‘Healthy eating’ clinics in primary care: Programme intensity and patients' health beliefs

The primary care setting is seen by many to be at the forefront of the attempt to encourage people to follow healthier diets. Conducted in a single practice, the present study firstly considered the effectiveness of three ‘healthy eating’ clinics for patients found to have elevated cholesterol levels at screening. Through the use of a randomised trial, these patients received either basic dietay information or were invited back more frequently and requested to complete food diaries, half of which were then analysed through a computer program. At one year follow up the three programmes were found to have produced a 6.7% reduction in cholesterol levels. However, no differences were found between the three programmes. The study secondly examined a range of health belieji, based on the health belief model, as predictors of reductions in cholesterol levels. These were generally found to be poor predictors, with only the belief that one's diet is related to the chances of developing a number of major conditions and the perception of bam'ers dealing with confidence predicting these reductions. Finally, the case for incorporating self-efficacy beliefs into the healh belief model is outlined and the need for health counsellors to tailor their messages to the pre-existing beliefi and behaviours of patients is highlighted.     

Parallel distributed processing and neuropsychology: A neural network model of Wisconsin card sorting and verbal fluency

Neural networks can be used as a tool in the explanation of neuropsychological data. Using the Hebbian Learning Rule and other such principles as competition and modifiable interlevel feedback, researchers have successfully modeled a widely used neuropsychological test, the Wisconsin Card Sorting Test. One of these models is reviewed here and extended to a qualitative analysis of how verbal fluency might be modeled, which demonstrates the importance of accounting for the attentional components of both tests. Difficulties remain in programming sequential cognitive processes within a parallel distributed processing (PDP) framework and integrating exceedingly complex neuropsychological tests such as Proverbs. PDP neural network methodology offers neuropsychologists co-validation procedures within narrowly defined areas of reliability and validity.     

Developmental sequences in the age of onset of disruptive child behaviors

Retrospective and prospective reports of the onset of disruptive child behaviors were analyzed in a sample of clinic-referred boys. The younger boys (ages 7–9 years), compared with the older boys (ages 10–12 years), showed the highest level of disruptive behavior and, judging from mothers' reports, had the fastest progression of onsets from less serious to more serious problem behaviors. Despite some overlap, developmental sequences in problem behavior within the domains of hyperactivity/inattention, oppositional behavior, and conduct problems were similar across the two age groups. This was also the case for developmental sequences of overt or confrontive problem behaviors and covert or concealing conduct problems. Sequences of the onset of oppositional behavior and conduct problems were validated through prospective data, based on the information from mothers, teachers, and boys themselves. The implications of the findings are discussed for the formulation of developmental pathways of behavior and the analysis of causal factors.     

A note on russell's paradox in locally cartesian closed categories

Working in the fragment of Martin-Löfs extensional type theory [12] which has products (but not sums) of dependent types, we consider two additional assumptions: firstly, that there are (strong) equality types; and secondly, that there is a type which is universal in the sense that terms of that type name all types, up to isomorphism. For such a type theory, we give a version of Russell's paradox showing that each type possesses a closed term and (hence) that all terms of each type are provably equal. We consider the kind of category theoretic structure which corresponds to this kind of type theory and obtain a categorical version of the paradox. A special case of this result is the degeneracy of a locally cartesian closed category with a morphism which is generic in the sense that every other morphism in the category can be obtained from it via pullback.The financial support of the Royal Society in London is gratefully acknowledged.     

Effects of attentional focusing on pain perception

Two experiments were conducted to examine the hypothesized differential effectiveness of two attentional focusing strategies in pain perception. In the first experiment, subjects (72 male college students) rated their levels of pain after being exposed to either low- or high-intensity pressure stimulation for 75 s. Subjects were instructed to use either an external or internal focus of attention during the pain induction. Results revealed that external focusing was more effective for coping than internal focusing across both levels of stimulus intensity. The second experiment was a replication of the first, and featured bolstered internal focusing and stimulus intensity manipulations. Results showed that high-intensity stimulation produced higher pain ratings than did low-intensity stimulation for subjects in the internal focusing conditions, but not for those in the external focusing conditions. The findings support the power of distraction strategies for dealing with short-term pain with a rapid onset. Theoretical implications are discussed.The authors thank Darwyn E. Linder and Daniel M. Landers for their help in development of this research. The authors are also indebted to Sarah Colley, Jona Davis, Nanci Neuberger, and Rebecca Roberts for their assistance in data collection.     

Criterion-related construct validity

Established results on latent variable models are applied to the study of the validity of a psychological test. When the test predicts a criterion by measuring a unidimensional latent construct, not only must the total score predict the criterion, but the joint distribution of criterion scores and item responses must exhibit a certain pattern. The presence of this population pattern may be tested with sample data using the stratified Wilcoxon rank sum test. Often, criterion information is available only for selected examinees, for instance, those who are admitted or hired. Three cases are discussed: (i) selection at random, (ii) selection based on the current test, and (iii) selection based on other measures of the latent construct. Discriminant validity is also discussed.This work was supported in part by Grant SES-87-01890 from the Measurement Methods and Data Improvement Program of the U.S. National Science Foundation.     

The epidemiology of suicide and attempted suicide

Since more than one century suicides have been registered in national statistics of death causes. They thus furnish one of the few parameters of psychiatrically relevant behaviour by means of which trends, cohort, age-group and period effects can be studied over longer periods. Since the second half of last century, the suicide rates for Swiss males--similar to those found in England and Wales--show a decrease in consecutive birth cohorts up to males born in the decade 1930-1940, and a continued decline in the total trend until about World War II. From then on the suicide rates of males in consecutive birth cohorts have been slowly increasing in the majority of European and North American countries--but not so in Sweden. Opposite to this, the predominantly low rates for females display little change. Further to the considerable differences between nations and the predominance of suicides committed by females in some Asian countries and Cuba, the changes indicate the significance of cultural and economic environmental factors. Typical period effects are mainly the result of changes in conception and conditions of life. In attempted suicide they proceed in a more sensitive and more rapid way and are about ten times higher. Such a period effect showing increases by about 300% in younger age-groups followed by a decline, attaining its peak about 1976, was ascertained in large cities of the Federal Republic of Germany. By the example of the effects of a television serial, the study of causal processes turning collective environmental factors into individual suicidal behaviour, proved that regularities are effective in learning by a process of modelling. Besides, the epidemiological data give essential hints how to treat suicidal behaviour.     

HIV infection: trauma and coping with trauma

The initial results of a German-Swedish research project demonstrate the at times active-resistant and at times passive-resigned approaches of AIDS patients toward their illness.     

Threshold tracking for assessment of long-term adaptation and sensitization in pain perception

To assess temporal variations in the perception of "phasic" heat pain stimuli a psychophysical tracking procedure was developed that enables repeated assessment of the pain threshold at short intervals. This "double-tracking" procedure produces two tracking curves simultaneously, one that approaches the pain threshold gradually from above, the other from below. The threshold for phasic heat pain was measured in 80 tracking trials with stimuli at temperatures near the pain threshold. Concurrently, the threshold for "tonic" heat pain was determined after every 20 tracking trials with a stimulus adjustment procedure. Eleven healthy subjects (age: 26.4 yr. +/- 6.0) participated in 2 sessions each. Phasic stimulation near the pain threshold did not produce any trends in either of the two threshold measures. Hence there was no long-term adaptation or sensitization. However, there were random variations (random walks) in the tracking curves, which we interpret as resulting from a stochastic relationship between stimulus and sensation. In agreement with other reports, discrimination seemed to be better at painful than at nonpainful temperatures.     

Decision time and movement time in depression: differential effects of practice before and after clinical improvement

Choice reaction time involves, at least two components of response latency, decision time and movement time. Studies of choice reaction time usually provide values of these two components averaged over a given number of trials. The aim of the present study of depressed subjects was to investigate changes across practice on Decision Time (DT) and Movement Time (MT) before and after clinical improvement. 19 depressed subjects were given two sessions of 50 trials each, one before treatment (Di) and one after recovery (Df). Decision time and movement time exhibited quite different patterns. Decision time significantly decreased with clinical improvement. No significant variation across trials was found, in either session. Movement time values varied across trials but the variations observed on Di and Df were significantly different, whereas before treatment latencies recorded at the end of the session were greater than those scored at the start, the contrary was observed after clinical recovery. No significant difference was found between values of movement time scored at the start of the two sessions.