Deliberate self-harm,clinical history and extreme scoring on the EPQ

Two hundred consecutive admissions to an inpatient psychiatric unit were assessed on the EPQ following recovery from the disturbance for which they were hospitalized. Case-history data was also checked for these patients and extended by using a clinical-history structured interview, also administered within 1 week of discharge. Results showed that for males, high P and high N was associated with a history of deliberate self-harm (DSH) by mutilation. High N was also associated with parental violence. In females, both low E and high N were associated with a history of self-mutilation. High N scores were also more likely to have appeared in court, and high P females were more likely to have a history of bedwetting and of parental violence.None of the associations between extreme scoring on the EPQ and self-mutilation were found for DSH by overdose.     

The importance of home practice for progressive relaxation training

The efficacy of home practice assignments was evaluated as a component of standardized progressive relaxation training. Subjects reporting general anxiety and tension problems were assigned to either a home practice relaxation, no home practice relaxation or wait-list control condition. Treatment was conducted for 10 sessions over a 5-week period. In addition, subjects in both conditions engaged in in-vivo application of their relaxation skills during a final 2-week application period. Group comparisons showed that both progressive relaxation conditions significantly improved on daily self-monitored general anxiety and tension levels relative to the wait-list control condition. Group analyses of percent subject improvements supported the effectiveness of home practice assignments, especially during the application period. No systematic differences between groups, on physiological and self-report variables, were found during several laboratory relaxation evaluation sessions. This study supports the contribution of home practice assignments to progressive relaxation training.     

Heterosocial-skills training and covert sensitization. Effects on social skills and sexual arousal in sexual deviants

There are few experimental investigations of the effects of social-skills training (SST) on sexual deviation. This study used a multiple baseline across 4 subjects with undesired sexual arousal to investigate the effects of heterosocial-skills training and covert sensitization on heterosocial skills and sexual-arousal patterns. SST produced large increases in heterosocial skills but it had unclear effects on sexual arousal. Subsequently, covert sensitization tended to reduce remaining deviant arousal but did not increase appropriate arousal significantly. These data generally support the view that individual components of sexual arousal require separate assessment and intervention.     

Development of a rating scale to measure social skills in children: The matson evaluation of social skills with youngsters (MESSY)

The development of a scale for assessing social skills with children is reported. The Matson Evaluation of Social Skills with Youngsters (MESSY) was completed on 744 children between 4 and 18 years of age. A self-report form was completed on 422 children while 322 children were rated on a teacher-report measure using a 5-point Likert-type scale. Analyses included test-retest reliability conducted at a 2-week interval using Pearson correlations, factor-analytic procedures and selected analyses of variance and appropriate post-hoc tests. Implications of present findings and directions for future research are discussed.     

Complementary pairing of handicapped workers with compensatory skills: a strategy to increase independence

Although the right to and the beneficial psychological effects of productive employment by the handicapped are well documented, many potential workers remain unemployable because of the nature of their handicapping conditions. This study is an experimental investigation of the effect on job performance of pairing handicapped persons with complementary skills. Workshop productivity was measured for two pairs of workers, each consisting of a cerebral-palsied person and a mentally-retarded partner. Using a multiple-baseline design with a reversal component, production on a packaging task was assessed during individual work and paired cooperative work. The combination of the cerebral-palsied workers' ability to provide reinforcement and the retarded workers' production skills resulted in a significant increase in productivity. The potential extension of this strategy to individuals with these and other disabilities is discussed.     

A comparison of social-skills training, pharmacotherapy and psychotherapy for depression

This study compared four treatments for unipolar (non-psychotic) depression: Amitriptyline, Social-Skills Training (SST) + Amitriptyline, SST + Placebo and Psychotherapy + Placebo. In addition, 25 normal women were assessed on the behavioral measures in order to evaluate the ecological validity of the dependent measures and the changes produced by treatment. The four treatments, conducted by experienced clinicians, all produced statistically-significant and clinically-meaningful changes in symptomatology. However, there were several notable differences. The SST groups had greater improvement on measures of social skill, and were more similar to the normal women after treatment. In addition the SST + Placebo group had the lowest level of attrition and had the highest proportion of patients who were significantly improved. Significance of the results for future research on SST and role-play measures of social skill was discussed.     

Exposure and communications training in the treatment of agoraphobia

Twenty-one agoraphobics participated in a 6-month study designed to (a) compare imaginal flooding under high- (no sedation) and low- (sedation used) anxiety conditions: (b) examine the long-term effects of imaginal flooding in the absence of further exposure treatment; and (c) explore the impact of communications training on chronic anxiety and panic attacks. A reevaluation of the effects of sedation is presented in this report.Imaginal flooding without sedation was, on the whole, superior to the attention control placebo and imaginal flooding with sedation on therapists' and clients' ratings of fear and avoidance. However, the superiority of the non-drug flooding group cannot be attributed (as was concluded in an earlier report) to higher levels of anxiety across flooding sessions. Rather the drug (methohexitone sodium) appears to have impeded across-session habituation, perhaps by interfering with long-term memorial processes.The effects of imaginal flooding without sedation were stable over 4 months without further exposure treatment. These clients did receive training in solving important interpersonal problems through self monitoring and increased expressiveness. Contrary to hypotheses, not only was no further improvement obtained on fear and avoidance with this treatment, but also anxious mood and panic attacks remained unaffected. It is surprising to note that in-vivo treatment was no more effective than imaginal flooding on fear and avoidance. These and other findings suggest imaginal flooding well warrants further study.     

Anxiety management training in the treatment of essential hypertension

The study was conducted to assess the efficacy of Anxiety Management Training as an adjunctive treatment for essential hypertension. Twenty-one patients with essential hypertension, all but one of whom were on antihypertension medication, were randomly assigned either to an Anxiety Management Training condition or a waiting-list control condition. At the time of a posttest assessment session, compared to subjects in the control condition, subjects in the Anxiety Management Training condition manifested a decrease in resting systolic and diastolic blood pressure and a decrease in systolic and diastolic blood pressure following a stressful task. At the time of a follow-up assessment session, subjects in the Anxiety Management Training condition not only manifested good maintenance of reduced blood pressure but also exhibited a further decrease in resting systolic blood pressure and a decrease in systolic blood pressure during the stressful task.     

Effects of massed practice and cue-controlled relaxation on tic frequency in Gilles de la Tourette's syndrome

The effects of massed practice (MP) and cue-controlled relaxation on tic frequency were assessed in three single-case studies. Measures of tic frequency, subjective tension and fatigue, and physiological arousal were obtained throughout treatment.MP failed to produce any reduction in tic frequency in the three Gilles de la Tourette's syndrome patients studied. Cue-controlled relaxation resulted in a moderate decrease in tic frequency in only one patient.Tic frequency was related to physiological arousal, as assessed by skin conductance response frequency. No evidence was obtained in support of the suggestion that ticquers demonstrate a deficit in their habituation to sensory stimulation.     

Assertion training: the effectiveness of a comprehensive cognitive--behavioral treatment package with professional nurses

The purpose of the study was to evaluate the effectiveness of a comprehensive cognitive-behavioral treatment package with a professional population of registered nurses using multiple self-report and role-play measures. Twenty-six self-referred registered nurses were randomly assigned to either a Treatment or Control group. The treatment package consisted of five weekly 2-hr sessions of group assertion training using the cognitive-behavioral model of Lange and Jakubowski. The Assertiveness Self-statement Test, the Rathus Assertiveness Schedule, the Adult Self-expression Scale, two Likert scales and role-play were used to evaluate changes over time. The results indicated: (1) the nurses in both groups at Pretreatment were clearly subassertive; (2) by Posttraining the Treatment-group members increased significantly their assertiveness as indicated on the self-report tests; (3) Treatment-group members had successfully maintained their improved assertiveness by the 2-month Follow-up; (4) the role-play ratings paralleled and supported the self-report results, but not at significant levels; (5) there was strong empirical support for the social validity of the treatment package; and (6) there was a high degree of treatment credibility for the cognitive-behavioral Assertion-training group. Overall, the results indicate clear support for the effectiveness of a broad-based cognitive-behavioral treatment package for treating subassertive behavior in a professional population of registered nurses.     

Generalization of treatment effects in training public speakers

Three studies compared the efficacy of various treatments for public-speaking incompetence. These effects were evaluated for the target behavior as well as for generalization effects across situations (conversations), settings (different sizes and types of audiences) and time (6-month follow-up). The first study showed that Self-instructional Training, either alone or in combination with other procedures, produced little or no benefits. The second study demonstrated the superiority of a Skills Training program over flooding therapy, while the final study failed to detect any enhancement of treatment benefits for the addition of home-practice to the Skills Training. In the first two studies generalization occurred across the three dimensions (settings, situations and time), while in the final study it was shown that the program was effective for a clinical population as well as recruited volunteers.     

Behavioral training for myopia: generalization of effects

The present study assessed generalization of training effects using a video computer system (VCS) as a training medium for modifying acuity. Eighteen myopic volunteers were matched according to pre-training acuity and assigned to either fading and feedback training group or a practice only control. Subjects were pre- and post-tested on three measures: the Snellen Letter Chart, a Behavioral Acuity Test and a performance test with the VCS. Compared to controls, trained subjects displayed significant improvements in acuity on the Behavioral Acuity Test. These results suggest that training effects generalize to untrained stimuli. Implications for the clinical implementation of behavioral training procedures for modifying myopia are discussed.     

Cognitive-behavioral treatment of agoraphobia: paradoxical intention vs self-statement training

Twenty-six agoraphobics were randomly assigned to either Paradoxical Intention (PI) or Self-Statement Training (SST) which consisted of 12 weekly 90-min group sessions with 4–5 patients per group. Major assessments were carried out at pre-treatment, 6th week and 12th week of treatment, and at 1- and 6-month follow-ups. Measures included clinical ratings of severity of condition, phobia, anxiety and depression. Furthermore, a behavioral test was administered during which changes in subjective units of discomfort and cognitions were assessed. The results indicated statistically-significant improvement over time with both treatments. ANCOVAs performed revealed superior effects on several agoraphobia measures for the PI condition at post-treatment. However, by the 6-month follow-up assessment, the groups were equivalent due to marked improvement during the follow-up phase in the SST condition. Cognitive changes were marked by a decrease in self-defeating statements without concomitant increase in coping statements. These results and recommendations for future research are discussed.     

Efficacy of self-instructional training for reducing children''s anxiety in an evaluative situation

Fifty-six fourth-grade children were categorized as either high or low in trait anxiety and then assigned to a self-instruction treatment, minimal-treatment, or no-treatment control condition. At both pretest and posttest, the subjects recited a memorized poem while being videotaped with the expectation that they would be judged on their performance. State anxiety measures, a behavior rating of anxiety, a measure of performance accuracy and the time involved in reciting a poem were obtained at both pretest and posttest. Contrary to expectation, the self-instructional training resulted in subjects' exhibiting greater signs of behavioral anxiety, subjects' hurrying through the task (taking less time to recite the poem) and high trait-anxiety subjects' reporting more state anxiety while anticipating reciting the poem. Correlational analyses indicated that trait anxiety was significantly related to the measures of state anxiety and the behavior rating of anxiety but not to performance accuracy.     

Cue exposure and response prevention with alcoholics: a controlled trial

Ten severely alcohol-dependent subjects were divided into two groups, one of which received only 6 sessions of in-vivo cue exposure and response prevention and the other of which received 6 sessions of imaginal cue exposure, followed by 6 sessions of in-vivo cue exposure and response prevention. The in-vivo cue exposure produced significant decrements on behavioural and subjective measures for both experimental groups on Desire to Drink and Difficulty to Resist Alcohol. Imaginal cue exposure produced trivial changes on these measures. The implications for both theory and practice are discussed.     

Sequential comparisons of relaxation training and biofeedback in the treatment of three kinds of chronic headache or,the machines may be necessary some time of the time

Two studies are reported in which patients with chronic headache, who did not improve significantly as a result of a 10-session, 8-week relaxation training program, were subsequently treated with biofeedback. For the tension headache sufferers, 36% of the relaxation non-responders showed significant improvement with frontal EMG biofeedback training. For those with vascular headaches, 44% of the relaxation non-responders showed significant improvement with thermal biofeedback. Vascular headache patients with combined migraine and tension symptoms did better than those with only migraine. Psychological test scores significantly differentiated successful vs non-successful biofeedback responders.     

The reduction of anxiety in children: a comparison of the effects of 'systematic desensitization in vitro' and 'systematic desensitization in vivo'

Twenty-four children between the ages of 5 and 10. selected on the basis of fear of water, as determined by parents and swimming teachers, were divided into two experimental groups and one control group. One of the experimental groups was treated with four sessions of in vitro desensitization (gradual imaginal exposure to fear evoking stimuli plus relaxation), followed by four sessions of in vivo desensitization (real-life exposure to fear evoking stimuli plus relaxation). The other group received eight sessions of in vivo desensitization. The control group took part only in the tests, which were administered at the commencement of treatment, after four sessions, and at the end of the course of treatments. In testing, a behavior observation record was used to score the subject's behavior in the given situation; in addition, two teacher's records were used, in which swimming teachers recorded their evaluation of the subject's anxiety in each situation.Better results were achieved by desensitization in vivo than by desensitizalion in vitro or by the control procedure. No differences were found between the latter two groups. It could not be demonstrated that desensitization in vitro increased the effectiveness of subsequent desensitization in vivo     

The relationship of role-play assessment of children's social skills to multiple measures of social competence

The present investigation evaluated the relationship of role-play performance of children's social skills with multiple measures of social competence. Thirty-eight psychiatric inpatient children (ages 7–13 yrs) completed measures to assess role-play performance, knowledge of social skills, self-efficacy and self-reported social behavior in diverse situations. Overt social interaction was directly but unobtrusively assessed in the hospital as well. Multiple measures of social skills were also completed by hospital staff, parents and teachers. The results indicated that role-play performance correlated significantly with child knowledge and self-efficacy but not with overt social behavior or self-reported social behavior in diverse situations. Role-play performance generally did not correlate with measures completed by staff, parents and teachers. Yet measures completed by these informants did converge and also were useful in delineating diagnostic groups of children whose social behavior would be expected to be problematic. The implications of the results for the use of role-play tests to evaluate social skills and to discriminate clinical populations are discussed.     

Acute pain in a clinical setting: Effects of cognitive-behavioural skills training

The present study evaluated the efficacy of cognitive-behavioural skills training, patterned after stress-inoculation training, as a preventive intervention for the attenuation of acute clinical pain during a noxious X-ray procedure—the knee arthrogram. Thirty-six adult male outpatients were randomly assigned to one of three groups: Skills Training. Attention-Placebo, and No-Treatment Control. An experimental pain test was administered before and after the interventions, as a generalization measure. Arthrogram pain was assessed by three dependent measures: patient's ratings, radiologist's ratings and videotape ratings completed by two‘blind’ raters. The results failed to support the efficacy of skills training for the attenuation of acute clinical pain, or its generalization to the experimental pain test. Although Skills Training subjects reported using significantly more coping strategies during the arthrogram. many subjects in the two control groups also reported using their own spontaneous strategies. Equivocal data were obtained on the role of ‘self-efficacy’ expectancies in mediating pain behaviour and experience. Experimental pain threshold but not pain tolerance was significantly related to acute clinical pain experienced during the arthrogram.     

Improving visual acuity in a myopic child: Assessing compliance and effectiveness

Improvements in visual acuity following vision training were evaluated for an 11$\text{1}\text{2}$-yr-old myopic male. Initial increases in the distance at which the S could discriminate letters were found. However, performance began to deteriorate as training progressed. A negative-reinforcement procedure was employed in order to rule out motivational factors potentially related to this decreased performance. Using a changing criterion within an ABCBC reversal design, the distance at which the S correctly discriminated letters increased by more than $\text{4}\text{1}\text{2}$ times and was clearly related to the reinforcement procedure.