A comparison of two methods for the administration of paradoxical intention

Recent research in the treatment of insomnia by paradoxical intention has utilized two different methods of instruction. Studies utilizing the random assignment of subjects to treatment groups employ a procedure in which clients are provided with a straight-forward explanation based on the present authors' understanding of the use of paradoxical intention with insomnia (type A administration). In contrast, controlled case studies have employed reframing, a procedure which explains the need for the paradoxical intention in a manner which best suits the specific understanding of the individual client (type B administration). The present study employed the type B method in a design employing the random assignment of clients to groups. Three additional groups (type A administration, placebo control, no-treatment control) completed the design. The results indicated that the type A method was superior to the type B procedure when the same method for administering paradoxical intention was applied to a randomized group of individuals.     

Paradoxical intention in the treatment of urinary retention

Although most cases of psychogenic urinary retention can be ameliorated by a program composed of various behavioral techniques, there is a small percentage of cases which resists the behavioral treatment of choice. The present multiple case paper focused on the treatment of several resistant cases of functional urinary retention. Following a two week baseline period, each individual was exposed to eight weekly behavioral sessions. Whereas most cases of urinary retention have significantly improved by this time, the five individuals chosen for the present study were dissatisfied with their progress. Thus, following the eighth week, paradoxical intention was employed. Within six weeks treatment for the urinary problem was terminated as all clients were comfortable with this aspect of their daily behavior. It was hypothesized that cases of psychogenic urinary retention which resist behavioral techniques are possibly exacerbated by performance anxiety. Such anxiety can be efficiently handled by paradoxical intention.     

The effects of token procedures on a teacher's social contacts with her students

The effects of a token system on a teacher's rate of social contacts with her students were investigated in a public school kindergarten. A group of six children were observed daily during a 20-min handwriting lesson. The children were divided into two groups (A and B) of three children each. Five conditions were imposed sequentially: (1) baseline without tokens, (2) contingent tokens for Group A, noncontingent tokens for Group B, (3) contingent tokens for Group B, noncontingent tokens for Group A, (4) reinstatement of condition 2, and (5) contingent tokens for both groups. It was consistently observed that the teacher's rate of social contact was higher with the children receiving the contingent tokens than with those who received noncontingent tokens.     

Perceptual learning in flavor-aversion learning: Alternating and blocked exposure to a compound of flavors and to an element of that compound

Rats received different schedules of pre-exposure to a compound flavor (AX) and to one element of that compound (X). In Group ALT, exposure consisted of alternating trials with AX and X; Group BLK received a block with all AX trials before a separate block with all X trials (or vice versa). Discrimination between AX and X was assessed then by establishing an aversion to X and measuring the generalization of this aversion to AX. In Experiments 1A and 1B, generalization was less in Group ALT than in Group BLK. In Experiment 2, this latter result was confirmed and furthermore only Group ALT, and not Group BLK, showed less generalization than a group that received exposure to X alone. These results are discussed in terms of their implications for theories of perceptual learning.     

Preconceptional family health evaluation: A regional education program for family planning clients and health professionals

The Preconceptional Family Health Evaluation Program was a regional project developed and funded for 2 years by the New England Regional Genetics Group (NERGG) to educate family planning health professionals about genetics, and to offer family planning clients preconceptional identification of genetic and environmental exposure risks. To meet these goals, genetic education was provided on a regional basis to 45 family planning professionals. A self-administered family health risk questionnaire adaptable to individual family planning settings was developed. Five hundred and twenty-nine family planning clients voluntarily completed the questionnaire. Cigarette smoking (35%) and alcohol use (57%) were two major categories of risks identified. The Preconceptional Family Health Evaluation Program was well received by all participants and provided an effective means for regional education of family planning health professionals. As a result of the program, state program planners, clinical genetics services, and family planning health professionals developed a strong relationship that will serve future educational and genetic risk screening efforts.     

Representation-mediated Inhibitory Learning in the Conditioned-suppression Procedure

In three experiments, rats in group I (for intermixed) were given non-reinforced exposure to two compound stimuli, AX and BX, where A and B represent different auditory cues, and X represents a visual cue. AX and BX were presented in alternation. Group B (blocked) received similar exposure except that subjects experienced a block of AX trials and then a block of BX trials. Subsequent shock reinforcement of A was found to endow B with inhibitory strength in group I, as assessed by retardation (Experiments 1 and 2) and summation tests (Experiment 3). This outcome confirms and extends the results reported by Espinet, Iraola, Bennett, and Mackintosh (1995) and constitutes a further example of mediated learning in which the associative strength of a stimulus is found to be modified as a consequence of training given to some other event with which that stimulus is associated.     

Therapist-controlled exposure in vivo versus self-controlled exposure in vivo: A comparison with obsessive-compulsive patients

Fourteen obsessive-compulsive clients were given treatment consisting of ten sessions of gradual exposure in vivo With half the clients, the exposure in vivo was therapist-controlled; with the other half, the exposure in vivo was self-controlled.

The results of the posttest showed that both versions of the treatment resulted in a significant improvement on the in vivo measurement, anxiety and avoidance scales, Leyton Obsessional Inventory, Self-Rating Depression Scale and anxious mood. Neither the posttest nor the follow-ups one month and 3.5 months later indicated a difference between the effects of the two conditions. Self-controlled exposure in vivo proved to be as effective as therapist-controlled exposure in vivo, in spite of the fact that in the latter condition each treatment session lasted twice as long as in the former condition.     

Therapist factor in the treatment of insomnia

This quasi-experiment attempted to replicate the finding of Turner and Ascher (1979) in contrasting progressive relaxation, stimulus control and paradoxical intention therapies for the treatment of insomnia using clinicians-in-training as therapists. Progressive relaxation and stimulus control were again shown to be effective, paradoxical intention instructions were not. A significant therapist effect was found which is discrepant with previous findings in the field.     

Perceptual learning during filial imprinting: Evidence from transfer of training studies

Chicks were first imprinted by exposing them to a moving training stimulus, B or C, that was projected onto a screen at one end of an experimental cabinet. Subsequently, subjects selectively approached the stimulus to which they had been exposed. On the following day, the chicks were placed into a chilled experimental cabinet (15°C) and received trials on which two stimuli (A and B) were projected onto screens located at opposite ends of the cabinet. If the subject approached Stimulus A, a stream of warm air was delivered; if it approached B, the trial terminated, and no heat was presented. For subjects that had been imprinted with Stimulus B, those in Group B, Stimulus A was novel, and Stimulus B was familiar. For chicks that had been imprinted with Stimulus C, Group C, both A and B were novel. In two experiments, Group B acquired the discrimination more rapidly than did Group C. This observation, made using a novel training procedure, was taken to support the suggestion that imprinting results in a form of perceptual learning in which the familiar imprinting object has become more discriminable from other novel objects.     

Paradoxical intention in the treatment of chronic insomnia: six case studies illustrating variability in therapeutic response

The relatively small behavioural literature available contains a number of encouraging reports evidencing the effectiveness of paradoxical intention therapy as a treatment for sleep onset insomnia. This present paper contributes a further six case studies of chronic insomniacs, referred for treatment within the context of a major treatment comparison study, who were randomly allocated to receive paradoxical intention. Therapy typically lasted for 8 weeks, consisting of two 4-week phases, the first of which involved a counterdemand manipulation designed to control for demand and expectancy factors. Considerable variability in response to therapy was observed, with 3 patients obtaining a rapid reduction in sleep onset latency while the sleep pattern of the 3 other Ss was significantly exacerbated. Although 1 S from this latter group did improve after several weeks treatment, the other 2 Ss were ultimately successfully treated with progressive relaxation training having been unable to persevere with paradoxical intention. These results are discussed with reference to previous research and the consideration of individual patient characteristics.     

Habituation of orienting responses as a function of “instructional set”

Electrodermal and plethysmographic recordings were obtained from three groups of alcoholic patients. The groups differed with respect to instructions given for response to a series of words spoken by the experimenter. Group A was told to report verbally their first associations for each word presented. Group B received instructions to think of an association for each word without reporting it. Group C was to respond to each word by repeating it after it was spoken by the experimenter. The instructions did not have the predicted differing effects upon rate of EDR habituation. However, the over-all amplitude of EDR was lower for Group B than for Group A or C. We observed very little habituation of the plethysmographic OR as measured by per cent of subjects responding to each word. As with the EDR data, Group B shows less responsivity, i.e., this group produced significantly fewer plethysmographic responses over all words than did either of the other two groups. The relative importance of association and of verbal responding to a stimulus word for eliciting autonomic responses was considered.     

PYRAMIDAL STAFF TRAINING IN THE EXTENSION OF TREATMENT FOR SEVERE BEHAVIOR DISORDERS

We implemented a pyramidal training procedure for staff working with individuals who exhibited self-injurious behavior (SIB), aggression, and disruption. Two adults with developmental disabilities and their direct-care staff and supervisors participated. Following successful treatment by the experimenters, two types of baselines were conducted with the clients and their direct-care staff. During an initial baseline, the staff implemented preexisting procedures. Staff members then received instruction on the new treatment procedures using training methods common throughout the institution, and data were collected during this “post-in-service” baseline. Experimenters then taught unit supervisors to implement treatment, collect and interpret data, and provide similar instructions and feedback to the staff members. The supervisor training was implemented in a multiple baseline design across subjects (clients and direct-care staff). Results showed little change following in-service training but noticeable improvements in direct-care staff behaviors and corresponding decreases in the clients' inappropriate behavior following the pyramidal training intervention with supervisors. Six additional clients (along with their direct-care staff and supervisors) participated in pre- and posttreatment replication designs, and their results provided additional support for the efficacy of the supervisor training procedures.     

The role of stimulus comparison in perceptual learning: An investigation with the domestic chick

In two experiments an imprinting procedure was used to familiarize chicks with two stimuli, A and B, that subsequently served as the discriminanda in a simultaneous discrimination. On the first day of each experiment, subjects either received presentations of A and B that were intermixed within a session (mixed exposure) or presentations of A in one session and of B in another (separate exposure). For half of the subjects in each of the exposure conditions, A and B differed in both colour and form; for the remainder A and B differed in form alone. On the second day of the experiments, the chicks were placed into a cool test apparatus and given training in which approaching A was rewarded by the delivery of a stream of warm air, but approaching B was not. Acquisition of this discrimination was more rapid when A and B differed in two respects than when they differed in form alone. When A and B differed in both colour and form, the heat-reinforced discrimination was acquired more rapidly after separate exposure than after mixed exposure; but when A and B differed in form alone, discrimination learning was more rapid following mixed exposure than separate exposure. The latter finding, that the opportunity to compare stimuli differing in only one dimension facilitates subsequent discrimination learning, is consistent with earlier suggestions (Gibson, 1969) regarding the conditions that promote perceptual learning.     

Alternating exposure to two compound flavors creates inhibitory associations between their unique features

Rats were exposed to two compound solutions, saline-lemon and sucrose-lemon. In Group ALT, trials with one solution alternated with trials with the other. Group BLK received all trials with one solution before any trials with the other. Previous retardation tests had implied that only alternating exposure would establish sucrose as an inhibitor of saline. To provide a complementary summation test for this inhibition, in Experiment 1, all the animals received pairings of peppermint and saline and were tested for consumption of peppermint-sucrose under sodium depletion. Consumption was increased by sodium depletion only in Group BLK. In Experiment 2, a retardation test was used to show that presentation of saline-lemon before sucrose-lemon on each exposure day would establish sucrose as an inhibitor of saline. Neither exposure to sucrose-lemon before saline-lemon nor alternating exposure to sucrose and saline alone had the same effect. These results provide support for an associative theory of perceptual learning that suggests that exposure to complex stimuli aids later discrimination partially as a result of establishing inhibitory associations between their unique elements.     

反事实思维对行人交通安全行为意向的影响

反事实思维是对过去发生事情进行否定而产生的假设性思维表征,对行为改变和绩效改善有显著影响。因此,作为一种重要的认知策略,反事实思维常常被用于行为干预的研究。本研究采用单因素(反事实启动/经验启动)被试间实验设计,以4种常见的行人不安全行为为实验材料,运用顺序启动范式的语义启动分别激活自变量的两个水平,将遵守交通规则行为意向的评分和反应时双变量作为因变量指标,探索反事实思维对行人安全行为的促进作用。结果表明:与基线水平和经验启动相比,反事实启动诱导产生的行人交通安全行为意向更加积极,并且产生的自动化水平更高。文章最后讨论了研究的理论意义和对安全管理实践的启发。     

替罗非班以及不同给药途径对AMI患者PCI术后sICAM-1的影响

探讨替罗非班以及不同给药途径对急性心肌梗死（AMI）患者经皮冠状动脉介入术（PCI）后可溶性细胞间粘附因子-1（sICAM-1）的影响.选择AMI直接PCI患者90例随机分成A、B、C三组：A组不给予替罗非班;B组PCI术后静脉给予替罗非班,C组PCI术中对梗死相关冠状动脉（IRA）内注射替罗非班,两组均静脉滴注36h;分别检测三组术前及术后24h血浆sICAM-1的浓度水平.结果显示,A组PCI术后24h血浆sICAM-1的浓度水平较术前高,而B、C两组较术前均降低,差异有统计学意义（P＆lt;0.05）,但B、C两组PCI术后差异无统计学意义（P＞0.05）.因此,对于行PCI术的AMI患者应给予替罗非班,抑制术后炎症反应以及粘附反应,降低PCI术后再狭窄的发生率,但其作用效果与给药途径无关.     

Evaluation of the school-based smoking-prevention program "BE smokeFREE"

This article examines the impact of the school-based smoking-prevention program "BE smokeFREE" on adolescent smoking. A national representative sample of 99 schools (195 classes, 4,441 students) was used when the intervention started in November 1994. Schools were allocated to one of four groups: a comparison group (A) and three intervention groups (B, C, and D). Group B received the most comprehensive intervention. A baseline (autumn 1994) and three follow-up data collections (1995, 1996, and 1997) were conducted. There were no significant differences in smoking habits among the four groups at baseline. The smoking habits in the group that was involved in the most comprehensive intervention (group B) changed more favourably than those of students in the comparison schools over the three follow-up data collections. At the third follow-up, the proportion of students smoking weekly or more in the comparison group was 29.2%, compared with 19.6% in the model intervention group. The two less comprehensive interventions (no teacher in-service courses in group C, and no involvement of parents in group D) appeared to be less effective than the model intervention. Multilevel multiple logistic regression analyses, comparing changes in smoking habits between students in group B with those among students in the comparison schools, confirm the conclusion that the comprehensive intervention was the most effective. This school-based intervention, based on a social influence approach, proved to be effective at reducing smoking rates among participants.     

Effects of a paradoxical intervention on a child's anxiety about sleep- and sports-related performance

A paradoxical instruction was used to treat a 10-yr.-old boy's complaint of crying when unable to sleep and the daytime equivalent of fearing the public display of crying when failing at sports performances. The instruction resolved both the sleep disturbance and the public crying. The results suggest that, like adults, children may experience anxiety about sleep difficulties and that paradoxical intention may have promise for the treatment of some children's insomnia.