Negative Behavioral Changes Research Articles

Refinements in the assessment of dementia-related behaviors: Factor structure of the memory and behavior problem checklist.

This study explored the factor structure of Zarit's Memory and Behavior Problem Checklist (MBPC), a 29-item inventory that samples negative behavior changes associated with dementia (e.g., incontinence and destroying property). Family caregivers for 185 progressive-dementia patients provided information on their affected relatives. A principal-components factor analysis with an oblique (nonorthogonal) rotation produced an 8-factor solution that accounted for 62.9% of the variance. A second-order factor analysis of the first 5 factors produced a 3-factor solution that accounted for 74.7% of the variance. The 3 factors were (a) self-care and self-maintenance functions, (b) memory problems and psychiatric symptoms associated with dementia, and (c) communication problems and agitation. Correlations between MBPC frequency scores and measures of adaptive ability and level of dementia were high and positive. Potential clinical and research applications of the scale in other related populations are discussed. The changes that occur in caregivers for demented family members have received considerable empirical attention. Disruptive behavior problems are very prevalent in dementia (Swearer, Drachman, O'Donnell, & Mitchell, 1988), and there is growing evidence that these behavior problems have significant adverse effects on caregivers (Dura, Stukenberg, & KiecoltGlaser, in press; Kiecolt-Glaser et al., 1987; Light & Lebowitz, 1989). In addition to the more well-known dementias, such as Dementia of the Alzheimer's Type (DAT), there are increasing numbers of demented patients with etiologies such as AIDS or head injury who receive care from family members. For caregiving research to advance, devices capable of assessing the salient aspects of both patient impairment and caregivers' experience are critical. Adequate global measures of level of dementia are available, including the Global Deterioration Scale (GDS; Reisberg, Ferris, DeLeon, & Crook, 1982) and the Clinical Dementia Rating (Hughes, Berg, Danziger, Coben, & Martin, 1982). These measures and others provide criteria for assessing the stage of dementia. For example, the Blessed Dementia Scale (Blessed, Tomlinson, & Roth, 1968) documents the presence of personality changes secondary to dementia, as well as differentiating levels of dementia. However, only the Memory and Behavior Problem Checklist (MBPC; Zarit, Reever, & Bach-Peterson, 1980) attempts to broadly and diversely sample the frequency of dementia-related problem behaviors and, as such,

Psychosexual consequences of traumatic brain injury: methodology and preliminary findings.

A methodology to systematically assess the psychosexual consequences of traumatic brain injury was developed and applied to a group of 21 male patients. A majority of the sample reported negative changes in sexual behaviour, including decreased sex drive, erectile function and frequency of intercourse. Common personality changes included depression, reduced self-esteem and a perceived decline in personal sex appeal. However, despite these changes in sexual behaviour, there was evidence that the quality of their marital relationships was preserved. Furthermore, there was no evidence of a relationship between the level of affect and sexual behaviour.

Gastrointestinal Symptoms and Bowel Patterns Across the Menstrual Cycle in Dysmenorrhea

Gastrointestinal (GI) functional indicators and symptoms across the menstrual cycle were examined in three groups of women: dysmenorrheic (n = 15), non-pill-taking nondysmenorrheic (n = 10), and nondysmenorrheic taking birth control pills (BCPs) (n = 9). Group assignment was based on the reported presence or absence of moderate to severe menstrual cramps in a GI Health Diary which subjects kept for two menstrual cycles. Stool consistencies and frequencies and GI symptoms were also recorded in this diary. Menstrual cycle phase significantly, p = .03, influenced stool consistencies for the sample as a whole with the loosest stools at menses. Reports of stomach pain were higher, p less than .001, at menses than at other cycle phases in all groups, and nausea, p less than .001, and decreased food intake, p less than .01, were more frequently reported by dysmenorrheic women at menses. More dysmenorrheic women had a history of menses-related GI symptoms. Both cycle phase and group differences were significant, p less than .05, for menstrual distress, with negative affect, pain, behavior changes, and autonomic reactions reported more frequently at menses by dysmenorrheic women.

The relationship among attitudes, behaviors, and biomedical measures of adolescents "at risk" for cardiovascular disease.

This study monitored trends in health behavior and attitudes of 93 adolescents who, according to clinical measures, were classified "at risk" for cardiovascular disease and determined the relationship among their health status, behavior, and attitude over a four-year period. Data collected included biomedical measures and self-reported health behaviors and attitudes. A greater proportion of "at risk" students reported negative health behavior changes in smoking, diet, alcohol, and stress. However, a positive health behavior trend was noted with respect to smokeless tobacco use declining from a high of 14% as freshmen to 8% as seniors. Also, students appeared sensitive to the potentially harmful effects of smoking. In general, a positive relationship existed among health status, health attitudes, and behavior. The findings justify screening to identify students "at risk" and beginning early intervention to prevent chronic disease in later life.

Psykososiale aspekter ved atopisk eksem hos barn: Familie og mestring

The purpose of the study was to investigate relationships between illness effects and coping problems, on the one hand, and selected, independent psychosocial variables, on the other, in an unselected group (N = 10) of preschool children with atopic exzema. The results showed that a worsening of the exzema was associated with various changes in mood and behavior. Generally, family interaction problems, poor formal knowledge about allergy and exzema (i.e. the mother's and the father's score on an information test), and social class level correlated highly with the dependent measures, i.e. with (1) the child's general emotional adaptation and (2) problems during physical examinations and medication procedures, (3) the parents' global rating of the child's illness coping and (4) negative changes in mood and behavior in the child during eczema periods. Suggestions for further research are mentioned.

99 VISITING BY SIBLINGS IN A NEONATAL INTENSIVE CARE UNIT (NICU)

Negative changes in sibling behavior have been documented following the birth of a newborn. They may be exaggerated by the prolonged hospitalization which occurs when sick neonates are admitted to NICUs. We randomly assigned 15 siblings (ages 3.8–7.25 years) of infants admitted to our NICU to a visiting group (n=8 permitted inside NICU, touch, hold neonate) or a control group (n=7 came to hospital for interview only). A structured interview was administered to sibs directly after the visit. Parents responded to questionnaires comparing the child's behavior before and after the neonate's birth, one week after admission to NICU and one week after experimental (or control) intervention. 80% of all children showed some behavioral changes after birth of the infant and both groups showed improved behavioral trends following the intervention. No differences were found between groups. 3/5 siblings in the control group and 0/5 in the visiting group gave negative or fearful descriptions of the hospital (p=0.08). None of the visits were disruptive of patient care and none of the children asked to leave the unit. Parents' comments were uniformly favorable. No nosocomial infections were documented following visits. In this study no detrimental effects and some favorable effects were found when siblings of this age were permitted to visit sick neonates in the hospital.

PSYCHOLOGICAL IMPACT OF CARDIAC CATHETERIZATION

Fifty children between 4 and 15 years of age were subdivided into three age groups and studied before, during, and after cardiac catheterization. Nearly all of the youngest, but less than half of the oldest patients manifested negative behavioral and intrapsychic changes after catheterization. The behavior patterns of the youngest children were affected specifically in the domains of regression, aggression, affectivity, and attitude. The increase of general and somatic anxiety was equally distributed among older and younger children. Among boys the increase of aggression was typically expressed in physical modes, whereas girls more often responded by verbal aggression. Since children do not perceive cardiac catheterization as an innocuous procedure, and the catheterization experience may, in selected cases, interact with previously existing conditions to produce long-term adverse effect, intervention to protect very young cardiac patients may be advisable. Prophylactic play therapy could be utilized; or where medically feasible, cardiac catheterization could be postponed until later childhood.

Guidelines for behavioral practice in the open community agency procedure and evaluation

Summary A step-wise practice procedure developed for conducting behavioral assessment and modification with individuals and families in open community settings was applied with a sample of 32 cases. These cases embraced 66 problem areas characteristic of the diverse behavioral difficulties encountered in open service settings. Eight practitioners working under close supervision employed the Procedure for a period of 8 months in two family service agencies. It was found that the Procedure provided for orderly and systematic behavior modification for the large variety of cases that may be encountered in the open setting and other services and occasional crises could be managed with only temporary delay in orderly progress in behavioral modification. There was a high degree of effectiveness for problems progressing to the point of modification or to maintenance. Although some countervailing conditions were found which interfered with case activity, these influences were rarely a serious threat to behavior modification. Positive changes in contracted behavior were not accompanied by an increase in negative changes in non-targeted behavior and there were more positive than negative changes in non-targeted behaviors incidental to work on targeted behavior. The most important potential threats to successful behavior modification in the open community setting were attrition (27 per cent premature termination) and client inaccessability. These areas should be addressed in future work on behavioral procedures for community settings. In addition to several procedural guidelines of the type applied here, behavior modification in the open setting also requires specialized procedures for purposes of handling such particular difficulties as family communication and decision making, as well as life situations involving crises and temporary and transitional status.