Perceived Health Barriers and Health Value in Seniors: Implications for Well-Being and Mortality1

There is growing evidence to suggest that the ways in which people think about their health problems may have significant implications for psychological and physical well-being. This possibility has the greatest consequences for those groups facing health problems on a daily basis, in particular, the elderly. This study examined the role of perceived health barriers and value for health in later life. A Perceived Health Barriers (absent, present) by Health Value (low, medium, high) 2.3 factorial design was analyzed for younger and older seniors on: number of life-threatening diseases, need for health care, and life satisfaction. In addition, a longitudinal design was used to examine the joint roles of perceived health barriers (PHBs) and health value (HV) on mortality. Findings generally indicated that individuals’ PHBs and HV are associated with health-related outcomes; however, the results differed for young and old elders. Among young elders, those with PHBs and those with high HV had the most negati e profile. That is, they had more diseases, higher health care needs, and lower life satisfaction. Among older elders, the findings were more complicated in that the relationship between PHB and the outcomes depended on HV. Overall, the patterns for old elders suggest that perceived health barriers are most relevant among those with medium value for health and least relevant among those with low value for health.     

EXPERIMENTAL ANALYSIS AND TREATMENT OF MULTIPLY CONTROLLED SELF-INJURY

A functional analysis of the self-injurious behavior (SIB) of 3 adults with profound developmental disabilities showed that each engaged in SIB in more than one assessment condition. Such outcomes may result from a failure to isolate the variable maintaining SIB, or they may reflect multiple sources of control over SIB. In order to identify more clearly the determinants of SIB, each subject was exposed to a series of treatments appropriate to one or both of the apparent functions of SIB. These treatments, applied sequentially on baselines appropriate to each behavioral function, identified the maintaining variables for SIB through differential outcomes across baselines. Results indicated that the SIB of 2 subjects was multiply controlled, confirming the outcomes of the functional analysis. However, the SIB of the 3rd subject was eliminated using a treatment designed for a single function, suggesting spurious results of the original assessment. Alternative interpretations of undifferentiated assessment data are discussed, as are analysis and treatment issues related to multiply determined behavior disorders.     

INCREASING CALORIE CONSUMPTION IN CHILDREN WITH CYSTIC FIBROSIS: REPLICATION WITH 2-YEAR FOLLOW-UP

Three mildly malnourished children with cystic fibrosis and their parents participated in a behavioral group-treatment program that focused on promoting and maintaining increased calorie consumption. Treatment included nutritional education, gradually increasing calorie goals, contingency management, and relaxation training, and was evaluated in a multiple baseline design across four meals. Children's calorie intake increased across meals, and total calorie intake was 32% to 60% above baseline at posttreatment. Increased calorie consumption was maintained at the 96-week follow-up (2 years posttreatment). The children's growth rates in weight and height were greater during the 2 years following treatment than the year prior to treatment. Increases in pace of eating and calories consumed per minute were also observed 1 year posttreatment. These findings replicated and extended earlier research supporting the efficacy of behavioral intervention in the treatment of malnutrition in children with cystic fibrosis.     

Momentary maximizing in concurrent schedules with a minimum interchangeover interval

Eight pigeons were trained on concurrent variable-interval variable-interval schedules with a minimum interchangeover time programmed as a consequence of changeovers. In Experiment 1 the reinforcement schedules remained constant while the minimum interchangeover time varied from 0 to 200 s. Relative response rates and relative time deviated from relative reinforcement rates toward indifference with long minimum interchangeover times. In Experiment 2 different reinforcement ratios were scheduled in successive experimental conditions with the minimum interchangeover time constant at 0, 2, 10, or 120 s. The exponent of the generalized matching equation was close to 1.0 when the minimum interchangeover time was 0 s (the typical procedure for concurrent schedules without a changeover delay) and decreased as that duration was increased. The data support the momentary maximizing theory and contradict molar maximizing theories and the melioration theory.     

Unit price as a useful metric in analyzing effects of reinforcer magnitude.

In this paper, we applied the behavioral-economic concept of unit price to the study of reinforcer magnitude in an attempt to provide a consistent account of the effects of reinforcer magnitude on behavior. Recent research in the experimental analysis of behavior and in behavioral pharmacology suggests that reinforcer magnitude interacts with the schedule of reinforcement to determine response rate and total consumption. The utility of the unit-price concept thus stems from its ability to quantify this interaction as a cost-benefit ratio (i.e., unit price = characteristics of the schedule of reinforcement divided by magnitude of reinforcement). Research employing the unit-price concept has shown that as unit price increases, a positively decelerating function exists for consumption (i.e., a function with an increasingly negative slope, when plotted on log coordinates) and a bitonic function exists for response rate. Based on these findings, the present analysis applied the unit-price concept to those studies of reinforcer magnitude and drug self-administration that examined the effects of reinforcer magnitude on response rate using simple schedules of reinforcement (e.g., fixed-ratio schedule). This resulted in three findings: (a) Reinforcer-magnitude manipulations and schedule manipulations interact in a manner that can be quantified in terms of unit price as benefit and cost factors, respectively; (b) different reinforcer-magnitude manipulations are functionally interchangeable as benefit factors in the unit-price ratio; and (c) these conclusions appear warranted despite the differences in reinforcers (food or drug), species (dogs, monkeys, or rats), and schedules (interval or ratio), and despite the fact that these studies were not designed for a unit-price analysis. In methodological terms, these results provide further evidence that employing the unit-price concept is a parsimonious method for examining the effects of reinforcer magnitude. In theoretical terms, these results suggest that a single process may underlie the effect of combined reinforcer-magnitude and schedule manipulations.     

Hypermnesia in free recall and cued recall

In three experiments, categorized lists and both free recall and cued recall tests were used to examine hypermnesia. In Experiment 1, materials were drawn from obvious and nonobvious categories in an attempt to vary the amount of relational processing at encoding. The study materials in Experiment 2 consisted of a long word list that comprised several exemplars from each of a number of common categories. In Experiment 3, a single exemplar was drawn from each of 45 categories. In each experiment, similar magnitudes of hypermnesia were obtained on free and cued recall tests. Examination of the specific items recalled across tests indicated that similar processes underlie the hypermnesic effect for both test conditions. Implications of the results for extant accounts of the hypermnesic effect are discussed. It is concluded that the dynamics of retrieval processes change in a systematic fashion across repeated tests and the retention interval following study and that an adequate account of the nature of these changes in retrieval dynamics is essential to our understanding of hypermnesia and related phenomena.     

Sensitivity of persons with hearing impairment to visual emotional expression — compensation or deficit?

The research examined whether subjects with hearing impairment would differ from normal hearing subjects in their ability to decode emotions from video stimuli (48 video takes in which two actors portrayed six different emotions). Studies in tactile and visual perception lead one to expect deficits, while there is also some evidence for compensation. Twenty-six subjects with hearing impairment and 26 matched normal hearing subjects participated (average age = 25.5 years; nine female, 17 male subjects in each group). Results indicate that in general subjects with hearing impairment were slightly less successful in decoding emotions from the visual stimuli than the normal hearing subjects. A comparison between highly (loss > 60–90 dBA) and moderately (loss about 30–60 dBA) impaired subjects on the other hand indicated poorer emotion decoding only for the moderately impaired group. Post-hoc analyses indicated that these effects were specific to males. Results are discussed with respect to compensation versus deficit, and with respect to issues of training.