Predictors of short-term treatment outcome in bulimia nervosa inpatients.

Recent studies, mostly performed on bulimic outpatients, did not find consistent predictors of treatment outcome in bulimia nervosa. This is the first study to investigate anamnestic and clinical factors predictive of the short-term outcome of hospital treatment in 31 female bulimia nervosa patients with a mean age of 22.9 yr. Treatment outcome was assessed by several self-rating instruments measuring different features of the specific and unspecific psychopathology of bulimia nervosa. The most relevant predictors of the outcome of the 8-week hospital treatment were duration of previous inpatient treatments for bulimia, the intensity of anorexic tendency and the pretreatment level of depression. The majority of predictors tested did not show a strong relationship to treatment outcome. The findings are discussed in relation to results of other studies as well as to possible implications for treatment and research.     

Cue-exposure vs self-control in the treatment of binge eating: a pilot study.

From a recent theory on the learned nature of craving responses and binge eating, it follows that craving will extinguish when the CS-US bond is broken by prolonged exposure to the cues predicting excessive food intake with response prevention. The present authors treated six obese bulimics with cue exposure and response prevention. Six other patients learned to avoid or escape the binge-related cues with the aid of self control techniques. Although both treatments appeared to be effective in reducing the binge frequency, a most remarkable finding of the present study is that all patients treated by cue exposure were abstinent, directly after treatment and during the 1 yr follow-up. In contrast to the 100% binge-free subjects treated by cue exposure, self control techniques and relapse prevention led to abstinence in merely 33% of the subjects.     

Emergenesis. Genetic traits that may not run in families.

Traits that are influenced by a configuration--rather than by a simple sum--of polymorphic genes may not be seen to be genetic unless one studies monozygotic twins (who share all their genes and thus all gene configurations) because such "emergenic" traits will tend not to run in families. Personal idiosyncrasies that have been found to be surprisingly concordant among MZ twins separated in infancy and reared apart may be emergenic traits. More speculatively, important human traits like leadership, genius in its many manifestations, being an effective therapist or parent, as well as certain psychopathological syndromes may also be emergenic. These ideas reemphasize the importance of the role played in human affairs by genetic variation.     

Scientific rewards and conflicts of ethical choices in human subjects research.

The primary responsibility of the American Psychological Association's (APA) Committee on Standards in Research (CSR) is to advise the APA on issues and standards related to the protection of human participants in psychological research. A related goal is to enhance the use of good ethical practices by APA members. The purpose of this article is to foster the view of research ethics not as an affront to the integrity of sound research, but as opportunities for scientific rewards, including increased understanding of the meaning of data, enhanced recruitment, and the inclusion of more representative samples. Three ethical practices are discussed as examples of this general premise: respect for confidentiality, use of debriefing, and assurance that participants are noncoerced volunteers. The Committee's intent is to promote consideration of these issues, not to promulgate specific guidelines or procedures.     

COMPARISON OF STAFF TRAINING STRATEGIES TO PROMOTE GENERALIZED TEACHING SKILLS

Two studies compared the effectiveness of different strategies for promoting generalization of staff skills in teaching self-care routines to clients with developmental disabilities. In Study 1, 9 direct-care staff members of group homes were trained sequentially through four conditions: (a) the provision of written instructions, (b) performance-based training using a single client program exemplar and simulated clients (single case training), (c) performance-based training using actual developmentally delayed clients as trainees (common stimuli training), and (d) performance-based training using multiple client program exemplars with simulated clients (general case training). The results indicated that staff members did not reach all generalization criteria until general case training was provided. Because staff members had been trained sequentially through several conditions in Study 1, a second study controlled for potential sequence effects. In Study 2, 7 staff members were trained using only the general case strategy after baseline. All staff members reached generalization criteria with only general case training, replicating the findings of Study 1. Together, the two studies demonstrated that the general case training strategy was more effective at promoting generalized training effects across clients, settings, and client programs than other commonly used staff training approaches.     

PROMOTING LAW ENFORCEMENT FOR CHILD PROTECTION: A COMMUNITY ANALYSIS

The Colorado Occupant Protection Project (COPP) intervention provided police with brief instruction concerning the importance of citations for drivers' failure to use child safety seats and special coupons to accompany citations. Coupons were exchangeable by drivers for a safety seat and brief training in its use, plus a waiver of the $50 citation fine. Over 4.5 years of archival records were employed, using an ABA design and a comparison community to evaluate the program. Few tickets were issued for nonuse of safety seats during the 3-year baseline in either community. Citations for nonuse of safety seats increased to over 50 per month during the intervention period at the test site, whereas rates remained essentially zero at the comparison site. After the COPP intervention was removed at the intervention site, citation rates for nonuse of safety seats decreased to about 15 per month. Differences between intervention conditions and settings were statistically significant. During the intervention, officers were 44 times more likely to write citations than were controls. Results suggested that a behavioral program can increase police citation writing for child protection purposes.     

The meaning of occupational stress items to survey respondents.

This study tested the effect of using the word stress in the measurement of self-reported occupational stressors and strains. Employees from two organizations responded to a questionnaire that included specific occupational stressors, strains, and 16 items in which the word stress was used. Survey respondents tended to interpret the word stress to refer both to employees' strains or reactions to the work environment and to job stressors or elements of the environment itself. Implications of these findings for occupational stress research are discussed.     

Effects of alcohol intoxication on risk taking, strategy, and error rate in visuomotor performance.

Adult men (N = 44) participated for 2 days (alcohol vs. placebo treatment) in a double-blind, crossover experiment. Performance on the Digit Symbol Substitution Task (DSST) and a visuomotor (VM) task was measured 4 times each day. On the alcohol-treatment day, data were obtained once during ascending breath alcohol levels (BALs), once during maximal BALs (0.05 or 0.10), and twice during descending BALs. Data were collected at the same time points on the placebo-treatment day. Limited evidence for acute tolerance was obtained with the DSST, but error rates on the VM task were higher during maximal and descending BALs. Error rates remained near placebo values, and participants displayed slightly greater caution, while BALs were ascending. Strategy scores on the VM task exceeded placebo scores during maximal intoxication. Data interpretation is focused on individuals in higher level (e.g., professional) positions.