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Background The aim of this exploratory archival study was to discern the utility of the Iowa Gambling Task (IGT) in identifying adaptive decision-making capacities among pilots with a history of alcohol dependence both with and without Cluster B personality features. Methods Participants included 18 male airmen at the rank of captain with a history of receiving alcohol dependence treatment and subsequent referral for a fitness-for-duty evaluation. Data from prior comprehensive neuropsychological evaluations conducted in a private practice setting at the mandate of the FAA utilizing criteria outlined in the HIMS program was used. ANOVA was conducted to compare pilots with (N = 4) and without Cluster B personality features (N = 14) on measures of decisionmaking capacities, intelligence, and executive functioning. Results Pilots with Cluster B personality features were found to have a significantly lower Total Net T-Score on IGT (M = 35.00, SD = 9.27) than pilots without features of Cluster B (M = 56.36, SD = 9.55). Furthermore, with the exception of the first 20 cards (i.e., Net 1); the groups significantly differed in their Net scores. No statistically significant difference was found on airmen's intelligence and executive functioning. Discussion The present study found that alcohol-dependent airmen with Cluster B personality features evidenced significantly poorer decisionmaking capacities as measured by the ICT in comparison to alcohol dependent airman without Cluster B personality features. Implications and limitations of the study are discussed.

This investigation examined the effectiveness of a self-help (SH), stepped-care (SC) weight loss program. Based on a failure to achieve pre-assigned weight loss goals, participants were eligible to be stepped-up from a SH program to two levels of treatment intensity (weight loss group [WLG]; individual counseling [IC]) beyond SH. The primary outcome was change in body weight. Fifty-three overweight/obese adults (BMI≥27 kg/m2; mean BMI of 37.3, SD=6.6, 89% Caucasian, and 77% female) participated in an 18-week weight loss intervention. During several phases of the investigation, those stepped-up to more intensive treatment lost comparable weight to those who were not stepped-up. Nevertheless, by the end of treatment, individuals who remained in SH (M = 8.6%) lost a significantly greater percentage of weight than individuals who received SH+IC (M = 4.7%; p

Using a Web-based, self-administered questionnaire, we assessed 498 university-student drinkers' self-efficacy to use 31 different behavioral strategies to reduce excessive drinking in each of three different locations (bar, party, own dorm/apartment). Averaging all 31 items within each drinking situation to create a single scale score revealed high internal consistency reliabilities and moderate inter-item correlations. Testing the association of self-efficacy with drinking location, sex, and frequency of recent binge drinking, we found that respondents reported higher self-efficacy to use these strategies when drinking in their own dorm/apartment than when drinking in bars and at parties; women reported higher mean self-efficacy than men; and drinkers who engaged in 3-or-more binges in the previous 2 weeks reported lower self-efficacy than those who reported either 0 or 1-or-2 binges in the same time period. This questionnaire could be used to identify self-efficacy deficits among clients with drinking problems and as an outcome measure to assess the degree to which interventions influence reported confidence to use specific drinking-reduction strategies in high-risk drinking situations.

This investigation compared a traditional behavioral weight loss program with a weight loss intervention emphasizing environmental modification and habit formation and disruption. Fifty-four overweight and obese adults (BMI ≥ 27 kg/m2) were randomly assigned to either a 14-week LEARN or TYL intervention. Forty-two participants completed the six-month follow-up assessment. Treatment outcomes between LEARN and TYL participants were equivalent. During the six-month no-treatment follow-up period, participants evidenced a 3.3 lb (SD = 9.2) weight gain. The TYL intervention appears to represent an attractive option for individuals seeking an alternative to the traditional behavioral approach to weight loss.

Objective Weight bias among weight loss treatment-seeking adults has been understudied. This investigation examined the 1) levels of implicit, explicit, and internalized weight bias among overweight/obese treatment-seeking adults, 2) association between weight bias and psychosocial maladjustment (binge eating, body image, depression), and 3) association between participation in weight loss treatment and changes in weight bias. Methods Fifty-four overweight and obese individuals (BMI ≥ 27) recruited for a weight loss intervention completed measures of depression, body image, binge eating, and implicit, explicit, and internalized weight bias. Results Participants evidenced significant implicit, explicit, and internalized weight bias. Greater weight bias was associated with greater depression, poorer body image, and increased binge eating. Despite significant reductions in negative internalized and explicit weight bias following treatment, weight bias remained strong. Conclusions Weight bias among treatment-seeking adults is associated with greater psychological maladjustment and may interfere with their ability to achieve optimal health and well-being.

In a stepped-care approach to treatment, patients are transitioned to more intensive treatments when less intensive treatments fail to meet treatment goals. Self-help programs are recommended as an initial, low intensity treatment phase in stepped-care models. This investigation examined the effectiveness of a self-help, stepped-care weight loss program. Fifty-eight overweight/obese adults (BMI ≥ 27 kg/m2) participated in a weight loss program. Participants were predominately Caucasian (93.1%) and female (89.7%) with a mean BMI of 36.6 (SD = 7.1). Of those completing the program, 57% of participants (N = 21) who remained in self-help maintained an 8% weight loss at follow-up. Participants who were stepped-up self-monitored fewer days and reported higher daily caloric intake than self-help participants. Once stepped-up, weight loss outcomes were equivalent between individuals who remained in self-help compared to those who were stepped-up. Individuals who were stepped-up benefited from early intensive intervention when unsuccessful at losing weight with self-help.

Few studies have explored the relationship between weight bias and weight loss treatment outcomes.This investigation examined the relationship between implicit and explicit weight bias and (a) program attrition, (b) weight loss, (c) self-monitoring adherence, (d) daily exercise levels and overall caloric expenditure, (e) daily caloric intake, and (f) daily caloric deficit among overweight/obese treatment-seeking adults.Forty-six overweight/obese adults (body mass indexor = 27 kg/m(2)) participating in an 18-week, stepped-care, behavioral weight loss program completed implicit and explicit measures of weight bias. Participants were instructed to self-monitor and electronically report daily energy intake, exercise, and energy expenditure.Greater weight bias was associated with inconsistent self-monitoring, greater caloric intake, lower energy expenditure and exercise, creation of a smaller caloric deficit, higher program attrition, as well as less weight loss during the self-help phase of the stepped-care treatment.Weight bias may interfere with overweight/obese treatment-seeking adults' ability to achieve optimal health.

Overweight is increasing in children, leading to negative health consequences. Children also lack appropriate levels of important vitamins and nutrients in their diets. Environmental cues, such as food proximity, have been shown to influence consumption rates in adults. The present study has tested whether proximity to either a nutrient-dense or caloric-dense food would influence children’s snack consumption in a day care setting. Children ( N = 46, age range 3.4-11) consumed more of both nutrient- and energy-dense foods when they are sitting closer to the food than if they are sitting farther away from the food, above and beyond the effects of age. The data indicate that it may be possible to increase the consumption of nutrient-dense foods or decrease the consumption of energy-dense foods, respectively, by modifying the proximity of such foods within a child’s environment.

The Dietary Guidelines for Americans recommend creating an energy deficit of at least 500 kcal a day to facilitate weight loss. This investigation examined the relationship between creating a consistent, self-reported energy deficit of at least 500 kcal a day and weight loss. The relationship between self-monitoring adherence and daily energy intake and expenditure and weight loss was also examined.Fifty-four overweight or obese adults (BMIor=27 kg/m(2)) participating in a 14-week weight loss program were given a 5% total body weight loss goal and instructed to create an energy deficit of at least 500 kcal a day to facilitate weight loss. Participants provided daily records of total energy intake and expenditure, physical activity, and weekly and overall weight loss during treatment.Individuals who averaged an energy deficit in excess of 500 kcal per day lost nearly four times the weight as individuals whose average energy deficit was below 500 kcal per day (p.01). Individuals who lost 5% of their body weight during the intervention self-monitored more than twice as many days than individuals who failed to lose 5% of their body weight (p.01).Individuals interested in losing weight should continue to be advised to regularly self-monitor energy intake and expenditure as well as to create a consistent daily energy deficit (e.g., 500 kcal day).

To evaluate the psychometric properties of a new self-report questionnaire designed to assess college students' intentions to employ 31 specific alcohol-reduction strategies.Students attending a large public university were recruited to complete alcohol-reduction, drinking history, and personality questionnaires online.Based on item-total correlations and principal components analysis, the authors eliminated 3 items and calculated average intention ratings across the remaining 28 items. The resulting scale had appropriate unidimensionality and excellent internal consistency. Correlations of intention questionnaire scores with measures of drinking history, alcohol outcome expectancies, sensation seeking, and impression management provided some support for criterion and discriminant validity of the questionnaire.This questionnaire could be employed as an outcome measure to evaluate prevention programs and as a clinical tool to identify clients who have little intention to employ drinking reduction strategies in heavy drinking situations.

Aims: To evaluate the psychometric properties of a previously published questionnaire designed to assess young drin- kers' self-efficacy to employ 31 cognitive-behavioral alcohol reduction strategies. Methods: Undergraduates (n= 353) recruited from a large Midwestern university completed the previously published Alcohol Reduction Strategies-Current Confidence questionnaire (and other measures) for a self-selected heavy drinking setting. Results: Item loadings from a principal components analysis, a high internal consistency reliability coefficient, and a moderate mean inter-item correlation suggested that all 31 items comprised a single scale. Correlations of questionnaire scores with selected aspects of drinking history and personality provided support for criterion and discriminant validity, respectively. Women reported higher current confidence to use these strategies than did men, but current confidence did not vary as a function of recent binge status. Conclusion: Given this further demonstration of its psychometric qual- ities, this questionnaire holds promise as a clinical tool to identify clients who lack confidence in their ability to employ cognitive- behavioral coping strategies to reduce their drinking.

This study was designed to assess undergraduates' (N = 424) definitions of binge drinking and to evaluate whether the number of drinks they said comprise a binge varied as a function of beverage type, respondent gender, and respondent binge drinking status. When asked to designate the specific number of drinks that comprise a binge for each of four beverage types, students reported that the number of beers constituting a binge was significantly larger than the number of glasses of wine, shots of hard liquor, and servings of any combination of alcoholic beverage types; men reported that a larger number of drinks constitute a binge than did women; and those who had engaged in 3 or more binges in the past 2 weeks reported that more drinks comprise a binge than those who had binged less often. Responses to an open-ended question asking their definition of a binge revealed that students sometimes characterize a binge in terms of motivations for and unhealthy consequences of drinking, in addition to defining a binge as comprising consumption of a large amount of alcohol in a limited (though often unspecified) time period. Furthermore, students attributed their open-ended definitions of binge drinking to informal sources of information and observation of others' drinking almost as often as they did to school-based or media-based sources. This suggests that educators might look for innovative ways to use both formal and informal social networking, and video illustrations of restrained drinking, as ways to influence young people's views of binge drinking. (PsycINFO Database Record (c) 2011 APA, all rights reserved). Language: en

Develop and evaluate key psychometric properties of a self-report questionnaire specifically designed to assess student drinkers' self-confidence to employ a variety of strategies intended to reduce unhealthy consequences of high-risk drinking.Four hundred ninety-eight participants rated their confidence (from "not at all confident" to "completely confident") to employ 17 harm reduction strategies when drinking.Factor analysis and internal consistency reliability analyses indicated that the 17 items constitute a single scale with good test-retest reliability. Consistent with other research examining previous use of such strategies, women in our sample reported significantly higher harm reduction self-efficacy than did men. Harm reduction self-efficacy was also associated with reported number of high-risk drinking episodes in the previous 2 weeks.This brief and easily administered questionnaire holds promise as a clinical tool to identify individuals with low harm reduction self-efficacy and as an outcome measure for health promotion and educational interventions.

BACKGROUND/AIMS: Research suggests that making overly positive self-evaluations is the norm rather than the exception. However, unlike other stigmatized groups, overweight individuals do not exhibit a positive in-group social identity and instead exhibit significant explicit, implicit, and internalized weight bias. Therefore, it is not known whether overweight/obese individuals will evidence self-enhancement on general traits (good, attractive), or on traits inconsistent with fat stereotypes (disciplined, active, healthy eater), on an assessment of implicit attitudes. Similarly, it is not known whether these ratings will be associated with preexisting levels of weight bias, gender, or short-term weight loss. METHODS: At baseline, 53 overweight/obese adults (BMI > 27 kg/m(2), mean BMI = 37.3 kg/m(2), SD = 6.6 kg/m(2), 89% Caucasian, and 77% female) participating in a weight loss intervention completed measures of explicit and internalized weight bias as well as implicit weight bias and identity (self-other comparisons). RESULTS: Although participants evidenced significant anti-fat attitudes, they implicitly identified themselves as significantly thinner, better, more attractive, active, disciplined, and more likely to eat healthy than ‘other’ people. Compared to men, women were less likely to view themselves as thin and attractive relative to others. Greater implicit anti-fat bias and implicitly seeing the self as thin relative to others was associated with less short-term weight loss. CONCLUSION: Despite evidence for explicit, implicit, and internalized weight bias, participants generally evidenced a positive implicit self-identity, including areas consistent with negative fat stereotypes.

Although overweight children and adolescents experience a number of immediate difficulties, little research has investigated the long-term psychological consequences for individuals who were overweight as children or adolescents despite their weight status as young adults. The goal of this study was to examine the relations between individuals' retrospective reports of their weight and height during elementary and high school, and their past and current weight concerns. It was expected that individuals who recall being overweight as a child or adolescent would have more weight concerns than their peers who recall being normal weight, even after controlling for current body size. Participants were 174 females and 61 males, ranging in age from 18-20 (M=18.66 yr, SD=0.63). For females, perceived elementary school weight in comparison to their peers significantly predicted current weight concerns, p

Objective: This investigation was designed to examine whether: (i) individuals could successfully lose 5% of their body weight with minimal assistance, (ii) weight loss would be improved by the addition of therapist assistance, and (iii) individuals unsuccessful at losing 5% total body weight during the minimal assistance phase (with or without therapist assistance) would benefit from a weekly weight loss group. Methods and Procedures: Fifty-four overweight or obese adults (BMI > 27 kg/m2) initially participated in a 14-week self-help (SH) or therapist-assisted SH (TASH) weight loss program. Participants who were unsuccessful at losing 5% total body weight were stepped-up to a 3-month, group-based behavioral weight loss program (BWLP) with weekly weigh-ins. Results: Although ∼60% of the participants were successful at losing 5% of their total body weight (lb) during the minimal assistance phase (M = 10.6; s.d. = 11.5; P < 0.01), treatment outcome was not improved by the addition of therapist assistance. For individuals who were unsuccessful at losing 5% of total body weight during a minimal assistance phase, the addition of a group-based BWLP did not improve their weight loss. Discussion: While many individuals were quite successful at losing weight with minimal assistance, other individuals evidenced difficulties losing weight, even when participating in a greater intensity intervention (i.e., BWLP group).

Whereas exercise-induced mood enhancement has been well documented, the relationship between mood and exercise participation is less well understood. Mood states influence evaluative judgments that could plausibly influence a decision to exercise. Further, most exercise-mood research is limited to normal weight adults in response to a single exercise session. The current investigation examines the influence of (a) morning mood on exercise, (b) exercise intensity/duration on mood enhancement, and (c) daily change in mood on exercise days compared with nonexercise days in obese behavioral weight loss program (BWLP) participants. Participants (N = 36) recorded morning, evening, and pre- and postexercise mood, as well as the type, duration, and intensity of exercise. Within-person analyses indicated that (a) morning mood was associated with an increased likelihood of exercising, (b) mood ratings were higher following exercise of greater intensity and duration, and (c) daily mood enhancement was associated with greater exercise initiation and greater exercise intensity. Measuring mood before and after exercise may yield important clinical information that can be used to promote physical activity in obese adults.

Objective: Anti-fat prejudice is a common attitude in our society, and it has implications for those who hold and are targets of this prejudice. Little is known, however, about how parents’ anti-fat attitudes impact the ways they feed their young children. We hypothesized that parents’ attitudes about weight would predict parents’ restrictive feeding practices above and beyond the effects of the child's actual weight and the parents’ concern about child overweight. Research Methods and Procedures: A total of 126 mothers and 102 fathers returned surveys about anti-fat attitudes, feeding practices (restriction for weight and restriction for health), and concern about child overweight. Results: Parental concern about child overweight was related to higher restrictive feeding practices for both mothers and fathers. Parents’ anti-fat attitudes also predicted restrictive feeding above and beyond the effects of parent and child BMI and parental concern about overweight. Discussion: These findings suggest that parents’ anti-fat attitudes impact the way they feed their children.

Research suggests that specific eating patterns (e.g., eating breakfast) may be related to favorable weight status. This investigation examined the relationship between eating patterns (i.e., skipping meals; consuming alcohol) and weight loss treatment outcomes (weight loss, energy intake, energy expenditure, and duration of exercise). Fifty-four overweight or obese adults (BMIor =27 kg/m(2)) participated in a self-help or therapist-assisted weight loss program. Daily energy intake from breakfast, lunch, dinner, and alcoholic beverages, total daily energy intake, total daily energy expenditure, physical activity, and weekly weight loss were assessed. On days that breakfast or dinner was skipped, or alcoholic beverages were not consumed, less total daily energy was consumed compared to days that breakfast, dinner, or alcoholic beverages were consumed. On days that breakfast or alcohol was consumed, daily energy expenditure (breakfast only) and duration of exercise were higher compared to days that breakfast or alcohol was not consumed. Individuals who skipped dinner or lunch more often had lower energy expenditure and exercise duration than individuals who skipped dinner or lunch less often. Individuals who consumed alcohol more often had high daily energy expenditure than individuals who consumed alcohol less often. Skipping meals or consuming alcoholic beverages was not associated with weekly weight loss. In this investigation, weight loss program participants may have compensated for excess energy intake from alcoholic beverages and meals with greater daily energy expenditure and longer exercise duration.

Objective: This investigation was designed to improve behavioral weight loss program (BWLP) treatment outcomes by providing stepped care (SC) to individuals experiencing difficulties with weight loss during treatment. SC entails transition to more intensive treatments when less intensive treatments fail to meet treatment goals. In a BWLP, motivational interviewing (MI) may increase participants' motivation toward behavioral change and thus complement the acquisition of behavioral change skills. It was hypothesized that BWLP + SC (MI) participants (i.e., participants who failed to meet weight loss goals and received MI) would demonstrate superior treatment outcomes when compared with BWLP (SC matched) participants (i.e., participants who failed to meet weight loss goals but did not receive MI). Design: Fifty-five obese, sedentary adults were randomly assigned to a BWLP + SC or a BWLP. Main outcome measures: Changes in weight, cardiorespiratory fitness, self-reported physical activity, and diet (i.e., calories, percentage daily intake of fat, protein, and carbohydrates) in response to treatment were assessed. Results: Participants significantly decreased their weight, increased physical activity/fitness, and improved dietary intake (ps

The current investigation examined the impact of a weight maintenance intervention (MI) designed to empower people to create a personal healthy food and physical activity environment on weight loss treatment outcomes. It was hypothesized that behavioral weight loss program (BWLP) participants who received an additional MI would evidence superior weight loss maintenance compared to participants who received a BWLP alone (no contact [NC]). Fifty-one obese adults were randomly assigned to participate in a 16-week weight loss intervention followed by NC or a 6-week MI. Thirty-eight participants completed the six-month follow-up. Body weight, percent body fat, cardiorespiratory fitness, self-reported physical activity, and self-reported diet (i.e., calories, percent daily intake of fat, protein, and carbohydrates) were assessed. Participants significantly decreased their weight, increased physical activity/fitness, and improved dietary intake (ps.05). MI participants had significantly greater weight loss maintenance than NC participants (ps.05). Helping obese individuals to modify their personal eating and physical activity environment in order to reduce exposure to "obesogenic" cues may contribute to long-term weight loss maintenance.

A comprehensive evaluation and assessment of the suicidal child is important to target those at risk. This article identifies risk factors for suicide in children and adolescents and provides a step-by-step interview scheme that captures all relevant information that is obtained when assessing these children and adolescents. Depression and Anxiety 14:157–163, 2001. © 2001 Wiley-Liss, Inc.