Anxiety in recovery from severe burn injury: an experimental comparison

Adjustment to burn injury is a slow process that often results in high distress and anxiety. This study aimed to investigate the impact on anxiety of viewing various types of photographic stimuli (including burn injuries), comparing a burn-injured and control sample. An experimental design was used comparing those recovering from a burn injury with age- and gender-matched controls. Thirty participants from a burns support group and their matched controls were asked to complete a trait anxiety measure (STAI Y-2). Participants then completed the state anxiety measure (STAI Y-1) after viewing different types of photographic stimuli (burn injuries, uninjured body parts, neutral) under controlled experimental conditions. Results demonstrated significant differences in anxiety levels between groups with respect to trait anxiety and state anxiety after each experimental condition. Age of injury was also found to be a significant influence over trait anxiety. A significant effect of experimental condition was found, as was a significant interaction between group and condition. Those with burn injuries were more anxious than controls - a difference that was further exaggerated when participants viewed photographs of burned or uninjured body parts in an experimental setting.     

The experimental critique and philosophical practice

Some experimental philosophers have criticized the standard intuition-based methodology in philosophy. One worry about this criticism is that it is just another version of the general skepticism toward the evidential efficacy of intuition, and is thereby subject to the same difficulties. In response, Weinberg provides a more nuanced version of the criticism by targeting merely the philosophical use of intuition. I contend that, though Weinberg’s approach differs from general skepticism about intuition, its focus on philosophical practices gives rise to a new difficulty. Most extant experimental surveys investigate intuitions about particular cases through vignettes giving little contextual information. However, philosophical practices crucially depend on intuitions about general claims and typically provide more contextual background. I argue that, due to these two differences between surveys’ and philosophers’ appeals to intuition, Weinberg’s critique lacks enough support from current experimental data. I conclude that experimental philosophers who engage in the negative program should pay more attention on testing philosophers’ use of general intuitions and context-rich intuitions.     

Extension and critique: A response to Robert Young

In response to Robert Young's critical comments concerning Hermeneutics and Education I clarify two issues. First, I suggest that a more detailed account of interpretation and learning could be developed in a hermeneutically informed cognitive psychology. This would be an account that escapes the textual model of silent reading construed as private mental experience, and that acknowledges the social and communicative dimensions of understanding. Second, in contrast to Young's view, I contend that phronesis is not reducible to a set of inner thought processes and that it has a role to play even in a critical social theory of education.     

Further evaluation of treatments for vocal stereotypy: Response interruption and redirection and response cost

The purpose of this study was to expand on research on treatments for stereotypy by evaluating the effects of response interruption and redirection (RIRD) and response cost (RC) alone and as a treatment package on vocal stereotypy. Treatment phases included RIRD, RC, and response interruption and redirection plus response cost (RIRD + RC). The efficacy of these treatments was determined by measuring duration of stereotypy in session and during treatment intervals. Vocal stereotypy decreased in all three treatment conditions; however, when data analysis included stereotypy occurring during treatment intervals, stereotypy during the RC condition occurred at similar levels as baseline for one treatment evaluation phase for Karl and both treatment evaluations phases for Jon. We discuss implications of these findings, limitations of the current study, and areas for future research.     

Further evaluation of response interruption and redirection as treatment for stereotypy

The effects of 2 forms of response interruption and redirection (RIRD)-motor RIRD and vocal RIRD-were examined with 4 boys with autism to evaluate further the effects of this intervention and its potential underlying mechanisms. In Experiment 1, the effects of motor RIRD and vocal RIRD on vocal stereotypy and appropriate vocalizations were compared for 2 participants. In Experiment 2, the effects of both RIRD procedures on both vocal and motor stereotypy and appropriate vocalizations were compared with 2 additional participants. Results suggested that RIRD was effective regardless of the procedural variation or topography of stereotypy and that vocal RIRD functioned as a punisher. This mechanism was further explored with 1 participant by manipulating the schedule of RIRD in Experiment 3. Results were consistent with the punishment interpretation.     

Anxiety and cancer treatment: response to stressful radiotherapy

Previous research with individuals undergoing surgery or diagnostic procedures provided a conceptual framework for analysis of radiation therapy, a common form of cancer treatment. The present investigation was designed to document the magnitude of anxiety patients experience in response to one particularly stressful form of radiation treatment. In addition, the change in anxiety responses with repeated exposures and individual differences among patients that may affect their adjustment were explored. In Part 1, gynecologic cancer patients receiving their first internal radiotherapy application were studied. As the time for treatment neared, subjective and physiologic indicants of anxiety and distress among the patients significantly increased. By 24 hours post-treatment, anxiety for all patients remained elevated. These post-treatment data are convergent with other investigations of post-treatment distress among cancer patients, but contrast with data obtained from those receiving treatment for benign conditions. A subset of the women who required two applications of radiotherapy participated in Part 2. These patients continued to respond negatively during the second treatment. Data on individual differences in anxiety responses (i.e., low vs. high anxiety) were obtained in both investigations and suggest that those with low levels of pre-treatment anxiety experience considerable disruption post-treatment.     

Comparing response blocking and response interruption/redirection on levels of motor stereotypy: Effects of data analysis procedures

Autism spectrum disorder (ASD) is marked by deficits in social communication and the presence of restrictive and/or repetitive behaviors or interests. Motor stereotypy is a form of repetitive behavior that is common in ASD. Response Interruption and Redirection (RIRD) and response blocking (RB) are two interventions found to be efficacious in reducing motor stereotypy. However, the current literature presents with inconsistencies regarding the relative efficacy of these two procedures. Thus, we sought to replicate and extend previous literature by evaluating the efficacy of both interventions on reducing motor stereotypy among 3 individuals with ASD. We also sought to evaluate how variations in data analysis affected the interpretation of treatment outcomes. Results indicated that both interventions were equally efficacious at reducing stereotypy when analyzing data exclusive of treatment‐implementation time. However, when analyzing total session time data, RB produced greater and more sustained reductions in stereotypy across all participants. These results emphasize the importance of data analysis decision‐making in evaluating intervention outcomes.     

Decreasing motor stereotypy in leisure contexts: Analysis of stimulus control with response interruption and redirection

Noncontingent access to preferred stimuli and activities may decrease stereotypic behavior in individuals with autism or other developmental disorders. However, prompted engagement, response interruption and redirection (RIRD), and/or contingent access to stereotypy may be required to achieve clinically significant reductions in stereotypy. Antecedent stimuli may also be manipulated during intervention to establish stimulus control by signaling when stereotypy will receive programmed consequences. The purpose of the current project was to replicate prior research in this area by a) evaluating the effectiveness of RIRD on motor stereotypy in an adolescent with autism and b) providing contingent access to stereotypy as a function of successively longer intervals without stereotypic behavior. We also assessed the extent that these procedures gained acceptable stimulus control. Results from this project suggest RIRD and contingent access to stereotypy may effectively decrease motor stereotypy in leisure contexts, though consistent inhibitory stimulus control may be difficult to establish.     

Abatement of intractable vocal stereotypy using an overcorrection procedure

We conducted a series of reversals to compare the effects of four different treatments on vocal stereotypy emitted by a 7‐year‐old boy with autism. The results showed that (1) the level of vocal stereotypy decreased during exposure to matched stimulation but returned to high levels immediately upon its removal; (2) stereotypy did not significantly decrease during differential reinforcement of other behavior; and (3) contingent withdrawal of movies and music (i.e., response cost) was only moderately effective. However, positive practice overcorrection decreased vocal stereotypy by clinically significant levels. Further, when differential reinforcement of engagement in a Lego^® building task was implemented, the level of engagement was significantly higher when positive practice overcorrection was in place than when overcorrection was withdrawn. Copyright © 2011 John Wiley & Sons, Ltd.