Cardiovascular reactivity to psychological stress in aerobically trained versus untrained mild hypertensives and normotensives

Cardiovascular reactivity to video game and mental arithmetic stressors was compared among three groups of men: aerobically trained mild hypertensives, untrained mild hypertensives, and a comparison group of untrained normotensives. Relative to the untrained hypertensives, the trained hypertensives reacted to the video game with marginally smaller systolic blood pressure and diastolic blood pressure, but there were no significant differences between these groups in reactivity during the mental arithmetic task. Comparisons between each hypertensive group and the normotensive group showed that blood pressure (BP) reactivity of normotensives during the video game was generally similar to that of trained hypertensives but smaller than that of untrained hypertensives. These results indicate that aerobic training, which has been found to reduce resting BP in mild hypertensives, may also exert a favorable impact in reducing cardiovascular reactivity of hypertensives during some stressful situations.     

The Dynamic Nature of Goals and Message Production as Revealed in a Sequential Analysis of Conflict Interactions

Although message‐production theories often assume that goals behave dynamically to direct communication behavior, few studies consider the interconnectedness of goals and behavior throughout interactions. Here, the interrelationship of communication goals and tactics was examined through a sequential analysis of 47 conflict interactions between close friends or dating partners. It was posited that for both the initiators and resistors in a conflict, the importance of relational or other‐identity goals would be associated with the use of integrative tactics and the importance of instrumental or self‐identity goals would be related to the use of distributive tactics. We examined these predictions within and across partners. Analyses indicated that for both conflict initiators and resistors, the importance of a combination self/instrumental goal predicted the use of distributive tactics and the importance of an other‐identity goal lead to partner‐oriented tactics. For resistors, the importance of an instrumental goal was associated with the use of distributive tactics and the importance of a combination identity/relational goal was aligned with issue‐oriented tactics as well. Across partners, several significant patterns between one partner’s use of distributive or integrative tactics and the other partner’s goals were observed. Implications of the results for understanding conflict and message production are discussed.     

The Heart of the Matter: An Essay about the Effects of Managed Care on Family Therapy with Children*

This essay is based on a pilot study that examined the effects of managed care on the treatment of children and families, with special attention to community mental health. We embarked on the pilot study to test the accuracy and generalizability of our impression that family therapy and other systemic practices have been marginalized in ordinary clinics and agencies, and to understand the reasons why. We interviewed managed care providers, researchers, family therapy trainers, and clinicians in the Northeast. Our findings led to seven themes that support our impression that, even though there is a consensus about the need for coordinated family-based services, there is a disconnection between state policies, contractual requirements and what is actually occurring at the implementation level. This study suggests that our knowledge of human systems may be in danger of being disqualified and lost, with damaging consequences for the care of children. Yet, as systemic thinkers and practitioners, it is our belief that ethical and effective treatment need not be at odds with care that is cost-efficient. The direction of our future research will be to study whether the involvement of all stakeholders at all levels of planning and training leads to systemic family-based practices that consistently save costs and provide high-quality care.     

Characteristics of adolescents at risk for compulsive overeating on a brief screening test

As part of a large survey of addictive behavior in high school students, 43% of a sample of 278 (26% of the males, 57% of the females) scored above the cutoff point set by Overeaters Anonymous on their scale for assessing compulsive overeating. While this at-risk group did not report poorer general adjustment, health, or school achievement than did the students not at risk, they did significantly more often perceive their life quality and relationship with the person closest to them as less positive. The at-risk subsample indicated the defensive effectiveness of overeating in their significantly more frequent report of dissociative experiences while eating, and less severe ratings of insecurity, worrying, and daydreaming. One of the most salient findings was the at-risk students' more frequent report of addictive problems in their parents (overeating, alcohol and drug use, and gambling).     

Somatic response to stress, physical symptoms and health service use: The role of current stress

The study examined physical symptoms and health service utilization of subjects high or low on a measure of the tendency to experience stress somatically and high or low on a measure of current stress. High somatic responders reported greater numbers of symptoms than low somatic responders regardless of stress level. However, high somatic responders who were experiencing high levels of current stress reported significantly more symptoms than high somatic responders who were experiencing low levels of stress. These findings indicate that somatic response to stress reflects both a general tendency to focus on physical symptoms, and a specific tendency to focus more on physical symptoms when under stress. Analysis of health service records indicated that high somatic responders had more visits prompted by symptoms than low somatic responders, but did not differ in frequency of health service visits designed to maintain health. The findings further clarify the relationship between somatic response to stress, physical symptoms and health service use.     

The utility of the Michigan Alcoholism Screening Test in the detection of alcoholics and problem drinkers

This study examined the vulnerability of the Michigan Alcoholism Screening Test (MAST), a widely used, direct alcohol inventory, to positive dissimulation. An earlier study by developers of the MAST suggested that most alcoholics were unable to alter their scores and thereby avoid detection by the instrument. But closer examination indicated that a standard scoring procedure was not employed. This study examined the ability of alcoholics to avoid detection by the MAST when using a standard scoring procedure. As predicted, alcoholics readily manipulated their MAST scores and avoided detection when so motivated. These results are discussed, indications and contraindications for use are included, and recommendations regarding future research are made.     

Factors associated with maintenance and relapse following self-management training

In this study, we examined factors associated with relapse and maintenance following a self-management training course. Thirty-five community professionals participated in a 3-week (30-hr) graduate-level extension course in self-management, which included a self-modification project. Results at a 10-week follow-up showed that end-of-class self-efficacy and outcome expectancy correctly classified over 80% of those who maintained gains in their projects versus those who relapsed. The professionals in the relapsed group also reported significantly more difficulty with anticipated high-risk situations than did those in the maintenance group.     

Children's preference for challenge: the role of perceived competence and control

This research tested the hypothesis that children's perceptions of academic competence and their personal control over school-related performance affects subsequent intrinsic interest and preference for challenge in an evaluative setting. In a correlational study, children's self-reported perceptions of academic competence and personal control were found to relate positively to their intrinsic interest in schoolwork and preference for challenging school activities. A subset of this sample was exposed to varying levels of a controlling directive, and preference for challenge was assessed behaviorally during a free-choice period in which subjects were unaware that they were being observed. As predicted, the data indicated that when given the evaluative, controlling directive, children who had high perceptions of academic competence and control preferred a greater challenge than did children whose perceptions were low on these measures. No difference between groups in terms of preference for challenge was evident when no controlling directive was presented. These findings are discussed in terms of theories of intrinsic motivation and potential processes that underly these effects.