Psychological, nutritional, and energy expenditure differences in college females with anorexia nervosa vs. comparable-mass controls

This is the first study to examine psychological and behavioral variables in nonhospitalized college females with subclinical anorexia nervosa (AN) as compared to healthy college females of comparable body mass (i.e., body mass index (BMI)<19). Participants who met all DSM-IV [Diagnostic and statistical manual of mental disorders, 4th ed. (1994). Washington, DC: APA.] criteria for AN-restrictive type (except for BMI<17.5; n=11) and control participants (n=15) with comparable body mass completed psychological, nutritional, and exercise assessments. Results suggested that those with AN evidenced more general psychopathology, more eating disorder symptoms, more dieting, more compulsive exercise, and less consumption of calories compared to participants in the control group. There was no difference in macronutrient consumption. There was no significant difference in expenditure of energy, despite differences in reports of compulsive exercise. Given similar body mass, this suggests that the women with AN were experiencing an energy deficit consistent with the disorder's defining features of "fear of gaining weight or becoming fat" and provides us with more understanding of individuals with AN in their natural environment.

Evaluation of a cognitive-behavioral therapy intervention to improve body image and decrease dieting in college women

This two-group experimental study evaluated the effectiveness of a cognitive-behavioral body image intervention, adapted from an effective clinical intervention, with normal college females. Participants included nonclinical, freshman college women who were assigned randomly to either the experimental intervention or the control group (brief educational session). Participants were assessed prior to the intervention and again 1 month later on dieting behavior, body image, fear of fat, and anxiety concerning physical appearance. Although it was hypothesized that each of these variables would be lower in the experimental group, none of these results, except for a trend for decreased dieting, were found. Overall these results of slightly reduced dieting behavior are consistent with other research targeting primary and secondary prevention. This intervention's failure to impact body image and eating behaviors of college students illustrates the continuing challenge of eating disorders prevention.

Comparison of extended versus brief treatments for marijuana use

Adult marijuana users (N = 291) seeking treatment were randomly assigned to an extended 14-session cognitive-behavioral group treatment (relapse prevention support group; RPSG), a brief 2-session individual treatment using motivational interviewing (individualized assessment and intervention; IAI), or a 4-month delayed treatment control (DTC) condition. Results indicated that marijuana use, dependence symptoms, and negative consequences were reduced significantly in relation to pretreatment levels at 1-, 4-, 7-, 13-, and 16-month follow-ups. Participants in the RPSG and IAI treatments showed significantly and substantially greater improvement than DTC participants at the 4-month follow-up. There were no significant differences between RPSG and IAI outcomes at any follow-up. The relative efficacy of brief versus extended interventions for chronic marijuana-using adults is discussed.

Determinants of attrition from cessation treatment in smokers with a history of major depressive disorder

Attrition from smoking cessation treatment by individuals with a history of major depression was investigated. An investigation of preinclusion attrition examined differences between eligible smokers who did (n = 258) and did not (n = 100) attend an initial assessment session. Postinclusion attrition was investigated by comparing early dropouts (n = 33), late dropouts (n = 27), and treatment completers (n = 117). Those who failed to attend the assessment session were more likely to be female, to smoke cigarettes with higher nicotine content, and to have a history of psychotropic medication use. Early-treatment dropouts reported a higher smoking rate than late-treatment dropouts and endorsed more symptoms of depression than late dropouts and treatment completers. Results are compared with previous investigations of smoking cessation attrition, and implications for treatment and attrition prevention are discussed.

Determinants of attrition from cessation treatment in smokers with a history of major depressive disorder

Attrition from smoking cessation treatment by individuals with a history of major depression was investigated. An investigation of preinclusion attrition examined differences between eligible smokers who did (n = 258) and did not (n = 100) attend an initial assessment session. Postinclusion attrition was investigated by comparing early dropouts (n = 33), late dropouts (n = 27), and treatment completers (n = 117). Those who failed to attend the assessment session were more likely to be female, to smoke cigarettes with higher nicotine content, and to have a history of psychotropic medication use. Early-treatment dropouts reported a higher smoking rate than late-treatment dropouts and endorsed more symptoms of depression than late dropouts and treatment completers. Results are compared with previous investigations of smoking cessation attrition, and implications for treatment and attrition prevention are discussed.

On Being a Person of Integrity...Or Ethics and Other Liabilities

The emergence of managed care and the health industry's response to it has precipitated a moral crisis for many health care professionals. Caught between the patients' best interests and the employers' and payers' restrictions, professionals find their good intentions tested. In this article, the author distinguishes moral from ethical problems and suggests that self-examination and self-diagnosis of the mindsets and conditions that contribute to moral malfunctioning in the workplace--self-management at the individual level--is essential for maintaining the ethical stance of the profession and the integrity of the professional.