Objective Behavioral inhibition in children has been hypothesized to be a risk factor for the later development of social phobia. However, this hypothesis has yet to be demonstrated in a prospective study. The purpose of the study presented here is to test whether behavioral inhibition in childhood constitutes a risk factor for social phobia during adolescence. Method The sample consisted of 2.242 high school students assessed over a 4-year period. Assessments included self-report questionnaires, structured clinical interviews, and measurements of heart rate. Cox proportional hazards models were used to evaluate risk. Results Social avoidance, a component of behavioral inhibition, predicted onset of social phobia during high school. However, social avoidance was not related to depression in adolescence. Another component of behavioral inhibition, fearfulness, increased the risk for both social phobia and depression. Among subjects who were both socially avoidant and fearful, 22.3% developed social phobia—a risk more than four times greater than that for subjects with neither feature of behavioral inhibition. Conclusion This prospective study demonstrates that behavioral inhibition in childhood increases the risk of social phobia in adolescence.
Study Objective: To determine the effect of a nurse-managed intervention for smoking cessation in patients who have had a myocardial infarction. Design: Randomized, with a 6-month treatment period and a 6-month follow-up. Setting: Kaiser Foundation hospitals in Redwood City, Santa Clara, Hayward, and San Jose, California. Patients: Sequential sample of 173 patients, 70 years of age or younger, who were smoking before hospitalization for acute myocardial infarction. Eighty-six patients were randomly assigned to the intervention and 87 to usual care; 130 patients (75%) completed the study and were available for follow-up. Intervention: Nurse-managed and focused on preventing relapse to smoking, the intervention was initiated in the hospital and maintained thereafter primarily through telephone contact. Patients were given an 18-page manual that emphasized how to identify and cope with high-risk situations for smoking relapse. Measurements and Main Results: One year after myocardial infarction, the smoking cessation rate, verified biochemically, was 71% in the intervention group compared with 45% in the usual care group, a 26% difference (95% CI, 9.5% to 42.6%). Assuming that all surviving patients lost to follow-up were smoking, the 12-month smoking cessation rate was 61% in the intervention group compared with 32% in the usual care group, a 29% difference (95% CI, 14.5% to 43.5%). Patients who either resumed smoking within 3 weeks after infarction or expressed little intention of stopping in the hospital were unlikely to have stopped by 12 months. Conclusions: A nurse-managed smoking cessation intervention largely conducted by telephone, initiated in the hospital, and focused on relapse prevention can significantly reduce smoking rates at 12 months in patients who have had a myocardial infarction.
Summary Participant modelling, a behaviourally-orientated treatment technique, is an effect method of treating phobias associated with minor medical procedures or apparatus such as needles or intravenous catheters. The steps in this technique are described and two cases of severe needle phobias successfully treated with participant modelling are presented to illustrate further its application.
The purpose of this study was to invetigate factors that might produce greater weight loss using computer-assisted therapy. Fifty-seven overweight women were randomized to a weight loss program using a pocket computer only (CAT group) or a guided 1200 calorie weight loss diet followed by the use of the pocket computer after a weight loss of 3.5 to 4.5 kg (FFF+ group). All subjects met for four, 1.5 hour group meetings to review their progress. There was a significant weight loss in both groups from preto post-treatment twelve weeks later, with the FFF+ group losing significantly more weight than the CAT only group (5.3 vs. 3.1 kg, respectively). The pretreatment to six-month follow-up weight loss was 3.8 and 0.9 kg for the FFF+ and CAT groups, respectively. Both groups exhibited significant reduction in serum lipids.
Zusammenfassung. Eine erhöhte Bedeutsamkeit von Figur und Gewicht sowie Diätverhalten gehören zu den am besten bestätigten und bedeutungsvollsten Risikofaktoren, die bei jungen Frauen zu einem erhöhten Risiko für spätere Essstörungssymptome oder -syndrome führen. Präventive Interventionen sollten daher versuchen, diese Faktoren zu reduzieren, um die Wahrscheinlichkeit der Entwicklung einer Essstörung zu verringern. Die vorliegende Untersuchung beschreibt die Überprüfung der Wirksamkeit eines für den deutschen Sprachraum adaptierten Internet-gestützten Präventionsprogramms (“Student Bodies“) zur Reduktion von Risikofaktoren für gestörtes Essverhalten bzw. Essstörungen. 100 Studentinnen von zwei Universitäten wurden per Zufall entweder einer Interventionsgruppe oder einer Wartekontrollgruppe zugewiesen. Die Dauer der Intervention betrug 8 Wochen. Zum Post-Zeitpunkt konnte die Wirksamkeit des adaptierten Programms im Vergleich zur Kontrollgruppe gut bestätigt werden. Die Effekte waren deutlich höher für eine Subgruppe von Frauen mit erhöhtem Risiko für Essstörungen.
This paper examines the effects of community-wide health education on diet-related knowledge and behavior and on plasma cholesterol levels during an experimental field study in medium-sized cities in northern California. Samples of the population aged 12–74 years were drawn at baseline and every 2 years thereafter to obtain four cross-sectional surveys; participants aged 25–74 years are included In this paper (n = 6,814 or about 425 per city per survey). The baseline sample was asked to return to three follow-up surveys, also 2 years apart, constituting the cohort survey sample (n = 777). Diet was assessed by 24-hour recalls. In the serial cross-sectional survey samples, nutritional knowledge increased over time in both men and women in all cities; among women, this increase was significantly greater in the treatment cities. Plasma cholesterol declined significantly only in men and in neither sex was there evidence of a larger decline In treatment than in control cities. Dietary saturated fat intake tended to decline, but not significantly in either sex, and there was no evidence of treatment impact. Dietary cholesterol intake declined in both sexes. Results in the cohort samples were similar, except plasma cholesterol levels were unchanged over time In men and increased in women, and dietary saturated fat intake declined significantly among women. Secular improvements in knowledge of nutrition and in dietary cholesterol intake occurred during the early 1980s In both men and women In these four cities, while there was less consistent improvement In dietary saturated fat intake. Only nutritional knowledge among women achieved greater Improvement in treatment cities than in control cities. Continued and greater change in nutrition probably requires more sustained effort and broader methods, Including changes in the food supply.
Although a variety of psychological benefits have been attributed to regular exercise, few experimentally controlled studies of healthy individuals currently exist. One hundred twenty healthy, sedentary, middle-aged men and women were randomly assigned to either a 6-month home-based aerobic exercise training program or to an assessment-only control condition. Adherence across the 6-month period was found by both self-report and heart rate microprocessor methods to exceed 75% in both sexes. To assess changes in a variety of psychological variables over time, a 14-item Likert rating scale was completed and returned on a biweekly basis throughout the 6-month period. Slope analyses conducted on the 11 items attaining acceptable test-retest reliability coefficients showed significant between-groups differences on the 3 items most closely associated with the actual physical changes that occurred with exercise (all ps less than .004). Implications in relation to repeated measurement of psychological changes in nonclinical populations and the determination of the relevant population-, activity-, and program-specific parameters involved are discussed.
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