Carbon-14 and tritium measurement by means of bremsstrahlung emissions.

The feasibility of measuring carbon-14 and tritium in vivo has been demonstrated in the rat; thin scintillation detectors were used for the measurement of bremsstrahlung produced by these soft beta emitters. Measurements of tritium in vivo are limited to the study of surface phenomena, whereas bremsstrahlung produced by carbon-14 may be detected from depths of several centimeters.

Comparison of carbohydrate-containing and carbohydrate-restricted hypocaloric diets in the treatment of obesity: effects of appetite and mood.

After a weight-maintaining diet base-line, obese female inpatients were provided with either a carbohydrate-restricted diet (827 kcal; 35% protein, 64% fat, 1% carbohydrate) or a carbohydrate-containing diet (827 kcal; 35% protein, 36% fat, 29% carbohydrate) for 6 wk. When compared with the psychological adjustment during the base-line diet, there was a temporary increase in appetite and a tendency toward dysphoric moods and attitudes during the 1st wk of both treatment diets. After adaptation to the treatment diets, appetite and other psychological states were similar to those during the pretreatment weight-maintaining diet. There was no support for the idea that a carbohydrate-free protein-supplemented fast decreases appetite and elevates mood in comparison with an isocaloric carbohydrate-containing diet. Thus, suppression of appetite alone does not appear to be sufficient reason in itself for using diets of this type.

Mood and appetite during minimal-carbohydrate and carbohydrate-supplemented hypocaloric diets.

After a baseline period of free-feeding, 20 obese outpatients alternated between four 2-wk periods of minimal-carbohydrate diet (800 kcal; 58% protein and 42% fat by weight) and of a carbohydrate-supplemented diet (1,000 kcal; 42% protein, 30% fat, and 28% carbohydrate). In a comparison of psychological adjustment during the baseline and low-calorie diets, the initial 2 wk of dieting was associated with a decrease in appetite and elevation of psychological well-being, regardless of the composition of the diet. Thereafter, appetite and mood approached basal levels. Further changes in these psychological reactions to dieting did not vary with the type of diet. There was no support for the idea that a minimal-carbohydrate, protein-supplemented fast decreases appetite and elevates mood more in comparison with a similar diet containing enough carbohydrate to minimize ketosis.

Resting metabolic rate in women with bulimia nervosa: a cross-sectional and treatment study.

Two studies on resting metabolic rate (RMR) in bulimia nervosa were conducted. The first study compared RMR before treatment in 25 normal-weight women with bulimia nervosa and 20 control subjects of similar height, weight, body composition, age, and activity level. No significant difference in RMR adjusted for fat-free weight was observed. The second study sought to determine whether RMR in women with bulimia nervosa changed if they ceased vomiting and resumed eating in a more normal fashion after cognitive-behavioral treatment. There was no differential change in RMR from pre- to posttreatment for the "improved" bulimics (9 of 12 subjects who received treatment) relative to 13 control subjects who were also tested twice at the same time intervals as the treated bulimia nervosa subjects. These findings do not support the hypothesis that normal-weight women with bulimia nervosa have a suppressed RMR, nor is it altered with treatment compared with matched control subjects.

Prevalence of weight reducing and weight gaining in adolescent girls and boys.

This is a survey of the prevalence of weight reducing and weight gaining in high school children. Our sample of 1,373 high school girls and boys was geographically, racially, and economically diverse. On the day of the survey, 63% of the girls and 16.2% of the boys reported being on weight reducing regimens; 9.1% of the girls and 28.4% of the boys were trying to gain weight. Most female reducers and male gainers were already normal weight. Compared to other racial groups, whites and Hispanics were more likely to be reducing, whereas blacks were more likely to be gaining. Exercise and moderate caloric reduction were most popular for weight reducing, and a small but significant number were regularly using fasting, vomiting, laxatives, and appetite suppressants. The direction of weight modification for girls and boys conformed to stereotyped physical ideals. The rate of weight reducing in female high school adolescents has increased significantly since similar surveys of American youths 20 years ago.

Musculoskeletal status and disability of MMPI profile subgroups among patients with low back pain.

The Minnesota Multiphasic Personality Inventory (MMPI) profiles of 205 male and 157 female patients with acute and chronic low back pain (LBP) were studied for replicable homogeneous subgroups using three cluster-analysis procedures. Two normal and three clinically elevated profile subgroups were identified. The two normal subgroups were characterized by relatively normal musculoskeletal condition and were least disabled, but they differed somewhat from each other in duration of pain, presence of physical abnormalities, and daily functioning. The third subgroup had the following characteristics: an elevated neurotic triad, greatest duration of symptoms, most abnormal physical findings, greatest limitation of motion, most pain complaints during physical examination, and the fewest number of intact functional activities. The fourth subgroup, with an elevated neurotic triad plus subclinical elevations on other scales, had somewhat less musculoskeletal impairment but had extensive work disability, financial compensation, and previous surgeries. The fifth and most pathologic profile subgroup surprisingly consisted largely of acute-pain patients whose musculoskeletal condition and daily functioning were similar to those of the normal subgroups. Patients in the three abnormal MMPI subgroups were exposed to more LBP physical-risk factors in the workplace. Implications for psychological treatment with these different profile types are discussed.

A comparison of weight control and weight control plus body image therapy for obese men and women.

Participants were 65 obese men and women who were randomly assigned to either weight control or weight control plus cognitive behavioral body image therapy. Both conditions showed clinically significant improvements in body image at posttreatment and 1-year follow-up. Adding body image therapy to weight control did not result in greater psychological improvements and did not result in better maintenance of body image change when participants regained weight after treatment. Weight loss and maintenance were equivalent between groups. Adding body image therapy did not improve or detract from weight loss. Although body image therapy has been shown to be effective in obese persons, it appears that a well-rounded cognitive-behavioral weight control program is effective as well.

Cognitive-behavioral body image therapy for body dysmorphic disorder.

Body dysmorphic disorder (BDD) is a distressing body image disorder that involves excessive preoccupation with physical appearance in a normal appearing person. Prior case reports of behavior therapy were encouraging, but no controlled evaluation of behavior therapy or any other type of treatment had been conducted. In the present study, 54 BDD subjects were randomly assigned to cognitive behavior therapy or no treatment. Patients were treated in small groups for eight 2-hour sessions. Therapy involved modification of intrusive thoughts of body dissatisfaction and overvalued beliefs about physical appearance, exposure to avoided body image situations, and elimination of body checking. Body dysmorphic disorder symptoms were significantly decreased in therapy subjects and the disorder was eliminated in 82% of cases at posttreatment and 77% at follow-up. Overall psychological symptoms and self-esteem also improved in therapy subjects.

Fast and slow neutrons in an 18-MV photon beam from a Philips SL/75-20 linear accelerator.

Fast- and slow-neutron contamination in an 18-MV photon beam from a Philips SL/75-20 linear accelerator has been measured. Aluminum and indium foils were activated to determine fast- and slow-neutron fluence, which were largely independent of field sizes. Measured fast-neutron fluences were typically 13.9 X 10(4) and 4.4 X 10(4) neutrons/cm2/rad of x ray inside and 5 cm outside the field, respectively. Slow-neutron fluences, 1.3 X 10(4) neutrons/cm2/rad of x ray, remained relatively constant inside and outside the field. The reported results are about three times higher than neutron fluences recently reported with a betatron operated at the same energy.

Relative measurements of fast neutron contamination in 18-MV photon beams from two linear accelerators and a betatron.

Fast neutron contamination in photon beams in the 20 MV range have been reported in recent years. In order to determine if the variations were due mainly to differences in measurement procedures, or inherent in the design of the accelerators, three different 18-MV (BJR) photon beams were compared using identical analytical techniques. The units studied were a Philips SL/75-20 and a Siemens Mevatron-20 linear accelerators and a Schimadzu betatron. Gamma spectroscopy of an activated aluminum foil was the method used. By comparing the relative amounts of neutron contamination, errors associated with absolute measurements such as detector efficiency and differences in activation foils were eliminated. Fast neutron contaminations per rad of x rays in a ratio of 6.7:3.7:1 were found for the Philips, Schimadzu and Siemens accelerators, respectively.

A comparison of eating disorders and body dysmorphic disorder on body image and psychological adjustment.

Eating and body dysmorphic disorders are two diagnoses with body image disturbance as a central feature. No empirical study of the similarity of these disorders or any controlled study of body dysmorphic disorder were available. The present study compared 45 women with anorexia or bulimia nervosa to 51 men and women with body dysmorphic disorder (BDD) and 50 nonclinical controls. The eating disorder patients were mainly preoccupied with weight and body shape. BDD subjects had more diverse physical complaints and reported more negative self-evaluation and avoidance due to appearance. However, the two groups showed equally severe body image symptoms overall, and were clearly abnormal compared with controls. Both types of patients had negative self-esteem, but eating disorder patients had more widespread psychological symptoms. In conclusion, the disorders are comparable on psychological measures. Explanations of the minor differences and questions for future research on the relation between eating and body dysmorphic disorders are presented.

Development of the body dysmorphic disorder examination.

The Body Dysmorphic Disorder Examination (BDDE) is a semi-structured clinical interview designed to diagnose body dysmorphic disorder and to measure symptoms of severely negative body image. It tape into preoccupation with and negative evaluation of appearance, self-consciousness and embarrassment, excessive importance given to appearance in self-evaluation, avoidance of activities, body camouflaging, and body checking. The BDDE had adequate internal consistency and test-retest and interrater reliability. It correlated with measures of body image, negative self-esteem, and psychological symptoms, and was sensitive to change following treatment of body dysmorphic disorder. The BDDE distinguished body dysmorphic disorder patients from clinical and non-clinical control subjects and agreed with other clinicians' diagnosis of body dysmorphic disorder. The BDDE provided unique information in predicting clinical status when controlling for psychological adjustment and other measures of body image.

Assessment of body image in eating disorders with the body dysmorphic disorder examination.

The Body Dysmorphic Disorder Examination (BDDE) has several advantages for the assessment of body image in eating disorder patients. It measures distressing self-consciousness, preoccupation with appearance, overvalued ideas about the importance of appearance to one's self-worth, and body image avoidance and checking behaviors. The BDDE is relevant for any type of appearance complaint and is not limited to weight or body shape concerns. The BDDE measures the useful targets for body image therapy. In a sample of eating disorder patients, the Body Dysmorphic Disorder Exam had good internal consistency and was significantly correlated with other measures of body image. It added new information to the discrimination of women with eating disorders from clinical and nonclinical controls beyond that provided by other measures of body image.

Comparison of cognitive-behavior therapy and desipramine in the treatment of bulimia nervosa.

A comparison of cognitive-behavior therapy alone, desipramine alone, and cognitive-behavior therapy combined with desipramine was made in the treatment of bulimia nervosa. The study was terminated early with an N of only 7 subjects per condition because of a high drop-out rate and lack of positive response in the desipramine alone group compared to the other two groups. By this time it was also apparent that at posttreatment and at 6 months follow-up no benefit was being realized from combining cognitive-behavior therapy with desipramine.

A review of camptocormia and an unusual case in the female.

Camptocormia is a rare low-back disorder involving an abnormal posture of extreme forward flexion. Most reports of camptocormia were of male military recruits during World Wars I and II. The differential diagnosis of the postural deformity, the psychologic formulation of camptocormia as a conversion disorder, and the treatments that have been used are reviewed. An unusual case of camptocormia in a female is presented to illustrate one psychologic basis and one form of effective treatment of this disorder.

The relation between biomechanical and psychological factors in patients with low-back pain.

Behavioral factors are increasingly being recognized for their role in determining the course and outcome of low-back disorders. This paper examines the relation between behavioral variables, which include psychological symptoms and pain tolerance, and biomechanical variables. The majority of the 89 patients tested could be classified into two groups. One group was intolerant of pain and showed reduced spinal mobility, restricted straight leg raising, and altered flexor-extensor muscle balance. The other group was more tolerant of pain and did not show restriction of motion or muscle imbalance. Spinal mobility was also related to psychological symptoms. A model is proposed which points to a feedback between spinal motion and the patient's ability to cope with pain as one mechanism that determines return to a functional range of motion.

Epidemiologic studies of low-back pain.

The records of 3920 patients (2068 females, 1852 males) entering a model family practice unit between 1975 and 1978 have been analyzed. Eleven percent of males and 9.5% of females reported an episode of low-back pain during that 3-year interval. The complaint of medically reported low-back pain was significantly related to occupational factors such as truck driving (p < 0.001), lifting, carrying, pulling, pushing, and twisting (P < 0.001 for all variables) as well as nondriving vibrational exposure (P < 0.001). Patients reporting low-back pain also reported more episodes of anxiety (P < 0.001) and depression (P < 0.001) and had more emotionally stressful occupations (P < 0.001). The mean number of pregnancies was greater in women with low-back pain (2.6) than in those without (1.6) (P < 0.001). The low-back pain sufferers were more likely to be cigarette smokers (P < 0.001), particularly when smoking was accompanied by a chronic cough (P < 0.001). This population is currently under prospective study to define the relevance of each of these risk factors to the complaint of low-back pain.