Behavioral treatment of obesity: a two-year follow-up

Data obtained from a two-year follow-up of 10 obese women treated via behavioral methods is presented. Failure to obtain lasting results was noted, and reasons for this failure suggested. Implications of these data for investigators in the area of obesity were discussed.A review of the recent literature indicates a number of studies with encouraging results obtained via the behavioral treatment of obesity (Hall and Hall, unpublished). However, long-term follow-up data are generally lacking. This lack of long-term data is especially troublesome in the area of obesity. With regard to traditional treatment methods, such as drugs, psychotherapy, and nutritional counseling, it has generally been noted that those overweight individuals who complete a course of treatment, and who lose weight, regain the weight lost (Stunkard and McClaren-Hume, 1958) Within the literature on the behavioral treatment of obesity, only one study (Stuart, 1967) has provided weight data for as long as 1 year after initiation of treatment Stuart's data indicated a gradual loss of weight over the year. However, these data did not reflect S's ability to control weight following termination of treatment, for during the year, follow-up sessions were scheduled monthly, and thus, therapist contact was available.The present paper, in an attempt to fill the need for long-term follow-up data, presents data obtained 2 years after the termination of a behavioral treatment program. None of the Ss had been in contact with the therapist since the termination of the study 2 years earlier.     

Behavioral techniques in the treatment of obesity: A comparative analysis

The relative efficacy of the major techniques typically used in behavioral treatment programs for weight reduction was investigated using obese adult volunteers. Study 1 compared the effects of self-monitoring, self-control procedures, monetary rewards, aversive imagery and relaxation training. These procedures resulted in significantly greater weight reduction than either a no treatment group or subjects who graphed and recorded daily weight. Self-monitoring of daily caloric intake was as effective as the other methods, both singly and combined, over a 4 week treatment period. Study 2 compared the long-term effects of self-monitoring vs the full complement of behavioral techniques used in Study 1. The full behavior management program was significantly more effective, both during the treatment period and at 3 and 12 week follow-ups, although self-monitoring again produced substantial weight loss.     

Behavioral treatment of adult obesity: Attentional controls and a 2-year follow-up

This research included controls for both amount of extra-therapy attention focused on target behaviors and for quality and duration of attention provided during therapy. Two pairs of therapists each conducted one group for each of four experimental conditions: nonspecific therapy, nonspecific therapy + attention prompting, behavior therapy, behavior therapy + positive induction (procedures designed to maximize favorableness of expectancies). Sixty-five obese adults ( OVERWEIGHT = 52%) attended 12 weekly group sessions and 3-month and 2-yr follow-ups. Ratings of expectancies, credibility and therapist characteristics were equivalent in all experimental conditions. Attrition was low (9.7%) and Ss averaged 1–2 lb weight losses per week during treatment, while improving concurrently in eating habits, cardiovascular fitness and adjustment. However, only participants who were in groups conducted by the therapist pair which was rated especially ‘democratic’ maintained average weight losses at the 2-yr follow-up. These results demonstrate the potentially vital role of several ‘nonspecific’ factors in long-term outcomes associated with behavioral treatments for adult obesity.     

发展行为遗传学简介

发展行为遗传学是发展心理学与行为遗传学的交叉学科, 旨在探明遗传与环境对人类心理与行为发展是否存在影响, 如何产生影响, 以及该影响及其作用机制是否随年龄增长而发展变化的问题。该学科与行为遗传学在研究对象、设计和内容等方面存在不同; 开展发展行为遗传学研究需要综合运用心理测量法和行为遗传学研究方法; 未来研究应拓宽和深化候选基因与行为关联性的考察, 并着力探析基因与环境的相互作用机制。     

Family-based obesity treatment, then and now: twenty-five years of pediatric obesity treatment.

OBJECTIVE: Family-based treatments for pediatric obesity were developed over 25 years ago. Over that time, youth have become more obese and the environment more obesiogenic, which may influence efficacy of pediatric weight control. Mixed-effects regression models were used to compare the efficacy of programs initiated 20 to 25 years ago to current programs through 24-month follow-up, as well as to reanalyze 10-year outcomes of previous research using contemporary measures and analytic strategies. MAIN OUTCOME MEASURES: z-BMI and percent overweight. RESULTS: Results showed significant reductions over time, with no differences in z-BMI change for older versus contemporary studies. Age was a predictor of z-BMI up to 24 months, with younger children showing larger change. Mixed-effects regression models replicated previous long-term effects of family-based interventions. Gender was a predictor of long-term z-BMI change, with girls benefiting more over time than did boys. CONCLUSION: The efficacy of the family-based behavioral approach to treating pediatric obesity replicates over a 25-year period. Challenges in evaluating treatment effects over time are discussed. Ideas for studying choice of treatments that vary in effect size and for strengthening family-based behavioral treatments are noted.     

Case report: Behavioral treatment of clinical abulia

Overemphasis of only conditioning factors in behavior modification may narrow treatment applicability. A case of severe dysphoria and restriction in living, which had resisted conventional psychoand chemo-therapies, is presented. Successful treatment was accomplished by broad-spectrum methods combining social-influence, cognitive restructuring, and specific goal-setting with counter-conditioning procedures. A strategy for intervention in self-perpetuating vicious cycles is exemplified, and non-learning aspects of behavior modification techniques are discussed.     

Triangulating causality between childhood obesity and neurobehavior: Behavioral genetic and longitudinal evidence

Childhood obesity is a serious health concern that is not yet fully understood. Previous research has linked obesity with neurobehavioral factors such as behavior, cognition, and brain morphology. The causal directions of these relationships remain mostly untested. We filled this gap by using the Adolescent Brain Cognitive Development study cohort comprising 11,875 children aged 9–10. First, correlations between the age- and sex-specific 95th BMI percentile (%BMIp95) and neurobehavioral measures were cross-sectionally analyzed. Effects were then aggregated by neurobehavioral domain for causal analyses. Behavioral genetic Direction of Causation modeling was used to test the direction of each relationship. Findings were validated by longitudinal cross-lagged panel modeling. %BMIp95 correlated with impulsivity, motivation, psychopathology, eating behavior, and cognitive tests (executive functioning, language, memory, perception, working memory). Greater %BMIp95 was also associated with reduced cortical thickness in frontal and temporal brain areas but with increased thickness in parietal and occipital areas. Similar although weaker patterns emerged for cortical surface area and volume. Behavioral genetic modeling suggested causal effects of %BMIp95 on eating behavior (β = 0.26), cognition (β = 0.05), cortical thickness (β = 0.15), and cortical surface area (β = 0.07). Personality/psychopathology (β = 0.09) and eating behavior (β = 0.16) appeared to influence %BMIp95. Longitudinal evidence broadly supported these findings. Results regarding cortical volume were inconsistent. Results supported causal effects of obesity on brain functioning and morphology. The present study highlights the importance of physical health for brain development and may inform interventions aimed at preventing or reducing pediatric obesity.

Research Highlights

• A continuous measure related to obesity, %BMIp95, has correlations with various measures of brain functioning and structure
• Behavioral genetic and longitudinal modeling suggest causal links from personality, psychopathology, and eating behavior to %BMIp95
• Results also indicate directional links from %BMIp95 to eating behavior, cognition, cortical thickness, and cortical surface area
• Obesity may play a role for healthy brain development during childhood

     

Behavioral treatment of obsessive-compulsive neurosis

Three chronic and severe obsessive-compulsive neurotics were treated with behavioral intervention strategies and psychotropic medication. The effects of treatment were evaluated in three separate experiments with single case experimental designs. The results suggest that response prevention was effective in reducing ritualistic behavior while the effects of flooding and antidepressant medication added little to outcome. The results also suggest that strategies aimed only at reducing compulsive behavior per se are insufficient in eliminating other associated difficulties (e.g., depressive symptoms, interpersonal problems) and that a comprehensive approach to treatment is needed.