Biobehavioral Model Research Articles

Maybe the Twain Shall Meet: The Nursing Perspective and the Biobehavioral Model of Addiction

Maybe the Twain Shall Meet: The Nursing Perspective and the Biobehavioral Model of Addiction

Causes and mechanisms of primary headaches: toward a bio-behavioral model.

Pathophysiological mechanisms of primary headache remain obscure, despite of numerous hypotheses that have been postulated for either migraine and cluster headache. Human experimental models are not available, however, observation of clinical features of migraine or cluster headache attacks support animal studies documenting the development of neurogenic inflammation in tissues receiving trigeminal innervation. The latter studies provided also the background for better understanding the mechanism of action of aborting drugs such as sumatriptan and dihydroergotamine. The debate is whether the primary cause of migraine and other neurovascular headaches is central or peripheral in origin. Trigger factors (stressful events) and personality traits in migraine patients suggest that activation of neurovascular systems is secondary to more complex events taking place in the central nervous system.

Stress and alcohol: the moderating effect of chronic stress on the acute stress--intoxication relationship.

The present study evaluated whether chronic stress levels moderated the impact of laboratory stressors on subjective and behavioral responses to alcohol. Healthy volunteers (N = 60; 30 male) completed measures of background stress levels (e.g., major life events). In addition, subjects were exposed to two laboratory stressors (i.e., cold pressor or film stressor task) or a control condition after consuming a 0.7 g/kg dose of alcohol. Regression analyses showed that the combination of high background stress levels and exposure to a lab stressor reduced two measures of perceived intoxication (i.e., Sensation Scale, Visual Analog Intoxication Scale). These data are consistent with a biobehavioral model of alcohol use where acute and chronic stressors are associated with a diminished response to alcohol. The possible mechanisms that may underlie this sobering effect include stress-related cognitive deficits and situation specific tolerance associated with high chronic stress levels.

Biobehavioral Rehabilitation for Older Adults With Essential Tremor

Essential tremor (ET), the most prevalent movement disorder, has a peak prevalence in the sixth decade of life. ET primarily affects the hands and head. Persons with ET are often significantly disabled in communication, work, leisure, domestic activities, and psychosocial adjustment. Medical intervention for ET is often limited in effectiveness. A biobehavioral rehabilitation model for older adults with ET is described.

Surviving cancer.

Research trends on quality of life outcomes for cancer survivors are discussed. Epidemiologic data indicate that female cancer survivors, coming primarily from patient groups with gynecologic, breast, and colorectal cancers, will outnumber male survivors 3 to 1. Male survivors will come from the ranks of patient groups with colorectal and other digestive tumors (such as stomach cancer), prostate, and bladder cancers. With the exception of breast cancer, there have been few well controlled descriptive, longitudinal studies of cancer survivors, with data on men being notably absent. A strategy for identifying differential levels of risk for psychologic morbidity for cancer survivors is proposed. Other important psychologic individual difference variables were identified: control, optimism, and stable coping strategies may be useful in the prediction of mental health outcomes; conscientiousness in the prediction of health behaviors; and sexual self-schema in the prediction of sexual outcomes. Finally, data suggest that psychologic and behavioral outcomes can be improved with psychologic interventions, but it is likely that even greater gains could be achieved if health behavior components were added. New directions for research include study of individual differences, examination of active components of multifaceted interventions, and study of the health consequences of interventions. In the latter regard, a biobehavioral model of stress and cancer is offered to integrate psychologic, behavioral, biologic, and disease factors into testable new research directions.

Effect of stress on perceived intoxication and the blood alcohol curve in men and women.

To determine the influence of stress on intoxication and blood alcohol concentration (BAC) 60 healthy male and female volunteers were exposed to a cold pressor test, distressing film, or control condition after consuming a moderate dose of alcohol. Two measures of perceived intoxication suggested a sobering effect of acute stressors. In addition, Ss viewing the distressing film showed longer latency to peak BAC than Ss in the control condition. As BAC began to fall, the cold pressor test initially increased rate of alcohol elimination. These stress-induced changes in intoxication and the BAC curve support a biobehavioral model in which stress may increase alcohol use partly because it attenuates alcohol's psychopharmacological impact.

Parental smoking, depression, and child development: persistent and unanswered questions.

Presented a review of the influences of parental smoking and depression on physical, behavioral, and cognitive development of children. The negative relationship between smoking and child development has been shown to follow a dose-response relationship and to be independent of several important confounds. Likewise, parental characteristics, particularly depression, have also been shown to be related to both smoking and child development. Since cigarette smoking is also linked with depression, there are many unanswered questions regarding the interrelationship of these three factors. Research should use a biobehavioral model to address the issues related to parental influences on child development. Suggestions are made for such an approach to studying parental smoking and child development which addresses the overlap between depression and parental smoking and their influence on child maturation.

A biobehavioral model of cancer stress and disease course.

Approximately 1 million Americans are diagnosed with cancer each year and must cope with the disease and treatments. Many studies have documented the deteriorations in quality of life that occur. These data suggest that the adjustment process is burdensome and lengthy. There is ample evidence showing that adults experiencing other long-term stressors experience not only high rates of adjustment difficulties (e.g., syndromal depression) but important biologic effects, such as persistent downregulation of elements of the immune system, and adverse health outcomes, such as higher rates of respiratory tract infections. Thus, deteriorations in quality of life with cancer are underscored if they have implications for biological processes, such as the immune system, relating to disease progression and spread. Considering these and other data, a biobehavioral model of adjustment to the stresses of cancer is offered, and mechanisms by which psychological and behavioral responses may influence biological processes and, perhaps, health outcomes are proposed. Finally, strategies for testing the model via experiments testing psychological interventions are offered.

A biobehavioral model of cancer stress and disease course.

A biobehavioral model of cancer stress and disease course.

Effects of caffeine and gender on physiology and performance: Further tests of a biobehavioral model

The present study extended testing of our biobehavioral model describing the effects of arousal and caffeine to include an examination of gender differences and their interactions with habitual and acute caffeine ingestion. Males and females selected as high or low habitual caffeine users were randomly assigned to receive either caffeine or a placebo and exposed to novel and repetitive recall tasks and to simple auditory stimuli. Electrodermal activity and recall task performance were recorded. The four major factors examined, including habitual caffeine use, acute ingestion, gender, and stimulus novelty, affected behavior, physiology, or both. Results showed that habitual caffeine usage systematically affected tonic arousal (skin conductance level) and improved recall task performance. Acute caffeine ingestion increased phasic arousal (skin conductance response amplitude) and reduced habituation rates. Gender interacted with other factors to significantly affect both tonic and phasic arousal, and females performed better than males on the recall tasks. These results were partially supportive of the theoretical model, and further work is needed to examine the interactions of acute and chronic caffeine intake with gender and novelty.

Persistent pain and the injured worker: Integrating biomedical, psychosocial, and behavioral factors in assessment

Health care providers are often asked to determine the level of impairment, degree of disability, and rehabilitation potential for injured workers. Compalints of persistent pain and especially compalaints that are: (1) not substantiated or that are disproportionate to physical pathology identified by physical examination and laboratory diagnostic procedures, or (2) that prove to be differentially responsive to identical treatments that are technically appropriate cause a great deal of frustration for health care providers and third-party payers. Much of the confusion in this area relates to the minimal association between (1) the extent of impairment and degree of disability, and (2) between the magnitude of physical pathology and severity of the pain report. In this paper, we discuss factors that contribute tothe frustration and confusion and propose a comprehensive biobehavioral model that integrates biomedical, psychosocial, and behavioral variables. We also present an assessment model, the Multiaxial Assessment of Pain (MAP) patients, and describe operationalizations of the primary components of this model.

A Biobehavioral Model for Hospital Psychiatry in an Era of Increasing Regulation and Cost Containment

Psychiatric hospitalization is increasingly a target of cost reduction by employers and third-party payers. The authors describe an evaluation of a biobehavioral model for the treatment of a mixed population of public- and private-sector patients in the psychiatric unit of a general hospital under conditions of severe regulation and cost containment. The program combined behavioral-education technology based on principles of social reinforcement with the traditional medical model in which the psychiatrist specified the patient's individual treatment within the general programmatic framework. Patient progress was monitored using standardized clinic rating scales, which showed that between 85 and 96 percent of the patients had improved significantly at discharge after an average stay of 12 days. Based on that and other findings, the authors believe that the new programmatic technology of biobehavioral psychiatry has the flexibility to ameliorate the adverse effects of increasing regulation and cost containment, even under demanding clinical conditions.

Follow-up of a cohort of alcoholic patients through 12 months of comprehensive biobehavioral treatment.

One hundred and eleven socially stable alcoholic patients were subjected to a comprehensive diagnostic and treatment protocol based on a biobehavioral model of alcoholism. Physical pathology, malnutrition, and toxicity were prevalent throughout the sample. After a period of inpatient care, subjects were treated for a period of 12 months with a combination of medical, nutritional, behavioral, and psychological support and care. At the end of the study period, 91 subjects (81.9%) remained in treatment contact. Sixty seven subjects (60.4%) were abstinent and physically stable at the 12-month date. Elevations of three scales of the MMPI were significantly predictive of treatment outcome.

Contingent Negative Variation in Migraine

The Contingent Negative Variation (CNV) is an event-related slow potential. It was recorded in healthy volunteers (n = 8) and in patients suffering from migraine without (n = 12) or with (n = 5) aura, during one (CNV1) and three second (CNV3) foreperiods in a forewarned reaction time task. CNV1 was recorded at the vertex while CNV3 was recorded at multiple electrode sites to assess topographical differences. Seven out of twelve migraine patients without aura had increased CNV1 amplitudes. CNV3 amplitudes were increased as well, but only at electrode positions C3 and C4 and not at Fz. CNV3, which allows for analysis of both an early and a late CNV component, could improve the discrimination of migraine without aura beyond that of CNV1. In migraine with aura all CNV parameters were at control levels, confirming previous results. The data obtained are discussed in terms of arousal, activation and stress and the "biobehavioral model of migraine" (Welch, 1986).

A biobehavioral model for breastfeeding effects on return to menses postpartum in Javanese women.

Abstract This paper examines the effects of nursing behavior on the duration of lactation amenorrhea in 382 rural Indonesian women who experienced resumption of menses while breastfeeding or were breastfeeding and amenorrheic at the end of a two‐year prospective study. Three primary breastfeeding variables (number of night‐time nursing bouts, number of day‐time nursing bouts, and minutes per bout) were used to develop a behavioral model for breastfeeding. Four breastfeeding patterns were identified for these women. These were designated as: (1) low intensity, (2) medium‐low intensity, (3) medium‐high intensity, and (4) high intensity breastfeeding behavior. Menses resumed at medians of 11.2,16.0,17.6, and 20.8 months, respectively, for these groups. The relationships among the breastfeeding variables in the behavioral model and return to menses were developed and tested by life table and proportional hazards models. Ten per cent of the high intensity breastfeeding group (6 women) delayed menses between 33 and 52 weeks, while 90 per cent (56 women) postponed return of menses for over one year.

Activity-based anorexia: A biobehavioral perspective

A biobehavioral model of activity-based anorexia is examined in terms of recent evidence. Strenuous exercise reduces the value of food reinforcement and results in decreased food intake. Reduction of food intake increases the motivational value of physical exercise. This produces an escalation in activity that further suppresses appetite. Cultural practices of diet and exercise initiate this anorexic cycle, and once started the process is resistant to change. These anorexias may be the result of natural selection favoring those organisms that became active in times of food scarcity. Proximate physiological mechanism(s) appear to involve the endogenous opiate system that mediates the relationshp between running and eating. It is argued that classification of human self-starvation should be based on environmental and/or biological conditions that control food regulation. Activity anorexia may be one instance of such a classification that could account for many instances of “an orexia nervosa”.