Advances in Behaviour Research and Therapy最新文献

Dramatic improvements in both treatment evaluation and outcome have occurred in smoking cessation over the past 20 years. Key strengths include the use of multicomponent intervention strategies, objective outcome criteria, and relatively sophisticated research designs. Problems still remain, however, in establishing common definitions of success (or even of treatment participation), in describing treatment methodology, and in both defining and reducing subject attrition. Inadequate sample sizes have traditionally plagued studies in the smoking cessation field. Yet progress is being made in all of these areas. Prospects for further improvements in methodological sophistication and treatment outcome appear to be excellent.

This paper examines the major strengths of current marital therapy research methodology, as well as some of the problems and challenges facing researchers. Strengths discussed include the widespread use of assessment instruments with demonstrated reliability and validity, concurrent use of both self-report and observational measures, use of clinical significance statistics, and the availability of detailed treatment manuals. Some of the current challenges discussed here include the need for assessment of individual quality of life rather than exclusive focus on marital satisfaction, better understanding of the unit of analysis employed (e.g., couple vs. individual partner), evaluation of nonstandardized treatments, more thorough description of inclusionary and exclusionary criteria used in research, and the need for longer term follow-up. The authors include a number of suggestions to improve and standardize current research methodology.

The present study evaluated the functioning of 324 children (6–13 years of age) who were hospitalized in an acute-care treatment facility. The major goals were to examine the role of antisocial behavior in predicting clinical course and to examine the extent to which measures of child, parent, and family functioning could predict follow-up status up to two years after discharge. Children with a diagnosis of Conduct Disorder were expected to show greater dysfunction at the inception of hospitalization and over the course of follow-up than children with other diagnoses. Measures were administered at the beginning of hospitalization to assess deviant and prosocial child behaviors, parent psychopathology, and family functioning. Child functioning was assessed repeatedly over the course of follow-up to evaluate performance at home and at school. Significant improvements in behavior were evident over the course of hospitalization. However, only a minority of patients were functioning within the normative range at posttreatment and follow-up. Youths with a diagnosis of Conduct Disorder were functioning more poorly at home and at school over the course of follow-up. Follow-up status could be reliably predicted from severity of initial dysfunction, antisocial child behavior, parent psychopathology and family functioning assessed at the beginning of hospitalization. The results attest to the severity and stability of dysfunction of children with antisocial behavior. The implications of these findings for developing alternative treatments are discussed. New models are suggested to guide clinical applications of treatment and treatment outcome research for the problem of severe antisocial behavior in children.

This monograph consists of five sections. In the first section we delineate the characteristics of acting out children, our view of the course of development of the problem, various treatments which have been utilized, and based upon the results of these treatments, the need for long term follow-up data of parent training, the most effective treatment available. In the second section we describe our parent training program: the parent interview, parent completed assessment measures, behavioral observation assessment measures, the treatment setting, therapists, the treatment program, and a brief overview of the outcome data. In the third section we present the method, results and discussion of a comprehensive follow-up study conducted four and a half to ten and a half years after parent training. The results indicate that the treated families were functioning similarly to a comparison (‘normal’) sample of families. In the fourth section we discuss the implications of the present findings for future research in parent training. In the final section we make recommendations about who should conduct parent training, what components should be included in such training, why such a therapeutic approach should be utilized, and finally, some of the problems associated with parent training are delineated.

An experiment was carried out to investigate whether multiply handicapped children, developmentally below 6 months, were able to use information in their environment to discriminate between different contingencies. In this experiment a multielement design was used. Of the 4 participants investigated, all showed clear signs of discrimination learning whilst using the specially designed electromechanical car in which they could sit and travel on a short journey. The effects of this type of technology on those who represent the lowest level of adaptive functioning found and those directly involved in their care is discussed.

Three studies investigating the effects of different organizational strategies on the behaviour of hospital residents with severe and profound mental handicaps are presented. A field study of 40 residents and 17 staff made over an 18 day period showed marked effects on the behaviour of residents and some effects on the behaviour of staff. Two experimental studies compared room management with teaching in small groups and with individual teaching. Room management provides both individualised teaching and a high engagement holding activity for those residents not receiving individual tuition. Whilst small groups can provide even higher levels of group engagement, individual tuition is difficult for staff to execute when trainees have a variety of different tasks to be taught. The individual teaching strategy increases the amount of time trainees receive individual tuition but the majority of trainees, who are not being taught at any one time, spend little time on task, have few materials available and often wander around the room. These studies emphasize the importance of inter-individual differences, task characteristics and the physical environment in determining the outcome of any organizational strategy. Rather than advocating a single ‘best’ strategy for organizing teaching for groups of students with mental handicaps, the circumstances under which a particular strategy may be viable are emphasized.

Complaints of dizziness and depersonalisation are frequently associated with anxiety and/or medical problems. However, neither experience can be tied exclusively to one medical or psychosomatic disorder. Although both experiences have been reported during anxiety, neither can be related directly to anxiety level and it seems probable that both arise in the wake of psychological concomitants to change in arousal rather than to high arousal itself.

The importance of cognitive processes is a neglected element in both dizziness and depersonalisation. Both experiences are amenable to cognitive intervention as a therapeutic measure. Cognitive and in particular cognitive-perceptual conflict can provoke both experiences. Cognitive attributions about the meaning of an attack form major distress-defining constituents of each experience

Two models are discussed: one, that dizziness and depersonalisation are the same experience described differently; the other, a bipolar hypothesis, proposes that the two experiences form opposite ends of a dimension describing disturbed self-world relations. This type of disturbance is not easily described in everyday vocabulary and attention to the precise phenomenology of both complaints would help further psychological understanding.

The present study aimed at obtaining some further support for the hypothesis of a distinction between two basically different kinds of learning in a Pavlovian conditioning preparation: signal-learning and affective-evaluative learning (Baeyens et al., 1988a, Baeyens et al., 1988b; Levey and Martin, 1987, Martin and Levey, 1987). In this respect, we conducted an experiment to verify the Levey and Martin, 1983, Levey and Martin, 1987, Martin and Levey, 1987 hypothesis that, unlike signal-learning, evaluative conditioning should be resistant to extinction. Mere contingent presentation of neutral with (dis)liked stimuli was sufficient to change the affective—evaluative tone of the originally neutral stimuli in a (negative) positive direction (p<0.0001). A subsequent extinction procedure did not have any influence on the acquired evaluative value of the originally neutral stimuli (p<0.0001). A follow-up study demonstrated that the evaluative discriminations were still present two months after the acquisition and extinction manipulations (p<0.0001). These findings provide full support for the resistance to extinction hypothesis. At a theoretical level, this is considered to be further evidence for the hypothesis that evaluative conditioning is not mediated by the acquisition of propositional—declarative knowledge about stimulus contingencies. Finally, we suggest an intriguing analogy between the evaluative conditioning phenomenon and the ‘laws of sympathetic magic’ (Rozin et al., 1986).