Paradoxical intention and recursive anxiety.

The present study was designed to investigate a possible relationship between "recursive anxiety" and paradoxical intention. Groups of subjects were chosen from among individuals with public speaking concerns. and for whom fear of fear or recursive anxiety clearly represented an important element, or was completely absent from the clinical profile. These subjects were offered a standard in vivo treatment program for public speaking phobia with inclusion or exclusion of paradoxical intention. A 2 x 2 factorial design was employed. Those whose public speaking anxiety was complicated by recursive anxiety experienced greater improvement when paradoxical intention was included in the treatment program than when it was not employed. In contrast, individuals reporting simple public speaking phobia demonstrated greater success with a treatment program in which paradoxical intention was absent. Wegner's hypothesis of "ironic" cognitive processing was used to explain the proposed relationship between paradoxical intention and fear of fear.

Utility of the functional assessment measure after discharge from inpatient rehabilitation.

OBJECTIVE: To assess the relationship between the Functional Independence Measure (FIM) and the Functional Assessment Measure (FAM), and community integration and return to work in patients with severe traumatic brain injuries (TBI). DESIGN: A cross-sectional, prospective design was used to collect data at 6 and 24 months postdischarge. The Return to Work Scale (RTW) and Community Integration Questionnaire (CIQ) were selected to assess return to work and community functioning. Predictor variables included the motor and cognitive subscales of the FIM and the FAM. SETTING: Follow-up database of an inpatient and community TBI Rehabilitation Unit. PARTICIPANTS: All consenting patients with TBI admitted to the unit, aged 16 or above. There were 88 patients at 6 and 79 patients at 24 month follow-up. RESULTS: At 6 months follow-up, the FAM and the FIM were roughly equivalent in their ability to predict RTW and CIQ scores. At 24 months, FAM motor was the only significant predictor of CIQ, and FAM cognitive scores displayed an advantage over the FIM in predicting employment status. CONCLUSIONS: The FAM subscales produced only modest gains in prediction of employment status and community integration at 24 months postdischarge. This may reflect ceiling effects on the functional measures, a limited range on the RTW measure, poor ecologic validity of functional disability measures in assessing handicap, or a combination of these factors.

Attentional biases in eating disorders: a visual probe detection procedure.

OBJECTIVE: To investigate attentional biases for body shape and weight-related stimulus words among subjects with anorexia nervosa, bulimia nervosa, and control subjects classified using a measure of dietary restraint. METHODS: A visual probe detection task was used to assess attention toward stimulus words reflecting either a thin or a large physique and positively or negatively valenced emotion words. RESULTS: In comparison to controls, subjects with eating disorders detected target probes more slowly when they appeared in the same location as had stimulus words connoting a thin physique. In addition, there was a trend toward faster detection or target probes that appeared in the same location as had stimulus words connoting a large physique. Neither of these effects were observed among restrained eaters. DISCUSSION: Our results extend prior work suggesting information-processing biases for body shape and weight-related stimuli among persons with eating disorders.

Conscious and preconscious processing of food, body weight and shape, and emotion-related words in women with anorexia nervosa.

OBJECTIVE: The present study was conducted to extend prior research on attention toward food and body weight and shape-related stimuli in women with eating disorders. METHOD: A modified Stroop color-naming task was completed by women with anorexia nervosa and by control females subdivided on a measure of dietary restraint. Eating disorder-relevant word categories included words connoting fatness, words connoting thinness, low caloric density food words, high caloric density food words, and neutral, control words. Valence effects were controlled for by including positively and negatively valenced emotion words. Stimuli were presented under both unmasked and masked conditions. RESULTS: Using unmasked stimuli, patients with anorexia nervosa, but not unrestrained or restrained eaters, had delayed color-naming latencies for both thin and fat word categories and, to a lesser extent, for high caloric density food words. No differences were observed with masked stimuli. DISCUSSION: Our findings suggest that both thinness and fatness are especially salient to women with anorexia. The lack of effects for emotion words suggests that these findings do not reflect a valence effect. We found no evidence for preconscious attentional biases in the masked condition.

Alcohol abuse and traumatic brain injury: effect on event-related potentials.

OBJECTIVE: To examine the individual and combined impact that traumatic brain injury (TBI) and heavy social use of alcohol have on electrophysiologic correlates of working memory and evaluation of task-relevant information. DESIGN: Case-control study. SETTING: University hospital brain injury rehabilitation unit. PARTICIPANTS: Forty male volunteers divided into four groups on the basis of their history of TBI and alcohol intake. Subjects with TBI had experienced a severe closed head injury at least 1 year before testing. MAIN OUTCOME MEASURE: Event-related potentials (ERPs) and neuropsychometric tests. RESULTS: Groups showed no significant differences in average age or neuropsychological tests. TBI groups did not differ in time postinjury or on severity measures. Alcohol use measures were significantly greater in the two alcohol groups. N200 latency and P300 amplitude were impaired in heavy social drinkers and in nondrinking subjects with TBI relative to controls, but were significantly impaired in subjects with TBI who were also heavy social drinkers. CONCLUSION: The results indicate that although alcohol use and TBI independently produce mile alterations in some aspects of late ERP components, the ERP changes are significantly greater when alcohol use and TBI are combined. This study provides evidence that heavy social drinking after TBI has a measurable impact on electrophysiologic correlates of cognition.

A standard measure for exercise prescription for aqua running.

Aqua running has been promoted as a method for cardiovascular conditioning for the injured athlete as well as for others who desire a low impact aerobic workout. Recent studies have suggested the need for an environment-specific measure of exercise intensity. Twenty healthy subjects, 10 men and 10 women, underwent a graded exercise test of aqua running to investigate the relationship between cadence and heart rate. This was done to determine the utility of cadence as a measure for exercise prescription. The graded exercise test followed a standard protocol for exercise testing in aqua running. Results demonstrated a high correlation between cadence and heart rate, both as a group as well as individually. We conclude that cadence may be used as a measure for exercise prescription for aqua running.

Neurological and skeletal outcomes in 113 patients with closed injuries to the cervical spinal cord.

Neurological and skeletal outcomes were evaluated in 113 patients for one year following closed lower cervical spinal cord injuries. The extent of neurological recovery did not depend on surgical versus nonsurgical management, or the degree of spinal angulation, vertebral displacement, spinal stenosis, or inferred mechanism of injury based on the initial plain cervical x-rays. Assessment of skeletal outcomes demonstrated significantly less vertebral angulation, more rapid stabilization, and less anterior callus formation among the patients in the surgical group. In addition, the surgical patients had marginally shorter lengths of hospitalization.

Emotional arousal and overeating in restrained eaters.

We tested the effects of 3 mood inductions (neutral, positive, and negative) on food intake in 91 women of varying degrees of dietary restraint. Mood induction was accomplished by exposure to 1 of 3 film segments: a travelogue (neutral affect), a comedy film (positive affect), and a horror film (negative affect). In subjects exposed to the neutral film, food intake decreased with increasing levels of dietary restraint. Among subjects who viewed either the comedy film or the horror film, however, food intake increased with increasing restraint. Although the horror film appeared to be more disinhibiting than the comedy film, this effect may have resulted from a difference in the intensity of the emotions induced rather than from their valence. These results suggest that emotional arousal, regardless of valence, may trigger overeating among restrained eaters.

On the special status of "ego threats".

This article comments on a recent article by Heatherton, Herman, and Polivy (1991) in which they suggest that ego threats are a prerequisite to affectively induced disinhibition of food intake in restrained eaters and current dieters. In contrast, the present review suggests that mood induction procedures that involve no apparent threat (e.g., viewing a frightening film) can also prompt disinhibition in restrained eaters. Thus, any mood induction procedure that does not directly physically threaten the S may disinhibit restrained eaters. It is concluded that recommendations to focus future research on ego threats are premature and may serve to obscure the mechanisms by which changes in affective state influence food intake in dieters.

Problem-solving deficits in suicidal patients: trait vulnerability or state phenomenon?

A diathesis-stress model has been proposed (Schotte & Clum, 1982, 1987), in which deficits in interpersonal problem-solving skills are said to predispose individuals under chronic stress to depression, hopelessness, and suicide ideation. The present study examined the stability of interpersonal problem-solving skills in a short-term, longitudinal study of hospitalized suicide ideators (N = 36). The Ss displayed marked changes in depressive symptoms, state anxiety, hopelessness, and suicide intent over time, and these improvements were associated with improvements in interpersonal problem-solving skills. It is concluded that interpersonal problem-solving deficits may be a concomitant, rather than a cause, of depression, hopelessness, and suicide intent.

Film-induced negative affect triggers overeating in restrained eaters.

We tested the effects of film-induced negative affect (i.e., exposure to a frightening film) in 60 women classified as either restrained or unrestrained eaters on the basis of their responses to the Revised Restraint Scale (Herman & Polivy, 1980). Exposure to the frightening film, in contrast to a neutral film, was associated with increases in anxiety, sadness, and anger. High restraint subjects exposed to the frightening film ate more than did equally restrained subjects exposed to a neutral film or low restraint subjects exposed to either film. Thus, negative affect triggered overeating among restrained eaters. Although unrestrained eaters exposed to the frightening film ate less than those who viewed the neutral film, this difference was not statistically significant. These results suggest that negative affect may prompt overeating in persons who attempt to restrict their caloric intake.

The effects of weight reduction on blood pressure in 301 obese patients.

The effects of weight reduction on blood pressure were assessed in 301 obese patients. Weight reduction was achieved by behavior modification, medication, or their combination and was associated with significant reductions in systolic and diastolic blood pressure. The weight reduction method was less important than the amount of weight lost in determining reductions in blood pressure. The greatest reductions in weight and blood pressure occurred during the first half of weight loss, suggesting that even brief treatment (ie, 8 to 10 weeks) may benefit obese, hypertensive patients. Despite repeated measurements, 36 patients who failed to lose weight showed no decrease in blood pressure. Although blood pressure rose during follow-up in patients who regained weight, it remained below baseline levels. These findings provide further support for weight reduction in the control of hypertension.

Effects of weight cycling on metabolic control in male outpatients with non-insulin-dependent diabetes mellitus.

Examined the effects of weight cycling (i.e., losing and regaining or gaining and relosing body weight) versus weight maintenance on metabolic control in 327 adult, male, outpatient veterans with non-insulin-dependent diabetes mellitus (NIDDM) who were followed over an average of 3.4 years. When compared with weight maintenance, weight cycling, whether defined as a categorical or as a continuous variable, was not found to be associated with deficits in metabolic control or increased need for hypoglycemic medication. Patients who weight cycled had fasting serum glucose and hemoglobin A1c levels comparable to those who remained within 10% of their initial body weights, and these levels of metabolic control were obtained with similar classes and dosages of hypoglycemic medication.

Bulimia vs bulimic behaviors on a college campus.

A self-report survey of bulimic behaviors was conducted with 1965 students who were selected to provide a cross section of a large, eastern university. Follow-up interviews of a subsample of respondents were conducted to validate the survey. After correcting for false-positive responses, only 1.3% of the female and 0.1% of the male respondents met diagnostic criteria for bulimia according to either the third edition or the proposed revision of the Diagnostic and Statistical Manual of Mental Disorders. In addition, an inflection point was found in the rates of binge eating, self-induced vomiting, and their combination at a frequency of about twice per month.