77 research outputs found
Controlling the uncontrolled: Are there incidental experimenter effects on physiologic responding?
The degree to which experimenters shape participant behavior has long been of interest in experimental social science research. Here, we extend this question to the domain of peripheral psychophysiology, where experimenters often have direct, physical contact with participants, yet researchers do not consistently test for their influence. We describe analytic tools for examining experimenter effects in peripheral physiology. Using these tools, we investigate nine data sets totaling 1,341 participants and 160 experimenters across different roles (e.g., lead research assistants, evaluators, confederates) to demonstrate how researchers can test for experimenter effects in participant autonomic nervous system activity during baseline recordings and reactivity to study tasks. Our results showed (a) little to no significant variance in participants' physiological reactivity due to their experimenters, and (b) little to no evidence that three characteristics of experimenters that are well known to shape interpersonal interactions-status (using five studies with 682 total participants), gender (using two studies with 359 total participants), and race (in two studies with 554 total participants)-influenced participants' physiology. We highlight several reasons that experimenter effects in physiological data are still cause for concern, including the fact that experimenters in these studies were already restricted on a number of characteristics (e.g., age, education). We present recommendations for examining and reducing experimenter effects in physiological data and discuss implications for replication
A megbocsátás pszichológiája: kialakulása, hatásai és fejlesztése
A megbocsátás az interperszonális sĂ©relmekre adott egyik lehetsĂ©ges válasznak tekinthetĹ‘, melynek fĂłkuszában a sĂ©relmet elszenvedĹ‘ szemĂ©ly kognitĂv, Ă©rzelmi Ă©s viselkedĂ©ses válaszaiban bekövetkezĹ‘ proszociális változás áll. A megbocsátás mentális Ă©s fizikai egĂ©szsĂ©gre kifejtett pozitĂv hatása jĂłl dokumentált. Magas szintje alacsony szorongás- Ă©s depressziĂłszinttel társul, illetve sikeresen csökkenti a stresszre adott fizikai választ (kortizol Ă©s kardiovaszkuláris reaktivitás). A megbocsátást - hatásai alapján - olyan emĂłciĂł fĂłkuszĂş megkĂĽzdĂ©si mĂłdkĂ©nt definiálhatjuk, mely sikeresen csökkenti az interperszonális sĂ©relem nyomán kialakult stresszreakciĂłt. Az utĂłbbi Ă©vekben számos intervenciĂłs technikát dolgoztak ki, melyek a megbocsátás támogatását, illetve fejlesztĂ©sĂ©t tűztĂ©k ki cĂ©lkĂ©nt. Ezek a mĂłdszerek általában sikeresen növelik a megbocsátásra valĂł hajlandĂłságot.</o:p
Cognitive behaviour therapy response and dropout rate across purging and nonpurging bulimia nervosa and binge eating disorder : DSM-5 implications
Background: With the imminent publication of the new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), there has been a growing interest in the study of the boundaries across the three bulimic spectrum syndromes [bulimia nervosa-purging type (BN-P), bulimia nervosa-non purging type (BN-NP) and binge eating disorder (BED)]. Therefore, the aims of this study were to determine differences in treatment response and dropout rates following Cognitive Behavioural Therapy (CBT) across the three bulimic-spectrum syndromes. Method: The sample comprised of 454 females (87 BED, 327 BN-P and 40 BN-NP) diagnosed according to DSM-IV-TR criteria who were treated with 22 weekly outpatient sessions of group CBT therapy. Patients were assessed before and after treatment using a food and binging/purging diary and some clinical questionnaires in the field of ED. "Full remission" was defined as total absence of binging and purging (laxatives and/or vomiting) behaviors and psychological improvement for at least 4 (consecutive). Results: Full remission rate was found to be significantly higher in BED (69.5%) than in both BN-P (p < 0.005) and BN-NP (p < 0.001), which presented no significant differences between them (30.9% and 35.5%). The rate of dropout from group CBT was also higher in BED (33.7%) than in BN-P (p < 0.001) and BN-NP (p < 0.05), which were similar (15.4% and 12.8%, respectively). Conclusions: Results suggest that purging and non-purging BN have similar treatment response and dropping out rates, whereas BED appears as a separate diagnosis with better outcome for those who complete treatment. The results support the proposed new DSM-5 classification
The STRATOB study: design of a randomized controlled clinical trial of Cognitive Behavioral Therapy and Brief Strategic Therapy with telecare in patients with obesity and binge-eating disorder referred to residential nutritional rehabilitation
bstract
BACKGROUND:
Overweight and obesity are linked with binge eating disorder (BED). Effective interventions to significantly reduce weight, maintain weight loss and manage associated pathologies like BED are typically combined treatment options (dietetic, nutritional, physical, behavioral, cognitive-behavioral, pharmacological, surgical). Significant difficulties with regard to availability, costs, treatment adherence and long-term efficacy are present. Particularly Cognitive Behavioral Therapy (CBT) is the therapeutic approach indicated both in in-patient and in out-patient settings for BED. In recent years systemic and systemic-strategic psychotherapies have been implemented to treat patients with obesity and BED involved in familiar problems. Particularly a brief protocol for the systemic-strategic treatment of BED, using overall the strategic dialogue, has been recently developed. Moreover telemedicine, a new promising low cost method, has been used for obesity with BED in out-patient settings in order to avoid relapse after the in-patient step of treatment and to keep on a continuity of care with the involvement of the same clinical in-patient team.
METHODS:
The comparison between CBT and Brief Strategic Therapy (BST) will be assessed in a two-arm randomized controlled clinical trial. Due to the novelty of the application of BST in BED treatment (no other RCTs including BST have been carried out), a pilot study will be carried out before conducting a large scale randomized controlled clinical trial (RCT). Both CBT and BST group will follow an in-hospital treatment (diet, physical activity, dietitian counseling, 8 psychological sessions) plus 8 out-patient telephone-based sessions of psychological support and monitoring with the same in-patient psychotherapists. Primary outcome measure of the randomized trial will be the change in the Global Index of the Outcome Questionnaire (OQ-45.2). Secondary outcome measures will be the percentage of BED patients remitted considering the number of weekly binge episodes and the weight loss. Data will be collected at baseline, at discharge from the hospital (c.a. 1 month after) and after 6-12-24 months from the end of the in-hospital treatment. Data at follow-up time points will be collected through tele-sessions.
DISCUSSION:
The STRATOB (Systemic and STRATegic psychotherapy for OBesity), a comprehensive two-phase stepped down program enhanced by telepsychology for the medium-term treatment of obese people with BED seeking intervention for weight loss, will shed light about the comparison of the effectiveness of the BST with the gold standard CBT and about the continuity of care at home using a low-level of telecare (mobile phones).
TRIAL REGISTRATION:
ClinicalTrials.gov Identifier: NCT0109625
Exploring the hardship of ease: Subjective and objective effort in the ease-of-processing paradigm
Uma revisĂŁo dos estudos latino-americanos sobre o transtorno da compulsĂŁo alimentar periĂłdica
Dopamine and Opioid Neurotransmission in Behavioral Addictions: A Comparative PET Study in Pathological Gambling and Binge Eating.
Although behavioral addictions share many clinical features with drug addictions, they show strikingly large variation in their behavioral phenotypes (such as in uncontrollable gambling or eating). Neurotransmitter function in behavioral addictions is poorly understood, but has important implications in understanding its relationship with substance use disorders and underlying mechanisms of therapeutic efficacy. Here, we compare opioid and dopamine function between two behavioral addiction phenotypes: pathological gambling (PG) and binge eating disorder (BED). Thirty-nine participants (15 PG, 7 BED, and 17 controls) were scanned with [11C]carfentanil and [18F]fluorodopa positron emission tomography using a high-resolution scanner. Binding potentials relative to non-displaceable binding (BPND) for [11C]carfentanil and influx rate constant (Ki) values for [18F]fluorodopa were analyzed with region-of-interest and whole-brain voxel-by-voxel analyses. BED subjects showed widespread reductions in [11C]carfentanil BPND in multiple subcortical and cortical brain regions and in striatal [18F]fluorodopa Ki compared with controls. In PG patients, [11C]carfentanil BPND was reduced in the anterior cingulate with no differences in [18F]fluorodopa Ki compared with controls. In the nucleus accumbens, a key region involved in reward processing, [11C]Carfentanil BPND was 30-34% lower and [18F]fluorodopa Ki was 20% lower in BED compared with PG and controls (p<0.002). BED and PG are thus dissociable as a function of dopaminergic and opioidergic neurotransmission. Compared with PG, BED patients show widespread losses of mu-opioid receptor availability together with presynaptic dopaminergic defects. These findings highlight the heterogeneity underlying the subtypes of addiction and indicate differential mechanisms in the expression of pathological behaviors and responses to treatment.This study was supported by the Academy of Finland (grant #256836), the Finnish Medical Foundation, the Finnish Alcohol Research Foundation and the Turku University Central Hospital (EVO grants). VV was supported by a Wellcome Trust Fellowship (093705/10/Z)
Hemodynamic mechanisms of the attenuated blood pressure response to mental stress after a single bout of maximal dynamic exercise in healthy subjects
Treatment Protocols for Eating Disorders: Clinicians’ Attitudes, Concerns, Adherence and Difficulties Delivering Evidence-Based Psychological Interventions
There are several protocols in existence that guide clinicians in the implementation of effective, evidence-based psychological interventions for eating disorders. These have been made accessible in the form of treatment manuals. However, relatively few clinicians use those protocols, preferring to offer more eclectic or integrative approaches. Following a summary of the research that shows that these evidence-based approaches can be used successfully in routine clinical settings, this review considers why there is such poor uptake of these therapies in such settings. This review focuses on the role of service culture and on clinicians’ own attitudes, beliefs and emotions. Possible means of enhancing uptake are considered, but these cannot be considered to be ideal solutions at present
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Ethnic variations in the pharmacological and nonpharmacological treatment of hypertension: biopsychosocial perspective
Blood pressure regulation is a complex, dynamic process influenced by psychosocial, behavioral, and cultural factors. Integrative theories of cross-population differences in the prevalence of hypertension and response to treatment include physiological, social, and genetic perspectives. Ethnic differences in salt sensitivity, calcium regulation of sodium flux, vascular reactivity to psychosocial stress, and drug metabolism are integral components of observed cross-cultural variations in hypertension. In general, pharmacological treatment of hypertension in blacks is most consistently achieved through diuretics and calcium-channel blockers; angiotensin-converting enzyme inhibitors and beta-blockers are more efficacious in whites. These stereotypical patterns are consistent with the higher prevalence of salt sensitivity, stress-induced vasoconstriction and slower natriuresis, and alpha-adrenergic receptor mediated vascular reactivity observed in blacks compared with whites. Some antihypertensive agents produce adverse glucose metabolic side effects, thus contraindicating their use in individuals with high sympathetic tone, insulin resistance, or obesity. Cross-population differences in adopted guidelines for treating hypertension exist but are not likely a factor in observed ethnic differences in rate of treatment or control. Attitudes toward nontraditional treatment options (e.g., herbal medicine), political and individual responsibilities in health care, and adaptations to acculturation and urbanization stress differ between and within societies and thus play a role in observed cross-cultural differences in hypertension as well. The value of regular exercise in controlling hypertension is widely recognized, and reductions in blood pressure reactivity to behavioral stress following acute exercise have been documented; however, empirical studies of ethnic differences in exercise-related blood pressure control are lacking. Overall, increased awareness of the multifactorial nature of hypertension by both the physician and the patient will facilitate treatment of this disease on an individual basis
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