John Keown: Euthanasia,ethics and public policy: an argument against legalisation, 2nd edition

Theoretical Medicine and Bioethics -     

Eating patterns and breakfast consumption in obese patients with binge eating disorder

This study examined eating patterns and breakfast consumption, and their relationships to weight and binge eating, in obese individuals with binge eating disorder (BED). One-hundred seventy-three consecutively evaluated men (n=46) and women (n=127) with BED were administered semi-structured interviews and self-report measures to assess the frequency of meals and snacks eaten, as well as binge eating and eating disorder features. Overall, those who consumed more frequent meals, particularly breakfast, and snacks, weighed less. Breakfast, which was eaten on a daily basis by less than half of participants (n=74; 43%), was the least frequently eaten meal of the day. Participants (n=56; 32%) who ate three meals per day weighed significantly less, and had significantly fewer binges, than participants (n=117; 68%) who did not regularly eat three meals per day. Thus, eating more frequently, having breakfast and consuming three meals every day, have potentially important clinical applications for the treatment of BED given that the effectiveness of specific interventions within treatments for BED are unknown, and that weight loss outcome for BED has been poor.     

Prediction of drug and alcohol abuse in hospitalized adolescents: comparisons by gender and substance type

The authors examined psychosocial correlates of drug and alcohol abuse in 462 hospitalized adolescents, and the extent to which these associations may be affected by gender or by substance type. Participants completed a battery of psychometrically-sound, self-report measures of psychological functioning, environmental stress, drug abuse, and alcohol abuse. Four multiple regression analyses were conducted to determine the joint and independent predictors of drug abuse and alcohol abuse, for males and for females. Multiple regression analysis revealed that seven variables--age, depression, impulsivity, low self-esteem, delinquent predisposition, low peer insecurity, and history of child abuse--jointly predicted both drug and alcohol abuse, for both males and females. However, several differences were found with respect to which variables made independent contributions to the predictive models--with only delinquent predisposition making a significant independent contribution for all four conditions. We found distinct patterns of psychosocial predictor variables for drug and alcohol abuse, as well as distinct patterns for males and females. These results may reflect differing risk factors for drug abuse and alcohol abuse in adolescent psychiatric patients--and differing risk factors for males and females. Such differences have potential implications for prevention and treatment.     

Acculturation, parent-adolescent conflict, and adolescent adjustment in Mexican American families

We tested an acculturation model in a community sample of Mexican American families (146 mothers, 137 fathers, and 146 adolescents) that proposed that differences between parents and adolescents in acculturation would be associated with parent-adolescent conflict and adolescent adjustment problems. Contrary to hypotheses, we found that families who exhibited an acculturation gap were not more likely to report parent-adolescent conflict or adolescent adjustment problems. In fact, familial conflict and adolescent sexual experience were associated with high levels of acculturation among adolescents and their parents. Pending replication, these findings suggest that both parent and children acculturation may independently predict familial processes and youth outcomes, irrespective of an acculturation gap. Future research should consider other factors aside from acculturation differences that might account for parent-adolescent conflict and adolescent adjustment in Mexican American families.     

Bias in visual attention behavior in a normal school-aged population

Hemi-field visual-spatial attention was studied on a timed letter cancellation task in proficient readers from 7th to 9th grades. Participants maintained greater accuracy in identifying targets in the left quadrants (top/bottom) when compared with the right quadrants (top/bottom), revealing a leftward bias in their responses. Effects of gender and age were evident on performance; females scored significantly higher than males, and 9th graders scored significantly higher than 7th and 8th graders. Thus, a substantial shift in brain maturation may take place from 8th to 9th grades or from the ages of 13.0 to 14.11. Discriminative characteristics of the task are analyzed by assigning greater value to targets located in the top left quadrant. The 9th graders, as compared to the younger students, and the girls, as compared to the boys, evidenced a reading-direction-related bias toward systematic preference for the upper-left to lower-right quadrants.     

Constraint, alcoholism, and electrodermal response in aversive classical conditioning and mismatch novelty paradigms

This study investigated whether low levels of the personality trait of constraint and early-onset alcoholism would be associated with deficits in aversive conditioning and smaller responses to novelty in a stimulus mismatch protocol. Personality traits (constraint and socialization) and skin conductance responses (SCRs) during conditioning and novelty paradigms were assessed in alcoholics (n=41) and non-alcoholics (n=32). The conditioning protocol involved measuring SCRs after conditioned stimuli (CS+: tones) paired with shock, CS− tones unpaired with shock, and CS+ probes unpaired with shock. The mismatch protocol involved measuring SCRs to auditory stimuli consisting of a series of 5 pure tones of the same pitch followed a shorter white noise stimulus (the novel stimulus). Contrary to the hypothesis, alcoholics did not differ from non-alcoholics in SCRs to CS+ probes or on the mismatch measure (SCR novel tone—SCR to 5^th tone). Higher levels of constraint and self-reports of fear during conditioning were associated with smaller responses to both the CS+ probes and the CS− tones as well as the mismatch measure within non-alcoholics, but not within alcoholics. In alcoholics, low constraint was associated with greater habituation to CS+ probes, and poor differential conditioning on measures of change across trials in SCR to CS+ probes and CS− stimuli. The results suggest that different processes influence levels of constraint in non-alcoholics and alcoholics. The data indicate that low constraint in non-alcoholics is associated with allocating fewer processing resources to potentially significant stimuli, rather than being associated with a specific deficit in aversive conditioning per se.     

Perceived neighborhood environments and physical activity in an elderly sample

Increasing evidence indicates the importance of environmental variables in explaining physical activity. This study evaluated sex differences in perception of home and neighborhood environmental support and assessed which neighborhood environmental variables were associated with reported physical activity of elderly people. A sample of 126 women (M age = 79.1 +/- 6.6 yr.) and 55 men (M age = 76.6 +/- 7.7 yr.) were healthy, community-dwelling individuals. A questionnaire about environmental variables was administered. Physical activity was assessed on the Baecke Questionnaire. Logistic regression analysis showed that Neighborhood Safety was related to total physical activity, activity in leisure time, and sport activities. Men were also likely to be more active in leisure time than women. Neighborhood Personal Safety was associated with physical activity of these elderly people, showing a potential influence of the environmental domain in physical activity.     

The Relations of Effortful Control and Impulsivity to Children's Sympathy: A Longitudinal Study

The relations of children's (n = 214 at Time 1; M age = 6 years at Time 1) dispositional sympathy to adult-reported and behavioral measures of effortful control (EC) and impulsivity were examined in a longitudinal study including five assessments, each two years apart. Especially for boys, relatively high levels of EC and growth in EC were related to high sympathy. Teacher-reported impulsivity was generally modestly negatively related to measures of teacher-reported sympathy for boys, and a decline in impulsivity was linked to boys’ sympathy. Some findings suggested a positive association between impulsivity and children's self-reported sympathy. EC, especially when reported by teachers, was more often a unique predictor of sympathy than was impulsivity. Results generally support the argument that sympathetic individuals, especially boys, are high in EC and that EC is a more consistent predictor of sympathy than impulsivity.