A Behavioural Medicine Approach to the Analysis and Treatment of Childhood Asthma

Abstract

Despite significant medical breakthroughs over the past decade in the discovery of the causes and treatment of asthma, clinical control of the illness has not improved. On the contrary, evidence suggests an increase in the prevalence and severity of childhood asthma. There is a consensus that learning factors influencing the development of symptoms must be understood and integrated into a total asthma management programme in order to ocor1ain optimal treatment results. The behavioural medicine approach focuses on helping the child and family recognize the constellation of risk factors which trigger attacks, develop constructive coping strategies for dealing with the attacks and develop healthy social skills regarding the asthma. The present paper presents an overview of the theoretical underpinnings of the behavioural medicine approach to childhood asthma, and a case study showing its practical applications.     

A review of abnormalities in the perception of visual illusions in schizophrenia

Specific abnormalities of vision in schizophrenia have been observed to affect high-level and some low-level integration mechanisms, suggesting that people with schizophrenia may experience anomalies across different stages in the visual system affecting either early or late processing or both. Here, we review the research into visual illusion perception in schizophrenia and the issues which previous research has faced. One general finding that emerged from the literature is that those with schizophrenia are mostly immune to the effects of high-level illusory displays, but this effect is not consistent across all low-level illusions. The present review suggests that this resistance is due to the weakening of top–down perceptual mechanisms and may be relevant to the understanding of symptoms of visual distortion rather than hallucinations as previously thought.     

Looking Fat or Being Bad? Effects of Body Size and Eating Style on Peer Evaluation in Adolescents

The present study examined adolescents' peer evaluations when information about body size (normal vs. overweight) and eating style (healthy vs. unhealthy) was provided. A study was conducted with a sample of 90 adolescents. Adolescents judged their peers on information about body size, but also about their eating style. The effect of body size was qualified by gender: Male adolescents were more positive about normal body weight peers, whereas females did not distinguish between normal weight and overweight peers. The results imply that not only are the consequences of unhealthy eating important; the behavior itself is also important. This holds promise for addressing adolescents' eating behavior.     

ENFRANCHISING INCOMPETENTS: SURETYSHIP AND THE JOINT AUTHORSHIP OF LAWS

Proposals to lower the age of voting, to 15 for example, are regularly met with worries that people that age are not sufficiently ‘competent’. Notice however that we allow people that age to sign binding legal contracts, provided that those contracts are co‐signed by their parents. Notice, further, that in a democracy voters are collectively ‘joint authors’ of the laws that they enact. Enfranchising some less competent voters is no worry, the Condorcet Jury Theorem assures us, so long as the electorate's competence averaging across all voters remains better‐than‐random.     

Changes in need satisfaction and motivation orientation as predictors of psychological and behavioural outcomes in exercise referral

Employing Self-Determination Theory (Deci & Ryan, 1985) as a theoretical framework, this study examined psychological need satisfaction and motivational regulations as predictors of psychological and behavioural outcomes in exercise referral (ER). ER patients (N?=?293; mean age 54.49) completed the measures of motivational regulations, psychological need satisfaction, health-related quality of life, life satisfaction, anxiety, depression and physical activity at entry, exit and 6 months following the end of a supervised exercise programme. Change in (Δ) intrinsic motivation during the scheme significantly predicted adherence and Δ habitual physical activity. Δ psychological need satisfaction from entry to exit significantly predicted Δ habitual physical activity from exit to 6-month follow-up. Δ psychological need satisfaction significantly predicted Δ motivational regulation and Δ psychological outcomes. Contrary to expectations, Δ self-determined regulation did not significantly predict Δ psychological outcomes during the structured part of the scheme, however, it did significantly predict Δ in psychological outcomes from exit to 6-month follow-up. These findings expand on cross-sectional research to demonstrate that psychological need satisfaction during supervised ER longitudinally predicts motivational regulation and psychological outcomes up to 6 months after a structured programme.     

Cognitive-behavioural health-promotion intervention increases fruit and vegetable consumption and physical activity among South African adolescents: a cluster-randomised controlled trial

Rates of chronic diseases are high among Black South Africans but few studies have tested cognitive-behavioural health-promotion interventions to reduce this problem. We tested the efficacy of such an intervention among adolescents in a cluster-randomised controlled trial. We randomly selected 9 of 17 matched pairs of schools and randomised one school in each pair to the cognitive-behavioural health-promotion intervention designed to encourage health-related behaviours and the other to a human immunodeficiency virus (HIV)/sexually transmitted disease (STD) risk-reduction intervention that served as the control. Interventions were based on social cognitive theory, the theory of planned behaviour and qualitative data from the target population. Data collectors, blind to participants' intervention, administered confidential assessments at baseline and 3, 6 and 12 months post-intervention. Primary outcomes were fruit and vegetable consumption and physical activity. Participants were 1057 grade 6 learners (mean age = 12.4 years), with 96.7% retained at 12-month follow-up. Generalised estimating equations revealed that averaged over the follow-ups, a greater percentage of health-promotion intervention participants than HIV/STD control participants met 5-a-Day fruit and vegetable and physical activity guidelines. The intervention also increased health-promotion knowledge, attitude and intention, but did not decrease substance use or substance-use attitude and intention. The findings suggest that theory based and contextually appropriate interventions may increase health behaviours among young adolescents in sub-Saharan Africa.     

Social desirability and self-reported driving behaviours: Should we be worried?

There is widespread use of self-report measures of driving behaviour in the traffic psychology literature, despite the frequent criticism that such measures are subject to social desirability bias. However, no research has yet investigated the more recently developed measures of driving anxiety and avoidance behaviour for socially desirable responding. Furthermore, relatively little research has investigated the issue of socially desirable responding on self-reported driver behaviour in general, and that which does exist has several shortcomings. The present study used a repeated measures design to assess the effect of social desirability on a measure of driving avoidance, the Driving and Riding Avoidance Scale (DRAS), and the Driver Behaviour Questionnaire (DBQ). A sample of 228 undergraduate students completed the DRAS, DBQ and a measure of socially desirable responding in class, which constituted a public place, and then again 2 months later in the privacy of their homes. None of the DBQ items were significantly different across the two locations. However, two of the DRAS general avoidance items were higher in the public setting, perhaps demonstrating the effect of socially desirable responding on driving avoidance due to environmental or practical concern. Nevertheless, overall it appears as though the DRAS and DBQ are not particularly vulnerable to socially desirable responding, although further well-designed research on the effects of such bias on these and other self-report measures of driving behaviour should be undertaken.     

Who Will See Me? The Impact of Type of Audience on Willingness to Display Group‐Mediated Attitude–Intention Consistency

The present study examined the role that group norms, group identification, and imagined audience (in-group vs. out-group) play in attitude–behavior processes. University students ( N =187) participated in a study concerned with the prediction of consumer behavior. Attitudes toward drinking their preferred beer, subjective norm, perceived behavioral control, group norm, and group identification were assessed. Intentions and perceived audience reactions to consumption were assessed. As expected, group norms, identification, and imagined audience interacted to influence likelihood of drinking one's preferred beer and perceived audience reactions. High identifiers were more responsive to group norms in the presence of an in-group audience than an out-group audience. The present results indicate that audience concerns impact upon the relationship between attitudes and behavior.     

Pharmacologic and Behavioral Withdrawal From Addictive Drugs

ABSTRACT— Recent theories suggest that drug withdrawal does not motivate drug use and relapse. However, data now show that withdrawal produces complex changes over time in at least two symptoms (i.e., negative affect and urges) that are highly predictive of relapse. Evidence suggests that falling levels of the drug in the blood and interruption of the drug self-administration ritual both affect these symptoms. Both of these forms of withdrawal motivate renewed drug use in addicted individuals.