The effects of outcome expectations and satisfaction on weight loss and maintenance: correlational and experimental analyses--a randomized trial.

This study examines the hypothesis that highly favorable outcome expectations promote weight loss and hinder weight maintenance. To investigate the effects of outcome expectations and satisfaction with treatment outcomes on weight loss, 349 adults were randomly assigned to 1 of 2 weight loss programs that emphasize either (a) an "optimistic" message, focusing exclusively on the positive aspects of weight loss, or (b) a "balanced" message, giving equal time to positive and negative aspects of weight loss. Participants changed their weight loss cognitions in response to the intervention, but there was no significant difference between the intervention treatment groups in short-term or long-term (18-month) weight loss. Independent of treatment message, positive outcome expectations and satisfaction were both associated with weight loss.     

An investigation of organic factors in the neuropsychological functioning of patients with borderline personality disorder

The hypothesis to be tested in this study was that the cognitive deficits that have been documented in patients with Borderline Personality Disorder (BPD) are largely the consequence of organic insult, either developmental or acquired. Using a cross-sectional design, 80 subjects (males and females) who met the criteria for BPD participated in the study. They completed a battery of neuropsychological tests and a comprehensive interview assessing organic status as well as measures of the potentially confounding factors of current levels of depression and anxiety. It was expected that BPD-patients with a probable history of organic insult would perform significantly worse than would BPD patients without such a history. Analyses of the results provided partial support for the hypothesis. Subjects with both BPD and a history of organic insult were significantly more impaired on several measures including measures of attention than were BPD only subjects. The results suggested that the impaired cognitive performance of persons diagnosed with BPD may, in part, be attributed to organic factors.     

Chronic Fatigue Syndrome: The Need for Subtypes

Chronic fatigue syndrome (CFS) is an important condition confronting patients, clinicians, and researchers. This article provides information concerning the need for appropriate diagnosis of CFS subtypes. We first review findings suggesting that CFS is best conceptualized as a separate diagnostic entity rather than as part of a unitary model of functional somatic distress. Next, research involving the case definitions of CFS is reviewed. Findings suggest that whether a broad or more conservative case definition is employed, and whether clinic or community samples are recruited, these decisions will have a major influence in the types of patients selected. Review of further findings suggests that subtyping individuals with CFS on sociodemographic, functional disability, viral, immune, neuroendocrine, neurology, autonomic, and genetic biomarkers can provide clarification for researchers and clinicians who encounter CFS characteristically confusing heterogeneous symptom profiles. Treatment studies that incorporate subtypes might be particularly helpful in better understanding the pathophysiology of CFS. This review suggests that there is a need for greater diagnostic clarity, and this might be accomplished by subgroups that integrate multiple variables including those in cognitive, emotional, and biological domains.     

Why is discrimination stressful? The mediating role of cognitive appraisal

This study attempts to shed light on past findings that experiences of racial and gender discrimination are associated with poor psychological and physical health outcomes by investigating the role of cognitive appraisal as a mediator of the relationship between experiences of discrimination and affective stress reactions. African American female college students (N = 115) imagined themselves in an audiotaped scenario in which they overheard 2 European American male classmates make negative evaluations of them. Participants then completed measures of causal attributions, cognitive appraisal, and affective stress reactions. Multiple regression analyses supported the hypotheses that attributions to racism and to discrimination that combines racism and sexism were associated with increased stress reactions. This relationship was mediated by cognitive appraisals of centrality.     

A prospective examination of body image and smoking cessation in women

This study prospectively examined body image in a community sample of women smokers (N = 141, 89% European–American, M age = 39.5, M BMI = 25.5) participating in a 12-week randomized smoking cessation trial. Participants completed measures assessing subjective and perceptual aspects of body image. Regression analyses showed that subjective body image was predictive of smoking rate at the end of treatment. A MANCOVA revealed that perceptual body image (body size estimation) significantly predicted smoking cessation. Quitting smoking actually worsened body image, although these results were no longer significant after controlling for weight gain. Results support the theory that a negative body image may hamper cessation attempts. In addition, weight gain during smoking cessation may adversely impact body image and lead to an increased risk for relapse.     

Impact of recent findings on study design of future autism clinical trials

There are specific challenges to studying the design of pharmacologic trials in child/adolescent and adult autism, such as subject stratification and parallel versus crossover designs. This article describes how optimal study design is influenced by subject selection and outcome measures chosen. Lessons learned in study design from the Research Units on Pediatric Psychopharmacology Autism Network trial with risperidone, Seaver Center trials with fluoxetine and valproate, Dartmouth trials with amantadine, and National Institutes of Health secretin trials are highlighted. The Internet System for Assessing Autistic Children system for managing multicenter clinical trials in autism and statistical issues in autism research are also described.     

Flanker and negative flanker effects in letter identification

In a speeded choice reaction time task, responses to centrally presented letter targets can be altered by the identity of surrounding task-irrelevant letters (flankers). In the standard flanker effect, flankers associated with the same response as the target lead to faster and more accurate responses, whereas flankers associated with a different response lead to slower and more error-prone responses. B. A. Eriksen and C. W. Eriksen (1974, pp. 143-149) have argued that these flanker effects occur through response competition. We present data from a novel version of the Eriksen task, in which some targets and flankers consist of letter forms that are morphed versions of target letters. In this paradigm, flankers induce classic flanker effects on well-formed targets. But flankers induce an opposite effect, termed a negative flanker effect on morphed letter targets. For example, targets that are morphs between the letters "A" and "H" are more likely to be identified as an "A" when flanked by an "H." The interpretation advanced here is that there are two distinct kinds of flanker effects contrast enhancement in perceptual processes and response competition in response selection processes.     

Contemporary longitudinal methods for the study of trauma and posttraumatic stress disorder

Traditional methods for analyzing trends in longitudinal data have typically emphasized average group change over time. In this article, we propose multilevel, regression-based methods for examining inter-individual differences in intra-individual change and apply these methods to research in trauma and posttraumatic stress disorder (PTSD). The outcome or dependent variable of interest is reconceptualized as an index of dynamic change reflecting the trend or trajectory of an individual's PTSD symptom severity scores across time. A basic statistical model is presented, and analyses and findings are demonstrated with an existing database used in previously published studies. The methods offer promise for future study of the natural course of PTSD chronicity or recovery, risk and resilience factors that influence individual growth or decline, and critical timepoints for intervention.     

Children's nighttime fears: parent-child ratings of frequency, content, origins, coping behaviors and severity

The present study investigated nighttime fears in normal school children aged 4 to 12 yr (N=176). Children and their parents were interviewed about the frequency, content, origins, coping behaviors and severity of children's nighttime fears. Results showed that 73.3% of the children reported nighttime fears, indicating that these fears are quite prevalent. Inspection of the developmental course of nighttime fears revealed that these fears are common among 4- to 6-year-olds, become even more frequent in 7- to 9-year-olds and then remain relatively stable in 10- to 12-year-olds. Inspection of the origins of nighttime fears revealed that most of the children (i.e., almost 80%) attributed their fear to negative information; conditioning and modeling were endorsed less frequently (25.6% and 13.2%, respectively). A substantial percentage of the children (24.0%) indicated that learning experiences had not played a role in the acquisition of their nighttime fears. Children reported a variety of coping strategies in order to deal with their nighttime fears and generally rated these strategies as helpful in reducing anxiety. Furthermore, children's nighttime fears were associated with moderate levels of anxiety. Moreover, in about 10% of the children, nighttime fears were related to one or more DSM-III-R anxiety disorders. Finally, parental reports of children's nighttime fears substantially deviated from children's reports. Most importantly, parents provided a marked underestimation of the frequency of nighttime fears, at least as reported by their children.     

Self-injurious behavior: gene-brain-behavior relationships

This paper summarizes a conference held at the National Institute of Child Health and Human Development on December 6-7, 1999, on self-injurious behavior [SIB] in developmental disabilities. Twenty-six of the top researchers in the U.S. from this field representing 13 different disciplines discussed environmental mechanisms, epidemiology, behavioral and pharmacological intervention strategies, neurochemical substrates, genetic syndromes in which SIB is a prominent behavioral phenotype, neurobiological and neurodevelopmental factors affecting SIB in humans as well as a variety of animal models of SIB. Findings over the last decade, especially new discoveries since 1995, were emphasized. SIB is a rapidly growing area of scientific interest to both basic and applied researchers. In many respects it is a model for the study of gene-brain-behavior relationships in developmental disabilities.