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A Systematic Review of Pyramidal Training for Implementing Behavioral Interventions. 实施行为干预的金字塔训练的系统综述。
IF 2 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2025-03-01 Epub Date: 2025-02-05 DOI: 10.1177/01454455251318247
Madeline R Risse, Kwang-Sun Cho Blair

The pyramidal training approach is a promising strategy to train behavioral interventionists in applied settings, as it maximizes efficiency of training by allowing for more trainees to learn and implement a diverse range of behavioral strategies in less time. This systematic review synthesized 30 single-case studies that evaluated pyramidal training in training practitioners to implement behavioral interventions. Results support the effectiveness of the pyramidal training model at the case, tier, and study levels across various settings, targeted skills, and participant types, particularly for improving practitioner implementation fidelity. However, strategies for promoting maintenance of trained skills, such as feedback and coaching, have not been routinely incorporated into pyramidal training procedures. Future researchers should evaluate the utility of post-training observations of implementation fidelity to determine the sustainability and most efficacious methods for promoting fidelity of trained behavioral interventions. Ultimately, the pyramidal training approach shows great promise but requires further optimization and empirical scrutiny.

金字塔训练方法是一种在应用环境中训练行为干预者的有前途的策略,因为它允许更多的受训者在更短的时间内学习和实施各种各样的行为策略,从而使训练效率最大化。本系统综述综合了30个单例研究,评估了金字塔训练在培训从业人员实施行为干预方面的作用。结果支持金字塔训练模型在案例、层次和研究层次上的有效性,这些层次跨越各种设置、目标技能和参与者类型,特别是在提高从业者实施保真度方面。然而,促进维持训练技能的策略,例如反馈和指导,并没有常规地纳入金字塔训练程序。未来的研究人员应该评估训练后观察的实施保真度的效用,以确定可持续性和最有效的方法来提高训练后行为干预的保真度。最终,金字塔训练方法显示出巨大的前景,但需要进一步优化和实证审查。
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引用次数: 0
A Quantitative Systematic Literature Review of Combination Punishment Literature: Progress Over the Last Decade. 对综合惩罚文献的定量系统文献综述:过去十年的进展。
IF 2 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2025-01-01 Epub Date: 2024-07-26 DOI: 10.1177/01454455241262414
Asude Sumeyye Ayvaci, Alison Dorothea Cox, Andreas Dimopoulos

This review evaluated single-case experimental design research that examined challenging behavior interventions utilizing punishment elements. Thirty articles published between 2013 and 2022 met study inclusion criteria. Study quality was also assessed. Through multiple levels of analysis (e.g., descriptive statistics, non-parametric statistics), we examined (a) participant and study trends, (b) differential outcomes related to temporal reinforcement approaches (antecedent, consequent, or combined reinforcement) applied alongside punishment element(s), (c) differential outcomes related to the punishment type (negative, positive) applied alongside reinforcement, and (d) effect sizes associated with study rigor across peer-reviewed and gray literature. Our results may tentatively suggest that, for certain situations, concurrently applying punishment with antecedent reinforcement approaches may coincide with significantly larger effect sizes compared to combined temporal reinforcement approaches, while positive punishment applied concurrently with reinforcement may coincide with larger but non-significant intervention effects. Most featured articles met rigor criteria, but larger effects were seen in peer-reviewed literature.

本综述评估了利用惩罚元素对挑战行为进行干预的单案例实验设计研究。2013年至2022年间发表的30篇文章符合研究纳入标准。同时还对研究质量进行了评估。通过多层次分析(如描述性统计、非参数统计),我们考察了:(a)参与者和研究趋势;(b)与惩罚元素同时应用的时间强化方法(先行强化、后继强化或综合强化)相关的不同结果;(c)与强化同时应用的惩罚类型(消极、积极)相关的不同结果;以及(d)与同行评审和灰色文献中研究严谨性相关的效应大小。我们的研究结果初步表明,在某些情况下,与结合时间强化法相比,同时采用惩罚与先行强化法可能会产生更大的效果,而同时采用积极惩罚与强化法可能会产生更大但不显著的干预效果。大多数专题文章都符合严谨性标准,但在同行评审的文献中可以看到更大的效果。
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引用次数: 0
Using Instructions and Acoustic Feedback to Improve Staff Delivery of Behavior-Specific Praise in a Clinical Setting. 在临床环境中使用指令和声音反馈来改进员工对特定行为的表扬。
IF 2 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2025-01-01 Epub Date: 2024-10-21 DOI: 10.1177/01454455241291472
Kwadwo Britwum, G David Smith, Michelle Britwum, Elizabeth Parthum, Eric Jacobs

Past research has shown the effectiveness of contingent acoustic feedback (CAF) in various human performance settings, but its impact on staff performance in clinical settings remains unclear. The current study replicated and extended Herron et al. (2018) by using vocal instructions and CAF to teach staff to use behavior-specific praise (BSP) to reinforce designated client behavior in a clinical setting. Results from a multiple-baseline-across-staff design revealed that this intervention increased the rate at which staff used BSP to reinforce designated client behavior. Paired sample t-tests showed a significant increase in the rate of BSP for each participant from baseline to the intervention phase, and participants maintained increased rates of BSP during probes conducted 1 to 3 weeks after the intervention was complete. Additionally, paired sample t-tests showed statistically significant increases in the rates of designated behavior for each client. Participants also rated the instructions and CAF procedure as more worthwhile, helpful, relevant, pleasant, and less disruptive than feedback methods typically used in their agency.

过去的研究表明,或然声学反馈(CAF)在各种人类表现环境中都很有效,但它对临床环境中工作人员表现的影响仍不清楚。目前的研究复制并扩展了 Herron 等人(2018 年)的研究,在临床环境中使用声音指令和 CAF 教员工使用特定行为表扬(BSP)来强化指定的客户行为。多基线跨员工设计的结果显示,这种干预提高了员工使用 BSP 来强化指定客户行为的比率。配对样本 t 检验显示,从基线到干预阶段,每位参与者的 BSP 率都有显著提高,而且在干预结束后 1 到 3 周进行的调查中,参与者的 BSP 率也保持了提高。此外,配对样本 t 检验表明,每个客户的指定行为率都有了统计学意义上的显著提高。与机构通常使用的反馈方法相比,参与者还认为指导和 CAF 程序更有价值、更有帮助、更相关、更令人愉快、干扰更少。
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引用次数: 0
Caregiver-Implemented Interventions to Improve Daily Living Skills for Individuals With Developmental Disabilities: A Systematic Review. 护理人员实施干预措施,提高发育障碍人士的日常生活技能:系统回顾。
IF 2 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2025-01-01 Epub Date: 2024-11-14 DOI: 10.1177/01454455241296514
Renming Liu, Stephanie Gerow, Catharine Lory, Kristina McGinnis, David Cosottile

Many individuals with intellectual and developmental disabilities (DD) encounter difficulties in performing daily living skills, which limits their self-sufficiency and autonomy. Caregivers, such as parents, are often the individuals who interact with individuals with DD the most during daily living skills routines. Therefore, it is critical to teach caregivers to implement daily living skills interventions with their children. A systematic review of the literature related to caregiver-implemented daily living skills interventions yielded 38 articles. Of those, 20 articles, with 21 experiments, were rated as high quality based on What Works Clearinghouse design standards. Behavior skill training was the most common strategy used to teach caregivers to implement interventions. Common daily living skills interventions included prompting, reinforcement, and task analysis. The most common form of prompting was verbal prompting, and the most common schedule of reinforcement was a continuous schedule of reinforcement. Of the 21 high-quality experiments, 86% demonstrated caregiver-implemented interventions yielded improvements in daily living skills. Several studies demonstrated generalization and maintenance of daily living skills. Implications for research and practice are discussed.

许多智力和发育障碍(DD)患者在掌握日常生活技能时会遇到困难,这限制了他们的自立和自主能力。在日常生活技能日常活动中,父母等照顾者往往是与智力发育障碍者互动最多的人。因此,教会照顾者对其子女实施日常生活技能干预至关重要。对有关照顾者实施日常生活技能干预的文献进行了系统性回顾,共获得 38 篇文章。其中有 20 篇文章和 21 项实验根据 What Works Clearinghouse 的设计标准被评为高质量。行为技能培训是用于指导护理人员实施干预措施的最常用策略。常见的日常生活技能干预包括提示、强化和任务分析。最常见的提示方式是口头提示,最常见的强化计划是持续强化计划。在 21 项高质量的实验中,86% 的实验表明护理人员实施的干预措施改善了日常生活技能。多项研究表明,日常生活技能得到了推广和保持。本文讨论了研究和实践的意义。
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引用次数: 0
Progressive Functional Analysis and Function-Based Intervention Via Telehealth: A Replication and Extension. 通过远程保健进行渐进式功能分析和基于功能的干预:复制和推广。
IF 2 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2025-01-01 Epub Date: 2024-10-27 DOI: 10.1177/01454455241291785
Emily Exline, Kristina McGinnis, Serena R Garza, Stephanie Gerow, Tracey N Sulak, Monserrat Austin

The purpose of this study was to evaluate a progressive functional analysis (FA) model and function-based intervention delivered by caregivers with coaching via telehealth. Children diagnosed with autism and at least one caregiver (e.g., parent) participated in the study. We conducted three assessments prior to and following intervention: a researcher-developed 10-min observation, the Parental Stress Index, and the externalizing section of the Vineland Adaptive Behavior Rating Scales, Third Edition (VABS-3). We included 47 participants in the present evaluation of the progressive FA model. We identified the function of challenging behavior for 36 participants. A function was not identified for nine participants who exhibited low or no challenging behavior during the assessment; the results were inconclusive for two participants. For the 17 participants who participated in the intervention evaluation phase, each of the participants achieved the mastery criterion, which was an 80% reduction in challenging behavior for most participants. Additionally, there was a statistically significant decrease in the VABS-3 externalizing behavior measure from pre- to post-assessment, although neither of the other pre-post measures resulted in statistically significant changes. This study replicates and extends previous research, supporting the use of progressive FA model and function-based interventions to improve challenging behavior.

本研究的目的是评估一种渐进式功能分析(FA)模式和基于功能的干预措施,由护理人员通过远程医疗提供指导。被诊断患有自闭症的儿童和至少一名照顾者(如父母)参与了这项研究。我们在干预前和干预后进行了三项评估:研究人员开发的 10 分钟观察法、父母压力指数和文兰适应行为量表第三版(VABS-3)的外化部分。我们对 47 名参与者进行了渐进式 FA 模型评估。我们确定了 36 名参与者挑战行为的功能。有 9 名参与者在评估过程中表现出的挑战行为较少或没有挑战行为,他们的挑战行为功能没有被确定;有 2 名参与者的评估结果没有定论。在参与干预评估阶段的 17 名参与者中,每位参与者都达到了掌握标准,即大多数参与者的挑战行为减少了 80%。此外,从评估前到评估后,VABS-3 外部化行为测量结果有了统计学意义上的显著下降,但其他评估前和评估后的测量结果都没有出现统计学意义上的显著变化。这项研究重复并扩展了之前的研究,支持使用渐进式 FA 模型和基于功能的干预来改善挑战性行为。
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引用次数: 0
Development and Validation of an Assessment-Driven Behavioral Intervention for Primary Complex Motor Stereotypies in Young Children. 针对幼儿初级复杂运动刻板印象的评估驱动行为干预的开发与验证。
IF 2 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2024-11-01 Epub Date: 2024-05-31 DOI: 10.1177/01454455241255085
Matthew L Edelstein, Emily D Pogue, Harvey S Singer

Complex motor stereotypies are rhythmic, repetitive, fixed, and non-goal directed movements (e.g., bilateral flapping/waving movements of the hands/arms). Movements typically begin in early childhood and can occur in otherwise normally developing ("primary") or autistic ("secondary") children. Stereotypies persist, occur multiple times a day, have prolonged durations, can be socially stigmatizing, and may lead to bullying and isolation. Prior behavioral treatment studies have focused on older children (ages 6-12) and report modest reductions in stereotypy (i.e., between 14% and 33%). The current study involves the functional assessment and treatment of five children with Primary Complex Motor Stereotypy using a modified awareness training procedure, differential reinforcement of other behavior, and schedule thinning in a nonconcurrent multiple baseline design. Results suggest a 99% reduction of motor stereotypy from baseline across all participants.

复杂运动刻板印象是指有节奏的、重复的、固定的和非目标定向的动作(如双手/双臂的拍打/挥舞动作)。这些动作通常始于幼儿期,可出现在发育正常的儿童("原发性")或自闭症儿童("继发性")身上。刻板行为持续存在,每天出现多次,持续时间较长,可能会在社会上留下污名,并可能导致欺凌和孤立。之前的行为治疗研究主要针对年龄较大的儿童(6-12 岁),研究报告显示,他们的刻板行为略有减少(即减少 14% 到 33%)。目前的研究涉及对五名患有原发性复杂运动刻板行为的儿童进行功能评估和治疗,采用的方法包括修改后的意识训练程序、对其他行为进行差别强化,以及在非并发多重基线设计中稀释日程表。结果表明,与基线相比,所有参与者的运动刻板行为减少了 99%。
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引用次数: 0
Implementation Study of "Building Resilience," Including Positive Psychology Interventions and Positive Emotion Regulation Training in Patients With Severe Mental Illness in an Adult Outpatient Psychiatric Mental Health Setting: An Exploratory Clinical Trial. 在成人精神科门诊精神疾病患者中开展 "建立复原力 "实施研究,包括积极心理学干预和积极情绪调节训练:一项探索性临床试验。
IF 2 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2024-11-01 Epub Date: 2024-08-20 DOI: 10.1177/01454455241269842
Karin Holmedal Byrne, Berit M Gustafsson

Deficits in positive emotion regulation skills may be an important factor in the development and maintenance of anxiety and mood disorders. A treatment, which includes strategies to build and strengthen positive emotion regulation skills has been provided to patients primarily diagnosed with an anxiety and or mood disorder in an adult mental health outpatient service setting. To study the effects on positive and negative emotion, emotion regulation skills, emotional disorder symptoms, quality of life, and wellbeing during a new developed treatment. An exploratory clinical trial was used to conduct a preliminary assessment of a novel intervention. The intervention was provided in a group format over a 6-week period and independent practice over an 8-week period. Outcome variables were assessed pre- and post-treatment and at a 2-month follow up. Life quality, subjective wellbeing ratings, depressive and anxiety symptoms improved at follow up. The data suggests that the intervention may have the potential to produce desired change in positive emotion regulation. Preliminary findings suggest the intervention can have beneficial effects. These findings are promising and support the possibility that disturbances in positive emotion regulation may be a generative target for treatment research.

积极情绪调节能力的缺陷可能是焦虑症和情绪障碍发展和维持的一个重要因素。在成人心理健康门诊服务环境中,我们为主要被诊断为焦虑症和情绪障碍的患者提供了一种治疗方法,其中包括建立和加强积极情绪调节技能的策略。研究新开发的治疗方法对积极和消极情绪、情绪调节技能、情绪障碍症状、生活质量和幸福感的影响。通过探索性临床试验对一种新型干预方法进行初步评估。干预以小组形式进行,为期 6 周,独立练习为期 8 周。结果变量在治疗前、治疗后和 2 个月的随访中进行评估。随访期间,生活质量、主观幸福感评分、抑郁症状和焦虑症状均有所改善。数据表明,该干预措施有可能在积极情绪调节方面产生预期的变化。初步研究结果表明,干预可以产生有益的效果。这些发现很有希望,并支持积极情绪调节方面的干扰可能成为治疗研究的生成目标的可能性。
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引用次数: 0
School Refusal Behaviors: The Roles of Adolescent and Parental Factors. 拒绝上学的行为:青少年和家长因素的作用。
IF 2 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2024-11-01 Epub Date: 2024-08-26 DOI: 10.1177/01454455241276414
Junwen Chen, Celina Feleppa, Tingyue Sun, Satoko Sasagawa, Michael Smithson, Liana Leach

School refusal behaviors in adolescents have deleterious immediate and long-term consequences and are associated with mental ill-health such as anxiety and depression. Understanding factors that place youth at higher risk of school refusal behavior may assist in developing effective management approaches. We investigated parental and adolescent factors that may be associated with school refusal behaviors by specifically focusing on the role of parental and adolescent emotion dysregulation, their anxiety and depression, and parental rearing style. First, we hypothesized that adolescents with school refusal behaviors, as well as their parents, will report higher levels of emotion dysregulation, anxiety, and depression compared to their counterparts without school refusal behaviors. Furthermore, we hypothesized that multivariate models testing the role of parental and child factors concurrently will show that parental (emotion dysregulation, anxiety and depression, and rearing styles) and adolescent (emotion dysregulation, anxiety, and depression) factors are associated with school refusal behaviors. One hundred and six adolescents aged 12 to 18 years and their parents completed an online questionnaire measuring both parental and adolescent emotion dysregulation, anxiety, depression, parental rearing styles, and adolescents' school refusal behaviors. Adolescents with school refusal behaviors reported greater anxiety and depression, with their parents showing greater emotion dysregulation. Multivariate analyses showed that parental emotion dysregulation and adolescent age were associated with school refusal behaviors independently. Future management for school refusal behaviors should consider age-tailored approaches by incorporating training for parental emotion regulation skills.

青少年的拒学行为会产生有害的直接和长期后果,并与焦虑和抑郁等心理疾病有关。了解青少年拒学行为的高危因素有助于制定有效的管理方法。我们调查了可能与拒学行为有关的父母和青少年因素,特别关注父母和青少年情绪失调的作用、他们的焦虑和抑郁以及父母的教养方式。首先,我们假设,与没有拒学行为的青少年相比,有拒学行为的青少年及其父母会报告更高水平的情绪失调、焦虑和抑郁。此外,我们还假设,同时测试父母和子女因素作用的多元模型将显示,父母(情绪失调、焦虑和抑郁以及抚养方式)和青少年(情绪失调、焦虑和抑郁)因素与拒绝上学行为有关。166 名 12 至 18 岁的青少年及其父母完成了一份在线问卷,调查内容包括父母和青少年的情绪失调、焦虑、抑郁、父母的养育方式以及青少年的拒学行为。有拒学行为的青少年焦虑和抑郁程度更高,其父母的情绪失调程度也更高。多变量分析表明,父母的情绪失调和青少年的年龄与拒学行为有独立的关联。未来对拒绝上学行为的管理应考虑采用适合不同年龄的方法,包括对父母情绪调节技能的培训。
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引用次数: 0
Functional Communication Training in Schools: A Systematic Analysis of the Evidence for Ecological Validity. 学校功能性沟通培训:对生态有效性证据的系统分析。
IF 2 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2024-11-01 Epub Date: 2024-07-26 DOI: 10.1177/01454455241264816
Laura C Chezan, Autumn M Bauer, Meka N McCammon, Erik Drasgow

Ecological validity refers to the meaningfulness or practical significance of research outcomes in everyday settings or the extent to which an intervention can be implemented by typical people during naturally occurring opportunities. In education, ecological validity may contribute to the adoption of interventions by teachers working with students in school settings. Our purpose in this review was to examine the evidence for ecological validity of functional communication training (FCT) used to address challenging behavior in school-age individuals with disabilities. We reviewed 19 single-case experimental design (SCED) studies published between 1985 and 2023. First, we used the What Works Clearinghouse (WWC) Standards to evaluate the empirical evidence of each study. Second, we evaluated the extent to which behavioral assessment and FCT procedures were described in the 15 studies that met the WWC Standards. Third, we conducted a systematic analysis of the evidence for ecological validity of behavioral assessment and FCT. Results indicate that 95% of the SCED studies met the WWC Standards. The description of procedures was complete for 50% of the behavioral assessments and for 11% of the FCT. The overall evidence for ecological validity was moderate for 16.7% and low for 83.3% of the behavioral assessments. The evidence for ecological validity for all FCT procedures was low. Future research and implications related to ecological validity are discussed.

生态效度指的是研究成果在日常环境中的意义或实际意义,或者是典型人群在自然发生的机会中实施干预措施的程度。在教育领域,生态效度可能有助于教师在学校环境中对学生采取干预措施。本综述旨在研究功能性沟通训练(FCT)用于解决学龄残疾儿童挑战性行为的生态有效性证据。我们回顾了 1985 年至 2023 年间发表的 19 项单例实验设计(SCED)研究。首先,我们使用 "有效信息交换所(WWC)标准 "来评估每项研究的实证证据。其次,我们评估了符合 WWC 标准的 15 项研究中对行为评估和 FCT 程序的描述程度。第三,我们对行为评估和 FCT 的生态有效性证据进行了系统分析。结果表明,95% 的 SCED 研究符合 WWC 标准。50%的行为评估和 11% 的 FCT 的程序描述是完整的。16.7% 的行为评估和 83.3% 的心理测验的生态有效性分别为中度和低度。所有 FCT 程序的生态有效性证据均较低。本文讨论了与生态效度相关的未来研究和影响。
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引用次数: 0
Expression of Concern: Behavioral Activation and Acceptance and Commitment Therapy in the Treatment of Anxiety and Depression in Cancer Survivors: A Randomized Clinical Trial. 关注的表达:行为激活和接纳与承诺疗法在治疗癌症幸存者焦虑和抑郁中的应用:随机临床试验
IF 2 3区 心理学 Q3 PSYCHOLOGY, CLINICAL Pub Date : 2024-10-16 DOI: 10.1177/01454455241290866
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引用次数: 0
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Behavior Modification
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