INCREASING TREATMENT ACCEPTABILITY THROUGH VIDEO

The effects of a video vignette on the treatment acceptability ratings of four behavioral interventions were evaluated. Two interventions involved positive reinforcement (DRO and DRI) and two negative consequences (contingent physical restraint and contingent electric shock). Seventy-four undergraduate psychology students were randomly assigned into two groups. The experimental group (n=36) viewed a video vignette of a self-abusive individual whereas the control group (n=38) did not. Acceptability ratings prior to the video showed no differences between the experimental and control groups. The post video ratings indicated significant acceptability increases for physical restraint for the experimental group. There also was a significant group by testing effect because the means for the experimental group rose whereas the control group's means were stable. These results replicated and extended Foxx, McHenry and Bremer (in press) who showed that treatment acceptability is alterable through video.     

Factor structure of the Treatment Evaluation Inventory: Implications for measurement of treatment acceptability

The Treatment Evaluation Inventory (TEI), a frequently used measure of treatment acceptability, was used by 164 undergraduates to rate the acceptability of each of the following treatments: differential reinforcement of other behavior, exclusionary time-out, overcorrection, medical restraint, contingent electric shock, and physical restraint. TEI ratings of each treatment type were grouped separately, variance-covariance matrices were formed and compared, and data were subjected to factor analysis. The results indicated that the factor structure of the TEI varied with the treatment it was used to evaluate. Item analysis of the TEI indicated a high degree of internal consistency, although item-total correlations varied between rated treatments. The findings suggest that although the TEI is a reliable instrument, sensitive assessment of the treatment acceptability construct probably requires multidimensional measurement.     

Acceptability of behavioral interventions: Perceptions of superintendents of public residential facilities

The acceptability of behavioral procedures has been examined with many groups of individuals that have significant roles in the lives of persons with mental retardation. However, for those individuals that live in public residential facilities, one critical person in the decision making process is the superintendent. The purpose of this study was to assess the acceptability of treatments to superintendents of public residential facilities. Using the Treatment Evaluation Inventory (Kazdin, 1980), superintendents rated the acceptability of five treatments (DRO, Time-out, medication, overcorrection and contingent shock) applied to a mild and severe behavior problem. The results showed a significant main effect for treatment and problem and a problem by treatment interaction. Acceptability was inversely related to treatment restrictiveness and, except for differential reinforcement of other behaviors (DRO), all treatments were more acceptable for the severe problem than for the mild problem.     

MOVEMENT SUPPRESSION TIME-OUT FOR UNDESIRABLE BEHAVIOR IN PSYCHOTIC AND SEVERELY DEVELOP MENTALLY DELAYED CHILDREN

The effects of a movement suppression time-out, which involved punishing any movement or verbalization while a client is in the time-out area, were evaluated in four experiments. The first experiment examined the effects of a DRO procedure and movement suppression plus DRO in suppressing self-injurious behavior in a psychotic child in three different situations. In Experiment 2, the results of the previous experiment were replicated with two dangerous behaviors in a second psychotic child. In a third experiment, movement suppression plus DRO was compared with contingent restraint in reducing inappropriate poking behavior in two settings. The movement suppression procedure eliminated poking whereas contingent restraint had little effect. In the final experiment, movement suppression time-out alone was compared with exclusionary time-out alone and simple corner time-out alone. Self-stimulation occurred at high levels during the exclusionary and simple corner time-out procedures. Self-stimulation was either suppressed or reduced during movement suppression time-out. The movement suppression time-out procedure produced a larger reduction in the target behavior in all three children. The effectiveness of the movement suppression procedure was explained in terms of the suppression of self-stimulation while the time-out procedure was being applied.     

COMPARISON OF EXTINCTION,DRO 0-SEC,AND DRO 6-SEC IN THE ELIMINATION OF IMITATIVE RESPONDING UNDER DISCRETE-TRIAL PARADIGMS1

Imitative response levels were observed for normal 5-yr-old children within a discrete-trial imitation paradigm. Following imitation training sessions, children were observed under conditions of contingent reinforcement for three experimental sessions. Following the contingent reinforcement phase, children were then observed under reversal conditions for four sessions. A 3 × 4 repeated measures design was employed for observing response decrements under conditions of extinction, DRO 6-sec, and DRO 0-sec. The DRO 0-sec group demonstrated a significantly greater decrement in imitative responding than did the DRO 6-sec and extinction group. The differences in effects between the two DRO conditions and results from previous studies in which DRO procedures have had little effect in reducing imitative responding, suggest an incomplete understanding of the ways in which DRO procedures may operate.     

Safety behaviours preserve threat beliefs: Protection from extinction of human fear conditioning by an avoidance response

A laboratory autonomic conditioning procedure was used to establish fear conditioning in human participants by pairing neutral stimuli with electric shock. Participants were also trained to make a button-press response to avoid shock. A target fear stimulus was then extinguished by presenting it without shock. The experimental group was given the opportunity to make the avoidance response during extinction whereas the control group was not. When the fear stimulus was tested without the response available, the control group showed normal extinction of both shock expectancy ratings and skin conductance responses, but the experimental group showed “protection from extinction”: they continued to give high expectancy ratings and strong skin conductance responses. We interpret this effect as analogous to the role of within-situation safety behaviours in preserving threat beliefs during exposure therapy for anxiety disorders. The results support a cognitive account of learning and anxiety. The procedure provides a potential laboratory model for further examination of the cognitive and neural mechanisms underlying anxiety and its reduction.     

“Weak,Sad, and Lazy Fatties”: Adolescents’ Explicit and Implicit Weight Bias Following Exposure to Weight Loss Reality TV Shows

Weight loss reality TV shows, which portray obese individuals and their struggle to lose weight, are highly popular. However, the shows often contain negative and stereotypical portrayals of obese individuals that can contribute to the formation of weight bias among viewers. In particular, adolescents might be highly susceptible to such portrayals, since physical appearance and body image play an important role during adolescence. In our experimental study, we investigated the priming effects of exposure to weight loss reality TV shows on implicit and explicit attitudes toward obese individuals among 353 adolescents. We exposed a treatment group (n = 173) to video clips of a weight loss reality TV show and a control group (n = 180) to video clips of an information-based TV magazine. Results indicated that for individuals who expressed a fear of being obese, exposure to the weight loss reality TV show reinforced negative explicit attitudes toward obese individuals by activating a perception of weight controllability. Exposure to the weight loss reality TV show also enhanced negative implicit attitudes toward obese individuals among all adolescents, irrespective of their fear of being obese. Altogether, our findings underscore the role of media in perpetuating weight bias.     

A Systematic Review of Behavioral Interventions to Reduce Restricted or Repetitive Behavior of Individuals with Visual Impairment

Restricted or repetitive behavior (RRB) is common for individuals with visual impairment (VI), autism spectrum disorder (ASD), and intellectual disability. Previous reviews have suggested that VI may moderate the effectiveness of behavioral interventions to decrease RRB. A search of the single case literature resulted in 30 studies and 40 experiments involving participants with VI to test behavioral interventions to reduce RRBs. Nearly all participants had significant intellectual disability, half were deafblind, and only two had an ASD diagnosis. Success rates were higher for participants with low vision (88.9%) than for participants with blindness (68.4%) and to reduce non-self-injurious behavior (81%) than for self-injurious behavior (68.4%). Although most interventions in this review involved punishment and more research on reinforcement-based interventions is needed, multi-component interventions combining differential reinforcement with brief restraint or specific response contingent on RRB appear to hold the most promise for reducing RRBs for individuals with VI.

     

Acceptability bias: The effects of treatment acceptability on visual analysis of graphed data

Vignettes depicting a mildly or severely self-abusive child with profound mental retardation who received either a differential reinforcement of other behavior or a contingent electric shock treatment were presented to 161 undergraduates. After subjects rated the acceptability of the given treatment on the Treatment Evaluation Inventory (TEI), they evaluated the efficacy of the given treatment based upon six AB data graphs. Visual analytic judgments were not significantly effected by type of treatment, severity of self-injurious behavior (SIB), or the treatment × SIB interaction. TEI scores differed significantly according to type of treatment. Simple and multiple correlations computed between TEI scores and graph evaluations provided evidence ofacceptability bias, such that more favorable appraisals of treatment acceptability were related to perceptions of greater treatment effectiveness.     

Effects of differential reinforcement on the behavior and self-esteem of children with emotional and behavioral disorders

Students in a residential special school for children with emotional and behavioral disorders participated in a study designed to reduce their levels of inappropriate behavior. The residential care staff rated the students' behavioral problems and their class teachers rated their overt self-esteem pre and post intervention. In addition, the students completed self-ratings of their self-esteem. The students were divided into two groups, experimental and control. A multiple baseline across behaviors design was used to assess behavioral changes in the experimental group. Both groups received tangible rewards to the same level but only the experimental group received them contingent upon behaving appropriately. Results showed that the experimental group students made substantial reductions in their levels of inappropriate behavior, which were maintained at a three-month followup. Also, ratings of their behavioral problems by residential child care staff suggested that this improvement in behavior had generalized beyond the classroom to the residential setting. However, no significant differences were found between the pre- and post-intervention ratings of their self-esteem or teacher ratings of their overt self-esteem.     

Efficacy of guided self-help behavioural activation and physical activity for depression: a randomized controlled trial

Behavioural activation and physical activity have received empirical support that highlight their efficacy in reducing depression. Even though both behavioural activation and physical activity share the common goal of reactivating the individual, limited research has directly compared these interventions, and more research is required to evaluate their efficacy when offered in low-intensity formats. The present study involves a randomized controlled clinical trial comparing the efficacy of two guided self-help interventions for the treatment of depression: behavioural activation and physical activity. Fifty-nine participants presenting mild-to-moderate symptoms of depression were randomized either to a behavioural activation intervention (n = 20), a physical activity intervention (n = 19) or a wait-list control group (n = 20). All participants completed symptom measure pre-, mid- and post-intervention, as well as at a two-month follow-up. Mixed-model analyses of variance revealed that both interventions were significantly more efficacious in reducing depressive symptoms in comparison with the control group. Physical activity involved significantly less time-investment compared to the behavioural activation condition (less than half the amount of time). These results indicate that physical activity and behavioural activation both effectively reduce depressive symptoms and are favourably applicable in low-intensity formats. Implications of these results and avenues for future research are discussed.     

Evaluation of fixed momentary dro schedules under signaled and unsignaled arrangements

Fixed momentary schedules of differential reinforcement of other behavior (FM DRO) generally have been ineffective as treatment for problem behavior. Because most early research on FM DRO included presentation of a signal at the end of the DRO interval, it is unclear whether the limited effects of FM DRO were due to (a) the momentary response requirement of the schedule per se or (b) discrimination of the contingency made more salient by the signal. To separate these two potential influences, we compared the effects of signaled versus unsignaled FM DRO with 4 individuals with developmental disabilities whose problem behavior was maintained by social-positive reinforcement. During signaled FM DRO, the experimenter presented a visual stimulus 3 s prior to the end of the DRO interval and delivered reinforcement contingent on the absence of problem behavior at the second the interval elapsed. Unsignaled DRO was identical except that interval termination was not signaled. Results indicated that signaled FM DRO was effective in decreasing 2 subjects' problem behavior, whereas an unsignaled schedule was required for the remaining 2 subjects. These results suggest that the response requirement per se of FM DRO may not be problematic if it is not easily discriminated.     

Token‐economy‐based contingency management increases daily steps in adults with developmental disabilities

Adults with developmental disabilities are less likely to meet physical activity guidelines than typically developing counterparts. Contingency management (CM) interventions increase physical activity in sedentary adults. The current study systematically replicated previous research among sedentary adults diagnosed with developmental disabilities living in a residential group home, using a token economy in the context of a CM intervention. Using a changing criterion design, participants (N = 4) were given tokens contingent on meeting increasing step goals over 8 weeks, tracked via a Fitbit Flex?. CM increased the number of steps substantially for three of four participants. These findings extend previous research supporting the use of token‐based CM interventions for increasing daily steps among individuals with developmental disabilities. Because the current study was conducted in a residential group home setting, it may offer a long‐term sustainable approach to improving the health of some individuals living with developmental disabilities.     

Anxiety sensitivity moderates the painful effects of feeling burdensome to others

Perceived burdensomeness (PB), the perception of being a burden to others, is associated with pain and physical symptoms. Anxiety sensitivity (AS), the fear of arousal-related sensations, arising from beliefs that the sensations may have adverse personal consequences (physical, cognitive, and social), may increase risk for pain responding, particularly in anxiety-provoking (e.g. socially threatening) contexts. Accordingly, individuals high in AS may have a stronger pain response when experiencing PB than those low in AS. Undergraduate participants (n = 262) completed the Anxiety Sensitivity Index (ASI-3), and then were randomly assigned to re-live an experience when they were either burdensome to others (burdensome condition) or contributed equally to a group (control condition). Both social and physical self-reported pain were assessed post-manipulation. Those high in AS reported significantly higher pain ratings in the burdensome condition than the control condition; for those low in AS, pain did not change across conditions. In particular, being fearful of the physical repercussions of anxiety (AS physical concerns) while also feeling burdensome to others was associated with greater physical pain. AS may exacerbate the already painful effects of feeling burdensome to others, and may have important implications for the development of future suicide- and pain-related interventions.     

Evaluation and treatment of covert stereotypy

The treatment of behavior maintained by automatic reinforcement (e.g. stereotypy) can present a unique challenge if practitioners cannot control delivery of the maintaining reinforcer. Further, some individuals might engage in stereotypy only when care providers are absent. In the current evaluation, an adolescent boy's hand flapping was demonstrated to occur in the absence of social contingencies and care providers. To reduce the behavior, two treatment strategies were assessed. In the first approach, verbal reminders to refrain from hand flapping were delivered on time‐based schedules. In the second approach (differential reinforcement of other behavior, DRO), we provided access to a preferred item contingent on prespecified time lengths with no hand flapping when the participant was alone in a room. Results of the investigation indicated that the verbal reminders were unsuccessful, whereas the DRO program resulted in near‐zero levels of stereotypy. Copyright © 2002 John Wiley & Sons, Ltd.     

Does Acquisitive Self‐Presentation in Personality Self‐Ratings Enhance Validity? Evidence from two experimental field studies

The aim of the present research was to demonstrate that acquisitive self‐presentation in personality scales is not a barrier to their criterion‐related validities in human resource contexts, but rather a means to improve them. A pilot study (Study 1) with 96 job incumbents provided preliminary positive evidence. In Study 2, in the experimental group (n=99), the instructions asked job incumbents to work on a Big‐Five personality inventory (BFI‐K) as if they took part in a personnel selection procedure for a personally very attractive position. In the control group (n=93) of Study 2, job incumbents were asked to answer the inventory items honestly. As expected, the correlation between the self‐ratings of the motive to get along (i.e., which comprises emotional stability, conscientiousness, and agreeableness) and contextual performance assessments was significantly higher in the experimental group than in the control group in Study 2. Additionally, the correlation between the self‐ratings of the motive to get ahead (i.e., which comprises extraversion and openness to experience) and task performance and leadership assessments was significantly higher in the experimental group than in the control group in Study 2. It is proposed that responding to a personality inventory in a human resource decision situation should be conceptualized as a workplace simulation.     

Acceptability of interventions for aggressive behavior in long-term care settings: comparing ratings and hierarchical selection

Fifty-six active treatment team members in long-term nursing care facilities completed an online survey assessing treatment acceptability of modern behavioral, pharmacological, and sensory interventions. A traditional treatment acceptability rating scale was compared to treatment selections in a paired-options format. Unlike earlier research, there were no significant differences in acceptability between the 3 interventions on the traditional rating scale. However, ratings and selections were significantly correlated for behavioral and pharmacological interventions. The clinical significance of such relations and the implications for the use of treatment ratings is discussed.     

In-vivo rating of treatment acceptability by children: Effects of probability instruction on student's spelling performance under group contingency conditions

In prior studies, Shapiro and Goldberg (1986, 1990) failed to find a relationship between in-vivo ratings by children of treatment acceptability and treatment effectiveness. These studies involved the use of interdependent and dependent group contingencies designed to improve the spelling performance of sixth grade students. To investigate whether the failure to link treatment acceptability and effectiveness may have been due to the subjects' inability to understand the differences in treatment conditions, this study utilized a pre-intervention training package to enhance salient differences between two types of group contingencies. Results of this study showed that both group contingencies were successful at improving the spelling performance of students, particularly the poorer spellers. Prior to treatment, students preferred the interdependent condition, with the higher-achieving students expressing the strongest preference. After implementation of the training package, both conditions were now rated as equally acceptable. Pre- and post-test acceptability ratings of each condition tended to be significantly correlated but correlations between acceptability ratings and treatment effectiveness were negligible at all points in the study. Limitations of the present study and suggestions for further research are discussed.     

The effects of self-injury on acute negative arousal: A laboratory simulation

Research suggests that performance of non-suicidal self-injury (NSSI) is associated with the reduction of high-arousal negative affect. The present study examined this phenomenon in a laboratory setting. Individuals with a history of NSSI (n?=?39) and non-NSSI controls (n?=?33) underwent an anger induction, and were randomized to self-administer either a high level of electric shock, or a mild shock (control condition) to their upper arm. Consistent with previous research, injurers displayed greater pain analgesia than controls. Contrary to expectations, high shock did not result in enhanced arousal reduction for injurers. However, the high shock led to greater arousal reduction for injurers than controls. Notably, in the high shock condition, higher levels of electrical stimulation (i.e., voltage administered) predicted greater reductions in negative arousal, whereas higher subjective ratings of pain predicted smaller reductions in negative arousal. This pattern suggests that more intense self-inflicted pain facilitates reduction of negative arousal provided the subjective experience of pain is not too aversive. Findings help clarify emotion-regulation models of NSSI.