PROMPTING ONE LOW-FAT,HIGH-FIBER SELECTION IN A FAST-FOOD RESTAURANT

Evidence increasingly links a high-fat, low-fiber diet to coronary heart disease and certain site cancers, indicating a need for large-scale dietary change. Studies showing the effectiveness of particular procedures in specific settings are important at this point. The present study, using an A-B-A-B design and sales data from computerized cash registers, replicated and extended previous work by showing that inexpensive prompts (i.e., signs and fliers) in a national fast-food restaurant could increase the sales of salads, a low-fat, high-fiber menu selection. Suggestions also are made pertinent to more widespread use of the procedures.     

Enhancing social diffusion theory as a basis for prevention intervention: A conceptual and strategic framework

Social diffusion theory has recently been recognized as a promising approach for large-scale disease prevention and health promotion efforts. This paper describes how principles and tactics from social cognitive theory, operant psychology, social psychology, social marketing, and the overarching stages of change model can be used to further develop the conceptual and strategic (technological) bases of social diffusion theory. Within an integrative framework, we discuss in detail more effective ways to train peer mediators of behavior change as one example of how social diffusion theory can benefit from this conceptual and strategic reformulation. We then further illustrate the use of peer mediators of change in human immunodeficiency virus (HIV) and cancer prevention intervention studies with both interventions training peer mediators to diffuse information, norms, and risk reduction strategies. Although the results of these studies showed reductions in high-risk behaviors across population segments, more closely following the framework discussed in this article should further increase the behavior change potential of future interventions based on social diffusion theory.     

The effects of videotape modeling and daily feedback on residential electricity conservation, home temperature and humidity, perceived comfort, and clothing worn: Winter and summer

Two studies were conducted in all-electric townhouses and apartments in the winter (N = 83) and summer (N = 54) to ascertain how energy conservation strategies focusing on thermostat change and set-backs and other low-cost/no-cost approaches would affect overall electricity use and electricity used for heating and cooling, the home thermal environment, the perceived comfort of participants, and clothing that was worn. The studies assessed the effectiveness of videotape modeling programs that demonstrated these conservation strategies when used alone or combined with daily feedback on electricity use. In the winter, the results indicated that videotape modeling and/or feedback were effective relative to baseline and to a control group in reducing overall electricity use by about 15% and electricity used for heating by about 25%. Hygrothermographs, which accurately and continuously recorded temperature and humidity in the homes, indicated that participants were able to live with no reported loss in comfort and no change in attire at a mean temperature of about 62 degrees F when home and about 59 degrees F when asleep. The results were highly discrepant with prior laboratory studies indicating comfort at 75 degrees F with the insulation value of the clothing worn by participants in this study. In the summer, a combination of strategies designed to keep a home cool with minimal or no air conditioning, in conjunction with videotape modeling and/or daily feedback, resulted in overall electricity reductions of about 15% with reductions on electricity for cooling of about 34%, but with feedback, and feedback and modeling more effective than modeling alone. Despite these electricity savings, hygrothermograph recordings indicated minimal temperature change in the homes, with no change in perceived comfort or clothing worn. The results are discussed in terms of discrepancies with laboratory studies, optimal combinations of video-media and personal contact to promote behavior change, and energy policies that may be mislabeled as sacrificial and underestimate the effectiveness of conservation strategies such as those investigated in these studies.     

Effects of self-monitoring and feedback on residential electricity consumption

Prior research has indicated that frequent feedback could reduce residential electricity consumption by 10% to 15%. However, because feedback was primarily given in written form, this procedure might not be practical. The present study evaluated a potentially more practical feedback procedure during peak-use periods with high electricity consuming households. The study was conducted during the winter in an upper-middle class neighborhood of almost identical, all-electric townhouses (N = 71) that averaged about 170 KWH per day per household for a monthly bill of over $200. Twelve households received daily written feedback. Sixteen households (self-monitoring) were taught to read their outdoor electricity meter and to record KWH used every day. A comparison group was composed of 14 households that had volunteered to participate and 29 others that had only given permission to have their meters read. During a 1-month period that the procedures were in effect, the feedback group reduced consumption by 13% and the self-monitoring group by about 7%. These reductions, relative to the comparison group, were maintained during an early spring 1-month follow-up period and, to a lesser extent, during a 6-week warm spring period. Self-monitoring participants were highly reliable and persistent meter readers. Reductions in electricity use were reported by households to be largely attributable to lowering of the heat thermostat, and large monetary and KWH savings were found. Techniques to make self-monitoring cost-effective important components of the self-monitoring procedure, methods to apply self-monitoring more broadly, and plans to combine behavioral procedures with physical technology are discussed.     

Issues in multivariate assessment of a large-scale behavioral program

Several social and research issues directly affected the development and implementation of multivariate assessment in a large community-based applied research program. Examples are drawn from experiences of the Preparation through Responsive Educational Programs Project for disruptive and skill deficient adolescents in suburban, rural, and urban junior high school settings, focusing on the assessment of academic and social skill development and long-term skill maintenance. The social context altered both project treatment and follow-up plans, requiring assessment of potentially unintended effects and decreasing consistency across sites. Future community acceptance of such programs may depend on the investigators' adaptation to diverse community pressures for program conduct and assessment and the measurement of phenomena that are not always directly observable.     

Cognitive-behavioral therapy for ADHD in medication-treated adults with continued symptoms

The purpose of the present study was to examine the potential efficacy, patient acceptability, and feasibility of a novel, cognitive-behavioral therapy (CBT) for adults with attention-deficit hyperactivity disorder (ADHD) who have been stabilized on medications but still show clinically significant symptoms. Thirty-one adults with ADHD and stable psychopharmacology for ADHD were randomized to CBT plus continued psychopharmacology or continued psychopharmacology alone. Assessments included ADHD severity and associated anxiety and depression rated by an independent evaluator (IE) and by self-report. At the outcome assessment, those who were randomized to CBT had lower IE-rated ADHD symptoms (p < .01) and global severity (p < .002), as well as self-reported ADHD symptoms (p < .0001) than those randomized to continued psychopharmacology alone. Those in the CBT group also had lower IE-rated and self-report anxiety (p's < .04), lower IE-rated depression (p < .01), and a trend to have lower self-reported depression (p = .06). CBT continued to show superiority over continued psychopharmacology alone when statistically controlling levels of depression in analyses of core ADHD symptoms. There were significantly more treatment responders among patients who received CBT (56%) compared to those who did not (13%) (p < .02). These data support the hypothesis that CBT for adults with ADHD with residual symptoms is a feasible, acceptable, and potentially efficacious next-step treatment approach, worthy of further testing.     

Social support and the course of bipolar disorder

The current study prospectively examined the impact of social support on symptom severity and recovery from episodes in bipolar disorder, both as a direct influence and as a buffer of life events. Fifty-nine individuals with Bipolar I disorder were followed longitudinally with monthly symptom severity interviews. Social support was measured by the Interpersonal Support Evaluation List and the Interview Schedule for Social Interaction, and life events were assessed using the Life Events and Difficulties Schedule. Individuals with low social support took longer to recover from episodes and were more symptomatic across a 6-month follow-up. Results suggest a polarity-specific effect, in that social support influences depression but not mania. Discussion focuses on theoretical implications of a series of polarity-specific findings within the field.     

THE FATHER,THE FATHER FUNCTION,THE FATHER PRINCIPLE: SOME CONTEMPORARY PSYCHOANALYTIC DEVELOPMENTS

The author discusses Freud's thinking on the role of the father, as well as that of later French theoreticians. To illustrate his remarks, he draws on the poetry of Carlos Drummond de Andrade (1912–1987), a Brazilian poet whose work often dealt with themes of the father, the family, and his own paternal relationship. The author also discusses the psychic formation of the father principle and how this may be evident in the clinical analytic setting, even when the analyst's approach privileges field theory, intersubjectivity, or other concepts emphasizing the relationship between analyst and patient.