The modification of a child's enuresis: some response-response relationships

The present study attempted to evaluate experimentally the relationship between two response classes, enuresis and oppositional behavior. One child who had a long history of bed-wetting was observed in his home setting. Parents' reports and initial observations confirmed that the child was oppositional much of the time. When a timeout operation and differential attention were presented, removed, and presented again, the frequency of oppositional behavior decreased, increased, and decreased accordingly. Fluctuations in enuretic activity also correlated with the presence and absence of the timeout and differential attention operations. The suppression of oppositional behavior and enuretic activity persisted over an 18-month treatment period. It was suggested that the parental operations performed on oppositional behavior may have led to an increase in the parents' social reward value. Cessation of enuretic activity was explained in terms of a shift in parental reinforcer effectiveness.     

The Dental Subscale of the Children's Fear Survey Schedule: Predictive Value and Clinical Usefulness

This study reports on the predictive value and clinical usefulness of the Dutch parental version of the Dental Subscale of the Children's Fear Survey Schedule (CFSS-DS). Parents of 718 children (4–12 years) completed this CFSS-DS version before or during the child's visit. The dentist rated the child's dental fear during treatment on a 5-point Likert-type Scale from 1 (not afraid at all) to 5 (very afraid). Reliability analysis was performed, and correlation coefficients between the two measures were calculated. The reliability of the scale proved to be high (Cronbach's = .93) and significant correlation coefficients were found (r = .58 and r = .68, p < .01). The negative predictive value of the CFSS-DS was high (.96), whereas its positive predictive value was relatively low (0.41). It was concluded that the CFSS-DS might be of clinical value as a screening device of dental fear, whereas its predictive value of fearful behavior should not be overestimated.     

Enuresis: The beginning work—what really happened

The harmless, inexpensive, and effective method of treating enuresis (bed-wetting) described in this paper was developed more than forty years ago; yet dangerous, brutal, and ineffective methods of toilet training continue to be widely used. This article has therefore been prepared, not only because of historical considerations, but also in the hope of substantially increasing its usage, with benefit to enuretic children (adolescents, even some adults) and their families, far and wide. This article is not copyrighted, and the simple apparatus required for the type of training here described is not patented.     

Applications of object relations theory and self-psychology in current group therapy

In an effort to explore how group therapists can apply psychoanalytic theory in the group modality to advantage, two major developments in analytic theory are examined. 1) Kernberg stresses the neutral interpretive stance and utilizes concepts of protective identification and splitting in dealing with borderline pathology. This paper illustrates concretely how such theory can be used by the group therapist to encourage working through in the group situation. 2) Kohut's work stresses the empathic, nurturant analytic stance and focuses upon idealization, the grandiose self and the self-object. An understanding of these concepts helps the group therapist avoid obstacles in the treatment of narcissistic patients and can enrich the therapeutic work. The paper concludes that treatment of the difficult patient may be enhanced by the group situation in combination with specific psychoanalytic concepts.     

Mental representation from the bottom up

Commonsense psychology and cognitive science both regularly assume the existence of representational states. I propose a naturalistic theory of representation sufficient to meet the pretheoretical constraints of a folk theory of representation, constraints including the capacities for accuracy and inaccuracy, selectivity of proper objects of representation, perspective, articulation, and efficacy or content-determined functionality. The proposed model states that a representing device is a device which changes state when information is received over multiple information channels originating at a single source. The changed state of a representing device is a representation. The unitary information source which would give rise to the information impinging on the representing device, and hence, give rise to the representation, is the content of the representation. The model meets the pretheoretic constraints, and also conforms to available neurobiological data for two invertebrate species.     

Quetiapine augmentation of selective serotonin reuptake inhibitors in treatment-resistant obsessive-compulsive disorder: a six-month follow-up case series

Obsessive-compulsive disorder (OCD) is a relatively common, often chronic and disabling disorder with high rates of partial and/or absent response to standard, recommended treatments, such as selective serotonin reuptake inhibitors (SSRIs) and psychotherapy. This article presents the cases of four patients suffering from OCD and comorbid mood or anxiety disorders, who were treated with SSRIs at adequate doses for at least 12 weeks, showing a partial response. Quetiapine treatment was added to SSRIs at a dose of 25 mg/day and titrated up to 200 mg/day. Patients were followed up for 6 months. After 12 weeks, all the patients were classified as "much improved" on the Clinical Global Impression-Improvement scale and showed a Yale-Brown Obsessive-Compulsive Scale score reduction > or =35%. After 6 months of follow-up, all the patients maintained the same level of improvement. Although quetiapine augmentation to SSRIs has shown mixed results in published controlled trials in the acute treatment (12 weeks) of patients with treatment-resistant OCD, this case series indicates that patients who benefit from this pharmacologic regimen in the acute phase tend to maintain such an improvement. Larger follow-up studies are warranted to confirm our findings.     

Skills for Social and Academic Success: A School-Based Intervention for Social Anxiety Disorder in Adolescents

This paper describes Skills for Academic and Social Success (SASS), a cognitive–behavioral, school-based intervention for adolescents with social anxiety disorder. Clinic-based treatment studies for socially anxious youth are reviewed, and a strong rationale for transporting empirically-based interventions into schools, such as SASS, is provided. The SASS program consists of 12, 40-min group sessions that emphasize social skills and in-vivo exposure. In addition to group sessions, students are seen individually at least twice and participate in 4 weekend social events with prosocial peers from their high schools. Meetings with teachers provide information about social anxiety and facilitate classroom exposures for socially anxious participants. Parents attend 2 psychoeducational meetings about social anxiety, its treatment, and approaches for managing their childs anxiety. Initial findings regarding the programs effectiveness are presented. We conclude by discussing the challenges involved in implementing treatment protocols in schools and provide suggestions to address these issues.     

A Chemically Induced “Shadow”?

Stevenson's classic yarn, Dr. Jekyll and Mr. Hyde, is explored as a vivid, insightful story of addiction. In spite of clinical temptations to chase deeper issues connected with the dark side, this article suggests that pastoral counselors and psychotherapists need to first ask whether a client's shadow may be chemically induced.     

CBT intensity and outcome for panic disorder in a primary care setting

A hybrid efficacy-effectiveness design in which participants (n = 91/93) were retained in the study regardless of whether or not they received treatment enabled evaluation of CBT intensity in relation to panic disorder in the primary care setting. CBT intensity was operationalized as number of cognitive-behavioral therapy sessions, number of follow-up booster phone calls, and secondarily, as number of cognitive behavioral coping and exposure strategies. Baseline psychosocial and demographic predictors of CBT intensity were analyzed first. Severity of anxiety sensitivity predicted number of cognitive behavioral sessions, but no baseline variables predicted number of follow-up booster phone calls or number of coping and exposure strategies. Multivariate logistic and linear regressions were used to evaluate the degree to which treatment intensity predicted 3-month and 12-month outcomes (anxiety sensitivity, phobic avoidance, depressive symptoms, disability, and medical and mental health functioning) after controlling for potential confounding baseline variables. Number of cognitive behavioral therapy sessions predicted lower anxiety sensitivity at 3 and 12 months, and number of follow-up booster phone calls predicted lower anxiety sensitivity, less phobic avoidance, and less depression at 12 months. These findings indicate that "dose" of psychotherapy was an important predictor of outcome. The significance of follow-up booster phone contact is discussed as an index of continued self-management of panic and anxiety following acute treatment.     

Developmental changes of parental-reported sleep disturbance symptoms in children with attention deficit disorder

The primary goal of this retrospective study was to assess parental report of current sleep disorders in school-aged attention deficit disorder (ADD) children, as well as recalled sleep problems from when the children were infants (0–12 months) and toddlers (1–3 years). Results of a sleep questionnaire completed by mothers of 48 ADD children and a comparison group of 30 patients with school problems indicate that ADD children were perceived to have significantly more sleep problems and that these problems had onset in infancy. Specific items in the questionnaire which were increased included latency to sleep onset of more than 30 min at least 3 nights per week, fatigue upon awakening, and recall of nightmares. Pediatric clinicians should be alert to possible sleep disorders in children suspected of attention disorders and should consider sleep hygiene measures as a component of treatment.     

Adjustment to disability: A cognitive-behavioral model for analysis and clinical management

Profound psychological reactions are frequently seen following the onset of severe disability. Stage models of adjustment, although limiting when used dogmatically, can serve as a helpful guideline for intervention when integrated within a framework that also addresses the sequence of associated irrational beliefs. This article proposes a three phase model for analyzing and facilitating the adjustment process which follows disability. Adjustment is analyzed along cognitive, emotional, and environmental dimensions.The first stage immediately follows the onset of incapacitating disability and is termed the Pre-encounter phase. From a rational emotive perspective, the individual in this phase has not yet acknowledged that an activating, or disabling event has occurred. Acknowledgment is limited to brief contact which is then followed by excessive arousal and extreme distortions in evaluative capabilities. Shock and denial are characteristic of this phase. During this stage, strategies for clinical management are specified with a stronger emphasis on targeting the environment and belief system of the rehabilitation team than the beliefs of the patient.The second stage is referred to as the Post encounter phase during which the disabling condition has been acknowledged as a valid activating event. Periods of anxiety, depression, and expressed anger are common at this time. The final stage is coined the Rational re-encounter phase and is highlighted by repeated re-encounters with various forms of the disabling activating event and anticipated activating events. During this phase the patient is more able to benefit from a traditional psychotherapeutic approach which has been tailored to the specific pattern of irrational beliefs often exhibited in response to life with a disability.     

Inpatient adolescent and latency-age children's perspectives on the curative factors in group psychotherapy

Thirty-three adolescent and 11 child psychiatric inpatients were administered a downward revision of Yalom's (1970) 60-item Q-sort, which sets forth 12 putative curative factors of group, to assess patient perceptions of which factors in group therapy are most curative. The impact that age, patient level of functioning, and time in treatment had on which factors were most valued was assessed. Patient perceptions of the value of group compared to other treatment modalities were also assessed. Both child and adolescent subjects highly valued the factors of Hope, Cohesiveness, and Universality. Patients' level of functioning had limited effects on adolescents' perceptions, but did effect children's perceptions of what was most valued in group. The modest effect of time in treatment was attributed to the short duration of inpatient treatment. Implications for inpatient adolescent and child group therapy and future research are explored.Appreciation is extended to Mary Kelly, Elly Cobb, and Anna Csaky-Chase for their conceptual and editorial assistance.     

Direct observation and automated scoring of the activity of active and inactive inbred mouse strains

Inbred mouse strains previously found to be low (A/J) and high (C57BL/6J) in open-field activity were tested in a plastic oval runway while their runway activity was directly observed and also monitored by a contact switch recording device. The activity of active C57BL/6J mice was accurately monitored by the recording device, but scores of inactive A/J mice were inflated by a factor between 2 and 3 X. Activity differences between strains were consistently maintained[during repeated tests under both high and very dim illumination if direct observational scores were used. Utilization of scores obtained by the automated recording device resulted in a failure to obtain group differences under the condition of dim illumination. These results were directly related to the mode of locomotion of the two mouse strains.     

Defending the “private” in constitutional privacy

Conclusion Suppose we agree to reject the view that privacy has narrow scope and consequently is irrelevant to the constitutional privacy cases. We then have (at least) these two options: (1) We might further emphasize and draw out similarities between tort and constitutional privacy claims in order to develop a notion of privacy fundamental to informational and Fourth Amendment privacy concerns as well as the constitutional cases. We can cite examples indicating this is a promising position. Consider consenting homosexuality conducted in one's home, for instance. We view it as a private matter, whether the state is seeking to regulate the behavior, or if others are attempting to gain or exploit information about it. I believe basic conceptual similarities between tort and constitutional interests can be identified by showing that there is a range of similar reasons for protecting both tort and constitutional privacy concerns. We might worry, however, that a comprehensive concept of privacy may be too general to be very useful, given that privacy violations can be so diverse, and can arise, for example, from misuse of confidential information, from conduct that is intrusive even if no information is gained or disclosed, from disturbance of an intimate relationship, or from disruption of various other important aspects of one's life.(2) We could concede that whatever privacy means in the tort and Fourth Amendment cases, it means something different in the constitutional cases. Nevertheless, we might take that something else seriously as a distinct but legitimate use of the term which is not spurious but is reflected in our ordinary language. This appears to me to be a fruitful alternative. After all, contrary to Henkin's view that tort privacy is what most people mean by privacy, the term is often used in contexts beyond informational privacy and clearly related to the interests at stake in the constitutional cases. Thus, for example, in a pamphlet explaining how to protect children by teaching them how to say No! to strangers without making them paranoid or antisocial, parents and teachers are told, Children have a right to privacy. Teach it. Reinforce it. One of the ways to help children prevent sexual assault is to encourage them to develop a sense of physical integrity. A sense that they have a right to their own body space and privacy. Just as we allow them to close the door when they use the bathroom, we must allow them to say no to any unwanted physical affection and touch. Unfortunately, the most obvious starting point for identifying the sense of private relevant to the constitutional cases is extremely worrisome. The Court itself has said ... only personal rights that can be deemed fundamental...are included in this guarantee of personal privacy...the right has some extension to activities relating to marriage...procreation...contraception...family relationships... and child rearing and education. The difficulty, of course, is that little more is offered by way of explanation of which rights are personal or fundamental or both. Focusing on marriage makes Roe v. Wade difficult to understand given that Ms. Roe was unmarried, and attending only to family issues does not help us make sense of the Stanley case protecting one's right to view pornography in one's home. It is perhaps more problematic that decisions such as what color shoes to wear are reasonably viewed as personal, yet are far from fundamental enough to warrant protection. And regulations governing the draft and employment, for example, are not viewed as privacy invasions although they might be said to interfere with matters of one's life that are both fundamental and personal in the vague sense described.Before we give up in frustration, however, I would urge that we recall that even in tort law the notion of privacy has been evolving through a constellation of judgments. Although there is no fixed way of using the term which we then proceed to analyze, the concept of privacy has not in those cases been taken to be meaningless or empty. Similarly, there is reason to believe that the scope of a personal and fundamental notion of privacy relevant to the constitutional cases can be further delineated through a consideration of cases, especially since it seems to me that in many cases application of the term is clear and unproblematic. A decision to have a vasectomy, for example, can uncontroversially be said to be a personal and fundamental one, and it is in that sense private. We fail to acknowledge the personal significance in an individual's life of forcing or refusing him the operation if we deny that this important sense of privacy is relevant to such a decision merely because an interest in determining for oneself what one ought to do is also at risk.Of course, once it is settled that something is a private matter, it is a separate issue to decide whether or not, in some social context, an invasion of it can be justified. Thus, I would claim, a mandatory sterilization program for male recidivists or for those in a country suffering grave poverty and overpopulation does invade privacy, and the social or legal question is whether or not the invasion can, in the particular circumstances, be justified. Although all will agree that both individual and social interests must be balanced by moral philosophers as well as the courts, in conflicts we will not always agree on the weight to be accorded individual claims.I have not provided a constitutional defense for citing privacy as one right at stake in the constitutional privacy cases. Nor have I attempted to enter the debate about how strictly to interpret the Constitution. But if I am correct, then we can agree there is an important interest in privacy at issue in those cases without merely conflating privacy and autonomy or liberty, and can continue the process of marking out its boundaries. If we reach such agreement, we will have made considerable progress. Moreover, the implications of this view are significant. Current constitutional standards, controversial though they may be, require strict scrutiny for cases concerning fundamental values, and privacy has been judged to be one such value. Thus these privacy claims have a greater chance of being protected when they conflict with other rights or general interests than they would have if only liberty, or freedom from governmental interference, were involved.

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Group climate and group development in a community meeting on a short-term inpatient psychiatric unit

Group climate and group development of the community meeting on a short-term inpatient psychiatric unit are examined. The Group Climate Questionnaire (GCQ) was administered to all staff and patients present at the weekly community meeting on an acute treatment unit in a teaching hospital over a 12-week period. Results show that staff and patients perceive the community meetings in relatively similar ways, that the group climate of a community meeting can attain a positive working state, and that, at times, the meeting can progress through developmental stages of group process. Behavioral observations support the GCQ as a measure of group interaction.The authors gratefully acknowledge the assistance of Mary Pat Donnelly with the statistical analyses and the cooperation of all staff and patients who participated in this study.     

Evidence of improved fluid management in patients receiving haemodialysis following a self-affirmation theory-based intervention: A randomised controlled trial

Objective: Haemodialysis patients are at risk of serious health complications; yet, treatment non-adherence remains high. Warnings about health risks associated with non-adherence may trigger defensive reactions. We studied whether an intervention based on self-affirmation theory reduced resistance to health-risk information and improved fluid treatment adherence.

Design: In a cluster randomised controlled trial, 91 patients either self-affirmed or completed a matched control task before reading about the health-risks associated with inadequate fluid control.

Outcome measures: Patients’ perceptions of the health-risk information, intention and self-efficacy to control fluid were assessed immediately after presentation of health-risk information. Interdialytic weight gain (IDWG), excess fluid removed during haemodialysis, is a clinical measure of fluid treatment adherence. IDWG data were collected up to 12 months post-intervention.

Results: Self-affirmed patients had significantly reduced IDWG levels over 12 months. However, contrary to predictions derived from self-affirmation theory, self-affirmed participants and controls did not differ in their evaluation of the health-risk information, intention to control fluid or self-efficacy.

Conclusion: A low-cost, high-reach health intervention based on self-affirmation theory was shown to reduce IDWG over a 12-month period, but the mechanism by which this apparent behaviour change occurred is uncertain. Further work is still required to identify mediators of the observed effects.     

Improved low-cost,MR-compatible olfactometer to deliver tobacco smoke odor

We describe a low-cost, MRI-compatible olfactometer that delivers fresh cigarette smoke odor, a challenging odorant to present, as well as other odorants. This new olfactometer retains all of the advantages of an earlier design that was capable of only delivering volatile odors (Lowen & Lukas, Behavior Research Methods, 38, 307–313, 2006). The new system incorporates a novel switching mechanism that allows it to deliver fresh smoke generated from a burning cigarette during a stimulus presentation paradigm that might be employed in a cue-reactivity experiment. An evaluation study established that the olfactometer reliably delivered smoke to the participants and that tobacco smoke was discriminated from other odorants; there were no adverse reactions to the device.     

Internet-Based,Unproctored Assessments on Mobile and Non-Mobile Devices: Usage,Measurement Equivalence,and Outcomes

Purpose

The purpose of this study was to determine the usage rates, measurement equivalence, and potential outcome differences between mobile and non-mobile device-based deliveries of an unproctored, non-cognitive assessment.

Design/Methodology/Approach

This study utilized a quasi-experimental design based on archival data obtained from applicants who completed a non-cognitive assessment on a mobile (n = 7,743; e.g., smartphones, tablet computers) or non-mobile (n = 929,341; e.g., desktop computers) device as part of an operational, high-stakes pre-employment selection process.

Findings

One percent of applicants used mobile devices to complete the assessment. Multiple-group confirmatory factor analysis indicated the assessment was equivalent across mobile and non-mobile devices at the configural, metric, scalar, and latent mean levels. A comparison of observed score means using one-way and factorial ANOVAs demonstrated that the use of mobile and non-mobile devices did not produce any practically significant score differences on the assessment across devices or applicant demographic subgroups.

Implications

Industry and technological trends suggest mobile device usage will only increase. Thus, demonstrating that mobile device functionality and hardware characteristics do not change the psychometric functioning or applicant outcomes for a non-cognitive, text-based selection assessment is critical to talent assessment.

Originality/Value

This study provides the first empirical examination of the usage of mobile devices to complete talent assessments and their impact on assessment properties and applicant outcomes, and serves as the foundation for future research and application of this growing technological trend in pre-employment assessment.

     

A Gabbay-Rule Free Axiomatization of T×W Validity

The semantical structures called T×W frames were introduced in (Thomason, 1984) for the Ockhamist temporal-modal language, _O, which consists of the usual propositional language augmented with the Priorean operators P and F and with a possibility operator . However, these structures are also suitable for interpreting an extended language, _SO, containing a further possibility operator ^s which expresses synchronism among possibly incompatible histories and which can thus be thought of as a cross-history simultaneity operator. In the present paper we provide an infinite set of axioms in _SO, which is shown to be strongly complete forT ×W-validity. Von Kutschera (1997) contains a finite axiomatization of T×W-validity which however makes use of the Gabbay Irreflexivity Rule (Gabbay, 1981). In order to avoid using this rule, the proof presented here develops a new technique to deal with reflexive maximal consistent sets in Henkin-style constructions.     

Social Epistemology,scientific practice and the elusive social

Social Epistemology, as formulated by Steve Fuller, is based on the suggestion that rational knowledge policy must be held accountable to brute facts about the nature of our human cognitive pursuits, whatever these may be. One difficulty for Fuller concerns the conception of the social which underwrites social epistemology. I argue that social epistemology conflates the social with human psychological properties that are available for public scrutiny and, accordingly, that social epistemology is best viewed as a brand of psychologism. Though Fuller's proposal signifies an important step in the ongoing attempt by scholars to eradicate the last traces of Descartes' epistemological device of a disembodiedres cogitans, I conclude that his conception of the social is too weak to serve as the basis for a socially-embedded discipline in anything but name only.