Effects of imaginal exposure to feared disasters in obsessive-compulsive checkers

The combined effects of imaginal exposure to feared catastrophes and in vivo exposure to external stimuli were compared with the effects of in vivo exposure alone in 15 obsessive-compulsives with checking rituals. The first group received 90 min of uninterrupted exposure in imagination, which concentrated mainly on disastrous consequences, followed by 30 min of exposure in vivo to stimuli-situations which triggered rituals. The second group was given 2 hr of exposure in vivo only. Both groups were prevented from performing rituals. Treatment consisted of 10 daily sessions within a 2 week period.Assessments were conducted before and after treatment and at follow-up ranging from 3 months to 2.5 yr with a mean of 11 months. At post-treatment both groups improved considerably and did not differ. But at follow-up those who received imaginal and in vivo exposure maintained their gains, whereas the group who were treated by exposure in vivo alone evidenced partial relapse on four of the six dependent measures. The results tend to indicate that a closer match between a patient's internal fear model and the content of exposure enhances long term treatment efficacy.     

Massed vs. spaced exposure sessions in the treatment of agoraphobia

The differential effects of massed and spaced sessions of exposure in vivo were investigated with 11 agoraphobics in a crossover design. Clients were randomly assigned to one of the following two groups: (a) 10 daily sessions followed by 10 weekly sessions, or (b) 10 once-weekly sessions followed by 10 daily sessions. The results indicated that both massed and spaced sessions of exposure in vivo effected changes in avoidance behavior and subjective anxiety of agoraphobics, massed practice being superior especially with respect to avoidance. It was suggested that the superiority of massed practice is due to the lack of opportunity to engage in avoidance or escape during short inter-session intervals. The relationship between subjective anxiety and avoidance were considered and the differences between clinical and statistical significance were discussed.     

Is horror a necessary component of flooding (implosion)?

Experimental results indicate that presentation of horrifying scenes is not necessary to obtain a favorable outcome in the treatment of phobias by flooding. Prolonged exposure to the feared object, even under relatively pleasant conditions is sufficient. Subjects were college students who rated highly fearful of rats. They were randomly assigned to one of three experimental groups and to a no treatment-control group. Treatment groups differed along the dimension of harshness of scene presentation. Control group subjects received no treatment but were assessed repeatedly as were experimental subjects. All experimental subjects showed improvement irrespective of treatment received-after treatment they were all willing to come closer to a live rat and experienced less anxiety at the closest point. However, subjects exposed to horrid scenes were judged by an independent evaluator as less likely to avoid fearful situations. The discussion centers on the discrepancy between rater's evaluation and other measures, implications of the results for treatment, and on the generalizability of findings to a patient population.     

Habituation during exposure treatment: Distraction vs attention-focusing

To investigate the effects of distraction and attention-focusing during in-vivo exposure to feared stimuli, the responses of 16 obsessive-compulsives with washing rituals were studied. A cross-over design was employed in which 6 of the subjects underwent exposure with attention focusing on the first day followed by exposure with distraction on the second day. The remaining subjects received the reverse order. Habituation of both heart rate and subjective anxiety was observed under both conditions, the rate of habituation tending to remain constant throughout the 90-min exposure. Greater between-session habituation and greater synchrony between the psychophysiological and the subjective measures of anxiety was observed when attention-focusing preceded distraction. Since habituation and synchrony have previously been found to be positively related to treatment outcome, the present results suggest that treatment by exposure to feared stimuli may be more effective if attention-focusing is promoted.     

Habituation of subjective anxiety during flooding in imagery

Patterns of habituation of subjective anxiety during flooding in fantasy are delineated for eleven obsessive-compulsive and six agoraphobic patients. The majority showed a curvilinear pattern of subjective anxiety response, while three patients showed a linear decelerating pattern. Habituation was found both within and across sessions. The results are compared with habituation patterns in physiological responses during flooding in fantasy and in vivo.     

Therapist-controlled exposure in vivo versus self-controlled exposure in vivo: A comparison with obsessive-compulsive patients

Fourteen obsessive-compulsive clients were given treatment consisting of ten sessions of gradual exposure in vivo With half the clients, the exposure in vivo was therapist-controlled; with the other half, the exposure in vivo was self-controlled.

The results of the posttest showed that both versions of the treatment resulted in a significant improvement on the in vivo measurement, anxiety and avoidance scales, Leyton Obsessional Inventory, Self-Rating Depression Scale and anxious mood. Neither the posttest nor the follow-ups one month and 3.5 months later indicated a difference between the effects of the two conditions. Self-controlled exposure in vivo proved to be as effective as therapist-controlled exposure in vivo, in spite of the fact that in the latter condition each treatment session lasted twice as long as in the former condition.     

A comparison of two methods for the administration of paradoxical intention

Recent research in the treatment of insomnia by paradoxical intention has utilized two different methods of instruction. Studies utilizing the random assignment of subjects to treatment groups employ a procedure in which clients are provided with a straight-forward explanation based on the present authors' understanding of the use of paradoxical intention with insomnia (type A administration). In contrast, controlled case studies have employed reframing, a procedure which explains the need for the paradoxical intention in a manner which best suits the specific understanding of the individual client (type B administration). The present study employed the type B method in a design employing the random assignment of clients to groups. Three additional groups (type A administration, placebo control, no-treatment control) completed the design. The results indicated that the type A method was superior to the type B procedure when the same method for administering paradoxical intention was applied to a randomized group of individuals.     

Juror decision making: A case of attitude change mediated by authoritarianism

For a jury to reach a unanimous decision, certain individuals must change their attitudes with regard to the defendant's guilt during deliberations. Because these changers are the key to the group decision-making process, they were carefully scrutinized to ascertain demographic or personality characteristics which might be mediating their behavior. In three experiments, two using college students as subjects and one using Philadelphia Court of Common Pleas jury pool members, it was found that authoritarians changed their attitude with regard to the defendant's guilt more than equalitarians. Further, most of these “changers” were aware they had changed their attitude. There was no generalizable evidence for the proposition that authoritarians are more likely to favor a guilty verdict.     

Conditional reasoning following contradictory evidence: A developmental analysis

Recent evidence suggests that young adults do not correctly understand the logical relationship of the conditional (if p the q) as it applies to hypothesis testing, and most training procedures have not been productive. However, the introduction of contradictory evidence following faulty inferences has led to accurate inferences with conditional statements. Third and seventh grade and college studients (9, 13, and 21 years of age, respectively) were tested to assess developmental differences in improvement following contradiction training and to test whether improved performance transfers to other conditional reasoning tasks. Significant improvement in conditional reasoning was found for the young adult group following the introduction of contradictory evidence, and the positive effect of the treatment transferred across tasks. The third grade students showed no effects from the introduction of the contradiction, but the seventh graders were often confused by the introduction of the contradiction. Seventh grade and college student performances were generally worse than that of the third graders for the positive instances (p · q), but while the contradiction training improved college studients' performance it did not affect the seventh graders. The results are discussed in terms of changes in cognitive structures.     

A multitrait-multimethod examination of affect structure: hedonic level and emotional intensity

Past research on the personality structure of affect suggests that hedonic level and emotional intensity are two separate major dimensions. The present study employed a multitrait-multimethod approach to verify this finding. Seventy-four University of Illinois students completed daily mood reports and self-report questionnaires, and their parents completed a questionnaire about them. Both hedonic level and intensity measures were used. The convergent validities (monotrait-multimethod correlations) were all significant and tended to be highest for emotional intensity. The multitrait-monomethod coefficients were nonsignificant, as were the correlations based on different measures of different traits. The data were interpreted as supporting the distinction between hedonic level and affect intensity, as well as supporting the validity of the measures.     

A within-subject analysis of stimulus control therapy with severe sleep-onset insomnia.

Stimulus control, a behavioral technique designed to reduce sleep difficulties, has been demonstrated to be effective when compared with control procedures. These comparisons, mainly involving between-subjects analyses, have neglected the contribution of the stimulus control procedure to the production of clinically significant amelioration of sleep dysfunction. In contrast, the present within-subjects experiment was conducted to assess the capability of stimulus control to produce clinically relevant reductions in multiple measures of sleep disturbance. A comparison with the credible placebo procedure indicated that the stimulus control techniques reduced subjects' sleep onset latency to a mean latency below 30 min per week. Additionally, sedative-hypnotic usage was greatly reduced.     

Pavlovian processes and response competition as determinants of avoidance response-prevention effects

Two experiments investigated the facilitation of avoidance extinction by exposure to lengthy (5-sec) shock during avoidance response prevention. In Experiment 1, animals exposed to light only or to light-shock pairings during response prevention showed equal facilitation of extinction relative to shock-only animals or to animals receiving no response prevention. Preshock rearing, directly antagonistic to the avoidance response, developed for shocked animals during response prevention and persisted during extinction for light-shock animals. Immediately before extinction, half of each group was permitted a single escape from a light-shock compound by means of the response previously required for avoidance. The only effect was upon the extinction performance of light-shock animals. Rearing was eliminated and extinction responding increased to a level far above that for any of the other animals. Experiment 2 demonstrated that the shock-only treatment affected the extinction performance and rearing of nonescape and escape animals in a manner entirely equivalent to the effects of the light-shock treatment of Experiment 1, provided stimulus conditions (light absent) were the same for all experimental phases. Thus, lengthy shock during avoidance response prevention simultaneously leads to the acquisition of competing behavior and enhances control by a warning signal or contextual stimuli over the avoidance response. Implications for the CS-only response-prevention treatment and the transfer of aversive control are discussed.     

Repetition and agreement with opposing arguments: A delayed action effect

If exposure to two arguments supporting opposing conclusions establishes two memory traces that influence attitudes, repetition of one of the arguments should produce a delayed action effect. In a computer-controlled experiment, subjects read a large number of arguments about fictitious brands of consumer products from a T.V. screen. They rated each brand immediately after reading about it and again after spending 10 min reading messages about other brands. In the critical conditions of the experiment, two arguments were presented about each brand. One described a good quality of the product (e.g., excellent durability); the other described a bad quality (e.g., below-average efficiency). Subjects read one of the opposing arguments concerning each brand repeatedly and studied the repeated arguments for memory tests. As predicted, repetition and studying affected ratings on the delayed post-test, but not on the immediate post-test. Specifically, attitudes shifted over the delay toward agreement with the repeated arguments, supporting the idea that the persistence of attitudes depends on more than one memory trace.     

Feedback during exposure to inescapable shocks and subsequent shock-escape performance

In two experiments, we assessed the ability of a feedback stimulus during helplessness training to reduce the performance deficits common to inescapable shock. In each experiment, four groups of rats were exposed to either escapable shock (E), inescapable shock with a feedback stimulus following shock termination (Y-FS), inescapable shock with no feedback stimulus (Y-NFS), or no shock (N). The feedback stimulus eliminated the interference effects of inescapable shock when tested with an FR-3 lever press escape task (Experiment 1) or on an FR-1 task with a 3-s delay between the response and shock termination (Experiment 2). These results suggest that stress-induced biochemical changes may mediate the interference effects seen in inescapably shocked rats.