Advances in Behaviour Research and Therapy最新文献

We propose a psychotherapy treatment implementation model whereby adequate levels of independent treatment components (delivery, receipt, and enactment) are prerequisite to asserting whether a valid clinical trial has been conducted. The delivery component refers to the accuracy of treatment presentation, receipt refers to the accuracy of the client's comprehension of treatment, and enactment refers to the extent of out of session application initiated by the client. Clinical scientists regularly address one or two of these components, but rarely all three, according to a survey we report. Sources and effects of model deficits, i.e., inadequate levels of treatment components, as well as methods of component assessment and induction, are discussed. We conclude that faults in any one of the components drain validity proportional to the degree of deficit, and that clinical trials have often incorrectly been considered fair tests, resulting in biased efficacy judgments.

Cognitive-behavioral therapy has been heralded as the most efficacious intervention for bulimia nervosa. The value of adding exposure with response prevention to cognitive techniques has been widely debated. Part 1 of this review examines the use and effectiveness of exposure treatments for bulimia nervosa. Models of bulimia nervosa which advocate the use of exposure techniques are evaluated. In addition, we examine methodological shortcomings that have hindered our ability to evaluate the efficacy of exposure treatments for this disorder. In Part 2, we place exposure treatments for bulimia nervosa into a broader learning theory context by examining rationales for the use of these techniques based on classical, operant, and social learning theories. In addition, we examine evidence for assumed mechanisms of action of various exposure-based approaches, and focus on models of cue reactivity based on research in the substance abuse area that have significant implications for understanding conditioning processes in bulimia nervosa. Finally, we present guidelines for enhancing laboratory and treatment research that investigate these behavioral principles in bulimia nervosa.

The psychosocial impact of HIV on the hemophilia community has been largely ignored in the literature. The current study examined the contributions of social support and coping methods to resiliency against HIV-related stress among hemophilic men and their long-term female partners. Main effect and stress buffering models of stress resiliency were tested. Criterion variables included subjective psychological distress and physical symptoms. Results revealed support for the main effect model only. Marital satisfaction and support from friends predicted husbands' functioning and support from friends predicted partners' functioning. For both spouses, avoidant coping was associated with poorer functioning. The findings of this study and other research with this sample have provided the foundation for a clinical intervention which is summarized in an appendix.

The responses of mentally retarded (MR) and non-mentally retarded (NMR) adults matched for parental occupational levels to a modified version of the Fear Survey Schedule (FSS-III) allowing only three response categories were compared. The fear items were subdivided into five dimensional categories of fear types: Social Rejection (SR), Agoraphobia (Ag), Tissue Damage (TD), Sex and Aggression (SA) and Animal (An). There was also a small group of Miscellaneous fears (Misc). Independent analyses of the prevalence and intensity of responses on individual items showed that both measures had contributed to the overall higher fear level in the MR group. The MR group showed a greater tendency to express high fear than the NMR group, while the NMR group was characterized on the SR and SA fear types by more frequent expression of moderate degrees of fear than the MR group. Within the NMR group, response distributions on all fear types were J-shaped and on individual items were almost entirely J-shaped. By contrast, for the MR group, U-shaped distributions, in which the frequency of high fear responses exceeded that of moderate ones, were found for the TD, SA and An fear types; distributions on about 25 per cent of the individual fears were also U-shaped. The results are discussed with reference to some large scale studies of the prevalence of fears and phobias in the general population.

Beginning with the purely theoretical extrapolation of Skinnerian principles to changing eating behavior in 1962, behavioral treatment has since become the principal means of managing mild to moderate obesity. Over the years treatments have become longer and more intensive, often being combined with aggressive Very Low Calorie Diets. Weight loss has been correspondingly greater. Yet a fundamental problem noted from the outset has remained: the inexorable pattern of relapse irrespective of diverse attempts to improve long-term maintenance. Although most patients maintain weight loss for at least a year, five year follow-ups have shown that virtually everyone returns to their baseline weight. The health effects of this pattern of loss and regain are unknown, but should not necessarily be judged to be harmful. Reactions to the long-term ineffectiveness of weight control treatment have varied. Whereas some critics have called for an end to treatment, proponents have suggested that innovative maintenance strategies can be devised, and that subtypes of obesity more amenable to behavioral treatment can be identified. It is argued here that an understanding of the mechanisms that cause or at least maintain obesity should determine treatment. This premise makes it unlikely that behavioral treatments can be improved, but rather points to the direct modification of the biological processes that regulate body weight. Cognitive-behavioral treatment is effective in reducing binge eating and other maladaptive behavior associated with obesity. It can potentially improve nutrition and increase physical activity, resulting in significant health benefits if not weight loss.

One hundred and three subjects and their mothers were assessed at three points during adolescence and young adulthood in a longitudinal examination of the predictive and mediational relationships between family variables and substance abuse. Latent variable path analysis with partial least-squares estimation procedures (LVPLS) was utilized to test a theoretical model including constructs of family structure, family environment (maternal depressive mood and interparental conflict), mother/adolescent dynamics (mother/adolescent supportive relationship and maternal control), and substance abuse (problematic alcohol use and marijunana/hard drug use). Higher levels of interparental conflict were consistently related to poorer quality of the mother/adolescent relationship and stricter maternal control. As hypothesized, family environment variables mediated the impact of family structure, and mother/adolescent dynamics variables mediated the impact of the family environment. Results revealed notable differences between the trajectories for males and females, as well as between different types of substance abuse. Implications for substance abuse prevention efforts are discussed.

Mentally retarded (MR) and non-mentally retarded (NMR) adults matched for parental occupational levels were compared in their responses to a modified version of the Fear Survey Schedule (FSS-III) allowing only three response categories. The fear items were subdivided into five dimensional categories of fear types: Social Rejection (SR), Agoraphobia (Ag), Tissue damage (TD), Sex and Aggression (SA) and Animal (An). The MR group showed a higher level of self-reported fear overall, modified by a significant group by fear type interaction. All fear types except SR contributed to the overall difference, particularly An and TD type fears. For SR fears, the direction of the difference was marginally reversed. In the NMR group, the usual finding that women express more fears than men was replicated, but there was no sex difference in the MR group. Explanations in terms of linguistic competence, parenting, and social and gender-identity factors are discussed.

Four experiments concerning UCS-inflation in humans were conducted employing a differential conditioning paradigm. In Experiment 1 (n = 30) one neutral slide (CS+) was paired with a mild electric shock (UCS) and another neutral slide (CS−) was never paired with a shock. An inflation phase followed, during which unsignalled UCSs gradually increased in strength for the inflation group, while they were kept constant for the control group. During the post-inflation trials, only the inflation group showed relatively large skin conductance responses (SCRs) on CS+ trials and prolonged differential UCS expectancies. Experiment 2 (n = 20) was similar to the first experiment, with the exception that (i) the UCS was inflated in only one trial, (ii) slides depicting angry faces were used as CSs and (iii) subjective evaluations of the CSs were measured in addition to the SCRs. Neither at the physiological nor at the subjective level, conditioning effects emerged in the inflation group. In Experiment 3 (n = 42) and 4 (n = 33), erotic slides were used as CSs and a mild tone served as UCS. During the inflation stage, only the inflation group was told that the tone indicated, in fact, “blushing”. Experiment 4 sought to increase the aversiveness of the “blush” manipulation by having two observers seated inside the experimental room. Though the “blush” manipulation appeared to successfully inflate the UCS, neither study revealed strong data confirming the idea that human conditioned responding is susceptible to UCS-inflation. Thus, UCS-inflation in humans is, at best, a fragile phenomenon.

This paper reviews the history and present position of the theory that there exists a cancer-prone (Type C) personality which succumbs more readily to cancer, and dies more quickly after contracting cancer, than other types of personality. In particular, Type C is characterized by (a) a tendency to suppress emotions like anxiety and anger, and present a bland surface, and (b) to find it difficult to cope with stress, to develop feelings of hopelessness and helplessness, and finally depression. Modern work supports this theory quite strongly, both by controlled comparisons between cancer and other types of patients, and by prospective studies in which healthy cancer-prone subjects are followed up for up to 15 years and compared with subjects who are not cancer-prone, for mortality from and incidence of cancer. Intervention studies show that psychological therapy can (a) prevent cancer from arising, and (b) prolong life in terminal cancer patients. Theories have been developed to identify the way in which psychosocial factors can influence cancer production through affecting the workings of the immune system, and much experimental support has been found for these theories. There appears little doubt that psychosocial determinants constitute an important risk factor for cancer, and interact synergistically with other risk factors such as smoking, genetic influences, etc.

The cognitive hypothesis proposes that panic disorder and hypochondriasis both result from the enduring tendency to misinterpret bodily changes or variations as indicating catastrophic harm. Although there is considerable overlap (and hence comorbidity), the differences between the two problems lies in (i) the extent to which the symptoms misinterpreted are capable of being rapidly increased by anxiety; (ii) the perceived imminence of the feared catastrophe; (iii) the safety seeking behaviors which are triggered (and which play a part in the maintenance of misinterpretation) and (iv) the general beliefs and assumptions upon which some of the misinterpretations are based. Recent research into misinterpretation and related factors is reviewed, and the implications for clinical treatments are outlined.