Timing of dietary change in response to a telephone counseling intervention: evidence from the WHEL study

OBJECTIVE: Little is known about temporal patterns of diet change within interventions, nor about predictors of early and sustained successful change. Social-cognitive theory asserts that early successes in achieving behavior change increase self-efficacy, leading to longer-term success. DESIGN: The authors conducted exploratory cluster analyses using dietary data from the first month of the telephone counseling intervention of the Women's Healthy Eating and Living (WHEL) Study. MAIN OUTCOME MEASURE: Change in dietary pattern at three early intervention timepoints. RESULTS: Three clusters were identified: Cluster 1 (25%) was close to meeting study goals at baseline, but still made major changes; Cluster 2 (49%) and Cluster 3 (26%) were not achieving study goals at baseline, but Cluster 2 made substantial immediate changes, while Cluster 3 changed their diet more gradually. Baseline demographic and behavioral variables were associated with cluster membership; however, the strongest predictors of cluster were self-efficacy, motivation, and approaches to study goals. Cluster membership predicted dietary pattern at 12 months. CONCLUSION: These data suggest that a one-on-one telephone counseling intervention that is intensive in the early weeks may maximize the level of change achieved in a study.     

Gray's three-arousal model: an empirical investigation

We evaluated the validity of Gray's and Fowles' three-arousal model in two studies of criminal offenders using a continuous motor task involving rewards and punishments. Consistent with predictions for the behavioral approach/activation system (BAS), offenders displayed significant (p<0.00001) increases in response time and heart rate (HR) from a no-incentive practice phase to a reward-only (experiment 1) and active-avoidance (experiment 2) phase. Trait impulsivity was correlated with the response time index of BAS activation in experiment 1 but not experiment 2. Consistent with predictions for the behavioral inhibition system (BIS), offenders showed a significant increase in number of skin conductance responses (SCRs) (p<0.05) from a reward-only to a mixed-incentive phase in experiment 1 and a significant increase in SC amplitude to punishment cues in both experiments. Consistent with predictions for the dynamics of the model, participants showed significant slowing of response time (p<0.0001) from reward-only (experiment 1) or active avoidance (experiment 2) to mixed-incentive phases despite showing an initial tendency toward response facilitation to the onset of the punishment cue signifying the beginning of the mixed-incentive phases. Participants also showed significant (p<0.002) decreases in HR between these phases in both studies, but this effect was only evident on trial 1. The BIS-influenced response time and HR indices were significantly (p<0.05) correlated with anxiety in experiment 1, but unexpectedly, anxiety was not correlated with SC indices of the BIS in either study. Although much of the data support the validity of the Gray/Fowles model, particular findings suggest that further refinement of this theory is indicated.     

Evaluation of early relational disturbance in high-risk populations: Borderline personality disorder features,maternal mental state,and observed interaction

Despite the longstanding theoretical association in the attachment literature between maternal trauma history and disturbances in the mother–infant interaction, few studies have investigated mechanisms of transmission of traumatogenic relational patterns in high-risk mother–infant dyads. This study investigated interrelationships among maternal trauma history, distorted maternal representations (DMRs, i.e. disturbed thoughts and feelings about the infant and self-as-parent), maternal mentalisation (i.e. capacity to conceive of self and other's intentions in terms of mental states including thoughts, feelings, and desires), and quality of interaction in a clinical sample of mothers with Borderline Personality Disorder (BPD) features and their infants (N = 61). Measures used included the Childhood Trauma Questionnaire, Parent Development Interview, Mother–Infant Relationship Scale, Borderline Symptom Checklist-23, and the Emotional Availability Scales. The results indicated BPD features mediated the relationship between maternal trauma history and DMRs predicting disturbance in interaction. In addition, analyses showed that maternal mentalisation had a buffering effect between DMRs and maternal non-hostility and yet the severity of BPD features moderated the relationship between mentalisation and DMRs. The findings suggest postpartum borderline pathology may adversely impact the experience of being a parent for women with a relational trauma history including deficits in mentalisation (i.e. hypermentalising) and disturbances in the mother–infant interaction. Implications for research and clinical practice are discussed.