Advances in Behaviour Research and Therapy最新文献

Biomedical and psychological perspectives on chronic pain have each advanced our understanding of the development and maintenance of chronic pain syndromes and have led to more effective assessment and treatment approaches. Little attention, however, has been given to the development of a comprehensive model that integrates both biomedical and psychological variables in the etiology, maintenance, and exacerbation of chronic pain. The purpose of this article is to propose a dynamic psychobiological model of chronic pain that emphasizes the interaction among psychological and biomedical variables. The experience of pain is viewed as a complex response that incorporates subjective-psychological, motor-behavioral, and physiological-organic components. Moreover, we postulate that there are varying degrees of synchrony among responses measured on these levels determining the development and etiology of chronic pain syndromes. Specifically, we propose that the development and maintenance of chronic pain is a function of several interacting components: (a) a predisposition to respond with a specific bodily system, (b) external or internal aversive stimulation, (c) maladaptive information processing of and coping with pain-related social and/or physiological stimuli, and (d) operant, respondent, and observational learning processes.

An empirical study attempted to identify theoretical and methodological dimensions of the field of behavior therapy. The similarities among 44 prominent behavior therapists were judged by 64 active members of the Association for the Advancement of Behavior Therapy (AABT). Multidimensional scaling of these similarity judgments revealed three dimensions along which these figures varied. The 3 dimensions discovered were interpreted as, (1) cognitivism vs. behaviorism, (2) research vs. clinical practice, and (3) seniority of the figures. Hierarchical clustering was used to produce a taxonomic scheme that provided an alternative grouping of the figures along conceptual and technical lines.

Videotape self-modeling (VSM) refers to the behavioral change resulting from the observation of oneself while engaging in only desired target behaviors (Dowrick, 1983a). A comprehensive review of 27 studies using some form of VSM was conducted. The studies were assessed across six variables, including: (1) author(s), (2) year of publication or presentation, (3) subject population (including number, major diagnostic category, and setting in which the research was conducted), (4) dependent variable (behavior targeted for change), (5) experimental design, and (6) a brief statement as to the effectiveness of the intervention. Results of the review reveal a strong trend toward the use of VSM procedures with specific clinical problems using within-subject methods. However, few if any studies provide sufficient information about the actual details of the procedure to allow for the standardized, empirically-based use of the technique. Theoretical bases for self-modeling effects are examined. The article concludes with a discussion of future research and the scientific, clinical and ethical issues inherent in the use of VSM procedures with clinical populations.

In spite of the importance of examining empirically the within-country stability and cross-national generalizability of dimensional models of self-assessed fears, surprisingly few studies utilizing a confirmatory approach have been conducted. Using a method based on “perfectly-congruent weights”, dimensions as measured by the Wolpe and Lang Fear Survey Schedule-III (“Social Fears”, “Agoraphobic Fears”, “Fears of Bodily Injury, Death and Illness”, “Fears of Sexual and Aggressive Scenes”, and “Harmless Animals Fears”), identified originally with Dutch noninstitutionalized phobic subjects (Ss) (cf., Arrindell, Emmelkamp, & Van der Ende, 1984), were shown to be retrievable in subsamples comprising Anglophone Canadian phobic and obsessive-compulsive outpatients. Within the pooled sample of Canadian outpatients, evidence in favor of invariance of fear factors across sex was also demonstrated. In addition, the findings provided further support for the notion that the situations that evoke fears and phobias are nonrandom (e.g., Eysenck, 1987). Special attention was given to the diagnostic implications, suggested by Marks (e.g., 1989), of the invariance of the Agoraphobic cluster of fears.

Verbal classical conditioning research is reviewed as it has developed since the original experiments by Staats and Staats (1957). The present contribution is offered in view of the recent discussion on the significance of evaluative response acquisition as compared to contingency learning in Pavlovian conditioning of human subjects. A brief review of the state of the art is followed by a critical discussion of the role of conditioning and cognitive, especially verbal, processes in this research area. It is concluded that acquisition of evaluative responses may occur in verbal classical conditioning, albeit perhaps under certain conditions. However, cognitive verbal learning, notably the learning of propositions, seems to influence evaluative meaning change.

Recent developments in research and treatment of schizophrenia have important implications for assessment of outcome of behavioral interventions. Major measurement domains were reviewed, and a number of general issues were discussed. Diagnosis, derived from structured interviews, has become a sine qua non for well-designed studies. Self-report does not have a major place as an outcome measure with this population, except in the context of interviewer rating scales. Behavioral observation is also used infrequently, primarily because of cost and clinical utility. In contrast, data derived from the family, either through behavioral assessment or interview, play an increasingly important role. Perhaps the most critical problem for evaluating behavioral interventions is the fact that medication and other components of compound treatment programs will invariably account for a significant portion of the overall outcome variance. Several suggestions are provided for dealing with this and other, related issues.

Methodology in the conduct of clinical outcome studies with anxiety disorders has advanced in several areas in recent years. Nevertheless, difficult issues concerning the conduct and interpretation of the results of these clinical trials remain. Developments that have facilitated clinical trials include the construction of structured interviews for anxiety and related disorders that allow consistency in identification of target disorders in a clinical context. An equally important development has been the introduction and widespread utilization of treatment manuals which allows for replicable independent variables. Remaining issues include ascertaining the optimal way of measuring change from among the variety of dependent variables available. A related difficulty is determination of the principle dependent variable (e.g., panic attacks, intrusive thoughts) in an anxiety disorder where many key features of anxiety disorders seem to coexist (symptom and syndrome comorbidity). Solving these issues as well as determining the optimal way to handle attrition will provide important methodological advances.