The Experience of Weight Control, Exercise and Healthy Eating in Medically Triggered Patients

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Experiences With Weight Loss Triggers in Women Prescribed to Lose Weight by Their Physician

Background: With the global rise of individuals classified as overweight and obese, weight-related screenings have been promoted to combat their high prevalence and associated health problems. Hopefully, such screenings can act as a ‘trigger’ for health behavior change, however little is known about the experience of weight loss triggers.Objectives: The aim of this study was to elaborate on the experiences and meanings of weight-control triggers in a sample of overweight women prescribed by their physician to lose weight.Patients and Methods: We conducted exploratory qualitative interviews, grounded in phenomenological practices, to elaborate on the experience and meaning of weight loss ‘triggers’ in a sample of overweight, female patients prescribed to lose weight by their physician.Results: Weight-related screenings can act as a ‘trigger’ for health behavior change. Overall, we discovered five novel themes that embodied patients’ complex experiences with triggers: (1) trigger realization, (2) trigger meaning, (3) knowing what to do, (4) perceptions of self, and (5) the good, the bad, the monitoring.Conclusions: We believe our findings advance the novel understanding of experiences with triggers. Specifically, our work sheds light on why triggers occur, and can guide how to create and manage both realized and meaningful triggers for healthy behavior change. The present results suggest that trigger realization can come from several different sources (e.g. medical, emotional, clothing, social), yet women are capable of deflecting any potential trigger experience. In addition, our findings suggest multiple facets of self-monitoring experiences can actually be counterproductive in weight control. The results provide insight for primary care, weight control counseling, and future interventions for triggered patients

Childhood ADHD and Growth in Adolescent Alcohol Use: The Roles of Functional Impairments, ADHD Symptom Persistence, and Parental Knowledge

Research on the relation between childhood Attention-Deficit/Hyperactivity Disorder (ADHD) and adolescent alcohol use has found mixed results. Studies are needed that operationalize alcohol use in developmentally appropriate ways and that test theoretically plausible moderators and mediators in a longitudinal framework. The current study tested childhood ADHD as a predictor of alcohol use frequency at age 17, and age-related increases in alcohol use frequency, through adolescence for 163 adolescents with ADHD diagnosed in childhood and 120 adolescents without ADHD histories. Childhood ADHD did not predict either alcohol outcome. However, parental knowledge of the teen’s friendships, activities, and whereabouts moderated the association such that childhood ADHD predicted alcohol use frequency at age 17 when parental knowledge was below median levels for the sample. Mediational pathways that explained this risk included social impairment, persistence of ADHD symptoms, grade point average, and delinquency. Social impairment was positively associated with alcohol use frequency through delinquency; it was negatively associated with alcohol use frequency as a direct effect independent of delinquency. These nuanced moderated-mediation findings help to explain previously inconsistent results for the ADHD-adolescent alcohol use association. The findings also imply that future research and intervention efforts should focus on ADHD-related social and academic impairments as well as symptom persistence and parenting efforts

Motorsports Involvement Among Adolescents and Young Adults with Childhood ADHD

Though children with attention-deficit/hyperactivity disorder (ADHD) are at risk for impulsive, health-endangering behavior, few studies have examined non-substance use-related risk-taking behaviors. This study examined whether adolescents and young adults with ADHD histories were more likely than those without ADHD histories to report frequent engagement in motorsports, a collection of risky driving-related activities associated with elevated rates of physical injury. Path analyses tested whether persistent impulsivity, comorbid conduct disorder or antisocial personality disorder (CD/ASP), and heavy alcohol use mediated this association. Analyses also explored whether frequent motorsporting was associated with unsafe and alcohol-influenced driving

Effects of Behavioral and Pharmacological Therapies on Peer Reinforcement of Deviancy in Children With ADHD-Only, ADHD and Conduct Problems, and Controls

Objective: This study compared the unique and combined effects of evidence-based treatments for ADHD—stimulant medication and behavior modification—on children’s rates of reinforcement for deviant peer behavior (RDPB). Method: Using a within-subjects design, 222 elementary school-age children attending a summer treatment program, including 151 children with ADHD (127 male), with and without comorbid conduct problems, and 71 control children (57 male), received varying combinations of behavior modification (no, low-intensity, and high-intensity) and methylphenidate (placebo, 0.15 mg/kg, 0.30 mg/kg, and 0.60 mg/kg). RDPB was measured through direct observation and compared across all behavior modification and medication conditions. Results: Children with ADHD reinforced the deviant behavior of their peers at a significantly higher rate than control children in the absence of either intervention. However, that difference largely disappeared in the presence of both behavior modification and medication. Both low and high-intensity behavior modification, as well as medium (0.30 mg/kg) and high (0.60 mg/kg) doses of methylphenidate, significantly reduced the rate of ADHD children’s RDPB to levels similar to the control group. Conclusions: Results indicate that although untreated children with ADHD do engage in RDPB at a greater rate than their non-ADHD peers, existing evidence-based interventions can substantially decrease the presence of RDPB, thereby limiting potential iatrogenic effects in group-based treatment settings. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract

A Dose-Ranging Study of Behavioral and Pharmacological Treatment in Social Settings for Children with ADHD

Placebo and three doses of methylphenidate (MPH) were crossed with 3 levels of behavioral modification (no behavioral modification, NBM; low-intensity behavioral modification, LBM; and high-intensity behavior modification, HBM) in the context of a summer treatment program (STP). Participants were 48 children with ADHD, aged 5-12. Behavior was examined in a variety of social settings (sports activities, art class, lunch) that are typical of elementary school, neighborhood, and after-school settings. Children received each behavioral condition for 3 weeks, order counterbalanced across groups. Children concurrently received in random order placebo, 0.15 mg/kg/dose, 0.3 mg/kg/dose, or 0.6 mg/kg/dose MPH, 3 times daily with dose manipulated on a daily basis in random order for each child. Both behavioral and medication treatments produced highly significant and positive effects on children\u27s behavior. The treatment modalities also interacted significantly. Whereas there was a linear dose-response curve for medication in NBM, the dose-response curves flattened considerably in LBM and HBM. Behavior modification produced effects as large as moderate doses, and on some measures, high doses of medication. These results replicate and extend to social-recreational settings previously reported results in a classroom setting from the same sample (Fabiano et al., School Psychology Review, 36, 195-216, ). Results illustrate the importance of taking dosage/intensity into account when evaluating combined treatments; there were no benefits of combined treatments when the dosage of either treatment was high but combination of the low-dose treatments produced substantial incremental improvement over unimodal treatment. [ABSTRACT FROM AUTHOR

Teacher Ratings of \u3ci\u3eDSM-III-R\u3c/i\u3e Symptoms for the Disruptive Behavior Disorders

Ratings were collected on a rating scale comprised of the DSM-III-R diagnostic criteria for disruptive behavior disorders. Teacher ratings were obtained for 931 boys in regular classrooms in grades K through 8 from around North America. Means and standard deviations for attention-deficit hyperactivity disorder (ADHD), oppositional-defiant disorder (ODD), and conduct disorder (CD) scales are reported by age. Frequencies of DSM-III-R symptoms are reported by age, and suggested diagnostic cutoffs are discussed. A factor analysis revealed three factors: one reflecting ODD and several CD symptoms, one on which ADHD symptoms of inattention loaded, and one comprised of ADHD impulsivity/overactivity symptoms. Conditional probability analyses revealed that several hallmark symptoms of ADHD had very poor predictive power, whereas combinations of symptoms from the two ADHD factors had good predictive power. Combinations of ODD symptoms also had very high predictive power. The limited utility of teacher ratings in assessing symptoms of conduct disorder in this age range is discussed

Effects of a Summer Treatment Program on Functional Sports Outcomes in Young Children with ADHD

International audienceParticipation in youth sports can be very beneficial, but children with Attention Deficit Hyperactivity Disorder (ADHD) may participate less often and less successfully. The current study evaluated functional sports outcomes for children with ADHD who attended an intensive behavioral treatment program that included a sports training component, and it compared outcomes to children with ADHD who did not attend the program. Results suggest that treatment resulted in significant improvements in many aspects of children's sports functioning, including knowledge of game rules, in vivo game performance, and fundamental skill tasks (motor proficiency, ability to trap a soccer ball appropriately, reduced handball penalties in soccer, and improved ability to catch a baseball). Parents also reported improved sports skills and good sportsmanship in the treatment group. No differences between groups were evident on additional skill tasks evaluating accurately kicking a soccer ball, throwing a baseball, or hitting a baseball off a tee. These results suggest intensive behavioral intervention that includes sports training can significantly improve functional sports outcomes for young children with ADHD