Journal of Consulting and Clinical Psychology

Epstein, Leonard H.

doi: 10.1037/0022-006X.60.4.493pmid: N/A

Behavioral medicine is a multidisciplinary field that combines research methods and findings from behavioral and biomedical sciences. Many investigators in the field have tended to emphasize the contribution of the biomedical more than the behavioral sciences. This is evident in the emphasis on biological rather than behavioral outcomes and on the reductionist approach within the field to reduce mechanisms responsible for behavioral effects and disease to biological influences. There has been a similar shift in psychology toward mechanistic, bottom-up approaches to understanding mechanisms responsible for integrated and dynamic behavior. These shifts in emphasis have stimulated investigators to examine the use of biomedical methods and findings as causes and explanations for behavior, rather than to utilize newer findings in behavioral sciences. New advances in basic research on learning are used to illustrate that findings from behavioral science have implications for the field of contemporary behavioral medicine. Finally, the importance of developing new technologies for measuring behavior is presented.

Agras, W. Stewart

doi: 10.1037/0022-006X.60.4.499pmid: N/A

Three types of organizational change are considered that may facilitate the development of behavioral medicine teaching, practice, and research over the next decade. The first and most critical of these changes is a consideration of the role of a Department of Behavioral Medicine within the medical school. The second is support for the development of research collaborations across centers, with the advantage of bringing a broader array of expertise and facilities to the solution of health problems. Finally, some changes in the role and organization of scientific societies that support behavioral medicine are considered. It is argued that, without such changes, behavioral medicine will become overly narrow in its focus and will not have the impact on the medical arena that it might otherwise have.

doi: 10.1037/0022-006X.60.4.499pmid: N/A

Three types of organizational change are considered that may facilitate the development of behavioral medicine teaching, practice, and research over the next decade. The first and most critical of these changes is a consideration of the role of a Department of Behavioral Medicine within the medical school. The second is support for the development of research collaborations across centers, with the advantage of bringing a broader array of expertise and facilities to the solution of health problems. Finally, some changes in the role and organization of scientific societies that support behavioral medicine are considered. It is argued that, without such changes, behavioral medicine will become overly narrow in its focus and will not have the impact on the medical arena that it might otherwise have.

Brownell, Kelly D.; Wadden, Thomas A.

doi: 10.1037/0022-006X.60.4.505pmid: N/A

Obesity remains a leading public health problem because of its complications, prevalence, and resistance to change, despite record rates of dieting. Risk factors exist at both population and individual levels, thus obesity has diverse etiologies and consequences. Dieting is often grounded in the notion that the body can be molded at will and that the rewards justify the effort, creating a drive for unrealistic goals. This article argues for establishing a “reasonable weight,” which may differ from health and aesthetic ideals. Intervention is less a matter of finding a “best” treatment but of finding the approach with “best fit” for the individual. Advances in treatment are most likely when research is driven by theory on the etiology of weight gain, the relapse process, and methods for permanent behavior change. This article integrates information on etiology, social beliefs about body weight, theory, and treatment into a comprehensive and compassionate model for intervention.

doi: 10.1037/0022-006X.60.4.505pmid: N/A

Obesity remains a leading public health problem because of its complications, prevalence, and resistance to change, despite record rates of dieting. Risk factors exist at both population and individual levels, thus obesity has diverse etiologies and consequences. Dieting is often grounded in the notion that the body can be molded at will and that the rewards justify the effort, creating a drive for unrealistic goals. This article argues for establishing a “reasonable weight,” which may differ from health and aesthetic ideals. Intervention is less a matter of finding a “best” treatment but of finding the approach with “best fit” for the individual. Advances in treatment are most likely when research is driven by theory on the etiology of weight gain, the relapse process, and methods for permanent behavior change. This article integrates information on etiology, social beliefs about body weight, theory, and treatment into a comprehensive and compassionate model for intervention.

Lichtenstein, Edward; Glasgow, Russell E.

doi: 10.1037/0022-006X.60.4.518pmid: N/A

This article discusses developments in understanding smoking and smoking cessation, methodological issues, and intervention approaches over the past 10 years. Although effective multisession clinic interventions have been developed, such programs reach relatively few smokers. This has led to self-help, work site, health care setting, and community interventions aimed at delivering less intensive programs to larger populations. Conceptual and empirical developments and trends within these above delivery contexts are reviewed, and avenues of research are identified. Nicotine replacement strategies have benefited from technological advances (e.g., transdermal patches) and present continuing challenges with respect to integration with behavioral strategies and incorporation into primary care medical settings. Research over the next decade should focus on the development of cost-effective interventions that can reach representative and high-risk smokers.

doi: 10.1037/0022-006X.60.4.518pmid: N/A

This article discusses developments in understanding smoking and smoking cessation, methodological issues, and intervention approaches over the past 10 years. Although effective multisession clinic interventions have been developed, such programs reach relatively few smokers. This has led to self-help, work site, health care setting, and community interventions aimed at delivering less intensive programs to larger populations. Conceptual and empirical developments and trends within these above delivery contexts are reviewed, and avenues of research are identified. Nicotine replacement strategies have benefited from technological advances (e.g., transdermal patches) and present continuing challenges with respect to integration with behavioral strategies and incorporation into primary care medical settings. Research over the next decade should focus on the development of cost-effective interventions that can reach representative and high-risk smokers.

doi: 10.1037/0022-006X.60.4.528pmid: N/A

Behavioral and cognitive–behavioral approaches to chronic pain are receiving increasing attention from researchers and clinicians. This article reviews and highlights recent research advances and future research directions. Assessment research reviewed includes studies examining the social context of pain, the relationship of chronic pain to depression, cognitive variables affecting pain, and comprehensive assessment measures. Treatment outcome studies reviewed are those evaluating the effects of behavioral and cognitive–behavioral treatments for chronic pain. These studies focus on comparisons of behavioral treatment with control conditions, comparisons of two behavioral treatments, and prevention of chronic pain. Future directions for assessment and treatment research are outlined.