Evaluating the Social Acceptability of Persons with Habit Disorders: The Effects of Topography, Frequency, and Gender Manipulation

In this study, 120 undergraduate students were asked to rate the social acceptability of a male and female who portrayed different habit behaviors (motor tics, vocal tics, Tourette's disorder, and trichotillomania). The portrayals of these behaviors were clinically valid as viewed by mental health professionals. Each habit behavior was portrayed in a variety of frequency/topography combinations including low frequency/mild topography, low frequency/severe topography, high frequency/mild topography, and high frequency/ severe topography. Participants were randomly assigned to one of four habit conditions (motor tic, vocal tic, Tourette's disorder, and trichotillomania) and were asked to rate the social acceptability of the frequency/topography combinations exhibited by each actor. Results showed that across the various habit conditions, the man with the habit was seen as less socially acceptable than the woman with the habit. In addition, low-frequency habit behaviors were more acceptable than high-frequency behaviors, and behaviors with mild topographies were more acceptable than those with severe topography habits. Motor tics were seen as more acceptable than vocal tics, Tourette's disorder, or trichotillomania. Implications and directions for future research are discussed.     

Evaluation of a cognitive-behavioural program for the management of chronic tic and habit disorders

The aim was to evaluate the efficacy of a manualized cognitive-behavioural program based on habit reversal for the management of chronic tic disorder (CTD) and habit disorder (HD). Forty-seven CTD and 43 HD received a 4-month treatment program. Thirty-eight (22 CTD, 16 HD) were placed on a waitlist control group, which subsequently received treatment. The treatment approach combined awareness training, relaxation (including modification of a tension-producing style of action), and habit-reversal training, with more general cognitive restructuring of anticipations linked to ticcing. Sixty-five percent of completers reported between 75 and 100% control over the tic. At 2-year follow-up, 52% rated 75-100% control. There were also significant changes post-treatment in measures of self-esteem, anxiety, depression and style of planning action. Successful tic/habit modification was associated in CTD and HD groups with successful change in style of planning action. There were no consistent differences in any outcome measures between CTD and HD groups.     

Exposure with response prevention versus habit reversal in Tourettes's syndrome: a controlled study

The intentional nature of tics provides the opportunity to apply behavioural interventions aimed at tic reduction through interruption of stimulus-response sequences. The aim of this study has been to evaluate the effect of exposure and response prevention (ER) versus habit reversal (HR) in 43 Tourette's syndrome (TS) patients. The three outcome measures were: the Yale Global Tic Severity Scale (YGTSS), 15-min tic frequency registrations monitored at the institute and 15-min home tic frequency registrations. Both treatment conditions resulted in statistically significant improvements on all outcome measures (p < 0.001). No significant differences were found between the treatment conditions on any of the outcome measures, although there was a tendency in favour of ER on the YGTSS (p = 0.05). These results suggest that, at least in the short term, TS tic symptoms can be treated effectively with both types of treatment.     

Prevention program for disturbed eating and body dissatisfaction in a Spanish university population: a pilot study

A pilot study was carried out in university students to evaluate the effect of a health promotion program for eating disturbances and body dissatisfaction. A subgroup of 135 medical students of both sexes in their second year was selected. There were divided in three groups, high-risk students (EDI > 40) and low-risk students (EDI < 40) who participated in the program and nonparticipants as comparison group. Program had a total of 16 workshops of 90 min. A year later the different assessment measurements were compared, body image, attitudes and eating behaviours, psychopathological levels and self-esteem. Differences by gender were found on the impact of the intervention. The program presented a statistical significant improvement in body-image satisfaction, eating attitudes only in high-risk female students in the intervention group. This pilot program for eating disorder prevention in university populations can be considered effective, mainly in female populations at risk for developing an eating disorder.     

Conversation and Communication by J. A. M. Meerloo

Recent research shows that adolescents are a high-risk group for HIV infection, and that educational campaigns designed to reduce risk taking concerning HIV/AIDS have been largely ineffective with this population. It is probable that irrational psychodynamic processes underlie this risky behavior. In order to explore these behaviors, a sample of low-risk high-school adolescents and one of high-risk institutionalized juvenile offenders were formed into small groups for psychodynamic group therapy. This article presents preliminary findings based on qualitative analysis of the group process. Several sources of participants' difficulties in forming realistic appraisals of HIV/AIDS risk and of acting in accordance with them were unidentified, especially attempts to cope with experiences of loss, developing sexuality, and sexual identity and changing relations with adults. Certain problems were developmentally salient with all adolescents, whereas others were especially marked for the high-risk population of developmentally disturbed adolescents.     

Users of different travel modes differ in journey satisfaction and habit strength but not environmental worldviews: A large-scale survey of drivers,walkers, bicyclists and bus users commuting to a UK university

People who travel to the same university workplace by bicycle, bus, car, and walking were compared in a survey (N = 1609). Data are presented on environmental worldviews, journey affective appraisals, and habit strength. Unexpectedly, findings showed comparable levels of environmental worldview across modes. This might reflect the role of attitudes on behaviour, or question the validity of the established environmental worldview scale used here. Results also replicated previous work on affective appraisal, and suggested that whilst walking, bicycling and bus use have distinctive affective appraisals associated with each mode, car driving was affectively neutral, generating no strong response on any dimension – a finding tentatively explained with reference to the normative status of driving. The survey also showed users of active travel modes reported stronger habit strength than car or public transport users, with possible links to the role of affect in formulating habit strength in line with habit theory.     

Whose Life Task Is It Anyway? Social Appraisal and Life Task Pursuit

The study uses a social contextual framework to examine how others are represented in individuals' life task appraisals and how such appraisals are related to strategies to pursue those life tasks. The extent to which life tasks nominated by 81 college students (45 females) were appraised as shared with others and pursued collaboratively was examined through a questionnaire. Participants listed five life tasks, indicated if each life task was theirs alone, indirectly shared (others were impacted by their life task pursuit), or directly shared (another person might also nominate the life task as theirs) with others in their lives, described three activities used to pursue their life tasks, and coded how others were involved inthese activities. Results indicated that the majority of college students' life tasks were appraised as involving others, that directly shared appraisals were found more frequently in the relationship domain, and that directly shared appraisals were associated with collaborative life task pursuit strategies. In addition, appraising life tasks as directly shared did not appear to reflect aspects of anxiety or compensation. A content analysis of the strategies coded as involving other individuals revealed diverse ways in which others are involved in life task pursuit ranging from active engagement of others to cognitive strategies where others are implied. The findings have implications for research on life tasks and other goal structures in that the structures may involve the social context in adaptive ways.     

Willingness to Use ADHD Self-Management: Mixed Methods Study of Perceptions by Adolescents and Parents

Little is known about perceptions surrounding self-management for attention deficit hyperactivity disorder (ADHD), although such interventions appear commonly used and are considered essential components of the chronic care model. Our research is part of a mixed methods study that followed students at high and low risk for ADHD over 11 years. During the final study years, area-representative samples of 148 adolescents (54.8 % participation; 97 ADHD high-risk group; 51 low-risk peers) and 161 parents (59.4 % participation; 108 parents of high-risk adolescent; 53 parents of low-risk peer) completed a cross-sectional survey on community-identified self-management interventions for ADHD (activity outlets, sleep regulation, dietary restriction, homework help, family rules, and prayer). Respondents also answered open-ended questions addressing undesirable self-management effects, which were analyzed using grounded theory methods. High-risk adolescents expressed significantly lower willingness towards all self-management interventions than did adult respondents, except for increased activity outlets. They also reported lower receptivity towards sleep regulation and dietary restriction than did their low-risk peer group. No gender or race differences in self-management willingness were found, except for higher receptivity to prayer in African American respondents. Cost, perceived ineffectiveness, disruptions to routines, causation of interpersonal conflicts, and reduced future self-reliance were seen as potential undesirable effects. Findings suggest that activity-based ADHD interventions appear particularly acceptable across all demographic and risk groups, unlike sleep regulation and dietary approaches. Further research on self-care effectiveness is needed to incorporate adolescents’ viewpoints about ADHD self-management, as interventions may be acceptable to adults, but resisted by adolescents.     

Using habit reversal to treat chronic vocal tic disorder in children

In the present study, a nonconcurrent multiple baseline design was used to evaluate the effectiveness of simplified habit reversal in three children diagnosed with chronic vocal tic disorder. In two children, vocal tics were substantially reduced. In a third child, tics were not reduced, and the addition of a supplemental contingency management program was ineffective. Despite these mixed results, the treatment was viewed as acceptable to the children's parents in all cases as measured by a standard index of treatment acceptability. Implications of these findings are discussed. Copyright © 2002 John Wiley & Sons, Ltd.     

An evaluation of behavioral treatments for Tourette syndrome.

The present study evaluated the effectiveness of self-monitoring, relaxation training and habit reversal in the treatment of 6 Tourette Syndrome (TS) subjects with multiple motor and vocal tics. A counterbalanced design was employed and tic frequencies were measured in the clinic setting using videotapes taken through a one-way mirror. Tics were reduced by an average of 55% with habit reversal, 44% with self-monitoring, and 32% with relaxation training and each behavioral procedure was the most effective treatment for at least one subject. All three treatment approaches may have some utility in the behavioral treatment of TS.     

Preparation and motor potentials in chronic tic and Tourette syndromes

Many studies have found that people with tic disorder show more difficulty when inhibiting an automated than a controlled response. Furthermore, although normal motor threshold and excitability are present, but reduced or impaired, motor inhibition seems manifest in patients with tic. In order to localize this inhibition impairment in tic disorder the present study examine two response-locked ERPs: the Bereitschaft (preparation BP) and the motor potentials (MP). The simple tic group showed faster BP latency and smaller amplitude than control and complex tic group and did not show a corresponding change in values with practice or with automated or controlled condition. The MP amplitudes revealed that whereas both controls and complex tic disorder showed a decrease in amplitude during control condition for both blocks, simple tic showed larger amplitude. Our ERP results are in agreement with RT results of a previous study. The explanation could lie with modulation in motor excitation inhibition circuits and seems worse in simple tics where the movements are more automatic and nonvoluntary.     

Community-based multiple-gate screening of children at risk for conduct disorder

The present study employed a multiple-gate screening procedure to identify children at risk for the development of conduct disorder. Measures of cross-setting disruptive behavior and parent discipline practices were administered in sequential fashion to screen a population of 7,231 children attending suburban elementary schools. Convergent validity of the respective gating measures was confirmed by significant correlations with adjustment constructs. Analyses of covariance performed between positive screens, negative screens, and low-risk comparison children on adjustment constructs at each gate supported the discriminative validity of the gating procedure. Hierarchical regression analyses demonstrated that the gating measures were predictive of diagnostic ratings of attention deficit hyperactivity disorder and oppositional defiant disorder that were obtained 18 months following the screening. A stepwise logistic regression analysis indicated that the best predictors of high-risk group membership were variables related to family process, including poor family communication and involvement, poor maternal coping skills, and an external parent locus of control.This study was supported by grant MH-46584 from the National Institute of Mental Health.     

Psychopathology in children of parents with recurrent depression

We examined the prevalence of psychopathology in children of parents with recurrent major depression (n=61)and children of normal control parents (n=46).Rates of psychopathology in the children of depressed parents were consistently higher when compared either with the control children or with rates of disorder reported for nonclinically referred children from other studies. Forty-one percent of high-risk children met criteria for at least one psychiatric disorder compared with 15% of low-risk children. Significant differences between groups were found for affective disorders and attention deficit disorder, and a nonsignificant trend was noted for anxiety disorder, all of which were more prevalent in the children of depressed parents.This work was supported, in part, by a W. T. Grant Foundation Faculty Scholar Award, No. 8308700.     

Motor impairment and antisocial behavior in adolescent males at high risk for schizophrenia

A familial link between schizophrenia and antisocial behavior has been established (e.g., Silverton, 1985). This study examined this relationship in a Danish cohort. The subjects were 36 high-risk males (offspring of a schizzophrenic parent) and 36 low-risk males (offspring of parents without psychopathology). This high-risk subjects exhibited more antisocial behavior than the low-risk subjects. We tested the hypothesis of a correlation between neurointegrative deficits, as defined by motor impairment, and antisocial behavior, rated at ages 10–13, in subjects at genetic risk for schizophrenia. Path analyses were conducted from motor impairment at 1 year and motor impairment at 10–13 years to antisocial behavior separately for high-risk and low-risk subjects. Adolescent motor impairment was a significant predictor of antisocial behavior for high-risk subjects. Motor impairment at 1 year was also associated with antisocial behavior for these subjects, although the association was partly due to the indirect effects of motor impairment at 1 year on motor impairment at 10–13 years, which, in turn, was associated with changes in antisocial behavior. As predicted, none of the path coefficients nor the effect coefficient was significant for low-risk subjects.     

Reactivity of Tic Observation Procedures to Situation and Setting

Tic frequency was assessed and compared across home and clinic as well as three experimentally-manipulated situations in order to assess the phenomenon of tic reactivity. Forty-three youngsters with chronic tic disorder recruited from two geographically-distinct sites were videotaped over three weekly laboratory visits under each of the following conditions: (1) alone/camera present, (2) other present/camera present, and (3) alone/camera hidden. Contrary to expectation, more tics were observed during overt as compared to covert observation, while the presence of another person had no overall impact on tic expression. Mean tic counts obtained from clinic observation did not significantly differ from those obtained at home collected either one day before or after. Tic frequency counts were remarkably stable over the three weekly assessments both at home and clinic. Study findings are consistent with past observations that tic expression can be influenced by environmental factors and suggest the stability of tic frequency may exhibit greater temporal and setting stability than previously thought. The clinical and research implications of these results are discussed.     

Modeling growth in boys' aggressive behavior across elementary school: links to later criminal involvement, conduct disorder, and antisocial personality disorder

The present study used general growth mixture modeling to identify pathways of antisocial behavior development within an epidemiological sample of urban, primarily African American boys. Teacher-rated aggression, measured longitudinally from 1st to 7th grade, was used to define growth trajectories. Three high-risk trajectories (chronic high, moderate, and increasing aggression) and one low-risk trajectory (stable low aggression) were found. Boys with chronic high and increasing trajectories were at increased risk for conduct disorder, juvenile and adult arrest, and antisocial personality disorder. Concentration problems were highest among boys with a chronic high trajectory and also differentiated boys with increasing aggression from boys with stable low aggression. Peer rejection was highest among boys with chronic high aggression. Interventions with boys with distinct patterns of aggression are discussed.     

An Inference-Based Approach to Treating Obsessive-Compulsive Disorders

This article outlines the conceptual and empirical basis for an inference-based approach (IBA) to treating obsessive-compulsive disorder (OCD). The IBA considers that in most cases the obsessional process begins with an initial doubt (e.g., “Maybe my hands are not clean”; “Perhaps the door was not locked”; “There's a chance I made an error”; “I could have harmed someone”) and that this doubt is a product of invalid reasoning. The IBA focus on initial doubt adds an extra upstream dimension to the current cognitive behavior therapy (CBT), which targets downstream appraisals, following on from the initial intrusion. Hence the aim of inference-based therapy (IBT) is to modify the reasoning narrative producing the doubt, and to return the person to the world of commonsense perception. IBT complements existing CBT and a case study illustrates the application of the IBT protocol. The IBA may be particularly useful in cases where belief in the initial probability of an obsessional doubt is strongly held and/or where consequences or appraisals following the doubt are absent or minimally associated with distress.     

EFFECTS OF ALCOHOL INTOXICATION AND VICTIMIZATION HISTORY ON WOMEN'S SEXUAL ASSAULT RESISTANCE INTENTIONS: THE ROLE OF SECONDARY COGNITIVE APPRAISALS

This study used an experimental paradigm to investigate the role of secondary cognitive appraisals in women's sexual assault resistance and whether these appraisals mediated influences of alcohol and prior victimization. After consuming a beverage (control, placebo, moderate, or high dose), 351 women projected themselves into a simulated interaction with a sexually aggressive man. Four types of secondary appraisals (shock at the man's behavior, concern about his feelings, uncertainty in the situation, conflict about what to do) and three resistance strategies (assertive, polite, passive) were examined. Path modeling revealed that, as expected, intoxication and prior sexual victimization influenced secondary appraisals, which in turn influenced intended resistance. Prior adult sexual assault (ASA) and childhood sexual abuse (CSA) also had direct effects: ASA negatively predicted assertive resistance and CSA positively predicted passivity. Findings suggest that secondary appraisals are key targets for intervention to facilitate effective resistance, thereby reducing the risk of adult sexual victimization.     

Ingroup Versus Outgroup Perceptions of the Characteristics of High-Risk Youth: Negative Stereotyping1

Adolescents tend to categorize themselves and their peers into discrete ingroups and outgroups. A comparison of ingroup versus outgroup perceptions of the characteristics of high-risk youth was investigated. Based on current stereotype research, we examined the perspective that outgroup members would hold a more extreme stereotype of high-risk youth compared to the perceptions of ingroup members. A total of 955 7th- and 10th-grade southern California adolescents completed a questionnaire regarding the characteristics of their own peer group and a high-risk group. Support was obtained for an extremity of judgement effect. Outgroup youth perceived that their high-risk peers engaged in fewer school and nonschool low-risk activities, more high-risk activities, and greater drug use than did ingroup members. Outgroup members also held perceptions of high-risk youth as less likely to hold a white-collar job than did the ingroup members. The perceptions that adolescents have of these groups may play major roles in their own social behavior. The implications of these results for future tobacco use prevention programs are considered.     

Automatic and controlled processing in chronic tic disorders

The study compared controlled and automatic processing in 17 people diagnosed with chronic tic disorder (CTD), 20 with habit disorder (HT), and 30 screened controls. Using a countermanding paradigm, time to initiate a response (GO-time) was compared with time taken to inhibit a response (STOP-time) under automated and controlled response conditions. The signals were 2 sets of traffic-light-like computer displays with ready, go, and stop lights. The automated response was a repetitive series of taps and the controlled response was a morse code pattern of taps. There were no group differences in GO time under any conditions. The control group but not the HD or CTD groups showed a significant practice effect over time. The CTD group was significantly slower to STOP the automated than the controlled response. The results suggest that the CTD group had specifically, greater difficulty inhibiting automated than controlled actions.