Chemical aversion conditioning in the treatment of alcoholism: further comments.

The literature on consummatory aversion (CA) conditioning in rats does provide a well-developed theoretical foundation for chemical aversion conditioning. Nevertheless, differences between rats and humans in CA learning suggest caution in extrapolating from the animal laboratory to the treatment of alcoholic patients. Serious methodological problems with studies of emetic therapy with alcoholics preclude unambiguous evaluation of its effects. Emetic therapy is an intrusive and relatively costly form of treatment which has not been shown to be more effective than alternative, less costly methods. The onus is on proponents of this method to demonstrate its specific advantages over alternative treatments.     

Chemical aversion treatment of alcoholism: Lithium as the aversive agent

Animal work indicating flavour aversion produced by chemical aversion therapy (CAT) with lithium might be effective in the treatment of alcoholism led to this treatment being given to 25 patients. The abstinence rate six months later of 36% was significantly better than the 12% rate for an equivalent group of patients, treated with a disulfuram-like drinking deterrent, calcium carbimide. The rate for the CAT group improves to 47% if 8 patients are excluded who did not develop sickness reactions to lithium. CAT with lithium appears safe given proper medical precautions.     

Conditioned ethanol aversion in rats induced by voluntary wheel running,forced swimming,and electric shock: An implication for aversion therapy of alcoholism

This study was planned to demonstrate rats’ acquisition of aversion to ethanol solution consumed before voluntary running, forced swimming, or electric shock delivery. Wistar rats under water deprivation were allotted to four groups of eight rats each, and all rats were allowed to drink 5% ethanol solution for 15 min. Immediately after the ethanol drinking, rats of Group Run were put into the individual running wheels for 15 min, those of Group Swim were put into the individual swimming pools for 15 min, those of Group Shock received electric shocks for 15 min (15 0.45-mA shocks of 0.7s with the intershock interval of 1 min) in the individual small chambers, and those of Group Control were directly returned back to the home cages. This procedure was repeated for six days, followed by a two-day choice test of ethanol aversion where a bottle containing 5% ethanol solution and a bottle of tap water were simultaneously presented for 15 min. In the test, Groups Run, Swim, and Shock drank ethanol solution significantly less than tap water, while Group Control drank both fluids equally. The effects of running, swimming, and shock were equivalent. The successful demonstration of acquired ethanol aversion induced by exercise (running and swimming) or shock in rats suggests an avenue for clinical application of exercise and shock treatments for human alcoholics, though there are many issues to be resolved before the practical use.     

Forgetting, preconditioning CS familiarization and taste aversion learning: An animal experiment with implications for alcoholism treatment

The rapid taste aversion acquisition, which typically occurs in many species when ingestion of a novel flavor precedes gastrointestinal distress, is retarded by preconditioning familiarity with the CS flavor. This CS familiarity effect (CSFE) might contraindicate taste aversion approaches to alcoholism treatment since alcoholics are quite accustomed to the tastes of alcoholic beverages. However, many alcoholics do develop strong nausea—induced alcohol aversions under appropriate conditioning parameters. Additionally, the CSFE is attenuated in rats by repeated conditioning trials including discrimination training. The present animal experiment was conducted to determine if the CSFE could additionally be weakened by process of forgetting, i.e. by preconditioning withdrawal of a familiar flavor analogous to an alcoholic's ‘drying out’ before psychotherapeutic intervention. Using saccharin as the CS flavor and cyclophosphamide as the conditioning agent, Sprague-Dawley derived rats acquired no aversions when conditioning was attempted immediately after flavor familiarization. However, significant and equivalent saccharin aversions were observed when conditioning was delayed for either 20 or 100 days after familiarization. These findings imply that the efficiency and cost effectiveness of taste aversion approaches to alcoholism treatment might be enhanced by a pretreatment period of abstinence from alcohol ingestion.     

A failure to find socially mediated taste aversion learning in Norway rats (R. norvegicus)

Observer rats interacted with conspecific demonstrators immediately after demonstrators ate a novel diet and were made ill by LiCl injection. Following their interaction with demonstrators, observers were tested for aversion to their ill demonstrator's diet. Previous research has shown that (a) an observer can extract information from a demonstrator sufficient to permit identification of the demonstrator's diet (Galef & Wigmore, 1983) and (b) a rat ill from LiCl toxicosis is an adequate unconditioned stimulus in a taste aversion learning paradigm (Lavin, Freise, & Coombes, 1980). Further, two of the present experiments demonstrated that cues emitted by a rat, reflecting the particular diet it has eaten, are an adequate conditional stimulus in a toxicosis-induced aversion learning situation. Observer avoidance of a diet previously ingested by an ill demonstrator was, however, not demonstrated. The implications of the failure to find socially mediated aversion learning are discussed.     

Modifications of Yalom's interactional group therapy model as a mode of treatment for alcoholism

As a result of a review of the literature and especially Brown and Yalom's (1977) clinical report, it is suggested that the preferred mode of treatment for alcoholism is group psychotherapy. The group's ability to provide support, structure and reinforcement for abstinence make it a powerful catalyst in the recovery process. In measures of time, efficacy and recovery, group psychotherapy generally succeeds where other treatment modalities frequently fail.     

Cortical substrates of taste aversion learning: dorsal prepiriform (insular) lesions disrupt taste aversion learning

The functional relation between restricted damage to ventral primary somatosensory neocortex and the ability of rats to acquire conditioned taste aversion (CTA( was examined by a combination of behavioral and neurohistological techniques. Lesions confined exclusively to the established gustatory neocortex (GN) did not disrupt CTA acquisition, nor did lesions confined to suprarhinal cortical areas ventral to the GN. Lesions that encroached on dorsal prepiriform and insular cortices produced CTA acquisition deficits and damaged a large proportion of efferent projections to the prefrontal and precentral neocortex. In a second experiment, lesions of dorsal prepiriform and insular cortices did not modify taste preference-aversion threshold to any of the four taste modalities. It is concluded tha ventral somatosensory neocortical fields, including the established GN, do not mediate CTA acquisition and that rhinal cortices ventral and posterior to the GN are preferentially involved in associative learning for tastes and illness.     

Family treatment approaches to drug abuse problems: a review.

This review covers the literature that has emerged specifically on the family treatment of drug abuse problems. Following a brief discussion of patterns and structures prevalent in drug-abusing families, 68 different studies or programs (discussed in 74 papers) are compared as to their techniques and results. These are categorized within the following modalities: marital treatment, group treatment for parents, concurrent parent and identified patient treatment, treatment with individual families (both inpatient and outpatient), sibling-oriented treatment, multiple family therapy, and social network therapy. A table presents the various studies, along with the types of results they provide. Outcomes are contrasted for the 14 studies that quantified their results. The final section presents implications for the following areas: treatment activities (clarification of technique, family recruitment, direction and effectiveness of treatment, confidentiality, and treatment delivery systems), training, prevention, and future research (outcome, technique and responsibility). It is concluded that family treatment for drug abuse is gaining widespread acceptance and shows considerable promise for dealing effectively with problems of this type.     

Changing rational-emotive therapy (RET) to rational emotive behavior therapy (REBT)

Reasons are given for changing the name of Rational-Emotive Therapy (RET) to Rational Emotive Behavior Therapy (REBT) and for bringing its behavioral aspects into more prominence. Excerpted from “Changing Rational-Emotive Therapy (RET) to Rational Emotive Behavior Therapy (REBT).Behavior Therapist, 1994,16(10), 1–2, and fromReason and Emotion in Psychotherapy, Rev ed. updated. New York Carol Publishing, 1994. Reprinted with permission.     

Multiple approaches to the treatment of violent couples

Abstract

The relationship of the discrepancy between couple's actual level of intimacy and desired level of intimacy and marital adjustment was explored using data from 185 randomly selected couples who completed the Personal Assessment of Intimacy in Relationships and the Marital Adjustment Test. Multivariate and univariate regression analyses indicated that the discrepancy between actual and desired intimacy of husbands and wives was highly predictive of marital adjustment (R²=.665). Particularly interesting was that couples with low intimacy scores who did not desire more intimacy had good marital adjustment. The relationship between intimacy and marital adjustment was curvilinear, and wives' marital adjustment was more affected by intimacy than husbands'. Implications for marital therapy are discussed.     

Methylphenidate and cognitive therapy: A comparison of treatment approaches with hyperactive boys

This study of hyperactive boys evaluated the effects of three modes of treatment in relation to an untreated group. The treatments were administered over a 3-month period and included cognitive training, stimulant drug therapy (methylphenidate), and the two treatments combined. A follow-up assessment was conducted approximately 3 months after contact between the training staff and the child had ceased. Analyses of attentional deployment and cognitive style measures, tests of academic achievement, and behavioral ratings showed that only those children in the two medication treatment conditions demonstrated improvement in attentional deployment and behavioral ratings. In the cognitive therapy condition, there were changes only on measures of attentional deployment. The data did not provide evidence indicating that the combined medication and cognitive therapy condition was any more effective than that condition involving medication alone. Discussion provides future guidelines for evaluation of the relative effectiveness of stimulant drug therapy and other psychological treatment modalities.     

Psychometric appraisal of the Scale for Interpersonal Behavior (SIB) in France.

The present study was carried out in France to evaluate the reliability and validity of the Scale for Interpersonal Behavior (SIB), a multidimensional measure of difficulty and distress in assertiveness that was originally developed in The Netherlands. This appraisal was conducted with a clinical sample (N = 166) and a general population sample (N = 150). The clinical series comprised 115 patients with social phobia and 51 patients with personality disorder, 28 of whom were of the avoidant type. Support was found for internal consistency and test-retest reliability of the French SIB. Compared to controls, both social phobics and patients with an avoidant personality disorder had significantly lower mean scores on all performance scales and significantly higher ones on all distress scales, with the social phobics occupying a position in between. Findings in relation to convergent and divergent validity were quite satisfactory. Sensitivity of the French SIB for detecting change was demonstrated in a subgroup of the clinical Ss who had undergone 15 sessions of cognitive-behavioral group therapy for underassertiveness.