Response Interruption and Differential Reinforcement of Alternative Behavior for the Treatment of Pica

Pica displayed by two individuals with autism was decreased by a treatment involving differential reinforcement and response interruption that altered the chain of behavior involved in pica (i.e., picking up items and placing them in the mouth). The treatment involved establishing prompts to ‘clean‐up’ as a new discriminative stimulus (SD) for picking up items from the floor; and holding potential pica items was established as an SD for discarding those items in a trash receptacle, putting them away, or using them appropriately. After demonstrating the effectiveness of the treatment in an analog setting, the treatment package was systematically generalized to community settings. Copyright © 2011 John Wiley & Sons, Ltd.     

The effects of brief cognitive-behaviour therapy for pathological skin picking: A randomized comparison to wait-list control

Thirty-four college students suffering from pathological skin picking were randomly assigned to a four-session cognitive-behavioural treatment (n = 17) or a waiting-list condition (n = 17). Severity of skin picking, psycho-social impact of skin picking, strength of skin-picking-related dysfunctional cognitions, and severity of skin injury were measured at pre-, post-, and two-months follow-up assessment. Participants in the treatment condition showed a significantly larger reduction on all measured variables in comparison to the waiting-list condition. The obtained effect sizes for the outcome measures were large, ranging from .90 to 1.89. Treatment effects were maintained at follow-up. In conclusion, cognitive-behavioural therapy, even in brief form, constitutes an adequate treatment option for pathological skin-picking behaviour.     

A preliminary investigation of acceptance and commitment therapy as a treatment for chronic skin picking

The effectiveness of a deliberately limited version of Acceptance and Commitment Therapy (ACT) for chronic skin picking was evaluated in a pair of multiple baseline across participants designs. Self-monitoring of skin picking showed that four of the five participants reached near zero levels of picking by post-treatment, but these gains were not fully maintained for three of the four participants at follow-up. The findings of the self-reported skin picking were generally corroborated by ratings of photographs of the damaged areas and by ratings on a validated measure of skin picking severity. All participants rated the intervention as socially acceptable, and reductions were found on measures of anxiety, depression, and experiential avoidance for most participants as a result of the intervention. Results support the construction of more comprehensive ACT protocols for skin picking.     

Skin picking in patients with obesity: Associations with impulsiveness and self‐harm

Previous studies suggest elevated prevalence rates of skin picking and self‐harm in patients with obesity compared to individuals in the general population. Hence, further studies should investigate prevalence rates and correlates of skin picking in this population – especially its differentiation to self‐harm. Skin picking and obesity are both associated with specific facets of impulsiveness. This relation should be explored to shed light on potentially shared mechanisms in etiology. Therefore, the present study examined the occurrence of skin picking and its associations with impulsiveness and self‐harm in a sample of pre‐bariatric surgery patients with obesity class II/III. Within the routine preoperative psychiatric evaluation, a total of 139 bariatric surgery candidates (78% female, BMI range 35–69) completed a self‐report questionnaire assessing sociodemographic variables, anxiety, depression, self‐harm, impulsiveness, and skin picking severity (urges: frequency, intensity, controllability; behavior: frequency, intensity, controllability; resistance, emotional distress, impairment, and avoidance). Ten participants (7.2% of the sample) reported recurrent skin picking leading to skin damage, repeated attempts to decrease skin picking, and psychosocial impairment (emotional distress, impairment in functional areas, avoidance) due to skin picking. In line with previous findings, skin picking severity shows a medium correlation with attentional impulsiveness. The majority of self‐harm types were not associated with skin picking severity. The current study reveals a high occurrence of skin picking compared to the general population. The results indicate an association between skin picking severity and attentional impulsiveness. Further research is needed to investigate the differentiation of skin picking and self‐harm in more detail.     

Reducing skin picking via competing activities

This study examined the outcomes of a competing activities intervention to decrease skin picking exhibited by a 9-year-old student with comorbid diagnoses. Results of an ABCBAB design revealed that the use of student-selected manipulatives resulted in reduced skin picking.     

Efficacy of telephone-administered cognitive behaviour therapy for obsessive-compulsive spectrum disorders: case studies

Cognitive behaviour therapy is effective for obsessive-compulsive disorder and for obsessive-compulsive spectrum disorders such as trichotillomania. Unfortunately, many people with these disorders, especially those living in rural areas, have limited access to treatment. Telephone-administered cognitive behaviour therapy may help address this problem. In a recent study of telephone treatment for obsessive-compulsive disorder, we found that such treatment was often effective (42% in remission at post-treatment, and 47% in remission at 12-week follow-up). This article presents 2 case reports of the same treatment, applied to obsessive-compulsive spectrum disorders (trichotillomania and compulsive skin picking). Treatment was associated with symptom reduction for both participants, although one subsequently relapsed. Possible reasons for relapse are discussed. The findings encourage further studies to identify the characteristics of people most likely to benefit from telephone treatment for spectrum disorders.     

The Perceived Value of Small Coins

Abstract

This study was concerned with the picking up of small coins as an unobtrusive measure of their perceived worth. Five sets of the four least valuable British coins were placed (“lost”) in a country town. Five pairs of observers noted the approximate age and sex of those 100 passersby who, having seen the coin, either did or did not pick it up. The results showed that the probability of a person picking up and keeping a “lost” coin increased linearly with its worth.     

Reducing covert self-injurious behavior maintained by automatic reinforcement through a variable momentary DRO procedure

Covert self-injurious behavior (i.e., behavior that occurs in the absence of other people) can be difficult to treat. Traditional treatments typically have involved sophisticated methods of observation and often have employed positive punishment procedures. The current study evaluated the effectiveness of a variable momentary differential reinforcement contingency in the treatment of covert self-injury. Neither positive punishment nor extinction was required to produce decreased skin picking.     

Continuous Access to Competing Stimulation as Intervention for Self-Injurious Skin Picking in a Child with Autism

Children with autism frequently display self-injurious behavior (SIB), but skin picking—a less severe topography of SIB—has not been the focus of much clinical research. The present study evaluated a home-based intervention that was implemented with a 9-year-old girl who had autism and picked her fingers with resulting tissue damage. The intervention allowed the girl to hold and manipulate preferred objects during play and leisure activities. Evaluated in an ABAB reversal design, intervention essentially eliminated skin picking. Clinical and research implications are discussed.     

DIFFERENTIAL REINFORCEMENT OF OTHER BEHAVIOR AND NONCONTINGENT REINFORCEMENT AS CONTROL PROCEDURES DURING THE MODIFICATION OF A PRESCHOOLER'S COMPLIANCE1

Differential reinforcement of other behavior (DRO) and noncontingent reinforcement were compared as control procedures during the modification of a 3-yr-old preschooler's compliance. The recorded reinforcer was teacher proximity (within 3 ft (0.9 m) of the subject for at least 5 sec) which was often accompanied by positive verbal comments that varied in content across experimental conditions. The verbal content during contingent reinforcement might have been: “Thank you for picking up the blocks”; during noncontingent reinforcement: “You're wearing a pretty dress”; and during DRO: “I don't blame you for not picking up because it isn't any fun”. Contingent reinforcement increased compliance in all manipulation conditions. Noncontingent reinforcement decreased compliance during two reversal conditions. However, the behavior was variable and did not decrease to the low levels reached during the two DRO reversals.     

Spinning My Silent Reverie: Confessions of a Compulsive Hair Twister

In this confessional essay of her compulsive hair knotting habit, the author considers the DSM-5's recent classification of body-focused repetitive behaviors as forms of obsessive–compulsive disorder and also Freud's analysis of this kind of tactile, repetitive motion as a symbolic substitute for masturbation. Yet although both Freud and the DSM-5 take seriously the etiology of habits that are otherwise generally overlooked and dismissed, Daum argues that neither explanation addresses the particularity of the specific compulsion. After all, hair twisting, nail biting, nose picking, skin picking, and beard stroking all involve different movements performed on different parts of the body, and as a result, conjure up different symbolic implications. Daum follows the historical thread of her own compulsion back to the archetypal tangles between women, hair, sexuality, spinning, weaving, and storytelling. As she explores these motifs in art, mythology, and folklore, Daum invites the reader to linger on the possibility that dismissing a “fussy habit” may be throwing away the key to one's intimate inner landscape.     

Hoarding in obsessive compulsive disorder: results from a case-control study

Hoarding occurs relatively frequently in obsessive-compulsive disorder (OCD), and there is evidence that patients with hoarding symptoms have more severe OCD and are less responsive to treatment. In the present study, we investigated hoarding symptoms in 126 subjects with OCD. Nearly 30% of the subjects had hoarding symptoms; hoarding was twice as prevalent in males than females. Compared to the 90 non-hoarding subjects, the 36 hoarding individuals had an earlier age at onset of, and more severe, obsessive-compulsive symptoms. Hoarders had greater prevalences of symmetry obsessions, counting compulsions, and ordering compulsions. Hoarders also had greater prevalences of social phobia, personality disorders, and pathological grooming behaviors (skin picking, nail biting, and trichotillomania). Hoarding and tics were more frequent in first-degree relatives of hoarding than non-hoarding probands. The findings suggest that the treatment of OCD patients with hoarding symptoms may be complicated by more severe OCD and the presence of co-occurring disorders. Hoarding appears to be transmitted in some OCD families and may differentiate a clinical subgroup of OCD.     

Hairpulling and Skin Picking in Relation to Affective Distress and Obsessive-Compulsive Symptoms

The current study examined the frequency and associated distress of both hairpulling and skin picking behaviors in 1,324 college students using the Massachusetts General Hospital Hairpulling Scale (MGHHS) and Skin Picking Scale (SPS). In this sample, many participants reported significant distress secondary to both hairpulling and skin picking. Participants who endorsed relatively frequent hairpulling or skin picking (N = 72) were scheduled for a follow-up testing session to further assess the relationship between these behaviors and measures of affective distress. Compared to a control sample, the follow-up sample endorsed significantly more symptoms of anxiety and stress reactivity, and had higher scores on a measure of obsessive-compulsive symptoms.

Reaching while walking: Reaching distance costs more than walking distance

Surprisingly little is known about how people plan and control everyday physical actions, such as walking along and picking up objects. In order to explore this topic, we conducted an experiment in which university students were asked to pick up a common object (a child’s beach bucket) that stood on a table several meters from the participant’s start position. The bucket stood either on the left side, in the middle, or on the right side of the table and, depending on instructions, was to be carried to a farther target whose horizontal position was also varied. The questions were which side of the table the participant would walk along when picking up the bucket and which hand the participant would use to pick up and carry the bucket. Participants, most of whom were righthanded, preferred to walk along the left side of the table and to pick up the bucket with the right hand, although they departed from that preference when the reaching distance across the table was uncomfortable or if the target was too far to the right. The data were well fit with a mathematical model that included a right-hand bias and an estimate of functional distance that expressed the cost of reaching over some distance as approximately twice the cost of walking over the same distance.     

The development of anti-litter behavior in a forest campground

This study evaluates the effectiveness of an incentive procedure designed to induce litter collection in a large forest campground. Children in the campground were offered their choice of a variety of reinforcers for picking up and properly disposing of litter. The procedure resulted in a sharp decline in four types of litter planted in the campground.     

Therapeutic rationale,monetary incentive and fear behavior: a methodological note on analogue research

Analogue research has been questioned as a means of evaluating clinical procedures (e.g. Cooper, Furst and Bridger, 1969). A major criticism has been the failure to include adequate controls. Placebo conditions have varied markedly in their similarity to active treatment procedures (Caputo, Nau and Borkovec, 1973), have not provided equally credible therapeutic rationales (Borkovec and Nau, 1972), and have thus generated differing expectancies and demands for improvement.To evaluate a therapy procedure, a comparison condition is needed in which no treatment intervenes between pre- and post-test measures, yet which provides adequate incentive for improvement. Rimm and Mahoney (1969) used a ‘contingent reinforcement’ placebo condition in which tokens, exchangeable for money, were dispensed for improvement in a graded approach to a feared stimulus. Little improvement occurred, suggesting a lack of effectiveness of money alone in improving approach behavior. However, as no therapeutic rationale was presented, it is likely that little expectancy for improvement occurred.The present study provided a ‘no treatment’ condition in which Ss participated in three test sessions with no intervening treatment procedure. Unlike Rimm and Mahoney (1969), two conditions provided a rationale explaining why Ss had maintained their fear and why no real therapy was needed to eliminate it. Also, monetary reward (a $5.00 bill rather than tokens) was dispensed only upon picking up the feared object. A follow-up session assessed the lasting effects of rationale and monetary incentive in the absence of extrinsic reinforcement. Thus, the present study attempted to determine the effect of therapeutic rationale and/or the possibility of receiving money, in the absence of ‘therapy’, on subclinical fear.     

Experience Influences Affordance Perception for Low Crawling Under Barriers With Altered Body Dimensions

Abstract

We examined the role of experience in affordance perception for low crawling with altered body dimensions under barriers of different heights. Adults decided which of five backpacks (10–30?cm thick) they would be able to wear while low crawling under barriers. Participants were assigned to one of three experience conditions. Participants in the Pre/Post-choice experience condition crawled under the barrier before and after picking a backpack, participants in the Feedback condition crawled under the barrier after picking a backpack, but participants in the No Experience condition received no low-crawling experience. Past research suggests that pre-choice experience with low crawling under the barrier would lead to more accurate responses. Overall, participants in all three conditions scaled the height of the backpack to the barrier height. Pre-choice low-crawling experience strongly influenced backpack choices such that participants in the Pre/Post condition picked significantly smaller backpacks and produced fewer failures than participants in the other conditions. The results provide evidence that brief practice, in an unfamiliar posture, can lead to improvements in affordance perception.     

The past thirty years of emotion research: appraisal and beyond

ABSTRACT

For this Special Issue, I highlight the past and present importance of appraisal theory as well as the challenges to its status as a total theory of emotions from the other functions of emotions: associative learning, self-regulation and social communication. This theoretical view applies both to emotion research in general and the specific fields of my interest in the emotions of moral judgment and intergroup processes. Methodologically, developments in analyses of large and more naturally occurring data sets will give an opportunity to square psychology’s structural models of discrete emotions with the more complicated reality that exists. Both for the field and for individual researchers picking up the study of emotions, my advice is to pay special attention to measures, their assumptions and their context.     

Schleiermacher and Spirit Christology: Unexplored Horizons of The Christian Faith

One of the more recent efforts at christological construction has focused on Spirit christology, issuing in sometimes opposing constructions. At first sight, considering Schleiermacher's synthetic approach to the doctrine of the Trinity, one would suspect the irrelevance of his christology for these present efforts. However, an analysis of the convergence between christology and pneumatology in the Glaubenslehre could contribute significantly to this debate. By interpreting the God-consciousness of Jesus as the presence of the Spirit in him and correlating this with the communication of this consciousness as the work of Christ in regeneration and sanctification we achieve an identity between Christ as Spirit-bearer and Spirit-sender (viz. the Redeemer understood according to his 'peculiar activity' and 'exclusive dignity'). By lending a stronger pneumatological bearing to Schleiermacher's theological discourse (picking up the suggestion of Karl Barth) Schleiermacher helps illuminate some of the issues that have arisen in debate over Spirit christology.