The effect of Achievement orientation on response to success and failure in pediatric cancer patients.

OBJECTIVE: To assess the effects of different cognitive orientations focused on social comparison or self-comparison, followed by success or failure feedback, on mood, task persistence, and task difficulty choice in children with cancer. METHOD: Children with cancer (N = 79) and a group of age-matched controls (N = 72 were randomly assigned in a 2 (Achievement Orientation) x 2 (Feedback) between-subjects design. RESULTS: Between-group differences revealed that children with cancer chose more difficult tasks for the future than those in the comparison group, while the comparison subjects chose to persist longer with the problems than did children with cancer, with no significant differences on measures of mood. CONCLUSIONS: The beneficial effects of achievement orientation as a clinical manipulation may not be as robust as expected with a medically ill population, due to the apparent stability of achievement orientations.

Are weight concerns predictive of smoking cessation? A prospective analysis.

Participants in an 8-session, community based smoking cessation intervention rated whether they would stay quit if they experienced weight gain. The majority reported that they would not relapse to smoking, even after a 20-lb, (9.07-kg) weight gain. Those who were weight concerned were more likely to be female, to weight less and be normal or underweight, and to report chronic dieting. This group was also significantly less likely to be abstinent posttreatment, and at the 1-, 6- and 12-month follow-ups. Individuals presenting for formal smoking cessation interventions may be less weight concerned than the general population of smokers. However, weight-concerned smokers who do present for treatment are less likely to quit smoking. Implications for recruitment and intervention are discussed.

How much weight gain occurs following smoking cessation? A comparison of weight gain using both continuous and point prevalence abstinence.

Estimates of postcessation weight gain vary widely. This study determined the magnitude of weight gain in a cohort using both point prevalence and continuous abstinence criteria for cessation. Participants were 196 volunteers who participated in a smoking cessation program and who either continuously smoked (n = 118), were continuously abstinent (n = 51), or who were point prevalent abstinent (n = 27) (i.e., quit at the 1-year follow-up visit but not at others). Continuously abstinent participants gained over 13 lbs. (5.90 kg) at 1 year, significantly more than continuously smoking (M = 2.4 lb.) and point prevalent abstinent participants (M = 6.7 lbs., or 3.04 kg). Individual growth curve analysis confirmed that weight gain and the rate of weight gain (pounds per month) were greater among continuously smoking participants and that these effects were independent of gender, baseline weight, smoking and dieting history, age, and education. Results suggest that studies using point prevalence abstinence to estimate postcessation weight gain may be underestimating postcessation weight gain.

Changes in food consumption and body weight associated with smoking cessation across menstrual cycle phase.

Forty women smokers were randomly assigned to smoking cessation for a 10-day period of time, either during the follicular or the luteal phase of their menstrual cycle. Measurements of dietary intake and body weight were collected during the same phase the previous (smoking as usual) month and during the cessation phase. Physical activity was controlled across the 2 months. Comparisons between the smoking and cessation months indicated that both groups increased their dietary intake during the cessation month, but no interaction occurred between phase and month. That is, women in both groups increased dietary intake to the same degree. All energy nutrients tested (fat, complex carbohydrates, and sugar) increased significantly from baseline to cessation. Conversely, body weight increased by 1.8 kg (4 lb) in the Luteal group, while weight remained stable (0.1 kg change) in the Follicular group.

The relationship between a history of depression and adherence to a multicomponent smoking-cessation program.

The purpose of this study was to determine whether a history of depression in female smokers (age 18-65) who did not self-report any current depression was associated with adherence to a multisession, multicomponent smoking-cessation program. Participants in a 13-week cognitive-behavioral group program plus random assignment to nicotine gum, appetite suppressant gum, or placebo chewing gum were grouped by depressive-history and compared on attendance, average expired carbon monoxide after planned cessation, and number of pieces of gum chewed. No significant differences between the depressive history (yes/no) subgroups were found on any of the three measures of adherence. The power to detect a significant difference (alpha = 0.05) was calculated to be 0.89. Group cognitive-behavioral treatment appears to be the basis of an effective smoking-cessation program for women with a history of depression who are not currently depressed.

An evaluation of a television-delivered behavioral weight loss program: are the ratings acceptable?

This experiment evaluated the efficacy of television delivery of a behavioral weight reduction program. Seventy-one overweight adults were randomly assigned to a live-contact weight loss group that was videotaped for viewing by other groups, a live-contact group that was not videotaped, a television-delivered group that observed the videotaped weight loss sessions, or a waiting-list control group. Participants in all 3 treatment groups lost significantly more weight during the 8-week treatment program than those in the waiting-list control group. There was no significant weight loss differences among the 3 treatment groups during the program. These weight changes were maintained at 3-month follow-up. At 15-month follow-up, the television-delivered group and the live-contact group maintained their weight losses, whereas the videotaped group did not. Cost-effectiveness analyses indicated that the television-delivered group received the most cost-effective treatment.

Cognitive behavioral strategies in athletic performance enhancement.

While we might debate the role of sport in our culture, its influence is certainly pervasive. Each day millions of Americans engage in some form of competition, training, or physical exercise. Such popularity and the value our culture places on competition have made sport a valid area of psychological inquiry. Within the cognitive behavioral model, sport psychology and, specifically, athletic performance enhancement have experienced vigorous growth over the past two decades. Behavior change strategies familiar to most cognitive behaviorists form the core of virtually all athletic performance enhancement interventions. Goal setting, imagery or mental rehearsal, relaxation training, stress management, self-monitoring, self-instruction, cognitive restructuring, and modeling interventions dominate this literature. Our examination of these performance enhancement programs, both through a qualitative review and the Whelan et al. (1989) meta-analysis, supports the efficacy of cognitive behavioral interventions for the enhancement of sport performance. First, the average effect size across the empirical literature indicates that these interventions are reliably effective. Furthermore, this positive result is observed across variations in treatment conditions, control conditions, and across different types of dependent measures. Evidence on goal setting, imagery, arousal management, cognitive self-regulation, and packaged programs specifically support the behavior change efficacy of these interventions. These findings are encouraging, but much work needs to be done. Few investigators cited in this review attend to crucial internal and external validity issues. Attention to treatment integrity, including training of behavior change agents, verification of intervention implementation, and verification of reception of the treatment, is sorely lacking. Psychological skill development and its relationship to performance improvements are rarely checked. Now that cognitive behavioral interventions appear to be reliably effective at posttreatment, we must have meaningful evaluation of maintenance of psychological skill and performance changes. Six-month, 12-month, and longer follow-up evaluations are necessary. We must also begin more detailed evaluations of these effective interventions.(ABSTRACT TRUNCATED AT 400 WORDS)

The effect of smoking and light activity on metabolism in men.

This experiment examined the metabolic effects of smoking during rest and light activity under naturalistic conditions. Thirty-nine male subjects first completed a submaximal graded exercise treadmill test to standardize activity level. Then 3 groups of subjects--smokers smoking (SS), smokers not smoking (SNS), and nonsmokers (NS)--were exposed to 3 stages of rest or 3 stages of light activity with order of rest or activity randomly determined over 2 different days. Energy expenditure was monitored continuously during these sessions. Significant increases in smokers' energy expenditure were observed during light activity when compared with smokers not smoking and nonsmokers. No differences were identified among groups at rest. These findings strengthen the conclusion that smoking or its components contribute to metabolic changes during typical levels of daily activity and suggest a mechanism for the frequently observed relationship between smoking status and body weight.

Assessment of childhood depression, anxiety, and aggression: convergent and discriminant validity of self-, parent-, teacher-, and peer-report measures.

Childhood depression, anxiety, and aggression assessment instruments were examined in a sample of 8- to 11-year-old elementary school children. A multitrait-multimethod design was used to evaluate self-, parent-, teacher-, and peer-report on each of the three traits. Results found the measures exhibited significant convergent and discriminant validity for both boys and girls. However, different patterns in convergence among the information sources emerged between boys and girls. Both the intercorrelations and the analyses of variance documented significant method variance. The implications of the high method variance or source bias in the assessment process are discussed. It is argued that investigators employ confirmatory factor analyses in evaluation of multitrait-multimethod data.

A comparison of behavioral and cognitive-behavioral interventions for bulimia nervosa.

This study examined the relative efficacy of cognitive-behavioral and behavioral treatment approaches for bulimia nervosa. Female bulimic Ss were randomly assigned to cognitive-behavioral, behavioral, or attention placebo conditions. At posttreatment, 92% of the cognitive-behavioral group, 100% of the behavioral group, and 69% of the nonspecific self-monitoring group were abstinent from binge eating-purging. At 6-month follow-up, 69% of the cognitive-behavioral group, 38% of the behavioral group, and 15% of the nonspecific self-monitoring group were abstinent from binge eating and purging. The results support the conceptualization of bulimia nervosa as a multifaceted disorder best treated with an approach that directly addresses maladaptive cognitions, problematic behaviors, and the development of more adaptive coping skills.

Relationship of smoking status, energy balance, and body weight: analysis of the Second National Health and Nutrition Examination Survey.

The relationship between smoking status and body mass index (weight/height) was evaluated, controlling for demographics, dietary intake, and physical activity. Subjects were 10,778 adult respondents from the Second National Health and Nutrition Examination Survey (NHANES II). Results indicate that never smokers and long-term quitters had similar relative body weights and that low-rate current smokers were not significantly different from never smokers. However, both medium- and high-rate current smokers weighed less than nonsmokers and low-rate smokers. When medium- versus high-rate smokers were contrasted, sex interacted with results. Specifically, weight-control properties of smoking were more pronounced in women than men. It is proposed that future research should more closely evaluate metabolic changes as a function of smoking status.

Metabolic effects of nicotine gum and cigarette smoking: potential implications for postcessation weight gain?

The effects of nicotine chewing gum and cigarettes on resting energy expenditure (REE) were evaluated. Twenty smoking women participated in nicotine gum and smoking administration, after which their REEs were measured. Results indicate an acute increase in REE for both nicotine gum and cigarettes. Metabolic rates for nicotine gum slowly returned to baseline, whereas rates for cigarettes quickly dropped and fell significantly below baseline. Thus, the metabolic effect of nicotine gum was greater than the effect of smoking.

Measurement reliability and reactivity using repeated measurements of resting energy expenditure with a face mask, mouthpiece, and ventilated canopy.

This investigation evaluated the measurement reliability and reactivity of repeated measurements of resting energy expenditure using different methods of data collection. Thirty subjects were randomly assigned to either face mask, mouthpiece/nose clip, or ventilated canopy collection systems for 45 min a day over 3 days. Results indicated that there were no significant differences among data collection systems nor were there any differences either within or between systems over time. Across all three days of measurement, the first 5 min of data collection on all systems were reactive compared to the subsequent 40 min of assessment. Analyses indicated that acceptable reliability coefficients were obtained after 20 min of continuous data collection in the ventilated canopy and after 40 min with the face mask after a 5-min acclimation period. The results suggest that, following an acclimation period, a single 20-min assessment of resting energy expenditure in both a face mask and ventilated canopy are stable and reliable.

The effects of phenylpropanolamine on dietary intake, physical activity, and body weight after smoking cessation.

This investigation evaluated the effect of phenylpropanolamine on the weight gain associated with 2 weeks of abstinence from smoking. Subjects were 57 adult female cigarette smokers who were randomly assigned, in a double-blind procedure, to chew gum with phenylpropanolamine or placebo gum, or to chew no gum. After a baseline assessment, subjects were paid to quit smoking for a period of 2 weeks. Forty-one (72%) of the 57 subjects were successful in quitting smoking for the 2-week period. Results indicated that, relative to the other two conditions, abstinent subjects receiving phenylpropanolamine gained 1.5 to 1.9 pounds less weight (p less than 0.05). In addition, abstinence rates were higher (p less than 0.03) and dietary intake lower for subjects receiving phenylpropanolamine (p less than 0.05) relative to the other two conditions. No changes in physical activity were observed. It is concluded that phenylpropanolamine may help reduce weight gain associated with smoking abstinence and in this way may enhance smoking cessation efforts in certain individuals.

The comparability of two commonly used carbon monoxide analysis systems: a technical note.

Carbon monoxide (CO) in expired breath is a common strategy for verifying smoking abstinence. The purpose of this investigation was to determine the comparability of two carbon monoxide (CO) analyzers: the commonly used Ecolyzer Series 2000 analyzer versus the new, highly portable, and less expensive Ecolyzer Model 210. Fifty-eight CO readings were obtained from 29 subjects (17 smokers, 12 nonsmokers) and analyzed on both systems simultaneously. Results indicated that the analyzers yielded highly comparable values for both smokers and nonsmokers. Moreover, the correlation between the two units' readings was very high (r = .92, p less than .001). There was, however, a significant analyzer by sex interaction with the Series 2000 analyzer yielding higher values for males. Overall, it was concluded that the Series 210 analyzer is a highly accurate and cost-effective instrument.

Smoking, body weight, and their effects on smoking behavior: a comprehensive review of the literature.

This article provides a comprehensive review of the research on smoking and body weight. The relationships between smoking and body weight are evaluated in 70 cross-sectional and longitudinal investigations. The mechanisms responsible for differences in body weight are discussed, the weight-related issues that promote smoking behavior are reviewed, methods for reducing postcessation weight gain are summarized, and future research directions are proposed. A proposed working research model for studying the relationship between smoking, energy balance, and weight gain is offered. It is concluded that smoking and body weight relationships are closely related and pose significant challenges for smoking researchers.

A developmental analysis of the influence of body weight on the sociometry of children.

The influence of relative weight on sociometric nominations (liking and disliking) and sociometric ratings by first, third, and fifth graders was assessed. In terms of nominations, first grade overweight males, relative to other males and to overweight females, received fewer liking nominations. On the sociometric ratings, third grade overweight males were rated lower by other males. Ratings by females at each grade level, and by fifth grade males, were influenced by gender considerations and not by weight considerations. That is, boys rated boys higher than they rated girls, and girls rated girls higher than they rated boys, regardless of the child's weight status. Additional analyses demonstrated that these findings were not qualified by the weight of the child making the ratings. Thus, developmental evidence was found for less liking (but not disliking) of overweight peers among first and third grade males, while weight did not appear to influence the decisions of fifth graders. These results call into question the validity of a social stigma often assumed to be associated with overweight children.

A conceptual model for cognitive-behavior therapy with children.

This paper briefly reviews the historical and conceptual developments that produced the cognitive-behavioral model for clinical interventions with children. It is suggested that this model should be expanded by including the person variables of emotion and developmental level and by broadening the scope of environmental variables to include the family, school, and other social/community contexts. The implications of this expansion of the cognitive-behavioral model for psychopathology, assessment, and intervention are discussed.

Adolescent sex education: a preventive mental health measure.

This paper addresses the issue of adolescent sex education as a means of preventing sexuality-related disorders. Past efforts in adolescent sex education have generally failed to empirically determine appropriate subject matter or the most effective delivery agent for these programs. Sex education programs are examined in terms of delivery agents, cognitive, attitudinal and behavorial goals and research methodology. Suggestions to empirically determine appropriate goals and delivery agents and to consider individual differences among adolescents are offered. Recommendations are made for improving experimental design in sex education research.