Double trouble: restrained eaters do not eat less and feel worse

Objective: While high levels of dietary restraint do not appear to reflect actual caloric restraint, it has been found to be a risk factor for a wide array of maladaptive eating patterns. These findings raise the question what, if not caloric restriction, dietary restraint entails. We propose that the very finding that restrained eaters do not eat less than they intend to do can provide an answer. Based on this disparity between the intention to restrain oneself and actual behaviour, we therefore hypothesised that high levels of restraint are associated with eating-related guilt.

Method: Three studies (N?=?148) using unobtrusive measures of food intake; different restraint scales; and different measures of guilt tested whether restraint is related to eating-related guilt.

Results: Results indicated that restraint was not associated with food intake, but instead was associated with increased levels of guilt after eating. Guilt was explicitly related to food intake. Moreover, the observed guilt could not be attributed to a general increase in negative affect.

Conclusion: The results of these studies suggest that restraint is not an indicator of actual restricted food intake, but rather a reflection concerns about food and eating manifested in eating-related guilt.     

Do sedentary motives adversely affect physical activity? Adding cross-behavioural cognitions to the theory of planned behaviour

The purpose of this study was to explore whether sedentary behavior cognitions explain physical activity (PA) intention and behavior when integrated within the theory of planned behavior framework (TPB). A random community sample of 206 adults and a sample of 174 undergraduate students completed measures of the TPB pertaining to PA and four popular leisure-time behaviors (TV viewing, computer use, sedentary hobbies, and sedentary socializing) and an adapted Godin Leisure-Time Exercize Questionnaire (community sample = cross-sectional, undergraduate sample = 2-week prospective). Results using ordinary least squares regression provided evidence that TV viewing intention explains additional variance in PA behavior, and affective attitude (community sample) and perceived behavioral control (undergraduate sample) towards TV viewing explains additional variance in PA intention even after controlling for PA-related TPB constructs. These results underscore the potential value of adding sedentary control interventions in concert with PA promotion.     

Attentional bias and emotional reactivity as predictors and moderators of behavioral treatment for social phobia

Cognitive behavioral therapy (CBT) is a well-established treatment for anxiety disorders, and evidence is accruing for the effectiveness of acceptance and commitment therapy (ACT). Little is known about factors that relate to treatment outcome overall (predictors), or who will thrive in each treatment (moderators). The goal of the current project was to test attentional bias and negative emotional reactivity as moderators and predictors of treatment outcome in a randomized controlled trial comparing CBT and ACT for social phobia. Forty-six patients received 12 sessions of CBT or ACT and were assessed for self-reported and clinician-rated symptoms at baseline, post treatment, 6, and 12 months. Attentional bias significantly moderated the relationship between treatment group and outcome with patients slow to disengage from threatening stimuli showing greater clinician-rated symptom reduction in CBT than in ACT. Negative emotional reactivity, but not positive emotional reactivity, was a significant overall predictor with patients high in negative emotional reactivity showing the greatest self-reported symptom reduction.     

A randomized pilot study of anger treatment for Iraq and Afghanistan veterans

Objective

Anger and aggression are serious problems for a significant proportion of veterans who have served in combat. While prior research has suggested that cognitive behavioral treatments may be effective for anger problems, there are few controlled studies of anger treatment in veterans and no studies of anger treatment focusing exclusively on veterans from the Iraq and Afghanistan wars. This randomized pilot study compared an adapted cognitive behavioral intervention (CBI) to a supportive intervention (SI) control condition for the treatment of anger problems in veterans returning from deployment in Iraq or Afghanistan.

Methods

25 veterans with warzone trauma, problems with anger, and one or more additional hyperarousal symptoms were randomized and 23 started treatment (CBI, n = 12; SI, n = 11). Outcome measures were administered at pre- and post- treatment and at 3 months post-treatment.

Results

CBI was associated with significantly more improvement than SI on measures of anger and interpersonal functioning. Gains were maintained at follow-up.

Conclusions

Findings suggest that CBI may be more effective than an active control providing psychoeducation, relaxation, and supportive therapy for treating anger problems in returning veterans. The findings need to be replicated in an adequately powered and more diverse sample.     

Rethinking ‘Don't Blame the Victim’

SUMMARY

The psychology of victims and the dynamics of victimhood have been largely ignored by scholars and clinicians. While in past years the tendency has been to blame victims, more recently the tide has turned. It is now politically incorrect to explore the role of victims in violent systems, as exploring the psychology of victims has become synonymous with blaming the victim. While shying away from blame, this article will explore the familial and cultural origins of victimhood, victims' characteristics, their relationships with the perpetrators, and it will offer a victim typology. As we move from btame to a more complex understanding of violent systems, the perpetuation of these systems in our culture, and the role victims play in these systems, we provide ourselves with better tools to predict and prevent further victimization.     

ADHD Assessment

Abstract

This study examined effects of negative versus positive symptom formats on the assessment and subsequent classification of ADHD in children in public schools. Symptoms associated with the disorder based on the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) were presented to parents and teachers of referred children according to both types of formats. Informants were then asked to indicate whether the symptoms described the child's behavior over the last six months. Overall, the negatively phrased symptoms appeared to generate response bias which resulted in an increased percentage of children meeting the DSM-IV criteria for ADHD. Additionally, the decision reliability or classification agreement between the two formats was low, suggesting the possibility of confirmation bias in the assessment process. Implications for practice and future research are discussed.     

Inclusion and Students with Emotional/Behavioral Disorders

Summary

This article presents a point/counterpoint approach to the issue of full inclusion of all students with emotional/behavioral disorders. To set the stage for the discussion that follows, the academic, social, and behavioral characteristics of these students pertinent to classroom performance are reviewed. The pros and cons of these four issues are then presented: (a) appropriateness of the general education curriculum for students with EBD; (b) social acceptance and other social competence issues; (c) mental health interventions and supports in general education settings; and (d) legality of full inclusion. Under the legality issue, case law on full inclusion pertaining to students with EBD is briefly reviewed. The basic premise of the authors who are full inclusion opponents is that a continuum of placements, including full-time placement in general education classrooms, should be preserved so that decisions about appropriate settings can be made on an individual basis. The basic premise of the author who is a full inclusion proponent is that, rather than maintaining two separate systems, we should direct our energies toward correcting the inadequacies of the general education classroom for the benefit of all students, including those with EBD.     

Combining Explicit Timing with an Interdependent Group Contingency Program to Decrease Transition Times

ABSTRACT

A sixth-grade teacher and consultant serving as a behavioral specialist developed, implemented, and evaluated the Timely Transitions Game (TTG), a procedure designed to reduce room-to-room transition times. The TTG combined several procedures that have been shown to alter student behavior including explicit timing procedures and an interdependent, group-oriented reward program with randomly selected criteria. Five transition times were measured and recorded each day. At the end of the school day, the teacher randomly selected a transition and a criterion (seconds taken to transition). If the class completed the randomly selected transition in less time than the randomly selected criterion, they earned a letter. When students earned enough letters (e.g., the five letters that spell M-U-S-I-C), they received access to the reward (e.g., listening to music during independent seat-work). Results indicated immediate and sustained decreases in transition times following the implementation of the intervention. Although methodological concerns prevent drawing cause-and-effect conclusions, the current study shows how educators can adapt and combine empirically validated strategies and procedures to remedy presenting problems.     

Brief treatment with alprazolam and behavioral guidance in panic disorder

Abstract

Thirty-two patients with panic disorder, with or without agoraphobic limitations, were treated with alprazolam (mean dose 3.5 mg/d) plus brief behavioral guidance in an open study during eight weeks. The sample had a notorious severity in the frequency of panics and phobic avoidance but was only mildly depressed. Before starting treatment the presence of demoralized mood and extensive avoidance were significant indicators of clinical severity, whereas the presence of dizziness as a relevant somatic complaint was not related to higher severity. After eight weeks of treatment a clinical improvement equal to or exceeding 80% of change was obtained in all cases (29) who completed treatment. Ninety-two percent of the patients were panic free at the end of treatment. There were significant reductions in all the scales with comparable declines in the subgroups formed according to the presence or absence of agoraphobic avoidance and demoralization. The data suggested that moderate doses of alprazolam could be a quick and effective treatment for panic-agoraphobic patients in the short term. The behavioral guidance probably helped in reducing agoraphobic avoidance and in obtaining global good effectiveness although this awaits controlled tests. Finally, the similarity in the response to treatment regardless of the presence of extensive avoidance or demoralized mood argues in favor of not considering the different variants of panic-agoraphobic syndrome differently, at least in samples with similar severity to the present one.