Fluid noncompliance and symptomatology in end-stage renal disease: cognitive and emotional variables

Fluid noncompliance in patients with end-stage renal disease (ESRD) is a widespread problem with severe consequences for health. In addition, ESRD patients report considerable stress in relation to their illness and dialysis treatment. The present study examined the role of cognitive and emotional variables in fluid noncompliance, symptomatology, and stress. Fifty hemodialysis patients were assessed (a) on the cognitive variables of locus of control, self-evaluations of their past compliance, and self-efficacy to resist fluid intake and (b) on the emotional variables of depression, anger, and anxiety. Results showed that cognitive variables accounted for fluid noncompliance and predicted future adherence. Patients high in negative emotions complied equally as well as patients low in negative emotions but were found to report substantially more symptomatology and distress associated with their treatment. The implications of these findings for treatment of ESRD patients and future research are discussed.     

Visual detectability gradients: effect of high-speed visual experience.

The detectability of a target pattern presented briefly with a number of similar nontarget patterns varies as a function of the spatial location of the target. Previous work attributes these detectability gradients to a visual search process--a non-eye movement serial scan--that examines a decaying neural representation of the image. (Heron, 1957; Efron, Yund, & Nichols, 1987, 1990a,b,c; Yund, Efron, & Nichols, 1990a,b,c). The results reported in the companion paper (Ostrosky-Solis, Efron, & Yund, 1991) indicated that literacy did not affect overall performance levels but did influence scanning behavior: "...reading, or learning to read, caused the scanning mechanisms of literate subjects to adopt more consistent scan paths, from subject to subject, than they would have adopted without this reading experience." The purpose of the present experiment was to determine the effect on this scanning mechanism, if any, of an entirely different type of visual experience--the high-speed visual processing required of tennis players. Unlike reading which requires the linguistic interpretation of a highly structured visual input, tennis skill requires rapid target detection and tracking in three-dimensional visual space as well as large scale visual-motor coordination. As in the previous experiments, subjects were required to detect a vertical stripe pattern among a number of similar non-target patterns. The experiment was performed on a group of 52 tennis players and on an age- and sex-matched group of 52 non-tennis players. The overall accuracy of target detection was greater among the tennis players than among the non-tennis players and, of more interest, there was a significant difference in the detectability gradients. The detection advantage of the tennis group seemed to reach its maximum in the first half of the scan and then to deteriorate as the scan proceeded. These results indicate that visual experience other than reading can affect the habitual activity of the scanning mechanism.     

Long-term smoking intervention at the worksite: effects of quit-smoking groups and an "enriched milieu" on smoking cessation in adult white-collar employees

Maximizing the potential of worksites for smoking intervention remains elusive. We hypothesized that long-term effectiveness of group intervention would be enhanced when offered within an "enriched milieu" (full program) compared with relative isolation (group only). The data failed to support the hypothesis. Although sustained abstinence rates were higher at full-program sites (50%) than at group-only sites (44%), the difference did not achieve statistical significance. Initial (35% vs. 47%) and 12-month (18% vs. 22%) quit rates at full-program and group-only sites also failed to demonstrate the "benefit" of the "enriched milieu."     

Self-management of diabetes mellitus: a critical review

Diabetes has no known cure and is a leading source of morbidity and mortality. Clinical management involves patients managing a complex and variable regimen. This article reviews the determinants of effective self-management and the methods of promoting better self-management. Trait variables (e.g., personality and demographics) have been presumed to affect self-management, but evidence suggests they have little impact. The important determinants of self-management are transient situational factors such as psychological stress and social pressure to eat. Interventions to promote better self-management have reported initial improvements in blood glucose control, but the long-term effects are unclear. We conclude that self-management has been inadequately assessed and that attempts to improve self-management have relied excessively on providing information. More research is needed to clarify determinants of self-management, and interventions to improve self-management will need to change these determinants.     

The role of cosmetics in attributions about sexual harassment

The purpose of this study was to investigate the effect of cosmetics use on attributions concerning the likelihood of provoking sexual harassment and of being sexually harassed. Subjects were 85 female and 76 male undergraduate volunteers. The study was a 3×2 between-subjects design with three levels of cosmetics use (heavy, moderate, no cosmetics) and two levels of sex of subject (male, female). Each subject viewed one of three colored photographs of a model wearing either heavy, moderate, or no cosmetics, and then indicated how likely the model was to provoke sexual harassment and to be sexually harassed. Data were analyzed using analyses of variance and the Newman-Keuls test. When the model wore heavy cosmetics, she was rated as more likely to provoke sexual harassment than when she wore moderate cosmetics. Similarly, when the model wore moderate cosmetics, she was rated as significantly more likely to provoke sexual harassment than when she was not wearing cosmetics. When the model wore either heavy or moderate cosmetics, she was also rated as more likely to be sexually harassed than when she did not wear cosmetics. In addition, male subjects rated the model as more likely to provoke and to be sexually harassed than did female subjects. Results are discussed in terms of sex role spillover.     

Washing, drying, and anointing in adult humans (Homo sapiens): commonalities with grooming sequences in rodents.

Very few behavioral patterns generalize across human and nonhuman species. We describe washing, drying, and anointing sequences in humans (Homo sapiens) that may have analogies with other species. The rank ordering of washing, drying, and anointing body parts was obtained over 3 successive days for 37 men and 60 women. Variation in rank ordering of body parts was nonrandom, and a cephalocaudal progression was evident for each behavior. Reliability of the behaviors as well as the correlations across rankings were highly significant, which indicates a generalized cephalocaudal progression for all 3 behaviors. Women's anointing was most variable, which suggests a more specific function. The cephalocaudal action pattern described for humans is similar to that for Mongolian gerbils and laboratory rats. Cross-species functions, such as these, may add to our understanding of common developmental and learning processes.     

The effects of parental alcoholism on perception of control and imposter phenomenon

The present study examined the differences in internal and external locus of control and imposter phenomenon among persons with alcoholic and non-alcoholic parents. The subjects were 48 college students and 21 members of local Adult Children of Alcoholic groups. The students were further divided into those with alcoholic parents and non-alcoholic parents. The subjects were administered the following three instruments: the Nowicki-Strickland Internal-External Control Scale for Adults (Nowicki & Duke, 1973), the Imposter Test (Chance & O’Toole, 1987), and a family history survey. Analysis of locus of control scores revealed a highly significant (p<.01) difference for externality, with Adult Children being most external and students with non-alcoholic parents least external. Similarly, internality scores differed significantly (p<.0001), with Adult Children being least, and the non-alcoholic group being most internally oriented. Analysis of variance for imposter phenomenon revealed a significant (p<.05) difference among the three groups, with the Adult Children of Alcoholics group having the highest scores and students with non-alcoholic parents having the lowest. These findings are consistent with the idea that parental alcoholism interferes with nurturing and consistent reinforcement, and with the development of personal adaptability.     

Managed Mental Health: A Primer for Counselors

The mental health service delivery system is experiencing a transformation attendant to rapidly developing cost containment mechanisms. This article reviews various aspects of the new managed mental health care systems and details the gains and losses the various mental health service provider professions may experience depending upon how each responds to the changing demands of alternate service delivery systems. Recommendations are presented regarding how counselors can establish a solid base in the new managed mental health care system.     

Relationship between rigidity-flexibility and cognitive abilities in adulthood

The interrelationship of measures of rigidity-flexibility and of psychometric intelligence is examined. The latent factors of Attitudinal Flexibility, Motor-Cognitive Flexibility, and Psychomotor Speed are derived from the Test of Behavioral Rigidity, and factors of Inductive Reasoning, Spatial Orientation, Verbal Ability, Numeric Ability, Verbal Memory, and Perceptual Speed are derived from the Thurstone Primary Mental Abilities Test and the Educational Testing Service Kit of Factor-Referenced Tests. The data base in this study comes from the fifth wave of the Seattle Longitudinal Study (N = 1,628; age range, 22-95 years). The Rigidity-Flexibility factors were found to be independent of the cognitive domain. Also, longitudinal stability of the factor structure of the rigidity-flexibility domain was confirmed for 837 participants tested in both 1977 and 1984.     

The effect of exercise on depressive symptoms in the moderately depressed elderly

Thirty community-dwelling, moderately depressed elderly were randomly assigned to 1 of 3 interventions: experimenter-accompanied exercise in the form of walking, a social contact control condition, and a wait-list control. Exercise and social contact both resulted in significant reductions in both the total and the psychological subscale of the Beck Depression Inventory (BDI). The exercise condition, however, unlike the control conditions, resulted in decreased somatic symptoms of the BDI. These results indicate that, at least in the short term, exercise has a broader effect compared with control conditions in reducing depressive symptoms in the moderately depressed elderly.