People who follow the lead of an initial dissenter Further Reading may even disagree with that person and be dissenting Weissbud order anafranil 10mg on-line, Bernice generic anafranil 50 mg visa. Although the ambiguity and unanimity of the situation are powerful contributors Consciousness to the incidence of conformity order anafranil 10 mg online, they are not the sole de- Awareness of external stimuli and of one’s own terminants. Individuals who have a low status within a group or are unfamiliar Wilhelm Wundt’s investigations of consciousness, with a particular situation are the ones most likely to begun in 1879, were central to the development of psy- conform. Wundt’s approach, called members of a study or activity group, or new residents to structuralism, sought to determine the structure of con- a community are more likely to be affected by the pres- sciousness by recording the verbal descriptions provided sure to conform. Personality traits, such as concern by laboratory subjects to various stimuli, a method that with being liked or the desire to be right, also play a role. Certain cultures proach to the study of consciousness was the functional- are more likely than others to value group harmony over ism of William James,who focused on how conscious- individual expression. Behavior- ganization managers, and even parents can establish an ism,pioneered by John B. Watson in the early 1900s, atmosphere or “culture” that either fosters conformity or shifted interest from conscious processes to observable allows for dissension and individuality. Teaching Your Child to was at the heart of Sigmund Freud’s model of human Handle Peer Pressure. He also formulated the concept of the preconscious,which functions as an Conscience intermediate or transitional level of mind between the The moral dimension of human consciousness, the unconscious and the conscious. A preconscious thought means by which humans modify instinctual drives can quickly become conscious by receiving attention, to conform to laws and moral codes. In contrast, the re- In meditation, an altered state of consciousness is pressed material contained in the unconscious can only achieved by performing certain rituals and exercises. The collective unconscious con- widely used in the United States for purposes of relax- tains images and symbols, called archetypes, that Jung ation. It has been found that during this type of medita- found are shared by people of diverse cultures and tend tion, people consume less oxygen, eliminate less carbon to emerge in dreams,myths, and other forms. In Jung’s dioxide, and breathe more slowly than when they are in view, a thorough analysis of both the personal and col- an ordinary resting state. Although sleep suspends the voluntary exercise of stances as alcohol, tobacco, and coffee. The major cate- both bodily functions and consciousness, it is a much gories of psychoactive drugs include depressants, which more active state than was once thought. Delta waves demarcate the thought, memory, and perception, are particularly deepest levels of sleep, when heart rate, respiration, tem- known for their consciousness-altering properties. They perature, and blood flow to the brain are reduced and can produce distortion of one’s body image, loss of growth hormone is secreted. In the comes from the Greek word for sleep (hypnos), hypno- United States, for example, hallucinations are devalued tized people are not really asleep. Their condition resem- by mainstream culture as a bizarre sign of insanity, bles sleep in that they are relaxed and out of touch with whereas the youth counterculture of the 1960s viewed ordinary environmental demands, but their minds remain drug-induced hallucinations as enlightening, “mind-ex- active and conscious. In certain other societies, halluci- include lack of initiative, selective redistribution of at- nations are respected as an important therapeutic tool tention, enhanced ability to fantasize, reduced reality used by ritual healers. Also, hypnosis is often followed by post-hypnotic amnesia, in which the Further Reading person is unable to remember what happened during the Dennett, D. It person lives in New York, that person needs a winter must study economics and culture too. The So- Psychology views certain factors that include: 1) The ciety for Consumer Psychology is a division of the Gestalt principle. The restaurant is popular, it is important to understand what group’s main focus is conducting scientific research, cultural implications are present beside the food; 2) The development and practice in the field. What could be the superficial or seem- journal, Journal of Consumer Psychology as well as an- ingly rational reason a person might have for making a other publication, Journal of Consumer Research and purchase (the need)? What other factors (wants) influence Psychology and Marketing, periodically serves as the it? For instance, even if shoes are purchased as foot pro- voice of those engaged in the understanding of why tection, the desired shoe may be open-toed, strapless, and people buy what they buy. New York: John sons to the picture on a candy bar wrapper, the ever-elu- Wiley & Sons 1994. He urged consumers to be Further Information cautious and not fall prey to hidden meanings or symbols Society for Consumer Psychology of the American Psycholog- in advertising, and pointed out less-than-honest repre- ical Association. Contrast Psychologists understand that in the burgeoning econ- The relative difference in intensity between two omy of the early twenty-first century people’s needs and stimuli and their effect on each other. In the 1970s and early 1980s, household items such as computers and video Contrast, or contrast effect, is the effect a visual recorders were new, and counted as luxuries. When one stimulus is present, it virtue of a changing society, those items had become more affects the other. As can be seen in this illustration, two than simple luxuries, as schools and businesses often came gray boxes of equal intensity are surrounded by, in one to require their use. Complex human behavior can take one case, a white field, and in the other, a black field. They have discovered that often in the most depressed eco- These tests are used in the study of visual perception nomic times, the sales of luxury items go up. For Consumer psychology is a pursuit that is likely to ex- example, black and yellow have the lowest contrast ef- pand now that an estimated $5 billion worth of products fect, which means the largest percentage of the popula- were purchased online by the spring of 2000. Online shop- tion can clearly detect the difference between these two ping habits might differ drastically from catalogue sales or colors. These trends are just beginning to be to mark school buses and many traffic signs. Jane Spear Control group Further Reading In an experiment that focuses on the effects of a Asker, Jennifer L. In such an experiment, in Conversion reaction which there are two groups of subjects, the group that is A psychological disorder characterized by physical exposed to the condition or factor is called the experi- symptoms for which no physiological cause can be mental group. For example, in a hypothetical study of the influence of the presence This condition was first described by Sigmund of loud music on the test performances of children, the Freud as conversion hysteria because it involved the control group would consist of the group of children not conversion of a repressed emotional problem to a physi- exposed to the loud music during the test. Today, conversion reaction is classified as scores would be compared with the experimental group, a somatoform disorder in the American Psychiatric As- the group of children who were exposed to loud music sociation’s Diagnostic and Statistical Manual of Men- during the test. Conversion reaction is a very rare condition, ac- counting for about 2 percent of all psychiatric diag- Further Reading noses, and usually first appears during adolescence or Atkinson, Rita L. San early adulthood, generally when an individual is under Diego: Harcourt Brace Jovanovich, 1987. Another source of “secondary gain” is the attraction of attention, sympathy, and sup- port that the patient may need but is unable to obtain in Convergent thinking other ways. The ability to narrow the number of possible solu- tions to a problem by applying logic and knowl- Some of the most common symptoms of conversion edge. Other physical com- ford, a psychologist well-known for his research on cre- plaints include tremors, abdominal pain, and speech im- ativity. Guilford posited that a prime component of cre- pairments such as aphonia, the inability to speak above ativity is divergent thinking, the capacity to arrive at a whisper. Sometimes a person will experience anesthe- unique and original solutions and the tendency to consid- sia in only one part of the body, such as “glove anesthe- er problems in terms of multiple solutions rather than sia,” which affects the hand only up to the wrist, al- just one. Convergent thinking, which narrows all options though such a problem could have no physiological ori- to one solution, corresponds closely to the types of tasks gin since there is no cut-off point between the nerves of usually called for in school and on standardized multi- the hand and arm. In contrast, creativity tests designed to docrine glands or autonomic nervous systems. If the assess divergent thinking often ask how many different symptoms of a conversion disorder are prolonged, they answers or solutions a person can think of to a specific may produce physiological damage by interrupting the question or problem. Some researchers have claimed that normal functioning of the body, and psychological creative achievement actually involves both divergent damage by inducing excessive dependence on family and convergent thinking—divergent thinking to generate members and other persons. The Standard Edition of the Complete Psy- Further Reading chological Works of Sigmund Freud. There are several different types of correlations; the most commonly used is called the Pear- A technique used to measure the likelihood of two son Product-Moment Correlation. See also Research methodology; Scientific method Psychologists are often interested in deciding whether two behaviors tend to occur together.

In some cases getting beyond our prejudices is required by law anafranil 50mg overnight delivery, as detailed in the U cheap anafranil 50 mg with mastercard. Civil Rights Act of 1964 generic anafranil 75 mg overnight delivery, the Equal Opportunity Employment Act of 1972, and the Fair Housing Act of 1978. There are individual differences in prejudice, such that some people are more likely to try to control and confront their stereotypes and prejudices whereas others apply them more freely [19] (Czopp, Monteith, & Mark, 2006; Plant & Devine, 1998). For instance, some people believe in group hierarchies—that some groups are naturally better than others—whereas other people are more egalitarian and hold fewer prejudices (Sidanius & Pratto, 1999; Stangor & Leary, [20] 2006). The tendency to hold stereotypes and prejudices and to act on them can be reduced, for instance, through positive interactions and friendships with members of other groups, through practice in avoiding using [21] them, and through education (Hewstone, 1996). Research Focus: Forming Judgments of People in Seconds Research has demonstrated that people can draw very accurate conclusions about others on the basis of very [22] limited data. Ambady and Rosenthal (1993) made videotapes of six female and seven male graduate students while they were teaching an undergraduate course. The courses covered diverse areas of the college curriculum, including humanities, social sciences, and natural sciences. For each teacher, three 10-second video clips were taken: 10 seconds from the first 10 minutes of the class, 10 seconds from the middle of the class, and 10 seconds from the last 10 minutes of the class. Ambady and her colleagues then compared the ratings of the participants who had seen the teacher for only 30 seconds with the ratings of the same instructors that had been made by students who had spent a whole semester with the teacher, and who had rated her at the end of the semester on scales such as ―Rate the quality of the section overall‖ and ―Rate section leader‘s performance overall. You can see that the correlations are all positive, and that many of them are quite large. The conclusion is that people are sometimes able to draw accurate impressions about other people very quickly. Half a minute: Predicting teacher evaluations from thin slices of nonverbal behavior and physical attractiveness. If the finding that judgments made about people in 30 seconds correlate highly with judgments made about the same people after a whole semester surprises you, then perhaps you may be even more surprised to hear that [23] we do not even need that much time. Indeed, Willis and Todorov (2006) found that even a tenth of a second was enough to make judgments that correlated highly with those same judgments made by other people who were given several minutes to make the judgments. Other research has found that we can make accurate [24] judgments, for instance, about our perceptions of salespersons (Ambady, Krabbenhoft, & Hogan, 2006) and [25] about the sexual orientation of other people (Ambady, Hallahan, & Conner, 1999), in just a few seconds. Taken together, this research shows that we are well able to form initial impressions of others quickly and often quite accurately. Close Relationships One of the most important tasks faced by humans is to develop successful relationships with others. These relationships include acquaintanceships and friendships but also the more important close relationships, which are the long-term intimate and romantic relationships that we develop with another person—for instance, in a marriage (Hendrick & Hendrick, [27] 2000). Because most of us will want to enter into a close relationship at some point, and because close relationships are evolutionarily important as they form the basis for effective child Attributed to Charles Stangor Saylor. A major interest of social psychologists is the study of interpersonal attraction, or what makes people like, and even love, each other. One important factor is a perceived similarity in values [28] and beliefs between the partners (Davis & Rusbult, 2001). Similarity is important for relationships both because it is more convenient (it‘s easier if both partners like to ski or go to the movies than if only one does), but also because similarity supports our values—I can feel better about myself and my choice of activities if I see that you also enjoy doing the same things that I do. Liking is also enhanced by self-disclosure, the tendency to communicate frequently, without fear of reprisal, and in an accepting and empathetic manner. Friends are friends because we can talk to them openly about our needs and goals, and because they listen to and respond to our needs [29] (Reis & Aron, 2008). If I open up to you about the concerns that are important to me, I expect you to do the same in return. Another important determinant of liking is proximity, or the extent to which people are physically near us. Research has found that we are more likely to develop friendships with people who are nearby, for instance, those who live in the same dorm that we do, and even with [30] people who just happen to sit nearer to us in our classes (Back, Schmukle, & Egloff, 2008). Proximity has its effect on liking through the principle of mere exposure, which is the tendency to prefer stimuli (including but not limited to people) that we have seen more frequently. At the end of the term, the other students in the class were shown pictures of the confederates and asked to indicate both if they recognized them and also how much they liked them. The number of times the confederates had attended class didn‘t influence the other students‘ ability to recognize them, Attributed to Charles Stangor Saylor. As predicted by the mere exposure hypothesis, students who had attended class more often were liked more (Figure 14. As predicted by the principles of mere exposure, confederates who had attended class more often were also liked more. The effect of mere exposure is powerful and occurs in a wide variety of situations. Infants tend to smile at a photograph of someone they have seen before more than they smile at a photograph of [32] someone they are seeing for the first time (Brooks-Gunn & Lewis, 1981), and people prefer side-to-side reversed images of their own faces over their normal (nonreversed) face, whereas their friends prefer their normal face over the reversed one (Mita, Dermer, & Knight, [33] 1977). This is expected on the basis of mere exposure, since people see their own faces primarily in mirrors and thus are exposed to the reversed face more often. We have an initial fear of the unknown, but as things become more familiar they seem more similar and safe, and thus produce more positive [34] affect and seem less threatening and dangerous (Freitas, Azizian, Travers, & Berry, 2005). In fact, research has found that stimuli tend to produce more positive affect as they become more [35] familiar (Harmon-Jones & Allen, 2001). Familiar people become more likely to be seen as part of the ingroup rather than the outgroup, and this may lead us to like them more. Leslie Zebrowitz and her colleagues found that we like people of our own race in part because they are perceived as similar to us (Zebrowitz, [36] Bornstad, & Lee, 2007). In the most successful relationships the two people begin to see themselves as a single unit. You might try completing the measure yourself for some different people that you know—for instance, your family members, friends, spouse, or girlfriend or boyfriend. The measure is simple to use and to interpret; if people see the circles representing the self and the other as more overlapping, this means that the relationship is close. But if they choose the circles that are less overlapping, then the relationship is less so. The respondent simply circles which of the seven figures he or she feels best characterizes the relationship. Inclusion of other in the self scale and the structure of interpersonal closeness. Although the closeness measure is very simple, it has been found to be predictive of people‘s satisfaction with their close relationships, and of the tendency for couples to stay together (Aron, [38] Aron, Tudor, & Nelson, 1991; Aron, Paris, & Aron, 1995). When the partners in a relationship feel that they are close, and when they indicate that the relationship is based on caring, warmth, acceptance and social support, we can say that the relationship is intimate (Reis [39] & Aron, 2008). When a couple begins to take care of a household together, has children, and perhaps has to care for elderly parents, the requirements of the relationship become correspondingly bigger. As a result of this complexity, the partners in close relationships increasingly turn to each other for help in coordinating activities, remembering dates and appointments, and accomplishing tasks. Relationships are close in part because the couple becomes highly interdependent, relying on [40] each other to meet important goals (Berscheid & Reis, 1998). In relationships in which a positive rapport between the partners is developed and maintained over a period of time, the partners are naturally happy with the relationship and they become committed to it. Commitment refers to the feelings and actions that keep partners working [41] together to maintain the relationship (Rusbult, Olsen, Davis, Hannon, 2001) and is characterized by mutual expectations that the self and the partner will be responsive to each [42] other‘s needs (Clark & Mills, 2004). Partners who are committed to the relationship see their mates as more attractive, are less able to imagine themselves with another partner, express less [43] interest in other potential mates, and are less likely to break up (Simpson & Harris, 1994). People also find relationships more satisfactory, and stay in them longer, when they feel that they are being rewarded by them. When the needs of either or both of the partners are not being met, Attributed to Charles Stangor Saylor. This is not to say that people only think about the benefits they are getting; they will also consider the needs of the other. Although sexual arousal and excitement are more important early on in relationships, intimacy is also determined by sexual and romantic attraction. Indeed, intimacy is also dependent on passion—the partners must display positive affect toward each other. Happy couples are in positive moods when they are around each other; they laugh with each other, express approval rather than criticism of each other‘s behaviors, and enjoy physical contact. People are happier in their relationships when they view the other person in a positive or even an “idealized‖ sense, rather than a more realistic and perhaps more negative one (Murray, Holmes, & Griffin, [44] 1996).

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The results showed some small associ- ations between this and the onset of back pain by follow-up best 25mg anafranil. Their new measure consisted of three subscales reflecting the dimensions of catastro- phizing purchase anafranil 10 mg line, namely rumination anafranil 50 mg for sale, magnification and helplessness. They then used this meas- ure to explore the relationship between catastrophizing and pain intensity in a clinical sample of 43 boys and girls aged between 8 and 16. The results indicated that catastro- phizing independently predicted both pain intensity and disability regardless of age and gender. The authors argued that catastrophizing functions by facilitating the escape from pain and by communicating distress to others. Meaning Although at first glance any pain would seem to be only negative in its meaning, research indicates that pain can have a range of meanings to different people. For example, the pain experienced during childbirth although painful, has a very clear cause and consequence. If the same kind of pain were to happen outside of childbirth then it would have a totally different meaning and would probably be experienced in a very different way. Beecher (1956), in his study of soldiers’ and civilians’ requests for medication, was one of the first people to examine this and asked the question: ‘What does pain mean to the individual? This has also been described in terms of secondary gains whereby the pain may have a positive reward for the individual. Self-efficacy Some research has emphasized the role of self-efficacy in pain perception and reduction. In addition, the concept of pain locus of control has been developed to emphasize the role of individual cognitions in pain perception (Manning and Wright 1983; Dolce 1987; Litt 1988). For example, in the experimental study described above, James and Hardardottir (2002) illustrated this association using the cold pressor task. Eccleston and Crombez have carried out much work in this area which they review in 1999. They illustrate that patients who attend to their pain experience more pain than those who are distracted. This association explains why patients suffering from back pain who take to their beds and therefore focus on their pain take longer to recover than those who carry on working and engaging with their lives. This association is also reflected in relatively recent changes in the general management approach to back pain problems – bedrest is no longer the main treatment option. In addition, Eccleston and Crombez provide a model of how pain and attention are related (Eccleston 1994; Eccleston and Crombez 1999). They argue that pain interrupts and demands attention and that this interrup- tion depends upon pain-related characteristics such as the threat value of the pain and environmental demands such as emotional arousal. They argue that pain causes a shift in attention towards the pain as a way to encourage escape and action. The result of this shift in attention towards the pain is a reduced ability to focus on other tasks resulting in attentional interference and disruption. This disruption has been shown in a series of experimental studies indicating that patients with high pain perform less well on difficult tasks which involve the greatest demand of their limited resources (e. Behavioural processes Pain behaviour and secondary gains The way in which an individual responds to the pain can itself increase or decrease the pain perception. In particular, research has looked at pain behaviours which have been defined by Turk et al. It has been suggested that pain behaviours are reinforced through attention, the acknowledgment they receive and through secondary gains, such as not having to go to work. Pain behaviour can also cause a lack of activity and muscle wastage, no social contact and no distraction leading to a sick role, which can also increase pain perception. Williams (2002) provides an evolutionary analysis of facial expressions of pain and argues that if the function of pain is to prioritize escape, recovery and healing, facial expressions are a means to communicate pain and to elicit help from others to achieve these goals. Further she argues that people often assume that individuals have more control over the extent of their pain induced facial expressions than they actually do and are more likely to offer help or sympathy when expressions are mild. Stronger forms of expressions are interpreted as amplified and as indications of malingering. The interaction between these different processes The three process model describes the separate components that influence pain per- ception. For example, emotional factors may influence an individual’s physi- ology and cognitive factors may influence an individual’s behaviour. However, it is likely that this process can be explained by changes in anxiety and focus with places and experiences that have previously been associated with pain resulting in increased anxiety and increased attention to pain, therefore increasing the pain experience. But it is also likely that they operate by increasing focus and anxiety – staying in bed leaves the individual with nothing to do other than think and worry about their pain. Research also indicates that fear influences attention, that fear interacts with catastrophizing and that catastrophizing influences attentional interference (Crombez et al. The three process model offers a framework for mapping out the different factors which influence pain. However, this categorization is probably best seen as a framework only with the different components being interrelated rather than discrete categories of discrete factors. However, chronic pain has proved to be more resistant to such approaches and recently, multidisciplinary pain clinics have been set up that adopt a multidisciplinary approach to pain treatment. The goals set by such clinics include: s Improving physical and lifestyle functioning: this involves improving muscle tone, improving self-esteem, improving self-efficacy, improving distraction and decreasing boredom, pain behaviour and secondary gains. In addition, current treatment philosophy emphasizes early intervention to prevent the transition of acute pain to chronic pain. Research shows that psychology is involved in the perception of pain in terms of factors such as learning, anxiety, worry, fear, catastrophizing, meaning and attention. Multidisciplinary pain clinics increasingly place psychological interventions at their core. There are several methods of pain treatment, which reflect an interaction between psychology and physiological factors. These methods can be categorized as respondent, cognitive and behavioural methods and are illustrated in Figure 12. Biofeedback aims to decrease anxiety and tension and there- fore to decrease pain. It seems to be of most use for acute pain and for repeated painful procedures such as burn dressing. Socratic questions challenge the individual to try and under- stand their automatic thoughts and involve questions such as ‘What evidence do you have to support your thoughts? For example, if a chronic pain patient has stopped activities that they belief may exacerbate their pain, the therapist will incrementally encourage them to become increasing more active. Each change in behaviour will be rewarded by the therapist and new exercises will be developed and agreed to encourage the patient to move towards their preset goal. Their extensive search of the data bases produced six studies of sufficient quality for inclusion and involved methodological practices such as blinding of outcome assessment, adequate length of follow-up and a high quality randomization procedure. The analysis showed that behavioural treatments effectively reduced pain intensity, increased functional status (e. However, it also takes the form of individual components such as relaxation and reinforcement. The control groups received standard medical care, placebo or were waiting list controls. The results of their analysis showed that psychological therapies were very effective at reducing headache in children and adolescents. Research also indicates that they are also important in the treatment and management of pain. This is an interesting paper, as it illustrates how a theoretical approach can be used as a basis for clinical practice. The paper emphasizes pain as a perception and suggests that treatment interventions can focus on the different factors that contribute to this perception. In addition, the paper highlights the role of adherence in treatment success, which has implications for understanding placebos and compliance with medical/ clinical recommendations. A cognitive–behavioural approach to pain regards pain as a perception that involves an integration of four sources of pain-related information: s Cognitive, e. The cognitive–behavioural approach to pain therefore aims to reduce pain by focusing on these different sources of pain-related information. The central role of self-control In particular, the cognitive–behavioural approach to pain aims to improve the indi- vidual’s self-control over the pain. Turk and Rudy (1986) summarize the objectives of interventions to improve self-control as follows: s Combat demoralization.

Caffeine is a bitter psychoactive drug found in the beans anafranil 75 mg otc, leaves anafranil 75mg discount, and fruits of plants generic anafranil 10mg overnight delivery, where it acts as a natural pesticide. It is found in a wide variety of products, including coffee, tea, soft drinks, candy, and desserts. In North America, more than 80% of adults consume caffeine daily [4] (Lovett, 2005). Food and Drug Administration lists caffeine as a safe food substance, it has at least some characteristics of dependence. People who reduce their caffeine intake often report being irritable, restless, and drowsy, as well as experiencing strong headaches, and these withdrawal symptoms may last up to a week. Most experts feel that using small amounts of caffeine during pregnancy is safe, but larger amounts of caffeine can be harmful to the fetus (U. Nicotine is a psychoactive drug found in the nightshade family of plants, where it acts as a natural pesticide. Nicotine is the main cause for the dependence-forming properties of tobacco use, and tobacco use is a major health threat. Nicotine creates both psychological and physical addiction, and it is one of the hardest addictions to break. Nicotine content in cigarettes has slowly increased over the years, making quitting smoking more and more difficult. For instance, the prescription drug Chantix acts as an antagonist, binding to nicotine receptors in the synapse, which prevents users from receiving the normal stimulant effect when they smoke. In many cases people are able to get past the physical dependence, allowing them to quit smoking at least temporarily. In the long run, however, the psychological enjoyment of smoking may lead to relapse. In the late 19th and early 20th centuries, it was a primary constituent in many popular tonics and elixirs and, although it was removed in 1905, was one of the original ingredients in Coca-Cola. It constricts blood vessels, dilates pupils, and increases body temperature, heart rate, and blood pressure. Since cocaine also tends to decrease appetite, chronic users may also become malnourished. The intensity and duration of cocaine‘s effects, which include increased energy and reduced fatigue, depend on how the drug is taken. The faster the drug is absorbed into the bloodstream and delivered to the brain, the more intense the high. The high from snorting cocaine may last 30 minutes, whereas the high from smoking crack“ ‖ cocaine may last only 10 minutes. In order to sustain the high, the user must administer the drug again, which may lead to frequent use, often in higher [6] doses, over a short period of time (National Institute on Drug Abuse, 2009). Amphetamine is a stimulant that produces increased wakefulness and focus, along with decreased fatigue and appetite. Some brand names of amphetamines are Adderall, Benzedrine, Dexedrine, and Vyvanse. The methylated version of amphetamine, methamphetamine (“meth‖ or “crank‖), is currently favored by users, partly [7] because it is available in ampoules ready for use by injection (Csaky & Barnes, 1984). Amphetamines may produce a very high level of tolerance, leading users to increase their intake, often in “jolts‖ taken every half hour or so. Although the level of physical dependency is small, amphetamines may produce very strong psychological dependence, effectively amounting to addiction. It is so effective that when used repeatedly it can seriously deplete the amount of neurotransmitters available in the brain, producing a catastrophic mental and physical “crash‖ resulting in serious, long-lasting depression. Slowing Down the Brain With Depressants: Alcohol, Barbiturates and Benzodiazepines, and Toxic Inhalants In contrast to stimulants, which work to increase neural activity, a depressantacts to slow down consciousness. Depressants are widely used as prescription medicines to relieve pain, to lower heart rate and respiration, and as anticonvulsants. The outcome of depressant use (similar to the effects of sleep) is a reduction in the transmission of impulses from [8] the lower brain to the cortex (Csaky & Barnes, 1984). In low to moderate doses, alcohol first acts to remove social inhibitions by slowing activity in the sympathetic nervous system. In higher doses, alcohol acts on the cerebellum to interfere with coordination and balance, producing the staggering gait of drunkenness. High enough blood levels such as those produced by “guzzling‖ large amounts of hard liquor at parties can be fatal. Alcohol use is highly costly to societies because so many people abuse alcohol and because judgment after drinking can be substantially impaired. It is estimated that almost half of automobile fatalities are caused by alcohol use, and excessive alcohol consumption is involved in a majority of violent crimes, including rape and murder (Abbey, Ross, McDuffie, & McAuslan, [9] 1996). Alcohol increases the likelihood that people will respond aggressively to provocations [10] (Bushman, 1993, 1997; Graham, Osgood, Wells, & Stockwell, 2006). Even people who are not normally aggressive may react with aggression when they are intoxicated. Alcohol increases aggression in part because it reduces the ability of the person who has [11] consumed it to inhibit his or her aggression (Steele & Southwick, 1985). When people are intoxicated, they become more self-focused and less aware of the social situation. As a result, they become less likely to notice the social constraints that normally prevent them from engaging aggressively, and are less likely to use those social constraints to guide them. For instance, we might normally notice the presence of a police officer or other people around us, which would remind us that being aggressive is not appropriate. The narrowing of attention that occurs when we are intoxicated also prevents us from being cognizant of the negative outcomes of our aggression. When we are sober, we realize that being aggressive may produce retaliation, as well as cause a host of other problems, but we are less likely to realize these potential consequences when we have been drinking (Bushman & Attributed to Charles Stangor Saylor. If we expect that alcohol will make us more aggressive, then we tend to become more aggressive when we drink. Barbiturates are depressants that are commonly prescribed as sleeping pills and painkillers. Brand names include Luminal (Phenobarbital), Mebaraland, Nembutal, Seconal, and Sombulex. In small to moderate doses, barbiturates produce relaxation and sleepiness, but in higher doses symptoms may include sluggishness, difficulty in thinking, slowness of speech, drowsiness, [13] faulty judgment, and eventually coma or even death (Medline Plus, 2008). Related to barbiturates, benzodiazepines are a family of depressants used to treat anxiety, insomnia, seizures, and muscle spasms. In low doses, they produce mild sedation and relieve anxiety; in high doses, they induce sleep. Brand names include Centrax, Dalmane, Doral, Halcion, Librium, ProSom, Restoril, Xanax, and Valium. These drugs are easily accessible as the vapors of glue, gasoline, propane, hair spray, and spray paint, and are inhaled to create a ““ change in consciousness. Related drugs are the nitrites (amyl and butyl nitrite; “poppers,‖ “rush,‖ “ locker room‖) and anesthetics such as nitrous oxide (laughing gas) and ether. Inhalants are some of the most dangerous recreational drugs, with a safety index below 10, and their continued use may lead to permanent brain damage. Opioids: Opium, Morphine, Heroin, and Codeine Opioids are chemicals that increase activity in opioid receptor neurons in the brain and in the digestive system, producing euphoria, analgesia, slower breathing, and constipation. Their chemical makeup is similar to the endorphins, the neurotransmitters that serve as the body‘s “ natural pain reducers. Morphine and heroin are stronger, more addictive drugs derived from opium, while codeine is a weaker analgesic and less addictive member of the opiate family. When morphine was first refined from opium in the early 19th century, it was touted as a cure for opium addiction, but it didn‘t take long to discover that it was actually more addicting than raw opium. When heroin was produced a few decades later, it was also initially thought to be a more potent, less addictive painkiller but was soon found to be much more addictive than morphine. Heroin is about twice as addictive as morphine, and creates severe tolerance, moderate physical dependence, and severe psychological dependence. The danger of heroin is demonstrated in the fact that it has the lowest safety ratio (6) of all the drugs listed in Table 5.

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However they can cause a hypertensive crisis if taken with certain foods (see Table 15-1) anafranil 75mg cheap. Spasms are caused by hyperex- citable neurons stimulated by cerebral neurons or from lack of inhibition of the stimulus in the spinal cord or at the skeletal muscles order anafranil 50mg overnight delivery. There are two groups of muscle relaxants: centrally acting and peripherally acting generic anafranil 10mg on line. Centrally acting mus- cle relaxants depress neuron activity in the spinal cord or in the brain. They are used to treat acute spasms from muscle trauma, but are less effective for treating spasms caused by chronic neurological disorders. These drugs decrease pain, increase range of motion and have a sedative effect on the patient. Centrally acting muscle relaxants should not be taken concurrently with central nervous system depressants such as barbiturates, narcotics, and alcohol. Diazepam (Valium) and Baclofen (Lioresal) These are used to treat acute spasms from muscle trauma and for treating spasms caused by chronic neurologic disorders. Peripherally acting muscle relax- ants depress neuron activity at the skeletal muscles and have a minimal effect on the central nervous system. These are most effective for spasticity or muscle contractions caused by chronic neurologic disorders. This is also used to treat malignant hypertension which is an allergic reaction to anesthesia. Patients experience fatigue and muscle weakness—particularly in respiratory muscles, facial muscles, and muscles in the extremities. They have drooping eye- lids (ptosis) and difficulty in chewing and swallowing and their respiratory mus- cles become paralyzed which leads to respiratory arrest. They include ambenonium (Mytelase), edrophonium Cl (Tensilon), Neostigmine bromide (Prostigmin), and Pyridostigmine bromide (Mestinon). Multiple lesions of the myelin sheath that surround the nerve fibers occur that are called plaque. At times patients don’t experience symptoms and other times symptoms can become severe and debilitating. Interferonß-1B (betaseron) and interferonß-1a (avonex) These are used to reduce the frequency and severity of relapses. Copolymer 1 This drug is in clinical trials and appears to decrease the disease’s activity. Copaxone (glatiramer acetate injection) This drug reduces new brain lesions and the frequency of relapses in people with relapsing-remitting multiple sclerosis. Part of the patient’s brain that controls thought, memory, and language becomes impaired. Alzheimer’s disease affects 5% of people between 65 and 74 years of age and half of those older than 85 years. Although the cause of Alzheimer’s disease remains unknown, investigators have discovered Alzheimer’s patients have abnormal clumps of amyloid plaques and tangled bundles of fibers called neurofibrillary tangles in parts of their brain. Amyloid plaques, neurofibrillary tangles, and decreased chemical levels impair thinking and memory by disrupting these messages and causing nerve cells to die. Eventually, the patient loses mental capacity and the ability to carry out daily activities. Although there isn’t a treatment that stops Alzheimer’s disease, there are medications that provide some relief to patients who are in the early and middle stages of the disease. Tacrine (Cognex), donepezil (Aricept), rivastigmine (Exelon), and galantamine (Reminyl) These drugs prevent some symptoms from becoming worse for a limited time. Tranquilizers, mood elevators, and sedatives These can help control behavioral symptoms such as sleeplessness, agitation, wandering, anxiety, and depression. Effects of Cholinergic and Anticholinergic Drugs Body Tissue Cholinergic Response Anticholinergic Response Cardiovascular* Decreases heart rate, lowers blood Increases heart rate with pressure due to vasodilation, large doses. Eye+ Increases papillary constriction, Dilates pupils of the eye or miosis (pupil becomes smaller), (mydriasis) and paralyzes and increases accommodation ciliary muscle (cycloplegia), (flattening or thickening of eye causing a decrease in lens for distant or near vision). Glandular* Increases salivation, perspiration, Decreases salivation, and tears sweating, and bronchial secretions. Bronchi (lung)* Stimulates bronchial smooth Dilates the bronchi and muscle contraction and increases decreases bronchial bronchial secretions. Striated muscle+ Increases neuromuscular Decreases tremors and transmission and maintains rigidity of muscles. Central nervous system Drowsiness, disorientation, and hallucination can result from large doses. Seventy-five percent of persons with seizures had their first seizure before 18 years of age. These include grand mal (tonic-clonic), petit mal (absence), and psychomotor seizures. Hydantoins (phenytoin, mephenytoin, ethotoin) These treat grand mal (tonic-clonic) seizures and psychomotor seizures. Barbiturates (Phenobarbital, mephobarbital, primidone) These are used for treating grand mal and acute episodes or status epilepticus; meningitis, toxic reactions, and eclampsia Succinimides (ethosuximide) These are used to treat absence seizures and may be used in combination with other anticonvulsants. Oxazolidones (trimethadione) This is used to treat petit mal seizures and may be used in combination with other drugs or singly for treating refractory petit mal seizures. Benzodiazepines (diazepam, clonazepam) These are effective in controlling petit mal seizures. Carbamazepine This is effective in treating refractory seizure disorders that have not responded to other anticonvulsant therapies. It is also used to control grand mal and partial seizures and a combination of these seizures. Valproate (valproic acid) This is used to treat petit mal, grand mal, and mixed types of seizures. It can suppress the sodium influx by binding to the sodium channel pro- longing the channel’s inactivation and preventing neurons from firing. Antipsychotics Psychosis is a disorder that is characterized by a number of symptoms. These include difficulty processing information and reaching a conclusion; experienc- ing delusions or hallucinations; being incoherent or in a catatonic state; or demonstrating aggressive violent behavior. Schizophrenia is a chronic psychotic disorder where patients exhibit either positive or negative symptoms. Positive symptoms are exaggeration of normal function such as agitation, incoherent speech, hallucination, delusion, and paranoia. Negative symptoms are characterized by a decrease or loss of motiva- tion or function such as social withdrawal, poor selfcare, and a decrease in the content of speech. Psychosis is caused by an imbalance in the neurotransmitter dopamine in the brain. Antipsychotic medication, also known as dopamine antagonists, block the D2 dopamine receptors in the brain thereby reducing the psychotic symptoms. A number of antipsychotic medications block the chemoreceptor trigger zone and vomiting (emetic) center of the brain. Although blocking dopamine improves the patient’s thought processes and behavior, it can cause side effects. These include symptoms of Parkinsonism (see Parkinsonism previously dis- cussed in this chapter). Patients who undergo long-term treatment for psychosis using antipsychotic medications also might be prescribed drugs to treat the symptoms of Parkinsonism. The typical category of antipsychotic med- ication is further subdivided into phenothiazines and nonphenothiazines. Phenothiazines block norepinephrine causing sedative and hypotensive effects early in treatment. Nonphenothiazines include butyrophenone haloperidol (Haldol) whose phar- macologics are similar to phenothiazines as it alters the effects of dopamine by blocking the dopamine receptor sites. Included in this group are prochlorperazine (Compazine), fluphenazine (Prolixin), perphenazine (Trilafon), and trifluoperazine (Stelazine).

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This issue can prove to be Good clinical practices require sponsors to be problematic when a single site is studying patients able to account for the drug supplies prepared and at different locations order 10mg anafranil overnight delivery. Finally buy anafranil 50mg without prescription, the double-blind shipped to the investigator purchase anafranil 10 mg without a prescription, the investigator’s use of code must not be broken except when essential those supplies and the return and destruction of for the management of adverse events. Planning drug supplies ing of treatment codes can make that patient’s data is a detailed and complex activity. Safety concerns are present throughout the drug Drug packaging should follow as consistent a development process. To be successful, monitors need to be com- Management of safety is a principal responsi- petent in bility of the sponsor monitor. The monitor has responsibility for informing the investigator basic medicine and therapeutics; about the safety requirements of the study. This will include a discussion of expected and unex- recognizing clinical signs and symptoms; pected adverse events, how to report adverse events should they occur and how to characterize interpretation of laboratory findings; the adverse events in terms of project-specific definitions. In source documents, safety issues The sponsor needs to provide ongoing review of may be uncovered in the progress notes of hospital safety data for investigational products. Monitors must be alert to exaggerated changes from baseline with expected pharmacolo- Closing down a study is important because it may gical effects, acute and chronic effects and multiple represent the sponsor’s last best chance to obtain drug treatment reactions. The study closedown Monitors are often the first company representa- (closeout) visit usually occurs after the last subject tives to learn about an adverse event. The timeliness has completed the trial including any posttreatment of reporting the event to sponsor safety group is follow-up visits. Drug supplies should be recon- important in satisfying regulatory reporting require- ciled, and the integrity of the double-blind treat- ments. Failure to adhere to the reporting timelines clinical study report is available, it should be given required for regulatory authorities is evidence of to the investigator for signature. The sponsor trials, a single lead investigator may sign a pooled monitor is responsible for assuring adherence to study report. The cases must be While the goal of monitoring is to provide ‘clean’ followed to completion. Computerized checking programs including the intent-to-treat analysis population and edit checks make the process more value- and the safety data listings. Each module satisfies a specific drafting of assigned study report sections documentation need. The modules are generally according to the clinical study report prototype; organized as follows: interpretation of adverse events; Module I: Includes a basic summary of the study not unlike a publication. The clin- not just a summary but also a critical assessment of ical representative should be able to interpret clin- the clinical evaluation of the drug. The ability to report provides an independent assessment of the understand computer-generated clinical output and risk-to-benefit ratio of the drug and its use. Quite apart from established in-house training Most vendors advertise widely in the trade programs, there is a wide selection of vendors journals, and many of their courses are tailored offering competency-based training. The format to meet the several certifications that are now of their programs may include: available in clinical research or regulatory affairs. A better almost every new chemical entity deviates from question, given the huge attrition rates in drug these general principles because special studies are development, might be: What governs whether a needed in pursuit of product-specific issues that are chemical becomes a medicine? Neither book covers all those disciplines and processes that can such custom-designed studies be generalized are needed for this putative transmogrification. This can also be called the ‘pre-marketing’ Regulatory affairs are so fundamental to precli- phase of the drug life cycle. It should be noted nical and clinical development that it deserves a that although all this is necessary, it is certainly section of this book to itself. Two major active relationship between regulation and the limitations then automatically arise. This is inten- smaller limitation is well illustrated by the disci- tional and again reinforces how an integrated pline of toxicology. In this case, the general prin- approach must be taken in drug development for ciples are fairly easily to enunciate, and have been there to be any chance at all of eventual success. In ancient directed at an identified pathological process, and/or times, and even today, tribal people knew the heal- specific receptors controlling these pathologies. The knowledge was accumu- safer, and are likely to have fewer adverse events lated through generations, recorded by chant and (side effects)ina largerpatient populationthanthose living memory and was derived largely from with multiple pharmacological properties. Although many of the drugs Research and development leading to a new, in use today were discovered by chance, most well-targeted pharmaceutical product is a long, drug discovery scientists engage in directed complex and expensive process. Historically, the research, based on a series of steps, each requiring cost of a new drug has been escalating by close to substantial scientific input. Average development some obvious, generally applicable milestones in time is 7–10 years, although some ‘blockbuster’ this process that facilitate the discovery of thera- drugs have taken 20 years. Targeted medicines and their Hence, the drug discovery and development implications process is a two-part exercise in mitigating the economic punishment to product sponsors while The understanding and use of medicines by physi- maximizing the probability that something that can ciansandhealershaveevolvedsignificantly,keeping be developed successfully is actually found. As few in step with technological and biological break- as 1% of promising lead molecules will be tested in throughs. From the use of herbal remedies to toxic human beings; fewer than one-third of those tested Principles and Practice of Pharmaceutical Medicine, 2nd Edition Edited by L. Some think that only about a half will produce financial returns that modern biology as well as other fields have only are disproportionately higher than their costs of increased the numbers of ‘hits’ overall, whereas development. Larger companies will rarely fund inter- nal research for drug discovery of orphan drug All drug discovery projects depend on luck to be products (or products targeting diseases with few successful, but research and careful planning can patients). On the other hand, small market niche improve chances of success and lower the cost. These tools are drawn from the repertoires tified, and a particular therapeutic area chosen, the of modern biology, chemistry, robotics and com- biological research begins. In comparison with older pro- stage of drug discovery that anecdotal clinical cesses of in vivo screening of huge numbers of observations, empirical outcomes and ‘data’ from molecules, however, these innovations have not folk medicine are often employed, if only as beenassociatedwithshorteningof thedevelopment direction-finding tools. Human disease or pathology is usually multifac- Molecular targets are not always obvious, even torial, and the first task of the researcher is to though cellular and histological disease patholo- narrow down the search by defining the molecular gies have been well described in the literature. At mechanisms better; optimally this will be a small this point, the researcher returns to the labora- number of pathophysiologically observable pro- tory bench to design critical experiments (see cesses, for example the pinpointing of one or two Figure 4. Taking cancer as an exam- difference is significant and can be reproducibly ple, malignant cells often contain over-expressed, observed in the laboratory, it can be exploited for mutated or absent ‘oncogenes’ (i. In other diseases, the cell which is code for particular proteins or receptors in normal identified can be normal but activated to a destruc- cells, but are mutated, and thus cause pathological tive state by stimulation with disease pathogens. In overactivity or underactivity of those gene pro- rheumatoid arthritis, for example, the normal T- ducts in tumor cells). An enzyme that is changes to alterations in the cellular architecture essential to life is a ‘no-hoper’ from the point of required for mitosis (cytoskeleton and cell moti- view of the drug developer. Nonsteroidal anti-inflammatory drugs such a research program might have found reports and methotrexate are examples of each of these in the literature of transgenic mice which, when in patients with rheumatoid arthritis. But the antibodies are also concerning cellular infiltrates in joint effusions, unattractive drugs. They are not orally available, with monocytes and T-lymphocytes being the and they elicit of immune responses after several most prevalent. Such antibodies will be compet- tion by phosphorylation or proteolysis, and to ing products for a long time in the future, given that examine the sorts of compound that may be cap- it is difficult to obtain regulatory approval for able of this. Gene expression profiling is useful not A key decision in each lab is when to incur the only in target identification as described here but expense, and time to clone the molecular target and also in finding significant use in later stages of drug set up the robotized in vitro assays which can development such as toxicology, surrogate marker screen compounds with a high rate of throughput. Cata- logues exist where the researcher can simply look The Human Genome Project has had a significant up which genes a particular antisense sequence will effect on target identification. One by-product was map to, and the use of fluorescent tags can then be that gene expression profiling technologies were used to probe the location of disease-producing invented which allowed for direct comparisons of mutants. But the pharmaceutical researcher should not ‘gene microarrays’ or ‘gene chips’; Cunningham, rely entirely on gene expression profiling for target 2000; Clarke et al. Technologies such as identification, even though the technology is very these allow the pharmaceutical researcher to com- powerful. Gene expression does not automatically pare the expression levels of nearly all the genes in lead to predictable protein synthesis. Proteins hugely outnumber only a few trial peptides need then be synthesized, genes in all mammals. In been coined to describe the analogous study of turn, this allows rapid identification and cloning of proteins within particular cells or tissues (Figeys, new targets for assay development. Thus, the application of proteomics also extends far beyond the target Pharmacologists are often able to develop tissue identification stage in drug development. In Further exploitation of this genomic and protei- some instances, studies on isolated tissues, such nomic can be obtained by making comparisons of as blood vessels, heart muscle or brain slices, will these data with epidemiological observations in allow a tissue- or organ-specific understanding of human populations.

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At weeks four and six all subjects took part in a laboratory session designed to assess their food intake order anafranil 10mg without a prescription. The results showed that subjects in the diet condition ate more than both the exercise and the control group supporting a causal link between dieting and overeating 10 mg anafranil. From this analysis the overeat- ing shown by dieters is actually caused by attempts at dieting generic anafranil 50 mg. According to the model, food intake is motivated by a physiologically determined hunger boundary and deterred by a physiologically determined satiety boundary. In addition, the boundary model suggests that the food intake of restrained eaters is regulated by a cognitively determined ‘diet boundary’. It indicates that dieters attempt to replace physiological control with cognitive control which represents ‘the dieters selected imposed quota for consumption on a given occasion’ (Herman and Polivy 1984: 149). Herman and Polivy (1984) described how after a low calorie preload the dieter can maintain her diet goal for the immediate future since food intake remains within the limits set by the ‘diet boundary’. The boundary model proposes a form of dual regulation, with food intake limited either by the diet boundary or the satiety boundary. The boundary model has also been used to examine differences between dieters, binge eaters, anorexics and normal eaters. Primarily this has been described in terms of a breakdown in the dieter’s self control reflecting a ‘motivational collapse’ and a state of giving in to the overpowering drives to eat (Polivy and Herman 1983). Ogden and Wardle (1991) analysed the cognitive set of the disinhibited dieter and suggested that such a collapse in self control reflected a passive model of overeating and that the ‘what the hell effect’ as described by Herman and Polivy (1984) contained elements of passivity in terms of factors such as ‘giving in’, ‘resignation’ and ‘passivity’. In particular, interviews with restrained and unrestrained eaters revealed that many restrained eaters reported passive cognitions after a high calorie preload including thoughts such as ‘I’m going to give into any urges I’ve got’ and ‘I can’t be bothered, it’s too much effort to stop eating’ (Ogden and Wardle 1991). In line with this model of overeating, Glynn and Ruderman (1986) developed the eating self-efficacy Fig. This also emphasized moti- vational collapse and suggested that overeating was a consequence of the failure of this self-control. An alternative model of overeating contended that overeating reflected an active decision to overeat and Ogden and Wardle (1991) argued that implicit within the ‘What the hell effect’ was an active reaction against the diet. This hypothesis was tested using a preload/taste test paradigm and cognitions were assessed using rating scales, interviews and the Stroop task which is a cognitive test of selective attention. The results from two studies indicated that dieters responded to high calorie foods with an increase in an active state of mind characterized by cognitions such as ‘rebellious’, ‘challenging’ and ‘defiant’ and thoughts such as ‘I don’t care now in a rebellious way, I’m just going to stuff my face’ (Ogden and Wardle 1991; Ogden and Greville 1993 see Focus on research 6. It was argued that rather than simply passively giving in to an overwhelming desire to eat as suggested by other models, the overeater may actively decide to overeat as a form of rebellion against self-imposed food restrictions. This rebellious state of mind has also been described by obese binge eaters who report bingeing as ‘a way to unleash resentment’ (Loro and Orleans 1981). Eating as an active decision may at times also indicate a rebellion against the deprivation of other substances such as cigarettes (Ogden 1994) and against the deprivation of emotional support (Bruch 1974). This has been called the ‘masking hypothesis’ and has been tested by empirical studies. For example, Polivy and Herman (1999) told female subjects that they had either passed or failed a cognitive task and then gave them food either ad libitum or in small controlled amounts. The results in part supported the masking hypothesis as the dieters who ate ad libitum attributed more of their distress to their eating behaviour than to the task failure. The authors argued that dieters may overeat as a way of shifting responsibility for their negative mood from uncontrollable aspects of their lives to their eating behaviour. This mood modification theory of overeating has been further supported by research indicating that dieters eat more than non-dieters when anxious regardless of the palatability of the food (Polivy et al. Overeating is therefore functional for dieters as it masks dysphoria and this function is not influenced by the sensory aspects of eating. This has been called the ‘theory of ironic processes of mental control’ (Wegner 1994). For example, in an early study participants were asked to try not to think of a white bear but to ring a bell if they did (Wegner et al. The results showed that those who were trying not to think about the bear thought about the bear more frequently than those who were told to think about it. A decision not to eat specific foods or to eat less is central to the dieter’s cognitive set. This results in a similar state of denial and attempted thought suppression and dieters have been shown to see food in terms of ‘forbiddenness’ (e. Therefore, as soon as food is denied it simultaneously becomes forbidden and which translates into eating which undermines any attempts at weight loss. Restrained and unrestrained eaters were given a preload that they were told was either high or low in calories and then were either distracted or not distracted. The results showed that the restrained eaters ate particularly more than the unrestrained eaters in the high calorie condition if they were distracted. The authors argued that this lends support to the theory of ironic processes as the restrained eaters have a limited cognitive capacity, and when this capacity is ‘filled’ up by the distraction their preoccupation with food can be translated into eating. This perspective has been applied to both the overeating characteristic of dieters and the more extreme form of binge eating found in bulimics and describes overeating as a consequence of ‘a motivated shift to low levels of self awareness’ (Heatherton and Baumeister 1991). It is argued that individuals prone to overeating show comparisons with ‘high standards and demanding ideals’ (Heatherton and Baumeister 1991: 89) and that this results in low self-esteem, self dislike and lowered mood. It is also argued that inhibitions exist at high levels of awareness when the individual is aware of the meanings associated with certain behaviours. In terms of the overeater, a state of high self awareness can become unpleasant as it results in self criticism and low mood. The individual is therefore motivated to escape from self awareness to avoid the accompanying unpleasantness but although such a shift in self awareness may provide relief from self-criticism it results in a reduction in inhibitions thereby causing overeating. Within this analysis disinhibitory overeating is indicative of a shift from high to low self awareness and a subsequent reduction in inhibitions. The traditional biomedical perspective of addictive behaviours viewed addictions as being irreversible and out of the individual’s control. It has been argued that this perspective encourages the belief that the behaviour is either ‘all or nothing’, and that this belief is responsible for the high relapse rate shown by both alcoholics and smokers (Marlatt and Gordon 1985). Thus, the abstaining alcoholic believes in either total abstention or relapse, which itself may promote the progression from lapse to full-blown relapse. This transition from lapse to relapse and the associated changes in mood and cognitions is illustrated in Figure 6. These parallels have been supported by research suggesting that both excessive eating and alcohol use can be triggered by high risk situations and low mood (Brownell et al. In addition, the transition from lapse to relapse in both alcohol and eating behaviour has been found to be related to the internal attributions (e. In particular, researchers exploring relapses in addictive behaviours describe the ‘abstinence violation effect’ which describes the transition from a lapse (one drink) to a relapse (becoming drunk) as involving cognitive dissonance (e. These factors find reflection in the overeating shown by dieters (Ogden and Wardle 1990). The results from this study indicated that the women described their dieting behaviour in terms of the impact on their family life, a preoccupation with food and weight and changes in mood. For example, when describing how she had prepared a meal for her family one woman said ‘I did not want to give in, but I felt that after preparing a three-course meal for everyone else, the least I could do was enjoy my efforts’. In terms of the preoccupation with food, one woman said ‘Why should I deprive myself of nice food’ and another said ‘Now that I’ve eaten that I might as well give in to all the drives to eat’. Such statements again illustrate a sense of self control and a feeling that eating reflects a breakdown in this control. In terms of mood, one woman said that she was ‘depressed that something as simple as eating cannot be controlled’. In summary, restraint theory indicates that dieting is linked with overeating and research inspired by this perspective has explored the processes involved in triggering this behaviour. Studies have used experimental and descriptive designs and suggest a role for physiological boundaries, cognitive shifts, mood modification, denial, a shift in self awareness and control. The aim of this study was to examine changes in cognitive state in dieters and non- dieters following the consumption of a ‘forbidden food’. The study used both self-report measures and the Stroop task to examine these changes. Self-report measures provide some insights into an individual’s state of mind, but are open to factors such as denial and expectancy effects.

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