Development and preliminary validation of the cognitive behavioral dieting scale.

OBJECTIVE: The purpose of this research was to empirically develop the Cognitive Behavioral Dieting Scale (CBDS), a measure of current dieting. METHOD: The first study involved item generation and a procedure to boost internal consistency while reducing scale length. Study 2 involved a factor analysis and measures of scale reliability. The third study evaluated the ability of the CBDS to predict calorie intake and negative calorie balance from a 24-hr diet recall. Study 4 evaluated construct validity by comparing the CBDS to dietary restraint, body image, and health behavior self-efficacy. RESULTS: The CBDS is a 14-item scale which measures current dieting behavior and related thoughts within the past 2 weeks. Internal consistency was alpha = .95 and 2-day test-retest reliability was r = .95. This scale provides a method for operationalizing dieting, provides a construct that is different from restraint, and assess dieting behavior on a continuum. Additionally, this scale was able to predict calorie intake and negative calorie balance above and beyond the predictive ability of physical variables (i.e., body mass index BMI] and exercise calories). An additional study of construct validity showed the CBDS was related to poor body image esteem and dietary restraint, but minimally related to healthy eating self-efficacy. DISCUSSION: In conclusion, the CBDS shows promise as a valid and reliable measure of dieting behavior. This scale should have utility in future research on how current dieting relates to eating disorders, dietary restraint, and obesity.

Muscle stretching as an alternative relaxation training procedure.

The purpose of this program of research was to explore the use of muscle stretching procedures in relaxation training with a clinical population. In the first controlled study, stretching exercises for four muscle groups (obicularis occuli, sternocleidomastoid/trapezius, triceps/pectoralis major, and forearm/wrist flexors) were prepared. A group of people using these procedures (SR, N = 8) was compared to a group using the Bernstein and Borkovec (1973) tense-release (TR; N = 8) techniques for those same muscle groups, as well as compared to an appropriate group of controls (WL; N = 8). Assessment of physiological (multi-site EMG) and subjective (emotions, muscle tension, and self-efficacy) responses showed that persons in the SR displayed less sadness, less self-reported muscle tension at four sites, and less EMG activity on the r.masseter than persons in the TR group. In the second study, 15 subjects were administered an expanded version of the SR relaxation procedures. Results showed that all subjects reported significant decreases in self-reported levels of muscle tension; muscle tension responders showed lowered trapezius EMG and respiration rates and cardiovascular responders showed lowered diastolic blood pressure. The results are discussed in terms of the utility of relaxation procedures based primarily on muscle stretching exercises for lowering subjective and objective states of arousal.

Double-blind controlled trial comparing carbamazepine to oxazepam treatment of alcohol withdrawal.

Of 86 alcoholic men with severe alcohol withdrawal who began a double-blind controlled study comparing carbamazepine, 800 mg/day, to oxazepam, 120 mg/day, 66 (carbamazepine, N = 32; oxazepam, N = 34) completed the 7-day trial. In general, the drugs were found to be equally efficacious in treating the withdrawal syndrome and not significantly different with respect to side effects. The subjects taking oxazepam had an increase in global psychological distress from day 3 to day 7, and those taking carbamazepine exhibited a decline. The study suggests that carbamazepine is as effective and safe as benzodiazepine treatment for alcohol withdrawal.

Guided imaginal coping: an integrative treatment for panic disorder.

Contemporary models suggest that persons with panic disorder inaccurately attribute somatic anxiety symptoms to catastrophic causes. This consequently exacerbates their physiological symptoms, triggering full-blown panic attacks. Researchers have modified catastrophic thinking using cognitive therapy, but typically have not employed these techniques during actual episodes of heightened arousal. Thus, reported cognitive changes may not generalize to naturalistic situations involving hyperreactivity. This study describes use of an intervention which simultaneously combines symptom exposure and cognitive therapy techniques. The client treated here experienced reductions in panic attack frequency as well as duration and became less depressed as therapy progressed. Discussion addresses potential causal mechanisms and directions for future research.

Relaxation training through muscle stretching procedures: a pilot case.

The present paper introduces a relaxation procedure based upon muscle stretching exercises. Traditional progressive relaxation training starts from muscle tensing exercises to teach voluntary control of muscle tension, but the literature shows widely varying results. An alternative method of relaxation training starts from muscle stretching exercises. Muscle stretching provides sensation contrasts for learning relaxation in addition to fostering relaxation through the stretching of muscles. The present report documents the rationale for the procedure and presents data from a clinical case study, including six months' follow-up, in support of its efficacy.

Pain center follow-up study of treated and untreated patients.

To investigate the outcome of patients treated in a multidisciplinary pain clinic, patients previously treated in the center and patients who had been eligible for, but did not desire such treatment, were contacted by phone. Their current life and pain status were assessed using a structured interview format. Fourteen individuals in each group agreed to participate in the study. The groups did not differ significantly on variables of sex, age, time since referral, marital status, premorbid income, and type of pain. Analysis of differences in discomfort level for the treated group revealed a 47% decrease from a mean of 7.02 to 3.67 (10-point scale). The telephone contact occurred approximately 2 1/2 years following initial referral. There were no statistical differences in current pain levels, number of pain-related visits to health professionals, pain-related expenses, employment status, disability status, history of pain-related litigation, use of medications, or frequency of pain-related surgeries since referral. Patients treated in the pain clinic were significantly more likely to use active, self-control strategies to manage pain than were individuals in the control group. Use of such strategies, however, was limited. The data suggest that outcome studies of pain patients should include control groups treated by other modalities or who receive no treatment; that maintenance of treatment goals is compromised by compliance problems; and that more comprehensive cost effectiveness studies of chronic pain treatment are needed.

The control issue in biofeedback training.

Well-delineated models and procedural descriptions are noticeably missing from the clinical biofeedback literature dealing with the training of physiological self-control. As a consequence, optimal protocols for the assessment and training of self-control of physiological functions have not eventuated. The present article reviews evidence suggesting that researchers have (a) confused self-control training, assessment, and measurement of tonic response levels, (b) neglected to determine the degree of acquired physiological self-control, and (c) failed to report the relationship between level of acquired physiological control and clinical outcome. The article also proposes an assessment and training paradigm that may be useful in reducing these methodological problems in future biofeedback research.

Modification of combined migraine-muscle contraction headaches using BVP and EMG feedback.

The effect of blood volume pulse (BVP) and frontalis muscle action potential (EMG) feedback on control of vasoconstriction of the temporal artery and frontalis muscle activity in combined migraine-muscle tension subjects was investigated in a multiple baseline design (across subjects and responses). The data indicated: (a) both subjects obtained an ability to control BVP during BVP feedback and EMG during EMG feedback; (b) there were decreases in frequency of migraine headaches during BVP feedback and decreases in muscle contraction headaches during EMG feedback. The results of this study supported the theoretical explanation of two pain mechanisms involved in combined muscle contraction-migraine headaches as well as the effectiveness of bio-feedback procedures that target directly the specific pain mechanism in the elimination of the two types of head pain.