Advances in Behaviour Research and Therapy最新文献

In the first section, a model of “coping modes” is presented which distinguishes two main classes of coping strategies: vigilance and cognitive avoidance. Vigilance is characterized by an approach to and an intensified processing of threat-relevant information. Its general purpose is to gain control over the main threat-related aspects of a situation, thereby protecting the individual from the perception of threat which would result from the confrontation with unexpected dangers. Cognitive avoidance is viewed as a withdrawal from threat-relevant information. Its general purpose is to reduce the arousal engendered by the confrontation with an aversive event. Both terms are employed to describe actual stress-related actions and cognitive operations as well as interindividual differences in the dispositional inclination toward a certain class of strategies. The second section introduces an instrument for the separate assessment of vigilant and avoidant coping. Finally, a study which demonstrates the predictive power of this instrument is reported. This study analyzes the influence of dispositional and actual vigilant and avoidant coping strategies on self-reported and biochemical stress indicators as evidenced by patients facing a surgical operation.

Studies of treatment outcome for drug dependence are methodologically inferior to those for alcohol dependence, probably because scientific interest in drug use is more recent. Also, the behavior of drug dependence is very complex, since multiple drug use is normative for psychoactive drugs. Compared to clients in alcohol and tobacco studies, those in studies of drug dependence are more heterogeneous in their drug use. It is recommended that research priority be given to the identification of homogeneous subsets of the drug user population, including users of alcohol and tobacco. Several methods of measuring drug use have been advocated, but all have limitations, and little is known about their impact on the interpretation of treatment outcome. Recently the quality of designs in this area of research has improved, but avoidance of randomized trials continues to retard the acquisition of knowledge about the relative effectiveness of treatment procedures. Variability in the duration of follow-ups also impedes interpretation of findings; a minimum of six months post treatment is recommended. It is concluded that measures of drug use should be the principal outcome in evaluations of treatment effectiveness, that the role of therapist variables deserves research attention, and that criteria be developed for the interpretation of nonabstinent outcomes, which are the norm of clients treated for drug dependence.

Successful coping with stressful events involves self-regulation. We identified three kinds of self-regulatory process. The first occurs automatically and unconsciously in order to maintain the homeostasis of a person's physiological functions; the other two are under the person's cognitive and voluntary control. Redressive self-control is aimed at resuming normal functions that have been disrupted; reformative self-control is directed at breaking habits in order to adopt new and more effective behaviors. Coping with acute stress requires redressive self-control; the adoption of new behaviors such as health related behaviors requires reformative self-control. Learned resourcefulness refers to the behavioral repertoire necessary for both redressive self-control and reformative self-control. This repertoire includes self-regulating one's emotional and cognitive responses during stressful situations, using problem-solving skills, and delaying immediate gratification for the sake of more meaningful rewards in the future. Research findings indicate that highly resourceful individuals cope more effectively with stressful situations and are more capable of adopting health related behaviors as well as other behaviors that require reformative self-control.

This paper addresses selected methodological issues related to treatment outcome studies in the alcohol field. In particular, an assessment is presented of where treatment evaluation methodology has excelled (strengths) and where weaknesses are apparent (key issues facing the field today). The four strengths discussed are (1) precision of measurement of the target behavior—drinking; (2) research on the veridicality of self-reports; (3) length of the follow-up interval; and (4) development of a convergent validity criterion approach to assessment and evaluation. The three key issues reviewed are: (1) How should treatment success be gauged? (2) What is an adequate follow-up interval upon which to base conclusions about treatment success or failure? (3) Can the validity of self-reports be enhanced?

To date, there has been only one study (Bouton et al., 1987) that aims specifically at developing a measure for assessing personal concern about acquiring AIDS. In the present study, it was argued that the suitability and/or validity of the Bouton et al. Fear of AIDS Scale should be seriously questioned on conceptual and psychometric grounds. In addition, there are no published studies in which the dimensionality of AIDS fear has been examined. The present investigation was carried out to examine whether fear of AIDS can be shown to emerge as a consistent fear composite in factor analysis of specific AIDS-related fears and whether it can be distinguished from Blood/Injury fears, the latter of which has been established as a complex which possesses both cross-sample and cross-national invariance qualities. The dimensional structure of a 38-item Fear of AIDS Schedule (the acronym FAIDSS being used for describing it) was explored with a sample of 684 American students. Principal components analysis with VARIMAX rotation revealed two separate but related, internally consistent and replicable dimensions of AIDS fear: (I) Fear of AIDS contraction associated with risky sexual behavior, and the fear of the psychological and somatic consequences of having caught the disease, and (II) Fear of exposure to the AIDS virus and other associated viruses through (a) interpersonal, not necessarily sexual, contact with members of risk groups and (b) the subjection to medical procedures. Both components were shown to be invariant across sex. Further analyses pointed to the possibility of using a general (i.e. overall) measure of AIDS fear next to the factorially-derived subscales. On the basis of the patterns of correlations of the fear of AIDS constructs with the conventional Fear Survey Schedule-III and background factors such as sex, age, ethnicity/race, students' major in college and religious preference, it was concluded that, if unjustified overgeneralizations or misleading undergeneralizations are to be avoided, the researcher/clinician should use both the subscales and the general scale conjointly. Evidence in favor of discriminant validity of the fear of AIDS constructs in relation to Blood/Injury fears was obtained. Some implications and recommendations for further study were given.

This paper selectively addresses methodological issues in treatment outcome studies of bulimia. Among the issues examined are the following: methodological strengths; problems, such as the comparability of treatments and lack of long-term follow-ups; dependent measures and their interrelationships; how to gauge treatment success and attrition rates. The quality of studies reflects lessons learned in research with other disorders. Increasingly, studies are showing greater methodological rigor.

One of the greatest difficulties with research on the relationship between life events and health outcome, concerns the measurement of life events. Simple scales which involve preset prompted questions for endorsement fail to provide an indication of personal meanings and contexts. Semi-structured interviews which include contexts as part of the weighting involve subjective elements. More needs to be known about cognitive factors which influence personal meanings. The mildly depressed appear vulnerable to life events. Understanding of vulnerability is currently limited. The clues to the transmission of vulnerability lie with cognitive psychology. This article explores cognitive factors in depression as important determinants of the reaction to life events and explores the evidence which contradicts the view of depression as driven by pessimistic beliefs about the world. A new methodology for measuring life events is evolved as a consequence.