The influence of four variables (status of communicator of drug effects, attitude of dentist, attitude of dental technician, and message of drug effects) on the obtainment of placebo effects in an oral surgery clinic was investigated. Dependent variables were (1) rating of pain experienced from mandibular-block injection, (2) pre-post placebo state anxiety, and (3) pre-postplacebo fear of injection. Enthusiastic messages of drug effects produced statistically and clinically significant reductions in postplacebo fear of injection and state anxiety and markedly lower ratings of pain experienced during injection of local anesthetic. Although there was a strong tendency for positive placebo effects to occur when the dental staff was perceived as friendly and supportive, only the attitude factors obtained statistical significance. The status of the communicator accounted for very small portions of the variance.

If you ask an overweight person, "Why are you fat?', you will, almost invariably, get the answer, "Because 1 eat too much." You will get this answer in spite of the fact that of thirteen studies, six find no significant differences in the caloric intake of obese versus nonobese subjects, five report that the obese eat significantly less than the nonobese, and only two report that they eat significantly more. It is hard to overcome this possibly incorrect belief about the cause of obesity when most practicing professionals and certainly every diet book is based on the assumption that excessive caloric intake is at fault. In spite of a failure rate approaching 90 to 95%, we still cling to dietary exhortations in our treatments, and suspect that lack of adherence to our recommendations is responsible for failure. Recent research in the field of biochemistry suggests that several newly discovered factors, as well as others that have been known for years but generally overlooked, may contribute to obesity in a way that is not easily remedied by dieting. Caloric restriction may lead to an adaptive metabolic response that reduces a person's daily energy needs, and to hormone and enzyme changes that lead to an enhanced rate of fat storage following caloric restriction. Adaptive responses may be associated with initial dispositional tendencies for some individuals to be heavier than others, and, together, these adaptive and dispositional tendencies may provide a basis for the continual frustration experienced by millions of persons who repeatedly diet to lose weight. We will review evidence for these adaptive and dispositional tendencies that resist weight loss efforts and then suggest an alternative approach to severe caloric restriction based on data from the Vanderbilt University Weight Management Program.

14 highly test-anxious students were seen in a combination program of group counseling and behavior therapy (systematic desensitization). Compared with volunteer controls (N = 6) and nonvolunteer controls (N : =23), grade-point averages for the treated group showed a significant increase and Test Anxiety Scale scores a significant decrease after completion of the program. While students felt that the relaxation training and systematic desensitization were helpful, all considered the advice and discussion to have played the more important role in the reduction of their anxiety and their increased academic effectiveness.

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