Neville M. Blampied

Motivational interviewing in health settings: a review

There is evidence that patient-centred approaches to health care consultations may have better outcomes than traditional advice giving, especially when lifestyle change is involved. Motivational interviewing (MI) is a patient-centred approach that is gathering increased interest in health settings. It provides a way of working with patients who may not seem ready to make the behaviour changes that are considered necessary by the health practitioner. The current paper provides an overview of MI, with particular reference to its application to health problems.

Motivational interviewing: a review

There has been considerable interest shown in motivational interviewing (MI), since Miller (1983) initially presented it as an alternative and potentially more effective way of working with problem drinkers, particularly those individuals who may have been perceived as being resistant or in denial. This interest has included developing specific interventions using MI, and extending its use beyond alcohol abuse to a range of problem behaviours, including other mental health problems (e.g., eating disorders) and health problems (e.g., diabetes). The current paper provides an overview of Ml — its development, theoretical basis, and applications. Research on its efficacy is reviewed, and recommendations are made for future research.

Treatment of infant sleep disturbance by trimeprazine in combination with extinction.

Chronic sleep disturbance is a common problem in preschool children. Prescription and non-prescription sedatives provide short-term palliative relief. Behavioral extinction by withdrawal of parental attention is enduringly effective but may be distressing short-term because of postextinction bursts of intense activity by the child. This study evaluated the effects of combining extinction and sedative medication (trimeprazine tartrate), prescribed in a reducing dose over the first 10 days of extinction. Control groups received either extinction alone or a placebo administered double-blind. After baseline, all subjects reduced their sleep disturbance to low levels, the extinction and placebo groups declining slowly, the medication group abruptly. These gains were maintained at follow-up. Measures of infant security and maternal anxiety showed improvements with treatment.

Scopolamine induced changes in activity and reactions to novelty

The behavior of hooded rats was observed in an exploration box comprising novel and familiar halves following IP injections of 0.1, 0.25, 0.5, 0.75 or 1.00 mg/kg scopolamine or isotonic saline. Drug administration occurred after, rather than before, exposure to one of the alternative halves. All doses decreased reactions to the previously inaccessible novel half but decreases were greater for the 2 lowest doses. Rearing behavior was also suppressed by each dose whereas the number of apparatus cells entered (locomotion) was decreased by low doses but increased by high. The 3 behavioral measures showed declines in frequency during the course of each experimental session. However, low doses of the drug enhanced and high doses retarded these declines for rearing and cells entered. The study illustrated the difficulty in explaining data by unitary processes (such as attenuated habituation) when several behavioral indices and drug doses are employed within a single investigation.

Shaken but unstirred? Effects of micronutrients on stress and trauma after an earthquake: RCT evidence comparing formulas and doses

To compare two micronutrient (vitamins and minerals) formulas (Berocca™ and CNE™) and assess their impact on emotions and stress related to the 6.3 earthquake on February 22nd 2011 in Christchurch, New Zealand.

Defensive burying: Effects of diazepam and oxprenolol measured in extinction

When a rat is shocked via a prod in a chamber with sawdust on the floor it will typically push the flooring material with snout and forepaws towards and over the prod. We administered diazepam (.5 and 1.0 mg/kg) and oxprenolol (10 and 20 mg/kg) the day following shock exposure, and observed the complete suppression of burying by diazepam, and some suppression with oxprenolol. These effects are independent of interference with initial association of shock and prod, and of changes in general activity.

Treatment of emotional dysregulation in full syndrome and subthreshold binge eating disorder.

The link between negative affect and binge eating in those with binge eating disorder (BED) has been well established. The present study examined the efficacy of a treatment for BED designed to increase recognition and regulation of negative emotion, replicating and extending a previous investigation (Clyne, C., & Blampied, N.M. [2004]. Training in emotion regulation as a treatment for binge eating: A preliminary study. Behaviour Change, 21, 269–281) by including a control group, a larger number of participants, and formal diagnoses rather than classifying binge eating symptomatology from self-report questionnaires. Twenty-three women diagnosed with subthreshold or full syndrome BED (using the Eating Disorders Examination) participated in a treatment program that focused on increasing emotional regulation skills. Each participant completed the Eating Disorders Examination Questionnaire, the Binge Eating Scale, the Emotional Eating Scale, and completed self-monitoring records of binge episodes. Binge abstinence rates following treatment (post-treatment and 1 year follow-up were 78% and 87% respectively) were comparable to other empirically supported treatments for BED. Other positive changes in eating and general pathology were observed. These effects were well-maintained up to 1 year later.

Infant sleep disturbance

Abstract Clinicians are commonly consulted by the parents of infants aged 6–24 months who are distressed by their infants sleep disturbance. Infant sleep disturbance (ISD) presents as frequent night awakening, delays in sleep onset and co-sleeping that is not of the parents’ choice. Conflicting advice leaves parents unsure regarding management. Recent research has described treatment approaches as well as models describing the complexity of variables that appear to control ISD. In this article, we describe the learning principles underlying the development of ISD and summarize empirically validated treatments. Practitioners are advised on the importance of appropriate assessment and support, as well as on suggestions they can make about prevention.

A multiple-baseline, double-blind evaluation of the effects of trimeprazine tartrate on infant sleep disturbance.

Infant sleep disturbance involving chronic night waking and resistance to settling to sleep or returning to sleep is a common problem for families with children 6-27 months old. Prescription and nonprescription sedatives are frequently administered without clear evidence that they are effective as either long-term or short-term palliatives. Trimeprazine tartrate, administered either 15 mg/5 mL or 30 mg/5 mL, was compared with both baseline and placebo in a multiple-baseline-across participants, double-blind study. No clinically significant effects of the low dose were detected, whereas the effects of the high dose were not consistently replicated across nor within participants. During active drug treatment, only 2 of 12 children achieved Sleep Behaviour Scale scores indicative of nonproblem sleep. Trimeprazine tartrate is not recommended as a pharmacological treatment for infant sleep disturbance unless as an adjunct to a behavioral therapy program.

Acceptability of alternative punishments : a community survey

In this study 201 randomly selected adult residents of Christchurch, New Zealand, were presented with one of four case descriptions, depicting either a boy or a girl having the behavior problem of serious noncompliance occurring either at school or at home. They then read descriptions of each of five alternative punishment techniques: time-out, response cost, overcorrection, social reprimands, and physical punishment (in counterbalanced order) and completed the Treatment Evaluation Inventory following each of the descriptions. The rankings of the procedures from most to least acceptable were response cost, social reprimands, time-out, overcorrection, and physical punishment. The least acceptable punishments were more acceptable when administered at home than at school, and this was especially true for girls. Otherwise, there were no differences in acceptability attributable to gender of the case. Differences between respondents in gender, age, education level, and family status were not associated with significant differences in punishment acceptability.