Effects on weight reduction of strong monetary contracts for calorie restriction or weight loss

Thirty-one severely obese adults participated in behavioral weight control groups. In three groups utilizing powerful monetary contracts, subjects deposited substantial sums of money which were returned contingent on either attendance, calorie restriction, or weight loss. Subjects in a fourth no-contract control condition made no monetary deposits. Weight and calorie contract groups lost an average of nearly 20 lb in 10 weeks. They did not differ from each other, but both produced significantly more weight loss than the attendance contract group. High dropout rates in the no-contract condition precluded statistical evaluation of this group. Results are discussed in terms of the potential clinical value of contracting procedures.     

Accuracy of parents' reports of height and weight

The accuracy of parents' reports of their own height and weight and the height and weight of their obese children, who were about to enter a weight control program, was assessed. Measured height and weights of 146 mothers, 55 fathers, and 150 children who attended a screening session were compared to the heights and weights they had previously reported on a demographic questionnaire. Eighty-four percent of the reported weights were accurate within ±5 lbs.; 71% of the reported heights were accurate within ±1 in. Parents' reports of weight tended to underestimate actual weights, with the magnitude of underestimation greater for mothers than for fathers, while reported heights overestimated actual height, with the magnitude of overestimation greatest for fathers. Errors in the parents' reports of children's weight were related to the child's actual weight and body mass index (BMI), with substantial underestimation of actual weight in the heaviest decile of children in the sample.Preparation of this paper was supported in part by Grant HDMH12520-01 from the National Institute of Child Health and Human Development and Mental Health. Reprints can be obtained from Rena R. Wing, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15261.     

Controversies in counseling for mitochondrial conditions

A healthy woman sought preconceptional genetic counseling regarding a family history of a mitochondrial myopathy in her brother and retinitis pigmentosa (RP) in her two maternal aunts. Several questions were raised: (1) What is the likelihood of a familial mitochondrial condition? (2) What molecular tests or prenatal screening can we offer? (3) How would these tests help assess the likelihood of a familial mitochondrial condition? A mitochondrial mutation previously identified in the brother consisted of a heteroplasmic 2.9 kb deletion. We detected this deletion in the peripheral blood of the brother by PCR amplification of the deletion breakpoint, but not in his mother, the consultand, nor in one of the two aunts affected with RP. Although the molecular analysis was encouraging to the consultand, a familial mitochondrial disorder could not be eliminated with certainty. The pros and cons of prenatal testing for mitochondrial disorders are discussed in general, and as specifically related to this family.     

An acceptance-based behavioral intervention for weight loss: a pilot study

On average, participants in behavioral weight-loss interventions lose 8 kilograms (kg) at 6 months, but there is marked variability in outcomes with some participants losing little or no weight. Individuals with difficulties with internal disinhibition (i.e., eating in response to emotions or thoughts) typically lose less weight in such programs and may require an innovative, specialized approach. This pilot study examined the preliminary acceptability and efficacy of a 24-week acceptance-based behavioral intervention for weight loss among overweight and obese adults reporting difficulty with eating in response to emotions and thoughts. Participants were 21 overweight or obese men and women (mean age=52.2±7.6 years; baseline mean body mass index=32.8±3.4). Eighty-six percent completed the 6-month program and a 3-month follow-up assessment. Ratings of program satisfaction averaged 4.9 on a five-point scale. Multilevel modeling analyses indicated participants lost an average of 12.0 kg (SE=1.4) after 6 months of treatment and 12.1 kg (SE=1.9) at 3-month follow-up, thus exceeding the weight losses typically seen in behavioral treatment programs. Decreases in internal disinhibition and weight-related experiential avoidance were found at 6- and 3-months follow-up. Greater decreases in weight-related experiential avoidance were associated with greater weight loss at the end of the program (r=.64, p=.002), suggesting a potential mechanism of action. Although there have been a few preliminary studies using acceptance-based approaches for obesity, this is the first study to specifically target emotional overeaters, a subgroup that might be particularly responsive to this new approach. Our findings provide initial support for the feasibility, efficacy, and acceptability of this approach for this subgroup of participants. Further study with longer follow-up, a more diverse sample, and comparison to a standard behavioral program is clearly warranted.     

Rates and Types of Student Aggression against Teachers: A Comparative Analysis of U.S. Elementary,Middle, and High Schools

Student perpetrated violence against teachers is widespread, yet few studies differentiate teacher experiences of violence by school level (i.e., elementary, middle, and high school). This study, based upon 2,558 pre-kindergarten through 12^th grade teacher survey responses, revealed differences in types of student aggression against teachers by school level. Middle and high school teachers were more likely to report verbal harassment compared to elementary school teachers. Middle school teachers were most likely to report property offenses. Elementary and middle school teachers were more likely to report physical aggression than high school teachers. Demographic predictors of teacher-directed violence were also examined at each school level. Across all school levels, urban teachers had a greater probability of experiencing a violent incident. For elementary teachers, race/ethnicity and teaching experience were also significant risk factors. Future research, policy, and practice implications and recommendations are discussed.

     

Epistemic Disadvantage

Philosophia - Recent philosophical literature on epistemic harms has paid little attention to the difference between deliberate and non-deliberate harms. In this paper, I analyze the “Curare...