Maintaining disulfiram ingestion among outpatient alcoholics: a security-deposit contingency contracting procedure

Disulfiram is frequently prescribed to alcoholic patients as a deterrent to drinking. Although ingestion of ethanol by a disulfiram patient quickly results in an intense dysphonc reaction, the drug is not generally credited with significant value in alcoholism treatment (Mottin, 1973). It is suggested that most alcoholics simply stop taking the medication (Gerrein et al., 1973). and review articles conclude that motivation for abstinence is the crucial variable involved in successful disulfiram treatment (Ditman, 1966: Mottin, 1973).Motivation may be a characteristic of environmental contingencies rather than of individuals. If so, environmental contingencies should permit one to design into a disulfiram treatment progrim the requisite motivation to achieve therapeutic success. Contingency management procedures supporting disulfiram ingestion reported to date (Liebson et al., 1973: Haynes, 1973) have been of the sort to be imposed upon difficult populations rather than offered to general treatment applicants. Contingency contracting may represent a technique for supporting disulfiram ingestion appropriate to the broader general population of voluntary alcoholism treatment applicants. Contingency contract treatment (Homme, 1969; Stuart, 1971) is a procedure in which client and therapist mutually agree to establish an incentive for the client to achieve a behavioral goal. Contingency contracts can be viewed as a form of self-control therapy, and have been applied in a wide variety of problem areas, including school problems (Homme, 1969: Cantrell, et al., 1969). delinquency (Stuart, 1971),weight control (Mann, 1972). smoking reduction (Elliott and Tighe, 1968: Winett, 1973), drug abuse (Boudin, 1972), and alcoholism (Miller, 1972).Frequently contingency contracting involves the client's posting of a financial security deposit to serve as his incentive for achieving the agreed-upon therapeutic goal (Tighe and Elliot, 1968). This security deposit can be earned back consequent upon achieving specific goals, or sacrificed consequent upon failure. Controlled studies by Mann (1972) and by Winett (1973) have demonstrated this security-deposit procedure to be effective in enhancing weight loss and smoking reduction, respectively.We report here on our experience with application of the security deposit contracting procedure to maintaining routine disulfiram ingestion among outpatients in an alcoholism treatment program.     

Alcoholic drinking: suppression by a brief time-out procedure

Volunteer chronic alcoholics were given daily access to substantial quantities of alcohol within a residential research setting. Drinking was suppressed to an average of approximately one-half of Baseline levels when 10 or 15 min of physical and social isolation was required as an immediate consequence to receiving each one-ounce drink of 95-proof ethanol. This time-out procedure suppressed the drinking of nine out of ten subjects. Drinking returned to high levels when brief contingent time-out was discontinued. The relevance of such reversible controlling relationships to the treatment of alcoholism is discussed.     

An analysis of speech perception in word deafness

A patient with a rather pure word deafness showed extreme suppression of right ear signals under dichotic conditions, suggesting that speech signals were being processed in the right hemisphere. Systematic errors in the identification and discrimination of natural and synthetic stop consonants further indicated that speech sounds were not being processed in the normal manner. Auditory comprehension improved considerably however, when the range of speech stimuli was limited by contextual constraints. Possible implications for the mechanism of word deafness are discussed.     

Semantic mechanisms in paralexia

This study explores the effects of semantic constraints on the occurrence of paralexic responses in two patients who tend to produce semantic errors in reading aloud. In the first experiment, semantic constraints were provided by using words as proper names (e.g., “brown” vs. “Sam Brown”), and in the second by using short, highly familiar phrases to restrict the meaning of the target word (e.g., the polar bear; green with envy). These constraints were found to be effective in reducing the frequency of paralexic errors.     

Dissociations of language function in dementia: A case study

In this report we describe and attempt to characterize the deterioration in semantic knowledge occurring in a victim of a progressive dementing disease. The subject was unable to match even highly familiar naming words with their actual or pictured referents; instead, she consistently overextended verbal labels to closely associated distractors. The alteration in scope of referential meanings suggested by this overextension effect was apparently related to a breakdown in the structure of underlying categories. On a nonverbal match-to-sample procedure, for example, dogs were treated as exemplars of the cat family. Evidence for the breakdown of semantic knowledge was not limited to picture labeling paradigms. Thus, we found that the subject was unable to utilize semantic context in the written disambiguation of spoken homophones but could, at the same time, use even minimal syntactic cues as the basis for proper lexical selection. This last result was consistent with other lines of evidence pointing to the relative preservation of syntactic operations, in marked contrast to the semantic loss. The importance of this dissociation of function in organic pathology is considered from a number of perspectives, including its relevance to models of language organization in the brain.     

Lexical decision for open- and closed-class words: failure to replicate differential frequency sensitivity

Bradley and her colleagues (D. C. Bradley, Computational distinctions of vocabulary type, unpublished Ph.D. thesis, Massachusetts Institute of Technology, 1978D. C. Bradley, M. E. Garrett, &; E. B. Zurif, in D. Caplan (Ed.), Biological studies of mental processes, Cambridge, MA: MIT Press, 1980) have reported a marked difference in frequency sensitivity between open- and closed-class words on a lexical decision task. This effect was obtained with normal subjects, but not with Broca's aphasics. Their results have already influenced experimental and theoretical investigations of syntactic processing. However, in three lexical decision experiments with normal subjects, modeled on those of Bradley et al., we failed to find such a theoretically interesting difference between the two classes. Instead, both classes showed similar reaction time frequency sensitivity for word frequencies less than approximately 316/million (H. Kucera &; W. N. Francis, Computational analysis of present-day English, Providence, RI: Brown Univ. Press, 1967, count); above 399/million, the closed class had an almost-flat function of reaction time versus the logarithm of the frequency, while the open class may have had too few members for meaningful assessment. Because reaction time may be a nonlinear function of log frequency, and because there is relatively little overlap between the frequency ranges of the two classes, comparisons of the members of the two classes which might straddle the function's inflection point must be made with extreme caution.     

The “feminine mystique” in male-dominated jobs: A comparison of attitudes and background factors of women in male-dominated versus female-dominated jobs

This paper examines various background factors plus success and work-related atttudes of 324 women as aggregated into one of three groups: those women working in male-dominated jobs, those in female-dominated jobs, and those in relatively sex-ratio balanced jobs. Overall results show that women holding male-dominated jobs are more likely to be older, better educated, have fathers with higher educational levels, and are more likely to be childless as compared to women in female-dominated jobs. Holding age and education constant, women in male-dominated jobs usually rated definitions of success as more important to their feelings of well-being than did women in female-dominated jobs. With these same constants, there were few differences in work attitudes among the three groups, but contrary to expectations, women in female-dominated jobs rated the importance of their work higher than did women in male-dominated jobs. The variables best predicting whether a woman held a male-dominated job were college attainment, problems related to sex discrimination, the age of the participant, her feelings toward achieving a very high salary, her feelings of the importance of her work, and her feelings about becoming an authority in her job.     

Short-term memory performance in the absence of phonological coding

These experiments examined the short-term memory performance of an aphasic patient with posterior damage who shows a selective deficit in phonological coding. In recognition memory tests, the patient relied on both visual and semantic coding, and often showed an essentially normal level of accuracy. However, for memory sets consisting of four function words, his performance was quite impaired. Also, his retention of order information was far below that of normal controls. The implications of these deficits in short-term memory for language comprehension and production are discussed.     

Imagery and verbal encoding in left and right hemisphere damaged patients

Neuropsychological aspects of imaginal and verbal encoding in memory were explored in two forced-choice recognition memory experiments with patients suffering from left and right anterior cerebral hemisphere damage. In the first experiment stimulus type and rate of presentation were varied. Predictions of patient performance based on the hypothesis that left anterior hemisphere pathology impairs verbal memory coding and right anterior hemisphere pathology impairs imaginal coding were confirmed. In a second recognition memory experiment for pictures of common objects, system-specific (imaginal or verbal) interference and distractor effects were demonstrated by analyzing the effects of interpolated tasks and the nature of false-recognition errors.     

An investigation of repetition and language processing in a case of conduction aphasia

A study is reported of a single case of conduction aphasia. A battery of tasks designed to investigate the parameters of the patient's severe repetition deficit is supplemented by tests of several language functions. The results provide extensive information on a wide range of the patient's language abilities and are used to evaluate the adequacy of four models that have been offered to account for conduction aphasia. An argument is made in support of the suggestion that the syndrome of conduction aphasia should be divided into two subgroups based on patients' ability to select and realize phonemes in speech output. It is concluded that the best explanation for the disorder of patients with repetition deficit but without significant speech output problems is the hypothesis that repetition ability is compromised by a pathological limitation of auditory-verbal short-term memory. This hypothesis is extended to account for the pattern of results obtained in the language tasks.     

Choice behavior of rats searching for food

The experiments reported here were designed to determine if several general principles drawn from appetitively motivated discrimination experiments in standard laboratory apparatus might also apply to food-searching behavior under more naturalistic conditions. Food-deprived rats searched for food in an open observation area. Choice behavior after finding food and after not finding food was analyzed. In all cases, not finding food in a possible food location was sufficient to direct subsequent search behavior away from that location for the remainder of the day's test. Finding food had variable effects on subsequent choice behavior, depending on the number of locations that actually contained food and the number of days food was in one location before being shifted to another. The results indicate that the rat's search strategy was influenced by food availability and distribution in ways that are predicted by discrimination learning experiments.     

Menstrual cycle effects on task performance examined in the context of stress research

The study examined the effects of degree of paramenstrual distress, signal frequency, task load and time on task on psychomotor performance across the menstrual cycle. Simple reaction time, choice reaction time and pursuit tracking were the tasks employed, and performance was assessed using the metrics of mean level, variability, and errors of omission and commission. The results showed performance as a function of menstrual cycle phase and paramenstrual distress to be highly task and metric specific, a finding typical of stressor variables: pursuit tracking was affected by phase, with mean performance at its worst premenstrually; choice reaction time was dependent on a complex interaction of experimental variables and measurement metrics; simple reaction time showed no significant effects. Patterns of attention allocation in a time-sharing situation combining both pursuit tracking and choice reaction time components were also investigated. Trends here indicated relatively better performance both menstrually and intermenstrually as components increased in signal/response frequency, with a corresponding deterioration premenstrually. Overall performance capacity appeared to be greatest at menstruation, and the degree of attentional selectivity was least. High distress women performed better on low frequency components, whereas asymptomatic women did better at higher signal rates.     

Imagery,propositions, and the form of internal representations

This paper has four major sections: First, we review the basic arguments offered by Pylyshyn (Psychological Bulletin, 1973, 80, 1–24) and others against using imagery as an explanatory construct in psychology. Second, we consider each of these points and find none that speak against any but the most primitive notions of imagery. Third, we review the results of various experiments on imagery. In each case, we compare two explanations of the findings: one which assumes the existence of a surface image manifesting emergent properties, and one which assumes that all internal representations are coded in terms of “abstract propositions.” We find imagery hypotheses to be at least as adequate as those based on propositional representation. Finally, we conclude that debate about the ultimate foundations of internal representation is fruitless; the empirical question is whether images have properties that cannot be derived directly from more abstract propositional structures.     

Structural complexity as a determinant of serial pattern learning

A new methodology extends the study of serial pattern learning to nonhuman organisms by constructing patterns using elements that are both familiar and motivationally meaningful to animals. Two experiments examine the ability of rats to anticipate various quantities of food as measured by running times in a runway when the quantities occur in a serial order. In Experiment 1, a serial monotonic pattern (14-7-3-1-0 food pellets) produced more rapid learning and more accurate anticipation of the various quantities (“tracking”) than a serial nonmonotonic pattern (14-1-3-7-0 food pellets), particularly with respect to the final 0-pellet element. In Experiment 2, the same monotonic pattern generated faster learning and more accurate anticipation of pattern elements than a weakly monotonic pattern (14-5-5-1-0 pellets). Associative explanations including simple excitatory or inhibitory effects, temporal anticipation, reinforcement contrast, and the number and discriminability of pairwise associations are not adequate to account for the data. Rather, the formally defined structural complexity of each pattern adequately predicts its relative difficulty.     

Cognitive mechanisms in number processing and calculation: evidence from dyscalculia

This article presents a framework for the cognitive analysis of number processing and calculation. Within this framework the primary objective is the development of a model that is sufficiently detailed to serve as a basis for explaining the number-processing/calculation performance of both normal and cognitively impaired subjects. First a general model of the cognitive mechanisms for number processing and calculation is outlined. It is shown that patterns of impairments observed in brain-damaged patients support the major assumptions of the model and that the model provides a theoretically motivated framework for interpreting the deficits. A single case is then discussed in some detail, to demonstrate that through detailed analyses of impaired performance the preliminary model can be elaborated to specify not only the general architecture of the number-processing and calculation systems, but also the inner workings of specific components and the consequences of damage to these components. The article concludes with a discussion of several general issues arising from the presented arguments.     

Defective stimulus set attention in generalized epilepsy

This study examined auditory selective attention in primary generalized and complex-partial (temporal lobe) epileptics using binaural and dichotic versions of the Continuous Performance Test. The patient groups did not differ from normal controls when only one channel was presented or when divided attention (simultaneously monitoring two channels) was required. However, generalized epileptics had significantly depressed hit rates when directed attention (responding to critical stimuli in only one channel) was required. These results suggest a contribution of brain stem “arousal” mechanisms to stimulus set attention. In addition, right ear perceptual advantages were found on these dichotic monitoring tasks, lending support to the contention that short-term auditory memory and verbal report are not required for the dichotic ear effect.     

Creating and criticizing theory

F. W. Vondracek, R. M. Lerner, and J. E. Schulenberg (Journal of Vocational Behavior, 1983, 23, 179–202) criticize the vocational literature for failing to “follow acceptable scientific procedures for building a theory” and for failing to attend to important methodological and substantive developments. It is argued here that no single acceptable process for creating theory exists and three strategies useful for developing a theory are illustrated: immerse yourself in data, pick a specific set of results to explain, and try to resolve inconsistencies in the literature. Three criteria for evaluating theories and criticisms of them are discussed: comprehensiveness (content value), accuracy (truth value), and clarity (form). The paper by Vondracek et al. is examined from this perspective and is shown to lack the specificity, clarity, and accuracy necessary to be an effective guide to better vocational research or theory.     

Classification of spelling errors and their relationship to reading ability, sex, grade placement, and intelligence

A simple scheme for the classification of spelling errors was applied to the errors of four groups of children, totaling 483 subjects, in grades 3 to 12. The subjects in two of the groups, Group I and Group IV, consisted of individuals who attended special schools for children with dyslexia or specific reading disability (SRD). Group II included school age siblings of subjects in Group I, and Group III included subjects drawn from regular school programs. It was shown that (a) type of spelling error is independent of sex, (b) there are no consistent effects of IQ or grade level on type of spelling error, and (c) disabled readers as a group are more likely to produce dysphonetic errors than are normal readers. Although the type of spelling error produced by children who had a spelling disability only was shown to be similar to that of normal readers and to differ from that of disabled readers as a group, disabled readers were shown to differ among themselves, lending strong support to the use of spelling error type as a characteristic for identifying subgroups.