This report presents the design and initial findings of an attempt to reduce the risk of coronary heart disease in healthy men by modifying their type A behavior pattern. A group of 27 professional and executive volunteers, aged 39--59, who had been medically assessed as free from coronary heart disease, were randomly assigned to brief psychotherapy and behavior therapy groups. Each treatment group met for 14 sessions over a period of 5 months. Pre- and postmeasures of physiological (serum cholesterol, serum triglycerides, blood pressure) and psychological (anxiety, psychological symptoms, satisfaction) variables were taken. Results indicate that both treatment groups changed in the desired direction on most of the psychological and physiological variables without apparent change in habits of diet, exercise, smoking, or work load. The findings are provocative, but only tentative, leaving questions of clinical validity, durability, and generalizability unresolved. Nevertheless, they indicate that this approach to modifying type A behavior may reduce coronary risk and therefore warrants further exploration.
To test the reliability and durability of positive treatment effects obtained in a type A intervention project for healthy managers, the analysis was extended to data available from a third treatment group (a special behavior therapy group for participants eliminated from the main sample because of manifestations of clinical CHD) and to measures obtained 6 months following the end of treatment. Immediately after treatment all three groups showed a similar pattern of improvement, although the two behavior therapy groups did show a greater decrease in serum cholesterol levels. Six months after treatment the sample as a whole showed good maintenance of treatment effects, but the differences between groups had become somewhat sharper, with the special behavior therapy group faring best, the regular behavior therapy group intermediate, and the psychotherapy group worst. The logical consistency of these findings increases our confidence in the initial treatment results, as well as permitting cautious optimism concerning the possibility of developing effective intervention programs for coronary-type (type A) behavior.
The characteristics of high school student nonmedical drug users and nonusers were assessed by three successive yearly surveys. The surveys asked about respondents' personal, parent, and family characteristics; their behavior; their attitudes concerning themselves; their parents and family, adult society, and school. Drug use estimates for respondents' parents and peers, as well as themselves, were also assessed. Drug users were consistently different from nonusers in many areas. The incidence of drug increased in each of the three successive surveys, drug users tending to be older and male. With regard to behavior, drug users more frequently acted in a nonadult approved manner than nonusers. Drug users estimated their parents more likely to use alcohol and cigarettes, and estimated more peers to use nonmedical drugs than nonusers. Prediction of drug users from the data could be made with 80% and better accuracy. The findings are discussed in terms of their significance in understanding the nature of adolescent drug use.
Behaviour therapy techniques have been applied to asthmatic individuals with some apparent success. The definitive studies isolating a) the critical ingredients of treatments, b) the efficacy of treatment over the long term, have yet to be done. There can be an autonomic conditioning component in asthma, and pulmonary function is improved when subjects are in a relaxed state. Studies reporting results of behavior therapy treatments are examined from an outcome and experimental design viewpoint. With the methodological deficiencies of these studies in mind, proposals for future research are generated. RESUME On a deja applique des techniques de therapie behaviorale a des asthmatiques avec quelque succes. Les etudes decisives isolant les composantes cruciales du traitement et I'efficacite a long terme du traitement sont encore a faire. II peut y avoir une composante de conditionnement autonome dans I'asthme et la fonction pu/monaire s'ameliore quand le sujet est dans un erat de relaxation [-'article examine les resultats obtenus en therapie behaviorale dans une perspective axee sur le plan experimental et Tissue du traitement. A la lumiere des lacunes methodologiques de ces etudes, des suggestions sont faites pour les recherches a venir.
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