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| Int'l Paper Session - Clinical Behavior Analysis and Health Psychology |
| Tuesday, May 31, 2005 |
| 10:30 AM–11:50 AM |
| Private Dining Room 1 (3rd floor) |
| Area: CBM |
| Chair: Tobias Lundgren (University of Uppsala, Sweden) |
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| Clinical Behavior Analysis of Elevated Blood Pressure |
| Domain: Applied Research |
| MARTTI T. TUOMISTO (University of Tampere, Finland), Raimo Lappalainen (University of Tampere, Finland), Jyrki Ollikainen (University of Tampere, Finland) |
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| Abstract: Circulation was regarded as a machine-like mechanic system in medicine for a century ago. Especially with the advent of behavioral medicine in the 70’s and 80’s it was understood that responses to environmental stimuli can both change and be changed in relation to cardiovascular responses primarily through the balance of the autonomic nervous system and neuroendocrinological functions. Some researchers (e.g., Engel, 1986) have maintained that circulation be treated as behavior (i.e., as any behavior) and explained using contingencies of survival and contingencies of reinforcement. Evidence exists that cardiovascular responses may be predicted and influenced through respondent (e.g., Fredrikson, Tuomisto, & Sundin, 1991), and operant conditioning, relational frames, and rule-governed behavior. According to this approach, cardiovascular responses such as blood pressure elevations are qualities of specific behavior (cf. emotions). Different cardiovascular-behavioral processes may be going on simultaneously and the same cardiovascular behavior may have different functions depending on the context in which it occurs. This significantly widens possibilities for the treatment of cardiovascular risk factors, disorders, and diseases compared to traditional surgical and drug treatment even without adding the possibilities of behavioral pharmacology. This perspective may include some basic concepts of cardiology and physiology. Such concepts are phylogenetic cardiovascular behavior and acquired physiological adjustments to pathological processes and diseases and they may be understood in terms of permanent physiological environment or establishing operations for cardiovascular and other behavior.Elevated blood pressure or hypertension is a major risk factor for other cardiovascular problems and mortality. Clinical behavior analysis has been used in a few instances to understand and treat the problem. However, large-scale applied projects have not been undertaken even if cardiovascular diseases and hypertension are among the most costly and common problems in modern societies and behavior analysis has been a tremendous success in many areas of life. There are, however, positive signs that behavioral medicine and cardiology are advancing. We have, for instance, been able to predict hypertension and the need for antihypertensive medication (Tuomisto et al., in press) using standardized behavioral challenges in the laboratory. In our view, it is important that the great |
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| Evaluation of a Brief Acceptance and Commitment-Based Behavior Therapy Model for the Treatment of Refractory Epilepsy in India and South Africa |
| Domain: Applied Research |
| TOBIAS LUNDGREN (University of Uppsala, Sweden), JoAnne Dahl (University of Uppsala, Sweden) |
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| Abstract: Epileptic seizures can be traumatic, stigmatizing and disabling for the persons who have a tendency to seize. In the western countries, most persons with epilepsy will be given an anticonvulsant drug therapy which appears to reduce seizure frequency but also leaves a number of undesirable side-effects. In many non-western countries these drugs are far too expensive and unaccessable to most people. The aim of this study was to develop and evaluate a brief treatment model based on acceptance and commitment therapy (ACT) applied on a group of people with refractory seizures in India and South Africa. The design of the study was a RCT ABC group design (n=48) with three conditions; ACT, Yoga and an attention control. The inclusion criteria for participation was: at least 4 seizures the last three months week, age 14 or older, no progressive disease and willing and able to participate in the study. Each condition consisted of one individual session, two group sessions followed by one more individual session. The ACT condition consisted of the treatment principles: Values identification, cognitive diffusion, exposure, commitment and behavior modification. The Yoga was based on 5 positions that stimulated the vagus nerve. The control group was given attention control based on acceptance and reflective listening. Treatment effects were measured by means of looking at life quality, experiential avoidance, seizure Index, Bulls-eye, EEG and blood serum levels. The result of the post and 6 months follow up showed a significant decrease in seizure index in the ACT group and the Yoga group compared to the attention control. There was also a significant increase in life quality and life function. The one year follow up will be presented at the conference. |
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| Applying Behavior Analysis and Acceptance and Commitment Therapy to Eating Disorders and Obesity |
| Domain: Applied Research |
| RAIMO LAPPALAINEN (University of Tampere, Finland), Martti T. Tuomisto (Tampere University Hospital, Finland), Greta Turunen (University of Tampere, Finland), Elina Tuomisto (University of Tampere, Finland), Markku Ojanen (University of Tampere, Finland) |
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| Abstract: Our aim is to present alternatives for the clinical application of behavioral analysis and Acceptance and Commitment Therapy (ACT) in eating disorders and obesity. Examples will be given how behaviour analysis can be applied while the eating disorder subject is eating. Also, data of emotional and other reactions during the interviews will be summarised. Further, examples will be given how behavior analysis and Acceptance and Commitment Therapy can be applied to treatment of obesity. Data from a randomized trial of 232 subjects will be presented. Subjects were randomly divided either to ACT or non-ACT mini-interventions in order to develop a short-term treatment for obesity. Possibilities to develop mini-intervention of obesity based on behavior analytic principles will be discussed. |
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