Checking Behavior Research Articles

Exploring how social networking sites impact youth with anxiety: A qualitative study of Facebook stressors among adolescents with an anxiety disorder diagnosis

Adolescents with anxiety disorders often have low self-esteem, poor problem-solving, and a strong desire to be accepted. Combined, these qualities may predispose them to experience unique stressors when using social network sites (SNSs). Focus groups of adolescent Facebook users who have a primary anxiety diagnosis uncovered narratives describing individuals’ perspectives related to how Facebook can influence their anxiety. Qualitative analysis revealed six themes related to Facebook stressors: seeking approval, fearing judgment, escalating interpersonal issues, wanting privacy, negotiating self and social identity, and connecting & disconnecting. Many participants reported a fear of receiving negative comments online and discussed strategies to avoid them, such as posting less content (i.e., comments, photographs) than their peers. Some participants described feeling positive emotions when they received a “like” from a SNS user, however, they also tended to describe these positive emotions as “false”, “unreal” and “fleeting.” Notably, many participants reported comparing themselves to peers on Facebook, which increased feelings of anxiety, as well as compulsive checking behaviours, such as monitoring posted content and friend lists. These findings were coupled with discussions surrounding rumination, privacy, and elevated personal conflict due in part to the public nature of Facebook. The narratives from our exploratory study suggest there are various mechanisms through which Facebook may exacerbate anxiety in adolescents who have pre-existing anxiety disorders and thereby may make them vulnerable to negative online experiences. Understanding the underlying themes of this phenomenon can aid clinicians, school staff, and parents in identifying potential stressors for anxious adolescents who use SNSs, and provide strategies around social media use for this specific patient population. Future quantitative studies are recommended to further understand the relationships between Facebook stressors and expressed anxiety in clinical populations.

OCD-like checking in the lab: A meta-analysis and improvement of an experimental paradigm

Van den Hout and Kindt (2003a) developed a Virtual Gas Stove Checking paradigm. They demonstrated that repeated checking resulted in lower confidence and reduced the vividness and detail of recollections. Over the past decades, many experiments have used (an adaptation of) this experimental paradigm to study phenomena related to obsessive compulsive disorders (OCD). The first aim of the present study was to conduct a meta-analysis of experiments (k = 28; N = 1662) on the repeated checking paradigm. Repeated checking was found to have large effects on decreases in memory confidence, vividness and detail. Unexpectedly, repeated checking also produced small reductions in memory accuracy. The second aim of the present study was to develop an improved version of the checking paradigm in which 1) stimuli presentations were fully balanced; and 2) the checking latency was comparable across stimuli in order to 3) assess actual checking behavior. The improved version (Virtual checking task 2.0) replicated earlier findings on meta-memory.

Different Facets of Body Image Disturbance in Binge Eating Disorder: A Review.

The goal of the present review is to give an overview of the current findings on various facets of body image disturbance in Binge Eating Disorder such as body dissatisfaction, overconcern with weight and shape, body-related checking and avoidance behavior, misperception of body size, and body-related cognitive bias. In addition, treatments for a disturbed body image in BED and evidence of body image disturbance in youth with binge eating are reviewed. The results show that a disturbed body image in BED is present in the form of overconcern with weight and shape. Furthermore, there are hints that body dissatisfaction, as well as body-related checking and avoidance behavior, are also impaired. Research concerning misperception of body size in BED has been neglected so far, but first findings show that individuals with BED rate their own body shape rather accurately. Furthermore, there are first hints that body-related cognitive biases are present in individuals with BED. Moreover, in children and adolescents, there are first hints that body dissatisfaction, as well as shape and weight concerns, seem to be associated with loss of control and binge eating. Treatments aimed directly at the convertibility of a disturbed body image in BED have revealed encouraging outcomes. In conclusion, body image disturbance seems to occur in BED, and first studies show that it can be treated effectively.

A social cichlid fish failed to pass the mark test.

Since the pioneering work in chimpanzees, mirror self-recognition (MSR), the ability to recognise oneself in a mirror, has been reported in great apes, Asian elephants, dolphins, and some social birds using the mark test, in which animals that possess MSR touch an imperceptible mark on their own bodies only when a mirror is present. However, giant pandas, which are solitary, failed to pass the mark test, suggesting that MSR evolved solely in highly social animals. In contrast to the increasing evidence of MSR in mammals and birds, little is known about MSR in fish. A Tanganyikan cichlid, Neolamprologus pulcher, is a good candidate for study because these fish live in highly social groups and recognise conspecifics about as rapidly as primates. We examined their responses to a mirror image and tested whether N. pulcher could pass the mark test. When the mirror was first exposed, they stayed in front of the mirror and exhibited aggressive behaviour towards the mirror image. These social behaviours suggested that the focal fish perceived the mirror image as an unfamiliar conspecific. The social responses decreased over the following days, as has generally been the case in animals with MSR. After mark injection, we found no increase in scraping behaviour or prolonged observation of the marked side. These results show a lack of contingency checking and mark-directed behaviours, meaning that N. pulcher failed to pass the mark test and did not recognise their self-image in the mirror.

Time-based prospective memory in children and adolescents with 22q11.2 deletion syndrome

Objective: 22q11.2 deletion syndrome, also known as velo-cardio-facial syndrome (VCFS) is a genetic disorder caused by a microdeletion on chromosome 22q11.2 and characterized by marked impairment in visual attention and executive function. The present study examined if this cognitive deficit extends to prospective memory (the type of memory involved in remembering to perform actions in the future). Method: 20 participants with 22q11.2DS aged between 6 and 14 were included in the study as well as 22 typically developing individuals (TDC) aged 6–12. To measure prospective memory, participants were asked to play a driving game (the Dresden Cruiser). This time-based prospective memory task required children to remember to refuel their car when the fuel level was low by pressing a refuel button while driving. Results and discussion: Participants with 22q11.2DS remembered less often to refuel the car. Furthermore, participants with 22q11.2DS checked the fuel gage significantly less often than the controls. Conclusions: Participants with 22q11.2DS therefore demonstrate difficulties completing a time-based prospective memory task. This can be explained by a generally less frequent time checking behavior in comparison to TDC.

Clustering of prevention behaviours in patients with high‐risk primary melanoma

Because melanoma patients are at high risk of further disease, we aimed to study their melanoma prevention behaviours. In a large cohort of patients newly diagnosed with high-risk melanoma in Queensland, Australia, we assessed clustering of preventive behaviours using latent class analysis. We assessed associated factors with prevalence proportion ratios (PPRs) and 95% confidence intervals (CIs) estimated by Poisson regression and also if preventive behaviour was associated with better tumour prognosis at diagnosis. Among 789 primary melanoma patients (57% male; 21% with previous melanoma), we identified 4 different behaviour clusters: "no/ low prevention" (34% of cohort), "sun protection only" (25%), "skin checks only" (25%), and "sun protection and skin checks" (17%). Prevalence of clusters differed between males and females and also the component behaviours. Preventive behaviours were associated with having skin that burned and past cutaneous cancer, and for males, combined sun protective and skin checking behaviour was associated with higher education and non-smoking. In patients with no past history of cutaneous cancer, males in the "skin checks only" cluster had significantly reduced chances of a thick (poor prognosis) melanoma (PPR=0.79, 95% CI 0.68, 0.91) and females in the "sun protection and skin checks" cluster were significantly less likely to have an ulcerated melanoma (PPR=0.85, 95% CI 0.74, 0.98) compared with the "no/ low prevention" cluster. These findings allow tailoring of preventive advice to melanoma patients to reduce their risk of future primary and recurrent disease.

Contrafreeloading in Rats Is Adaptive and Flexible: Support for an Animal Model of Compulsive Checking.

Contrafreeloading involves working unnecessarily to obtain a reward that is otherwise freely available. It has been observed in numerous species and can be adaptive when it provides an organism with updated information about available resources. Humans frequently update their knowledge of the environment through checking behaviors. Compulsive checking occurs when such actions are performed with excessive frequency. In a putative animal model of compulsive checking, rats treated chronically with the dopamine agonist quinpirole display exaggerated contrafreeloading for water. Although this effect has been attributed to behavioral rigidity, some evidence suggests the behavior remains somewhat flexible and may be adaptive under certain conditions. We assessed the ability of quinpirole-treated rats with contrafreeloading experience to adapt to changing contingencies by requiring them to alternate between response levers. Rats treated with quinpirole or saline were first trained to obtain water by pressing either of two levers. Next, free water was made available for 8 days, and contrafreeloading was measured. Rates of contrafreeloading were significantly higher in the drug-treated rats than in controls. On the following 5 days, each reward caused the associated lever to become inactive until a reward was earned from the alternate lever. Quinpirole-treated rats learned this new response requirement more quickly than controls. Thus, exaggerated checking behavior induced by chronic quinpirole treatment can be advantageous when environmental contingencies change. These results provide support for this animal model of compulsive checking and hint at the presence of a specialized neural checking module involving the dopamine system.

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OBJECTIVES/SPECIFIC AIMS: Sleep disturbance is a common problem following military deployment. Insomnia is associated with other adverse psychiatric and medical health outcomes. There are specialized cognitive behavioral therapies that can effectively treat insomnia; however, these tend to emphasize dysfunctional beliefs about sleep rather than nocturnal vigilance. Deployment to a threatening environment can engender nocturnal vigilance, which appears to be a salient feature of sleep disturbance in formerly deployed veterans. The purpose of this analysis is to characterize sleep-interfering thoughts and behaviors observed in an ongoing pilot study of a novel 2-session intervention incorporating various cognitive techniques to improve sleep in veterans. METHODS/STUDY POPULATION: To date, 10 formerly deployed US veterans with disturbed sleep have been recruited from the greater DC area. Participants are assessed at baseline, receive 2 intervention sessions, and are again assessed in 3 months. Sleep-interfering thoughts and behaviors are evaluated via self-report forms including the Fear of Sleep Inventory (FoSI), interviews, and prospective diaries. A portion of both intervention sessions addresses vigilant behaviors and sleep-interfering thoughts by teaching participants 1 of 4 techniques that target nocturnal vigilance: cognitive defusion, body scan, self-guided pleasant imagery, and dream rescripting. RESULTS/ANTICIPATED RESULTS: All of the first 10 participants endorsed sleep-interfering thoughts on the Fear of Sleep Index (FOSI) at a severity level of at least “a few times per month” (rating of ≥1), including several regarding previous trauma (#5) and nightmares (#10 and #16). Other elicited thoughts included thoughts about their environment (n=6), sleep (n=5), social or occupational concerns (n=8), nightmares (n=5), and health (n=4). All of the first 10 participants endorsed vigilant behaviors, including being over-attentive to their environment (n=7), checking behaviors (n=6), and being “on-guard” (n=8). Cognitive technique was selected by the participant in collaboration with the facilitator. Customized recommendations were given as to the timing and duration of practice, but all participants were instructed to practice at least once daily. Three participants (n=3) were fully compliant with their cognitive technique recommendations (choosing a body scan or imagery), 5 were partially compliant, and 2 were not compliant (both chose cognitive defusion). There was a significant reduction in sleep onset latency and wake after sleep onset from baseline to post-treatment (p<0.05). DISCUSSION/SIGNIFICANCE OF IMPACT: The preliminary data suggests that veterans exhibit cognitive and behavioral patterns that involve vigilance and interfere with sleep and demonstrates the need for an intervention targeting the link between nocturnal vigilance and sleep disturbance. More veteran participants and feedback are needed to optimize the efficacy and effectiveness of this sleep training.

Couple Satisfaction Forecast Based on Five Personality Factors and Coping Strategies in Women with Obsessive-Compulsive Disorder in Shiraz

The family institution is one of the most important social institutions that begin with marriage, so marriage has a fundamental and fundamental importance since the foundation's opening ceremony, and the foundation of the family is laid in marriage. If the marriage is successful, it helps a lot in psychosocial development. The success of marriage depends on the level of readiness of individuals for marriage and their realistic understanding of marital relationships. Couples' relationship has unique characteristics that awareness and acceptance of these characteristics by the couple can contribute to the success of marriage (Nazari, 2007). It is not advisable to achieve mutual maturity in marriage and marital satisfaction in most cases, but with regard to factors affecting marital satisfaction, we can expect that by increasing the level of marital satisfaction and mental health, many psychological, emotional and social problems (Mazarei, 2009). The description of the obsessive-compulsive disorder since its inception, by Scirol (1838) has not changed so far. This disorder is introduced with various titles such as obsessive compulsive disorder, Norouz or obsessive compulsive disorder and obsessive-compulsive disorder. Obsessive-compulsive disorder or obsessive-compulsive disorder is determined by intrusive thoughts, mental images and compulsive behaviors. Mandatory practices include obvious rituals (such as frequent washing of hands & checking behaviors) and subtle rituals; These two types of ritual are considered here as despicable behaviors. Revised Text The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM IV-TR) defines obsessive-compulsive disorder as recognizing the predictive ways that differs from over-concern concerns about real life issues. This refers to the differentiation of obsessive-compulsive thoughts from the concerns that are common in anxiety disorder.Problem statementThe study of the history of mental disorders shows that these disorders have always been and are human beings, and humans resort to appropriate and inappropriate ways to prevent and treat it. One of these disorders is obsessive-compulsive disorder (OCD), which has an adverse effect on the psychosocial and economic performance of the individual and even the family, especially marital satisfaction. Obsessive-Compulsive Disorder (OCD): An OCD is a chronic anxiety disorder that is associated with extreme mental employment in the order and the affairs, as well as in perfection, to a degree that results in loss of flexibility, clarity, and efficiency (Kaplan & Saduk, 2010). Another definition of this disorder is that obsessive-compulsive disorder (OCD) is a common heterogeneous mental disorder with thoughts and actions. Obsessive compulsive disorder involves disturbing thoughts, recurrences, and unwanted continuous thoughts.Statistical societyThe statistical population of this study included all paired individuals with obsessive-compulsive disorder referring to Shiraz clinics in 2014.MethodThe present research is based on descriptive-cross-sectional research with respect to its objectives and its nature, using correlation method in the form of a pre-design.ParticipantsIn this research, 60 people who referred to health centers were selected using purposeful sampling method. They were selected based on a questionnaire, structured clinical interview and obsessive-compulsory psychiatrist's opinion. Referring to psychiatric centers, Hafez Hospital and Imam Reza Clinic (AS) their statistics were reviewed.Information gathering toolEnrich Marital Satisfaction Inventory (1989): This questionnaire has been used as a valid research tool in numerous surveys to measure marital satisfaction.Information gathering toolEnrich Marital Satisfaction Inventory (1989): This questionnaire has been used as a valid research tool in numerous surveys to measure marital satisfaction. …

Manipulating beliefs about losing control causes checking behaviour

Cognitive theories of obsessive-compulsive disorder (OCD) posit that maladaptive beliefs lead to the development of symptoms. However, psychometric studies have provided mixed evidence regarding whether beliefs about control over thoughts predict OCD symptoms above and beyond other obsessive beliefs. Clinical reports have documented concerns among those diagnosed with OCD regarding a potential loss of control over their thoughts and behaviour, indicating that broadening the scope of beliefs about control by integrating aspects of losing control may better explain their role in OCD. In this study, 133 undergraduate participants underwent a bogus EEG session and received (positive or negative) false feedback about the possibility that they may lose control over their thoughts and behaviour, and completed a task asking them to control the pace of pictures. As hypothesized, participants in the high (versus low) beliefs about losing control condition checked significantly more often which keys they should use to control the pictures, t(106.95) = 2.28, p = .02, d = .44, demonstrating that manipulating beliefs about control can impact checking behaviour when a potential loss of control is emphasized. Also, checking behaviour predicted a lower desire for control, such that compulsions may be seen as opportunities to re-establish disrupted control cognitions.

Glutamate mGlu5 receptor antagonist, MPEP, reduces the quinpirole-induced compulsive-like checking in rats

There is increasing evidence for an interaction between dopaminergic and glutamatergic systems in obsessive-compulsive disorder (OCD). In the present study, it was tested whether group I metabotropic glutamate 5 receptors (mGlu5R) mediate compulsive-like checking behavior in an animal OCD model induced by quinpirole, a dopamine D2/3 receptor agonist. Rats were tested on a large open field with four boxes placed in different locations. To induce locomotor sensitization, rats were administered quinpirole chronically (0,5mgkg-1, twice a week for 5 weeks, sc). In the treated group, 2-methyl-6-(phenyl ethynyl) pyridine (MPEP), an mGluR5 antagonist was administered to rats (1 or 5mgkg−1, i.p.) prior to each quinpirole injection. The distance traveled and the speed of rats were used to assess locomotor activity. After each rat's checking place was identified, the number of visits and the length of check were used as the main criteria to assess the compulsive checking behavior. The results showed that treatment of MPEP significantly inhibited the increase in QNP-induced increase in locomotion and compulsive control behavior. Our findings, therefore, support the hypothesis that mGluR5 receptors mediate dopaminergic compulsive-like control behavior.

Long-lasting contribution of dopamine in the nucleus accumbens core, but not dorsal lateral striatum, to sign-tracking.

The attribution of incentive salience to reward-paired cues is dependent on dopamine release in the nucleus accumbens core (NAcC). These dopamine signals conform to traditional reward-prediction error signals and have been shown to diminish with time. Here we examined whether the diminishing dopamine signal in the NAcC has functional implications for the expression of sign-tracking, a Pavlovian conditioned response indicative of the attribution of incentive salience to reward-paired cues. Food-restricted male Sprague Dawley rats were trained in a Pavlovian paradigm in which an insertable lever predicted delivery of food reward in a nearby food cup. After 7 or 14 training sessions, rats received infusions of saline, the dopamine antagonist flupenthixol, or the GABA agonists baclofen and muscimol into the NAcC or the dorsal lateral striatum (DLS). Dopamine antagonism within the NAcC attenuated sign-tracking, whereas reversible inactivation did not affect sign-tracking but increased non-specific food cup checking behaviors. Neither drug in the DLS affected sign-tracking behavior. Critically, extended training did not alter these effects. Although extended experience with an incentive stimulus may reduce cue-evoked dopamine in the NAcC, this does not remove the dependence on dopamine in this region to promote Pavlovian cue approach nor result in the recruitment of dorsal lateral striatal systems for this behavior. These data support the notion that dopamine within the mesoaccumbal system, but not the nigrostriatal system, contributes critically to incentive motivational processes independent of the length of training.

Living with an autonomous spatiotemporal home heating system: Exploration of the user experiences (UX) through a longitudinal technology intervention-based mixed-methods approach

Rising energy demands place pressure on domestic energy consumption, but savings can be delivered through home automation and engaging users with their heating and energy behaviours. The aim of this paper is to explore user experiences (UX) of living with an automated heating system regarding experiences of control, understanding of the system, emerging thermal behaviours, and interactions with the system as this area is not sufficiently researched in the existing homes setting through extended deployment. We present a longitudinal deployment of a quasi-autonomous spatiotemporal home heating system in three homes. Users were provided with a smartphone control application linked to a self-learning heating algorithm. Rich qualitative and quantitative data presented here enabled a holistic exploration of UX. The paper's contribution focuses on highlighting key aspects of UX living with an automated heating systems including (i) adoption of the control interface into the social context, (ii) how users' vigilance in maintaining preferred conditions prevailed as a better indicator of system over-ride than gross deviation from thermal comfort, (iii) limited but motivated proactivity in system-initiated communications as best strategy for soliciting user feedback when inference fails, and (iv) two main motivations for interacting with the interface – managing irregularities when absent from the house and maintaining immediate comfort, latter compromising of a checking behaviour that can transit to a system state alteration behaviour depending on mismatches. We conclude by highlighting the complex socio-technical context in which thermal decisions are made in a situated action manner, and by calling for a more holistic, UX-focused approach in the design of automated home systems involving user experiences.

Relationship between Muscularity Concerns and Body Checking Behaviors in Turkish Bodybuilders

ObjectiveMuscle dysmorphia is a common body dysmorphic disorder among male bodybuilders. The major problem is difficulty in diagnosing muscle dysmorphia and often underreported. Muscularity concern is one of the underlying problems in the process of body image disturbance. Researchers have defined muscularity concern as repetitive body checking behaviors more than once in the same day. We aim to investigate the association between muscularity concerns and body checking behaviors among Turkish bodybuilders.MethodsParticipants were 120 male bodybuilders, (mean age 31.05±10.60) recruited from bodybuilding gyms in this study. Their height and weight were measured and Fat Free Mass Index (FFMI) score were calculated. Body checking behaviors (numbers of checking their muscles in a mirror and mirror‐like surfaces) were self‐reported by the bodybuilders. Muscle Dysmorphia Disorder Inventory (MDDI) was used to determine muscularity concerns. The data were analyzed using the IBM SPSS Statistics 23.0. Correlation analyses were used to determine the relationship between the measures of MDDI and the numbers of body checking behaviors.ResultsIn this study it is determined that participants check their muscles in the mirror mean average 9.2 (2–13) times a day, and it was higher in the high‐level MDDI scores compared with the low‐level MDDI scores (relatively 77.6% and 22.4% of the study population) The FFMI scores showed positive correlation with the MDDI scores and body checking behaviors (respectively; r=0,614 and r= 0,390, p=0,001).ConclusionsIt was found that bodybuilders with muscle dysmorphia concerned about their muscularity (higher MDDI score) and more frequent repeated body checking behaviors. Therefore, body checking behaviors and FFMI scores appeared to be a good diagnostic tool for health professionals to use when detecting muscle dysmorphia in bodybuilders.Support or Funding InformationThere is no funding support

Checking behavior in rhesus monkeys is related to anxiety and frontal activity

When facing doubt, humans can go back over a performed action in order to optimize subsequent performance. The present study aimed to establish and characterize physiological doubt and checking behavior in non-human primates (NHP). We trained two rhesus monkeys (Macaca mulatta) in a newly designed “Check-or-Go” task that allows the animal to repeatedly check and change the availability of a reward before making the final decision towards obtaining that reward. By manipulating the ambiguity of a visual cue in which the reward status is embedded, we successfully modulated animal certainty and created doubt that led the animals to check. This voluntary checking behavior was further characterized by making EEG recordings and measuring correlated changes in salivary cortisol. Our data show that monkeys have the metacognitive ability to express voluntary checking behavior similar to that observed in humans, which depends on uncertainty monitoring, relates to anxiety and involves brain frontal areas.

Two sides of the same coin? A new instrument to assess body checking and avoidance behaviors in eating disorders

Body checking (BC) and avoidance behaviors (BA) are the dominant behavioral features of body image disturbances (BID) that characterize most individuals with eating disorders (EDs). Whereas BC can be reliably assessed, a valid assessment tool for BA is lacking, preventing an adequate assessment of BID differences across different EDs (anorexia nervosa, AN; bulimia nervosa, BN; binge eating disorder, BED). A total of 310 women with EDs and 112 nonclinical controls completed measures of BC-, BA- and ED-related symptoms. BA did not differentiate between EDs, whereas BC did: it was highest in AN and BN, and lowest in BED. Multivariate analyses also discriminated AN from BN based on BC. Given that results are of preliminary nature, evidence is promising that EDs can be discriminated from healthy controls and that differential BID profiles for the behavioral component among ED subgroups exist. However, replication of the factor structure remains open within ED subsamples.

Why Do People with OCD and Health Anxiety Seek Reassurance Excessively? An Investigation of Differences and Similarities in Function

Excessive reassurance seeking (ERS) is commonly reported in patients who have OCD or health anxiety. Despite its prevalence and associated risk of ongoing difficulties, little is known about the function of ERS. It has been conceptualised as a type of compulsive checking behaviour, but could also be seen as being a supportive maneuver. This study offers a new approach towards defining ERS and support seeking (SS), and similarities between these two constructs in a sample of OCD and health anxious patients. A semi-structured interview was employed. Participants reflected on the nature and goals of their reassurance and support seeking—its impact on themselves and other people. Twenty interviews were conducted, transcribed and analysed in accordance to framework thematic analysis. Six overarching themes were identified in terms of ERS and five for SS. Results revealed limited diagnosis specificity of ERS. Strikingly, participants with health anxiety did not report seeking support.

Cost-Effectiveness Analysis of a Skin Awareness Intervention for Early Detection of Skin Cancer Targeting Men Older Than 50 Years.

To assess the cost-effectiveness of an educational intervention encouraging self-skin examinations for early detection of skin cancers among men older than 50 years. A lifetime Markov model was constructed to combine data from the Skin Awareness Trial and other published sources. The model incorporated a health system perspective and the cost and health outcomes for melanoma, squamous and basal cell carcinomas, and benign skin lesions. Key model outcomes included Australian costs (2015), quality-adjusted life-years (QALYs), life-years, and counts of skin cancers. Univariate and probabilistic sensitivity analyses were undertaken to address parameter uncertainty. The mean cost of the intervention was A$5,298 compared with A$4,684 for usual care, whereas mean QALYs were 7.58 for the intervention group and 7.77 for the usual care group. The intervention was thus inferior to usual care. When only survival gain is considered, the model predicted the intervention would cost A$1,059 per life-year saved. The likelihood that the intervention was cost-effective up to A$50,000 per QALY gained was 43.9%. The model was stable to most data estimates; nevertheless, it relies on the specificity of clinical diagnosis of skin cancers and is subject to limited health utility data for people with skin lesions. Although the intervention improved skin checking behaviors and encouraged men to seek medical advice about suspicious lesions, the overall costs and effects from also detecting more squamous and basal cell carcinomas and benign lesions outweighed the positive health gains from detecting more thin melanomas.

Body checking in non-clinical women: Experimental evidence of a specific impact on fear of uncontrollable weight gain.

Body checking is used widely among clinical and non-clinical individuals. It is suggested to be a safety behavior, reducing anxiety initially but potentially enhancing eating and shape concerns in the longer term. However, there is little causal evidence of those negative effects. This experimental study tests the potential negative impact of body checking. Fifty non-clinical women took part in a study of the effects of body checking in naturalistic settings. Each checked their wrist size every 15 minutes for eight hours on one day, then did not check the next day (order randomized). The impact on eating cognitions and body dissatisfaction was measured at the end of each day, and levels of change in those characteristics were also associated with eating pathology levels. Body checking did not result in more negative general eating attitudes or body dissatisfaction, but did result in a significant increase in a specific cognition that is hypothesised to be relevant to eating pathology - the fear of uncontrollable weight gain following eating. This impact was greater among those women with more negative existing eating attitudes. These findings add to the small experimental evidence base, demonstrating negative causal links between body checking and eating pathology. The findings need to be extended to clinical groups, but support the use of existing cognitive-behavioral methods to reduce body checking behavior.

Role of the medial prefrontal cortex and nucleus accumbens in an operant model of checking behaviour and uncertainty.

Background:Excessive checking is a common, debilitating symptom of obsessive–compulsive disorder. To further examine cognitive processes underpinning checking behaviour, and clarify how and why checking develops, we designed a novel operant paradigm for rats, the observing response task. The present study used the observing response task to investigate checking behaviour following excitotoxic lesions of the medial prefrontal cortex, nucleus accumbens core and dorsal striatum, brain regions considered to be of relevance to obsessive–compulsive disorder.Methods:In the observing response task, rats pressed an ‘observing’ lever for information (provided by light onset) about the location of an ‘active’ lever that provided food reinforcement. Following training, rats received excitotoxic lesions of the regions described above and performance was evaluated post-operatively before histological processing.Results:Medial prefrontal cortex lesions selectively increased functional checking with a less-prominent effect on non-functional checking and reduced discrimination accuracy during light information periods. Rats with nucleus accumbens core lesions made significantly more checking responses than sham-lesioned rats, including both functional and non-functional checking. Dorsal striatum lesions had no direct effect on checking per se, but reduced both active and inactive lever presses, and therefore changed the relative balance between checking responses and instrumental responses.Conclusions:These results suggest that the medial prefrontal cortex and nucleus accumbens core are important in the control of checking, perhaps via their role in processing uncertainty of reinforcement, and that dysfunction of these regions may therefore promote excessive checking behaviour, possibly relevant to obsessive-compulsive disorder.