{"title":"Health Through Cholesterol Reduction: Are there Unforeseen Risks?","authors":"Matthew F. Muldoon, Stephen B. Manuck","doi":"10.1093/abm/14.2.101","DOIUrl":"https://doi.org/10.1093/abm/14.2.101","url":null,"abstract":"While abundant scientific evidence documents the risks of untreated hypercholesterolemia, long-term cholesterol-lowering could also be associated with adverse health effects. This article discusses potential connections between reduced serum cholesterol levels and three specific adverse outcomes: (a) cancer, (b) hemorrhagic stroke, and(c) death from non-illness related causes (suicide, accident, or violence). Included are data from epidemiologic studies of both serum cholesterol and dietary fat consumption, and evidence from randomized, clinical trials of cholesterol lowering with either dietary or pharmacologic treatment. While some evidence links reduced serum cholesterol with each of these three illnesses or events, the inconsistencies and limitations of the available evidence presently preclude conclusions regarding either the safety or dangers of cholesterol-lowering treatments.","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":"142 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140311132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Douglas R. Southard, Richard A. Winett, Janet L. Walberg-Rankin, Tamara E. Neubauer, Kathryn Donckers-Roseveare, Paul A. Burkett, Robert A. Gould, David Lombard, John F. Moore
{"title":"Increasing the Effectiveness of the National Cholesterol Education Program: Dietary and Behavioral Interventions for Clinical Settings","authors":"Douglas R. Southard, Richard A. Winett, Janet L. Walberg-Rankin, Tamara E. Neubauer, Kathryn Donckers-Roseveare, Paul A. Burkett, Robert A. Gould, David Lombard, John F. Moore","doi":"10.1093/abm/14.1.21","DOIUrl":"https://doi.org/10.1093/abm/14.1.21","url":null,"abstract":"The National Cholesterol Education Program (NCEP) is the cornerstone of primary care efforts to treat hypercholesterolemia. It provides diagnostic criteria and an outline of appropriate assessment and treatment protocols. The initial treatment emphasis is on the Step 1, low-cholesterol, low-fat diet. A review of these guidelines from a behavioral perspective suggests that there may be several areas of concern. These include: (a) the absence of attention given to developing sufficient motivation for behavior change; (b) the limited efficacy of routine dietary education for promoting dietary changes; (c) the apparent need for diets more rigorous than the Step 1 and Step 2 guidelines to substantially lower cholesterol in some individuals; (d) the extensive support such dietary interventions must have from established behavioral change strategies; and (e) the lack of enthusiasm and experience many physicians and other medical personnel have for nutrition interventions. It is suggested that more conceptually-based behavioral assessment procedures, such as those based upon the stages of change model, could broaden the impact of the NCEP. In addition, data are presented which suggest that the NCEP could have greater effectiveness if more exacting behavioral strategies are followed. Interactive, multimedia systems are discussed as one means to facilitate dietary interventions in primary care settings. Finally, the importance of integrating measures designed to enhance long-term maintenance of dietary modifications is emphasized along with the need for more ongoing research within the NCEP.","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":"13 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140314878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Life Stress and Illness: The Question of Specificity","authors":"Tirril Harris","doi":"10.1093/abm/13.4.211","DOIUrl":"https://doi.org/10.1093/abm/13.4.211","url":null,"abstract":"The hypothesis that specific disorders arise from specific psychosocial circumstances has received little attention in the last couple of decades. Recently developed measurements of stress, specifically the Life Events and Difficulties Schedule (LEDS), allow a more focused perspective on the differing psychosocial pathways to psychiatric and physical disorder. This is the result of the level of measurement employed by the LEDS, whereby specific qualities of distress, such as losses, dangers, frustrations, and so on, can be distinguished from each other within the overall category of distressing/unpleasant experience. Studies of depression, anxiety, schizophrenia, abdominal pain, appendectomy, menorrhagia, secondary amenorrhea, and myocardial infarction using the LEDS suggest that the specific qualities of the stressors involved in the onset of each condition may parallel similar predisposing vulnerabilities in the personalities of those becoming ill, and corresponding psychiatric conditions between stressor and somatic onset. An overall framework is outlined within which disorders are typified as more or less disengaged/overengaged, and suggestions are offered for future research.","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":"2020 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140310991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cognitive-Behavioral Treatment of Rheumatoid Arthritis: A Preliminary Review of Efficacy and Methodology","authors":"Lance M. McCracken","doi":"10.1093/abm/13.2.57","DOIUrl":"https://doi.org/10.1093/abm/13.2.57","url":null,"abstract":"Rheumatoid arthritis (RA) is a chronic, painful, and debilitating disease which affects approximately 1% of the adult population. A great deal of literature suggests that psychological factors are important to patient outcomes in RA. This article discusses these factors and then reviews the cognitive-behavioral treatment literature for this population. Although cognitive-behavioral treatments appear to assist RA patients in managing their pain, additional findings are inconsistent and methodological limitations in the literature preclude firm conclusions. A final section of this paper presents suggestions to improve the design of future studies evaluating cognitive-behavioral treatments for these patients.","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":"33 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140314808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Helen C. Gift, Barbara Gerbert, Gerald C. Kress, Susan T. Reisine
{"title":"Social, Economic, and Professional Dimensions of the Oral Health Care Delivery System","authors":"Helen C. Gift, Barbara Gerbert, Gerald C. Kress, Susan T. Reisine","doi":"10.1093/abm/12.4.161","DOIUrl":"https://doi.org/10.1093/abm/12.4.161","url":null,"abstract":"This article reviews issues which serve as the basis for future research in the area of the oral health care delivery system. The review is presented within the context of the larger health care and social environment and includes assessments of structure and organization, participants, access and utilization, professional training, and science transfer. The major trends in the sociodemographics of the U.S. population, changes in oral health status, and abilities to alter disease processes through prevention and treatment strategies are among the challenges addressed. The conclusions of the review illustrate the complexity of the oral health care delivery system as a research opportunity for behavioral and social scientists.","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":"44 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140315198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Nutritional Remedies: Reasonable and Questionable","authors":"Johanna T. Dwyer","doi":"10.1093/abm/14.2.120","DOIUrl":"https://doi.org/10.1093/abm/14.2.120","url":null,"abstract":"This article reviews common, reasonable therapies and questionable nutritional remedies for diseases and conditions that have dietary implications. Standard and questionable dietary remedies are defined and distinguished from other types of therapies, such as experimental or investigational Reasons for concern about questionable remedies are summarized. Some of the possible causes of their popularity are briefly reviewed. Several disorders are discussed to illustrate general points and concerns about the use of unproven remedies in clinical practice. The article concludes with remarks about some collaborative efforts between nutritionists and behavior therapists that are likely to be helpful to patients.","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":"10 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140311303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Does Social Support Aid in Weight Loss and Smoking Interventions? Reply from a Family Systems Perspective","authors":"Jason B. Lassner","doi":"10.1093/abm/13.2.66","DOIUrl":"https://doi.org/10.1093/abm/13.2.66","url":null,"abstract":"This article suggests that the inconsistent ability of social support interventions to enhance treatment outcomes in weight loss and smoking cessation studies is a result of inadequate theoretical conceptualization and operational definition of social support. Family systems theory is proposed as a theoretical framework which capitalizes on the salience of patient-partner interactions in producing long-term behavior change. A model is presented which outlines how this alternative conceptualization of social support would alter previous interventions. Preliminary evidence in favor of the proposed model is presented in the form of retrospective analysis of previous studies. Based on a desire to resolve the inconsistency of previous research, a call is made for the consideration of systems theory in future social support intervention studies.","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":"25 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140310995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Is Obesity a Risk Factor for Cardiovascular Disease?","authors":"Robert W. Jeffery","doi":"10.1093/abm/14.2.109","DOIUrl":"https://doi.org/10.1093/abm/14.2.109","url":null,"abstract":"This article reviews research on the relationship between cardiovascular disease (CVD) and obesity. A preponderance of evidence strongly suggests that obesity is causally related to elevated blood pressure, elevated cholesterol, and glucose intolerance, all of which are primary risk factors for CVD. Nevertheless, data linking obesity to CVD itself are less consistent. While some studies show a positive and graded relationship between obesity and CVD incidence and mortality, others show no effect or even an inverse relationship. Possible reasons for these conflicting findings are discussed. These include heterogeneity of obesities, particularly central versus peripheral obesity; misclassification of individuals due to use of inaccurate obesity indices; analytic difficulties in estimating the contributions of obesity as a single variable in a complex chain of causation; and the presence of confounders such as cigarette smoking that lower weight, but are themselves a cause of CVD.","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":"45 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140310996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reducing Breast Cancer Risk through Changes in Diet and Alcohol Intake: from Clinic to Community","authors":"Karen Glanz","doi":"10.1093/abm/16.4.334","DOIUrl":"https://doi.org/10.1093/abm/16.4.334","url":null,"abstract":"This article reviews and summarizes evidence regarding the association of dietary factors, including alcohol intake, with breast cancer risk and survival, and reviews investigations of strategies for dietary behavior change for breast cancer prevention. Although the evidence remains inconclusive, several nutritional factors have often been found to be associated with breast cancer incidence and survival: total fat intake, saturated fat intake, obesity, and moderate to heavy alcohol consumption. Fiber, fruits and vegetables, vitamins A and C, and soy products may also have protective effects, though they have been less well researched. Clear evidence exists from clinical trials that intensive educational and behavioral interventions can be effective for promoting lower-fat diets. Clinical interventions and community-based interventions using combinations of educational and environmental strategies have achieved significant, though smaller, changes across large populations. Research needs include investigating influences on the maintenance of dietary change, examining the role of readiness to adopt new eating patterns, and continuous refinement of measurement tools. Because dietary changes that may reduce breast cancer risk meet general preventive guidelines, behavioral scientists should maximize the opportunities to learn more about promoting healthful diets for cancer prevention.","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":"42 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140311134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Dudley McGlynn, Elliot N. Gale, Alan G. Glaros, Linda LeResche, Donna L. Massoth, James M. Weiffenbach
{"title":"Biobehavioral Research in Dentistry: Some Directions for the 1990s","authors":"F. Dudley McGlynn, Elliot N. Gale, Alan G. Glaros, Linda LeResche, Donna L. Massoth, James M. Weiffenbach","doi":"10.1093/abm/12.4.133","DOIUrl":"https://doi.org/10.1093/abm/12.4.133","url":null,"abstract":"Literatures related to five promising areas of biobehavioral research in dentistry are overviewed: etiology and treatment of temporomandibular disorders and of bruxism, assessment of facial and other pain with measures of facial expression, the connection between stress and periodontal disease, and taste sensory function and dysfunction. In each case, the current status of the literature is described and some directions for continued research are offered. The biopsychosocial perspective on illness and health is favored as an organizing framework for these and similar efforts.","PeriodicalId":7939,"journal":{"name":"Annals of Behavioral Medicine","volume":"10 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140310997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}