Assertive training for agoraphobics

Twenty-one unassertive agoraphobic patients were assigned to one of three treatments: (1) prolonged exposure in vivo, (2) assertive training and (3) a combination of assertive training and prolonged exposure in vivo. Each treatment was conducted in groups which were led by two therapists. Assessments involved both phobic targets and assertiveness, and were made before and after treatment, and at 1-month follow-up. Exposure in vivo was found to be superior to assertive training on phobic targets. Assertive training produced greater gains in assertiveness than exposure in vivo. The combination of treatments produced results comparable to exposure in viro. Results indicated that the type of change produced by the treatments is a rather specific one and is related to the specific target of treatment.     

Processing of fearful and neutral information by obsessive-compulsives

Eighteen obsessive-compulsive and non-obsessive-compulsive outpatients provided data for a study of thinking processes in obsessive-compulsives. First we explored whether the concepts of obsessive-compulsives are excessively complex and over-specific (complex concepts) or, conversely, whether they are excessively ‘simple’, so that items that non-obsessive-compulsives would view as different from one another are classed together by obsessives. Secondly, we examined whether the cognitive mechanisms underlying obsessional fears are specific to the content of the fear, or whether they reflect a general deficit in information processing. To this end, obsessive-compulsive and non-obsessive-compulsive patients sorted four decks of cards into piles; two decks were sorted using ‘neutral’ principles, and two using ‘feared’ principles (contamination and serious mistakes). Results indicated that obsessive thinking is characterized by ‘complex concepts,’ and suggested that this deficit is general, not specific to obsessives' thinking about feared topics. Results also suggested the existence of an additional thinking deficit that is specific to fear-associated topics.     

Treatment of adolescent agoraphobics: Effects on parent-adolescent relations

Three adolescent agoraphobics, accompanied by their mothers, were treated in a small group. Treatment consisted of self-initiated exposure, panic management and cognitive restructuring, with the parent acting as co-therapist. Measures of adolescent-parent relationships were administered as well as measures of agoraphobia. As with adult agoraphobics treated with their spouse, results indicated a parallel relationship between phobia and family relations; that is, as phobia improved, the relationship improved. Unlike adult agoraphobics, adolescents were unable to comprehend that agoraphobic fears concerning health or dying were unrealistic. This interfered with motivation and underscored the need of the parent as a co-therapist.     

Physiological responses in blood phobics

Eighteen patients with blood phobia were shown a film of thoracic operations containing large amounts of blood. Their heart rate (HR) and blood pressure (BP) were measured continuously before, during and after the watching of the film. The group data showed a diphasic response; an increase in HR and BP from baseline to the beginning of the film, and then a sharp drop in these parameters with the lowest values 4 min after the film was turned off. Individual data from 5 patients who fainted or were on the edge of doing so, showed massive bradycardia or drop in BP or both. In all of these patients at least one (range 1–33) 5-sec period of asystole was recorded. Possible theoretical explanations for this characteristic response pattern are discussed.     

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.     

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     

Acquisition of agoraphobia, mode of onset and anxiety response patterns

The ways in which 80 agoraphobic patients had acquired their phobia were investigated. The patients were requested to answer a questionnaire concerning: (a) the origin of the phobia, with items relevant for conditioning experiences, vicarious experiences and experiences of negative information/instruction; (b) physiological reactions; (c) anticipatory anxiety; (d) negative thoughts while in the phobic situation. In addition, data on mode of onset, precipitating factors, family history of phobias, marital and occupational status and severity of the phobia were obtained. The reported anxiety reaction was conceptualized in terms of the Three-Systems Model of fear and anxiety, i.e. anxiety as composed of a physiological, cognitive and behavioral component. The results showed that a large majority (81%) of the patients attributed their phobias to conditioning experiences, while 9% recalled vicarious learning, none recalled instruction/information and 10% could not recall any specific onset circumstances at all. In another classification 46% of the patients had a rapid, 36% a gradual and 18% a slow onset of their phobias. There was no relationship between either the ways of acquisition, or the modes of onset, and the anxiety components, nor did the conditioning and the indirect groups differ in severity of phobic reactions.     

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.     

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.     

The factor structure of the state-trait anxiety inventory for children: Kindergarten through the fourth grades

The A-State and A-Trait scales of Spielberger's State-Trait Anxiety Inventory for Children (STAIC) were administered to a total of 1786 kindergarten, 1st-, 2nd-, 3rd- and 4th-grade disadvantaged black children. For the K-2 groups, the STAIC A-State scale was administered twice; it was administered only once in the 3rd–4th grades. The A-Trait scale was administered once to all 10 groups of children. A series of factor analyses, computed separately by sex and grade level, identified 3 factors: trait anxiety and 2 distinct state anxiety factors corresponding to the anxiety-present and anxiety-absent content of the A-State items. Similar 3-factor patterns were observed for both males and females for all five grade levels. Other factor solutions were examined but considered less satisfactory in terms of simple structure and psychological meaningfulness. The results were interpreted as providing strong evidence for the state-trait distinction in anxiety research with children.     

Nicotine fading,self-monitoring and cigarette fading to produce cigarette abstinence or controlled smoking

This study developed and evaluated a smoking-treatment program. Twelve subjects were randomly assigned to one of two groups within a multiple baseline design. Subjects were first given a nicotine-fading and self-monitoring procedure for 3 weeks in which they changed their cigarette brands each week to ones containing progressively less nicotine and tar and plotted their daily intake of the two substances. Those subjects unable to quit smoking were then given a cigarette-fading procedure in which they systematically reduced the number of cigarettes smoked for 3 weeks. The study had two goals: (1) to achieve a reasonable percentage of abstinence; and (2) to reduce non-abstainers' smoking to a ‘safer’ level by having them smoke very low tar and nicotine cigarettes. The 12-month follow-up results revealed that 33% of the subjects were abstinent and all non-abstainers were smoking cigarettes lower in tar and nicotine than their baseline brands. Half the non-abstainers had decreased their smoking rate relative to baseline while the other half had increased. The subjects decreased their daily nicotine intake by 13.3 mg (81.6% reduction from baseline) and tar intake by 218.2 mg (85.5% reduction from baseline). These results suggest that the study's goals were achieved and that the non-aversive combined procedure could be used to treat not only habitual smokers but also those with cardiovascular and respiratory problems who cannot be treated by smoking-cessation procedures that use cigarette smoke as the aversive stimulus. Finally, a least-restrictive model for treating smoking is proposed and discussed.     

Factors in the referral of children for behavioral treatment: A comparison of mothers of clinic-referred deviant,clinic-referred non-deviant and non-c

The purpose of this study was to compare a non-clinic sample of mothers and children to two groups of clinic-referred children and their mothers. The two clinic-referred groups differed from one another in that the selection criterion for one group of children (Clinic Deviant) was that they were significantly more deviant and non-compliant than the non-clinic group whereas the selection criterion for the second group of children (Clinic Non-deviant) was that they did not differ significantly from the non-clinic group on deviant and non-compliant behavior. Home observations by independent observers and parent questionnaires examining parental adjustment and parental perceptions of child adjustment were completed. The results indicated that both clinic groups perceived their children as more maladjusted than parents in the non-clinic groups perceived their children. Parents of the children in the Clinic Non-deviant group were significantly more depressed than those in the remaining two groups, whereas parents in the Clinic Deviant group issued more vague, interrupted commands than those in the Clinic Non-deviant group. Implications of the findings are discussed.     

Pain sensitivity and coping strategies among dysmenorrheic women: much ado about nothing

Samples of spasmodic, congestive and combined dysmenorrheic women and non-dysmenorrheic women were subjected to an ischemic pain procedure to measure their pain threshold, pain tolerance and self-reported pain. Cognitive and behavioral strategies that subjects had spontaneously used during the pain procedure were later assessed. A classification system was derived for categorizing subjects' responses to the interview and questionnaire used in this assessment. Contrary to previous claims that dysmenorrheic women may be hypersensitive to pain, no differences in pain sensitivity were discovered among the four groups of subjects. A few differences in cognitive and behavioral strategies did emerge, but these were of insufficient magnitude to contend that dysmenorrheic women are disadvantaged in their strategies for coping with pain.     

Personality types and recidivism among Borstal trainees

A cluster analysis of the 16 Personality Factor Questionnaire, Hostility and Direction of Hostility Questionnaire and Psychological Screening Inventory scores from 181 delinquents at Deerbolt Borstal, England, revealed four personality types which were labelled ‘Withdrawn’, ‘Normal’, ‘Disturbed’ and ‘Truculent’. A 3-year reconviction follow-up showed that the groups differed in terms of recidivism. Sixty-four percent of the Withdrawn group reconvicted whilst 87% of the Normal, 79% of the Disturbed and 76% of the Truculent group reconvicted. Controlling for the influence of number of previous convictions the Withdrawn group differed significantly from the other groups in terms of recidivism. The results are discussed with reference to similar results obtained in a previously reported study in a detention centre.     

The acquisition of taste aversions in humans with eating and drinking disorders

A written questionnaire or interview concerned with acquisition of illness-induced (taste) aversions to foods and drinks was given to three groups of people with eating and drinking disorders. These groups consisted of 101 male and 1 female hospitalized alcoholics, 8 male and 8 female college-student heavy consumers of alcohol and 18 females with anorexia nervosa and/or bulimia. In most respects taste-aversion acquisition in these three groups was similar to taste-aversion acquisition in a general college-student population previously studied by Logue, Ophir and Strauss (1981), and to taste-aversion acquisition in other species. In all three groups the aversions were more likely to be reported as having been formed through forward rather than simultaneous or backward conditioning, and long-delay learning was frequent. The aversions usually formed to the tastes rather than to the appearance or other aspects of the foods and drinks. Extinction appeared more effective in decreasing the aversions than did forgetting. While the illness responsible for the aversions forming was usually attributed to the subsequently aversive food or drink, in at least one third of the cases subjects reported that something else might have caused their illness. Aversions were more likely to have formed to relatively less familiar and less preferred foods and drinks. However, the hospitalized alcoholics reported fewer aversions, less generalization of aversions, and stronger nausea as the cause of the aversions than did Logue et al.'s (1981) subjects. About 15% of these subjects reported taste aversions to alcoholic beverages. The college-student heavy consumers of alcohol reported no generalization of their taste aversions, but in other respects were similar to Logue et al.'s subjects. Thirty-one percent of these subjects reported taste aversions to alcoholic beverages. The anorexic and bulimic subjects were also similar to Logue et al.'s subjects with the exception that they, like the hospitalized alcoholics, reported stronger nausea as the cause of the aversions. These data may help to understand and treat people with eating and drinking disorders     

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.     

Controlled comparison of aversive therapy and covert sensitization in compulsive homosexuality

Ethical objections to the use of behaviour therapy in homosexuality are discussed. It is pointed out that these objections were often based on a limited view of the aims of the therapy. The need for evaluating such therapy, as it is currently used, is elaborated.Twenty subjects requesting behaviour therapy to reduce compulsive homosexual urges were randomly allocated, half to receive aversive therapy using electric shocks and half to receive covert sensitization. Both groups were studied for one year. There was no consistent trend for one therapy to be more effective than the other in reducing the strength of compulsive homosexual urges, and the response to both was similar to that reported in previous studies. It was considered that aversive therapies in homosexuality do not act by establishing a conditioned aversion, nor by altering the subjects' sexual orientation. They reduce aversive arousal produced by behaviour completion mechanisms when subjects attempt to refrain from homosexual behaviour in response to stimuli which have repeatedly provoked such behaviour in the past.     

Stress responsivity among dysmenorrheic women at different phases of their menstrual cycle: more ado about nothing

Dysmenorrheic and nondysmenorrheic women in the follicular, luteal and menstrual phase of their menstrual cycle participated in a stressful laboratory procedure. Pulse rate, pulse volume and skin conductance were measured continuously during baseline, during confrontation of three stressful tasks (i.e. stress-reactivity periods) and following each confrontation (i.e. stress-recovery periods). The hypothesis that dysmenorrheic Ss in the menstrual phase of their cycle would show greater stress responsitivity was generally not confirmed, and the broader contention that women differ in their stress responsivity as a function of their menstrual cycle phase was shown to be of questionable validity.     

Effects of repeated exposure to sexually violent or nonviolent stimuli on sexual arousal to rape and nonrape depictions

The major purpose of this investigation was to examine the effects of repeated exposure to sexually violent stimuli (SVS) in relatively ‘naturalistic settings’ on sexual arousal to rape and nonrape stimuli. Repeated exposure effects using nonviolent erotica were also examined. Sixty-nine male Ss participated in the study. A preexposure session was conducted in which Ss were exposed to written and pictorial depictions of rape and mutually-consenting intercourse. Based on Ss' penile tumescence to these depictions, they were classified as either Force-oriented, Nonforce-oriented or Unclassifiable. Subsequently, Ss were randomly assigned to sexually violent (SVS), sexually nonviolent (SNVS) or control conditions within each force-orientation group. Those assigned to the SVS condition were then exposed to 10 SVS including feature-length films and written and pictorial depictions over a period of 4 weeks. Ss in the SNVS condition were exposed to 10 similar media presentations depicting sexually nonviolent activities only. Ss in the control condition were not exposed to any stimuli during this 4-week period. Soon after completion of the exposure phase, Ss returned for a postexposure laboratory session in which they were presented with four depictions that were similar in theme to those in the preexposure session. Penile tumescence scores and self-reports of sexual arousal were obtained. Results revealed that, for Force-oriented Ss, those exposed to either SVS or SNVS were less aroused to the rape depictions in the postexposure session than those in the control condition. A similar pattern occurred with the nonrape depictions for these Ss, though it was considerably less pronounced. No evidence of a similar ‘satiation’ pattern was obtained for either Nonforce-oriented or Unclassifiable Ss, with these Ss showing no significant differences among the three exposure conditions. The findings are discussed in the context of cognitions, personality differences, conditioning processes, stimulus parameters and response habituation theories. Social and clinical implications are also discussed.