Need-driven Behavior Research Articles

Physiology in Perspective

EditorialPhysiology in PerspectiveNikki ForresterNikki ForresterAmerican Physiological Society, Rockville, MarylandPublished Online:20 Jan 2023https://doi.org/10.1152/physiol.00002.2023MoreSectionsPDF (79 KB)Download PDF ToolsExport citationAdd to favoritesGet permissionsTrack citations ShareShare onFacebookTwitterLinkedInWeChat This issue of Physiology features four outstanding review articles that summarize current knowledge and uncover areas for future research across a range of topics in physiology. First, we analyze how developmental hypoxia affects the vertebrate cardiovascular system. Next, we describe the role of coupling delay in synchronized oscillations, with a focus on the segmentation clock. Third, we evaluate mechanistic models for how the insular cortex regulates the physiological needs of organisms and their need-driven behaviors. Finally, we explore how breakthroughs in precision medicine can improve diagnoses and treatments for people with mental illness.The environment during early development can have profound effects on an organism’s morphology, physiology, function, and behavior. Adaptive responses to adverse temperature, oxygen, or pH conditions can persist throughout an organism’s lifetime and even across generations through epigenetic changes. Hypoxia, or an insufficient supply of oxygen, is a particularly common and disruptive environmental stressor. Whereas oxygen levels are tightly regulated in mammalian wombs, embryonic birds and ectothermic vertebrates can experience highly variable oxygen levels during development. Because the vertebrate cardiovascular system is heavily involved in mitigating oxygen deprivation, it is especially sensitive to developmental hypoxia. In this review, Galli et al. (1) conduct a comparative analysis of vertebrate cardiovascular responses to developmental hypoxia to identify common and novel responses as well as potential medical and ecological implications.In segmented animals, cells must be able to communicate with one another to ensure the proper segmentation of somites. Cells achieve this by sending and receiving information via signaling pathways, such as the Notch signaling pathway. The Notch signaling pathway plays a critical role in somitogenesis by coordinating the segmentation clock, which is a molecular oscillator that regulates the periodic formation of somites in embryos. If these oscillations are out of synchrony between cells, then somite segmentation does not occur properly, potentially causing respiratory complications or death. Mathematical models suggest that the time required to transmit signals between cells, or coupling delay, is important for oscillatory dynamics, but the biological implications of coupling delay remain less understood. In this review, Kageyama et al. (2) describe the biological importance of coupling delay in synchronized oscillations of the segmentation clock and reveal areas for future analysis.All cellular organisms must maintain the appropriate intracellular environment. When the necessary conditions for homeostasis are not met by the environment and cannot be regulated internally, organisms must take actions to fulfill their physiological needs. In multicellular animals, this process often involves powerful motivations, such as thirst or hunger, and the concerted action of different tissues and organs. However, the neural basis of the motivations that drive these behaviors is relatively unclear. Animal models suggest that the insular cortex receives internal sensory information and regulates physiological needs and need-driven behavior. In this review, Prilutski and Livneh (3) discuss mechanistic models for how the insular cortex regulates physiological needs, develop a framework for testing these models, and outline implications for various diseases and disorders.Diagnostic errors in mental disorders are common, with low inter-reliability and some studies reporting misdiagnosis rates of up to 66%. Even when patients are correctly diagnosed, the lack of clinical guidelines for drug selection can complicate a psychiatrist’s ability to select accurate treatments. Precision medicine holds the potential to improve care for patients with mental illness, in part through comprehensively exploring the physiological basis of such conditions. In addition, recent advancements in multi-omics technologies and data analytics can pave the way for better diagnostic tests and treatment decisions. In this review, Scala et al. (4) explore how breakthroughs in precision medicine and multi-omic physiological profiling can improve disease classification, psychiatric diagnoses, and treatments.No conflicts of interest, financial or otherwise, are declared by the author.

Physiological Needs: Sensations and Predictions in the Insular Cortex.

Physiological needs create powerful motivations (e.g., thirst and hunger). Studies in humans and animal models have implicated the insular cortex in the neural regulation of physiological needs and need-driven behavior. We review prominent mechanistic models of how the insular cortex might achieve this regulation and present a conceptual and analytical framework for testing these models in healthy and pathological conditions.

Predictors of need-driven behaviors in nursing home residents with dementia and associated certified nursing assistant burden

Objective: We examined predictors of staff-reported need-driven behaviors and resistiveness to care in nursing home residents with dementia and predictors of certified nursing assistant (CNA) burden related to both constructs. Background and proximal factors from the need-driven dementia-compromised behavior model [Algase, D.L., Beck, C., Kolanowski, A., Whall, A., Berent, S., Richards, K., et al. (1996). Need-driven dementia-compromised behavior: An alternative view of disruptive behavior. American Journal of Alzheimer's Disease, 5, 10–19] were examined as potential predictors of need-driven behaviors (NDBs) and resistiveness to care and CNA burden. Method: We used secondary data analysis of prospective data from 10 nursing homes in Birmingham, Alabama. One-hundred and sixty-one residents (83.43 ± 8.56 years) with mini mental state examination (MMSE) score = 6.41 (± 6.66) were assessed via chart review, resident surveys, and surveys of CNAs. Results: Multiple regression models revealed that cognitive functioning, activities of daily living functioning, race, gender, and CNA-reported weekly resident pain intensity were associated with resident NDBs. Regression models also revealed that weekly pain intensity and medical comorbidity were associated with CNA burden associated with the resident NDBs. However, we were unable to explain a significant amount of variance in the resistiveness to care or CNA burden associated with resistiveness to care. Discussion: Results underscore the role of pain in both resident NDBs and associated CNA burden. Future research should focus on predictors of resident resistiveness to care and the relation of pain assessment and management practices to CNA burden. Moreover, interventions to improve resident care should seek to include CNAs in institutional pain assessment and management processes.

The Human Condition and the Gift: Towards a Theoretical Perspective on Close Relationships

Hannah Arendt’s exposition of the human condition provides the basic framework for a theoretical perspective on close relationships. According to Arendt, the human condition is comprised of three modes of activity: labor, work, and action. Labor is need-driven behavior, work concerns goal-directed activity and the fabrication of things, and action involves the mutual validation of unique individuals. Within this framework, the gift is the means by which relational ties are made concrete. I propose a model of gift-giving organized by two axes: whether or not the partner is singularized by the gift and whether or not the gift is given with an expectation of a return gift. I then apply this model to the three modes of the human condition.

Special Section—Behavioral symptoms of dementia: their measurement and intervention. Keeping wandering nursing home residents at the table: improving food intake using a behavioral communication intervention

The purpose of this multiple case design study (n = 3) with an embedded experiment was to determine the effect of the systematic use of a behavioral nursing intervention on the mealtime behavior of nursing home residents with probable Alzheimer's disease. It was hypothesized that the systematic behavioral intervention would increase time spent seated during the meal and proportion of food consumed while decreasing the frequency of table-leaving events during mealtime. The intervention was designed to impact the proximal factors of physiological need and social interaction from the Need-Driven Behavior Model. Results demonstrate that all cases were able to sit at the table longer and eat more food during the intervention, while body weight for all cases remained stable throughout the study. Two of the three cases left the table fewer times during the intervention. There were no statistically significant changes in proportion of fluids consumed in any case.

Derivation of an intervention for need-driven behavior. Activity preferences of persons with dementia.

Derivation of an intervention for need-driven behavior. Activity preferences of persons with dementia.