial reductions in patients' serum potassium levels and in weight gains between dialysis treatments between T1 and T2, however, these program effects tapered off to preintervention levels between T2 and T3, indicating a need for long-term intervention programs.
Abstract: This research examined the relative efficacies of three intervention strategies designed to increase compliance to medical regimens in a group of ambulatory hemodialysis patients. The interventions examined included behavioral contracting (with or without the involvement of a family member or friend) and weekly telephone contacts with patients. Compliance was assessed with regard to following dietary restrictions and limiting fluid intake. Data were collected from 116 patients drawn from two outpatient clinics. Within clinics, patients were randomly assigned either to an intervention program or to a control group. The study employed a pretest-posttest control group design. Patients were interviewed before the intervention programs began (T1), after a 6-week intervention period (T2), and 3 months after completion of the intervention period (T3). Results showed that the interventions achieved substantial reductions in patients' serum potassium levels and in weight gains between dialysis treatments between T1 and T2. In general, however, these program effects tapered off to preintervention levels between T2 and T3. The findings thus indicate a need for long-term intervention programs.
102 citations
TL;DR: It was found that compared to nonfamily history subjects, family history subjects manifested reliably greater cardiovascular reactivity during each task and in anticipation of the shock avoidance task, congruent with the notion that excessive sympathetic nervous system reactivity—possibly genetically determined—is involved in the development of some form of essential hypertension.
Abstract: Thirty subjects with a family history of hypertension and 28 subjects without such a history performed a Stroop Color-Word Interference task, a mental arithmetic task (serial subtraction of sevens), and a shock avoidance task (repeating digits backward while expecting to be shocked for mistakes). Systolic and diastolic blood pressure and pulse rate were recorded while subjects anticipated, undertook, and recovered from the shock avoidance task and undertook and recovered from the Stroop and mental arithmetic tasks. It was found that compared to nonfamily history subjects, family history subjects manifested reliably greater cardiovascular reactivity during each task and in anticipation of the shock avoidance task. These results are congruent with the notion that excessive sympathetic nervous system reactivity—possibly genetically determined—is involved in the development of some form(s) of essential hypertension. Further, the results indicated that family history subjects manifested greater consistency, or stereotypy, of cardiovascular response across the experimental tasks than nonfamily history subjects. The possible role of cardiovascular stereotypy in the development of essential hypertension is also discussed.
77 citations
TL;DR: This paper draws together some selected materials bearing on the impact of dental disease and dental conditions on individuals and on societies to bring together examples of data from empirical studies and to point up some of the areas and themes which may deserve new research effort in the future.
Abstract: Among the diseases and chronic conditions afflicting populations throughout the world, dental caries and periodontal disease are among the foremost in prevalence (Dunning, 1979). The many consequences of dental disease and dental conditions involve not only physical health but also economic, social, and psychological well-being of individuals. But their true impact on individuals has never been adequately assessed, and their complex implications for society have rarely been examined. In recent years the level of technology and innovative treatment in dentistry has considerably advanced. But it has not been matched by a comparable growth in systematic knowledge concerning the social, psychological, and economic sequellae of dental disease and impairments. Yet such information can have great importance for adequate understanding of the problems of dental conditions and for rational planning of programs of care at the level of both the individual and the community. In this paper we draw together some selected materials bearing on the impact of dental disease and dental conditions on individuals and on societies. We consider a series of selected problems of dental health and disease in the context of their social, psychological, and economic implications. Our purposes are (1) to bring together examples of data from empirical studies and (2) to point up some of the areas and themes which may deserve new research effort in the future.
TL;DR: Results showed that treated subjects improved on measures of unauthorized pain requests, physical and emotional self-ratings, “tanking” ratings, compliance with hospital routine, and state and trait anxiety, whereas no-treated subjects showed little improvement.
Abstract: A treatment program of stress inoculation for the pain experienced by 16 severely burned adults was carried out by the nursing staff of a burn and trauma unit. Results showed that treated subjects improved on measures of unauthorized pain requests, physical and emotional self-ratings, “tanking” ratings, compliance with hospital routine, and state and trait anxiety, whereas no-treated subjects showed little improvement.
TL;DR: Children classified as Type A resemble Type A adults when compared on physiological responses to stress; however, the results depend on the method used to determine Type A behavior.
Abstract: Forty-one male and female children were tested for Type A (coronary-prone) behavior using the Bortner test and the MYTH questionnaire. Based on their classification as A or B, three physiological variables were compared: systolic blood pressure (SBP), heart rate (HR) (phasic, tonic, and variability), and skin conductance (SC) (magnitude and latency of responses, number of spontaneous responses) during a 3-min rest period, a 10-min unsignaled reaction time (RT), and a 10-min word task. When using the Bortner to classify groups, Type As showed a tendency toward higher SBP levels and greater SBP reactivity to tasks, and significantly greater HR levels, HR reactivity to tasks, HR variability during rest, and SCR magnitude to RT signals. When using the MYTH, Type A females showed larger increases in SBP and HR to tasks, a lower mean HR, and a faster RT. Type A males showed a higher mean HR. Thus, children classified as Type A resemble Type A adults when compared on physiological responses to stress; however, the results depend on the method used to determine Type A behavior.
TL;DR: Self-regulation of skin temperature in different directions at different sites did not in fact result in significantly different magnitudes of change in migraine activity across groups, and a physiological model is proposed to explain how warming and cooling may produce clinical improvement in migraine.
Abstract: All combinations of cooling versus warming and finger versus temporal artery were used in the present study, the aim of which was to identify an optimal biofeedback training site and to assess the specific effects of skin temperature biofeedback upon migraine. After an initial 4-week baseline phase, during which daily records of headache activity and medication were kept, 24 migraine patients were randomly assigned to one of the four experimental conditions. Training sessions for all patients were of 50-min duration and occurred once per week for 8 weeks. The headache charts were completed for another 4 weeks after treatment was terminated and again at 6-month follow-up. The results showed significant reductions in migraine activity and drug usage. However, self-regulation of skin temperature in different directions at different sites did not in fact result in significantly different magnitudes of change in migraine activity across groups. The role of nonspecific factors is discussed and a physiological model is proposed to explain how warming and cooling may produce clinical improvement in migraine.
TL;DR: The self-management treatment program was designed to teach patients skills for identifying and modifying environmental, behavioral, physiological, and cognitive conditions related to poor sleep.
Abstract: Three controlled case studies are presented to demonstrate the application of behavioral self-management to two subtypes of sleep-maintenance insomnia. Patient 1 suffered from brief but frequent arousals to wakefulness and to NREM Stage 1 sleep. Patient 2 suffered from brief but frequent arousals and extended minutes awake after sleep onset. Patient 3 suffered from an extended latency to sleep onset and also extended minutes awake after sleep onset. The self-management treatment program was designed to teach these patients skills for identifying and modifying environmental, behavioral, physiological, and cognitive conditions related to poor sleep. Results are documented using home and laboratory all-night sleep recordings during treatment and at 3 and 12 months following the end of treatment.
TL;DR: The use of visual display is effective in producing compliance to exercise regimens and in light of the small sample size, however, no definitive conclusions can be drawn regarding the effects of exercise on hand functioning.
Abstract: A hand exerciser with an electronic counter and a visual display was used to measure compliance objectively, to investigate the effects of visual feedback on compliance, and to assess the impact of exercise on seven mild and five moderate rheumatoid arthritis patients. A multiple time-series design varying the onset of the visual display was utilized. Compliance was assessed weekly over the 7 weeks of the study. Pretest and posttest measures of various indicators of hand functioning were taken by an occupational therapist. Visual display of the number of exercises completed decreased the number of noncompliant patients from six to two, with the maximum degree of noncompliance reduced from 44 to 5%. Thus the use of visual display is effective in producing compliance to exercise regimens. In light of the small sample size, however, no definitive conclusions can be drawn regarding the effects of exercise on hand functioning.
TL;DR: It is my opinion that it seems unlikely that the dentist will have any significant impact on the oral health and oral health behaviors of the larger society in the near-future.
Abstract: Dental providers have been charged with the responsibility to incorporate preventive activities in their practices and have been urged to educate and motivate patients to carry out these activities conscientiously. At the outset, it is important to recognize that some of the fundamental assumptions regarding the effectiveness of prevention technologies and the long-term efficacy of dental treatment have yet to be confirmed. It is also important to recognize that only a small percentage of the population is receiving routine dental care, and it is my opinion that it seems unlikely that the dentist will have any significant impact on the oral health and oral health behaviors of the larger society in the near-future. Given these caveats, one can still examine the impact of the provider on behaviors affecting or promoting oral health, such as regular visits and appropriate self-care procedures. The fundamental concerns are those of providing patient access to the dental setting, retaining the patients in the setting, and influencing the patient to engage in activities both within and without the setting, generally considered to be important in the promotion or maintenance of oral health.
TL;DR: The development and growth of the social and behavioral sciences in the field of dentistry perhaps can best be described through a brief history of the Federal Government's involvement in this area, since prior to the mid-1950s, before Federal support began, there was very little scientific behavioral literature in the dental field.
Abstract: The development and growth of the social and behavioral sciences in the field of dentistry perhaps can best be described through a brief history of the Federal Government's involvement in this area, since prior to the mid-1950s, before Federal support began, there was very little scientific behavioral literature in the dental field. During the earliest stages of development in the 1950s, a relatively broad range of substantive issues was being examined, suggesting a wide variety of behavioral and social science disciplines potentially applicable to dentistry. These issues include research on psychophysiological aspects of oral functions, psychologic aspects of oral disease or malfunction conditions, individual behavior characteristics, therapeutic regimens, and public behaviors in health-care programs. In an annotated bibliography on psychology in dentistry published in 1962, the literature fell into three categories (Borland et al., 1962). The first category included anecdotal accounts of patients' experiences, followed by a set of recipes for influencing their behaviors. A small second group of references, although more consistent with accepted concepts in psychology, psychiatry, and similar disciplines, also reflected inadequate preparation in the behavioral sciences. An extremely small third group of articles, authored by sophisticated behavioral scientists, presented theoretical material that followed the rigorous demands of research methods. Although a few early articles dealt with psychosomatic p r o c e s s e s involved in some dental diseases and with the sociopsychological aspects
TL;DR: It becomes a challenge for the dentist to attempt to affect and motivate patients to assume responsibility for maintaining and improving their oral health, since any oral health behaviors which prevent or retard the loss of teeth are valuable and worthy of promotion.
Abstract: Dentistry has long had an interest in the prevention of oral pathology, but without remarkable effect and without widespread professional consensus as to how this interest is to be implemented. Much hinges upon how well dentists can enlist the cooperation of patients to maintain primary and secondary levels of preventive oral health behavior. Primary prevention in dentistry seeks to maintain people's sound oral health. Forms of primary prevention include community w a t e r fluoridation at the collective level and dental flossing, brushing, and avoidance of cariogenic foods practiced on an individual basis. In contrast, secondary prevention seeks to reverse or confine oral pathology through the use of dental services, as patients themselves cannot perform their own secondary prevention. This dental care can be strategic because the dentist is in a paramount position to influence the patient's efforts in primary prevention. Dr. Ayer has raised the question of whether the role of motivating people to engage in preventive activities is an appropriate one for the dentist. Until such time as the oral health-care delivery system changes, it will be necessary to promote oral health within its present confines. It becomes a challenge for the dentist, therefore, to attempt to affect and motivate patients to assume responsibility for maintaining and improving their oral health, since any oral health behaviors which prevent or retard the loss of teeth are valuable and worthy of promotion.
TL;DR: The study showed that outpatient asthmatic adolescents are similar in many respects to older institutionalized asthmatics, except that in the former, psychological symptoms are more diffuse and recognition of respiratory symptoms is less severe.
Abstract: Outpatient adolescent asthmatics were studied using the Asthma Symptom Checklist (ASC) of Kinsman et al.The study showed that outpatient asthmatic adolescents are similar in many respects to older institutionalized asthmatics, except that in the former, psychological symptoms are more diffuse and recognition of respiratory symptoms is less severe. Further studies are needed to determine which psychological symptoms are most important in predicting prognosis in affected asthmatics or the development of “psychosomatic” asthma.
TL;DR: A series of studies validating this package for a variety of retarded individuals is presented, and a description of the teaching strategies are included.
Abstract: This paper describes a cost-effective treatment package for the obese retarded population. The components of the treatment package and a description of the teaching strategies are included. A series of studies validating this package for a variety of retarded individuals is presented.
TL;DR: This paper discusses and evaluates the following topics: (1) patient characteristics, (2) etiological hypotheses, (3) experimental models of the syndrome, (4) psychological characteristics of the patients, (5) psychophysiological characteristics of, and (6) relaxation therapies.
Abstract: Myofascial pain-dysfunction (MPD) syndrome is a muscle-contraction headache-like pain of the face. In the past this has also been called temporomandibular joint syndrome. This syndrome is thought to be, in part, a stress-related pain. This paper discusses and evaluates the following topics: (1) patient characteristics, (2) etiological hypotheses, (3) experimental models of the syndrome, (4) psychological characteristics of the patients, (5) psychophysiological characteristics of the patients, and (6) relaxation therapies. Future research is also discussed.
TL;DR: This project investigated the effects of a systematic pinpointing and feedback system upon staff follow-through with assignments on a rehabilitation impatient service and indicated that team performance was significantly affected during intervention weeks.
Abstract: This project investigated the effects of a systematic pinpointing and feedback system upon staff follow-through with assignments on a rehabilitation impatient service. The number and percentage of tasks were recorded over 8 weeks. An ABAB time series reversal design was used where the baseline phases occurred during weeks 1–2 and 5–6, and the intervention occurred during weeks 3–4 and 7–8. Intervention consisted of directing chart round interactions so that assignments were given to specific team members and a list of these tasks was distributed to the team. Results indicated that team performance was significantly affected during intervention weeks. Specifically, the percentage of pinpointing increased from 40% during baseline to an intervention average of 96%. Also, team compliance increased from baseline levels averaging 44% to a mean of 87% during the intervention. The effects of such inexpensive techniques on team effectiveness and the resultant cost benefits to patients in a rehabilitation setting are reviewed.
TL;DR: Nine issues which were raised at the conference are outlined, the extreme positions that were advanced for each are presented, and then the author's own "Hege l ian" synthesis is stated.
Abstract: A number o f papers have been presented which reviewed interesting and important dental findings, many of which should be integrated into the repertoire of researchers isolated from dentistry, but otherwise well versed in the behavioral medicine literature. The situation is reminiscent of a cartoon from P u n c h . The scene depicts the speaker's corner at Hyde Park, and at every soapbox but one there is a crowd gathered around the speaker. The isolated person orating with absolutely no one listening is saying, \" H o w can it be that these vital facts are virtually unknown in our country today?\" This paper will not be an overall summary; that would be an impossible task for a conference as preliminary and diverse as this one. First, the papers have surveyed both the foundations and the applications of the entire field and were not centered on specific research problems or research areas. Second, this report comes from a particular perspective, that of a social psychologist. While sensitive to other disciplines, my training and orientation inevitably shape my viewpoints. The papers presented displayed a wide variability. They showed very few threads of agreement, yet there were a number of counterthemes; people addressed the same issue from different viewpoints. These diverse viewpoints on a given theme become particularly difficult to summarize, so instead nine issues which were raised at the conference are outlined, the extreme positions that were advanced for each are presented, and then my own \"Hege l ian\" synthesis is stated.