Alexander Pope’s the Rape of the Lock Essay

The Rape of the Lock begins with a passage outlining the subject of the poem and invoking the aid of the muse. Then the sun (â€Å"Sol†) appears to initiate the leisurely morning routines of a wealthy household. Lapdogs shake themselves awake, bells begin to ring, and although it is already noon, Belinda still sleeps. She has been dreaming, and we learn that â€Å"her guardian Sylph,† Ariel, has sent the dream. The dream is of a handsome youth who tells her that she is protected by â€Å"unnumbered Spirits†Ã¢â‚¬â€an army of supernatural beings who once lived on earth as human women. The youth explains that they are the invisible guardians of women’s chastity, although the credit is usually mistakenly given to â€Å"Honor† rather than to their divine stewardship. Of these Spirits, one particular group—the Sylphs, who dwell in the air—serve as Belinda’s personal guardians; they are devoted, lover-like, to any woman that â€Å"re jects mankind,† and they understand and reward the vanities of an elegant and frivolous lady like Belinda. Ariel, the chief of all Belinda’s puckish protectors, warns her in the dream that â€Å"some dread event† is going to befall her that day, though he can tell her nothing more specific than that she should â€Å"beware of Man!† Then Belinda awakes, to the licking tongue of her lapdog, Shock. Upon the delivery of a billet-doux, or love-letter, she forgets all about the dream. She then proceeds to her dressing table and goes through an elaborate ritual of dressing, in which her own image in the mirror is described as a â€Å"heavenly image,† a â€Å"goddess.† The Sylphs, unseen, assist their charge as she prepares herself for the day’s activities. Commentary The opening of the poem establishes its mock-heroic style. Pope introduces the conventional epic subjects of love and war and includes an invocation to the muse and a dedication to the man (the historical John Caryll) who commissioned the poem. Yet the tone already indicates that the high seriousness of these traditional topics has suffered a diminishment. The second line confirms in explicit terms what the first line already suggests: the â€Å"am’rous causes† the poem describes are not comparable to the grand love  of Greek heroes but rather represent a trivialized version of that emotion. The â€Å"contests† Pope alludes to will prove to be â€Å"mighty† only in an ironic sense. They are card-games and flirtatious tussles, not the great battles of epic tradition. Belinda is not, like Helen of Troy, â€Å"the face that launched a thousand ships† (see the SparkNote on The Iliad), but rather a face that—although also beautiful—prompt s a lot of foppish nonsense. The first two verse-paragraphs emphasize the comic inappropriateness of the epic style (and corresponding mind-set) to the subject at hand. Pope achieves this discrepancy at the level of the line and half-line; the reader is meant to dwell on the incompatibility between the two sides of his parallel formulations. Thus, in this world, it is â€Å"little men† who in â€Å"tasks so bold†¦ engage†; and â€Å"soft bosoms† are the dwelling-place for â€Å"mighty rage.† In this startling juxtaposition of the petty and the grand, the former is real while the latter is ironic. In mock epic, the high heroic style works not to dignify the subject but rather to expose and ridicule it. Therefore, the basic irony of the style supports the substance of the poem’s satire, which attacks the misguided values of a society that takes small matters for serious ones while failing to attend to issues of genuine importance. With Belinda’s dream, Pope introduces the â€Å"machinery† of the poem—the supernatural powers that influence the action from behind the scenes. Here, the sprites that watch over Belinda are meant to mimic the gods of the Greek and Roman traditions, who are sometimes benevolent and sometimes malicious, but always intimately involved in earthly events. The scheme also makes use of other ancient hierarchies and systems of order. Ariel explains that women’s spirits, when they die, return â€Å"to their first Elements.† Each female personality type (these types correspond to the four humours) is converted into a particular kind of sprite. These gnomes, sylphs, salamanders, and nymphs, in turn, are associated with the four elements of earth, air, fire, and water. The airy sylphs are those who in their lifetimes were â€Å"light Coquettes†; they have a particular concern for Belinda because she is of this type, and this will be the aspect of feminine nature with which the poem is most concerned. Indeed, Pope already begins to sketch this character of the â€Å"coquette† in this initial canto. He draws th e portrait indirectly, through characteristics of the Sylphs rather than of Belinda herself. Their priorities reveal that the central concerns of  womanhood, at least for women of Belinda’s class, are social ones. Woman’s â€Å"joy in gilded Chariots† indicates an obsession with pomp and superficial splendor, while â€Å"love of Ombre,† a fashionable card game, suggests frivolity. The erotic charge of this social world in turn prompts another central concern: the protection of chastity. These are women who value above all the prospect marrying to advantage, and they have learned at an early age how to promote themselves and manipulate their suitors without compromising themselves. The Sylphs become an allegory for the mannered conventions that govern female social behavior. Principles like honor and chastity have become no more than another part of conventional interaction. Pope makes it clear that these women are not conducting themselves on the basis of abstract moral principles, but are governed by an elaborate social mechanism—of which the Sylphs cut a fitting caricature. And while Pope’s technique of employing supernatural machinery allows him to critique this situation, it also helps to keep the satire light and to exonerate individual women from too severe a judgment. If Belinda has all the typical female foibles, Pope wants us to recognize that it is partly because she has been educated and trained to act in this way. The society as a whole is as much to blame as she is. Nor are men exempt from this judgment. The competition among the young lords for the attention of beautiful ladies is depicted as a battle of vanity, as â€Å"wigs with wigs, with sword-knots sword-knots strive.† Pope’s phrases here expose an absurd attention to exhibitions of pride and ostentation. He emphasizes the inanity of discriminating so closely between things and people that are essentially the same in all important (and even most unimportant) respects. Pope’s portrayal of Belinda at her dressing table introduces mock-heroic motifs that will run through the poem. The scene of her toilette is rendered first as a religious sacrament, in which Belinda herself is the priestess and her image in the looking glass is the Goddess she serves. This parody of the religious rites before a battle gives way, then, to another kind of mock-epic scene, that of the ritualized arming of the hero. Combs, pins, and cosmetics take the place of weapons as â€Å"awful Beauty puts on all its arms.† Canto 2 Summary Belinda, rivaling the sun in her radiance, sets out by boat on the river Thames for Hampton Court Palace. She is accompanied by a party of glitzy ladies (â€Å"Nymphs†) and gentlemen, but is far and away the most striking member of the group. Pope’s description of her charms includes â€Å"the sparkling Cross she wore† on her â€Å"white breast,† her â€Å"quick† eyes and â€Å"lively looks,† and the easy grace with which she bestows her smiles and attentions evenly among all the adoring guests. Her crowning glories, though, are the two ringlets that dangle on her â€Å"iv’ry neck.† These curls are described as love’s labyrinths, specifically designed to ensnare any poor heart who might get entangled in them. One of the young gentlemen on the boat, the Baron, particularly admires Belinda’s locks, and has determined to steal them for himself. We read that he rose early that morning to build an altar to love and pray for success in this project. He sacrificed several tokens of his former affections, including garters, gloves, and billet-doux (love-letters). He then prostrated himself before a pyre built with â€Å"all the trophies of his former loves,† fanning its flames with his â€Å"am’rous sighs.† The gods listened to his prayer but decided to grant only half of it. As the pleasure-boat continues on its way, everyone is carefree except Ariel, who remembers that some bad event has been foretold for the day. He summons an army of sylphs, who assemble around him in their iridescent beauty. He reminds them with great ceremony that one of their duties, after regulating celestial bodies and the weather and guarding the British monarch, is â€Å"to tend the Fair†: to keep watch over ladies’ powders, perfumes, curls, and clothing, and to â€Å"assist their blushes, and inspire their airs.† Therefore, since â€Å"some dire disaster† threatens Belinda, Ariel assigns her an extensive troop of bodyguards. Brillante is to guard her earrings, Momentilla her watch, and Crispissa her locks. Ariel himself will protect Shock, the lapdog. A band of fifty Sylphs will guard the all-important petticoat. Ariel pronounces that any sylph who neglects his assigned duty will be severely punished. They disperse to their posts and wait for fate to unfold. Commentary From the first, Pope describes Belinda’s beauty as something divine, an assessment which she herself corroborates in the first canto when she  creates, at least metaphorically, an altar to her own image. This praise is certainly in some sense ironical, reflecting negatively on a system of public values in which external characteristics rank higher than moral or intellectual ones. But Pope also shows a real reverence for his heroine’s physical and social charms, claiming in lines 17–18 that these are compelling enough to cause one to forget her â€Å"female errors.† Certainly he has some interest in flattering Arabella Fermor, the real-life woman on whom Belinda is based; in order for his poem to achieve the desired reconciliation, it must not offend (see â€Å"Context†. Pope also exhibits his appreciation for the ways in which physical beauty is an art form: he recognizes, with a mixture of censure and awe, the fact that Belinda’s legendary locks of hair, which appear so natural and spontaneous, are actually a carefully contrived effect. In this, the mysteries of the lady’s dressing table are akin, perhaps, to Pope’s own literary art, which he describes elsewhere as â€Å"nature to advantage dress’d.† If the secret mechanisms and techniques of female beauty get at least a passing nod of appreciation from the author, he nevertheless suggests that the general human readiness to worship beauty amounts to a kind of sacrilege. The cross that Belinda wears around her neck serves a more ornamental than symbolic or religious function. Because of this, he says, it can be adored by â€Å"Jews† and â€Å"Infidels† as readily as by Christians. And there is some ambiguity about whether any of the admirers are really valuing the cross itself, or the â€Å"white breast† on which it lies—or the felicitous effect of the whole. The Baron, of course, is the most significant of those who worship at the altar of Belinda’s beauty. The ritual sacrifices he performs in the pre-d awn hours are another mock-heroic element of the poem, mimicking the epic tradition of sacrificing to the gods before an important battle or journey, and drapes his project with an absurdly grand import that actually only exposes its triviality. The fact that he discards all his other love tokens in these preparations reveals his capriciousness as a lover. Earnest prayer, in this parodic scene, is replaced by the self-indulgent sighs of the lover. By having the gods grant only half of what the Baron asks, Pope alludes to the epic convention by which the favor of the gods is only a mixed blessing: in epic poems, to win the sponsorship of one god is to incur the wrath of another; divine gifts, such as immortality, can seem a blessing but become a  curse. Yet in this poem, the ramifications of a prayer â€Å"half† granted are negligible rather than tragic; it merely means that he will manage to steal just one lock rather than both of them. In the first canto, the religious imagery surrounding Belinda’s grooming rituals gave way to a militaristic conceit. Here, the same pattern holds. Her curls are compared to a trap perfectly calibrated to ensnare the enemy. Yet the character of female coyness is such that it se eks simultaneously to attract and repel, so that the counterpart to the enticing ringlets is the formidable petticoat. This undergarment is described as a defensive armament comparable to the Shield of Achilles (see Scroll XVIII of The Iliad), and supported in its function of protecting the maiden’s chastity by the invisible might of fifty Sylphs. The Sylphs, who are Belinda’s protectors, are essentially charged to protect her not from failure but from too great a success in attracting men. This paradoxical situation dramatizes the contradictory values and motives implied in the era’s sexual conventions. In this canto, the sexual allegory of the poem begins to come into fuller view. The title of the poem already associates the cutting of Belinda’s hair with a more explicit sexual conquest, and here Pope cultivates that suggestion. He multiplies his sexually metaphorical language for the incident, adding words like â€Å"ravish† and â€Å"betray† to the â€Å"rape† of the title. He also slips in some commentary on the implications of his society’s sexual mores, as when he remarks that â€Å"when success a Lover’s toil attends, / few ask, if fraud or force attain’d his ends.† When Ariel speculates about the possible forms the â€Å"dire disaster† might take, he includes a breach of chastity (â€Å"Diana’s law†), the breaking of china (another allusion to the loss of virginity), and the staining of honor or a gown (the two incommensurate events could happen equally easily and accidentally). He also mentions some pettier social â€Å"disasters† against which the Sylphs are equally prepared to fight, like missing a ball (here, as grave as missing prayers) or losing the lapdog. In the Sylphs’ defensive efforts, Belinda’s petticoat is the battlefield that requires the most extensive fortifications. This fact furthers the idea that the rape of the lock stands in for a literal rape, or at least re presents a threat to her chastity more serious than just the mere theft of a curl. Summary The boat arrives at Hampton Court Palace, and the ladies and gentlemen disembark to their courtly amusements. After a pleasant round of chatting and gossip, Belinda sits down with two of the men to a game of cards. They play ombre, a three-handed game of tricks and trumps, somewhat like bridge, and it is described in terms of a heroic battle: the cards are troops combating on the â€Å"velvet plain† of the card-table. Belinda, under the watchful care of the Sylphs, begins favorably. She declares spades as trumps and leads with her highest cards, sure of success. Soon, however, the hand takes a turn for the worse when â€Å"to the Baron fate inclines the field†: he catches her king of clubs with his queen and then leads back with his high diamonds. Belinda is in danger of being beaten, but recovers in the last trick so as to just barely win back the amount she bid. The next ritual amusement is the serving of coffee. The curling vapors of the steaming coffee remind the Baron of his intention to attempt Belinda’s lock. Clarissa draws out her scissors for his use, as a lady would arm a knight in a romance. Taking up the scissors, he tries three times to clip the lock from behind without Belinda seeing. The Sylphs endeavor furiously to intervene, blowing the hair out of harm’s way and tweaking her diamond earring to make her turn around. Ariel, in a last-minute effort, gains access to her brain, where he is surprised to find â€Å"an earthly lover lurking at her heart.† He gives up protecting her then; the implication is that she secretly wants to be violated. Finally, the shears close on the curl. A daring sylph jumps in between the blades and is cut in two; but being a supernatural creature, he is quickly restored. The deed is done, and the Baron exults while Belinda’s screams fill the air. Commentary This canto is full of classic examples of Pope’s masterful use of the heroic couplet. In introducing Hampton Court Palace, he describes it as the place where Queen Anne â€Å"dost sometimes counsel take—and sometimes tea.† This line employs a zeugma, a rhetorical device in which a word or phrase modifies two other words or phrases in a parallel construction, but modifies each in a different way or according to a different sense. Here, the modifying word is â€Å"take†; it applies to the paralleled terms â€Å"counsel† and â€Å"tea.† But one does  not â€Å"take† tea in the same way one takes counsel, and the effect of the zeugma is to show the royal residence as a place that houses both serious matters of state and frivolous social occasions. The reader is asked to contemplate that paradox and to reflect on the relative value and importance of these two different registers of activity. (For another example of this rhetorical techniq ue, see lines 157–8: â€Å"Not louder shrieks to pitying heaven are cast, / when husbands, or when lapdogs breathe their last.†) A similar point is made, in a less compact phrasing, in the second and third verse-paragraphs of this canto. Here, against the gossip and chatter of the young lords and ladies, Pope opens a window onto more serious matters that are occurring â€Å"meanwhile† and elsewhere, including criminal trials and executions, and economic exchange. The rendering of the card game as a battle constitutes an amusing and deft narrative feat. By parodying the battle scenes of the great epic poems, Pope is suggesting that the energy and passion once applied to brave and serious purposes is now expended on such insignificant trials as games and gambling, which often become a mere front for flirtation. The structure of â€Å"the three attempts† by which the lock is cut is a convention of heroic challenges, particularly in the romance genre. The romance is further invoked in the image of Clarissa arming the Baron—not with a real weapon, however, but with a pair of sewing scissors. Belinda is not a real adversary, or course, and Pope makes it plain that her resistance—and, by implication, her subsequent distress—is to some degree an affectation. The melodrama of her screams is complemented by the ironic comparison of the Baron’s feat to the conquest of nations. Belinda’s â€Å"anxious cares† and â€Å"secret passions† after the loss of her lock are equal to the emotions of all who have ever known â€Å"rage, resentment and despair.† After the disappointed Sylphs withdraw, an earthy gnome called Umbriel flies down to the â€Å"Cave of Spleen.† (The spleen, an organ that removes disease-causing agents from the bloodstream, was traditionally associated with the passions, particularly malaise; â€Å"spleen† is a synonym for â€Å"ill-temper.†) In his descent he passes through Belinda’s bedroom, where she lies prostrate with discomfiture and the headache. She is attended by  Ã¢â‚¬Å"two handmaidens,† Ill-Nature and Affectation. Umbriel passes safely through this melancholy chamber, holding a sprig of â€Å"spleenwort† before him as a charm. He addresses the â€Å"Goddess of Spleen,† and returns with a bag of â€Å"sighs, sobs, and passions† and a vial of sorrow, grief, and tears. He unleashes the first bag on Belinda, fueling her ire and despair. There to commiserate with Belinda is her friend Thalestris. (In Greek mythology, Thalestris is the name of one of the Amazons, a race of warrior women who excluded men from their society.) Thalestris delivers a speech calculated to further foment Belinda’s indignation and urge her to avenge herself. She then goes to Sir Plume, â€Å"her beau,† to ask him to demand that the Baron return the hair. Sir Plume makes a weak and slang-filled speech, to which the Baron disdainfully refuses to acquiesce. At this, Umbriel releases the contents of the remaining vial, throwing Belinda into a fit of sorrow and self-pity. With â€Å"beauteous grief† she bemoans her fate, regrets not having heeded the dream-warning, and laments the lonely, pitiful state of her sole remaining curl. Commentary The canto opens with a list of examples of â€Å"rage, resentment, and despair,† comparing on an equal footing the pathos of kings imprisoned in battle, of women who become old maids, of evil-doers who die without being saved, and of a woman whose dress is disheveled. By placing such disparate sorts of aggravation in parallel, Pope accentuates the absolute necessity of assigning them to some rank of moral import. The effect is to chastise a social world that fails to make these distinctions. Umbriel’s journey to the Cave of Spleen mimics the journeys to the underworld made by both Odysseus and Aeneas. Pope uses psychological allegory (for the spleen was the seat of malaise or melancholy), as a way of exploring the sources and nature of Belinda’s feelings. The presence of Ill-nature and Affectation as handmaidens serves to indicate that her grief is less than pure (â€Å"affected† or put-on), and that her display of temper has hidden motives. We learn that her sorrow is decorative in much the same way the curl was; it gives her the occasion, for example, to wear a new nightdress. The speech of Thalestris invokes a courtly ethic. She encourages Belinda to think about the Baron’s misdeed as an affront to her honor, and draws on ideals of chivalry in  demanding that Sir Plume challenge the Baron in defense of Belinda’s honor. He makes a muddle of the task, showing how far from courtly behavior this generation of gentlemen has fallen. Sir Plume’s speech is riddled with foppish slang and has none of the logical, moral, or oratorical power that a knight should properly wield. This attention to questions of honor returns us to the sexual allegory of the poem. The real danger, Thalestris suggests, is that â€Å"the ravisher† might display the lock and make it a source of public humiliation to Belinda and, by association, to her friends. Thus the real question is a superficial one—public reputation—rather than the moral imperative to chastity. Belinda’s own words at the close of the canto corroborate this suggestion; she exclaims, â€Å"Oh, hadst thou, cruel! been content to seize / Hairs less in sight, or any hairs but these!† (The â€Å"hairs less in sight† suggest her pubic hair). Pope is pointing out the degree to which she values outward appearance (whether beauty or reputation) above all else; she would rather suffer a breach to her integrity than a breach to her appearance. The Baron remains impassive against all the ladies’ tears and reproaches. Clarissa delivers a speech in which she questions why a society that so adores beauty in women does not also place a value on â€Å"good sense† and â€Å"good humour.† Women are frequently called angels, she argues, but without reference to the moral qualities of these creatures. Especially since beauty is necessarily so short-lived, we must have something more substantial and permanent to fall back on. This sensible, moralizing speech falls on deaf ears, however, and Belinda, Thalestris and the rest ignore her and proceed to launch an all-out attack on the offending Baron. A chaotic tussle ensues, with the gnome Umbriel presiding in a posture of self- congratulation. The gentlemen are slain or revived according to the smiles and frowns of the fair ladies. Belinda and the Baron meet in combat and she emerges victorious by peppering him with snuff and drawing her bodkin. Having achieved a position of advantage, she again demands that he return the lock. But the ringlet has been lost in the chaos, and cannot be found. The poet avers that the lock has risen to the heavenly spheres to become a star; stargazers may admire it now for all eternity. In this way, the poet reasons, it will attract more envy than it ever could on earth. Commentary Readers have often interpreted Clarissa’s speech as the voice of the poet  expressing the moral of the story. Certainly, her oration’s thesis aligns with Pope’s professed task of putting the dispute between the two families into a more reasonable perspective. But Pope’s position achieves more complexity than Clarissa’s speech, since he has used the occasion of the poem as a vehicle to critically address a number of broader societal issues as well. And Clarissa’s righteous stance loses authority in light of the fact that it was she who originally gave the Baron the scissors. Clarissa’s failure to inspire a reconciliation proves that the quarrel is itself a kind of flirtatious game that all parties are enjoying. The description of the â€Å"battle† has a markedly erotic quality, as ladies and lords wallow in their mock-agonies. Sir Plume â€Å"draw[s] Clarissa down† in a sexual way, and Belinda â€Å"flies† on her foe with flashing eyes and an erotic ardor. When Pope informs us that the Baron fights on unafraid because he â€Å"sought no more than on his foe to die,† the expression means that his goal all along was sexual consummation. This final battle is the culmination of the long sequence of mock-heroic military actions. Pope invokes by name the Roman gods who were most active in warfare, and he alludes as well to the Aeneid , comparing the stoic Baron to Aeneas (â€Å"the Trojan†), who had to leave his love to become the founder of Rome. Belinda’s tossing of the snuff makes a perfect turning point, ideally suited to the scale of this trivial battle. The snuff causes the Baron to sneeze, a comic and decidedly unheroic thing for a hero to do. The bodkin, too, serves nicely: here a bodkin is a decorative hairpin, not the weapon of ancient days (or even of Hamlet’s time). Still, Pope gives the pin an elaborate history in accordance with the conventions of true epic. The mock-heroic conclusion of the poem is designed to compliment the lady it alludes to (Arabella Fermor), while also giving the poet himself due credit for being the instrument of her immortality. This ending effectively indulges the heroine’s vanity, even though the poem has functioned throughout as a critique of that vanity. And no real moral development has taken place: Belinda is asked to come to terms with her loss through a kind of bribe or distraction that reinforces her basically frivolous outlook. But even in its most mocking moments, this poem is a gentle one, in which Pope shows a basic sympathy with the social world in spite of its folly and foibles. The searing critiques of his later satires would be much more stringent and less forgiving.

Chocolate in the Ivory Coast

In countries like Burkina Faso, Ghana, Togo, and Mali children are sent away from their families to cocoa farms in exchange for promised money and other useful items for their family. Families will â€Å"send their children to work†, or basically sell, them for promised goods that are usually never received. Even though it is not slavery, there are still many moral problems with the cocoa farming. The children work long hours, in dangerous conditions, for usually nothing more than a bed to sleep in and minimal food to eat.Children from these poor countries are sent to The Ivory Coast in search of skills that will help them in life or help their family, but most of the time they are just taken advantage of. Cocoa farming in The Ivory coast is morally and ethically wrong because the children are taken advantage of and they are forced into a type of â€Å"slavery† The children that are taken from countries like Burkina Faso, Ghana, Togo, and Mali are severely taken advanta ge of for many reasons.First of all, they are promised goods in exchange for their service that most of the time are not delivered or provided. Most of the time these services are just ploys to take these children into â€Å"slavery†. Most children go to work at the farms under the impression that they will learn skills or jobs that they can use to help their family. Most of the time the only skill they learn is how to pick and cut open cocoa beans.As well as being taken advantage of, the children are also forced into hard work that is only slightly different from slave labor. The hours are horribly long, and they rarely get breaks so they basically work all day. The conditions are dangerous, as the children are using sharp machetes in dense fields, and can often cut themselves or other workers. They are not paid, but work only for a bed to sleep in and a small amount of food.It is also seldom to find children that leave the farms because they do not know where to go or what to do. The small food and bed they get is better than starving on the streets for many of them. To conclude, the process of using child labor to farm cocoa in the ivory coast is a very labor intensive and dangerous process that children should not be doing. Families send their children to work at the farms and most of the time the children do not leave. This process violates several moral and ethical standards, and needs to be changed.

Structural Functionalist Theory

This essay is an attempt to discuss the problems political parties in Zambia are facing by using structural-functionalist and their contributions to liberal democracy. The academic piece shall begin by defining the key terms; those being, structural-functionalist, political parties and liberal democracy. This will be followed by a comprehensive discussion of political parties, focused on, with examples, the Zambian scene. Lastly, a brief conclusion based on the discussion will be outlined.â€Å"Functionalism holds that society is a complex system whose various parts work together to produce stability and solidarity† (Giddens 2006:20). It also views society in terms of their functions. Merton (1968), made an important distinctions between manifest and latent functions. The manifest functions of an institution are open, stated, conscious functions. They involve intended, recognized consequences of an aspect of the society such as the university’s role in classifying acade mic competence and excellence.By contrast, latent functions as unconscious or unintended functions and may reflect hidden purposes of an institution. Structural-functionalist acknowledges that not all parts of the society contribute to its stability all the time. This function refers to an element or process in society that may actually disrupt as social system or lead to a decrease in stability† (Schaefer, 2004: 14). Social life depends on unity and cooperation of a group.The functionalist points out that for society to be stable the different parts of the society must contribute to the stability of society. For instance, the teachers should teach the society to reduce illiteracy, the doctors are making sure that society is healthy, and the police maintain order. Hence society becomes stable since everyone is contributing. According to MacIver (1962), a political party is an association organized in support of some principles or policy which constitutional means it endeavors to make the determinant of government.Not only that, a political party consists of a group of citizens, more or less organized, who act as a political unit and who by the use of their voting power, aim to control the government and carry out their general policies. Similarly, a political party is different from a pressure group, though in some cases the distinction between the two is almost blurred. According to Ball (1976), It may be said that a political party is an organization of numerous people who are openly committed to broad matters of public policy and who want to assume direct responsibility  for their policies by seeking monopolize power or share it with other parties in a position of political power.According to Barker (1951), the panorama of a party system is so fluid that a good number of pressure groups behave like political parties. The cases of fragmentation and polarization of political parties may also be taken note of. It is also possible that some minor politi cal organizations emerge at the time of elections and then they disappear. But the most essential fact remains that three, four even more parties manage to share power.For instance, in Zambia before voting is taken place, there are many parties heard like Movement for Multiparty Development (MMD), United Party for National Development (UPND), Patriot Front (PF) and Heritage Party (HP). But at the end of elections only few will be available to be strong holding oppositions party for example the UPND and MMD. Political parties act as a check against the tendency of absolutism and totalitarianism, ideologies also known by names such as ‘Caesarism’ and ‘Bonapartism’ (CITE). When one party forms government or few form coalition to hold power, other parties play a role of opposition.It not only keeps the government vigilant, it also prevents it from being arbitrary and irresponsible. The leaders of the opposition expose acts of corruption, nepotism, scandals and maladministration in which great men in power are involved. According to Lasswell (1950), the political parties enable the power to hold the government in check. The constant presence of a recognized opposition is an obstacle to despotism, with a programmed fairly within the limits of a possible public opinion, is a bulwark against the tyranny, not only of a despot but also a practical political majority.Significant political developments have occurred in Zambia since the 2001 tripartite elections. After having had two previous elections in 1991 and 1996, the 2001 elections produced a multiparty Parliament for the first time since Zambia’s independence in 1964. These elections seem to signal that the country has moved from a dominant one party political system to a competitive multi-party system According to The Post Newspaper (20/01/2013), opposition parties have serious financial difficulties.And for the new member of the opposition, MMD, this is even worse. The MMD doesn't know how to operate without a lot of money. They were used to receiving a lot of money from all sorts of characters doing business with government. And the MMD was also parasitic on government institutions for resources. As a result of this, a series of other problems have appeared. Passions about the future of their party rightly fired people up, but wrongly led them to attack and despise their colleagues. The impact of disunity upon members of the party is clear to see.They must in the very near future learn again to display the camaraderie and common purpose that are fundamental to a party's prospects. If they don't do so, they stand no chance of being re-elected Also, according to Okar (2005), the ruling parties deliberately employ a â€Å"divide-and rule† tactic to fragment and weaken the opposition parties. Wilson (1956) says, â€Å"The numbers of parties that appeared with the opening to democratization is not a demonstration of increased participation, but rather of fragmentation and therefore weakness of the party systems†.Zambia had more than five political parties, and the dominant party was the movement for multi party democracy (MMD), which ruled the country since 1991 to 2011. According to The Post Newspaper (20/01/2013), opposition political parties like, UPND, that was bound together by regional, cultural and language ties is also now failing to conceal its problems and challenges. The regional, tribal and cultural glue that held them together is also starting to weaken. The hopes that they had of getting into government by 2011 have disappeared. The illusions that they had about their popularity have also dried up.And they can no longer deny the fact that they are a regional political party that has serious problems and challenges becoming national. Their arrogance and pomposity can no longer carry them. The bragging of being this and that has proved unsustainable because it is unrealistic. They can no longer claim to be the mos t educated, the most knowledgeable when it comes to business and economic matters, the leading entrepreneurs. Parliamentary statistics actually show that UPND has the least educated members of parliament of the three major political parties.And their leader, Hakainde Hichilema, who tried to project himself as a leading entrepreneur, an outstanding economist and a very rich man can no longer lay much claim to these credentials. According to Mwansa,(2012), The leadership of opposition parties suffer from overly rated ambition for power and pride, such that it overcrowds their effective participation on important national matters that affect the citizenry and poor people. They could be more effective by engaging government and the ruling party in debating policy frameworks on how to develop the country.Particularly,  pushing policies that address the needs of poor people such as improving access to clean water and sanitation, quality healthcare, education, rural and agricultural deve lopment, and debate macroeconomic policy frameworks required for growth and development, critically contributing to poverty eradication, employment creation and addressing inequalities. According to Soko, (2013), the opposition parties have to find their own political shoes rather than to follow in Sata's shoes if they are to earn confidence of the electorates on social and developmental programmers’.The strategies the opposition want to use today, of protesting against the Chief Justice, the demand to have a medical board to examine president Sata's health, the demand to have the constitution changed, among others were Sata's strategies when he was in the opposition. The opposition just seem to be recycling Sata's political strategies with the hope of gaining confidence and trust from the Zambians but this will not work for them as they are being viewed as imitators instead of being initiators.Opposition parties are also not given a fair chance by media. Media is always crit icizing them and portraying opposition parties in a horrible way. All favor is upon the ruling party which is not supposed to be the case. Lastly, one of the very crucial problems in Africa at present is the unwillingness of the incumbent parties to be opposition parties due to their over-dependence on the benefits available to the ruling parties. Therefore, they are ill-equipped to become the opposition.In conclusion, the ruling party in Zambia should try by all means to incorporate the opposition parties in some development decisions, there also has to be inter-party dialogue over how to move beyond the dominant party situation. Because the ruling party feel comfortable once in power and do not want to give chance to the opposition parties to rule the nation. Media should also be an independent source of information and not favor any party but be like a no man’s land that is not owned by anyone, the opposition parties should be able to broadcast their manifestos to the publ ic.

Ebay Essay Example | Topics and Well Written Essays - 500 words - 2

Ebay - Essay Example Marketing is a process that entails finding out what exactly the customers wants and needs, then providing customer with goods and services that meet or exceed their expectations, it is not merely â€Å"selling† and â€Å"advertising†. Some of the internal strength that facilitated success were, product being customer oriented this means finding out what the customer really wants and not what he/she can find an alternative and manage then provide it to them. Service orientation-that is, having an objective of customer satisfaction. A profit orientation is marketing the products in a way that will earn the business good profit to enhance its survival and facilitate its expansion to serve more customers (Blattberg and Scott, 385). Weaknesses that may have hindered complete meeting my objective; knowing what the customer needs its quite difficult because it is not easy to get to interact with all of them in person, finding means of quick delivery of products, constant change in technology constantly affecting customer’s preferences, therefore, need to monitor closer relationships with customers. Since it is marketing at global level one must adhere by all rules of all the countries he/she markets the product and the legality of the product, which is not easy. What came first, your product or your target market? Did you have a product you wanted to sell, find a target market for it on E-Bay, then analyze your environment and adjust your marketing mix-----or, did you analyze your environment, find a target market, and then find a product to market on E-Bay with a specific marketing mix? Explain your strategy. My strategy is by first scanning the environment to which I intend to market my products. By scanning the environment, I identify the factors that are likely to affect marketing my success (global, technological, social, economic influences) such as the availability of the product, demand of the product, competition, technology advancement in

DOES THE INTRODUCTION OF TECHNOLOGY IN WORKPLACES NECESSARILY Essay

DOES THE INTRODUCTION OF TECHNOLOGY IN WORKPLACES NECESSARILY TRANSFORM KNOWLEDGE AND SKILL AND GENERATE NEW OPPORTUNITIES FOR LEARNING - Essay Example However the opposite views also exist. The following paper critically evaluates the adoption of technology in the production system and its effect on labourers. The interaction between man and machine was actually initiated through industrial revolution in England. The industrial revolution multiplied the British production manifold and it may be considered as one of the most primary footsteps of machines into human domain (Form, 1987). This boom in the industrial output made the cities attractive and these began to overflow. This initiated the process of urbanization. The nineteenth century life was however harsh for the workers as the children worked either in the mines, factories or the cotton mills. Cotton became a prime export product for the Britons. Cheap houses were provided to the workers in order to make it easier for them to attend work early and spend most of the time there. Law had to interfere in order to protect the lives of these children and make the streets hygienic. (Form, 1987) At the very beginning of the twentieth century, Henry Ford started the assembly line production system for the first time and the production system suddenly became a comprehensive, constructive and integrated action – â€Å"The first step forward in assembly came when we began taking the work to the men instead of the men to the work. We now have two general principles in all operations–that a man shall never have to take more than one step, if possibly it can be avoided, and that no man need ever stoop over.† (Ford, 2007, p.58). The efficiency of workers increased manifold – â€Å"With one workman doing a complete job he could turn out from thirty-five to forty pieces in a nine-hour day, or about twenty minutes to an assembly.† (Ford, 2007, p.58) However, the adoption of modern day’s technology started at the advent of information technology. The common sentiment or logic behind the adoption of information technology

A Normal C Reactive Protein and Significant Bacterial Infection in Literature review

A Normal C Reactive Protein and Significant Bacterial Infection in Children with Fever - Literature review Example One of the most common reasons for Emergency Department (ED) visit is the fever. Fever accounts to approximately 10 – 35% of admissions in children younger than three years of age (Nuttall, 2003; Andreola et al., 2007; Behjati 2008; Liu et al, 2008). In this age group, severe bacterial infections or SBI represents to about 10 – 25%; however, Andreola et al (2007) noted that this diagnosis is frequently confusing especially with the absence of localising findings. Hence, a need for specific and sensitive laboratory markers for infection is required because of the presence of clinical findings such as body temperature. More than a decade ago, an algorithm which incorporates with laboratory findings, such as white blood cell count and absolute neutrophil count was published and was proven to be useful in the medical practice especially in the identification children who are at higher risk of severe bacterial illness. Additional markers such as C – reactive protein ( CRP) and procalcitonin (PCT) are maybe useful (Nuttall, 2003; Andreola et al, 2007). In 1930, CRP is discovered by Tillett and Francis as C – Polysaccharide fraction called as fraction C from the sera of an acutely ill patient. In 1941, fraction C was found to be a peptide instead of a polysaccharide, thus renamed as C reactive peptide. In 1950, it was reported that CRP can be detected in more than 70 types of disorders. Carlan added that CRP can be normal in invasive bacterial disease, and produces the largest, the most rapid, and most quantifiable acute response to inflammation and infection.

English assignment Essay Example | Topics and Well Written Essays - 500 words

English assignment - Essay Example rious sorts can take place in the lives of every man; a man who â€Å"is eating or opening a window or just walking dully along† is not free from the clutches of misfortune or suffering (Schakel & Ridl 737). The old people hope for a â€Å"miraculous birth†; however, the new generation or rather children do not â€Å"specially want it to happen† (Schakel & Ridl 738). The lines echo the indifference of the new generation towards the sufferings of the old people and show how the old people are being disrespected, uncared, looked down and are marginalised in the contemporary society. The poem effectively combines the tragedy of Icarus with similar portraits from the readers’ own world. Just as the ploughman neglected the ‘forsaken cry’ of Icarus, the modern man fails to value the martyrdom and loses hold of his human innocence. The poem, in a way, propagates the Christian values of showing empathetic feelings towards the sufferings of the fellow human beings. The poem brings to light man’s lack of concern for his fellow beings and exhorts the readers to look into their life introspectively to amend their ways and absorb the Christian values of love and empathy towards everyone. Even though the primary purpose of dramas is performance on the stage, an effective reader can give shapes and lives to the characters in a play in the mind of his imagination which can act as a theatre. Reading a play necessitates an awareness of the names, nature and the relationship of the characters to each other. Similarly, an effective reader should have the imaginative capability to visualize the scenery on the stage as well as the costumes and the appearance of various characters. The effectiveness of a play depends on the character formation and the building of the dramatic conflict in the play and this paper tries to bring out how character and conflict affects the drama The New New by Kelly Stuart. Unlike other plays the script of The New New â€Å"does not start with a list of

Francis Scott Key and the "Star Spangled Banner" Research Paper

Francis Scott Key and the "Star Spangled Banner" - Research Paper Example Penned more than two hundred years ago, the Star Spangled Banner is hailed as America’s national anthem. Written at a time when the country was facing series of attacks from the British, the song does not hide its distaste for the enemy and its profound pride when the nation’s flag remained firmly etched on the ground after the war, a sign of victory. Although it is still regarded as a musical and iconic symbol of the country, critics have deemed the Star Spangled Banner as violent and overtly boastful. The question is: should the song be discarded as the national anthem for being violent and boastful? Since he was a prominent attorney at the time, Francis Scott Key was sent to negotiate the release of William Beanes from the British fleet at Baltimore. As part of the negotiations, Key and his allies presented British prisoners in exchange for Beanes. The deal was sealed; however, the British had one extra demand- Key and his allies were not to leave until they witnessed the destruction of Baltimore. They had no option but to oblige as the British ship was heavily guarded and they had no soldiers to redeem them from captivity. The ensuing battle between the British forces and Fort McHenry lasted for 25 hours. When Key saw the American flag was still standing the next day, he knew the British had been defeated. The victory stirred Key to write the Star Spangled Banner lyrics. On September 20, 1814, the Baltimore Patriots published the poem, christened as â€Å"Defence of Fort M’Henry†. The poem became a song once it was sung to the tune of a song belonging to the British Anacreontic Society known as â€Å"To Anacreon in Heaven†. The military adopted it to be their theme song during the First World War and subsequently, the congress and president Herbert Hoover raised it to the national anthem in 1931. (Maryland, n.d.) The Banner is a bone of

Daffodils by William Wordsworth Essay Example | Topics and Well Written Essays - 1500 words

Daffodils by William Wordsworth - Essay Example â€Å"Daffodils† takes one on the journey of the Romantic age, where one can find all the elements of love, passion, excitement, and praise for the blossoming fields occupied with waving daffodils. In Daffodils the poet narrates the story of his encounter with the God’s most beautiful creation, the daffodils. The first stanza describes the gloominess on the poets face when he is wandering pointlessly beside the lake surrounded by loneliness he notices a floating cloud in the sky, sweeping above the valleys and the hills. And then his eyes meet a large number of daffodils gathered by the side of the lake. Sheltered by a growing tree the daffodils were glowing and gleaming like gold. The constant push of the airy breeze was making them dance in joy and delight. The yellow sheet of daffodils made the entire atmosphere vibrant and full of life. The line: â€Å"A host, of golden daffodils† describes the richness to the color of the flower. Gold is a highly treasured piece of metal, very rare on earth. The poet gives the same status to daffodils which beauty has captured the attention of the poet. According to the poet, the aligned daffodils resemble the shining stars up in the night sky in the form of Milky Way, enlightening the entire space with their glow and imperfection. The use of night sky to describe the imperfection of daffodils can be explained by the example of darkness in a closed room; darkness is associated with loneliness and despair, but as the moonlight enters the room it suddenly lights up and the feeling of isolation is gone. As the poet glance at the dancing daffodils, he also lights up from within and is unable to escape the feeling of joy. The power of daffodils accentuates the entire atmosphere and the waves of the lake also start to dance with them.  

611 Assignment 4 Example | Topics and Well Written Essays - 750 words

611 4 - Assignment Example : the preparation of a Project plan that involves the use of tools such as GHANTT charts and all key steps to be implemented in the initialization stage of the project are reviewed to ensure that they are executed as planned. Secondly, necessary documentation is drafted: this includes schedule, plans and system documentation which will be important to the users. Third deliverable is to draft a Kick-off presentation which helps communicate with the members of the board and explains the importance of the project and its need to be implemented. The last deliverable in this stage of initialization is the use of monthly reports that are going to strategically help in reviewing results. In analysis of the project, deliverables include drafting the technological requirements and recommendations report that is used to provide technical options for implementation. Infrastructure preparation and specifications, deliverables include reports that contain information such as infrastructure, softw are, hardware, security and technical standards and procedures. Resources used include the Generic WBS that defines the sequence of the project in an outline format. A scheduling system would be used in this stage so as to ensure that tasks to be handled are handled in an effective manner. Phase four: this involves installation. Deliverables include: production test plans and schedule for the project, migration installation plan and actual installation plan, tests and validation. Another deliverable would be the delivery of training documents, the training plan and user training sessions. Project status reports are very handy at this phase as they help report on the core issues. The main purpose of project management tools is to help project managers plan better, execute plans effectively and control the project management process. This is executed by the use of project plans. Project management tools help reduce time wastage in project implementation and aid in easy

The Sales Force Technology Essay Example for Free

The Sales Force Technology Essay Forbes Firms continue to struggle with the implementation of sales force technology tools and the role they play in sales representative performance. This research expands previous literature in the area of sales force automation (SFA) and customer relationship management (CRM) by looking at the consequences after technology adoption by a sales force. Data were gathered from three sources to include 662 sales representatives, 60 sales managers, and ï ¬ rm archival data. Using structural equation modeling, our ï ¬ ndings indicate that SFA usage has a direct impact on effort, thereby reducing number of hours worked, and CRM usage has a direct positive impact on adaptive selling behaviors. Moreover, experience moderates the relationship between CRM usage and adaptive selling. Discussion, limitations, and directions for future research are also discussed. As competition increases and technology advances, organizations continue to seek ways to adjust to changing business environments. This is especially true in the personal selling context where salespeople are recognized as the boundary spanners and are expected to be relationship managers (Kotler 1984). Today’s salesperson is constrained to do more in less time, and technological advancements have become an integral part of the personal selling and sales management process. Foreseeing this changing environment, Leigh and Tanner (2004) stressed the necessity for sales organizations to focus on technology-related strategies, business processes, and applications, and called on sales researchers to put forth theoretical models and empirical studies investigating these emerging issues. Notably, sales force technology usage has changed the methods of selling. Salespeople are no longer selling just a â€Å"product†; instead, they are providing a valuable â€Å"solution† to customer problems. Anderson and Dubinsky (2004) discussed the concept of consultative selling, where a salesperson acts as an expert and provides customized solutions. This role requires salespeople to develop a technological orientation to access, analyze, and communicate information in order to establish a strong relationship with customers (Hunter and  Adam Rapp (Ph.D., University of Connecticut), Assistant Professor of Marketing, College of Business Administration (Market ing), Kent State University, [emailprotected] Raj Agnihotri (MBA, Oklahoma City University), Ph.D. candidate, College of Business Administration (Marketing), Kent State University, [emailprotected] Lukas P. Forbes (Ph.D., University of Kentucky), Assistant Professor of Marketing, Ford College of Business, Western Kentucky University, [emailprotected] Perreault 2007). Sales technology enables salespeople answering the queries of customers to effectively provide competent solutions. This can lead to strong relationships between a salesperson and a customer. Thus, technology tools are used not only for smoothing the work process but they also have strategic utilizations. To this point, numerous models investigating technology acceptance have been postulated in the literature (Compeau, Higgins, and Huff 1999; Davis, Bagozzi, and Warshaw 1989; Venkatesh and Davis 2000; Venkatesh et al. 2003). These studies focus mainly on ï ¬ nding and examining the variables inï ¬â€šuencing salespeople’s motivation, or attitudes to adopt technology (Avlonitis and Panagopoulos 2005; Jones, Sundaram, and Chin 2002; Keillor, Barshaw, and Pettijohn 1997; Morgan and Inks 2001; Pullig, Maxham, and Hair 2002; Schillewaert et al. 2005; Speier and Venkatesh 2002). Notably, most existing research has focused on technology adoption with a few notable exceptions. For example, Ahearne et al. (2008) and Hunter and Perreault (2007) investigated the mediating effects of relationship-forging tasks, and Ahearne, Jelinek, and Rapp (2005) proposed moderating effects of training and support on links between different types of sales technology use (adoption) and sales performance. However, there is still a need to investigate the links between technology use and performance (Sundaram et al. 2007). Within this study, we make two extensions to the prior research. First, we shift the focus from technology adoption to technology usage and consequence (Hunter and Perreault 2007; Sundaram et al. 2007). The rationale for this diversion is that the success of technology acceptance resides â€Å"not simply in whether or not salespeople adopt technology, but whether or not adoption (i.e. use) actually improves performance† (Ahearne, Jelinek, and Rapp 2005, p. 380). For this purpose, we ground our arguments in the technology-to-performance  chain (TPC) m odel, which explores the link between technology and an individual’s performance and postulates that â€Å"performance impacts will depend increasingly upon task–technology ï ¬ t rather than utilization† (Goodhue and Thompson 1995, p. 216). Second, this research focuses on the multidimensionality of the technology usage construct. Hunter and Perreault (2006; 2007) made a distinction between sales force automation (SFA) and customer relationship management (CRM) tools and reinvigorated the issue of sales technology and its effectiveness. We extend that distinction. They suggested that SFA and CRM technologies should be considered as two different sales technology tools, and that â€Å"different use of technology have differential effects on various aspects of performance . . . thus, how a sales representative uses technology and on which behavioral tasks (work processes) matters† (Hunter and Perreault 2007, p. 30). Aligning with this logic, we perceive this new research direction as a valuable addition to an already established and rich literature of sales technology. The purpose of this research study, therefore, is to expand research with regard to the different dimensions of technology usage by investigating th eir impact on sales representative’s behavior that inï ¬â€šuences performance. We also investigate the role of salesperson experience within this model. THEORETICAL DEVELOPMENT As mentioned previously, examining the relationship between technology acceptance and salesperson performance has only recently gained mainstream attention; however, studies investigating this link report positive ï ¬ ndings. For example, researchers have documented that the growing use of technology tools inï ¬â€šuences salesperson performance positively (Ahearne, Srinivasan, and Weinstein 2004) by enhancing sales efï ¬ ciency and sales effectiveness (Ahearne, Jelinek, and Rapp 2005). It has been argued that increasing the use of technology encourages salesperson knowledge  attainment, which further improves his or her performance (Ko and Dennis 2004). More recently, Hunter and Perreault (2006) suggest that salespeople’s technology orientation inï ¬â€šuences their internal role performance. In another study, Sundaram et al. (2007) theorize that technology use and technology impact on performance are directly proportional to each other. They provide empirical evidence suggesting that the extent to which salespeople use technology may improve overall sales performance. Bringing new insights into this subject, Hunter and Perreault (2007) propose new behavioral mechanisms that relate to sales representative performance. Speciï ¬ cally, they suggest that through relationship-forging tasks, salespeople are able to exploit different dimensions of technology utilization (i.e., accessing, analyzing, and communicating information), which in turn, affect different facets of sales performance. Our research builds on the logic presented by previous researchers regarding the consideration of different dimensions of technology use and their differential effects on salespeople’s behavior. To provide theoretical grounding, we base our conceptual framework on the TPC model proposed by Goodhue and Thompson (1995). The TPC model emphasizes that in order to see a positive link between technology and performance, â€Å"the technology must be utilized, and the technology must be a good ï ¬ t with the tasks it supports† (Goodhue and Thompson 1995, p. 213, emphasis in original). Notably, tasks are viewed as activities performed by individuals to achieve outputs and technologies are tools that help them to perform these tasks. The use of certain applications of technology depends on the speciï ¬ c characteristics of the assigned task. Within the sales context, salespeople carry out operational (e.g., learning about existing and new products, generating automated report s) as well as strategic (e.g., identifying most important customers, preparing sales presentations based on customers’ speciï ¬ c needs) activities and need different tools to help perform these activities. Moreover, the TPC model highlights the importance of an individual’s characteristics (e.g., training or experience), suggesting their impact on how â€Å"easily and well† one will use the technology tools (Goodhue and Thompson 1995, p. 216). The current research contributes to this idea by suggesting that the effect of technology use on salespeople’s behavior will  depend upon whether they are using the technology for operational purpose (i.e., SFA) or for strategic purpose (i.e., CRM). Also, our framework incorporates salesperson experience to assess the inï ¬â€šuence of individual characteristics. Dimensions of Sales Technology Usage In a broad sense, technology is deï ¬ ned as â€Å"an ability to act, a competence to perform, translating materials, energy and information in one set of states into another, more highly valued set of states† (Metcalfe 1995, p. 34). In a sales research domain, sales technology describes information technologies aiding or enabling the sales task performance (Hunter and Perreault 2007). In the past, scholars from different research streams have raised the issue concerning the different dimensions and aspects of technology use and proposed several frameworks that support this concept (Goodhue and Thompson 1995; Orlikowski 1992). Although previous researchers build their arguments on different concepts, in essence, they all agree there are different aspects and dimensions of technology use. Considering the fact that different dimensions of technology use should be employed for different purposes, sales managers must develop and support an environment where salespeople use technology in accordance with the required behavior. For example, salespeople involved in operational activities such as exchanging information with colleagues  and managers, taking or tracking inventory levels, or learning about existing, new, and competitive products will employ different technology tools as compared to situations where they execute strategic activities such as identifying potential customers, identifying the most important customers from the list of current customers, or working on improvement of sales presentation skills. Thus, it will be beneï ¬ cial for sales managers, as well as for salespeople, to understand how employing different technology tools will inï ¬â€šuence performance-enhancing behaviors (Hunter and Perreault 2007). Accordingly, we view the use of SFA and the use of CRM as two dimensions of sales technology based on their level of speciï ¬ city for inï ¬â€šuencing different salespersons’ behaviors. SFA usage, with an operational orientation, includes the utilization of technological to ols supporting the routine sales  functions (Jacobs 2006). CRM usage, with a strategic orientation, includes methods and employing technology tools that help salespeople develop sales strategies (Rigby and Ledingham 2004). Importantly, both the routine sales functions and strategic sales activities that a salesperson engages in can develop, sustain, and strengthen customer relationships. Use of SFA Technology Hunter and Perreault suggest that SFA technology includes â€Å"tools that are intended to make repetitive (administrative) tasks more efï ¬ cient† (2007, p. 17). Highlighting its potential beneï ¬ ts, previous research views SFA use as a competitive equivalence (Morgan and Inks 2001) and suggests that it enhances the â€Å"precision† of salespeople’s activities (Honeycutt et al. 2005) by providing fast and reliable information ï ¬â€šow among customers, salespeople, and ï ¬ rms (Speier and Venkatesh 2002). Sales managers and salespeople alike identify SFA as a tool to enhance efï ¬ ciency (Erffmeyer and Johnson 2001) and to improve productivity (Engle and Barnes 2000; Pullig, Maxham, and Hair 2002). SFA tools assist with routine tasks, allow salespeople to focus on re lationship-oriented activities, and free up time for more customer-centric tasks (Cotteleer, Inderrieden, and Lee 2006). To attain the advantages of SFA, salespeople need to understand the speciï ¬ c purpose of using SFA. Keeping this in mind, we adapt the Rivers and Dart’s conceptualization of SFA that describes it as transforming â€Å"manual sales activities to electronic processes through the use of various combinations of hardware and software applications† (1999, p. 59). We view SFA as a tool that converts repetitive and routine manual processes to automated processes, and assists salespeople trying to operate in an efï ¬ cient and timely manner. Examples of SFA tools could include programs such as quarterly automated sales reports and calendaring tools. The domain for SFA applications includes the attainment and storage of information. However, the information being utilized,  analyzed, and obtained with the help of SFA tools is unlike that from CRM tools. Use of CRM Technology Unlike the routine purpose of SFA applications, CRM technology usage focuses on relationship and st rategy building (Rigby, Reichheld, and Schefter 2002). Day views CRM as â€Å"a cross-functional process for achieving a continuing dialogue with customers† (2001, p. 1). CRM is also described as a â€Å"business strategy that includes information technology  to provide an enterprise with a comprehensive, reliable, and integrated view of its customer base† (Zikmund, McLeod, and Gilbert 2003, p. 3). In essence, salespeople use CRM technology tools for developing and managing customer relationships (Yin, Anderson, and Swaminathan 2004). This characterization is aligned with the analysis aspect of sales technology use suggested by Hunter and Perreault (2007). They deï ¬ ned it as the degree to which salespeople depend on technology â€Å"to study and synthesize data and understand the implications of data relevant to the demands of their sales jobs† (Hunter and Perreault 2007, p. 21). Outlining the functionality of sales technology, Widmier, Jackson, and McCabe (2002) postulate different sales functions (e.g., presentations, informing, communications, sales reporting) that can be supported by sales technology. Importantly, these functions of sales technology can be separated on the basis of whether their strategic orientation is â€Å"customer† centric or â€Å"back-ofï ¬ ce† centric (Geiger and Turley 2006). We characterize the use of CRM as utilizing customer-centric technology tools that help salespeople formulate strategies to achieve effectiveness in their selling methods. Therefore, the optimal utilization of CRM tools will depend on how well salespeople assimilate the information obtained through data patterns in their job-speciï ¬ c behaviors. We believe that the use of CRM technology tools not only accelerates the regular sales operation, but also aids salespeople in developing and managing long-term customer relationships. CONCEPTUAL MODEL DEVELOPMENT In light of the above-mentioned arguments, we propose a model (Figure 1) examining the effects of SFA and CRM on salespeople’s behaviors after technology adoption and how these behaviors can inï ¬â€šuence s alesperson performance. Effort A salesperson’s effort, in general, can be characterized as â€Å"persistence—in terms of the length of time devoted to work and continuing to try in the face of failure† (Sujan, Weitz, and Kumar 1994, p. 40), and it can be assessed via a litany  of measures. Speciï ¬ cally, â€Å"the duration of time spent working and the intensity of work activities† are viewed as components of effort (Brown and Peterson 1994, p. 71); other research studies measure effort by the number of hours invested by salespeople to accomplish their sales goals or the number of sales calls made (e.g., Rapp et al. 2006). Past scholars have conceptualized that the utilization of technology tools improves salesperson efï ¬ ciency (Keillor, Barshaw, and Pettijohn 1997; Pullig, Maxham, and Hair 2002) and that technology assists salespeople in formulating a professional sales encounter (Marshall, Moncrief, and Lassk 1999). Salespeople can maintain direct contact, even with re mote customers, through e-mails and cell phones, thus saving travel hours. They can receive and manage orders from customers in an easy, timely fashion. Various SFA applications (e.g., calendaring; routing tables) inject activeness in salespeople’s typical sales routines and reduce downtime. Salespeople, in today’s competitive environment, face a great deal of data that include information about distributors, dealers, retailers, and ultimately, the end customer. In addition to this, salespeople need to keep track of competitor’s activities as well as product market situations. Notably, SFA  tools provide answers to salespeople in such complex data utilization and management scenarios. Different application tools, spreadsheets, Web browsers, inventory management software, and other database software enable salespeople to manage the records of products, competitors, and customers in timely manner. Hence, salespeople using SFA tools will be more organized and able to complete their schedules on time (Ahearne, Jelinek, and Rapp 2005). One key representation of salespeople’s efforts to realize their job objectives is the activity through which they complete their tasks (Brown and Peterson 1994). The use of SFA reduces â€Å"the amount of time spent on such activities as managing contacts, scheduling sales calls, developing sales plans, and planning sales routes† (Widmier, Jackson, and McCabe 2002, p. 190). Also, salespeople using SFA tools can cut down work hours doing paperwork and other reporting-related tasks (Colombo 1994; Parathasarathy and Sohi 1997). Importantly, these administrative tasks (e.g., sales reporting) are non-customer-centric activities (Geiger and Turley 2006);  however, salespeople spend many hours completing them. Thus, reductions in such activities, with the help of SFA, will provide salespeople with an opportunity to reduce their working ho urs. Formally stated,  Hypothesis 1: Relative to salespeople reporting lower use of SFA, salespeople reporting higher use of SFA will report fewer hours of work. Underlining the importance of CRM usage, Ahearne, Jelinek, and Rapp (2005) argued that such technology tools aid salespeople by managing information about a larger number of customers. Salespeople equipped with such valuable information are able to relate to customers without as much difï ¬ culty and can be more responsive to critical issues, thereby shortening the duration of each sales encounter. They will also complete tasks with less effort (Ahearne, Jelinek, and Rapp 2005). Mostly, CRM tools make customers’ cross-referencing possible among different departments within an organization that can generate more sales potential and reduce efforts by evading multiple attempts on the same prospective clients (Widmier, Jackson, and McCabe 2002). Moreover, the use of CRM tools will ease the processes of presale planning activities and improve the accuracy of sales forecasts, speeding up the overall sales process (Hunter and Perreault 2006). Parallel to this thought, it is pragmatic to think that salespeople using CRM tools will not ï ¬ nd examining customer data to be an overly complex and time-consuming process. Moreover, they can promptly focus on vital information, which, in turn, enables them to develop winning strategies in shorter time. We believe that salespeople equipped with CRM technology will be able to conserve their efforts by speeding the process of strategy development. CRM use will help salespeople conï ¬ gure product offerings per customer stipulations without showing extra efforts (Widmier, Jackson, and McCabe 2002). Under these circumstances, salespeople will be able to decrease their efforts by investing less time in the formulation of customer relationship strategies, reducing backorders, and lessening the number of calls required to ï ¬ nalize a sale (Columbo 1994; Thetgyi 2000). Based on this, we hypothesize: Hypothesis 2: Relative to salespeople reporting lower use of CRM, salespeople reporting higher use of CRM will report fewer hours of work. Adaptive Selling Adaptive selling is  deï ¬ ned as â€Å"engaging in planning to determine the suitability of sales behaviors and activities that will be undertaken, the capacity to engage in a wide range of selling behaviors and activities, and the alteration of sales behaviors and activities in keeping with situational considerations† (Sujan, Weitz, and Kumar 1994, p. 40). In more ge neral terms, adaptive selling can be deï ¬ ned as an approach to personal selling in which selling behaviors are altered during the sales interaction or across customer interactions, based on information about a customer and nature of the selling situation. Acquisition, analysis, and use of customer information are particularly important for salespeople in demonstrating adaptive selling behaviors (Weitz, Sujan, and Sujan 1986). Moreover, if salespeople have precise customer information, they will be more capable of practicing such behaviors (Hunter and Perreault 2006). CRM tools can also aid salespeople in tracking customer purchase patterns and enabling them to recognize potentially viable customers. Salespeople, with the help of CRM technology, can obtain critical customer information to successfully plan an effective sales encounter (Ahearne et al. 2008). CRM tools will be useful for keeping salespeople informed as well as for developing, implementing, or revising sales planning. Such customer database systems provide opportunities to meticulously research customers and design their sales presentations according to particular customer needs and wants (Marshall, Moncrief, and Lassk 1999). Equipped with sound customer information, salespeople will better anticipate customer responses, prepare appropriate ways to meet customer needs, and overcome customer objections. We propose that CRM tools provide access to customer information that enables salespeople to improve or enhance their adaptive selling skills. Based on this argument, we hypothesize: Hypothesis 3: Salespeople’s use of the CRM technology will be positively related with their adaptive selling behaviors. Experience as a Moderator Salesperson’s experience has been deï ¬ ned as a composite of three different areas: the employee’s general sales experience, the amount of time spent working with their current company, and the time spent in their territory (Rapp et al. 2006). Previous studies document the positive relationship of experience with different individual outcomes. For example,  individual’s performance adaptability has been associated positively with greater amounts of rel evant work experience (Pulakos et al. 2000). It has been argued that individuals seeking knowledge usually carry dissimilar wants and expectations (Markus 2001). This idea is especially applicable in a personal selling context, where no single formula or approach can guarantee success of every salesperson. Salespeople with different breadth and depth of experience will have different abilities and expectations. Within this research study, we suggest that less-experienced salespeople, even if they use sales technology tools (i.e., SFA and CRM), will be less likely to exploit such tools in a better way, relative to more experienced salespeople. Importantly, our research differs from the previous work of Ko and Dennis (2004) in that we examine different dimensions of technology use as well as behavioral outcomes of the technology/experience interaction rather than outcome-based performance. Thus, our hypotheses differ according to our proposed arguments.  Sales researchers agree that the uses of CRM technology tools are essential for making customer alliances; however, individual characteristics can affect this process (Jones, Sundaram, and Ch in 2002). Because CRM is used in crafting customer relationship strategies, salespeople’s experience will play a critical role in the relationship between CRM utilization and adaptive selling behaviors. CRM will provide valuable customer information; however, to be successful in utilizing such information, salespeople need to have a â€Å"deep base of organizational, contextual, and domain knowledge† (Ko and Dennis 2004, p. 313) and be well versed in handling difï ¬ cult objections. Salespeople with relatively less experience will have had less exposure to the capabilities of CRM tools, and a lower level of understanding about adaptive selling. With the lack of knowledge regarding various tasks and selling situations, less-experienced salespeople will be less capable of exploiting the rich data available in a CRM repository. Experienced salespeople are more likely to maintain focus on the task-related  activities, identify and realize the link between CRM tools utilization an d adaptive selling behaviors, and smartly engage in activities relevant to task completion. To sum, we argue that more-experienced salespeople will employ information toward formulating plans in a better way that helps them to practice adaptive selling than those salespeople with less experience. Based on these arguments, we propose that Hypothesis 4: The relationship between use of CRM and adaptive selling will be more positive for employees who report higher levels of experience, as compared to those who report lower levels of experience. In the case of technology use, it has been argued that the inï ¬â€šuence of technology is moderated by contextual variables (Orlikowski 1992). It seems especially true in a situation where technology is being used as a tool to formulate strategies or as a medium to support routine tasks. Experienced salespeople are more likely to have created an optimal schedule (i.e., necessary efforts required to accomplish maximum output), and given the strategic utilization of CRM, they can further cut down their efforts to achieve sales objectives. Consistent with the arguments of Hunter and Perreault (2006), we argue that more-experienced salespeople have learned the necessary skills to execute different activities. We also suggest that moreexperienced salespeople have discovered ways to reduce their levels of effort while maintaining their higher levels of performance, relative to those with less experience. Importantly, for those who have already adopted technology, more-experienced sales representatives will feel the greatest inï ¬â€šuence on their behavioral outcomes. Formally stated, Hypothesis 5: The relationship between use of CRM and effort will be more negative for employees who report higher  levels of experience, as compared to those who report lower levels of experience. Salesperson Performance In a general sense, job performance is an outcome of effort and strategy (Bandura 2002). Sales literature has recognized the signiï ¬ cance of salesperson efforts in different theoretical frameworks of performance (Walk er, Churchill, and Ford 1977) and proposed a signiï ¬ cant positive relationship between effort and adaptive selling behaviors and salesperson’s productivity (Sujan, Weitz, and Sujan 1988). Previous literature enjoys a relatively wide consensus about the critical role of effort and adaptability in achieving high performance objectives. To  this point, numerous researchers have examined the links between performance and adaptive selling and effort (Anglin, Stohlman, and Gentry 1990; Brown and Peterson 1994; Goolsby, Lagace, and Boolrom 1992; Holmes and Srivastava 2002; Predmore and Bonnice 1994; Sujan, Weitz, and Kumar 1994). Within this research study, we revisit these links and offer that, parallel to previous ï ¬ ndings, both salesperson behaviors of adaptive selling and effort will demonstrate unique positive relationships with their performance. Hypothesis 6: Salesperson effort will be positively related with salesperson performance. Hypothesis 7: Salesperson adaptive selling behaviors will be positively related with salesperson performance. RESEARCH METHOD Sample Our sample was drawn from the human health-care segment of a medium-sized pharmaceutical company. Data were collected from three separate sources in the form of salesperson surveys, manager surveys, and archival job performance data from company records. Sales representatives in this ï ¬ rm were responsible for marketing directly to physicians within a speciï ¬ c geographical area. All sales representatives were responsible for a particular portfolio of products and completed training for each product line. In sum, 900 sales representatives of the human health-care division of the company were contacted for this study. Usable survey responses were obtained from 662 (74 percent) of the representatives and from 60 different sales managers. There was an average of 11 sales representatives per manager. Respondents completed and returned a questionnaire mailed directly to them by the researchers. Management’s strong endorsement of questionnaire completion via e-mail and telephone, coupled with two waves of mailings, led to the high  response rate. The sample was 40 percen t male, the average age was 34.9 (standard deviation [SD] = 4.6), and 91 percent reported their ethnicity as Caucasian. Measures Use of SFA SFA usage was assessed by the sales representative using a fouritem scale. The scale asked sales representatives the amount of usage on four speciï ¬ c SFA applications. All four items were representative of tasks that helped salespeople streamline or automate some of the basic processes and functions of the sales tasks. Item responses were  anchored by (1) â€Å"I do not use this technology at all† and (7) â€Å"I use this technology to a great extent.† The scale demonstrated acceptable reliability (ÃŽ ± = 0.72). See the Appendix for a complete list of scale items. Use of CRM Similar to the above, CRM usage was assessed by asking the salesperson four questions regarding his or her use of technologies that helped manage customer relationships. These questions were speciï ¬ c to the software and database applications that the ï ¬ rm had in place. Again, item responses were anchored by (1) â€Å"I do not use this technology at all† and (7) â€Å"I use this technology to a great extent.† The scale demonstrated acceptable rel iability (ÃŽ ± = 0.75). Effort Salesperson effort was measured as a self-report item assessing average number of hours worked per week. Although not an ideal evaluation tool, this approach is similar to other research that has demonstrated that self-report evaluations are often representative of objective measures of evaluations (Sharma, Rich, and Levy 2004). Adaptive Selling Adaptive selling was measured using a shortened four-item scale stemming from the adaptive selling scale originally developed by Spiro and Weitz (1990). Items were adapted slightly to ï ¬ t the speciï ¬ c selling context. This measure was assessed by the sales manager and exhibited strong reliability (ÃŽ ± = 0.90). In this setting, sales managers have frequent contact with their salespeople. By meeting with sales representatives, conducting customer follow-up visits, and participating in ride-alongs, we argue that the sales manager can observe the behavior of the salesperson, in this circumstance, adaptive selling tendencies. Experience Experience was a composite measure consisting of three separate measures of sales experience. Sales representatives were questioned about the length of time they had worked in their territory, for their company, and in a sales ï ¬ eld. These scores were each z-scored and then averaged to form an overall experience index. Salesperson Performance We operationalized salesperson performance as the outcomebased measure of percentage of quota. Percentage of quota achieved is deï ¬ ned as the total sales brought to a close by a salesperson relative to the sales organization’s sales targets for that individual. Percent of quota, or total sales divided by expected sales target, is a strong measure of sales representative performance because it controls for some potential contaminating factors such as territory size  (Churchill et al. 1985). Sales representatives’ quotas are annually set by a consulting company, in conjunction with corporate sales management, and are based on market information and company records. Quotas are discussed with sales representatives to ensure that the representatives understand the methods used to set their annual quotas. Analytical Strategy We analyzed our data using a covariance-based structural equation modeling package, AMOS 5.0 (Arbuckle 1997). In evaluating this model, we followed the procedures recommended by Anderson and Gerbing (1988). First, we conducted a conï ¬ rmatory factor analysis (CFA) to examine the adequacy of the measurement component of the proposed model and evaluate discriminant validity. After ensuring an appropriate ï ¬ t, we then derived the full structural model from our hypotheses. To gauge model ï ¬ t, we report the comparative ï ¬ t index (CFI) (Bentler 1990) and the standardized root mean square residual (SRMR) (Hu and Bentler 1999). The CFI has been identiï ¬ ed as a strong approximation of the population value for a single model, with values ≠¥ 0.90 considered indicative of good ï ¬ t. SRMR is a measure of the standardized difference between the observed and unobserved covariance and predicted covariance, with values ≠¤ 0.08 considered a â€Å"relatively good ï ¬ t for the model,† and values ≠¤ 0.10 considered â€Å"fair† (Hu and Bentler 1999). Based on an exploratory and follow-up CFA, we determined that all items loaded signiï ¬ cantly on their respective factors and no cross-loadings were present. Each indicator exhibited a highly signiï ¬ cant estimate (p 0.001), which suggests high convergent validity (Gerbing and Anderson 1988). Also, discriminant validity was assessed according to the Fornell and Larcker (1981) suggested approach. By examining the amount of variance extracted for each of the latent constructs and comparing this to the squared correlations among the constructs, we found that the shared variance among any two constructs was always less than the average variance explained by the construct, which suggests that discriminant validity has been achieved. Finally, because four of the variables were collected from the same source,  we conducted checks for common method variance, which could inï ¬â€šate any observed correlations between the dependent and independent variables. As suggested by Grifï ¬ th and Lusch (2007), we used a CFA approach to assess Harman’s one-factor test. To do this, one would create a single latent factor for all same-source indicators as an alternative explanation to our results. Based on our analysis, our measurement model ï ¬ t yielded a χ2 of 295.61 (88), p 0.01; CFI = 0.93; SRMR = 0.04. By ï ¬ tting the same-source factor model, our ï ¬ t was signiï ¬ cantly worse with a χ2 of 789.53 (101); p 0.01; CFI = 0.77; SRMR = 0.08. Second, we employed the partial correlation procedure of including a marker variable (i.e., a variable not theoretically related to at least one other variable in the study). By using a measure of sales ethics as the marker variable, we found no signiï ¬ cant relationships to other variables in the model. These analyses indicate that our structural equation analysis is not as susceptible to an inherent common method bias in the responses to the survey. Table 1 provides descriptive statistics and pairwise correlations for this study. As mentioned, model ï ¬ t for the measurement model was good (χ2 = 295.61 (88), p 0.01; CFI = 0.93; SRMR = 0.04). Next, we ï ¬ t a linear effects model that amounts to the hypothesized model depicted in Figure 1 minus the two interactions (i.e., H4 and H5). This model was ï ¬ t in order to test the linear relationships. This model also serves as a baseline model for tests of the interactions. Notably, the linear relationships between experience and both adaptive selling and effort, although not hypothesized, were included in this model so as to serve as a baseline for the hypothesized model. To test the interaction effects, CRM usage and experience were both mean-centered (by virtue of using z-scores) so as to reduce effects of multicollinearity. We then calculated a multiplicative interactive term between the two variables and ï ¬ t a second model that included this product as an antecedent of both effort and adaptive selling. Because the linear effects model is nested in the hypothesized model, a signiï ¬ cant Δχ2 between them indicates that one or both of the interactions are signiï ¬ cant (Cortina, Chen, and Dunlap 2001). To note, we speciï ¬ ed the relationship between the observed scores and their respective latent variables by ï ¬ xing the measurement error terms for each co nstruct at (1 – rxx) times the variance of each scale score. Following procedures advanced by Mathieu, Tannenbaum, and Salas (1992) and supported  by Cortina,  Chen, and Dunlap (2001), the reliability of the interaction term was estimated using the formula presented by Bohrnstedt and Marwell (1978). RESULTS We derived the full structural model from our hypotheses. Structural model ï ¬ t was within acceptable limits (χ2 = 240.21 (95), p 0.01; CFI = 0.95; SRMR = 0.04) (see Table 2). Although the χ2-statistic is signiï ¬ cant, it is not always the best indication of model ï ¬ t (e.g., Bagozzi and Yi 1988), because it has the drawback of being sensitive to sample size and the number of parameters in the model. Notably, our initial ï ¬ ndings show that SFA usage is negatively related to effort (H1: ÃŽ ² = –0.123, p 0.05) and that CRM usage does not have a negative relationship with effort as originally hypothesized (H2: ÃŽ ² = 0.091). As expected, the linear effect of CRM usage to adaptive selling was positive and signiï ¬ cant (H3: ÃŽ ² = 0.122, p 0.05). Finally, although not hypothesized, the linear effect of experience to effort (ÃŽ ² = 0.166, p 0.01) and adaptive selling (ÃŽ ² = 0.106, p 0.05) were both signiï ¬ cant. Next, we tested the hypothesized model. By adding the interaction terms, we found that the model demonstrated an excellent ï ¬ t (χ2 = 233.53 (93), p 0.01; CFI = 0.95; SRMR = 0.04) and was a signiï ¬ cant improvement over the linear effects model (Δχ2 (2) = 6.68, p 0.05). The moderating effect of experience on CRM usage to effort was not present (H5: ÃŽ ² = 0.083); however, the moderating inï ¬â€šuence of experience on the relationship between CRM and adaptive selling was evident (H4: ÃŽ ² = 0.112, p 0.05). The ï ¬ nal portion of our model examined both adaptive selling and effort as predictors of salesperson performance. We found that both effort (H6: ÃŽ ² = 0.115, p 0.05) and adaptive selling (H7: ÃŽ ² = 0.086, p 0.05) had signiï ¬ cant relationships with performance. As a post hoc analysis, we included experience as an additional predictor of performance and found that it exhibited a signiï ¬ cant relationship (ÃŽ ² = 0.107, p 0.05), while not changing the levels of signiï ¬ cance of the other two variables. The proportions of variance of the endogenous variables accounted for were as follows: R ²Effort = 0.047; R ²Adaptive selling = 0.034; and R ²Performance = 0.031. To interpret the nature of the interaction, we plotted it using standard practices (Aiken and West 1991). Speciï ¬ cally, using the information from the moderated regression analysis, we plotted the relationship between  CRM usage that correspond to the average, low (one SD below the mean) and high (one SD above the mean) values of the experience moderator (see Figure 2). Corresponding to our expectations, we ï ¬ nd that CRM usage has a positive linear effect on adaptive selling and that increased levels of experience enhance this relationship as demonstrated by the steeper slope (more positive) for high-experience salespeople.

Binge eating disorder Essay Example for Free

Binge eating disorder Essay Binge eating disorder (BED) is characterized by recurrent episodes of binge eating not accompanied by inappropriate compensatory behaviors. Although it is not yet officially recognized, it was included in the current Diagnostic and Statistical Manual of Mental Disorders (DSM) as a disorder to be studied, with research criteria included. It is also slated to be included in the next DSM as one of the officially recognized eating disorders. There have been several treatment modalities employed in its treatment: pharmacotherapy, psychotherapy, and a combination of the two. Being a â€Å"young† disorder, BED still needs future research to show which modality treats it best in the long run. Approaches to Treatment of Binge Eating Disorder What Is BED? How Is It Different From Bulimia Nervosa? Binge eating disorder (BED) is characterized by recurrent episodes of binge eating not accompanied by inappropriate compensatory behaviors (Sadock Sadock, 2003). Although binge eating, by itself, is more commonly associated with bulimia nervosa, binge eating disorder is recognized as a separate entity. Unlike BED, bulimia nervosa involves excessive concern with body shape and weight, and bulimics often have a â€Å"self-perception of being too fat, with an intrusive dread of fatness† (World Health Organization [WHO], 1993). Moreover, the absence of compensatory behaviors further distinguishes BED from the non-purging type of bulimia nervosa, which is defined by the Diagnostic and Statistical Manual of Mental Disorders, or DSM-IV, as when the individual â€Å"has used other inappropriate compensatory behaviors, such as fasting or excessive exercise, but has not regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas† (American Psychiatric Association [APA], 2000). Diagnosis of Binge Eating Disorder Although binge eating disorder still has to gain official recognition, the Text Revision of DSM-IV (APA, 2000) lays down the following â€Å"research criteria† for diagnosing the disorder: A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following: (1) eating, in a discrete period of time (e. g. , within any 2-hour period), an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances (2) the sense of lack of control over eating during the episode (e. g. , a feeling that one cannot stop eating or control what or how much one is eating) B. Binge-eating episodes are associated with three (or more) of the following: (1) eating much more rapidly than normal (2) eating until feeling uncomfortably full (3) eating large amounts of food when not feeling physically hungry (4) eating alone because of being embarrassed by how much one is eating (5) feeling disgusted with oneself, depressed, or very guilty after overeating C. Marked distress regarding binge eating is present. D. The binge eating occurs, on average, at least 2 days a week for 6 months. E. The binge eating is not associated with the regular use of inappropriate compensatory behaviors (e. g. , purging, fasting, excessive exercise, etc. ) and does not occur exclusively during the course of anorexia nervosa or bulimia nervosa. Several issues have been raised regarding the criteria mentioned above. For example, one question raised by some experts in the field is that there is no definite way to assess just how much food constitutes â€Å"an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances. † Fulfilling these criteria would at best be a subjective process. While the DSM-IV criteria for BED is usually applied to adults, Marcus and Kalarchian (2003) have proposed a separate set of provisional research criteria for diagnosing BED in children. These are: A. Recurrent episodes of being eating. An episode of binge eating is characterized by both of the following: (1) food seeking in absence of hunger (e. g. after a full meal) (2) a sense of lack of control over eating (e. g. , endorse that ‘‘When I start to eat, I just can’t stop’’) B. Binge episodes are associated with one or more of the following: (1) food seeking in response to negative affect (e. g. , sadness, boredom, restlessness) (2) food seeking as a reward (3) sneaking or hiding food C. Symptoms persist over a period of 3 months. D. Eating is not associated with the regular use of inappropriate compensatory behaviors (e. g. , purging, fasting, excessive exercise) and does not occur exclusively during the course of anorexia nervosa or bulimia nervosa. Some of the questionnaires used to diagnose binge eating disorder are: the Binge Eating Scale (BES), the Three Factor Eating Questionnaire, the Body Shape Questionnaire, the Structured Clinical Interview for the Diagnosis of DSM Disorders (SCID), and the Eating Disorders Examination (EDE). The Treatment of Binge Eating Disorder Overview In the management of BED, the primary goal is to achieve abstinence from binge eating (Bulik, Brownley Shapiro, 2007). However, studies have shown that BED has comorbid conditions that require as much attention, such as depression, generalized anxiety disorder, panic attacks and even attempts at suicide (Grucza, Przybeck Cloninger, 2007). Furthermore, since patients diagnosed with BED do not usually engage in inappropriate compensatory behaviors, they are usually obese as well, a condition that sometimes causes more concern in professionals caring for BED patients because of its health implications. Because of the different aspects of this disorder, different treatment modalities are being used, with some experts favoring one and others favoring another. Pharmacotherapy Medications used to treat binge eating disorder include appetite suppressants, anticonvulsants, selective serotonin and norepinephrine reuptake inhibitors, and tricyclic antidepressants. These have been studied in double-blind placebo-controlled trials, and the results, though modest, have been promising (Appolinario McElroy, 2004). Appetite suppressants. According to Appolinario, Bacaltchuk, Sichieri, Claudino, Godoy-Matos, Morgan, Zanella Coutinho (2003), fenfluramine hydrochloride was the first antiobesity agent shown to be effective in treating binge eating disorder. However, this drug has been withdrawn from the market because of intolerable side effects. Currently, the anti-obesity agent that seems to be the most studied in the treatment of BED is sibutramine. Sibutramine is a drug that inhibits the reuptake of serotonin, norepinephrine, and, to some extent, dopamine. A study by Appolinario et al. (2003) showed that patients taking sibutramine, as opposed to those given a placebo pill, experienced a significant reduction in the number of days with binge episodes. Whereas those in the placebo group actually gained some weight, the patients given sibutramine lost an average of 7. 4 kg. The study participants were asked to fill out the Binge Eating Scale and the Beck Depression Inventory before and after their treatment program, and the sibutramine group had significantly lower scores after treatment. The study cites dry mouth and constipation as the adverse reactions commonly encountered by those taking sibutramine. The authors concluded that sibutramine is effective and well tolerated for treating obese BED patients. Another study supporting the use of sibutramine in BED was published in the American Journal of Psychiatry in January 2008. Wilfley, Crow, Hudson, Mitchell, Berkowitz, Blakesley, Walsh, and the Sibutramine Binge Eating Disorder Research Group (2008) found that patients taking sibutramine (15 mg daily for 24 weeks) were able to significantly reduce the following measures: weekly binge frequency, weight (mean of 4. 3 kg), frequency of binge days, body mass index, and eating pathology, such as cognitive restraint, disinhibition and hunger. Moreover, these patients also experienced global improvement and had a greater percentage of abstinence from binge eating (58. 7%, compared with the 42. 8% of the placebo group). Anticonvulsants. In the February 2003 edition of the American Journal of Psychiatry, McElroy, Arnold, Shapira, Keck, Rosenthal, Karim, Kamin Hudson (2003) reported that 30 patients with binge eating disorder randomly assigned to receive a flexible dose (25 to 600 mg per day) of the anticonvulsant drug topiramate had a significantly greater rate of reduction in binge frequency, binge day frequency, weight (mean loss of 5. 9 kg), and body mass index. They also had lower scores on the Yale-Brown Obsessive Compulsive Scale, which was modified for binge eating, and on the Clinical Global Impression severity scale. However, six patients receiving topiramate were unable to continue participating in the study because of adverse events, mostly headaches and paresthesias. The researchers concluded that topiramate was useful for the short-term treatment of BED. The journal Biological Psychiatry also published a study by McElroy, Hudson, Capece, Beyers, Fisher, Rosenthal, and the Topiramate Binge Eating Disorder Research Group (2007), which showed that 195 patients taking topiramate were able to reduce binge eating days per week, binge episodes per week, weight (mean loss of 4. 5 kg), and body mass index compared with those assigned to take placebo. Thirty percent of those taking topiramate left the study, mostly due to adverse effects such as paresthesia, upper respiratory tract infection, somnolence and nausea. However, thirty percent of those taking the placebo pill also were not able to continue with the program. Despite the adverse events reported, the authors concluded that topiramate is well tolerated and was efficacious in treating BED and its features, particularly obesity. Another antiepileptic drug that was evaluated for efficacy in the treatment of binge eating disorder is zonisamide. McElroy, Kotwal, Guerdjikova, Welge, Nelson, Lake, D’Alessio, Keck Hudson (2006) reported in the Journal of Clinical Psychiatry that thirty patients given zonisamide (100 to 600 mg per day for 16 weeks) had a reduction in the frequency of their binge eating episodes, body weight, body mass index, and scores on the Yale-Brown Obsessive Compulsive Scale Modified for Binge Eating and the Clinical Global Impressions Severity Scale. Eight of the patients receiving zonisamide discontinued treatment because of accidental injury with bone fracture, psychological complaints and cognitive complaints. In conclusion, the researchers noted that zonisamide was efficacious in treatment of BED with obesity but that it was not well tolerated. Selective serotonin reuptake inhibitors (SSRIs) and norepinephrine reuptake inhibitors. Several selective serotonin reuptake inhibitors have been shown to have beneficial effects in the management of binge eating disorder. Among the earliest SSRI’s shown to be useful in BED treatment was fluvoxamine. Hudson, McElroy, Raymond, Crow, Keck, Carter, Mitchell, Strakowski, Pope, Coleman Jonas (1998) reported that forty-two patients who received a flexible dose of fluvoxamine (50 to 300 mg) for 9 weeks had a significantly greater decrease in the frequency of binges and in body mass index. Furthermore, these patients given fluvoxamine achieved a greater reduction in Clinical Global Impression severity score and a greater rate of increase in Clinical Global Impression improvement scores. However, fluvoxamine did not have a significant effect on the participants’ Hamilton depression scale scores, and the proportion of patients who dropped out of the study because of adverse effects came from the fluvoxamine group. Furthermore, another study done 5 years later on a different, smaller set of patients showed that there was a reduction in binge frequency, eating concern, shape concern and weight concern in both the group receiving fluvoxamine and the group receiving placebo (Pearlstein, Spurell, Hohlstein, Gurney, Read, Fuchs Keller, 2003). The authors say this is just an example of the â€Å"inconsistent results of antidepressant studies in binge eating disorder† (Pearlstein et al. , 2003). Another SSRI shows greater promise. McElroy, Hudson, Malhotra, Welge, Nelson Keck (2003) conducted a 6-week, double-blind, flexible-dose (20 to 60 mg per day) study on the efficacy of citalopram in reducing the frequency of binge eating episodes. They reported that the 19 patients receiving citalopram, compared with those receiving placebo, had a significantly greater rate of reduction in the frequency of binge eating episodes, frequency of binge days, weight, body mass index and severity of illness. In addition, citalopram was said to be well tolerated by the participants of the study. A head-to-head comparison of two SSRI’s – sertraline and fluoxetine – was conducted by Leombruni, Piero, Lavagnino, Brustolin, Campisi Fassino (2008) and published in the journal Progress in Neuro-psychopharmacology and Biological Psychiatry. Twenty-two participants were given 100 to 200 mg of sertraline daily, while twenty were given 40 to 80 mg of fluoxetine per day. After 8 weeks, participants from both groups had significant weight loss and their scores in the Binge Eating Scale improved. There was no significant difference found between the two drugs, and the researchers concluded that both SSRI’s are effective options in treating patients with BED. A drug that inhibits both serotonin and norepinephrine reuptake was studied by Noma, Uwatoko, Yamamoto Hayashi (2008). Although the trial did not focus exclusively on individuals with binge eating disorder but consisted of 25 binge eaters, some of whom were diagnosed with anorexia or bulimia nervosa. These patients received the drug milnacipran for 8 weeks and were found to have improved scores in relation to their drive for binge eating and regret for the same. Milnacipran was noted to be more effective in patients without purging. Venlafaxine, another medication that inhibits the reuptake of both serotonin and norepinephrine, was mentioned by Appolinario et al. (2003) as effective in BED therapy. McElroy, Guerdjikova, Kotwal, Welge, Nelson, Lake, Keck Hudson (2007) examined the effects of atomoxetine, a norepinephrine reuptake inhibitor, on BED. Twenty patients who received the drug had a significant decrease in binge-eating episode frequency, binge day frequency, weight, and body mass index. Their scores on the Clinical Global Impressions Severity of Illness scale, the Yale-Brown Obsessive Compulsive Scale Modified for Binge Eating obsession subscale, and the Three Factor Eating Questionnaire hunger subscale improved as well. However, three of the patients receiving atomoxetine asked to discontinue their treatment because of increased depressive symptoms, constipation or nervousness. Tricyclic antidepressants. Bulik, Brownley Shapiro (2007), in a review of the diagnosis and management of binge eating disorder, also mentions imipramine as one of the drugs that were shown in trials to be effective in the treatment of BED. Imipramine is a tricyclic antidepressant that is used mainly for the treatment of depression and enuresis. A drug from the same family, desipramine, was also mentioned as having beneficial effects in BED. There have indeed been many drugs explored by research for the treatment of binge eating disorder. However, while a lot of studies show that they do have a beneficial effect on patients with BED, particularly with regards to a reduction in binge frequency and weight, the results are somewhat modest. In addition, there have been no long-term studies tracking the efficacy of these drugs as yet. And then, of course, there is the concern that many of those individuals taking these drugs might give them up due to the adverse effects they cause. More importantly, the drugs do not address the underlying cause of binge eating, the psychopathology in individuals that lead them to take in large amounts of food despite the knowledge that doing so could harm them physically and socially. Thus, while many experts in the field would agree that medications help to curb the comorbidities of BED, they still encourage the use of psychotherapy. Psychotherapy Cognitive behavioral therapy. The behavioral therapeutic approach to binge eating disorder that is probably the most tested is cognitive behavioral therapy, or CBT (Bulik, Brownley Shapiro, 2007). As the name implies, the theory behind this practice is the cognitive behavioral model of binge eating, which â€Å"postulates that binge eating develops in response to restrictive food intake and occurs in the context of ongoing dietary restraint and the experience of negative emotions† (Levine Marcus, 2003). In short, inaccurate thoughts and beliefs – for example, those about body shape and weight – lead to inappropriate eating behavior. CBT helps patients identify these binge-triggering thoughts and modify them so as to accomplish binge abstinence. According to Bulik, Brownley Shapiro (2007), cognitive behavioral therapy has been reported by several studies to be effective in reducing â€Å"binge frequency, related psychological aspects of binge eating (restraint, disinhibition, and hunger), depressed mood, and ratings of illness severity in individuals with BED. † Levine Marcus (2003) note that, while cognitive behavioral therapy has been traditionally used in the management of individuals with bulimia nervosa, the technique has been modified to accommodate the differences between bulimia nervosa and binge eating disorder. For example, unlike people with bulimia nervosa, those with binge eating disorder tend to be obese, so CBT can directly target cognitions about having a large body size. They explain, â€Å"Overweight individuals with BED may be helped to accept their body size and to restructure maladaptive thoughts about the amount of weight loss they are likely to achieve. That is, although modest weight loss may relate to improvements in binge eating, for most BED patients this decrease may not correspond with their desired weight loss. It is therefore important that cognitions about acceptable body sizes be targeted during treatment. † Interpersonal psychotherapy. Another type of therapy that has found success in patients with bulimia nervosa and has since been also applied to people with binge eating disorder is interpersonal psychotherapy, or IPT. While CBT focuses on the thoughts that trigger eating binges, interpersonal psychotherapy operates on the theory that binge eating stems from the internal milieu created by specific social and interpersonal problems. Thus, it â€Å"focuses on identifying and addressing specific, problematic interpersonal patterns, in an effort to ameliorate dysfunctional eating behaviors† (Levine Marcus, 2003). As with CBT, IPT is focused, structured and time-limited. However, it does not address the patient’s beliefs about eating, weight and shape and, unlike CBT, does not directly target eating behaviors. In the Archives of General Psychiatry, Wilfley, Welch, Stein, Spurrell, Cohen, Saelens, Dounchis, Frank, Wiseman Matt (2002) report on a comparative study that they conducted between CBT and IPT. Both were done in a group setting, and the participants in each group went through 20 weekly sessions of therapy. Results showed that â€Å"binge-eating recovery rates† were similar for both CBT and IPT immediately after treatment. They further conducted follow-up on each participant and noted that, while, there was a slight increase in binge eating when the treatment ended, the frequency of such binges remained significantly lower than the frequency prior to initiation of either CBT or IPT. In addition, the researchers reported significant reductions in psychiatric symptoms, and these were maintained through follow-up. They noted that, while dietary restraint decreased more quickly in patients who underwent CBT, a similar level of dietary restraint was accomplished by those who underwent IPT by the time of follow-up. The participants’ weight decreased only slightly, but significantly, and the authors then concluded that group IPT is a reasonable alternative to group CBT for dealing with overweight BED patients. Dialectical behavior therapy. Another type of therapy used for the treatment of BED is dialectical behavior therapy, or DBT. This is described by Levine Marcus (2003) as â€Å"a comprehensive treatment program based on cognitive and behavioral principles and complemented by the use of acceptance-based strategies derived primarily from Zen Buddhism. † Patients undergo a weekly individual outpatient therapy and, at the same time, a weekly group skills therapy that has the goal of increasing behavioral skills that can help them deal with binge eating. According to Bulik, Brownley Shapiro (2007), dialectical behavior therapy â€Å"fosters the development of skills in the domains of mindfulness, emotion regulation, interpersonal effectiveness, and distress tolerance. † Although it is still considered an â€Å"alternative† form of behavior therapy, there have been studies showing that DBT has led to a greater reduction in binge days, binge episodes, and concerns with weight, shape and eating. Other behavioral therapies. Aside from cognitive behavior therapy, interpersonal psychotherapy and dialectical behavior therapy, Bulik, Brownley Shapiro (2007) mention self-help, exercise and virtual reality therapy as treatment modalities that have been tried in patients with BED. Self-help interventions are delivered in various formats, and may be done with or without structure, and with out without the aid of a facilitator or a therapist. It has been shown by some studies to result in greater reductions in the mean number of binge days and in the clinical severity of BED. Abstinence and cessation rates were also reported to be improved with self-help, but weight loss was not significantly achieved. Medications and Psychotherapy: Combined and Compared Several studies have explored the option of combining pharmacotherapy with psychotherapy. Bulik, Brownley Shapiro (2007) discuss the results of these studies. For example, a trial compared fluoxetine alone with CBT alone and fluoxetine plus CBT. The authors of that trial reported that CBT plus fluoxetine, and CBT alone, were more effective than fluoxetine alone in reducing the frequency of binges, concerns with eating and body shape, disinhibition and depression. Another comparison discussed in the same paper compared desipramine alone, weight loss therapy, and CBT. Bulik, Brownley Shapiro (2007) relate: â€Å"Binge eating was significantly reduced after 12 weeks in both groups receiving CBT; however, this effect did not persist at 36 weeks of treatment. Average weight loss was greatest in the weight loss therapy group in the early stages of treatment, but over time (i. e. , at 3-month follow-up) the group receiving desipramine lost the most weight. Desipramine showed no clear advantage in reducing symptoms of depression. † Claudino, de Oliveira, Appolinario, Cordas, Duchesne, Sichieri Bacaltchuk (2007) compared topiramate alone with CBT plus topiramate and concluded that â€Å"topiramate added to CBT improved the efficacy of the later, increasing binge remission and weight loss in the short run. Topiramate was well tolerated, as shown by few adverse events during treatment. † Finally, Molinari, Baruffi, Croci, Marchi Petroni (2005) conducted a comparison of CBT alone, fluoxetine alone, and CBT plus fluoxetine. Results showed that â€Å"the two groups which underwent psychotherapy resulted in a better outcome in terms of number of bingeing episodes, maintenance of weight loss reduction from baseline and psychological well being than the group treated with pharmacological therapy alone. † The authors concluded that the results of their study highlight the importance of a multidisciplinary approach to binge eating disorder. However, as with pharmacotherapy alone and with psychotherapy alone, the long-term efficacy of a combined drugs-and-talk approach to binge eating disorder still has to be proven by future studies. Practical Advice To Tell Patients Empowering patients to take control of their disorder is also important. Smith, Barston, Segal Segal (2008) offer the following tips that concerned eating disorder professionals can give their patients: †¢ Eat breakfast. Skipping breakfast often leads to overeating later in the day, so start your day right with a healthy meal. Eating breakfast also jump starts your metabolism in the morning. Studies show that people who eat breakfast are thinner than those who don’t. †¢ Avoid temptation. You’re much more likely to overeat if you have junk food, desserts, and unhealthy snacks in the house. Remove the temptation by clearing your fridge and cupboards of your favorite binge foods. †¢ Stop dieting. The deprivation and hunger of strict dieting can trigger food cravings and the urge to overeat. Instead of dieting, focus on eating in moderation. Find nutritious foods that you enjoy and avoid labeling foods as â€Å"good† or â€Å"bad. † †¢ Exercise. Not only will exercise help you lost weight in a healthy way, but it also lifts depression, improves overall health, and reduces stress. The natural mood-boosting effects of exercise can help put a stop to emotional eating. †¢ Destress. Learn how to cope with stress in healthy ways that don’t involve food. Conclusion Binge eating disorder is still relatively â€Å"young. † With its anticipated inclusion in the next edition of the DSM, a lot of studies have turned their attention to this eating disorder that has only been recognized as an entity separate from the other eating disorder in the last decade. Hopefully, these studies, and the ones still to be conducted, will provide a sound basis for how best to approach binge eating disorder. More importantly, only future research can tell which treatment modalities really work best in the long term. In the meantime, patients with binge eating disorder need help in the here and now. References American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed. Text rev. ) Washington, DC: American Psychiatric Association Sadock, B. J. , Sadock, V. A. (2003). Synopsis of Psychiatry: Behavioral Sciences / Clinical Psychiatry (9th ed. ). Philadelphia, PA: Lippincott Williams Wilkins. World Health Organization. (1993). The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research. Geneva: World Health Organization. Marcus, M. D. Kalarchian, M. A. (2003). Binge eating in children and adolescents. Int J Eat Disord, 34(Suppl), S47–S57. Retrieved from PubMed database. Bulik, C. M. , Brownley, K. A. , Shapiro, J. R. (2007). Diagnosis and management of binge eating disorder. World Psychiatry, 6(3), 142-148. Grucza, R. A. , Przybeck, T. R. Cloninger, C. R. (2007). Prevalence and correlates of binge eating disorder in a community sample. Comprehensive Psychiatry, 48(2), 124-131. Appolinario, J. C. McElroy, S. L. (2004). Pharmacological approaches in the treatment of binge eating disorder. Current Drug Targets, 5(3), 301-307. Appolinario, J. C. , Bacaltchuk, J. , Sichieri, R. , Claudino, A. M. , Godoy-Matos, A. , Morgan, C. , Zanella, M. T. Coutinho, W. (2003). A randomized, double-blind, placebo-controlled study of sibutramine in the treatment of binge-eating disorder. Archives of General Psychiatry, 60, 1109-1116. Wilfley, D. E. , Crow, S. J. , Hudson, J. I. , Mitchell, J. E. , Berkowitz, R. I. , Blakesley, V. , Walsh, B. T. , the Sibutramine Binge Eating Disorder Research Group. (2008). Efficacy of sibutramine for the treatment of binge eating disorder: a randomized multicenter placebo- controlled double-blind study. American Journal of Psychiatry, 165(1), 51-58. McElroy, S. L. , Arnold, L. M. , Shapira, N. A. , Keck, P. E. Jr. , Rosenthal, N. R. , Karim, M. R. , Kamin, M. Hudson, J. I. (2003). Topiramate in the treatment of binge eating disorder associated with obesity: a randomized, placebo-controlled trial. American Journal of Psychiatry, 160(2), 255-261. McElroy, S. L. , Hudson, J. I. , Capece, J. A. , Beyers, K. , Fisher, A. C. , Rosenthal, N. R. the Topiramate Binge Eating Disorder Research Group. (2007). Topiramate for the treatment of binge eating disorder associated with obesity: a placebo-controlled study. Biological Psychiatry, 61(9), 1039-1048. McElroy, S. L. , Kotwal, R. , Guerdjikova, A. I. , Welge, J. A. , Nelson, E. B. , Lake, K. A. , D’Alessio, D. A. , Keck, P. E. , Hudson, J. I. (2006). Zonisamide in the treatment of binge eating disorder with obesity: a randomized controlled trial. Journal of Clinical Psychiatry, 67(12), 1897-1906. Hudson, J. I. , McElroy, S. L. , Raymond, N. C. , Crow, S. , Keck, P. E. Jr. , Carter, W. P. , Mitchell, J. E. , Strakowski, S. M. , Pope, H. G. Jr. , Coleman, B. S. Jonas, J. M. (1998). Fluvoxamine in the treatment of binge-eating disorder: a multicenter placebo-controlled, double-blind trial. American Journal of Psychiatry, 155(12), 1756-1762. Pearlstein, T. , Spurell, E. , Hohlstein, L. A. , Gurney, V. , Read, J. , Fuchs, C. Keller, M. B. (2003). A double-blind, placebo-controlled trial of fluvoxamine in binge eating disorder: a high placebo response. Archives of Women’s Mental Health, 6(2), 147-151. McElroy, S. L. , Hudson, J. I. , Malhotra, S. , Welge, J. A. , Nelson, E. B. Keck, P. E. Jr. (2003). Citalopram in the treatment of binge-eating disorder: a placebo-controlled trial. Journal of Clinical Psychiatry, 64(7), 807-813. Leombruni, P. , Piero, A. , Lavagnino, L. , Brustolin, A. , Campisi, S. Fassino, S. (2008). A randomized, double-blind trial comparing sertraline and fluoxetine 6-month treatment in obese patients with binge eating disorder. Progress in Neuro-psychopharmacology and Biological Psychiatry, 32(6), 1599-1605. Noma, S. , Uwatoko, T. , Yamamoto, H. Hayashi, T. (2008). Effects of milnacipran on binge eating – a pilot study. Neuropsychiatric Disease and Treatment (4)1, 295-300. McElroy, S. L. , Guerdjikova, A. , Kotwal, R. , Welge, J. A. , Nelson, E. B. , Lake, K. A. , Keck, P. E. Jr. Hudson, J. I. (2007). Atomoxetine in the treatment of binge-eating disorder: a randomized placebo-controlled trial. Journal of Clinical Psychiatry, 68(3), 390-398. Levine, M. D. Marcus, M. D. (2003). Psychosocial treatment of binge eating disorder: An update. Eating Disorders Review, 14(4). Retrieved from http://www. gurze. net/site12_5_00/newsletter16. htm. Wilfley, D. E. , Welch, R. R. , Stein, R. I. , Spurrell, E. B. , Cohen, L. R. , Saelens, B. E. , Dounchis, J. Z. , Frank, M. A. , Wiseman, C. V. Matt, G. E. (2002). A randomized comparison of group cognitive-behavioral therapy and group interpersonal psychotherapy for the treatment of overweight individuals with binge-eating disorder. Archives of General Psychiatry, 59, 713-721. Claudino, A. M. , de Oliveira, I. R. , Appolinario, J. C. , Cordas, T. A. , Duchesne, M. , Sichieri, R. Bacaltchuk, J. (2007). Double-blind, randomized, placebo-controlled trial of topiramate plus cgnitive-behavior therapy in binge-eating disorder. Journal of Clinical Psychiatry, 68(9), 1324-1332. Molinari, E. , Bariffu, M. , Croci, M. , Marchi, S. Petroni, M. L (2005). Bingea eating disorder in obesity: comparison of different therapeutic strategies. Eating and Weight Disorders, 10(3), 154-161. Smith, M. , Barston, S. , Segal, R. Segal, J. (2008). Binge eating disorder: Symptoms, causes, treatment, and help. Retrieved from http://www. helpguide. org/mental/binge_eating_disorder. htm.