An investigation into the possibility of an innovative treatment for weight‐related hyperphagia: Towards a more effective combination of physiological and psychological treatment for clinically obese patients who binge‐eat,category DSM IV EDNOS (Eating Disorders Not Otherwise Specified)

This paper describes Phase One of a five‐phase doctoral research inquiry into hyperphagia (eating beyond requirement) as experienced in Binge Eating Disorder (BED). It is a response to the need for a treatment plan which combines the opportunity to explore psychological reasons for overeating, as well as to understand physiological reasons for uncontrollable cravings. Three participants, recruited through local gyms, received twelve sessions of integrative counselling combining cognitive behavioural therapy and physiological information with a person‐centred approach and psychodynamic theory to help participants discover for themselves the emotional causes of their overeating. The results informed Phase Two in which a small group addressed the same issues. The outcome of both phases will be used to design a treatment programme (Phase Three) for a larger group as a pilot study (Phase Four), all phases being part of an action research project which will be evaluated in Phase Five. The study is aimed at promoting a better understanding on the part of health professionals and counsellors of the need for sufferers of BED to address emotional causes of overeating and providing such treatment in primary care. Participants in Phase One self‐reported a steady decrease in Body Mass Index (BMI) during an interval of one year and achieved an awareness of the way in which their complex relationship with food was underpinned by emotionally painful and avoidant relationships with others.     

Physique Attitudes and Self-Presentational Concerns: Exploratory Interviews with Female Group Aerobic Exercisers and Instructors

The purpose of this study was to explore physique attitudes and self-presentational concerns among women who regularly participate in or instruct group aerobic classes. We were interested in conceptualizations of the ideal body, self-presentational concerns, and the influence of instructors in the group aerobics context. Five instructors and 6 exercisers participated in semi-structured interviews. Two higher order themes were identified from the interview data: (a) perceived body ideals and (b) body image experiences in the group aerobics context. Participants described the ideal body as lean and toned and attainable, but cautioned that being too muscular was unattractive and should be avoided. Exercisers experienced heightened self-presentation during aerobics more than the instructors did. Both exercisers and instructors thought that instructors should serve as body role models.     

An account of subjective probability judgment for joint events: Conjunctive and disjunctive

Probability judgment is a vital part of many aspects of everyday life. In the present paper, we present a new theory of the way in which individuals produce probability estimates for joint events: conjunctive and disjunctive. We propose that a majority of individuals produce conjunctive (disjunctive) estimates by making a quasi‐random adjustment, positive or negative, from the less (more) likely component probability with the other component playing no obvious role. In two studies, we produce evidence supporting propositions that follow from our theory. First, the component probabilities do appear to play the distinct roles we propose in determining the joint event probabilities. Second, contrary to probability theory and other accounts of probability judgment, we show that the conjunctive‐less likely probability difference is unrelated to the more likely disjunctive probability difference (in normative theory these quantities are identical). In conclusion, while violating the norms of probability judgment, we argue that estimates produced in the manner we propose will be close enough to the normative values especially given the changing nature of the external environment and the incomplete nature of available information.     

Is there anybody there? A psychodynamic view of panic attack

The effectiveness of cognitive-behavioural therapy is frequently cited when adopting this model as treatment of choice for panic attacks and anxiety disorders. However, Frank (1974), in discussing treatment effectiveness and patient compliance, argues that 'the more closely the conceptual framework of therapy fits that of the patient, the more readily he can accept it' (p. 370). In the following process analysis, my client's clear requirement for an exploratory approach meant that it was a psychodynamic understanding of the complex aetiology of her panic attacks that ultimately produced improved coping skills and a subjective sense of improvement for her. Process analysis has been chosen to illustrate the theoretical base, clinical impact and experiential immediacy of psychodynamic work; attention is drawn to the importance of transference and countertransference experiences in the choice of clinical interventions which tally with the client's sense of internal reality.     

ADHD outside the laboratory: boys' executive function performance on tasks in videogame play and on a visit to the zoo

One current theory of attention-deficit/hyperactivity disorder (ADHD) proposes that a primary deficit in behavioral inhibition gives rise to secondary deficits in 4 executive functions and motor control. To date, empirical support for this model is based primarily on laboratory-based cognitive methods. This study assessed behavioral inhibition and executive functioning in children with ADHD in 2 real-life contexts: videogames (motor-skill target game, cognitively demanding adventure game) and an outing at the zoo (route tasks). Participants were a community sample of 57 boys diagnosed with ADHD (20 inattentive, 37 combined type) and 57 normally developing control boys, matched individually for age and nonverbal IQ. Operationally defined measures of behavioral inhibition and specific executive functions were derived from these activities and assessed under contrasting conditions of low or high working memory and distractor loads. There were no group differences in basic motor skills on the target game, nor in terms of the ability to inhibit a prepotent or ongoing response in the adventure videogame. However, boys with ADHD exhibited more self-talk, more effortful response preparation, and completed fewer challenges in the latter videogame. Also, they manifested inhibition deficits in terms of interference control during the route task at the zoo and took longer to complete the tasks. Typically, these differences were greatest under conditions of high working memory and distractor loads. Findings from this study suggest that cognitive difficulties in ADHD may be context dependent and that ADHD is associated with deficits in some but not all aspects of behavioral inhibition.     

Confirmation of an Inhibitory Control Deficit in Attention-Deficit/Hyperactivity Disorder

The objective of this study was to determine whether deficient inhibitory control distinguishes children with a diagnosis of attention-deficit/hyperactivity (ADHD) disorder, conduct disorder (CD), and comorbid ADHD + CD from normally developing children. Participants were rigorously diagnosed children (age 7 to 12 years) with ADHD (N = 72), CD (N = 13) or ADHD + CD (N = 47) and 33 control children (NC). We studied inhibitory control using the stop-signal paradigm, a laboratory task that assessed the ability to inhibit an ongoing action. The ADHD group had significantly impaired inhibitory control compared to NC, CD, and ADHD + CD children. These results indicate that children with ADHD have deficient inhibition as measured in the stop-signal paradigm and that ADHD occurring in the presence of ADHD + CD may represent a phenocopy of CD rather than a variant of ADHD.     

Selective inhibition in children with attention-deficit hyperactivity disorder off and on stimulant medication

Selective inhibition requires discrimination between auditory signals and is assessed using a modification of the stop-signal task. Selective inhibition was assessed in a group of 59 clinic-referred, DSM-IV-diagnosed children with attention-deficit hyperactivity disorder (ADHD) and compared to that of a community sample of 59 children. Methylphenidate (MPH) effects on selective inhibition were assessed in a subset of the ADHD sample that participated in an acute, randomized, placebo-controlled, crossover trial with 3 fixed doses of MPH. Children with ADHD performed more poorly than controls on the majority of selective stop-signal task parameters: they exhibited more anticipatory (invalid) responses, with less accurate and more variable responses on the response execution task, as well as a slower selective inhibition process. MPH improved speed of both inhibition and response execution processes; it also reduced variability of response execution and decreased nonselective inhibition. On the one hand, findings are consistent with purported inhibition deficit in ADHD, but on the other hand, suggest that neither the impairment itself, nor MPH effects, were restricted to inhibition.